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Aydogan Avşar P, Akkuş M. ZO-1 Serum Levels as a Potential Biomarker for Psychotic Disorder. Clin Neuropharmacol 2024; 47:67-71. [PMID: 38743599 DOI: 10.1097/wnf.0000000000000590] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE There are limited studies in the literature on the relationship between intestinal and blood-brain barrier permeability and the etiology of schizophrenia. We hypothesized that the difference in serum ZO-1 levels in patients with schizophrenia may affect the severity of the disease. The aim of this study was to investigate the role of changes in serum ZO-1 concentrations in the etiopathogenesis of patients with schizophrenia. METHODS A total of 46 patients, 34 with schizophrenia, 12 with a first psychotic attack, and 37 healthy controls, were included in the study. Symptom severity was determined by applying the Positive and Negative Syndrome Scale and the Clinical Global Impression-Severity Scale. Serum ZO-1 levels were measured from venous blood samples. RESULTS Serum ZO-1 levels were higher in patients with psychotic disorder compared to healthy controls. There was no statistically significant difference between the groups in the first psychotic attack group and the schizophrenia patients. There was a statistically significant positive correlation between serum ZO-1 levels and Positive and Negative Syndrome Scale positive symptom score. CONCLUSIONS These findings regarding ZO-1 levels suggest that dysregulation of the blood-brain barrier in psychotic disorder may play a role in the etiology of the disorder.
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Affiliation(s)
- Pinar Aydogan Avşar
- Department of Child and Adolescent Psychiatry, Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey
| | - Merve Akkuş
- Department of Psychiatry, Kütahya Health Sciences University, Evliya Celebi Education and Research Hospital, Kütahya, Turkey
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Byrne JF, Healy C, Föcking M, Susai SR, Mongan D, Wynne K, Kodosaki E, Heurich M, de Haan L, Hickie IB, Smesny S, Thompson A, Markulev C, Young AR, Schäfer MR, Riecher-Rössler A, Mossaheb N, Berger G, Schlögelhofer M, Nordentoft M, Chen EYH, Verma S, Nieman DH, Woods SW, Cornblatt BA, Stone WS, Mathalon DH, Bearden CE, Cadenhead KS, Addington J, Walker EF, Cannon TD, Cannon M, McGorry P, Amminger P, Cagney G, Nelson B, Jeffries C, Perkins D, Cotter DR. Proteomic Biomarkers for the Prediction of Transition to Psychosis in Individuals at Clinical High Risk: A Multi-cohort Model Development Study. Schizophr Bull 2024; 50:579-588. [PMID: 38243809 PMCID: PMC11059811 DOI: 10.1093/schbul/sbad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Psychosis risk prediction is one of the leading challenges in psychiatry. Previous investigations have suggested that plasma proteomic data may be useful in accurately predicting transition to psychosis in individuals at clinical high risk (CHR). We hypothesized that an a priori-specified proteomic prediction model would have strong predictive accuracy for psychosis risk and aimed to replicate longitudinal associations between plasma proteins and transition to psychosis. This study used plasma samples from participants in 3 CHR cohorts: the North American Prodrome Longitudinal Studies 2 and 3, and the NEURAPRO randomized control trial (total n = 754). Plasma proteomic data were quantified using mass spectrometry. The primary outcome was transition to psychosis over the study follow-up period. Logistic regression models were internally validated, and optimism-corrected performance metrics derived with a bootstrap procedure. In the overall sample of CHR participants (age: 18.5, SD: 3.9; 51.9% male), 20.4% (n = 154) developed psychosis within 4.4 years. The a priori-specified model showed poor risk-prediction accuracy for the development of psychosis (C-statistic: 0.51 [95% CI: 0.50, 0.59], calibration slope: 0.45). At a group level, Complement C8B, C4B, C5, and leucine-rich α-2 glycoprotein 1 (LRG1) were associated with transition to psychosis but did not surpass correction for multiple comparisons. This study did not confirm the findings from a previous proteomic prediction model of transition from CHR to psychosis. Certain complement proteins may be weakly associated with transition at a group level. Previous findings, derived from small samples, should be interpreted with caution.
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Affiliation(s)
- Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Eleftheria Kodosaki
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Meike Heurich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - Andrew Thompson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Connie Markulev
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Alison Ruth Young
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Miriam R Schäfer
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | | | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Monika Schlögelhofer
- BioPsyC—Biopsychosocial Corporation, Non-profit Association for Research Funding Ltd, Vienna, Austria
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, 2/F New Clinical Building, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Swapna Verma
- Office of Education, Duke-NUS Graduate Medical School, Singapore, Singapore
- Department of Psychosis & East Region, Institute of Mental Health, Singapore, Singapore
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116d, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Pat McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Gerard Cagney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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Miyano T, Mikkaichi T, Nakamura K, Yoshigae Y, Abernathy K, Ogura Y, Kiyosawa N. Circulating microRNA Profiles Identify a Patient Subgroup with High Inflammation and Severe Symptoms in Schizophrenia Experiencing Acute Psychosis. Int J Mol Sci 2024; 25:4291. [PMID: 38673876 PMCID: PMC11050142 DOI: 10.3390/ijms25084291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Schizophrenia is a complex and heterogenous psychiatric disorder. This study aimed to demonstrate the potential of circulating microRNAs (miRNAs) as a clinical biomarker to stratify schizophrenia patients and to enhance understandings of their heterogenous pathophysiology. We measured levels of 179 miRNA and 378 proteins in plasma samples of schizophrenia patients experiencing acute psychosis and obtained their Positive and Negative Syndrome Scale (PANSS) scores. The plasma miRNA profile revealed three subgroups of schizophrenia patients, where one subgroup tended to have higher scores of all the PANSS subscales compared to the other subgroups. The subgroup with high PANSS scores had four distinctively downregulated miRNAs, which enriched 'Immune Response' according to miRNA set enrichment analysis and were reported to negatively regulate IL-1β, IL-6, and TNFα. The same subgroup had 22 distinctively upregulated proteins, which enriched 'Cytokine-cytokine receptor interaction' according to protein set enrichment analysis, and all the mapped proteins were pro-inflammatory cytokines. Hence, the subgroup is inferred to have comparatively high inflammation within schizophrenia. In conclusion, miRNAs are a potential biomarker that reflects both disease symptoms and molecular pathophysiology, and identify a patient subgroup with high inflammation. These findings provide insights for the precision medicinal strategies for anti-inflammatory treatments in the high-inflammation subgroup of schizophrenia.
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Affiliation(s)
- Takuya Miyano
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Tsuyoshi Mikkaichi
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Kouichi Nakamura
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Yasushi Yoshigae
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Kelly Abernathy
- Clinical Research Department, Sirtsei Pharmaceuticals, Inc., 3000 RDU Center Drive, Suite 130, Morrisville, NC 27560, USA;
| | - Yuji Ogura
- Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., 1-16-13 Kitakasai, Edogawa, Tokyo 134-8630, Japan;
| | - Naoki Kiyosawa
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
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Prokhorova TA, Androsova LV, Tereshkina EB, Boksha IS, Savushkina OK, Pochueva VV, Sheshenin VS, Burbaeva GS, Klyushnik TP. [Clinical and psychopathological characteristics of patients with late-onset schizophrenia and schizophrenia-like psychoses in clusters identified by biological parameters]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:137-144. [PMID: 38676688 DOI: 10.17116/jnevro2024124041137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To assess clinical and psychopathological characteristics of late-aged female patients with late-onset psychoses in clusters formed on the basis of biochemical and immunological blood parameters. MATERIAL AND METHODS We examined 59 women with schizophrenia and schizophrenia-like psychoses with onset after 40 years (ICD-10 F20, F22.8, F25, F23, F06.2), including 34 women with late-onset (40-60 years) and 25 with very late onset psychoses (after 60 years). At the time of hospitalization, a clinical/ psychopathological study was carried out using CGI-S, PANSS, CDSS, and HAMD-17, as well as the activities of glutathione reductase (GR) and glutathione-S-transferase (GT) have been determined in erythrocyte hemolysates, and the activities of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) have been assessed in blood plasma. Biochemical and immunological parameters have been also determined in 34 age-matched mentally healthy women. RESULTS Clustering by signs such as GR, GT, LE and α1-PI has yielded two clusters of objects (patients) significantly different in GT (p<0.0001), LE (p<0.0001), and α1-PI (p<0.001) activities. Relatively to the controls, in the cluster 1 patients, the activities of GST and α1-PI are increased, the activity of LE is decreased, whereas, in the cluster 2 patients, the activity of GR is decreased, and the activities of LE and α1-PI are increased. Cluster 1 patients differ from cluster 2 patients in greater severity of the condition (CGI-S, p=0.04) and higher total scores on PANSS subscales' items. Cluster 1 includes 76% of patients with very late onset. Different correlations between clinical and biological signs are found in two clusters. CONCLUSION The identified clusters have different clinical and psychopathological characteristics. Dividing patients into subgroups according to biochemical and immunological parameters is promising for the search for differentiated therapeutic approaches.
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Affiliation(s)
| | | | | | - I S Boksha
- Mental Health Research Center, Moscow, Russia
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Hidalgo-Figueroa M, Salazar A, Romero-López-Alberca C, MacDowell KS, García-Bueno B, Bioque M, Bernardo M, Parellada M, González-Pinto A, García-Portilla MP, Lobo A, Rodriguez-Jimenez R, Berrocoso E, Leza JC. Association of Prolactin, Oxytocin, and Homocysteine With the Clinical and Cognitive Features of a First Episode of Psychosis Over a 1-Year Follow-Up. Int J Neuropsychopharmacol 2023; 26:796-807. [PMID: 37603404 PMCID: PMC10674080 DOI: 10.1093/ijnp/pyad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/20/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND The clinical debut of schizophrenia is frequently a first episode of psychosis (FEP). As such, there is considerable interest in identifying associations between biological markers and clinical or cognitive characteristics that help predict the progression and outcome of FEP patients. Previous studies showed that high prolactin, low oxytocin, and high homocysteine are factors associated with FEP 6 months after diagnosis, at which point plasma levels were correlated with some clinical and cognitive characteristics. METHODS We reexamined 75 patients at 12 months after diagnosis to measure the evolution of these molecules and assess their association with clinical features. RESULTS At follow-up, FEP patients had lower prolactin levels than at baseline, and patients treated with risperidone or paliperidone had higher prolactin levels than patients who received other antipsychotic agents. By contrast, no changes in oxytocin and homocysteine plasma levels were observed between the baseline and follow-up. In terms of clinical features, we found that plasma prolactin and homocysteine levels were correlated with the severity of the psychotic symptoms in male FEP patients, suggesting that they might be factors associated with psychotic symptomatology but only in men. Together with oxytocin, these molecules may also be related to sustained attention, verbal ability, and working memory cognitive domains in FEP patients. CONCLUSION This study suggests that focusing on prolactin, oxytocin, and homocysteine at a FEP may help select adequate pharmacological treatments and develop new tools to improve the outcome of these patients, where sex should also be borne in mind.
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Affiliation(s)
- Maria Hidalgo-Figueroa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Psychobiology Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain
| | - Alejandro Salazar
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real (Cádiz), Spain
- The Observatory of Pain, University of Cádiz, Cádiz, Spain
| | - Cristina Romero-López-Alberca
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Personality, Evaluation and Psychological Treatment Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain
| | - Karina S MacDowell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - Borja García-Bueno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, EHU, Vitoria-Gasteiz, Spain
| | - M Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12)/Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Psychobiology Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain
| | - Juan C Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
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Lennox B, Xiong W, Waters P, Coles A, Jones PB, Yeo T, May JTM, Yeeles K, Anthony D, Probert F. The serum metabolomic profile of a distinct, inflammatory subtype of acute psychosis. Mol Psychiatry 2022; 27:4722-4730. [PMID: 36131046 PMCID: PMC7613906 DOI: 10.1038/s41380-022-01784-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 12/14/2022]
Abstract
A range of studies suggest that a proportion of psychosis may have an autoimmune basis, but this has not translated through into clinical practice-there is no biochemical test able to accurately identify psychosis resulting from an underlying inflammatory cause. Such a test would be an important step towards identifying who might require different treatments and have the potential to improve outcomes for patients. To identify novel subgroups within patients with acute psychosis we measured the serum nuclear magnetic resonance (NMR) metabolite profiles of 75 patients who had identified antibodies (anti-glycine receptor [GlyR], voltage-gated potassium channel [VGKC], Contactin-associated protein-like 2 [CASPR2], leucine-rich glioma inactivated 1 [LGI1], N-methyl-D-aspartate receptor [NMDAR] antibody) and 70 antibody negative patients matched for age, gender, and ethnicity. Clinical symptoms were assessed using the positive and negative syndrome scale (PANSS). Unsupervised principal component analysis identified two distinct biochemical signatures within the cohort. Orthogonal partial least squared discriminatory analysis revealed that the serum metabolomes of NMDAR, LGI1, and CASPR2 antibody psychosis patients were indistinct from the antibody negative control group while VGKC and GlyR antibody patients had significantly decreased lipoprotein fatty acids and increased amino acid concentrations. Furthermore, these patients had more severe presentation with higher PANSS scores than either the antibody negative controls or the NMDAR, LGI1, and CASPR2 antibody groups. These results suggest that a proportion of patients with acute psychosis have a distinct clinical and biochemical phenotype that may indicate an inflammatory subtype.
