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Chen YJ, Lu ML, Chiu YH, Chen C, Santos VHJ, Goh KK. Linking childhood trauma to the psychopathology of schizophrenia: the role of oxytocin. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:24. [PMID: 38388569 PMCID: PMC10883944 DOI: 10.1038/s41537-024-00433-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/31/2023] [Indexed: 02/24/2024]
Abstract
Childhood trauma has been linked to schizophrenia, but underlying biological mechanisms remain elusive. This study explored the potential role of plasma oxytocin as a mediator in the relationship between childhood trauma and the psychopathology of schizophrenia. 160 patients with schizophrenia and 80 age- and sex-matched healthy controls were assessed for childhood trauma experiences using the Childhood Trauma Questionnaire and structured interviews. Psychopathology was evaluated using the Positive and Negative Syndrome Scale and plasma oxytocin levels were measured. Results showed that patients with schizophrenia had lower oxytocin levels and higher childhood trauma scores than healthy controls. There was a significant correlation between childhood trauma scores and psychopathology, with plasma oxytocin levels being inversely associated with psychopathology, except for positive symptoms. Hierarchical regression analysis indicated that both childhood trauma scores and plasma oxytocin levels significantly predicted psychopathology. Plasma oxytocin levels partially mediated the relationship between childhood trauma and schizophrenia psychopathology. This study underscores the potential role of oxytocin in bridging the gap between childhood trauma and schizophrenia.
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Affiliation(s)
- Yuan-Jung Chen
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chenyi Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Vitor Hugo Jesus Santos
- Department of Psychiatry and Mental Health, Faculty of Health Sciences (FCS-UBI), Cova da Beira University Hospital Center, Covilhã, Portugal
| | - Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan.
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2
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Riehle M, Straková A, Lincoln TM. Emotional Experience of People With Schizophrenia and People at Risk for Psychosis: A Meta-Analysis. JAMA Psychiatry 2024; 81:57-66. [PMID: 37755868 PMCID: PMC10535019 DOI: 10.1001/jamapsychiatry.2023.3589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/12/2023] [Indexed: 09/28/2023]
Abstract
Importance Psychotic symptoms are associated with subjective reports of aberrant emotion, such as excessive fear or anhedonia, but whether these aberrations reflect aberrant emotional experience of normative stimuli is uncertain both for individuals with schizophrenia and those at risk for psychosis. Objective To provide a meta-analysis of study samples of emotional experience in individuals with schizophrenia and those at risk for psychosis as assessed in laboratory-based emotion-induction studies. Data Sources MEDLINE and PsycINFO databases were searched for articles published from January 1986 and Google Scholar citations of a relevant earlier meta-analysis until August 2022. Reference lists were manually searched for additional studies. Study Selection Included studies measured positive or negative emotional experience in response to standardized emotionally evocative stimuli and compared participants diagnosed with schizophrenia or participants at risk for psychosis with healthy controls. Data Extraction and Synthesis The meta-analysis was registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Data were extracted by 2 independent coders, and random-effects analyses were conducted. Main Outcomes and Measures Outcomes were 3 scales of emotional experience (unipolar positive emotion, unipolar negative emotion, bipolar valence), analyzed separately for pleasant, neutral, and unpleasant stimuli. A meta-analysis was conducted for differences between the 2 clinical groups combined and controls. Subgroup differences (schizophrenia vs at risk) and the influence of several other variables were tested in moderator analyses. Results This systematic review and meta-analysis included data from 111 studies and 6913 participants (schizophrenia: 2848 [41.2%]; at risk: 877 [12.7%]; healthy controls: 3188 [46.1%]). Compared with controls, people with schizophrenia and those at risk for psychosis experienced pleasant stimuli as less positive (unipolar positive: standardized mean difference [SMD] Hedges g = -0.19; P =.001; bipolar valence: SMD Hedges g = -0.28; P <.001) and more negative (Hedges g = 0.52; P <.001), neutral stimuli as more negative (Hedges g = 0.55; P <.001), and unpleasant stimuli as both more positive (unipolar positive: SMD Hedges g = 0.23; P =.005; bipolar valence: Hedges g = 0.12; P =.01) and more negative (Hedges g = 0.22; P <.001). Moderator analyses indicated a less aberrant emotional experience for odors than for visual stimuli (unipolar negative, pleasant z score = -2.97; P =.003; unipolar negative, neutral z score = -2.70; P =.007), an association between higher negative symptoms and diminished positive emotion for pleasant stimuli in schizophrenia (z score = -2.98; P =.003), and that subgroup differences were limited to neutral stimuli. Conclusions and Relevance Results suggest a pattern of aberrant emotional experience of normative stimuli in schizophrenia and that this already was observable before disorder onset. In particular, the aberrant experience of pleasant stimuli needs to be considered as an intervention target.
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Affiliation(s)
- Marcel Riehle
- Institute for Psychology, Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Alexandra Straková
- Department of Psychology, Comenius University in Bratislava, Bratislava, Slovakia
| | - Tania M. Lincoln
- Institute for Psychology, Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
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3
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Jin Y, Song D, Yan Y, Quan Z, Qing H. The Role of Oxytocin in Early-Life-Stress-Related Neuropsychiatric Disorders. Int J Mol Sci 2023; 24:10430. [PMID: 37445607 DOI: 10.3390/ijms241310430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Early-life stress during critical periods of brain development can have long-term effects on physical and mental health. Oxytocin is a critical social regulator and anti-inflammatory hormone that modulates stress-related functions and social behaviors and alleviates diseases. Oxytocin-related neural systems show high plasticity in early postpartum and adolescent periods. Early-life stress can influence the oxytocin system long term by altering the expression and signaling of oxytocin receptors. Deficits in social behavior, emotional control, and stress responses may result, thus increasing the risk of anxiety, depression, and other stress-related neuropsychiatric diseases. Oxytocin is regarded as an important target for the treatment of stress-related neuropsychiatric disorders. Here, we describe the history of oxytocin and its role in neural circuits and related behaviors. We then review abnormalities in the oxytocin system in early-life stress and the functions of oxytocin in treating stress-related neuropsychiatric disorders.
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Affiliation(s)
- Yue Jin
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Da Song
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Yan Yan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Zhenzhen Quan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Hong Qing
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
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4
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Exploring a Possible Interplay between Schizophrenia, Oxytocin, and Estrogens: A Narrative Review. Brain Sci 2023; 13:brainsci13030461. [PMID: 36979271 PMCID: PMC10046503 DOI: 10.3390/brainsci13030461] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Schizophrenia is characterized by symptoms of psychosis and sociocognitive deficits. Considering oxytocin’s antipsychotic and prosocial properties, numerous clinical, and preclinical studies have explored the neuropeptide’s therapeutic efficacy. Sex differences in the clinical course of schizophrenia, as well as in oxytocin-mediated behaviors, indicate the involvement of gonadal steroid hormones. The current narrative review aimed to explore empirical evidence on the interplay between schizophrenia psychopathology and oxytocin’s therapeutic potential in consideration of female gonadal steroid interactions, with a focus on estrogens. The review was conducted using the PubMed and PsychINFO databases and conforms to the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. The results suggest a potential synergistic effect of the combined antipsychotic effect of oxytocin and neuroprotective effect of estrogen on schizophrenia. Consideration of typical menstrual cycle-related hormonal changes is warranted and further research is needed to confirm this assumption.
