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Yang K, Hasegawa Y, Bhattarai JP, Hua J, Dower M, Etyemez S, Prasad N, Duvall L, Paez A, Smith A, Wang Y, Zhang YF, Lane AP, Ishizuka K, Kamath V, Ma M, Kamiya A, Sawa A. Inflammation-related pathology in the olfactory epithelium: its impact on the olfactory system in psychotic disorders. Mol Psychiatry 2024:10.1038/s41380-024-02425-8. [PMID: 38321120 DOI: 10.1038/s41380-024-02425-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 02/08/2024]
Abstract
Smell deficits and neurobiological changes in the olfactory bulb (OB) and olfactory epithelium (OE) have been observed in schizophrenia and related disorders. The OE is the most peripheral olfactory system located outside the cranium, and is connected with the brain via direct neuronal projections to the OB. Nevertheless, it is unknown whether and how a disturbance of the OE affects the OB in schizophrenia and related disorders. Addressing this gap would be the first step in studying the impact of OE pathology in the disease pathophysiology in the brain. In this cross-species study, we observed that chronic, local OE inflammation with a set of upregulated genes in an inducible olfactory inflammation (IOI) mouse model led to a volume reduction, layer structure changes, and alterations of neuron functionality in the OB. Furthermore, IOI model also displayed behavioral deficits relevant to negative symptoms (avolition) in parallel to smell deficits. In first episode psychosis (FEP) patients, we observed a significant alteration in immune/inflammation-related molecular signatures in olfactory neuronal cells (ONCs) enriched from biopsied OE and a significant reduction in the OB volume, compared with those of healthy controls (HC). The increased expression of immune/inflammation-related molecules in ONCs was significantly correlated to the OB volume reduction in FEP patients, but no correlation was found in HCs. Moreover, the increased expression of human orthologues of the IOI genes in ONCs was significantly correlated with the OB volume reduction in FEP, but not in HCs. Together, our study implies a potential mechanism of the OE-OB pathology in patients with psychotic disorders (schizophrenia and related disorders). We hope that this mechanism may have a cross-disease implication, including COVID-19-elicited mental conditions that include smell deficits.
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Affiliation(s)
- Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yuto Hasegawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janardhan P Bhattarai
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jun Hua
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Milan Dower
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Semra Etyemez
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neal Prasad
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lauren Duvall
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adrian Paez
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Amy Smith
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yingqi Wang
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Yun-Feng Zhang
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Andrew P Lane
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Minghong Ma
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Atsushi Kamiya
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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2
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Yang K, Hasegawa Y, Bhattarai JP, Hua J, Dower M, Etyemez S, Prasad N, Duvall L, Paez A, Smith A, Wang Y, Zhang YF, Lane AP, Ishizuka K, Kamath V, Ma M, Kamiya A, Sawa A. Inflammation-related pathology in the olfactory epithelium: its impact on the olfactory system in psychotic disorders. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2022.09.23.509224. [PMID: 36203543 PMCID: PMC9536041 DOI: 10.1101/2022.09.23.509224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Smell deficits and neurobiological changes in the olfactory bulb (OB) and olfactory epithelium (OE) have been observed in schizophrenia and related disorders. The OE is the most peripheral olfactory system located outside the cranium, and is connected with the brain via direct neuronal projections to the OB. Nevertheless, it is unknown whether and how a disturbance of the OE affects the OB in schizophrenia and related disorders. Addressing this gap would be the first step in studying the impact of OE pathology in the disease pathophysiology in the brain. In this cross-species study, we observed that chronic, local OE inflammation with a set of upregulated genes in an inducible olfactory inflammation (IOI) mouse model led to a volume reduction, layer structure changes, and alterations of neuron functionality in the OB. Furthermore, IOI model also displayed behavioral deficits relevant to negative symptoms (avolition) in parallel to smell deficits. In first episode psychosis (FEP) patients, we observed a significant alteration in immune/inflammation-related molecular signatures in olfactory neuronal cells (ONCs) enriched from biopsied OE and a significant reduction in the OB volume, compared with those of healthy controls (HC). The increased expression of immune/inflammation-related molecules in ONCs was significantly correlated to the OB volume reduction in FEP patients, but no correlation was found in HCs. Moreover, the increased expression of human orthologues of the IOI genes in ONCs was significantly correlated with the OB volume reduction in FEP, but not in HCs. Together, our study implies a potential mechanism of the OE-OB pathology in patients with psychotic disorders (schizophrenia and related disorders). We hope that this mechanism may have a cross-disease implication, including COVID-19-elicited mental conditions that include smell deficits.