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Affiliation(s)
- Belinda Lennox
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Wenzheng Xiong
- Department of Pharmacology, University of Oxford, Oxford, UK
- Department of Chemistry, University of Oxford, Oxford, UK
| | - Patrick Waters
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Alasdair Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Tianrong Yeo
- Department of Pharmacology, University of Oxford, Oxford, UK
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Jeanne Tan May May
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ksenija Yeeles
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Daniel Anthony
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Fay Probert
- Department of Chemistry, University of Oxford, Oxford, UK
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7
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Goetzl EJ, Srihari VH, Guloksuz S, Ferrara M, Tek C, Heninger GR. Neural cell-derived plasma exosome protein abnormalities implicate mitochondrial impairment in first episodes of psychosis. FASEB J 2021; 35:e21339. [PMID: 33454965 DOI: 10.1096/fj.202002519r] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023]
Abstract
Neuroprotective and other functional proteins of mitochondria were quantified in extracts of plasma neural-derived exosomes from ten first-episode psychosis (FP) patients and ten matched psychiatrically normal controls (ctls). Astrocyte-derived extracellular vesicles (ADEVs) and neuron-derived extracellular vesicles (NDEVs) were immunoabsorbed separately from physically precipitated plasma total EVs. Extracted mitochondrial ATP synthase was specifically immunofixed to plastic wells for quantification of catalytic activity based on conversion of NADH to NAD+ . Other extracted mitochondrial functional proteins were quantified by ELISAs. All protein levels were normalized with EV content of the CD81 exosome marker. FP patient ADEV level but not NDEV level of mitochondrial ATP synthase activity was significantly lower than that of ctls. FP patient ADEV and NDEV levels of the functionally critical mitochondrial proteins mitofusin 2 and cyclophilin D, but not of transcription factor A of mitochondria, and of the mitochondrial short open-reading frame neuroprotective and metabolic regulatory peptides humanin and MOTS-c were significantly lower than those of ctls. In contrast, FP patient NDEV, but not ADEV, level of the mitochondrial-tethering protein syntaphilin, but not of myosin VI, was significantly higher than that of ctls. The distinctively different neural levels of some mitochondrial proteins in FP patients than ctls now should be correlated with diverse clinical characteristics. Drugs that increase depressed levels of proteins and mimetics of deficient short open-reading frame peptides may be of therapeutic value in early phases of schizophrenia.
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Affiliation(s)
- Edward J Goetzl
- Department of Medicine, University of California Medical Center, San Francisco, CA, USA
- Campus for Jewish Living, San Francisco, CA, USA
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sinan Guloksuz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Maria Ferrara
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Cenk Tek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - George R Heninger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Cullen AE, Palmer-Cooper EC, Hardwick M, Vaggers S, Crowley H, Pollak TA, Lennox BR. Influence of methodological and patient factors on serum NMDAR IgG antibody detection in psychotic disorders: a meta-analysis of cross-sectional and case-control studies. Lancet Psychiatry 2021; 8:109-120. [PMID: 33357497 DOI: 10.1016/s2215-0366(20)30432-6] [Citation(s) in RCA: 15] [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: 06/29/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Antibodies targeting the N-methyl-D-aspartate receptor (NMDAR) have been detected in patients with psychosis. However, studies measuring the IgG subclass in serum have provided variable estimates of prevalence, and it is unclear whether these antibodies are more common in patients than controls. Because these inconsistencies could be due to methodological approaches and patient characteristics, we aimed to investigate the effect of these factors on heterogeneity. METHODS We searched Web of Science and Ovid (MEDLINE and PsycINFO) for cross-sectional and case-control studies published between Jan 1, 2000, and May 5, 2019, that reported NMDAR IgG antibody seropositivity in patients with psychosis. Pooled proportions and odds ratios (ORs) were derived using random-effects models. We estimated between-study variance (τ2) and the proportion of observed variance due to heterogeneity (I2). We then used univariable random-effects meta-regression analysis to investigate the effect of study factors on heterogeneity of proportions and ORs. Our protocol was registered on PROSPERO (CRD42018099874). FINDINGS Of 1276 articles in the initial search, 28 studies were eligible for inclusion, including 14 cross-sectional studies and 14 case-control studies. In cross-sectional studies, NMDAR IgG antibodies were detected in 0·73% (95% CI 0·09-1·38; I2 56%; p=0·026) of patients with psychosis, and in case-control studies, patients with psychosis were not significantly more likely to be seropositive than healthy individuals (OR 1·57, 95% CI 0·78-3·16; I2 15%; p=0·20). Meta-regression analyses indicated that heterogeneity was significantly associated with assay type across both study designs, illness stage in cross-sectional studies, and study quality in case-control studies. Compared with studies using a fixed cell-based assay, cross-sectional and case-control studies using the live method yielded higher pooled prevalence estimates (0·36% [95% CI -0·23 to 0·95] vs 2·97% [0·70 to 5·25]) and higher ORs (0·65 [0·33 to 1·29] vs 4·43 [1·73 to 11·36]). In cross-sectional studies, the prevalence was higher in exclusively first-episode samples than in multi-episode or mixed samples (2·18% [0·25 to 4·12] vs 0·16% [-0·31 to 0·63]), and in case-control studies, higher ORs were reported in low-quality studies than in high-quality studies (3·80 [1·47 to 9·83] vs 0·72 [0·36 to 1·42]). INTERPRETATION Higher estimates of NMDAR IgG antibody prevalence have been obtained with the live cell-based assay, and studies using this method find that seropositivity is more common in patients with psychosis than in controls. The effects of illness stage and study quality on heterogeneity were not consistent across study designs, and we provide clear recommendations for clinicians and researchers regarding interpreting these findings. FUNDING None.
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Affiliation(s)
- Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Emma C Palmer-Cooper
- Department of Psychiatry, University of Oxford, Oxford, UK; School of Psychology, University of Southampton, Southampton, UK
| | - Marc Hardwick
- Department of Psychiatry, University of Oxford, Oxford, UK; University of Oxford Medical School, Oxford, UK
| | - Sophie Vaggers
- Department of Psychiatry, University of Oxford, Oxford, UK; University of Oxford Medical School, Oxford, UK
| | - Hannah Crowley
- Department of Psychiatry, University of Oxford, Oxford, UK; University of Oxford Medical School, Oxford, UK
| | - Thomas A Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Belinda R Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, UK
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9
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Kwobah E, Koen N, Mwangi A, Atwoli L, Stein DJ. Prevalence and correlates of metabolic syndrome and its components in adults with psychotic disorders in Eldoret, Kenya. PLoS One 2021; 16:e0245086. [PMID: 33428652 PMCID: PMC7799838 DOI: 10.1371/journal.pone.0245086] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 12/22/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND A high prevalence of metabolic syndrome and its components in patients with psychotic disorders may increase the risk for cardiovascular diseases. Unfortunately, relatively little work in this field has emerged from low-resourced contexts. This study investigated the prevalence, correlates, and treatment patterns of metabolic disorders in patients with psychotic disorders in Western Kenya. METHODS 300 patients with psychosis and 300 controls were recruited at Moi Teaching and Referral Hospital in Eldoret, Kenya. Data on demographic characteristics, weight, height, abdominal circumference, blood pressure, blood glucose, lipid profile, and treatments were collected. Categorical and continuous data were compared between the patient and control groups using Pearson's chi-squared tests and t-tests, respectively. Variables found to be significantly different between these groups were included in logistic regression models to determine potential predictors of metabolic syndrome. RESULTS Compared to controls, patients with psychosis were found to have a higher mean random blood glucose [5.23 vs 4.79, p = 0.003], higher body mass index [5.23 vs 4.79, p = 0.001], higher triglycerides [1.98 vs 1.56, p<0.001], larger waist circumference [89.23 vs 86.39, p = 0.009] and lower high density lipoprotein [1.22 vs 1.32, p<0.001]. The odds of developing metabolic syndrome were increased with age [OR = 1.05, CI: 1.02-1.07] and presence of a psychotic disorder [OR = 2.09 [CI 1.23-3.55]; and were reduced with female gender [OR 0.41, CI 0.25-0.67], among those who were never married [OR 0.52, CI 0.28-0.94] and among the widowed/separated/ divorced marital status [OR 0.38, CI 0.17-0.81]. While the majority of patients received treatment with olanzapine, there was no association between olanzapine use and metabolic syndrome and its components. More than half of the patients in this study sample were not receiving treatment for the various components of metabolic syndrome. CONCLUSION In the study setting of Eldoret, metabolic syndrome and its components were more prevalent among patients with psychotic disorders than in controls; and a clear treatment gap for these disorders was evident. There is a need for efforts to ensure adequate screening and treatment for these physical disorders in resource-limited settings.
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Affiliation(s)
- Edith Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council [SAMRC], Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Ann Mwangi
- Department of Behavioral Sciences, Moi University School of Medicine, Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council [SAMRC], Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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10
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Abe K, Chiba Y, Katsuse O, Takahashi Y, Suda A, Hattori S, Yoshimi R, Kirino Y, Kunii M, Yoshimi A, Asami T, Hishimoto A. Exploratory investigation on antibodies to GluN1 and cognitive dysfunction in patients with chronic autoimmune psychosis. Neurosci Lett 2020; 743:135588. [PMID: 33359543 DOI: 10.1016/j.neulet.2020.135588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/14/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Mild cognitive dysfunction has been implicated in a number of psychiatric diseases and affects social functioning. Although clinical criteria were recently proposed for autoimmune psychosis (AP), biomarkers have not yet been established for the severity and prognosis of cognitive dysfunction. We herein investigated the relationships between 3 types of serum antibodies and cognitive dysfunction in chronic psychiatric patients suspected of AP. METHODS We included 31 patients suspected of AP and obtained information on their clinical characteristics. Three types of autoantibodies (the anti-N-methyl-D-aspartate receptor (anti-NMDAR Ab), anti-N-terminal of GluN1 (anti-GluN1-NT Ab), and anti-thyroid antibodies) were evaluated in serum. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. We examined the relationships between serum autoantibodies and cognitive dysfunction in patients using multiple regression models. RESULTS Serum titers of anti-GluN1-NT Ab significantly contributed to the estimated score of working memory (B= -55.85, β= -0.46, p= 0.01), while no correlation was observed between the other 2 types of antibodies and cognitive function. CONCLUSIONS The present results indicate the potential of serum anti-GluN1-NT Ab as a biomarker for the severity and prognosis of cognitive dysfunction underlying various psychiatric symptoms in patients with AP. The pathological significance of anti-GluN1-NT Ab needs to be verified in future studies.
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Affiliation(s)
- Kie Abe
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yuhei Chiba
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Omi Katsuse
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan; Yokohama Hoyu Hospital 644 Kanegaya, Asahi-ku, Yokohama, 241-0812, Japan
| | - Yukitoshi Takahashi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders 886 Urushiyama, Aoi-ku, Shizuoka, 420-8688, Japan
| | - Akira Suda
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Saki Hattori
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Misako Kunii
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Takeshi Asami
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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11
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Appiah-Kusi E, Wilson R, Colizzi M, Foglia E, Klamerus E, Caldwell A, Bossong MG, McGuire P, Bhattacharyya S. Childhood trauma and being at-risk for psychosis are associated with higher peripheral endocannabinoids. Psychol Med 2020; 50:1862-1871. [PMID: 31422779 DOI: 10.1017/s0033291719001946] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evidence has been accumulating regarding alterations in components of the endocannabinoid system in patients with psychosis. Of all the putative risk factors associated with psychosis, being at clinical high-risk for psychosis (CHR) has the strongest association with the onset of psychosis, and exposure to childhood trauma has been linked to an increased risk of development of psychotic disorder. We aimed to investigate whether being at-risk for psychosis and exposure to childhood trauma were associated with altered endocannabinoid levels. METHOD We compared 33 CHR participants with 58 healthy controls (HC) and collected information about previous exposure to childhood trauma as well as plasma samples to analyse endocannabinoid levels. RESULTS Individuals with both CHR and experience of childhood trauma had higher N-palmitoylethanolamine (p < 0.001) and anandamide (p < 0.001) levels in peripheral blood compared to HC and those with no childhood trauma. There was also a significant correlation between N-palmitoylethanolamine levels and symptoms as well as childhood trauma. CONCLUSIONS Our results suggest an association between CHR and/or childhood maltreatment and elevated endocannabinoid levels in peripheral blood, with a greater alteration in those with both CHR status and history of childhood maltreatment compared to those with either of those risks alone. Furthermore, endocannabinoid levels increased linearly with the number of risk factors and elevated endocannabinoid levels correlated with the severity of CHR symptoms and extent of childhood maltreatment. Further studies in larger cohorts, employing longitudinal designs are needed to confirm these findings and delineate the precise role of endocannabinoid alterations in the pathophysiology of psychosis.
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Affiliation(s)
- E Appiah-Kusi
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - R Wilson
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - M Colizzi
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Policlinico 'G. B. Rossi', P.le L.A. Scuro 10, 37134, Verona, Italy
| | - E Foglia
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - E Klamerus
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - A Caldwell
- King's College London, Mass Spectometry Facility, Franklin Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - M G Bossong
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - P McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - S Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
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12
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van der Leeuw C, de Witte LD, Stellinga A, van der Ley C, Bruggeman R, Kahn RS, van Os J, Marcelis M. Vitamin D concentration and psychotic disorder: associations with disease status, clinical variables and urbanicity. Psychol Med 2020; 50:1680-1686. [PMID: 31327333 DOI: 10.1017/s0033291719001739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The association between schizophrenia and decreased vitamin D levels is well documented. Low maternal and postnatal vitamin D levels suggest a possible etiological mechanism. Alternatively, vitamin D deficiency in patients with schizophrenia is presumably (also) the result of disease-related factors or demographic risk factors such as urbanicity. METHODS In a study population of 347 patients with psychotic disorder and 282 controls, group differences in vitamin D concentration were examined. Within the patient group, associations between vitamin D, symptom levels and clinical variables were analyzed. Group × urbanicity interactions in the model of vitamin D concentration were examined. Both current urbanicity and urbanicity at birth were assessed. RESULTS Vitamin D concentrations were significantly lower in patients (B = -8.05; 95% confidence interval (CI) -13.68 to -2.42; p = 0.005). In patients, higher vitamin D concentration was associated with lower positive (B = -0.02; 95% CI -0.04 to 0.00; p = 0.049) and negative symptom levels (B = -0.03; 95% CI -0.05 to -0.01; p = 0.008). Group differences were moderated by urbanicity at birth (χ2 = 6.76 and p = 0.001), but not by current urbanicity (χ2 = 1.50 and p = 0.224). Urbanicity at birth was negatively associated with vitamin D concentration in patients (B = -5.11; 95% CI -9.41 to -0.81; p = 0.020), but not in controls (B = 0.72; 95% CI -4.02 to 5.46; p = 0.765). CONCLUSIONS Lower vitamin D levels in patients with psychotic disorder may in part reflect the effect of psychosis risk mediated by early environmental adversity. The data also suggest that lower vitamin D and psychopathology may be related through direct or indirect mechanisms.