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5
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Larsen EM, Donaldson KR, Jonas KG, Lian W, Bromet EJ, Kotov R, Mohanty A. Pleasant and unpleasant odor identification ability is associated with distinct dimensions of negative symptoms transdiagnostically in psychotic disorders. Schizophr Res 2022; 248:183-193. [PMID: 36084492 PMCID: PMC10774004 DOI: 10.1016/j.schres.2022.08.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/12/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Negative symptoms are among the greatest sources of functional impairment for individuals with schizophrenia, yet their mechanisms remain poorly understood. Olfactory impairment is associated with negative symptoms. The processing of pleasant olfactory stimuli is subserved by reward-related neural circuitry while unpleasant olfactory processing is subserved by emotion-related neural circuitry, suggesting that these two odor dimensions may offer a window into differential mechanisms of negative symptoms. We examined whether pleasant and unpleasant odor identification bears differential relationships with avolition and inexpressivity dimensions of negative symptoms, whether these relationships are transdiagnostic, and whether pleasant and unpleasant odor processing also relate differently to other domains of functioning in a sample of individuals diagnosed with schizophrenia (N = 54), other psychotic disorders (N = 65), and never-psychotic adults (N = 160). Hierarchical regressions showed that pleasant odor identification was uniquely associated with avolition, while unpleasant odor identification was uniquely associated with inexpressivity. These relationships were largely transdiagnostic across groups. Additionally, pleasant and unpleasant odor identification displayed signs of specificity with other functional and cognitive measures. These results align with past work suggesting dissociable pathomechanisms of negative symptoms and provide a potential avenue for future work using valence-specific olfactory dysfunction as a semi-objective and low-cost marker for understanding and predicting the severity of specific negative symptom profiles.
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Affiliation(s)
- Emmett M. Larsen
- Department of Psychology, Stony Brook University, Stony Brook, NY
| | | | - Katherine G. Jonas
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Wenxuan Lian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Aprajita Mohanty
- Department of Psychology, Stony Brook University, Stony Brook, NY
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6
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Shi W, Fan L, Wang H, Liu B, Li W, Li J, Cheng L, Chu C, Song M, Sui J, Luo N, Cui Y, Dong Z, Lu Y, Ma Y, Ma L, Li K, Chen J, Chen Y, Guo H, Li P, Lu L, Lv L, Wan P, Wang H, Wang H, Yan H, Yan J, Yang Y, Zhang H, Zhang D, Jiang T. Two subtypes of schizophrenia identified by an individual-level atypical pattern of tensor-based morphometric measurement. Cereb Cortex 2022; 33:3683-3700. [PMID: 36005854 DOI: 10.1093/cercor/bhac301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
Difficulties in parsing the multiaspect heterogeneity of schizophrenia (SCZ) based on current nosology highlight the need to subtype SCZ using objective biomarkers. Here, utilizing a large-scale multisite SCZ dataset, we identified and validated 2 neuroanatomical subtypes with individual-level abnormal patterns of the tensor-based morphometric measurement. Remarkably, compared with subtype 1, which showed moderate deficits of some subcortical nuclei and an enlarged striatum and cerebellum, subtype 2, which showed cerebellar atrophy and more severe subcortical nuclei atrophy, had a higher subscale score of negative symptoms, which is considered to be a core aspect of SCZ and is associated with functional outcome. Moreover, with the neuroimaging-clinic association analysis, we explored the detailed relationship between the heterogeneity of clinical symptoms and the heterogeneous abnormal neuroanatomical patterns with respect to the 2 subtypes. And the neuroimaging-transcription association analysis highlighted several potential heterogeneous biological factors that may underlie the subtypes. Our work provided an effective framework for investigating the heterogeneity of SCZ from multilevel aspects and may provide new insights for precision psychiatry.
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Affiliation(s)
- Weiyang Shi
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lingzhong Fan
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China.,Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Haiyan Wang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Bing Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Chinese Institute for Brain Research, Beijing 102206, China
| | - Wen Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jin Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Luqi Cheng
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin 541004, China
| | - Congying Chu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Ming Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Sui
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Na Luo
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Yue Cui
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhenwei Dong
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuheng Lu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yawei Ma
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Liang Ma
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Kaixin Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yunchun Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, Zhumadian 463000, China
| | - Peng Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Ping Wan
- Zhumadian Psychiatric Hospital, Zhumadian 463000, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Huiling Wang
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Hao Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Jun Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.,Department of Psychology, Xinxiang Medical University, Xinxiang 453002, China
| | - Dai Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China.,Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China.,Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,Research Center for Augmented Intelligence, Zhejiang Lab, Hangzhou 311100, China.,Innovation Academy for Artificial Intelligence, Chinese Academy of Sciences, Beijing 100190, China
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7
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Marazziti D, Diep PT, Carter S, Carbone MG. Oxytocin: An Old Hormone, A Novel Psychotropic Drug And Possible Use In Treating Psychiatric Disorders. Curr Med Chem 2022; 29:5615-5687. [PMID: 35894453 DOI: 10.2174/0929867329666220727120646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/17/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Oxytocin is a nonapeptide synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. Historically, this molecule has been involved as a key factor in the formation of infant attachment, maternal behavior and pair bonding and, more generally, in linking social signals with cognition, behaviors and reward. In the last decades, the whole oxytocin system has gained a growing interest as it was proposed to be implicated in etiopathogenesis of several neurodevelopmental and neuropsychiatric disorders. METHODS With the main goal of an in-depth understanding of the oxytocin role in the regulation of different functions and complex behaviors as well as its intriguing implications in different neuropsychiatric disorders, we performed a critical review of the current state of art. We carried out this work through PubMed database up to June 2021 with the search terms: 1) "oxytocin and neuropsychiatric disorders"; 2) "oxytocin and neurodevelopmental disorders"; 3) "oxytocin and anorexia"; 4) "oxytocin and eating disorders"; 5) "oxytocin and obsessive-compulsive disorder"; 6) "oxytocin and schizophrenia"; 7) "oxytocin and depression"; 8) "oxytocin and bipolar disorder"; 9) "oxytocin and psychosis"; 10) "oxytocin and anxiety"; 11) "oxytocin and personality disorder"; 12) "oxytocin and PTSD". RESULTS Biological, genetic, and epigenetic studies highlighted quality and quantity modifications in the expression of oxytocin peptide or in oxytocin receptor isoforms. These alterations would seem to be correlated with a higher risk of presenting several neuropsychiatric disorders belonging to different psychopathological spectra. Collaterally, the exogenous oxytocin administration has shown to ameliorate many neuropsychiatric clinical conditions. CONCLUSION Finally, we briefly analyzed the potential pharmacological use of oxytocin in patient with severe symptomatic SARS-CoV-2 infection due to its anti-inflammatory, anti-oxidative and immunoregulatory properties.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy.,Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Phuoc-Tan Diep
- Department of Histopathology, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom
| | - Sue Carter
- Director Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Manuel G Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese, Italy
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Florea T, Palimariciuc M, Cristofor AC, Dobrin I, Chiriță R, Bîrsan M, Dobrin RP, Pădurariu M. Oxytocin: Narrative Expert Review of Current Perspectives on the Relationship with Other Neurotransmitters and the Impact on the Main Psychiatric Disorders. Medicina (B Aires) 2022; 58:medicina58070923. [PMID: 35888641 PMCID: PMC9318841 DOI: 10.3390/medicina58070923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 12/23/2022] Open
Abstract
Is a cyclic neuropeptide produced primarily in the hypothalamus and plays an important neuromodulatory role for other neurotransmitter systems, with an impact on behavior, response to danger, stress, and complex social interactions, such as pair bonding and child care. This narrative expert review examines the literature on oxytocin as a brain hormone. We focused on oxytocin structure, distribution, genetics, and the oxytocin receptor system, as well as the relationship of oxytocin with other neurotransmitters and the resulting impacts on the main psychiatric disorders. Oxytocin levels have been correlated over time with mental illness, with numerous studies focusing on oxytocin and the pathophysiology of the main psychiatric disorders, such as autism, schizophrenia, personality disorders, mood, and eating disorders. We highlight the role oxytocin plays in improving symptoms such as anxiety, depression, and social behavior, as the literature suggests. Risk factors and causes for psychiatric disorders range from genetic to environmental and social factors. Oxytocin could impact the latter, being linked with other neurotransmitter systems that are responsible for integrating different situations during the development phases of individuals. Also, these systems have an important role in how the body responds to stressors or bonding with others, helping with the creation of social support groups that could speed up recovery in many situations. Oxytocin has the potential to become a key therapeutic agent for future treatment and prevention strategies concerning the main psychiatric disorders.