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3
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Yang K, Ayala-Grosso C, Bhattarai JP, Sheriff A, Takahashi T, Cristino AS, Zelano C, Ma M. Unraveling the Link between Olfactory Deficits and Neuropsychiatric Disorders. J Neurosci 2023; 43:7501-7510. [PMID: 37940584 PMCID: PMC10634556 DOI: 10.1523/jneurosci.1380-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 11/10/2023] Open
Abstract
Smell loss has caught public attention during the recent COVID-19 pandemic. Research on olfactory function in health and disease gains new momentum. Smell deficits have long been recognized as an early clinical sign associated with neuropsychiatric disorders. Here we review research on the associations between olfactory deficits and neuropathological conditions, focusing on recent progress in four areas: (1) human clinical studies of the correlations between smell deficits and neuropsychiatric disorders; (2) development of olfactory mucosa-derived tissue and cell models for studying the molecular pathologic mechanisms; (3) recent findings in brain imaging studies of structural and functional connectivity changes in olfactory pathways in neuropsychiatric disorders; and (4) application of preclinical animal models to validate and extend the findings from human subjects. Together, these studies have provided strong evidence of the link between the olfactory system and neuropsychiatric disorders, highlighting the relevance of deepening our understanding of the role of the olfactory system in pathophysiological processes. Following the lead of studies reviewed here, future research in this field may open the door to the early detection of neuropsychiatric disorders, personalized treatment approaches, and potential therapeutic interventions through nasal administration techniques, such as nasal brush or nasal spray.
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Affiliation(s)
- Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
| | - Carlos Ayala-Grosso
- Unit of Cellular Therapy, Centre of Experimental Medicine, Instituto Venezolano de Investigaciones Cientificas, Caracas, 1020-A, Venezuela
- Unit of Advanced Therapies, Instituto Distrital de Ciencia Biotecnología e Innovación en Salud, Bogotá, Colombia 111-611
| | - Janardhan P Bhattarai
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Andrew Sheriff
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, 930-0194, Japan
| | - Alexandre S Cristino
- Griffith Institute for Drug Discovery, Griffith University, Brisbane, Queensland 4111, Australia
| | - Christina Zelano
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611
| | - Minghong Ma
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
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4
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Bhattarai JP, Etyemez S, Jaaro-Peled H, Janke E, Leon Tolosa UD, Kamiya A, Gottfried JA, Sawa A, Ma M. Olfactory modulation of the medial prefrontal cortex circuitry: Implications for social cognition. Semin Cell Dev Biol 2022; 129:31-39. [PMID: 33975755 PMCID: PMC8573060 DOI: 10.1016/j.semcdb.2021.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
Olfactory dysfunction is manifested in a wide range of neurological and psychiatric diseases, and often emerges prior to the onset of more classical symptoms and signs. From a behavioral perspective, olfactory deficits typically arise in conjunction with impairments of cognition, motivation, memory, and emotion. However, a conceptual framework for explaining the impact of olfactory processing on higher brain functions in health and disease remains lacking. Here we aim to provide circuit-level insights into this question by synthesizing recent advances in olfactory network connectivity with other cortical brain regions such as the prefrontal cortex. We will focus on social cognition as a representative model for exploring and critically evaluating the relationship between olfactory cortices and higher-order cortical regions in rodent models. Although rodents do not recapitulate all dimensions of human social cognition, they have experimentally accessible neural circuits and well-established behavioral tests for social motivation, memory/recognition, and hierarchy, which can be extrapolated to other species including humans. In particular, the medial prefrontal cortex (mPFC) has been recognized as a key brain region in mediating social cognition in both rodents and humans. This review will highlight the underappreciated connectivity, both anatomical and functional, between the olfactory system and mPFC circuitry, which together provide a neural substrate for olfactory modulation of social cognition and social behaviors. We will provide future perspectives on the functional investigation of the olfactory-mPFC circuit in rodent models and discuss how to translate such animal research to human studies.
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Affiliation(s)
- Janardhan P Bhattarai
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Semra Etyemez
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Hanna Jaaro-Peled
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Emma Janke
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Usuy D Leon Tolosa
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Atsushi Kamiya
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jay A Gottfried
- Department of Psychology, University of Pennsylvania, School of Arts and Sciences, Philadelphia, PA 19104, USA; Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Akira Sawa
- Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, MD 21287, USA; Departments of Neuroscience, Biomedical Engineering, and Genetic Medicine, John Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
| | - Minghong Ma
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
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5
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Olfactory impairment in psychiatric disorders: Does nasal inflammation impact disease psychophysiology? Transl Psychiatry 2022; 12:314. [PMID: 35927242 PMCID: PMC9352903 DOI: 10.1038/s41398-022-02081-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022] Open
Abstract
Olfactory impairments contribute to the psychopathology of mental illnesses such as schizophrenia and depression. Recent neuroscience research has shed light on the previously underappreciated olfactory neural circuits involved in regulation of higher brain functions. Although environmental factors such as air pollutants and respiratory viral infections are known to contribute to the risk for psychiatric disorders, the role of nasal inflammation in neurobehavioral outcomes and disease pathophysiology remains poorly understood. Here, we will first provide an overview of published findings on the impact of nasal inflammation in the olfactory system. We will then summarize clinical studies on olfactory impairments in schizophrenia and depression, followed by preclinical evidence on the neurobehavioral outcomes produced by olfactory dysfunction. Lastly, we will discuss the potential impact of nasal inflammation on brain development and function, as well as how we can address the role of nasal inflammation in the pathophysiological mechanisms underlying psychiatric disorders. Considering the current outbreak of Coronavirus Disease 2019 (COVID-19), which often causes nasal inflammation and serious adverse effects for olfactory function that might result in long-lasting neuropsychiatric sequelae, this line of research is particularly critical to understanding of the potential significance of nasal inflammation in the pathophysiology of psychiatric disorders.