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Affiliation(s)
- C van der Leeuw
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Mondriaan, Maastricht, the Netherlands
| | - L D de Witte
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - A Stellinga
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C van der Ley
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R Bruggeman
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R S Kahn
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - J van Os
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - M Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
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Mohamed MF, Siepmann T, Suwileh S, Mohammed MH, Mohamed S, Abdalla LO, Elzouki AN, Mahmoud MH, Al-Mohanadi D, Danjuma M. Myxedema psychosis: A protocol for a systematic review and a pooled analysis. Medicine (Baltimore) 2020; 99:e20778. [PMID: 32590756 PMCID: PMC7328932 DOI: 10.1097/md.0000000000020778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Myxedema psychosis (MP) is a rare presentation of hypothyroidism. Although known for >70 years, a significant lack of systematic literature describing this condition exists. This limits the clinician's ability to identify and manage this entity properly. Hence, we aimed to systematically review the literature and summarize the presentation, diagnosis, management, and outcomes of this rare entity. METHODS Systematic review following PRISMA guidance. We will perform a comprehensive search of PubMed, Medline, Embase, Google Scholar (first 300 hits), and Cochrane databases for published observational studies, case series, and case reports. We will use descriptive statistics to provide summary estimates of demographics, common presenting features, laboratory test results, imaging findings, treatment administered, and outcomes. Moreover, continuous variables will be compared by the Wilcoxon Mann Whitney test, whereas categorical variables will be assessed by the χ test. Bivariate and multivariate regression will be performed to assess risk factors associated with poor outcome. A scoping review revealed that a meta-analysis might not be feasible owing to the paucity of systematic studies describing the condition. RESULTS This is the first systematic review examining this rare entity. Thus, the result of which will be significant. We hope that this review will help in identifying relevant predictive clinical or laboratory characteristics. Additionally, it identifies the best treatment strategies. The findings of this review will help increase our knowledge of this condition so as to recognize this condition promptly. Also, it will assist in differentiating MP from masqueraders, such as Hashimoto encephalopathy (HE). The results of this review will be published in a peer-reviewed journal. CONCLUSION This is the first systematic review exploring MP demographics, diagnosis treatment, and outcomes. The information gathered by this review will be necessary for patients, clinicians, researchers, and guideline makers. PROSPERO REGISTRATION NUMBER CRD42020160310.
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Affiliation(s)
- Mouhand F.H. Mohamed
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
- Dresden International University Division of Health Care Sciences Center for Clinical Research and Management Education Dresden
| | - Timo Siepmann
- Dresden International University Division of Health Care Sciences Center for Clinical Research and Management Education Dresden
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Salah Suwileh
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Lina O. Abdalla
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Abdel-Naser Elzouki
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University
| | | | - Dabia Al-Mohanadi
- Primary Health Care Centers
- Endocrine Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Danjuma
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University
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Corsi-Zuelli F, Loureiro CM, Shuhama R, Fachim HA, Menezes PR, Louzada-Junior P, Mondelli V, Del-Ben CM. Cytokine profile in first-episode psychosis, unaffected siblings and community-based controls: the effects of familial liability and childhood maltreatment. Psychol Med 2020; 50:1139-1147. [PMID: 31064423 DOI: 10.1017/s0033291719001016] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 11/07/2022]
Abstract
BACKGROUND Inflammation is a possible biological mechanism underlying the association between childhood maltreatment and psychosis. Previous investigations on this regard were mainly conducted on chronic schizophrenia and lacked control for confounders. We aim to investigate the role of familial liability, childhood maltreatment and recent stress in determining cytokine abnormalities at the onset of psychosis. METHODS We recruited 114 first-episode psychosis (FEP) patients, 57 unaffected biological siblings of FEP patients, and 251 community-based controls. Plasma cytokines (IL-1β, IL-6, TNF-α, IFN-γ, IL-4, IL-10 and TGF-β) were measured and differences across the groups analysed after adjusting for potential confounders. RESULTS FEP had a higher pro- and anti-inflammatory cytokine profile (IL-1β, IL-6, TNF-α, IL-10 and TGF-β), which was not observed in unaffected siblings. Siblings presented decreased IL-1β when compared with patients and controls. Childhood maltreatment was associated with higher levels of TGF-β in both patients and siblings when compared with controls. Physical childhood abuse was associated with increased levels of TGF-β in FEP patients but with decreased levels in controls. Other childhood maltreatment subtypes or recent stressors did not affect cytokine levels in any of the groups. CONCLUSIONS Normal or reduced cytokines in siblings represent possibly a protective factor and suggest that the identified inflammatory profile in FEP can be a real pathophysiological component of psychosis. Experience of childhood maltreatment may contribute as long-term immune priming for the TGF-β pathway, and increased levels of this cytokine in both patients and siblings exposed to childhood maltreatment point to a possible biological candidate of familial risk for psychosis.
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Affiliation(s)
- Fabiana Corsi-Zuelli
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Camila Marcelino Loureiro
- Department of Internal Medicine, Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Rosana Shuhama
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Helene Aparecida Fachim
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo Louzada-Junior
- Department of Internal Medicine, Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Cristina Marta Del-Ben
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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Kudla D, Lambert M, Domin S, Kasper S, Naber D. Effectiveness, tolerability, and safety of ziprasidone in patients with schizophrenia or schizoaffective disorder: Results of a multi-centre observational trial. Eur Psychiatry 2020; 22:195-202. [PMID: 17140769 DOI: 10.1016/j.eurpsy.2006.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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] [Received: 11/22/2005] [Revised: 06/20/2006] [Accepted: 06/21/2006] [Indexed: 11/16/2022] Open
Abstract
AbstractPurposeThe ZEISIG study (Ziprasidone Experience in Schizophrenia in Germany/Austria) investigated the effectiveness of ziprasidone as measured by discontinuation rates and mean changes of the BPRS total. Secondary objectives included quality of life, subjective well-being, tolerability, and safety.Subjects and methodsTwo hundred and seventy-six subjects with schizophrenia and schizoaffective disorder were treated within an open-label, 12-week, prospective, flexible-dose observational trial of ziprasidone (40–160 mg/day). Baseline and outcome assessments mainly included Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions Scale (CGI), Short-Form 12 (SF-12), and Subjective Well-being under Neuroleptic treatment (SWN-K).ResultsStudy discontinuation due to any cause was evident in 58% of subjects, most of them within the first 4 weeks after study initiation. In study completers, ziprasidone was associated with improvements in BPRS total (44.8 to 33.6; p < 0.001), CGI, SF-12, and SWN-K total scores (80.5 to 89.5). Ziprasidone was related to reduction of weight, fasting glucose, and serum lipids. No cardiovascular adverse event or significant increase of the QTc interval was observed.Discussion and conclusionApproximately 60% of subjects discontinued ziprasidone prematurely, probably related to an initial and overall underdose. The present study confirmed previous tolerability and safety data of ziprasidone as well as results of its effectiveness. Independent from reason to switch, previous antipsychotic class, and severity of illness at baseline, the recommended starting dose of 80 mg/day as well as the maximum treatment dose of 160 mg/day may not be sufficient for a selected subgroup of patients.
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Affiliation(s)
- Duerten Kudla
- Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
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Garyfallos G, Dimelis D, Kouniakis P, Sidiropoulos N, Karastergiou A, Lavrentiadis G, Giouzepas J, Fokas K. Olanzapine versus risperidone: weight gain and elevation of serum triglyceride levels. Eur Psychiatry 2020; 18:320-1. [PMID: 14611929 DOI: 10.1016/j.eurpsy.2003.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- George Garyfallos
- The B' University Department of Psychiatry, Aristotelian University of Thessaloniki, and Community Mental Health Center, 20 Papadopoulou Str-Sikies, 56625 Thessaloniki, Greece.
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Steen NE, Dieset I, Hope S, Vedal TSJ, Smeland OB, Matson W, Kaddurah-Daouk R, Agartz I, Melle I, Djurovic S, Jönsson EG, Bogdanov M, Andreassen OA. Metabolic dysfunctions in the kynurenine pathway, noradrenergic and purine metabolism in schizophrenia and bipolar disorders. Psychol Med 2020; 50:595-606. [PMID: 30867076 DOI: 10.1017/s0033291719000400] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND We aimed at exploring potential pathophysiological processes across psychotic disorders, applying metabolomics in a large and well-characterized sample of patients and healthy controls. METHODS Patients with schizophrenia and bipolar disorders (N = 212) and healthy controls (N = 68) had blood sampling with subsequent metabolomics analyses using electrochemical coulometric array detection. Concentrations of 52 metabolites including tyrosine, tryptophan and purine pathways were compared between patients and controls while controlling for demographic and clinical characteristics. Significant findings were further tested in medication-free subsamples. RESULTS Significantly decreased plasma concentrations in patients compared to healthy controls were found for 3-hydroxykynurenine (3OHKY, p = 0.0008), xanthurenic acid (XANU, p = 1.5×10-5), vanillylmandelic acid (VMA, p = 4.5×10-5) and metanephrine (MN, p = 0.0001). Plasma concentration of xanthine (XAN) was increased in the patient group (p = 3.5×10-5). Differences of 3OHKY, XANU, VMA and XAN were replicated across schizophrenia spectrum disorders and bipolar disorders subsamples of medication-free individuals. CONCLUSIONS Although prone to residual confounding, the present results suggest the kynurenine pathway of tryptophan metabolism, noradrenergic and purinergic system dysfunction as trait factors in schizophrenia spectrum and bipolar disorders. Of special interest is XANU, a metabolite previously not found to be associated with bipolar disorders.
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Affiliation(s)
- Nils Eiel Steen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Dieset
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sigrun Hope
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway
| | - Trude S J Vedal
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neuroscience, University of California San Diego, La Jolla, CA92093, USA
| | | | - Rima Kaddurah-Daouk
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
- Duke Institute of Brain Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Srdjan Djurovic
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Erik G Jönsson
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | | | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Wedervang-Resell K, Friis S, Lonning V, Smelror RE, Johannessen C, Reponen EJ, Lyngstad SH, Lekva T, Aukrust P, Ueland T, Andreassen OA, Agartz I, Myhre AM. Increased interleukin 18 activity in adolescents with early-onset psychosis is associated with cortisol and depressive symptoms. Psychoneuroendocrinology 2020; 112:104513. [PMID: 31761332 DOI: 10.1016/j.psyneuen.2019.104513] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/14/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Evidence indicates that the pathophysiology of adult psychosis involves immune dysregulation, but its associations with stress are often not considered. The inflammatory cytokine interleukin (IL)-18, which is elevated in adult schizophrenia, is suggested to be sensitive to stress. We compared the associations of IL-18 with cortisol and clinical variables in adolescents with early-onset psychosis (EOP) aged 12-18 years and age-matched healthy controls (HC). METHOD We measured serum IL-18, IL-18 binding protein (IL-18BP), IL-18 receptor accessory protein (IL-18RAP), IL-18 receptor 1 (IL-18R1) and cortisol, and calculated the IL-18/IL-18BP ratio in patients (n = 31) and HC (n = 60). Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale and depressive symptoms by the Mood and Feelings Questionnaire-Child version (MFQ-C). Bivariate correlation analysis was used to explore relationships between IL-18/IL-18BP ratio and cortisol, depression and other clinical characteristics. Hierarchical multiple linear regression analysis was used to assess their individual contributions to the variance of the IL-18/IL-18BP ratio. RESULTS Patients had significantly higher IL-18 levels and IL-18/IL-18BP ratios than HC, but similar IL-18BP, IL-18RAP and IL-18R1. Both cortisol (R2 change = 0.05) and the MFQ-C score (R2 change = 0.09) contributed significantly to the variance in IL-18/IL-18BP ratios after controlling for confounders. CONCLUSION We found increased IL-18 system activity in adolescents with EOP. Cortisol and depressive symptoms each contributed to the variance in the IL-18/IL-18BP ratio. Our findings support activation of inflammatory pathways in adolescent psychosis and suggest interactions between stress, inflammation and depressive symptoms in EOP.
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Affiliation(s)
- Kirsten Wedervang-Resell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway.
| | - Svein Friis
- Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vera Lonning
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Runar E Smelror
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Cecilie Johannessen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Elina J Reponen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siv H Lyngstad
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anne M Myhre
- Division of Mental Health and Addiction, Department of Psychiatric Research and Development, Oslo University Hospital, Oslo, Norway; Child and Adolescent Psychiatry Unit, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
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Lee CH, Sinclair D, O'Donnell M, Galletly C, Liu D, Weickert CS, Weickert TW. Transcriptional changes in the stress pathway are related to symptoms in schizophrenia and to mood in schizoaffective disorder. Schizophr Res 2019; 213:87-95. [PMID: 31296417 DOI: 10.1016/j.schres.2019.06.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 01/07/2023]
Abstract
Altered levels of stress-signalling transcripts have been identified in post-mortem brains of people with schizophrenia, and since stress effects may be expressed throughout the body, there should be similar changes in peripheral cells. However, the extent to which these markers are altered in peripheral white blood cells of people with schizophrenia is not known. Furthermore, how peripheral cortisol and stress-related mRNA are associated with negative symptom severity and emotional states in people with schizophrenia versus schizoaffective disorder has not been determined. Whole blood samples were collected from 86 patients with either schizophrenia or schizoaffective disorder (56 people with schizophrenia and 30 people with schizoaffective disorder), and 77 healthy controls. Total RNA was isolated, cDNA was synthesized, and stress-signalling mRNA levels (for NR3C1, FKBP5, FKBP4, PTGES3 and BAG1) were determined. Stress and symptom severity scores were measured by the Depression, Anxiety and Stress Scale, and the Positive and Negative Syndrome Scale, respectively. We found increased FKBP5 mRNA, Z(156) = 2.5, p = 0.01, decreased FKBP4 mRNA, t(155) = 3.5, p ≤ 0.001, and decreased PTGES3 mRNA, t(153) = 3.0, p ≤ 0.01, in schizophrenia and schizoaffective disorder cohorts combined compared to healthy controls. Stress-related peripheral mRNA levels were differentially correlated with negative emotional states and symptom severity in schizoaffective disorder (β's = -0.45-0.56, p's = 0.05-0.001) and schizophrenia (β's = -0.34-0.38, p's = 0.04-0.03), respectively. Therefore, molecules of the stress-signalling pathway appear to differentially contribute to clinical features of schizophrenia versus schizoaffective disorder.