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Affiliation(s)
- Tudor Florea
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universității Street, 700115 Iasi, Romania; (T.F.); (M.P.); (A.C.C.); (I.D.); (R.C.)
| | - Matei Palimariciuc
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universității Street, 700115 Iasi, Romania; (T.F.); (M.P.); (A.C.C.); (I.D.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania;
| | - Ana Caterina Cristofor
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universității Street, 700115 Iasi, Romania; (T.F.); (M.P.); (A.C.C.); (I.D.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania;
| | - Irina Dobrin
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universității Street, 700115 Iasi, Romania; (T.F.); (M.P.); (A.C.C.); (I.D.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania;
| | - Roxana Chiriță
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universității Street, 700115 Iasi, Romania; (T.F.); (M.P.); (A.C.C.); (I.D.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania;
| | - Magdalena Bîrsan
- Department of Drug Industry and Pharmaceutical Biotechnology, Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy of Iaşi, 16 Universităţii Street, 700115 Iaşi, Romania;
| | - Romeo Petru Dobrin
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universității Street, 700115 Iasi, Romania; (T.F.); (M.P.); (A.C.C.); (I.D.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania;
- Correspondence:
| | - Manuela Pădurariu
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania;
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Hering A, Jieu B, Jones A, Muttenthaler M. Approaches to Improve the Quantitation of Oxytocin in Human Serum by Mass Spectrometry. Front Chem 2022; 10:889154. [PMID: 35755255 PMCID: PMC9218718 DOI: 10.3389/fchem.2022.889154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/03/2022] [Indexed: 11/26/2022] Open
Abstract
The neuropeptide oxytocin (OT) regulates several peripheral and central functions and is a molecule of interest in psychiatric diseases such as autism spectrum disorder, schizophrenia, anxiety and depression. The study of OT in human serum samples is however hampered by inconsistent sample preparation and analysis as well as low endogenous blood concentration (1-10 pM). This results in varying reports on OT's blood levels and interpretation of OT's role in different (patho)physiological states. Quantitative mass spectrometry (MS) is a highly promising technology to address this problem but still requires large sample volumes to achieve adequate sensitivity and reliability for the quantitation of compounds at low concentrations. We therefore systematically evaluated sample preparation methods for MS to achieve a reliable sample preparation protocol with good peptide recovery, minimal matrix effects and good overall method efficiency in line with FDA guidelines for bioanalytic method development and validation. Additionally, we investigated a strategy to improve the ionization efficiency of OT by adding charged and/or hydrophobic moieties to OT to improve the lower limit of quantitation. Optimized sample preparation in combination with OT modification with a quaternary pyridinium ion improved the sensitivity of OT by ∼40-fold on a tandem triple quadrupole mass spectrometer (API4000 QTRAP), resulting in a lower limit of quantitation of 5 pM in water (linear range 5 pM - 1 mM) and 2 nM in human serum (linear range 2 nM - 1 mM) compared to 200 pM in water and 86 nM in serum with unmodified OT. This approach and protocol provide a solid foundation towards method development for OT quantitation using MS, which should be of high value for fundamental research as well as clinical monitoring of OT upon drug treatments.
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Affiliation(s)
- Anke Hering
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Beverly Jieu
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Alun Jones
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Markus Muttenthaler
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Institute of Biological Chemistry, Faculty of Chemistry, University of Vienna, Vienna, Austria
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10
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Arnovitz MD, Spitzberg AJ, Davani AJ, Vadhan NP, Holland J, Kane JM, Michaels TI. MDMA for the Treatment of Negative Symptoms in Schizophrenia. J Clin Med 2022; 11:jcm11123255. [PMID: 35743326 PMCID: PMC9225098 DOI: 10.3390/jcm11123255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 02/05/2023] Open
Abstract
The profound economic burden of schizophrenia is due, in part, to the negative symptoms of the disease, which can severely limit daily functioning. There is much debate in the field regarding their measurement and classification and there are no FDA-approved treatments for negative symptoms despite an abundance of research. 3,4-Methylenedioxy methamphetamine (MDMA) is a schedule I substance that has emerged as a novel therapeutic given its ability to enhance social interactions, generate empathy, and induce a state of metaplasticity in the brain. This review provides a rationale for the use of MDMA in the treatment of negative symptoms by reviewing the literature on negative symptoms, their treatment, MDMA, and MDMA-assisted therapy. It reviews recent evidence that supports the safe and potentially effective use of MDMA to treat negative symptoms and concludes with considerations regarding safety and possible mechanisms of action.
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Affiliation(s)
- Mitchell D. Arnovitz
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
| | - Andrew J. Spitzberg
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
| | - Ashkhan J. Davani
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
| | - Nehal P. Vadhan
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | | | - John M. Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Timothy I. Michaels
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Queens, NY 11004, USA; (M.D.A.); (A.J.S.); (A.J.D.); (N.P.V.); (J.M.K.)
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- Correspondence:
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11
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Spilka MJ, Keller WR, Buchanan RW, Gold JM, Koenig JI, Strauss GP. Endogenous oxytocin levels are associated with facial emotion recognition accuracy but not gaze behavior in individuals with schizophrenia. Acta Psychiatr Scand 2022; 145:494-506. [PMID: 35243618 PMCID: PMC9007857 DOI: 10.1111/acps.13421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/26/2022] [Accepted: 02/26/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Difficulties in social cognition are common in individuals with schizophrenia (SZ) and are not ameliorated by antipsychotic treatment. Intranasal oxytocin (OT) administration has been explored as a potential intervention to improve social cognition; however, results are inconsistent, suggesting potential individual difference variables that may influence treatment response. Less is known about the relationship between endogenous OT and social cognition in SZ, knowledge of which may improve the development of OT-focused therapies. We examined plasma OT in relationship to facial emotion recognition and visual attention to salient facial features in SZ and controls. METHODS Forty-two individuals with SZ and 23 healthy controls viewed photographs of facial expressions of varying emotional intensity and identified the emotional expression displayed. Participants' gaze behavior during the task was recorded via eye tracking. Plasma oxytocin concentrations were determined by radioimmunoassay. RESULTS SZ were less accurate than controls at identifying high-intensity fearful facial expressions and low-intensity sad expressions. Lower overall and high-intensity facial emotion recognition accuracy was associated with lower plasma OT levels in SZ but not controls. OT was not associated with visual attention to salient facial features; however, SZ had reduced visual attention to the nose region compared to controls. CONCLUSION Individual differences in endogenous OT predict facial emotion recognition ability in SZ but are not associated with visual attention to salient facial features. Increased understanding of the association between endogenous OT and social cognitive abilities in SZ may help improve the design and interpretation of OT-focused clinical trials in SZ.
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Affiliation(s)
| | - William R. Keller
- Dartmouth College, Geisel School of Medicine, Department of Psychiatry, USA
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, USA
| | - James I. Koenig
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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12
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Wang P, Wang SC, Liu X, Jia S, Wang X, Li T, Yu J, Parpura V, Wang YF. Neural Functions of Hypothalamic Oxytocin and its Regulation. ASN Neuro 2022; 14:17590914221100706. [PMID: 35593066 PMCID: PMC9125079 DOI: 10.1177/17590914221100706] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Oxytocin (OT), a nonapeptide, has a variety of functions. Despite extensive studies on OT over past decades, our understanding of its neural functions and their regulation remains incomplete. OT is mainly produced in OT neurons in the supraoptic nucleus (SON), paraventricular nucleus (PVN) and accessory nuclei between the SON and PVN. OT exerts neuromodulatory effects in the brain and spinal cord. While magnocellular OT neurons in the SON and PVN mainly innervate the pituitary and forebrain regions, and parvocellular OT neurons in the PVN innervate brainstem and spinal cord, the two sets of OT neurons have close interactions histologically and functionally. OT expression occurs at early life to promote mental and physical development, while its subsequent decrease in expression in later life stage accompanies aging and diseases. Adaptive changes in this OT system, however, take place under different conditions and upon the maturation of OT release machinery. OT can modulate social recognition and behaviors, learning and memory, emotion, reward, and other higher brain functions. OT also regulates eating and drinking, sleep and wakefulness, nociception and analgesia, sexual behavior, parturition, lactation and other instinctive behaviors. OT regulates the autonomic nervous system, and somatic and specialized senses. Notably, OT can have different modulatory effects on the same function under different conditions. Such divergence may derive from different neural connections, OT receptor gene dimorphism and methylation, and complex interactions with other hormones. In this review, brain functions of OT and their underlying neural mechanisms as well as the perspectives of their clinical usage are presented.