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6
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Nasal Microbiota, Olfactory Health, Neurological Disorders and Aging—A Review. Microorganisms 2022; 10:microorganisms10071405. [PMID: 35889124 PMCID: PMC9320618 DOI: 10.3390/microorganisms10071405] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/07/2023] Open
Abstract
The nasal region is one of the distinct environments for the survival of various microbiota. The human microbial niche begins to inhabit the human body right from birth, and the microbiota survive as commensals or opportunistic pathogens throughout the life of humans in their bodies in various habitats. These microbial communities help to maintain a healthy microenvironment by preventing the attack of pathogens and being involved in immune regulation. Any dysbiosis of microbiota residing in the mucosal surfaces, such as the nasal passages, guts, and genital regions, causes immune modulation and severe infections. The coexistence of microorganisms in the mucosal layers of respiratory passage, resulting in infections due to their co-abundance and interactions, and the background molecular mechanisms responsible for such interactions, need to be considered for investigation. Additional clinical evaluations can explain the interactions among the nasal microbiota, nasal dysbiosis and neurodegenerative diseases (NDs). The respiratory airways usually act as a substratum place for the microbes and can act as the base for respiratory tract infections. The microbial metabolites and the microbes can cross the blood–brain barrier and may cause NDs, such as Parkinson’s disease (PD), Alzheimer’s disease (AD), and multiple sclerosis (MS). The scientific investigations on the potential role of the nasal microbiota in olfactory functions and the relationship between their dysfunction and neurological diseases are limited. Recently, the consequences of the severe acute respiratory syndrome coronavirus (SARS-CoV-2) in patients with neurological diseases are under exploration. The crosstalk between the gut and the nasal microbiota is highly influential, because their mucosal regions are the prominent microbial niche and are connected to the olfaction, immune regulation, and homeostasis of the central nervous system. Diet is one of the major factors, which strongly influences the mucosal membranes of the airways, gut, and lung. Unhealthy diet practices cause dysbiosis in gut microbiota and the mucosal barrier. The current review summarizes the interrelationship between the nasal microbiota dysbiosis, resulting olfactory dysfunctions, and the progression of NDs during aging and the involvement of coronavirus disease 2019 in provoking the NDs.
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7
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Etyemez S, Narita Z, Mihaljevic M, Ishizuka K, Kamath V, Yang K, Sawa A. Olfactory dysfunction and face processing of social cognition in first-episode psychosis. Neurosci Res 2021; 176:79-84. [PMID: 34655664 DOI: 10.1016/j.neures.2021.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/20/2021] [Accepted: 10/10/2021] [Indexed: 01/05/2023]
Abstract
Olfactory functional deficits have been reported in psychotic disorders. Olfactory dysfunction has a predictive value for prognosis and disease course. Thus, it is important to know which specific symptoms and cognitive changes are associated with olfactory dysfunction in early-stage psychosis. Deficits in social cognition are a difficult problem in psychosis. Here we conduct a detailed assessment of odor function and face processing and show that odor discrimination capacity is specifically associated with face processing function in patients with first episode psychosis. This finding indicates that the high-throughput olfactory assessment may aid a prediction of the difficult clinical dimension from early-stage psychosis.
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Affiliation(s)
- Semra Etyemez
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Zui Narita
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Marina Mihaljevic
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vidyulata Kamath
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
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8
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Sasabayashi D, Takayanagi Y, Takahashi T, Katagiri N, Sakuma A, Obara C, Katsura M, Okada N, Koike S, Yamasue H, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State. Schizophr Bull 2020; 46:834-845. [PMID: 32162659 PMCID: PMC7342178 DOI: 10.1093/schbul/sbaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan; tel: +81-76-434-7323, fax: +81-76-434-5030, e-mail:
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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9
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Impaired olfactory ability associated with larger left hippocampus and rectus volumes at earliest stages of schizophrenia: A sign of neuroinflammation? Psychiatry Res 2020; 289:112909. [PMID: 32387788 DOI: 10.1016/j.psychres.2020.112909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 11/22/2022]
Abstract
Impaired olfactory identification has been reported as a first sign of schizophrenia during the earliest stages of illness, including before illness onset. The aim of this study was to examine the relationship between volumes of these regions (amygdala, hippocampus, gyrus rectus and orbitofrontal cortex) and olfactory ability in three groups of participants: healthy control participants (Ctls), patients with first-episode schizophrenia (FE-Scz) and chronic schizophrenia patients (Scz). Exploratory analyses were performed in a sample of individuals at ultra-high risk (UHR) for psychosis in a co-submission paper (Masaoka et al., 2020). The relationship to brain structural measures was not apparent prior to psychosis onset, but was only evident following illness onset, with a different pattern of relationships apparent across illness stages (FE-Scz vs Scz). Path analysis found that lower olfactory ability was related to larger volumes of the left hippocampus and gyrus rectus in the FE-Scz group. We speculate that larger hippocampus and rectus in early schizophrenia are indicative of swelling, potentially caused by an active neurochemical or immunological process, such as inflammation or neurotoxicity, which is associated with impaired olfactory ability. The volumetric decreases in the chronic stage of Scz may be due to degeneration resulting from an active immune process and its resolution.