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Affiliation(s)
- Cynthia H Lee
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW 2031, Australia
| | | | - Maryanne O'Donnell
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, University of Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Australia; Ramsay Health Care (SA) Mental Health, Australia
| | - Dennis Liu
- Discipline of Psychiatry, University of Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Australia
| | - Cynthia Shannon Weickert
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW 2031, Australia; Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210, USA
| | - Thomas W Weickert
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW 2031, Australia; Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210, USA.
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Millar S, Stone N, Bellman Z, Yates A, England T, O'Sullivan S. A systematic review of cannabidiol dosing in clinical populations. Br J Clin Pharmacol 2019; 85:1888-1900. [PMID: 31222854 PMCID: PMC6710502 DOI: 10.1111/bcp.14038] [Citation(s) in RCA: 130] [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: 02/07/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS Cannabidiol (CBD) is a cannabis-derived medicinal product with potential application in a wide-variety of contexts; however, its effective dose in different disease states remains unclear. This review aimed to investigate what doses have been applied in clinical populations, in order to understand the active range of CBD in a variety of medical contexts. METHODS Publications involving administration of CBD alone were collected by searching PubMed, EMBASE and ClinicalTrials.gov. RESULTS A total of 1038 articles were retrieved, of which 35 studies met inclusion criteria covering 13 medical contexts. Twenty-three studies reported a significant improvement in primary outcomes (e.g. psychotic symptoms, anxiety, seizures), with doses ranging between <1 and 50 mg/kg/d. Plasma concentrations were not provided in any publication. CBD was reported as well tolerated and epilepsy was the most frequently studied medical condition, with all 11 studies demonstrating positive effects of CBD on reducing seizure frequency or severity (average 15 mg/kg/d within randomised controlled trials). There was no signal of positive activity of CBD in small randomised controlled trials (range n = 6-62) assessing diabetes, Crohn's disease, ocular hypertension, fatty liver disease or chronic pain. However, low doses (average 2.4 mg/kg/d) were used in these studies. CONCLUSION This review highlights that CBD has a potential wide range of activity in several pathologies. Pharmacokinetic studies as well as conclusive phase III trials to elucidate effective plasma concentrations within medical contexts are severely lacking and highly encouraged.
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Affiliation(s)
- S.A. Millar
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | - N.L. Stone
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | - Z.D. Bellman
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | | | - T.J. England
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
| | - S.E. O'Sullivan
- Division of Medical Sciences and Graduate Entry Medicine, School of MedicineUniversity of Nottingham, Royal Derby HospitalDerbyUK
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21
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Davies C, Paloyelis Y, Rutigliano G, Cappucciati M, De Micheli A, Ramella-Cravaro V, Provenzani U, Antoniades M, Modinos G, Oliver D, Stahl D, Murguia S, Zelaya F, Allen P, Shergill S, Morrison P, Williams S, Taylor D, McGuire P, Fusar-Poli P. Oxytocin modulates hippocampal perfusion in people at clinical high risk for psychosis. Neuropsychopharmacology 2019; 44:1300-1309. [PMID: 30626906 PMCID: PMC6784972 DOI: 10.1038/s41386-018-0311-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 12/15/2022]
Abstract
Preclinical and human studies suggest that hippocampal dysfunction is a key factor in the onset of psychosis. People at Clinical High Risk for psychosis (CHR-P) present with a clinical syndrome that can include social withdrawal and have a 20-35% risk of developing psychosis in the next 2 years. Recent research shows that resting hippocampal blood flow is altered in CHR-P individuals and predicts adverse clinical outcomes, such as non-remission/transition to frank psychosis. Previous work in healthy males indicates that a single dose of intranasal oxytocin has positive effects on social function and marked effects on resting hippocampal blood flow. The present study examined the effects of intranasal oxytocin on hippocampal blood flow in CHR-P individuals. In a double-blind, placebo-controlled, crossover design, 30 CHR-P males were studied using pseudo-continuous Arterial Spin Labelling on 2 occasions, once after 40IU intranasal oxytocin and once after placebo. The effects of oxytocin on left hippocampal blood flow were examined in a region-of-interest analysis of data acquired at 22-28 and at 30-36 minutes post-intranasal administration. Relative to placebo, administration of oxytocin was associated with increased hippocampal blood flow at both time points (p = .0056; p = .034), although the effect at the second did not survive adjustment for the effect of global blood flow. These data indicate that oxytocin can modulate hippocampal function in CHR-P individuals and therefore merits further investigation as a candidate novel treatment for this group.
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Grants
- G0901868 Medical Research Council
- 22593 Brain and Behavior Research Foundation (Brain & Behavior Research Foundation)
- Dominic Oliver is supported by the UK Medical Research Council (MR/N013700/1) and is a King’s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences.
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
- DH | National Institute for Health Research (NIHR)
- This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King’s College London (PFP, PM, DS); by a Brain & Behaviour Research Foundation NARSAD Award (grant number 22593 to PFP); and by the Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders had no influence on the design, collection, analysis and interpretation of the data, writing of the report and decision to submit this article for publication.
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Affiliation(s)
- Cathy Davies
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Grazia Rutigliano
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marco Cappucciati
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andrea De Micheli
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK
| | - Valentina Ramella-Cravaro
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Umberto Provenzani
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Mathilde Antoniades
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gemma Modinos
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dominic Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Silvia Murguia
- Tower Hamlets Early Detection Service (THEDS), East London NHS Foundation Trust, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychology, University of Roehampton, London, UK
| | - Sukhi Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Morrison
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Steve Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - David Taylor
- Institute of Pharmaceutical Science, King's College London, London, UK
| | - Philip McGuire
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach And Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK.
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
- Outreach And Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK.
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Reyes-Madrigal F, León-Ortiz P, Mao X, Mora-Durán R, Shungu DC, de la Fuente-Sandoval C. Striatal Glutathione in First-episode Psychosis Patients Measured In Vivo with Proton Magnetic Resonance Spectroscopy. Arch Med Res 2019; 50:207-213. [PMID: 31499481 PMCID: PMC10624128 DOI: 10.1016/j.arcmed.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/01/2019] [Accepted: 08/07/2019] [Indexed: 12/25/2022]
Abstract
Deficits of brain glutathione (GSH), the most abundant and primary antioxidant in living tissue, and associated redox imbalance are postulated to be implicated in schizophrenia. This pilot clinical study compared the levels of striatal GSH, measured in vivo with proton magnetic resonance spectroscopy (1H MRS) at 3T, in 10 drug-naïve, first-episode psychosis (FEP) patients with those in 9 matched healthy control subjects. The results revealed a significant GSH deficit in FEP patients (0.92 ± 0.24 × 10-3) compared to the healthy control group (1.10 ± 0.10 × 10-3) (U = 25.00, p = 0.02), as well as a positive correlation between GSH levels and the Positive Symptoms subscale of the PANSS in the FEP group (ρ = 0.96; p <0.001). These preliminary findings suggest a possible role of striatal oxidative stress in early-stage psychosis that warrants further scrutiny and confirmation in larger studies.
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Affiliation(s)
- Francisco Reyes-Madrigal
- Laboratorio de Psiquiatría Experimental, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - Pablo León-Ortiz
- Laboratorio de Psiquiatría Experimental, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México; Subdirección de Enseñanza, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - Xiangling Mao
- Department of Radiology, Weill Cornell Medical College, New York City, NY, USA
| | - Ricardo Mora-Durán
- Departamento de Urgencias, Hospital Fray Bernardino Álvarez, Ciudad de México, México
| | - Dikoma C Shungu
- Department of Radiology, Weill Cornell Medical College, New York City, NY, USA
| | - Camilo de la Fuente-Sandoval
- Laboratorio de Psiquiatría Experimental, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México; Departamento de Neuropsiquiatría, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México.
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He Y, Yuan L, Li Z, Zhou Y, Ma X, Ouyang L, Chen X. Plasma protein levels of brain-derived neurotrophic factor pathways and their association with cognitive performance in patients with clinical high risk for psychosis and first episode psychosis. Schizophr Res 2019; 206:460-461. [PMID: 30503369 DOI: 10.1016/j.schres.2018.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Ying He
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Liu Yuan
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Zongchang Li
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Yao Zhou
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Xiaoqian Ma
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Lijun Ouyang
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Xiaogang Chen
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, Changsha, Hunan 410011, China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan 410011, China; China National Technology Institute on Mental Disorders, Changsha, Hunan 410011, China.
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Delaney S, Fallon B, Alaedini A, Yolken R, Indart A, Feng T, Wang Y, Javitt D. Inflammatory biomarkers in psychosis and clinical high risk populations. Schizophr Res 2019; 206:440-443. [PMID: 30414721 DOI: 10.1016/j.schres.2018.10.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 05/31/2018] [Revised: 10/01/2018] [Accepted: 10/20/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Immunological, nutritional, and microbial factors have been implicated in the pathophysiology of schizophrenia, but the interrelationship among measures is understudied. In particular, an increase in the levels of the pro-inflammatory cytokine interleukin-6 (IL-6) is associated with all phases of the illness, and may be associated with other inflammatory markers. Vitamin D is a modulator of the immune system, and LPS antibodies are an indirect measure of gut barrier function. In this study we investigated potential contributing inflammatory mechanisms for IL-6 elevation. METHODS We compared the levels of vitamin D, C-reactive protein (CRP), antibodies to lipopolysaccharide (LPS), and IL-6 in children, adolescents and young adults with psychosis (n = 47), individuals at clinical high risk for psychosis (n = 17) and unaffected comparison controls (n = 33). Participants were diagnosed by a psychiatrist, using a structured interview, the MINI-Neuropsychiatric Interview. 25(OH)D was measured in serum using chemiluminescent micro particle immunoassay, and anti-LPS antibodies, CRP and IL-6 levels were measured by ELISA. RESULTS IL-6 and C-reactive protein levels were significantly elevated in the psychosis group relative to the unaffected control subjects. In the psychosis group, levels of IL-6 correlated positively with IgA anti-LPS antibodies and negatively correlated with vitamin D. CONCLUSIONS Our findings show a significant correlation between IL-6, anti-LPS antibodies and vitamin D deficiency in psychosis, suggesting the existence of multiple potential pathways related to IL-6 elevation in psychosis, and therefore multiple potential strategies for risk mitigation. Collectively these findings support hypotheses regarding interrelated inflammatory contributions to the pathophysiology of psychosis.
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Affiliation(s)
- Shannon Delaney
- Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, United States of America.
| | - Brian Fallon
- Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, United States of America
| | - Armin Alaedini
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States of America
| | - Robert Yolken
- Johns Hopkins School of Medicine, Baltimore, MD 21218, United States of America
| | - Alyssa Indart
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States of America
| | - Tianshu Feng
- Mailman School of Public Health, Columbia University New York, NY 10032, United States of America
| | - Yuanjia Wang
- Mailman School of Public Health, Columbia University New York, NY 10032, United States of America
| | - Daniel Javitt
- Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, United States of America
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25
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Laskaris L, Zalesky A, Weickert CS, Di Biase MA, Chana G, Baune BT, Bousman C, Nelson B, McGorry P, Everall I, Pantelis C, Cropley V. Investigation of peripheral complement factors across stages of psychosis. Schizophr Res 2019; 204:30-37. [PMID: 30527272 DOI: 10.1016/j.schres.2018.11.035] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 10/02/2018] [Accepted: 11/30/2018] [Indexed: 12/21/2022]
Abstract
The complement cascade has been proposed to contribute to the pathogenesis of schizophrenia. However, it remains unclear whether peripheral complement levels differ in cases compared to controls, change over the course of illness and whether they are associated with current symptomatology. This study aimed to: i) investigate whether peripheral complement protein levels are altered at different stages of illness, and ii) identify patterns among complement protein levels that predict clinical symptoms. Complement factors C1q, C3 and C4 were quantified in 183 participants [n = 83 Healthy Controls (HC), n = 10 Ultra-High Risk (UHR) for psychosis, n = 40 First Episode Psychosis (FEP), n = 50 Chronic schizophrenia] using Multiplex ELISA. Permutation-based t-tests were used to assess between-group differences in complement protein levels at each of the three illness stages, relative to age- and gender-matched healthy controls. Canonical correlation analysis was used to identify patterns of complement protein levels that correlated with clinical symptoms. C4 was significantly increased in chronic schizophrenia patients, while C3 and C4 were significantly increased in UHR patients. There were no differences in C1q, C3 and C4 in FEP patients when adjusting for BMI. A molecular pattern of increased C4 and decreased C3 was associated with positive and negative symptom severity in the pooled patient sample. Our findings indicate that peripheral complement concentration is increased across specific stages of psychosis and its imbalance may be associated with symptom severity. Given the small sample size of the UHR group, these findings should be regarded as exploratory, requiring replication.
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Affiliation(s)
- Liliana Laskaris
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, VIC, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Melbourne School of Engineering, The University of Melbourne, Parkville, VIC, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Schizophrenia Research Institute, Randwick, NSW, Australia; School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Brain & Mind Centre, The University of Sydney, NSW, Australia
| | - Maria A Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Gursharan Chana
- Melbourne School of Engineering, The University of Melbourne, Parkville, VIC, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, VIC, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, The University of Adelaide, SA, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Cooperative Research Centre for Mental Health, Carlton, VIC, Australia; Departments of Medical Genetics, Psychiatry, Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ian Everall
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Cooperative Research Centre for Mental Health, Carlton, VIC, Australia; Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; North Western Mental Health, Melbourne Health, Parkville, VIC, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, VIC, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, VIC, Australia; Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, VIC, Australia.