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Affiliation(s)
- Ping Wang
- Department of Genetics, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Stephani C. Wang
- Division of Cardiology, Department of Medicine, University of California-Irvine, Irvine, California, USA
| | - Xiaoyu Liu
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Shuwei Jia
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Xiaoran Wang
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Tong Li
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
- Neuroscience Laboratory for Translational Medicine, School of Mental Health, Qiqihar Medical University, Qiqihar, China
| | - Jiawei Yu
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
- Kerqin District Maternity & Child Healthcare Hospital, Tongliao, Inner Mongolia, China
| | - Vladimir Parpura
- Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yu-Feng Wang
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
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13
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Kaliuzhna M, Kirschner M, Carruzzo F, Hartmann-Riemer MN, Bischof M, Seifritz E, Tobler PN, Kaiser S. How far to go in deconstructing negative symptoms? Behavioural and neural level evidence for the amotivation domain. Schizophr Res 2021; 236:41-47. [PMID: 34390980 DOI: 10.1016/j.schres.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/06/2021] [Accepted: 08/04/2021] [Indexed: 11/15/2022]
Abstract
Negative symptoms in schizophrenia are conceptualised as loading onto two factors: amotivation and diminished expression, which relate to different behavioural and neural markers. This distinction has proven useful for understanding the cognitive, motivational and neural mechanisms involved in negative symptoms, and for the development of treatments. Recently, it has been advocated that an even finer distinction into five subdomains is needed to understand the mechanisms underlying negative symptoms, and to prevent masking specific treatment and intervention effects. However, it is currently unclear whether such a fine-grained approach offers additional insights grounded in theory. In the present work, we focused on the factor amotivation, which has been shown to selectively correlate with the propensity to discount rewards in the face of effort and with the activity in the ventral striatum during reward anticipation. In a reanalysis of these studies we explored whether subdomains of amotivation - avolition, asociality, anhedonia - showed preferential correlation with these previously identified behavioural and neural markers. We show that for both behavioural and neural markers, a fine-grained model with the three subdomains did not better explain the data than a model with the amotivation factor only. Moreover, none of the three subdomains correlated significantly more or less with the behavioural or neural markers. Thus, no additional information was gained on amotivation in schizophrenia by selectively looking at its three subdomains. Consequently, the two-factor solution currently remains a valid option for the study of negative symptoms and further research is needed for behavioural and neural validation of the five-factor model.
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Affiliation(s)
- Mariia Kaliuzhna
- Clinical and Experimental Psychopathology Group, Department of Psychiatry, University of Geneva, Switzerland.
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Fabien Carruzzo
- Clinical and Experimental Psychopathology Group, Department of Psychiatry, University of Geneva, Switzerland
| | - Matthias N Hartmann-Riemer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Martin Bischof
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Philippe N Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Switzerland
| | - Stefan Kaiser
- Clinical and Experimental Psychopathology Group, Department of Psychiatry, University of Geneva, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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14
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Sabe M, Zhao N, Crippa A, Strauss GP, Kaiser S. Intranasal Oxytocin for Negative Symptoms of Schizophrenia: Systematic Review, Meta-Analysis, and Dose-Response Meta-Analysis of Randomized Controlled Trials. Int J Neuropsychopharmacol 2021; 24:601-614. [PMID: 33890987 PMCID: PMC8378078 DOI: 10.1093/ijnp/pyab020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/12/2021] [Accepted: 04/21/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Negative symptoms are a core aspect of psychopathology in schizophrenia. Currently available pharmacological agents have proven minimally efficacious for remediating negative symptoms. A promising treatment avenue is the intranasal administration of the neuropeptide oxytocin. However, there have been inconsistencies in effects of oxytocin on negative symptoms throughout the literature, and factors leading to inconsistent effects are unclear. METHODS We conducted a systematic review and meta-analysis of randomized clinical trials to compare the effectiveness of oxytocin with placebo for the treatment of negative symptoms and determine moderators of treatment effect. Random effects meta-analyses and dose-response meta-analysis were performed on mean changes in negative symptoms. RESULTS In an initial analysis of all 9 identified randomized clinical trials, intranasal oxytocin showed no significant effect on negative symptoms. For higher doses (>40-80 IU), a beneficial effect on negative symptoms was found with a moderate effect size, but this effect disappeared after exclusion of 1 outlier study. The dose-response meta-analysis predicted that higher doses of oxytocin may be more efficacious for negative symptoms. For positive symptoms, no beneficial effect of oxytocin was found in the main meta-analysis, but the dose-response meta-analysis suggested a potential advantage of higher doses. CONCLUSIONS The present results show no consistent beneficial effect of intranasal oxytocin for the treatment of negative and positive symptoms. The dose-response meta-analysis does not allow drawing any firm conclusions but suggests that high doses of intranasal oxytocin may be more efficacious. If future studies are conducted, an effort to reach adequate CNS concentrations for a sufficient duration is required.
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Affiliation(s)
- Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Nan Zhao
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Alessio Crippa
- Department of Public Health Sciences, Karolinska Institutet, Stockholm,Sweden
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
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15
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Nakata Y, Kanahara N, Kimura A, Niitsu T, Komatsu H, Oda Y, Nakamura M, Ishikawa M, Hasegawa T, Kamata Y, Yamauchi A, Inazumi K, Kimura H, Shiko Y, Kawasaki Y, Iyo M. Oxytocin system dysfunction in patients with treatment-resistant schizophrenia: Alterations of blood oxytocin levels and effect of a genetic variant of OXTR. J Psychiatr Res 2021; 138:219-227. [PMID: 33866050 DOI: 10.1016/j.jpsychires.2021.03.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
Treatment-resistant schizophrenia (TRS) has a quite complex pathophysiology that includes not only severe positive symptoms but also other symptom domains. Much attention has been devoted to the overlapping psychological and biological profiles of schizophrenia and autistic spectrum disorder (ASD). We compared TRS patients (n = 30) with schizophrenia patients in remission (RemSZ, n = 28) and ASD patients (n = 28), focusing on general cognitive and social cognitive impairment and oxytocin system dysfunction. Our analyses revealed that there was no difference in oxytocin concentration among the three groups. The TRS patients' oxytocin blood concentrations were positively correlated with their processing speed and theory-of-mind scores, whereas the RemSZ and ASD groups had no significant relation with any measures. Rs53576, a single nucleotide polymorphism on the oxytocin receptor gene, affected social cognition abilities in the schizophrenia group. Although the overall findings are preliminary, they indicate that oxytocin system dysfunction could be involved in the serious cognitive deficits in TRS patients. Further, these results suggest that patients with TRS might have early neurodevelopmental abnormalities based on their shared biological features with ASD patients.
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Affiliation(s)
- Yusuke Nakata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan.
| | - Atsushi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideki Komatsu
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasunori Oda
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Miwako Nakamura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masatomo Ishikawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Palliative Care Center, Chiba University Hospital, Chiba, Japan
| | - Yu Kamata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Yamauchi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Psychiatry, Chiba Rosai Hospital, Ichihara, Japan
| | - Kazuhiko Inazumi
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Psychiatry, Gakuji-kai Kimura Hospital, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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16
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Oxytocin in Schizophrenia: Pathophysiology and Implications for Future Treatment. Int J Mol Sci 2021; 22:ijms22042146. [PMID: 33670047 PMCID: PMC7926349 DOI: 10.3390/ijms22042146] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022] Open
Abstract
Schizophrenia is a form of mental disorder that is behaviorally characterized by abnormal behavior, such as social function deficits or other behaviors that are disconnected from reality. Dysregulation of oxytocin may play a role in regulating the expression of schizophrenia. Given oxytocin’s role in social cognition and behavior, a variety of studies have examined the potential clinical benefits of oxytocin in improving the psychopathology of patients with schizophrenia. In this review, we highlight the evidence for the role of endogenous oxytocin in schizophrenia, from animal models to human studies. We further discuss the potential of oxytocin as a therapeutic agent for schizophrenia and its implication in future treatment.