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10
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He Y, Li Z, Ma X, Yuan L, Ouyang L, Tang J, Tsuang MT, Chen X. Olfactory and cognitive functions in Chinese individuals at clinical high risk for psychosis. Psychiatry Res 2019; 272:51-53. [PMID: 30579181 DOI: 10.1016/j.psychres.2018.12.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/16/2022]
Abstract
The abnormal olfactory function has been regarded as a sign in psychosis. To confirm the theory that olfactory and cognitive functions are deficient in Chinese cohort with clinical high risk state of psychosis, 19 individuals at clinical high risk for psychosis (CHRs) and 37 healthy controls (HCs) were recruited. The CHRs scored significantly lower than the HCs in the olfactory identification test and all other cognitive tests. Our findings suggest that olfactory dysfunction may be an early change of psychosis.
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Affiliation(s)
- Ying He
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, Changsha, Hunan 410011, China; Center for Behavioral Genomics, Department of Psychiatry, Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Zongchang Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, Changsha, Hunan 410011, China
| | - Xiaoqian Ma
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, Changsha, Hunan 410011, China
| | - Liu Yuan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, Changsha, Hunan 410011, China
| | - Lijun Ouyang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, Changsha, Hunan 410011, China
| | - Jinsong Tang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, Changsha, Hunan 410011, China
| | - Ming T Tsuang
- Center for Behavioral Genomics, Department of Psychiatry, Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA; Harvard Institute of Psychiatric Epidemiology and Genetics, Harvard School of Public Health, Boston, MA, USA
| | - Xiaogang Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Renmin Road 139, 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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11
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Tang SX, Moberg PJ, Yi JJ, Wiemken AS, Dress EM, Moore TM, Calkins ME, McDonald-McGinn DM, Zackai EH, Emanuel BS, Gur RC, Gur RE, Turetsky BI. Olfactory deficits and psychosis-spectrum symptoms in 22q11.2 deletion syndrome. Schizophr Res 2018; 202:113-119. [PMID: 30007867 PMCID: PMC6432914 DOI: 10.1016/j.schres.2018.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/18/2018] [Accepted: 07/02/2018] [Indexed: 11/28/2022]
Abstract
Olfactory functioning is a promising biomarker for psychosis in 22q11.2 deletion syndrome (22q11DS) but has not been well studied to date. This is a pilot effort to evaluate the potential for tests of olfactory functioning to contribute to risk and resilience prediction in 22q11DS, and is the first study to evaluate relationships among olfactory deficits, cognition and psychosis-spectrum symptoms. Odor identification and discrimination were evaluated in 32 individuals with 22q11DS and 110 healthy comparison subjects (HC). Individuals with 22q11DS also underwent cognitive testing with the Penn Computerized Neurocognitive Battery, which evaluates executive functioning, episodic memory, complex cognition, and social cognition. Positive, negative, disorganized and general psychosis-spectrum symptoms were rated according to the Scale of Prodromal Symptoms. Age-normalized scores were calculated for odor identification and discrimination based on normative data. Both odor identification (p < 0.001, Cohen's d = -2.15, 95% CI [-2.62, -1.68]) and discrimination (p < 0.001, Cohen's d = -1.81, 95% CI [-2.26, -1.35]) were significantly impaired in 22q11DS relative to HC. There were no sex differences in either group. Neither odor identification nor discrimination was correlated with overall cognition or any specific cognitive domain in 22q11DS. Impairment in odor discrimination was correlated with higher negative and overall psychosis-spectrum symptoms. There was no significant effect of catechol-O-methyltransferase Val(158)Met genotype or presence of velopharyngeal insufficiency on olfactory functioning. Olfactory deficits, particularly olfactory discrimination, are robust in 22q11DS and appear to be independent of cognitive deficits. They are also clinically relevant and related to psychosis-spectrum symptoms. Olfactory functioning appears to be a promising biomarker for psychosis in 22q11DS.