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26
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Gjerde PB, Jørgensen KN, Steen NE, Melle I, Andreassen OA, Steen VM, Agartz I. Association between olanzapine treatment and brain cortical thickness and gray/white matter contrast is moderated by cholesterol in psychotic disorders. Psychiatry Res Neuroimaging 2018; 282:55-63. [PMID: 30415175 DOI: 10.1016/j.pscychresns.2018.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 01/21/2023]
Abstract
Altered cortical brain morphology is observed in psychotic disorders. Despite the importance of lipid homeostasis for healthy brain functioning, knowledge about its role in cortical alterations in psychosis is limited. In a sample of patients with psychotic disorders, we investigated the relationship between treatment with olanzapine (OLZ), and cortical thickness and gray/white matter intensity contrast, and the association between these measures and serum lipid levels. We included 33 OLZ users, 19 unmedicated psychotic patients and 76 healthy controls (HC). Data on serum lipids and cortical measures based on MR brain images processed with FreeSurfer were analyzed with General Linear Models. We found that intensity contrast was similar in OLZ users as compared to HC and that the cortex (frontal, orbitofrontal, medial temporal) was thinner in OLZ users (p < 0.05, Bonferroni corrected). An OLZ-specific HDL interaction effect was further found for the pericentral cortical thickness measure (p < 0.05, Bonferroni corrected). Additionally, nominally significant findings indicated similar OLZ-specific interaction effects for cortical thickness in several regions, and an OLZ-specific interaction with LDL for occipital lobe contrast (p < 0.05, uncorrected). Our findings may suggest a drug-related lipid-effect on brain myelination. Experimental studies and replications in different study samples are needed to clarify these complex relationships further.
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Affiliation(s)
- Priyanthi B Gjerde
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.
| | - Kjetil N Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Vinderen, 0373 Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Nils E Steen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Vidar M Steen
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Vinderen, 0373 Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden.
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27
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Sanada K, de Azúa SR, Nakajima S, Alberich S, Ugarte A, Zugasti J, Vega P, Martínez-Cengotitabengoa M, González-Pinto A. Correlates of neurocognitive functions in individuals at ultra-high risk for psychosis - A 6-month follow-up study. Psychiatry Res 2018; 268:1-7. [PMID: 29986171 DOI: 10.1016/j.psychres.2018.06.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 02/24/2018] [Revised: 06/12/2018] [Accepted: 06/21/2018] [Indexed: 01/30/2023]
Abstract
Cognitive deficits are evident at the prodromal phase of psychosis. It has been noted that brain-derived neurotrophic factor (BDNF) is correlated with cognition in both preclinical and clinical studies. However, to our knowledge, no study has evaluated blood BDNF levels and their association with cognitive impairment in individuals at ultra-high risk for psychosis (UHR). We included 13 individuals at UHR and 30 healthy controls (HC) matched by sex, age, and educational level. Plasma BDNF levels were measured at baseline and 6 months. Neurocognitive functions (executive functions, speed of processing, verbal learning and memory, working memory) were examined at 6 months. Regression analyses were conducted to examine the relationship between BDNF levels and cognitive performance. BDNF levels were lower in UHR group than in HC group both at baseline and at 6 months (P = 0.001, and P = 0.007, respectively). There were no associations between plasma BDNF levels and all of the cognitive domains in both groups. Our findings showed that peripheral BDNF levels were not related to cognitive deficits in UHR and HC groups while the lower BDNF level in the former persisted up to 6 months. Further research is needed in a large sample.
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Affiliation(s)
- Kenji Sanada
- Department of Psychiatry, Showa University School of Medicine, Tokyo, Japan
| | - Sonia Ruiz de Azúa
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; University of the Basque Country
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Susana Alberich
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Amaia Ugarte
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Jone Zugasti
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Patricia Vega
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | - Mónica Martínez-Cengotitabengoa
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; University of the Basque Country; National Distance Education University (UNED), Spain
| | - Ana González-Pinto
- Department of Psychiatry, Araba University Hospital, BioAraba Research Institute, OSI Araba Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; University of the Basque Country.
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28
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Scheffler F, Kilian S, Chiliza B, Asmal L, Phahladira L, du Plessis S, Kidd M, Murray RM, Di Forti M, Seedat S, Emsley R. Effects of cannabis use on body mass, fasting glucose and lipids during the first 12 months of treatment in schizophrenia spectrum disorders. Schizophr Res 2018. [PMID: 29519756 DOI: 10.1016/j.schres.2018.02.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 01/03/2023]
Abstract
While acute cannabis use stimulates appetite, general population studies suggest that chronic use is associated with reduced risk of obesity and other cardiometabolic risk factors. In this study we investigated changes in body mass index (BMI), fasting blood glucose and lipids, and rates of metabolic syndrome risk factors in cannabis users vs. non-users in 109 minimally treated patients with first-episode schizophrenia, schizophreniform or schizo-affective disorder who were treated according to a standardized treatment regime with depot antipsychotic medication over 12 months. Participants underwent repeated urine toxicology tests for cannabis and those testing positive at any time during the study (n = 40), were compared with those who tested negative at all time points (n = 69). There was a significant group*time interaction effect (p = 0.002) with the cannabis negative group showing a greater increase in BMI than the cannabis positive group, after adjusting for age, sex, methamphetamine use and modal dose of antipsychotic. There were no group*time interaction effects for fasting blood glucose or lipids. Post hoc tests indicated significant increases in fasting blood glucose and triglycerides and a decrease in high-density lipoprotein cholesterol for the cannabis negative group, with no significant changes in the cannabis positive group. Rates of metabolic syndrome did not differ significantly between groups, although more cannabis negative patients had elevated waist-circumference at endpoint (p = 0.003). It may be that chronic cannabis use directly suppresses appetite, thereby preventing weight gain in users. However, other indirect effects such as dietary neglect and smoking may be contributory and could explain our findings.
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Affiliation(s)
- F Scheffler
- Department of Psychiatry, Stellenbosch University, South Africa.
| | - S Kilian
- Department of Psychiatry, Stellenbosch University, South Africa
| | - B Chiliza
- Centre for Statistical Consultation, Stellenbosch University, South Africa
| | - L Asmal
- Department of Psychiatry, Stellenbosch University, South Africa
| | - L Phahladira
- Department of Psychiatry, Stellenbosch University, South Africa
| | - S du Plessis
- Department of Psychiatry, Stellenbosch University, South Africa
| | - M Kidd
- Centre for Statistical Consultation, Stellenbosch University, South Africa
| | - R M Murray
- Department of Psychiatry, King's College, London, United Kingdom
| | - M Di Forti
- Department of Psychiatry, King's College, London, United Kingdom
| | - S Seedat
- Department of Psychiatry, Stellenbosch University, South Africa
| | - R Emsley
- Department of Psychiatry, Stellenbosch University, South Africa
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29
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Berg AO, Jørgensen KN, Nerhus M, Athanasiu L, Popejoy AB, Bettella F, Norbom LCB, Gurholt TP, Dahl SR, Andreassen OA, Djurovic S, Agartz I, Melle I. Vitamin D levels, brain volume, and genetic architecture in patients with psychosis. PLoS One 2018; 13:e0200250. [PMID: 30142216 PMCID: PMC6108467 DOI: 10.1371/journal.pone.0200250] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/18/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Lower vitamin D levels are found in people with schizophrenia and depressive disorders, and also associated with neuroimaging abnormalities such as reduced brain volume in both animals and humans. Reduced whole brain and increased ventricular volume are also systematically reported in schizophrenia. Even though vitamin D deficiency has been proposed as a risk mechanism for schizophrenia there exist no studies to date of the association between vitamin D levels and brain volume in this population. Therefore, we investigated the relationship between vitamin D levels and brain phenotypes in psychotic disorders, and assessed possible interactions with genetic variants in vitamin D receptor (VDR) and other genetic variants that play a role in vitamin D levels in the body. METHODS Our sample consisted of 83 psychosis patients and 101 healthy controls. We measured vitamin D levels as serum 25-hydroxyvitamin D. All participants were genotyped and neuroimaging conducted by structural magnetic resonance imaging. RESULTS Vitamin D levels were significantly positively associated with peripheral grey matter volume in patients (β 860.6; 95% confidence interval (CI) 333.4-1466, p < .003). A significant interaction effect of BSML marker (rs1544410) was observed to mediate the association between patient status and both white matter volume (β 23603.3; 95% CI 2732.8-48708.6, p < .05) and whole brain volume (β 46670.6, 95% CI 8817.8-93888.3, p < .04). Vitamin D did not predict ventricular volume, which rather was associated with patient status (β 4423.3, 95% CI 1583.2-7267.8p < .002) and CYP24A1 marker (rs6013897) (β 2491.5, 95% CI 269.7-4978.5, p < .04). CONCLUSIONS This is the first study of the association between vitamin D levels and brain volume in patients with psychotic disorders that takes into account possible interaction with genetic polymorphisms. The present findings warrant replication in independent samples.
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Affiliation(s)
- Akiah Ottesen Berg
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- * E-mail:
| | - Kjetil N. Jørgensen
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Mari Nerhus
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Akershus University Hospital, Division for Mental Health, Lørenskog, Norway
| | - Lavinia Athanasiu
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alice B. Popejoy
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute for Public Health Genetics, University of Washington, Seattle, Washington, United States of America
| | - Francesco Bettella
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Linn Christin Bonaventure Norbom
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Tiril P. Gurholt
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Sandra R. Dahl
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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30
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Lindgren M, Torniainen-Holm M, Härkänen T, Dickerson F, Yolken RH, Suvisaari J. The association between toxoplasma and the psychosis continuum in a general population setting. Schizophr Res 2018; 193:329-335. [PMID: 28711477 DOI: 10.1016/j.schres.2017.06.052] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 11/18/2022]
Abstract
Toxoplasma gondii infection is associated with increased risk for psychosis. However, the possible association between T. gondii and psychotic-like symptoms in the general adult population is unknown. We investigated whether T. gondii is associated with psychotic-like symptoms and psychosis diagnoses using data from Health 2000, a large cross-sectional health survey of the Finnish general population aged 30 and above. Seropositivity to toxoplasma was defined as a cutoff of 50IU/ml of IgG antibodies. Lifetime psychotic-like symptoms were identified with section G of the Composite International Diagnostic Interview, Munich version (M-CIDI). Symptoms were considered clinically relevant if they caused distress or help-seeking or there were at least three of them. Lifetime psychotic disorders were screened from the sample and were diagnosed with DSM-IV using SCID-I interview and information from medical records. All data were available for 5906 participants. We adjusted for variables related to T. gondii seropositivity (age, gender, education, region of residence, cat ownership, and C-reactive protein measuring inflammation) in regression models. We found that T. gondii seropositivity was significantly associated with clinically relevant psychotic-like symptoms (OR 1.77, p=0.001) and with the number of psychotic-like symptoms (IRR=1.55, p=0.001). The association between toxoplasma and diagnosed psychotic disorders did not reach statistical significance (OR 1.45 for schizophrenia). In a large sample representing the whole Finnish adult population, we found that serological evidence of toxoplasma infection predicted psychotic-like symptoms, independent of demographic factors and levels of C-reactive protein. Toxoplasma infection may be a risk factor for manifestation of psychotic-like symptoms.
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Affiliation(s)
- Maija Lindgren
- National Institute for Health and Welfare (THL), Mental Health Unit, Finland.
| | - Minna Torniainen-Holm
- National Institute for Health and Welfare (THL), Mental Health Unit, Finland; Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Tommi Härkänen
- National Institute for Health and Welfare (THL), Health Monitoring Unit, Finland
| | - Faith Dickerson
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jaana Suvisaari
- National Institute for Health and Welfare (THL), Mental Health Unit, Finland
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Counotte J, Drexhage HA, Wijkhuijs JM, Pot-Kolder R, Bergink V, Hoek HW, Veling W. Th17/T regulator cell balance and NK cell numbers in relation to psychosis liability and social stress reactivity. Brain Behav Immun 2018; 69:408-417. [PMID: 29289662 DOI: 10.1016/j.bbi.2017.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/21/2017] [Accepted: 12/27/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Psychotic disorders are characterized by a deranged immune system, including altered number and function of Natural Killer (NK) and T cells. Psychotic disorders arise from an interaction between genetic vulnerability and exposure to environmental risk factors. Exposure to social adversity during early life is particularly relevant to psychosis risk and is thought to increase reactivity to subsequent minor daily social stressors. Virtual reality allows controlled experimental exposure to virtual social stressors. AIM To investigate the interplay between social adversity during early life, cell numbers of NK cells and T helper subsets and social stress reactivity in relation to psychosis liability. METHODS Circulating numbers of Th1, Th2, Th17, T regulator and NK cells were determined using flow cytometry in 80 participants with low psychosis liability (46 healthy controls and 34 siblings) and 53 participants with high psychosis liability (14 ultra-high risk (UHR) patients and 39 recent-onset psychosis patients), with and without the experience of childhood trauma. We examined if cell numbers predicted subjective stress when participants were exposed to social stressors (crowdedness, hostility and being part of an ethnic minority) in a virtual reality environment. RESULTS There were no significant group differences in Th1, Th2, Th17, T regulator and NK cell numbers between groups with a high or low liability for psychosis. However, in the high psychosis liability group, childhood trauma was associated with increased Th17 cell numbers (p = 0.028). Moreover, in the high psychosis liability group increased T regulator and decreased NK cell numbers predicted stress experience during exposure to virtual social stressors (p = 0.015 and p = 0.009 for T regulator and NK cells, respectively). CONCLUSION A deranged Th17/T regulator balance and a reduced NK cell number are associated intermediate biological factors in the relation childhood trauma, psychosis liability and social stress reactivity.
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Affiliation(s)
- J Counotte
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands.
| | - H A Drexhage
- Erasmus Medical Center Rotterdam, Department of Immunology, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - J M Wijkhuijs
- Health E-Solutions, Westplein 11, 3016 BM Rotterdam, The Netherlands
| | - R Pot-Kolder
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; VU University, Department of Clinical Psychology, de Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
| | - V Bergink
- Erasmus Medical Center Rotterdam, Department of Psychiatry, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30.001, 9700 RB Groningen, The Netherlands; Columbia University, Mailman School of Public Health, Department of Epidemiology, 722 West 168th Street, NY 10032, New York, NY, USA
| | - W Veling
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30.001, 9700 RB Groningen, The Netherlands
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English JA, Lopez LM, O’Gorman A, Föcking M, Hryniewiecka M, Scaife C, Sabherwal S, Wynne K, Dicker P, Rutten BPF, Lewis G, Zammit S, Cannon M, Cagney G, Cotter DR. Blood-Based Protein Changes in Childhood Are Associated With Increased Risk for Later Psychotic Disorder: Evidence From a Nested Case-Control Study of the ALSPAC Longitudinal Birth Cohort. Schizophr Bull 2018; 44:297-306. [PMID: 29036721 PMCID: PMC5814944 DOI: 10.1093/schbul/sbx075] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The identification of early biological changes associated with the psychotic disorder (PD) is important as it may provide clues to the underlying pathophysiological mechanisms. We undertook the first proteomic profiling of blood plasma samples of children who later develop a PD. Participants were recruited from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) cohort who also participated in psychiatric assessment interviews at age 18. Protein expression levels at age 11 were compared between individuals who developed PD at age 18 (n = 37) with population-based age-matched controls (n = 38). Sixty out of 181 plasma proteins profiled were found to be differentially expressed (P < .05) in children with an outcome of the PD. Thirty-four of these proteins were found to be differentially expressed following correction for multiple comparisons. Pathway analysis implicated the complement and coagulation cascade. A second, targeted proteomic approach was used to verify these findings in age 11 plasma from subjects who reported psychotic experiences at age 18 (n = 40) in comparison to age-matched controls (n = 66). Our findings indicate that the complement and coagulation system is dysregulated in the blood during childhood before the development of the PD.