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17
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Sanathara N, Alhassen L, Marmouzi I, Khoudari M, Phan J, Alhassen W, Civelli O, Alachkar A. Oxytocin-MCH circuit regulates monosynaptic inputs to MCH neurons and modulates social recognition memory. Neuropharmacology 2020; 184:108423. [PMID: 33290754 DOI: 10.1016/j.neuropharm.2020.108423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023]
Abstract
Oxytocin regulates social behaviors and has been linked to the etiology of autism and schizophrenia. Oxytocin and another hypothalamic neuropeptide, melanin concentrating hormone (MCH), share several physiological actions such as emotion, social behavior and recognition, maternal care, sexual behavior and stress, which suggests that these two systems may interact, however, how they would do it is not known. Here, we study the interactions between the oxytocin and MCH systems in behaviors related to autism and schizophrenia. Specifically, we examined the synaptic inputs of the oxytocin-to the MCH neurons. We selectively deleted oxytocin receptors (OXTR) from MCH neurons (OXTR-cKO mice) using a Cre/loxP recombinase-technology, and used rabies-mediated circuit mapping technique to reveal the changes in the direct monosynaptic inputs to MCH neurons. We examined the behavioral responses of OXTR-cKO mice. Deletion of OXTR from MCH neurons induced a significant decrease in the primary inputs received by MCH neurons from the paraventricular nucleus and the lateral hypothalamus, and from the nucleus accumbens and ventral tegmental area. While OXTR-cKO mice exhibited similar social interactions as control mice, they displayed significantly impaired social recognition memory and increased stereotypic behavior. Our study identifies a selective role for the oxytocin-MCH pathway in social recognition memory and stereotyped behavior that are relevant to psychiatric disorders such as schizophrenia and autism, and warrant further investigation of this circuit to uncover potential benefit of targeting the oxytocin-MCH circuit as a novel therapeutic target for treatment of social recognition deficits in these two disorders.
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Affiliation(s)
- Nayna Sanathara
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA
| | - Lamees Alhassen
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA
| | - Ilias Marmouzi
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA
| | - Mohammad Khoudari
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA
| | - Joseph Phan
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA
| | - Wedad Alhassen
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA
| | - Olivier Civelli
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA; Department of Developmental and Cell Biology, School of Biological Sciences, University of California-Irvine, CA, 92697, USA
| | - Amal Alachkar
- Departments of Pharmaceutical Sciences, School of Pharmacy, University of California-Irvine, CA, 92697, USA; Institute for Genomics and Bioinformatics, School of Information and Computer Sciences, University of California-Irvine, CA, 92697, USA.
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18
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Hudgens-Haney ME, Clementz BA, Ivleva EI, Keshavan MS, Pearlson GD, Gershon ES, Keedy SK, Sweeney JA, Gaudoux F, Bunouf P, Canolle B, Tonner F, Gatti-McArthur S, Tamminga CA. Cognitive Impairment and Diminished Neural Responses Constitute a Biomarker Signature of Negative Symptoms in Psychosis. Schizophr Bull 2020; 46:1269-1281. [PMID: 32043133 PMCID: PMC7505197 DOI: 10.1093/schbul/sbaa001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The treatment of negative symptoms (NS) in psychosis represents an urgent unmet medical need given the significant functional impairment it contributes to psychosis syndromes. The lack of progress in treating NS is impacted by the lack of known pathophysiology or associated quantitative biomarkers, which could provide tools for research. This current analysis investigated potential associations between NS and an extensive battery of behavioral and brain-based biomarkers in 932 psychosis probands from the B-SNIP database. The current analyses examined associations between PANSS-defined NS and (1) cognition, (2) pro-/anti-saccades, (3) evoked and resting-state electroencephalography (EEG), (4) resting-state fMRI, and (5) tractography. Canonical correlation analyses yielded symptom-biomarker constructs separately for each biomarker modality. Biomarker modalities were integrated using canonical discriminant analysis to summarize the symptom-biomarker relationships into a "biomarker signature" for NS. Finally, distinct biomarker profiles for 2 NS domains ("diminished expression" vs "avolition/apathy") were computed using step-wise linear regression. NS were associated with cognitive impairment, diminished EEG response amplitudes, deviant resting-state activity, and oculomotor abnormalities. While a connection between NS and poor cognition has been established, association to neurophysiology is novel, suggesting directions for future mechanistic studies. Each biomarker modality was related to NS in distinct and complex ways, giving NS a rich, interconnected fingerprint and suggesting that any one biomarker modality may not adequately capture the full spectrum of symptomology.
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Affiliation(s)
| | - Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT
- Institute of Living, Hartford Hospital, Hartford, CT
| | | | - Sarah K Keedy
- Department of Psychiatry, University of Chicago, Chicago, IL
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | | | | | | | | | | | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
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19
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Carnemolla SE, Hsieh JW, Sipione R, Landis BN, Kumfor F, Piguet O, Manuel AL. Olfactory dysfunction in frontotemporal dementia and psychiatric disorders: A systematic review. Neurosci Biobehav Rev 2020; 118:588-611. [PMID: 32818582 DOI: 10.1016/j.neubiorev.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a progressive neurodegenerative disease. Diagnosis of FTD, especially the behavioural variant, is challenging because of symptomatic overlap with psychiatric disorders (depression, schizophrenia, bipolar disorder). Olfactory dysfunction is common in both FTD and psychiatric disorders, and often appears years before symptom onset. This systematic review analysed 74 studies on olfactory function in FTD, depression, schizophrenia and bipolar disorder to identify differences in olfactory dysfunction profiles, focusing on the most common smell measures: odour identification and discrimination. Results revealed that FTD patients were severely impaired in odour identification but not discrimination; in contrast, patients diagnosed with schizophrenia showed impairments in both measures, while those diagnosed with depression showed no olfactory impairments. Findings in bipolar disorder were mixed. Therefore, testing odour identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. Given the high prevalence of odour identification impairments in FTD, and that smell dysfunction predicts neurodegeneration in other diseases, olfactory testing seems a promising avenue towards improving diagnosis between FTD and psychiatric disorders.
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Affiliation(s)
| | - Julien Wen Hsieh
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Rebecca Sipione
- Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Basile N Landis
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Aurélie L Manuel
- The University of Sydney, Brain & Mind Centre, Sydney, Australia.
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20
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Guessoum SB, Le Strat Y, Dubertret C, Mallet J. A transnosographic approach of negative symptoms pathophysiology in schizophrenia and depressive disorders. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109862. [PMID: 31927053 DOI: 10.1016/j.pnpbp.2020.109862] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Negative Symptoms (blunted affect, alogia, anhedonia, avolition and asociality) are observed in schizophrenia but also in depressive disorders. OBJECTIVE To gather cognitive, neuroanatomical, neurofunctional and neurobiological knowledge of negative symptoms in studies on schizophrenia, depressive disorder, and transnosographic studies. RESULTS Blunted affect in schizophrenia is characterized by amygdala hyperactivation and frontal hypoactivation, also found in depressive disorder. Mirror neurons, may be related to blunted affect in schizophrenia. Alogia may be related to cognitive dysfunction and basal ganglia area impairments in schizophrenia. Data surrounding alogia in depressive disorder is scarce; wider speech deficits are often studied instead. Consummatory Anhedonia may be less affected than Anticipatory Anhedonia in schizophrenia. Anhedonia is associated with reward impairments and altered striatal functions in both diagnostics. Amotivation is associated with Corticostriatal Hypoactivation in both disorders. Anhedonia and amotivation are transnosographically associated with dopamine dysregulation. Asociality may be related to oxytocin. CONCLUSION Pathophysiological hypotheses are specific to each dimension of negative symptoms and overlap across diagnostic boundaries, possibly underpinning the observed clinical continuum.