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Affiliation(s)
- Sunny X. Tang
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Paul J. Moberg
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - James J. Yi
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry
| | - Andrew S. Wiemken
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Erich M. Dress
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Tyler M. Moore
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Monica E. Calkins
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Donna M. McDonald-McGinn
- Children’s Hospital of Philadelphia, Division of Human Genetics,University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Elaine H. Zackai
- Children’s Hospital of Philadelphia, Division of Human Genetics,University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Beverly S. Emanuel
- Children’s Hospital of Philadelphia, Division of Human Genetics,University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Ruben C. Gur
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Raquel E. Gur
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry
| | - Bruce I. Turetsky
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
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12
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Takahashi T, Nakamura M, Sasabayashi D, Komori Y, Higuchi Y, Nishikawa Y, Nishiyama S, Itoh H, Masaoka Y, Suzuki M. Olfactory deficits in individuals at risk for psychosis and patients with schizophrenia: relationship with socio-cognitive functions and symptom severity. Eur Arch Psychiatry Clin Neurosci 2018; 268:689-698. [PMID: 29071372 DOI: 10.1007/s00406-017-0845-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/19/2017] [Indexed: 01/18/2023]
Abstract
Odor identification deficits are well documented in patients with schizophrenia, but it remains unclear whether individuals at clinical high-risk for psychosis exhibit similar changes and whether their olfactory function is related to social/cognitive functions and symptomatology. In this study, we investigated odor detection sensitivity and identification ability in 32 individuals with at-risk mental state (ARMS), 59 schizophrenia patients, and 169 healthy controls using a T&T olfactometer. The ARMS and schizophrenia subjects were administered the Brief Assessment of Cognition in Schizophrenia (BACS), the Schizophrenia Cognition Rating Scale (SCoRS), and the Social and Occupational Functioning Assessment Scale (SOFAS) to assess their cognitive and social functions, and the Positive and Negative Syndrome Scale (PANSS) for clinical symptoms. Both the ARMS and schizophrenia subjects had lower odor identification ability when compared with healthy controls, while no significant difference was found in the odor detection sensitivity. The lower odor identification ability in the ARMS group correlated with the severity of negative symptoms and weakly correlated with lower performance on the BACS verbal fluency test. The olfactory measures of schizophrenia patients did not correlate with illness duration, medication, symptom severity, and social and cognitive functions. For the ARMS and schizophrenia groups, the olfactory measures did not correlate with the SOFAS and SCoRS scores. These findings suggest that high-risk subjects for psychosis already show odor identification deficits similar to those observed in schizophrenia patients, which probably reflect a biological trait related to vulnerability to psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Mihoko Nakamura
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuko Komori
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Hiroko Itoh
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuri Masaoka
- Department of Physiology, Showa University School of Medicine, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
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13
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Kamath V, Paksarian D, Cui L, Moberg PJ, Turetsky BI, Merikangas KR. Olfactory processing in bipolar disorder, major depression, and anxiety. Bipolar Disord 2018; 20:547-555. [PMID: 29441710 DOI: 10.1111/bdi.12625] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/22/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Although olfactory abnormalities are well established in schizophrenia, considerably less work has examined olfactory performance in other neuropsychiatric conditions. In the current study, we examined odor identification, odor discrimination, detection threshold, and odor hedonic processing performance in individuals with bipolar I disorder (n = 43; n = 13 with psychotic features), bipolar II disorder (n = 48), major depressive disorder (MDD) (n = 134), anxiety (n = 48), and no mental disorder (n = 72) who participated in a community-based family study. METHODS Best estimate DSM-IV diagnoses were based on in-depth personal interviews as well as interviews with family members. Olfactory tests were administered during an in-person clinical visit and were compared using robust linear regression adjusting for age, sex, and psychiatric medication use, as well as nicotine use when necessary. RESULTS Compared to controls, odor identification performance was lower among individuals with MDD (b = -1.37, 95% confidence interval [CI]: -2.50, -0.24) and bipolar I disorder (b = -1.79, 95% CI: -3.51, -0.67). Among the latter group, performance was only reduced among those with psychotic features (b = -3.49, 95% CI: -6.33, -0.65), particularly for pleasant odors (b = -1.46, 95% CI: -2.51, -0.42). Those with MDD showed lower identification accuracy for neutral odors (b = -0.63, 95% CI: -1.20, -0.06). Performances on measures of odor discrimination and detection threshold did not differ by diagnostic group. CONCLUSIONS Collectively, these findings indicate that odor identification difficulties may exist in mood disorders, especially when psychotic features are present. In contrast, the global olfactory dysfunction observed in schizophrenia may not be a feature of other neuropsychiatric conditions.