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Affiliation(s)
- Jane A English
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lorna M Lopez
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aoife O’Gorman
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Caitriona Scaife
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin (UCD), Dublin, Ireland
| | - Sophie Sabherwal
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin (UCD), Dublin, Ireland
| | - Patrick Dicker
- Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Bart P F Rutten
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Division of Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Stanley Zammit
- MRC Centre for Neuropsychiatric Genetics & Genomics, Cardiff University, Cardiff, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gerard Cagney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin (UCD), Dublin, Ireland
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
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Abstract
The interest of 5-hydroxytryptamine (5HT) for psychiatry arose originally from Gaddum's (8, 9) observation that its peripheral pharmacological actions were antagonized in a highly specific manner by a low concentration of lysergic acid diethylamide (LSD). This led to the hypothesis that the hallucinogenic action of LSD was due to its antagonism to 5HT in the central nervous system (Woolley and Shaw, 21; Gaddum, 7). However, Cerletti and Rothlin (5) subsequently found that brom-LSD, which is not a hallucinogen, was an equally potent antagonist of the peripheral actions of 5HT.
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Krivoy A, Onn R, Vilner Y, Hochman E, Weizman S, Paz A, Hess S, Sagy R, Kimhi-Nesher S, Kalter E, Friedman T, Friedman Z, Bormant G, Trommer S, Valevski A, Weizman A. Vitamin D Supplementation in Chronic Schizophrenia Patients Treated with Clozapine: A Randomized, Double-Blind, Placebo-controlled Clinical Trial. EBioMedicine 2017; 26:138-145. [PMID: 29226809 PMCID: PMC5832639 DOI: 10.1016/j.ebiom.2017.11.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While accumulating evidence suggests that vitamin D deficiency may be involved in the risk to develop schizophrenia and its outcome, there are no studies on vitamin D supplementation in this context. We sought to assess the effect of vitamin D supplementation on psychiatric, cognitive and metabolic parameters in chronic clozapine-treated schizophrenia patients. METHODS This eight-week, randomized, double-blind, placebo-controlled clinical trial, recruited schizophrenia patients who had been maintained on clozapine treatment for at least 18weeks and had low levels of vitamin D (<75nmol/l) and total PANSS scores >70 (to ascertain the presence of residual symptoms). Patients were randomly allocated to either weekly oral drops of vitamin D (14,000IU) or placebo and subsequently assessed at two-week intervals for psychosis severity, mood, cognition and metabolic profile. RESULTS Twenty four patients were randomly assigned to vitamin D (aged 39.4±9.6years, 75% males) and the other 23 patients to the placebo arm (aged 42.5±11.2years, 60.9% males). After eight weeks, the vitamin D group exhibited a significant increase in vitamin D levels (31.4 vs -0.4nmol/l, p<0.0001). There was no significant effect of vitamin D on psychotic, depressive or metabolic parameters. However, in the vitamin D group, there was a trend towards improved cognition (effect size=0.17, significance lost following Bonferroni correction). CONCLUSIONS Vitamin D supplementation was associated with a trend towards improved cognition, but did not affect psychosis, mood or metabolic status. It is possible that the robust decrease in the PANSS scores in both groups may have obscured an effect of vitamin D supplementation.
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Affiliation(s)
- Amir Krivoy
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel; Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK.
| | - Roy Onn
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Vilner
- Geha Mental Health Center, Petah-Tikva, Israel
| | - Eldar Hochman
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel
| | - Shira Weizman
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Amir Paz
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Shmuel Hess
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Roi Sagy
- Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Brill Mental Health Center, Tel-Aviv, Israel
| | - Shiri Kimhi-Nesher
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Ehud Kalter
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Tal Friedman
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | | | - Gil Bormant
- Geha Mental Health Center, Petah-Tikva, Israel
| | - Sharon Trommer
- Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Avi Valevski
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Abraham Weizman
- Geha Mental Health Center, Petah-Tikva, Israel; Sacker Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel
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Abstract
OBJECTIVES This study aimed to investigate the possible relationship between plasma concentrations of nesfatin 1 and first attack psychosis. METHODS Totally, 32 patients with the first episode psychosis and 33 randomly selected weight- and body mass index-matched healthy volunteers admitted to Mustafa Kemal University, Faculty of Medicine, Training and Research Hospital, Psychiatry outpatient clinic were included. Healthy control subjects were matched in terms of weight and body mass index (BMI). The Positive and Negative Syndrome Scale (PANNS) was applied to the patient group. The enzyme-linked immunosorbent assay (ELISA) method was used to measure plasma nesfatin 1 levels. RESULTS The mean nesfatin 1 level was lower in the patients with the first attack psychosis (0.60 ± 1.00 ng/mL) than in the control group (0.75 ± 1.07 ng/mL).However it did not reach statistical significance (t = -0.567, p = 0.573). There was no statistically significant correlation between plasma nesfatin 1 levels and total PANNS scores in the patient group (r = -0.262, p = 0.148). CONCLUSION Our study was the first to investigate the nesfatin 1 levels in patients with the first episode psychosis. Based on our study results, nesfatin 1 might be related to some central nervous system pathologies, including the severity of a psychiatric disorder; however, further large-scale studies are required to establish a conclusion (Tab. 1, Ref. 21).
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Primavera D, Manchia M, Deriu L, Tusconi M, Collu R, Scherma M, Fadda P, Fratta W, Carpiniello B. Longitudinal assessment of brain-derived neurotrophic factor in Sardinian psychotic patients (LABSP): a protocol for a prospective observational study. BMJ Open 2017; 7:e014938. [PMID: 28550022 PMCID: PMC5729982 DOI: 10.1136/bmjopen-2016-014938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Brain-derived neurotrophic factor (BDNF) plays a crucial role in neurodevelopment, synaptic plasticity and neuronal function and survival. Serum and plasma BDNF levels are moderately, but consistently, decreased in patients with schizophrenia (SCZ) compared with healthy controls. There is a lack of knowledge, however, on the temporal manifestation of this decline. Clinical, illness course and treatment factors might influence the variation of BDNF serum levels in patients with psychosis. In this context, we propose a longitudinal study of a cohort of SCZ and schizophrenic and schizoaffective disorder (SAD) Sardinian patients with the aim of disentangling the relationship between peripheral BDNF serum levels and changes of psychopathology, cognition and drug treatments. METHODS AND ANALYSIS Longitudinal assessment of BDNF in Sardinian psychotic patients (LABSP) is a 24-month observational prospective cohort study. Patients with SAD will be recruited at the Psychiatry Research Unit of the Department of Medical Science and Public Health, University of Cagliari and University of Cagliari Health Agency, Cagliari, Italy. We will collect BDNF serum levels as well as sociodemographic, psychopathological and neurocognitive measures. Structured, semistructured and self-rating assessment tools, such as the Positive and Negative Syndrome Scale for psychopathological measures and the Brief Assessment of Cognition in Schizophrenia for cognitive function, will be used. ETHICS AND DISSEMINATION This study protocol was approved by the University of Cagliari Health Agency Ethics Committee (NP2016/5491). The study will be conducted in accordance with the principles of good clinical practice, in the Declaration of Helsinki in compliance with the regulations. Participation will be voluntary and written informed consent will be obtained for each participant upon entry into the study. We plan to disseminate the results of our study through conference presentations and publication in international peer-reviewed journals. Access to raw data will be available in anonymised form upon request to the corresponding author.
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Affiliation(s)
- Diego Primavera
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Canada
| | - Luca Deriu
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Massimo Tusconi
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Collu
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Maria Scherma
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Paola Fadda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Centre of Excellence 'Neurobiology of Dependence', University of Cagliari, Cagliari, Italy
| | - Walter Fratta
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Centre of Excellence 'Neurobiology of Dependence', University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
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van der Leeuw C, Peeters S, Gronenschild E, Michielse S, Verbeek M, Menheere P, van Os J, Marcelis M. Serum S100B: A proxy marker for grey and white matter status in the absence and presence of (increased risk of) psychotic disorder? PLoS One 2017; 12:e0174752. [PMID: 28358925 PMCID: PMC5373815 DOI: 10.1371/journal.pone.0174752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/14/2017] [Indexed: 11/20/2022] Open
Abstract
S100B is a protein with dose-dependent neurotrophic and neurotoxic effects. Whether S100B in psychotic disorder mirrors pathophysiological mechanisms (which elicit exacerbation of disease) or compensatory action is unclear, as is its validity as a proxy marker for brain status. Insight may be gained by examining associations between serum S100B and indices of grey (cortical thickness (CT)) and white matter (fractional anisotropy (FA)), in relation to the absence or presence of (increased risk of) psychotic disorder. Blood samples and cerebral magnetic resonance imaging (MRI) scans were acquired in 32 patients with psychotic disorder, 44 non-psychotic siblings of patients with psychotic disorder and 26 controls. Interactions between S100B and group were examined in separate models of CT and FA measures with multilevel regression analyses weighted for number of vertices and voxels (i.e. units of volume) respectively. All analyses were adjusted for sex, age, body mass index (BMI), scan sequence, handedness and highest level of education. Neither CT nor FA was associated with S100B. There were no significant S100B × group interactions (CT: χ2 = 0.044, p = 0.978; FA: χ2 = 3.672, p = 0.159). No evidence was present for S100B as a proxy marker of grey or white matter status. The association between S100B and brain measures was not moderated by psychosis risk.
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Affiliation(s)
- Christine van der Leeuw
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
- * E-mail:
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, the Netherlands
| | - Ed Gronenschild
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Marcel Verbeek
- Departments of Neurology and Laboratory Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Paul Menheere
- Central Diagnostic Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, United Kingdom
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
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Lennox BR, Palmer-Cooper EC, Pollak T, Hainsworth J, Marks J, Jacobson L, Lang B, Fox H, Ferry B, Scoriels L, Crowley H, Jones PB, Harrison PJ, Vincent A. Prevalence and clinical characteristics of serum neuronal cell surface antibodies in first-episode psychosis: a case-control study. Lancet Psychiatry 2017; 4:42-48. [PMID: 27965002 PMCID: PMC5890880 DOI: 10.1016/s2215-0366(16)30375-3] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [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: 06/19/2016] [Revised: 10/12/2016] [Accepted: 10/24/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psychosis is a common presenting feature in antibody-mediated encephalitis, for which prompt recognition and treatment usually leads to remission. We aimed to investigate whether people with circumscribed schizophrenia-like illnesses have such antibodies-especially antibodies against the N-methyl-D-aspartate receptor (NMDAR)-more commonly than do healthy controls. METHODS We recruited patients aged 14-35 years presenting to any of 35 mental health services sites across England with first-episode psychosis, less than 6 weeks of treatment with antipsychotic medication, and a score of 4 or more on at least one selected Positive and Negative Syndrome Scale (PANSS) item. Patients and controls provided venous blood samples. We completed standardised symptom rating scales (PANSS, ACE-III, GAF) at baseline, and tested serum samples for antibodies against NMDAR, LGI1, CASPR2, the GABAA receptor, and the AMPA receptor using live cell-based assays. Treating clinicians assessed outcomes of ICD diagnosis and functioning (GAF) at 6 months. We included healthy controls from the general population, recruited as part of another study in Cambridge, UK. FINDINGS Between Feb 1, 2013, and Aug 31, 2014, we enrolled 228 patients with first-episode psychosis and 105 healthy controls. 20 (9%) of 228 patients had serum antibodies against one or more of the neuronal cell surface antibodies compared with four (4%) of 105 controls (unadjusted odds ratio 2·4, 95% CI 0·8-7·3). These associations remained non-significant when adjusted for current cigarette smoking, alcohol consumption, and illicit drug use. Seven (3%) patients had NMDAR antibodies compared with no controls (p=0·0204). The other antibodies did not differ between groups. Antibody-positive patients had lower PANSS positive, PANSS total, and catatonia scores than did antibody-negative patients. Patients had comparable scores on other PANSS items, ACE-III, and GAF at baseline, with no difference in outcomes at 6 months. INTERPRETATION Some patients with first-episode psychosis had antibodies against NMDAR that might be relevant to their illness, but did not differ from patients without NMDAR antibodies in clinical characteristics. Our study suggests that the only way to detect patients with these potentially pathogenic antibodies is to screen all patients with first-episode psychosis at first presentation. FUNDING Medical Research Council.