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Affiliation(s)
- Sélim Benjamin Guessoum
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France
| | - Yann Le Strat
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France.
| | - Caroline Dubertret
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France.
| | - Jasmina Mallet
- AP-HP; Psychiatry Department, University Hospital Louis Mourier; University of Paris, 178 rue des Renouillers, 92700 Colombes, France; INSERM UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), 102-108 rue de la Santé, 75014 Paris, France.
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21
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Banki L, Büki A, Horvath G, Kekesi G, Kis G, Somogyvári F, Jancsó G, Vécsei L, Varga E, Tuboly G. Distinct changes in chronic pain sensitivity and oxytocin receptor expression in a new rat model (Wisket) of schizophrenia. Neurosci Lett 2020; 714:134561. [DOI: 10.1016/j.neulet.2019.134561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 10/11/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022]
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22
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Strauss GP, Granholm E, Holden JL, Ruiz I, Gold JM, Kelly DL, Buchanan RW. The effects of combined oxytocin and cognitive behavioral social skills training on social cognition in schizophrenia. Psychol Med 2019; 49:1731-1739. [PMID: 30180918 DOI: 10.1017/s0033291718002465] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with schizophrenia have deficits in social cognition that are associated with poor functional outcome. Unfortunately, current treatments result in only modest improvement in social cognition. Oxytocin, a neuropeptide with pro-social effects, has significant benefits for social cognition in the general population. However, studies examining the efficacy of oxytocin in schizophrenia have yielded inconsistent results. One reason for inconsistency may be that oxytocin has typically not been combined with psychosocial interventions. It may be necessary for individuals with schizophrenia to receive concurrent psychosocial treatment while taking oxytocin to have the context needed to make gains in social cognitive skills. METHODS The current study tested this hypothesis in a 24-week (48 session) double-blind, placebo-controlled trial that combined oxytocin and Cognitive-Behavioral Social Skills Training (CBSST), which included elements from Social Cognition and Interaction Training (SCIT). Participants included 62 outpatients diagnosed with schizophrenia (placebo n = 31; oxytocin n = 31) who received 36 IU BID, with supervised administration 45 min prior to sessions on CBSST group therapy days. Participants completed a battery of measures administered at 0, 12, and 24 weeks that assessed social cognition. RESULTS CBSST generally failed to enhance social cognition from baseline to end of study, and there was no additive benefit of oxytocin beyond the effects of CBSST alone. CONCLUSIONS Findings suggest that combined CBSST and oxytocin had minimal benefit for social cognition, adding to the growing literature indicating null effects of oxytocin in multi-dose trials. Methodological and biological factors may contribute to inconsistent results across studies.
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Affiliation(s)
| | - Eric Granholm
- VA San Diego Healthcare System, Department of Psychiatry,University of California San Diego School of Medicine,San Diego, CA,USA
| | - Jason L Holden
- VA San Diego Healthcare System, Department of Psychiatry,University of California San Diego School of Medicine,San Diego, CA,USA
| | - Ivan Ruiz
- Department of Psychology,University of Georgia,Athens, GA,USA
| | - James M Gold
- Department of Psychiatry,Maryland Psychiatric Research Center, University of Maryland School of Medicine,Baltimore, MD,USA
| | - Deanna L Kelly
- Department of Psychiatry,Maryland Psychiatric Research Center, University of Maryland School of Medicine,Baltimore, MD,USA
| | - Robert W Buchanan
- Department of Psychiatry,Maryland Psychiatric Research Center, University of Maryland School of Medicine,Baltimore, MD,USA
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Strauss GP, Chapman HC, Keller WR, Koenig JI, Gold JM, Carpenter WT, Buchanan RW. Endogenous oxytocin levels are associated with impaired social cognition and neurocognition in schizophrenia. J Psychiatr Res 2019; 112:38-43. [PMID: 30849617 DOI: 10.1016/j.jpsychires.2019.02.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 02/15/2019] [Accepted: 02/21/2019] [Indexed: 01/20/2023]
Abstract
Intranasal administration of the neuropeptide oxytocin (OT) has yielded inconsistent effects on social cognition and general cognition in individuals with schizophrenia (SZ). Few studies have examined whether endogenous peripheral OT levels are also associated with social and general cognition in SZ. The current study examined whether plasma OT levels are associated with performance on a higher-order social cognition measure (i.e., a task that requires inferential processes and knowledge not directly presented in social stimuli), as well as domains of general cognition. Participants included 30 individuals with SZ and 21 demographically matched healthy controls (CN). The MATRICS Consensus Cognitive Battery was administered to assess neuropsychological impairment in relation to 7 domains (processing speed, attention/vigilance, working memory, verbal learning, visual learning, reasoning/problem solving, and social cognition). Plasma OT levels were measured via radioimmunoassay. SZ had significantly lower endogenous OT levels and poorer MCCB performance on all 7 domains than CN. In CN and SZ, lower endogenous OT was associated with poorer social cognition. In SZ, lower endogenous OT was also associated with poorer processing speed and working memory. The significant association between OT and social cognition in both CN and SZ highlights the importance of endogenous OT levels as a biological predictor of social cognition, irrespective of clinical status. Significant associations between plasma OT and general neurocognition may reflect either an anxiolytic effect of plasma OT that results in better neurocognitive performance, or OT's action on dopamine and enhancement of dopamine tone that results in improved cognition.
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Affiliation(s)
| | | | - William R Keller
- Dartmouth College Geisel School of Medicine, Department of Psychiatry, USA
| | - James I Koenig
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
| | - James M Gold
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
| | - William T Carpenter
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
| | - Robert W Buchanan
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center, USA
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24
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Luckhaus C, Juckel G, Hurlemann R. [Oxytocin in schizophrenia : Evidence for an etiological and therapeutic relevance of the social neuromodulator]. DER NERVENARZT 2019; 90:277-284. [PMID: 30215130 DOI: 10.1007/s00115-018-0615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Neurobiological results from animal models as well as biochemical and genetic findings in patients indicate that the oxytocin (OT) system may be dysfunctional in schizophrenia. On this pathogenetic basis transnasally administered OT (tnOT) could be an innovative treatment option for schizophrenia. Experimental data from animal studies are also suggestive of a particular effectiveness in treatment-resistant schizophrenia. To date, clinical data on tnOT treatment of schizophrenia patients does not unequivocally support a general therapeutic effect on the psychopathology but suggests positive effects on higher integrated social cognitive performance, such as empathy and mentalization. In particular, tnOT augmentation of a social cognitive skills training resulted in a marked and lasting treatment effect; however, numerous person- and context-dependent variables can potentially moderate individual effects of OT and may even reverse effects in certain constellations. Most clinical studies so far have not systematically accounted and controlled for these factors with the probable result of larger variance of recorded treatment effects and lower likelihood of ascertaining positive effectiveness. Furthermore, there is still a gap of knowledge on dose response relations and central nervous system (CNS) permeation in man following tnOT administration. This review aims to give a concise overview on the evidence for the etiological relevance of the neurohormone OT and its treatment potential in schizophrenia.