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Affiliation(s)
- Vidyulata Kamath
- Division of Medical Psychology, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Paul J Moberg
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Bruce I Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
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14
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Turetsky BI, Moberg PJ, Quarmley M, Dress E, Calkins ME, Ruparel K, Prabhakaran K, Gur RE, Roalf DR. Structural anomalies of the peripheral olfactory system in psychosis high-risk subjects. Schizophr Res 2018; 195:197-205. [PMID: 28974405 PMCID: PMC5878118 DOI: 10.1016/j.schres.2017.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 09/05/2017] [Accepted: 09/13/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Olfactory impairments are prominent in both schizophrenia and the preceding at-risk state. Their presence prior to illness predicts poor functional outcome. In schizophrenia, these impairments reflect peripheral olfactory structural abnormalities, which are hypothesized to arise during early embryonic development. If this is correct, then similar structural anomalies should be apparent among clinical high-risk subjects. METHODS Thirty-nine clinical high-risk (CR) subjects (24M/15F) were compared to 36 low-risk (LR) subjects (19M/17F). Olfactory measures derived from 3T MRI scans included olfactory bulb volume, primary olfactory cortical gray matter volume, and the depth of the olfactory sulcus overlying the bulb. Additionally, nasal cavity volumes were assessed with acoustic rhinometry. RESULTS Male CR subjects exhibited bilateral reductions in olfactory bulb volume and abnormal asymmetries of the posterior nasal cavities and olfactory sulci (left reduced relative to right). Post-hoc contrasts also indicated reduced left, but not right, olfactory cortical gray matter volume. Female CRs had no significant abnormalities, although they exhibited similar trend effects. Left olfactory bulb volume correlated, across all CR subjects, with negative, but not positive, symptoms. In a classification analysis, with 80% target specificity, olfactory measurements distinguished male CR from male LR subjects with 93% sensitivity. Among females, the comparable sensitivity was 69%. CONCLUSION Psychosis-risk youths exhibit an array of sexually dimorphic and laterally asymmetric anomalies of the peripheral olfactory system. These are consistent with a developmental disruption primarily affecting male fetuses. These structural biomarkers may enhance the identification of at-risk subjects with poor prognosis, before their clinical trajectory is apparent.
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Affiliation(s)
- Bruce I. Turetsky
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Paul J. Moberg
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Megan Quarmley
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Erich Dress
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Monica E. Calkins
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Kosha Ruparel
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Karthik Prabhakaran
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Raquel E. Gur
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - David R. Roalf
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
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15
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Koskinen K, Reichert JL, Hoier S, Schachenreiter J, Duller S, Moissl-Eichinger C, Schöpf V. The nasal microbiome mirrors and potentially shapes olfactory function. Sci Rep 2018; 8:1296. [PMID: 29358754 PMCID: PMC5778015 DOI: 10.1038/s41598-018-19438-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/29/2017] [Indexed: 02/07/2023] Open
Abstract
Olfactory function is a key sense for human well-being and health, with olfactory dysfunction having been linked to serious diseases. As the microbiome is involved in normal olfactory epithelium development, we explored the relationship between olfactory function (odor threshold, discrimination, identification) and nasal microbiome in 67 healthy volunteers. Twenty-eight subjects were found to have normal olfactory function, 29 had a particularly good sense of smell ("good normosmics") and 10 were hyposmic. Microbial community composition differed significantly between the three olfactory groups. In particular, butyric acid-producing microorganisms were found to be associated with impaired olfactory function. We describe the first insights of the potential interplay between the olfactory epithelium microbial community and olfactory function, and suggest that the microbiome composition is able to mirror and potentially shape olfactory function by producing strong odor compounds.
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Affiliation(s)
- Kaisa Koskinen
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Johanna L Reichert
- BioTechMed-Graz, Graz, Austria
- Institute of Psychology, University of Graz, Graz, Austria
| | - Stefan Hoier
- Hanusch Krankenhaus Vienna, Department of Otorhinolaryngology, Head and Neck Surgery, Vienna, Austria
| | | | - Stefanie Duller
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Christine Moissl-Eichinger
- Department of Internal Medicine, Medical University of Graz, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
| | - Veronika Schöpf
- BioTechMed-Graz, Graz, Austria.
- Institute of Psychology, University of Graz, Graz, Austria.
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16
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Roalf DR, Quarmley M, Calkins ME, Satterthwaite TD, Ruparel K, Elliott MA, Moore TM, Gur RC, Gur RE, Moberg PJ, Turetsky BI. Temporal Lobe Volume Decrements in Psychosis Spectrum Youths. Schizophr Bull 2017; 43:601-610. [PMID: 27559077 PMCID: PMC5463880 DOI: 10.1093/schbul/sbw112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Structural brain abnormalities have been amply demonstrated in schizophrenia. These include volume decrements in the perirhinal/entorhinal regions of the ventromedial temporal lobe, which comprise the primary olfactory cortex. Olfactory impairments, which are a hallmark of schizophrenia, precede the onset of illness, distinguish adolescents experiencing prodromal symptoms from healthy youths, and may predict the transition from the prodrome to frank psychosis. We therefore examined temporal lobe regional volumes in a large adolescent sample to determine if structural deficits in ventromedial temporal lobe areas were associated, not only with schizophrenia, but also with a heightened risk for psychosis. Seven temporal lobe regional volumes (amygdala [AM], hippocampus, inferior temporal gyrus, parahippocampal gyrus, superior temporal gyrus, temporal pole, and entorhinal cortex [EC]) were measured in 386 psychosis spectrum adolescents, 521 adolescents with other types of psychopathology, and 359 healthy adolescents from the Philadelphia Neurodevelopment Cohort. Total intracranial and left EC volumes, which were both smallest among the psychosis spectrum, were the only measures that distinguished all 3 groups. Left AM was also smaller in psychosis spectrum compared with healthy subjects. EC volume decrement was strongly correlated with impaired cognition and less robustly associated with heightened negative/disorganized symptoms. AM volume decrement correlated with positive symptoms (persecution/special abilities). Temporal lobe volumes classified psychosis spectrum youths with very high specificity but relatively low sensitivity. These MRI measures may therefore serve as important confirmatory biomarkers denoting a worrisome preclinical trajectory among at-risk youths, and the specific pattern of deficits may predict specific symptom profiles.