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Affiliation(s)
- Belinda R Lennox
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
| | | | - Thomas Pollak
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jane Hainsworth
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Jacqui Marks
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Leslie Jacobson
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Bethan Lang
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Hannah Fox
- Department of Clinical Laboratory Immunology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Berne Ferry
- Department of Clinical Laboratory Immunology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Linda Scoriels
- Department of Psychiatry, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK; Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hannah Crowley
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Peter B Jones
- Department of Psychiatry, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
| | - Paul J Harrison
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Angela Vincent
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Nerhus M, Berg AO, Kvitland LR, Dieset I, Hope S, Dahl SR, Weibell MA, Romm KL, Faerden A, Andreassen OA, Melle I. Low vitamin D is associated with negative and depressive symptoms in psychotic disorders. Schizophr Res 2016; 178:44-49. [PMID: 27595553 DOI: 10.1016/j.schres.2016.08.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 08/19/2016] [Accepted: 08/23/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are indications that low S-25(OH)D is associated with increased disease severity in psychotic disorder. Our first aim was to investigate the relations between low S-25(OH)D and positive, negative and depressive symptoms. Our second aim was to explore if associations between S-25(OH)D and symptoms were influenced by levels of inflammatory markers. METHODS Participants (N=358) with a medical history of one or more psychotic episodes were recruited. Current symptomatology was assessed by The Structured Interview for the Positive and Negative Syndrome Scaleanalyzed by a five-factor model. The Calgary Depression Scale for Schizophrenia was used to assess depression and suicidal ideation. Blood samples were analyzed for S-25(OH)D, CRP, sTNF-R1, IL-Ra and OPG. We performed bivariate correlations and multiple regression models to evaluate the effect of S-25(OH)D on the outcomes. RESULTS Low S-25(OH)D was significantly associated with negative symptoms (adjusted R2=0.113, F(6,357)=8.58, p<0.001) and with depression (adjusted R2=0.045, F(4,357)=5.233, p<0.001) when adjusting for possible confounding factors (i.e. gender, education, diagnose, hospitalization status, ethnicity, season and thyroid status). CRP was correlated with both S-25(OH)D (rho=-0.13, p=0.02) and negative symptoms (rho=0.14, p=0.01), but did not act as a mediator. The correlations between S-25(OH)D and the inflammatory markers sTNF-R1, IL-Ra and OPG were not significant. CONCLUSION There is a strong association between low S-25(OH)D and higher negative and depressive symptoms in psychotic disorders. Randomized controlled trials should be performed to investigate the effect of vitamin D supplementation as adjuvant treatment strategy in patients with prominent negative or depressive symptoms.
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Affiliation(s)
- Mari Nerhus
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Akiah O Berg
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Levi R Kvitland
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Ingrid Dieset
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Sigrun Hope
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Sandra R Dahl
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
| | - Melissa A Weibell
- Regional Center for Clinical Research in Psychosis, Psychiatric Division, Stavanger, Norway.
| | - Kristin L Romm
- Regional Centre for Early Intervention in Psychosis, Division of Mental Health and Addiction, Oslo University hospital, Norway.
| | - Ann Faerden
- Section of acute psychiatry, Division of Mental Health and Addiction, Oslo University hospital, Norway.
| | - Ole A Andreassen
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Ingrid Melle
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
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Garcia-Portilla MP, Garcia-Alvarez L, Sarramea F, Galvan G, Diaz-Mesa E, Bobes-Bascaran T, Al-Halabi S, Elizagarate E, Iglesias C, Saiz Martínez PA, Bobes J. It is feasible and effective to help patients with severe mental disorders to quit smoking: An ecological pragmatic clinical trial with transdermal nicotine patches and varenicline. Schizophr Res 2016; 176:272-280. [PMID: 27237598 DOI: 10.1016/j.schres.2016.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/06/2016] [Accepted: 05/17/2016] [Indexed: 01/22/2023]
Abstract
Despite the proven association between smoking and high rates of medical morbidity and reduced life expectancy in people with severe mental disorders (SMD), their smoking rates do not decline as they do in the general population. We carried out a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to investigate the clinical efficacy, safety and tolerability of a 12-week smoking cessation programme for patients with SMD in the community under real-world clinical conditions. Eighty-two adult outpatients with schizophrenic/bipolar disorder smoking ≥15 cigarettes/day were assigned by shared decision between doctors and patients to transdermal nicotine patches (TNP) [36(46.2%)] or varenicline [39(50%)]. Short-term efficacy: The 12-week 7-day smoking cessation (self-reported cigarettes/day=0 and breath carbon monoxide levels≤9ppm) prevalence was 49.3%, without statistically significant differences between medications (TNP 50.0% vs varenicline 48.6%, chi-square=0.015, p=1.000). Long-term efficacy: At weeks 24 and 36, 41.3 and 37.3% of patients were abstinent, with no statistically significant differences between treatments. Safety and Tolerability: no patients made suicide attempts/required hospitalization. There was no worsening on the psychometric scales. Patients significantly increased weight [TNP 1.1(2.8) vs varenicline 2.5(3.3), p=0.063], without significant changes in vital signs/laboratory results, except significant decreases in alkaline phosphatase and low-density lipoprotein-cholesterol levels in the varenicline group. Patients under varenicline more frequently presented nausea/vomiting (p<0.0005), patients under TNP experienced skin reactions more frequently (p=0.002). Three patients under varenicline had elevated liver enzymes. In conclusion, we have demonstrated that in real-world clinical settings it is feasible and safe to help patients with stabilized severe mental disorders to quit smoking.
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Affiliation(s)
- Maria P Garcia-Portilla
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain.
| | | | - Fernando Sarramea
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain; UGC Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Gonzalo Galvan
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain
| | - Eva Diaz-Mesa
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain
| | - Teresa Bobes-Bascaran
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 46010, Valencia, Spain
| | - Susana Al-Halabi
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
| | - Edorta Elizagarate
- Unidad de Psicosis Refractarias, Hospital Psiquiátrico de Álava, 01006 Vitoria, Spain
| | - Celso Iglesias
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
| | - Pilar A Saiz Martínez
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain
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41
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Föcking M, Dicker P, Lopez LM, Cannon M, Schäfer MR, McGorry PD, Smesny S, Cotter DR, Amminger GP. Differential expression of the inflammation marker IL12p40 in the at-risk mental state for psychosis: a predictor of transition to psychotic disorder? BMC Psychiatry 2016; 16:326. [PMID: 27650124 PMCID: PMC5029014 DOI: 10.1186/s12888-016-1039-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/09/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The identification of biomarkers of transition from the at-risk mental state (ARMS) to psychotic disorder is important because early treatment of psychosis is associated with improved outcome. Increasing evidence points to an inflammatory contribution to psychosis. We questioned whether raised levels of plasma inflammatory markers predict transition from ARMS to psychotic disorder and whether any such predictors could be reduced by omega-3 (ω-3) polyunsaturated fatty acids (PUFAs). METHODS We measured the levels of 40 neuroinflammation biomarkers using a commercially available immunoassay kit. Firstly, we compared inflammatory markers in subjects in the ARMS who transitioned to psychotic disorder (n = 11) compared to subjects who did not (n = 28). Then we compared inflammatory markers in all subjects before and after ω-3 PUFA treatment (n = 40). RESULTS Our data provides preliminary evidence that elevations in the baseline plasma levels of the inflammatory marker IL12/IL23p40 are associated with transition from ARMS to psychotic disorder. IL12/IL23p40 levels did not change following 12 weeks administration of ω-3 PUFAs. These findings provide evidence that elevated plasma IL12/IL23p40 is a potential biomarker of increased risk for transition to psychotic disorder. CONCLUSION Further studies are required to confirm and extend this finding. Our results do not provide support for the possibility that administration of ω-3 PUFAs act to reduced transition to psychotic disorder by reducing blood levels of IL12/IL23p40. TRIAL REGISTRATION ClinicalTrials.gov, a service of the U.S. National Institutes of Health, Identifier: NCT00396643 , last updated December 20, 2007. Retrospectively registered.
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Affiliation(s)
- Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Patrick Dicker
- Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lorna M. Lopez
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - Miriam R. Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne Centre for Youth Mental Health and Melbourne Health, Parkville, VIC Australia
| | - Patrick D. McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne Centre for Youth Mental Health and Melbourne Health, Parkville, VIC Australia
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - David R. Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - G. Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne Centre for Youth Mental Health and Melbourne Health, Parkville, VIC Australia
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42
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Baumann PS, Griffa A, Fournier M, Golay P, Ferrari C, Alameda L, Cuenod M, Thiran JP, Hagmann P, Do KQ, Conus P. Impaired fornix-hippocampus integrity is linked to peripheral glutathione peroxidase in early psychosis. Transl Psychiatry 2016; 6:e859. [PMID: 27459724 PMCID: PMC5545707 DOI: 10.1038/tp.2016.117] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/17/2016] [Accepted: 04/15/2016] [Indexed: 12/19/2022] Open
Abstract
Several lines of evidence implicate the fornix-hippocampus circuit in schizophrenia. In early-phase psychosis, this circuit has not been extensively investigated and the underlying mechanisms affecting the circuit are unknown. The hippocampus and fornix are vulnerable to oxidative stress at peripuberty in a glutathione (GSH)-deficient animal model. The purposes of the current study were to assess the integrity of the fornix-hippocampus circuit in early-psychosis patients (EP), and to study its relationship with peripheral redox markers. Diffusion spectrum imaging and T1-weighted magnetic resonance imaging (MRI) were used to assess the fornix and hippocampus in 42 EP patients compared with 42 gender- and age-matched healthy controls. Generalized fractional anisotropy (gFA) and volumetric properties were used to measure fornix and hippocampal integrity, respectively. Correlation analysis was used to quantify the relationship of gFA in the fornix and hippocampal volume, with blood GSH levels and glutathione peroxidase (GPx) activity. Patients compared with controls exhibited lower gFA in the fornix as well as smaller volume in the hippocampus. In EP, but not in controls, smaller hippocampal volume was associated with high GPx activity. Disruption of the fornix-hippocampus circuit is already present in the early stages of psychosis. Higher blood GPx activity is associated with smaller hippocampal volume, which may support a role of oxidative stress in disease mechanisms.
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Affiliation(s)
- P S Baumann
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - A Griffa
- Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - M Fournier
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - P Golay
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ferrari
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - L Alameda
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - M Cuenod
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - J-P Thiran
- Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - P Hagmann
- Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - K Q Do
- Department of Psychiatry, Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - P Conus
- Department of Psychiatry, Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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van den Oord EJCG, Clark SL, Xie LY, Shabalin AA, Dozmorov MG, Kumar G, Vladimirov VI, Magnusson PKE, Aberg KA. A Whole Methylome CpG-SNP Association Study of Psychosis in Blood and Brain Tissue. Schizophr Bull 2016; 42:1018-26. [PMID: 26656881 PMCID: PMC4903046 DOI: 10.1093/schbul/sbv182] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 11/14/2022]
Abstract
Mutated CpG sites (CpG-SNPs) are potential hotspots for human diseases because in addition to the sequence variation they may show individual differences in DNA methylation. We performed methylome-wide association studies (MWAS) to test whether methylation differences at those sites were associated with schizophrenia. We assayed all common CpG-SNPs with methyl-CpG binding domain protein-enriched genome sequencing (MBD-seq) using DNA extracted from 1408 blood samples and 66 postmortem brain samples (BA10) of schizophrenia cases and controls. Seven CpG-SNPs passed our FDR threshold of 0.1 in the blood MWAS. Of the CpG-SNPs methylated in brain, 94% were also methylated in blood. This significantly exceeded the 46.2% overlap expected by chance (P-value < 1.0×10(-8)) and justified replicating findings from blood in brain tissue. CpG-SNP rs3796293 in IL1RAP replicated (P-value = .003) with the same direction of effects. This site was further validated through targeted bisulfite pyrosequencing in 736 independent case-control blood samples (P-value < 9.5×10(-4)). Our top result in the brain MWAS (P-value = 8.8×10(-7)) was CpG-SNP rs16872141 located in the potential promoter of ENC1. Overall, our results suggested that CpG-SNP methylation may reflect effects of environmental insults and can provide biomarkers in blood that could potentially improve disease management.
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Affiliation(s)
- Edwin J C G van den Oord
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA;
| | - Shaunna L Clark
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA
| | - Lin Ying Xie
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA
| | - Andrey A Shabalin
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA
| | - Mikhail G Dozmorov
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
| | - Gaurav Kumar
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA
| | - Vladimir I Vladimirov
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA; Lieber Institute for Brain Development, Johns Hopkins University, Baltimore, MD
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Karolina A Aberg
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA
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Lee LHN, White RF, Barr AM, Honer WG, Procyshyn RM. Elevated clozapine plasma concentration secondary to a urinary tract infection: proposed mechanisms. J Psychiatry Neurosci 2016; 41:E67-8. [PMID: 27332768 PMCID: PMC4915939 DOI: 10.1503/jpn.150156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Lik Hang N Lee
- From the Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (Lee, Barr); the Department of Psychiatry, University of British Columbia (White, Honer, Procyshyn); the B.C. Psychosis Program, UBC Hospital (White, Honer, Procyshyn); and the British Columbia Mental Health and Addictions Research Institute (Barr, Honer, Procyshyn), Vancouver, B.C., Canada
| | - Randall F White
- From the Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (Lee, Barr); the Department of Psychiatry, University of British Columbia (White, Honer, Procyshyn); the B.C. Psychosis Program, UBC Hospital (White, Honer, Procyshyn); and the British Columbia Mental Health and Addictions Research Institute (Barr, Honer, Procyshyn), Vancouver, B.C., Canada
| | - Alasdair M Barr
- From the Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (Lee, Barr); the Department of Psychiatry, University of British Columbia (White, Honer, Procyshyn); the B.C. Psychosis Program, UBC Hospital (White, Honer, Procyshyn); and the British Columbia Mental Health and Addictions Research Institute (Barr, Honer, Procyshyn), Vancouver, B.C., Canada
| | - William G Honer
- From the Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (Lee, Barr); the Department of Psychiatry, University of British Columbia (White, Honer, Procyshyn); the B.C. Psychosis Program, UBC Hospital (White, Honer, Procyshyn); and the British Columbia Mental Health and Addictions Research Institute (Barr, Honer, Procyshyn), Vancouver, B.C., Canada
| | - Ric M Procyshyn
- From the Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia (Lee, Barr); the Department of Psychiatry, University of British Columbia (White, Honer, Procyshyn); the B.C. Psychosis Program, UBC Hospital (White, Honer, Procyshyn); and the British Columbia Mental Health and Addictions Research Institute (Barr, Honer, Procyshyn), Vancouver, B.C., Canada
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Fusté M, Meléndez-Pérez I, Villalta-Gil V, Pinacho R, Villalmanzo N, Cardoner N, Menchón JM, Haro JM, Soriano-Mas C, Ramos B. Specificity proteins 1 and 4, hippocampal volume and first-episode psychosis. Br J Psychiatry 2016; 208:591-2. [PMID: 26541691 DOI: 10.1192/bjp.bp.114.152140] [Citation(s) in RCA: 2] [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] [Received: 05/30/2014] [Accepted: 11/03/2014] [Indexed: 11/23/2022]
Abstract
We assessed specificity protein 1 (SP1) and 4 (SP4) transcription factor levels in peripheral blood mononuclear cells and conducted a voxel-based morphometry analysis on brain structural magnetic resonance images from 11 patients with first-episode psychosis and 14 healthy controls. We found lower SP1 and SP4 levels in patients, which correlated positively with right hippocampal volume. These results extend previous evidence showing that such transcription factors may constitute a molecular pathway to the development of psychosis.