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Affiliation(s)
- C Luckhaus
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin der Ruhr-Universität Bochum, LWL-Universitätsklinikum Bochum, Alexandrinenstr 1-3, 44791, Bochum, Deutschland.
| | - G Juckel
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin der Ruhr-Universität Bochum, LWL-Universitätsklinikum Bochum, Alexandrinenstr 1-3, 44791, Bochum, Deutschland
| | - R Hurlemann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Deutschland
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25
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Oxytocin reduces a chemosensory-induced stress bias in social perception. Neuropsychopharmacology 2019; 44:281-288. [PMID: 29703998 PMCID: PMC6300531 DOI: 10.1038/s41386-018-0063-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/02/2018] [Accepted: 04/04/2018] [Indexed: 01/01/2023]
Abstract
Social transmission of fear is not restricted to visual or auditory cues, but extends to the phylogenetically more ancient olfactory domain. Anxious individuals exhibit heightened sensitivity towards chemosensory stress signals in sweat; however, it is still unknown whether endogenous neuromodulators such as the peptide hormone oxytocin (OXT) influence the chemosensory communication of stress. Here, we investigated whether OXT selectively diminishes behavioral and neural responses to social chemosensory stress cues utilizing a randomized, double-blind, placebo (PLC)-controlled, within-subject functional MRI study design. Axillary sweat was obtained from 30 healthy male donors undergoing the Trier Social Stress Test (stress) and bicycle ergometer training (sport). Subsequently, 58 healthy participants (30 females) completed a forced-choice emotional face recognition task with stimuli of varying intensities (neutral to fearful) while they were exposed to both sweat stimuli and a non-social control odor following intranasal OXT or PLC administration, respectively. OXT diminished stress-induced recognition accuracy and response time biases towards fear. On the neural level, OXT reduced stress-evoked responses in the amygdala in both sexes, the anterior cingulate cortex (ACC) in females, and the hippocampus in males. Furthermore, OXT reinstated the functional connectivity between the ACC and the fusiform face area that was disrupted by stress odors under PLC. Our findings reveal a new role for OXT signaling in the modulation of chemosensory communication of stress in humans. Mechanistically, this effect appears to be rooted in a downregulation of stress-induced limbic activations and concomitant strengthening of top-down control descending from the ACC to the fusiform face area.
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26
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Aydın O, Balıkçı K, Taş C, Ünal-Aydın P, Taneli F, Esen-Danacı A. Assessing the relationship between attachment, parental attitude and plasma oxytocin in schizophrenia patients and their unaffected siblings. Nord J Psychiatry 2019; 73:51-57. [PMID: 30636461 DOI: 10.1080/08039488.2018.1554698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND It is widely acknowledged that schizophrenia patients tend to have insecure attachment styles and improper parenting. However, the biological processes related to these adversities remain unclear and that the disturbance in oxytocin system is considered as one of the strongest predictors of such adversities. METHODS Thirty-four patients with schizophrenia and their unaffected thirty-four healthy siblings were recruited for the study and they were compared with thirty-one healthy controls. We examined attachment styles via Experience in Close Relationship-Revised Test and perceived parental attitudes with the My Memories of Upbringing-Short Version Test. In addition, we evaluated plasma oxytocin levels across groups. RESULTS The patients with schizophrenia had lower plasma oxytocin levels and obtained higher levels for attachment anxiety and avoidance with more parental rejection and over protection. There was a significantly negative relationship between the levels of plasma oxytocin in blood and parental over protection in the healthy sibling and healthy control groups. In contrast, there was a significantly positive relationship between the levels of plasma oxytocin in blood and parental over protection in the schizophrenia group. Results of the regression analyses revealed that the plasma oxytocin levels and over protection were notable factors in discriminating the groups from each other. CONCLUSION Our findings suggested that disturbance in oxytocin is associated with susceptibility to schizophrenia predisposition. In sum, therapeutic interventions that address oxytocin and over protection may influence the outcomes in this severe mental disorder.
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Affiliation(s)
- Orkun Aydın
- a Department of Psychology, Faculty of Arts and Social Sciences , International University of Sarajevo , Sarajevo , Bosnia-Herzegovina
| | - Kuzeymen Balıkçı
- b Department of Psychiatry, School of Medicine , Near East University , Nicosia , Northern Cyprus Turkish Republic
| | - Cumhur Taş
- c Department of Psychology, Faculty of Humanities and Social Sciences , Uskudar University , Istanbul , Turkey
| | - Pınar Ünal-Aydın
- a Department of Psychology, Faculty of Arts and Social Sciences , International University of Sarajevo , Sarajevo , Bosnia-Herzegovina
| | - Fatma Taneli
- d Department of Medical Biochemistry, Faculty of Medicine , Celal Bayar University , Manisa , Turkey
| | - Ayşen Esen-Danacı
- e Department of Psychiatry, Faculty of Medicine , Celal Bayar University , Manisa , Turkey
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27
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Kampka N, Frommann N, Henning U, Schwark R, Wölwer W, Pietrowsky R, Luckhaus C. Oxytocin reactivity to an emotional challenge paradigm and its relation to social-cognitive functions in healthy volunteers. J Neural Transm (Vienna) 2018; 126:211-218. [DOI: 10.1007/s00702-018-1955-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 11/06/2018] [Indexed: 12/16/2022]
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28
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Jusiak K, Brudkowska Ż, Gołębiowska M, Morylowska-Topolska J, Gołębiowska B, Próchnicki M, Próchnicka A, Karakuła-Juchnowicz H. The role of oxytocin in the pathogenesis and treatment of schizophrenia. CURRENT PROBLEMS OF PSYCHIATRY 2017. [DOI: 10.1515/cpp-2017-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: Until recently, oxytocin was mainly associated with the pathophysiology of childbirth and sexual functions, but lately this hormone has become the object of interest to psychiatry and psychology due to the significant influence of oxytocin on human behavior in the field of social and emotional functioning. Current scientific research focuses on the participation of oxytocin in the pathogenesis and therapy of mental disorders.
Aim: The aim of the paper is to present, on the basis of available literature, the significance of oxytocin for various psychological functions, with particular emphasis on the influence of oxytocin on the course and clinical picture of schizophrenia.
Method: Available articles from the Medline / PubMed database were analyzed, which were searched using keywords: oxytocin, schizophrenia, therapeutic use of oxytocin, social cognition, positive symptoms, negative symptoms and time descriptors: 2013-2017. There are included articles published in Polish and English.
Results:The research results carried out so far suggest that oxytocin plays a significant role in modulating complex socio-emotional behaviors in schizophrenic patients. The existing research results also indicate a relationship between the dysregulation of the oxytocinergic system and the pathophysiology of schizophrenia. Many of the studies prove that there is a relationship between the level of oxytocin in the patients' blood plasma and the severity of the disease symptoms. Recent genetic studies indicate a possible relationship between polymorphism of oxytocin genesand polymorphism of oxytocin receptor genes and the risk of developing schizophrenia.
Conclusions: Contemporary research on the therapeutic potential of oxytocin and its influence on the functioning of schizophrenia patients seem to be very promising and may contribute to increasing the effectiveness of treatment of schizophrenia and possibly other mental disorders, which in turn will improve the quality of life of patients in cognitive, social and emotional functioning.
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Affiliation(s)
- Katarzyna Jusiak
- I Department of Psychiatry, Psychotherapy and Early Intervention , Medical University of Lublin
| | - Żaneta Brudkowska
- Department of Clinical Neuropsychiatry , Medical University of Lublin
| | - Maria Gołębiowska
- Department of Pediatric Neurology, III Chair of Pediatrics , Medical University of Lublin
| | | | - Beata Gołębiowska
- Department of Pediatric Neurology, III Chair of Pediatrics , Medical University of Lublin
| | - Michał Próchnicki
- Department of Clinical Neuropsychiatry , Medical University of Lublin
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Balikci K, Aydin O, Tas C, Esen Danaci A. Oxytocin and social cognition in patients with schizophrenia: comparison with healthy siblings and healthy controls. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1387405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Kuzeymen Balikci
- Department of Psychiatry, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Orkun Aydin
- Izzet Baysal Mental Health and Disease Research and Training Hospital, Bolu, Turkey
| | - Cumhur Tas
- Department of Psychology, Uskudar University, Istanbul, Turkey
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30
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Stohn JP, Martinez ME, Zafer M, López-Espíndola D, Keyes LM, Hernandez A. Increased aggression and lack of maternal behavior in Dio3-deficient mice are associated with abnormalities in oxytocin and vasopressin systems. GENES BRAIN AND BEHAVIOR 2017; 17:23-35. [PMID: 28715127 DOI: 10.1111/gbb.12400] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/03/2017] [Accepted: 07/12/2017] [Indexed: 12/17/2022]
Abstract
Thyroid hormones regulate many aspects of brain development and function, and alterations in the levels of thyroid hormone action lead to abnormal anxiety- and depression-like behaviors. A complement of factors in the brain function independently of circulating levels of hormone to strictly controlled local thyroid hormone signaling. A critical factor is the type 3 deiodinase (DIO3), which is located in neurons and protects the brain from excessive thyroid hormone. Here, we examined whether a local increase in brain thyroid hormone action secondary to DIO3 deficiency is of consequence for social behaviors. Although we did not observe alterations in sociability, Dio3-/- mice of both sexes exhibited a significant increase in aggression-related behaviors and mild deficits in olfactory function. In addition, 85% of Dio3-/- dams manifested no pup-retrieval behavior and increased aggression toward the newborns. The abnormal social behaviors of Dio3-/- mice were associated with sexually dimorphic alterations in the physiology of oxytocin (OXT) and arginine vasopressin (AVP), 2 neuropeptides with important roles in determining social interactions. These alterations included low adult serum levels of OXT and AVP, and an abnormal expression of Oxt, Avp and their receptors in the neonatal and adult hypothalamus. Our results demonstrate that DIO3 is essential for normal aggression and maternal behaviors, and indicate that abnormal local regulation of thyroid hormone action in the brain may contribute to the social deficits associated with neurodevelopmental disorders.