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Affiliation(s)
- David R. Roalf
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Megan Quarmley
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Monica E. Calkins
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Theodore D. Satterthwaite
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kosha Ruparel
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mark A. Elliott
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tyler M. Moore
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ruben C. Gur
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Raquel E. Gur
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Paul J. Moberg
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Smell and Taste Center, Department of Otorhinolaryngology—Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Bruce I. Turetsky
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Smell and Taste Center, Department of Otorhinolaryngology—Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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17
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Olfactory disturbances in ageing with and without dementia: towards new diagnostic tools. The Journal of Laryngology & Otology 2017; 131:572-579. [PMID: 28424103 DOI: 10.1017/s0022215117000858] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Olfactory disorders increase with age and often affect elderly people who have pre-dementia or dementia. Despite the frequent occurrence of olfactory changes at the early stages of neurodegenerative disorders such as Alzheimer's disease, olfactory disorders are rarely assessed in daily clinical practice, mainly due to a lack of standardised assessment tools. The aims of this review were to (1) summarise the existing literature on olfactory disorders in ageing populations and patients with neurodegenerative disorders; (2) present the strengths and weaknesses of current olfactory disorder assessment tools; and (3) discuss the benefits of developing specific olfactory tests for neurodegenerative diseases. METHODS A systematic review was performed of literature published between 2000 and 2015 addressing olfactory disorders in elderly people with or without Alzheimer's disease or other related disorders to identify the main tools currently used for olfactory disorder assessment. RESULTS Olfactory disorder assessment is a promising method for improving both the early and differential diagnosis of Alzheimer's disease. However, the current lack of consensus on which tests should be used does not permit the consistent integration of olfactory disorder assessment into clinical settings. CONCLUSION Otolaryngologists are encouraged to use olfactory tests in older adults to help predict the development of neurodegenerative diseases. Olfactory tests should be specifically adapted to assess olfactory disorders in Alzheimer's disease patients.
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18
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Kotlicka-Antczak M, Pawełczyk A, Karbownik MS, Pawełczyk T, Strzelecki D, Żurner N, Urban-Kowalczyk M. Deficits in the identification of pleasant odors predict the transition of an at-risk mental state to psychosis. Schizophr Res 2017; 181:49-54. [PMID: 27765522 DOI: 10.1016/j.schres.2016.10.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/30/2016] [Accepted: 10/10/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Existing knowledge of the relationship between olfactory identification (OI) ability and clinical risk of psychosis is inconsistent. To address this inconsistency, the aim of the present study was to identify the relationship between OI ability, with regard to the hedonic attributes of odors, and the risk of transition to psychosis in individuals with an ARMS. METHODS A group of 81 individuals meeting the ARMS criteria according to the Comprehensive Assessment of At Risk Mental State were at baseline administered with the University of Pennsylvania Smell Identification Test. The hedonic attributes of odorants were normatively established. Participants were followed up for transition to psychosis for a mean period of 36.1months (SD:27.5months). RESULTS The presence of deficits in the identification of pleasant odors was found to be a risk factor for conversion from an ARMS to schizophrenia. The hazard ratio for each point in deficit scores in the Cox regression model was 1.455 (95% CI: 1.211-1.747), p<0.0001. Significant deficits in the identification of pleasant odors were associated with a risk for conversion at both early and late time points from baseline. CONCLUSIONS The findings imply that the impaired identification of pleasant odorants may be a risk factor for the transition of an ARMS into a psychotic disorder, and highlights the need for further research of OI in "at-risk" cohorts, taking into account the hedonic attributes of odors.
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Affiliation(s)
- Magdalena Kotlicka-Antczak
- Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland.
| | - Agnieszka Pawełczyk
- Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland.
| | - Michał S Karbownik
- Medical University of Łódź, Department of Pharmacology and Toxicology, ul. Żeligowskiego 7/9, 90-752 Łódź, Poland.
| | - Tomasz Pawełczyk
- Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland.
| | - Dominik Strzelecki
- Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland.
| | - Natalia Żurner
- Adolescent Psychiatry Unit, Central Clinical Hospital of Medical University of Łódź, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland.
| | - Małgorzata Urban-Kowalczyk
- Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland.