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Affiliation(s)
- Montserrat Fusté
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Iria Meléndez-Pérez
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Victoria Villalta-Gil
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Raquel Pinacho
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Núria Villalmanzo
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Narcís Cardoner
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - José M Menchón
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Josep Maria Haro
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Carles Soriano-Mas
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
| | - Belén Ramos
- Montserrat Fusté, MBBS, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Iria Meléndez-Pérez, MSc, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Victoria Villalta-Gil, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain and Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Raquel Pinacho, MSc, Núria Villalmanzo, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Narcís Cardoner, MD, PhD, José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Josep Maria Haro, MD, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain; Carles Soriano-Mas, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, CIBERSAM and Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain; Belén Ramos, PhD, Unitat de recerca, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
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Lally J, Gardner-Sood P, Firdosi M, Iyegbe C, Stubbs B, Greenwood K, Murray R, Smith S, Howes O, Gaughran F. Clinical correlates of vitamin D deficiency in established psychosis. BMC Psychiatry 2016; 16:76. [PMID: 27000113 PMCID: PMC4802895 DOI: 10.1186/s12888-016-0780-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 03/11/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Suboptimal vitamin D levels have been identified in populations with psychotic disorders. We sought to explore the relationship between vitamin D deficiency, clinical characteristics and cardiovascular disease risk factors among people with established psychosis. METHODS Vitamin D levels were measured in 324 community dwelling individuals in England with established psychotic disorders, along with measures of mental health, cardiovascular risk and lifestyle choices. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25-OHD) levels below 10 ng/ml (equivalent to <25 nmol/L) and "sufficient" Vitamin D as above 30 ng/ml (>50 nmol/L). RESULTS The mean 25-OHD serum level was 12.4 (SD 7.3) ng/ml, (range 4.0-51.7 ng/ml). Forty nine percent (n = 158) were vitamin D deficient, with only 14 % (n = 45) meeting criteria for sufficiency. Accounting for age, gender, ethnicity and season of sampling, serum 25-OHD levels were negatively correlated with waist circumference (r = -0.220, p < 0.002), triglycerides (r = -0.160, p = 0.024), total cholesterol (r = -0.144, p = 0.043), fasting glucose (r = -0.191, p = 0.007), HbA1c (r = -0.183, p = 0.01), and serum CRP levels (r = -0.211, p = 0.003) and were linked to the presence of metabolic syndrome. CONCLUSIONS This is the largest cross sectional study of serum 25-OHD levels in community dwelling individuals with established psychosis, indicating a high level of vitamin D deficiency. Lower vitamin D levels are associated with increased cardiovascular disease risk factors and in particular metabolic syndrome. Further research is needed to define appropriate protocols for vitamin D testing and supplementation in practice to see if this can improve cardiovascular disease risk. TRIAL REGISTRATION ISRCTN number is ISRCTN58667926 Date of registration: 23/04/2010.
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Affiliation(s)
- J. Lally
- />Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, SE5 8AF UK
- />National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - P. Gardner-Sood
- />Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, SE5 8AF UK
| | - M. Firdosi
- />South London and Maudsley NHS Foundation Trust, London, UK
| | - C. Iyegbe
- />Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, SE5 8AF UK
| | - B. Stubbs
- />Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- />Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - K. Greenwood
- />Honorary Senior Research Fellow, School of Psychology, University of Sussex, Brighton and Early Intervention in Psychosis Service, Sussex Partnership NHS Foundation Trust, West Sussex, UK
| | - R. Murray
- />Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London and Honorary Consultant, National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - S. Smith
- />Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London and Honorary Consultant, National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - O. Howes
- />Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, SE5 8AF UK
- />Department of Psychosis Studies, MRC Clinical Sciences Centre, Imperial College- Hammersmith Hospital Campus, London, W12 0NN, UK, London, UK
| | - F. Gaughran
- />Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, SE5 8AF UK
- />National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
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Češková E. [Psychiatry in everyday life]. Cas Lek Cesk 2016; 155:40-42. [PMID: 27481201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Severe mental disorders including its main representative schizophrenia are chronic lifelong diseases. Most patients like those with somatic disease can live in the society under certain conditions as continuous psychopharmacotherapy and availability of community services. Similarly as in somatic medicine a great attentions is devoted to the individualized treatment.Psychotic disorders have some specific features, like lack of insight associated with poor adherence. Nowadays we have a possibility of an objective adherence evaluation by plasma levels measurement and the depots, long-action injections of antipsychotics (including the second generation antipsychotics), are available. Unfortunately this modern approach is restricted by insurance companies.In spite of the fact that therapeutic drug monitoring is an advantageous tool for treatment optimization this interdisciplinary service is in many faculty and regional hospitals not provided. Providers of health care should realise that accessibility of some services and medication could reduce the danger of untreated psychosis.
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Ota VK, Noto C, Santoro ML, Spindola LM, Gouvea ES, Carvalho CM, Santos CM, Xavier G, Higuchi CH, Yonamine C, Moretti PN, Abílio VC, Hayashi MAF, Brietzke E, Gadelha A, Cordeiro Q, Bressan RA, Belangero SI. Increased expression of NDEL1 and MBP genes in the peripheral blood of antipsychotic-naïve patients with first-episode psychosis. Eur Neuropsychopharmacol 2015; 25:2416-25. [PMID: 26476704 DOI: 10.1016/j.euroneuro.2015.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/12/2015] [Accepted: 09/24/2015] [Indexed: 01/22/2023]
Abstract
Schizophrenia is a multifactorial neurodevelopmental disorder with high heritability. First-episode psychosis (FEP) is a critical period for determining the disease prognosis and is especially helpful for identifying potential biomarkers associated with the onset and progression of the disorder. We investigated the mRNA expression of 12 schizophrenia-related genes in the blood of antipsychotic-naïve FEP patients (N=73) and healthy controls (N=73). To evaluate the influences of antipsychotic treatment and progression of the disorder, we compared the gene expression within patients before and after two months of treatment with risperidone (N=64). We observed a significantly increased myelin basic protein (MBP) and nuclear distribution protein nudE-like 1 (NDEL1) mRNA levels in FEP patients compared with controls. Comparing FEP before and after risperidone treatment, no significant differences were identified; however; a trend of relatively low NDEL1 expression was observed after risperidone treatment. Animals chronically treated with saline or risperidone exhibited no significant change in Ndel1 expression levels in the blood or the prefrontal cortex (PFC), suggesting that the trend of low NDEL1 expression observed in FEP patients after treatment is likely due to factors other than risperidone treatment (i.e., disease progression). In addition to the recognized association with schizophrenia, MBP and NDEL1 gene products also play an essential role in the functions that are deregulated in schizophrenia, such as neurodevelopment. Our data strengthen the importance of these biological processes in psychotic disorders, indicating that these changes can be detected peripherally and potentially represent putative novel blood biomarkers of susceptibility and disorder progression.
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Affiliation(s)
- Vanessa Kiyomi Ota
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Cristiano Noto
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil; Department of Psychiatry of Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), Brazil
| | - Marcos Leite Santoro
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil
| | - Leticia Maria Spindola
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Eduardo Sauerbronn Gouvea
- Department of Psychiatry of UNIFESP, Brazil; Department of Psychiatry of Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), Brazil
| | - Carolina Muniz Carvalho
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil
| | - Camila Maurício Santos
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Gabriela Xavier
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil
| | - Cinthia Hiroko Higuchi
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Camila Yonamine
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Pharmacology of UNIFESP, Brazil
| | - Patricia Natalia Moretti
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Vanessa Costhek Abílio
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil; Department of Pharmacology of UNIFESP, Brazil
| | - Mirian Akemi F Hayashi
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Pharmacology of UNIFESP, Brazil
| | - Elisa Brietzke
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Ary Gadelha
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry of UNIFESP, Brazil; Department of Psychiatry of Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), Brazil
| | - Rodrigo Affonseca Bressan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil
| | - Sintia Iole Belangero
- Genetics Division of Department of Morphology and Genetics of Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences of UNIFESP, Brazil; Department of Psychiatry of UNIFESP, Brazil.
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Petrikis P, Tigas S, Tzallas AT, Papadopoulos I, Skapinakis P, Mavreas V. Parameters of glucose and lipid metabolism at the fasted state in drug-naïve first-episode patients with psychosis: Evidence for insulin resistance. Psychiatry Res 2015; 229:901-4. [PMID: 26279127 DOI: 10.1016/j.psychres.2015.07.041] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 06/03/2015] [Accepted: 07/12/2015] [Indexed: 11/16/2022]
Abstract
Diabetes and dyslipidemia are common in patients with psychosis; this association may be partly related to adverse metabolic effects of antipsychotic medications. We assessed glucose and lipid metabolism during the fasted state in drug-naïve patients with psychosis. Fasting serum concentrations of total cholesterol, triglycerides, high density lipoprotein (HDL), glucose, insulin, connecting peptide (C-peptide), homeostatic model assessment index (HOMA-IR), glycated hemoglobin (HbA1C) and serum cortisol were compared between a group of 40 newly diagnosed drug-naïve, first-episode patients with psychosis and a group of 40 healthy controls, matched for age, sex and BMI. Total cholesterol, triglycerides and fasting glucose levels were similar, whereas insulin and C-peptide levels were higher and HDL marginally lower in the patients' group compared to those in healthy controls. Drug-naïve patients with psychosis were more insulin resistant (as assessed by the HOMA-R index) compared to healthy controls. Serum cortisol did not differ between the two groups. There is evidence that drug-naïve, first-episode patients with psychosis are more insulin resistant compared to healthy controls.
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Affiliation(s)
- Petros Petrikis
- Department of Psychiatry, Medical School, University of Ioannina, P.O. Box 1186, 45110 Ioannina, Greece.
| | - Stelios Tigas
- Department of Endocrinology, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Alexandros T Tzallas
- Department of Computer Engineering, School of Applied Technology, Technological Educational Institute of Epirus, 47100 Arta, Greece
| | - Ioannis Papadopoulos
- Department of Psychiatry, Medical School, University of Ioannina, P.O. Box 1186, 45110 Ioannina, Greece
| | - Petros Skapinakis
- Department of Psychiatry, Medical School, University of Ioannina, P.O. Box 1186, 45110 Ioannina, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, Medical School, University of Ioannina, P.O. Box 1186, 45110 Ioannina, Greece
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Goldstein JM, Lancaster K, Longenecker JM, Abbs B, Holsen LM, Cherkerzian S, Whitfield-Gabrieli S, Makris N, Tsuang MT, Buka SL, Seidman LJ, Klibanski A. Sex differences, hormones, and fMRI stress response circuitry deficits in psychoses. Psychiatry Res 2015; 232:226-36. [PMID: 25914141 PMCID: PMC4439265 DOI: 10.1016/j.pscychresns.2015.03.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 02/05/2015] [Accepted: 03/23/2015] [Indexed: 11/20/2022]
Abstract
Response to stress is dysregulated in psychosis (PSY). fMRI studies showed hyperactivity in hypothalamus (HYPO), hippocampus (HIPP), amygdala (AMYG), anterior cingulate (ACC), orbital and medial prefrontal (OFC; mPFC) cortices, with some studies reporting sex differences. We predicted abnormal steroid hormone levels in PSY would be associated with sex differences in hyperactivity in HYPO, AMYG, and HIPP, and hypoactivity in PFC and ACC, with more severe deficits in men. We studied 32 PSY cases (50.0% women) and 39 controls (43.6% women) using a novel visual stress challenge while collecting blood. PSY males showed BOLD hyperactivity across all hypothesized regions, including HYPO and ACC by FWE-correction. Females showed hyperactivity in HIPP and AMYG and hypoactivity in OFC and mPFC, the latter FWE-corrected. Interaction of group by sex was significant in mPFC (F = 7.00, p = 0.01), with PSY females exhibiting the lowest activity. Male hyperactivity in HYPO and ACC was significantly associated with hypercortisolemia post-stress challenge, and mPFC with low androgens. Steroid hormones and neural activity were dissociated in PSY women. Findings suggest disruptions in neural circuitry-hormone associations in response to stress are sex-dependent in psychosis, particularly in prefrontal cortex.
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Affiliation(s)
- Jill M Goldstein
- Connors Center for Women׳s Health and Gender Biology, Division of Women׳s Health, Brigham and Women׳s Hospital, Boston, MA, USA; Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA; Division of Psychiatric Neuroscience, Athinoula A. Martinos Center, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Katie Lancaster
- Connors Center for Women׳s Health and Gender Biology, Division of Women׳s Health, Brigham and Women׳s Hospital, Boston, MA, USA.
| | - Julia M Longenecker
- Connors Center for Women׳s Health and Gender Biology, Division of Women׳s Health, Brigham and Women׳s Hospital, Boston, MA, USA.
| | - Brandon Abbs
- Connors Center for Women׳s Health and Gender Biology, Division of Women׳s Health, Brigham and Women׳s Hospital, Boston, MA, USA.
| | - Laura M Holsen
- Connors Center for Women׳s Health and Gender Biology, Division of Women׳s Health, Brigham and Women׳s Hospital, Boston, MA, USA; Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA; Division of Psychiatric Neuroscience, Athinoula A. Martinos Center, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Sara Cherkerzian
- Connors Center for Women׳s Health and Gender Biology, Division of Women׳s Health, Brigham and Women׳s Hospital, Boston, MA, USA.
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Nicolas Makris
- Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA; Division of Psychiatric Neuroscience, Athinoula A. Martinos Center, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Ming T Tsuang
- Center for Behavior Genomics, Department of Psychiatry, University of California at San Diego, San Diego, CA, USA.
| | - Stephen L Buka
- Department of Community Health, Brown University, Providence, RI, USA.
| | - Larry J Seidman
- Division of Psychiatric Neuroscience, Athinoula A. Martinos Center, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Division of Public Psychiatry, Massachusetts Mental Health Center and Harvard Medical School, Boston, MA, USA.
| | - Anne Klibanski
- Department of Medicine, Harvard Medical School, Boston, MA, USA; Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
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