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19
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Atkinson RJ, Fulham WR, Michie PT, Ward PB, Todd J, Stain H, Langdon R, Thienel R, Paulik G, Cooper G, Schall U. Electrophysiological, cognitive and clinical profiles of at-risk mental state: The longitudinal Minds in Transition (MinT) study. PLoS One 2017; 12:e0171657. [PMID: 28187217 PMCID: PMC5302824 DOI: 10.1371/journal.pone.0171657] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 01/24/2017] [Indexed: 12/22/2022] Open
Abstract
The onset of schizophrenia is typically preceded by a prodromal period lasting several years during which sub-threshold symptoms may be identified retrospectively. Clinical interviews are currently used to identify individuals who have an ultra-high risk (UHR) of developing a psychotic illness with a view to provision of interventions that prevent, delay or reduce severity of future mental health issues. The utility of bio-markers as an adjunct in the identification of UHR individuals is not yet established. Several event-related potential measures, especially mismatch-negativity (MMN), have been identified as potential biomarkers for schizophrenia. In this 12-month longitudinal study, demographic, clinical and neuropsychological data were acquired from 102 anti-psychotic naive UHR and 61 healthy controls, of whom 80 UHR and 58 controls provided valid EEG data during a passive auditory task at baseline. Despite widespread differences between UHR and controls on demographic, clinical and neuropsychological measures, MMN and P3a did not differ between these groups. Of 67 UHR at the 12-month follow-up, 7 (10%) had transitioned to a psychotic illness. The statistical power to detect differences between those who did or did not transition was limited by the lower than expected transition rate. ERPs did not predict transition, with trends in the opposite direction to that predicted. In exploratory analysis, the strongest predictors of transition were measures of verbal memory and subjective emotional disturbance.
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Affiliation(s)
- Rebbekah J. Atkinson
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
| | - W. Ross Fulham
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- * E-mail:
| | - Patricia T. Michie
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- School of Psychology, University of Newcastle, Newcastle, New South Wales, Australia
| | - Philip B. Ward
- School of Medicine and Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Schizophrenia Research Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Juanita Todd
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- School of Psychology, University of Newcastle, Newcastle, New South Wales, Australia
| | - Helen Stain
- Centre for Rural and Remote Mental Health, Bloomfield Hospital, Orange, New South Wales, Australia
- School of Social and Health Sciences, Leeds Trinity University, Horsforth Leeds, United Kingdom
| | - Robyn Langdon
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- ARC Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, New South Wales, Australia
- Department of Cognitive Science, Macquarie University, Sydney, New South Wales, Australia
| | - Renate Thienel
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- Hunter Institute for Mental Health, Newcastle, New South Wales, Australia
| | - Georgie Paulik
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- School of Psychology, University of Western Australia, Nedlands, Western Australia, Australia
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
| | - Gavin Cooper
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
| | | | - Ulrich Schall
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia
- Hunter New England Health, Newcastle, Australia
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Kollndorfer K, Reichert J, Braunsteiner J, Schöpf V. Assessment of Olfactory Memory in Olfactory Dysfunction. Perception 2016; 46:516-529. [PMID: 28325138 DOI: 10.1177/0301006616683201] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To assess all clinically relevant components of olfactory perception, examinations for olfactory sensitivity, discrimination, and identification are performed. Besides the standard perceptual test battery, episodic olfactory memory might offer additional information about olfactory abilities relative to these standard clinical tests. As both olfactory deficits and memory deficits are early symptoms in neurodegenerative disorders, olfactory memory may be of particular interest. However, to date little is known about episodic olfactory memory performance in patients with decreased olfactory function. This study includes the investigation of olfactory memory performance in 14 hyposmic patients (8 female, mean age 52.6 years) completing two episodic odor memory tests (Sniffin' Test of Odor Memory and Odor Memory Test). To control for a general impairment in memory function, a verbal and a figural memory test were carried out. A regression model with multiple predictors was calculated for both odor memory tests separately. Odor identification was identified as the only significant predictor for both odor memory tasks. From our results, we conclude that currently available olfactory memory tests are highly influenced by odor identification abilities, implying the need for the development and validation of additional tests in this field which could serve as additional olfactory perception variables for clinical assessment.
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Affiliation(s)
- Kathrin Kollndorfer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Johanna Reichert
- Institute of Psychology, University of Graz, Austria; BioTechMed, Graz, Austria
| | - Josephine Braunsteiner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Veronika Schöpf
- Institute of Psychology, University of Graz, Austria; BioTechMed, Graz, Austria
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21
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Yung AR, Cotter J, Wood SJ, McGorry P, Thompson AD, Nelson B, Lin A. Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis. Psychol Med 2015; 45:3453-3465. [PMID: 26166153 DOI: 10.1017/s003329171500135x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study. METHOD Participants were 268 (152 females, 116 males) individuals identified as UHR 2-14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS). RESULTS Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p < 0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p < 0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups. CONCLUSIONS Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.
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Affiliation(s)
- A R Yung
- Institute of Brain,Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - J Cotter
- Institute of Brain,Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - S J Wood
- School of Psychology,University of Birmingham,Birmingham,UK
| | - P McGorry
- Orygen,The National Centre of Excellence in Youth Mental Health,University of Melbourne,Melbourne,Australia
| | - A D Thompson
- Warwick Medical School,University of Warwick,Coventry,UK
| | - B Nelson
- Orygen,The National Centre of Excellence in Youth Mental Health,University of Melbourne,Melbourne,Australia
| | - A Lin
- Telethon Kids Institute,The University of Western Australia,Subiaco,Australia
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