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Affiliation(s)
- J P Stohn
- Maine Medical Center Research Institute, Center for Molecular Medicine, Scarborough, ME, USA
| | - M E Martinez
- Maine Medical Center Research Institute, Center for Molecular Medicine, Scarborough, ME, USA
| | - M Zafer
- Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - D López-Espíndola
- Maine Medical Center Research Institute, Center for Molecular Medicine, Scarborough, ME, USA
| | - L M Keyes
- Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - A Hernandez
- Maine Medical Center Research Institute, Center for Molecular Medicine, Scarborough, ME, USA
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31
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Kaiser S, Lyne J, Agartz I, Clarke M, Mørch-Johnsen L, Faerden A. Individual negative symptoms and domains - Relevance for assessment, pathomechanisms and treatment. Schizophr Res 2017; 186:39-45. [PMID: 27453425 DOI: 10.1016/j.schres.2016.07.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 12/12/2022]
Abstract
The negative symptoms of schizophrenia can be divided into two domains. Avolition/apathy includes the individual symptoms of avolition, asociality and anhedonia. Diminished expression includes blunted affect and alogia. Until now, causes and treatment of negative symptoms have remained a major challenge, which is partially related to the focus on negative symptoms as a broad entity. Here, we propose that negative symptoms may become more tractable when the different domains and individual symptoms are taken into account. There is now increasing evidence that the relationship with clinical variables - in particular outcome - differs between the domains of avolition/apathy and diminished expression. Regarding models of negative symptom formation, those relevant to avolition/apathy are now converging on processes underlying goal-directed behavior and dysfunctions of the reward system. In contrast, models of the diminished expression domains are only beginning to emerge. The aim of this article is to review the specific clinical, behavioral and neural correlates of individual symptoms and domains as a better understanding of these areas may facilitate specific treatment approaches.
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Affiliation(s)
- Stefan Kaiser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - John Lyne
- Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland; North Dublin Mental Health Services, Ashlin Centre, Beaumont Road, Dublin 9, Ireland; Dublin and East Treatment and Early Care Team (DETECT) Services, Dublin, Ireland
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT) Services, Dublin, Ireland; College of Life Sciences, University College Dublin, Dublin, Ireland
| | - Lynn Mørch-Johnsen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Ann Faerden
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Oxytocin effects in schizophrenia: Reconciling mixed findings and moving forward. Neurosci Biobehav Rev 2017; 80:36-56. [PMID: 28506922 DOI: 10.1016/j.neubiorev.2017.05.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 05/06/2017] [Accepted: 05/09/2017] [Indexed: 12/22/2022]
Abstract
Schizophrenia is a severe mental illness that causes major functional impairment. Current pharmacologic treatments are inadequate, particularly for addressing negative and cognitive symptoms of the disorder. Oxytocin, a neuropeptide known to moderate social behaviors, has been investigated as a potential therapeutic for schizophrenia in recent years. Results have been decidedly mixed, leading to controversy regarding oxytocin's utility. In this review, we outline several considerations for interpreting the extant literature and propose a focused agenda for future work that builds on the most compelling findings regarding oxytocin effects in schizophrenia to date. Specifically, we examine underlying causes of heterogeneity in randomized clinical trials (RCTs) conducted thus far and highlight the complexity of the human oxytocin system. We then review evidence of oxytocin's effects on specific deficits in schizophrenia, arguing for further study using objective, precise outcome measures in order to determine whether oxytocin has the potential to improve functional impairment in schizophrenia.
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33
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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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Abstract
Negative symptoms have long been conceptualized as a core aspect of schizophrenia. They play a key role in the functional outcome of the disorder, and their management represents a significant unmet need. Improvements in definition, characterization, assessment instruments and experimental models are needed in order to foster research aimed at developing effective interventions. A consensus has recently been reached on the following aspects: a) five constructs should be considered as negative symptoms, i.e. blunted affect, alogia, anhedonia, asociality and avolition; b) for each construct, symptoms due to identifiable factors, such as medication effects, psychotic symptoms or depression, should be distinguished from those regarded as primary; c) the five constructs cluster in two factors, one including blunted affect and alogia and the other consisting of anhedonia, avolition and asociality. In this paper, for each construct, we report the current definition; highlight differences among the main assessment instruments; illustrate quantitative measures, if available, and their relationship with the evaluations based on rating scales; and describe correlates as well as experimental models. We conclude that: a) the assessment of the negative symptom dimension has recently improved, but even current expert consensus-based instruments diverge on several aspects; b) the use of objective measures might contribute to overcome uncertainties about the reliability of rating scales, but these measures require further investigation and validation; c) the boundaries with other illness components, in particular neurocognition and social cognition, are not well defined; and d) without further reducing the heterogeneity within the negative symptom dimension, attempts to develop successful interventions are likely to lead to great efforts paid back by small rewards.
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Affiliation(s)
- Stephen R Marder
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Semel Institute for Neuroscience at UCLA, Los Angeles, CA, USA
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35
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Marder SR, Galderisi S. The current conceptualization of negative symptoms in schizophrenia. WORLD PSYCHIATRY : OFFICIAL JOURNAL OF THE WORLD PSYCHIATRIC ASSOCIATION (WPA) 2017. [PMID: 28127915 DOI: 10.1002/wps.20385.] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Negative symptoms have long been conceptualized as a core aspect of schizophrenia. They play a key role in the functional outcome of the disorder, and their management represents a significant unmet need. Improvements in definition, characterization, assessment instruments and experimental models are needed in order to foster research aimed at developing effective interventions. A consensus has recently been reached on the following aspects: a) five constructs should be considered as negative symptoms, i.e. blunted affect, alogia, anhedonia, asociality and avolition; b) for each construct, symptoms due to identifiable factors, such as medication effects, psychotic symptoms or depression, should be distinguished from those regarded as primary; c) the five constructs cluster in two factors, one including blunted affect and alogia and the other consisting of anhedonia, avolition and asociality. In this paper, for each construct, we report the current definition; highlight differences among the main assessment instruments; illustrate quantitative measures, if available, and their relationship with the evaluations based on rating scales; and describe correlates as well as experimental models. We conclude that: a) the assessment of the negative symptom dimension has recently improved, but even current expert consensus-based instruments diverge on several aspects; b) the use of objective measures might contribute to overcome uncertainties about the reliability of rating scales, but these measures require further investigation and validation; c) the boundaries with other illness components, in particular neurocognition and social cognition, are not well defined; and d) without further reducing the heterogeneity within the negative symptom dimension, attempts to develop successful interventions are likely to lead to great efforts paid back by small rewards.
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Affiliation(s)
- Stephen R Marder
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Semel Institute for Neuroscience at UCLA, Los Angeles, CA, USA
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36
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Ettinger U, Hurlemann R, Chan RCK. Oxytocin and Schizophrenia Spectrum Disorders. Curr Top Behav Neurosci 2017; 35:515-527. [PMID: 28864974 DOI: 10.1007/7854_2017_27] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In this chapter, we present an overview of studies of oxytocin (OXT) in schizophrenia and the schizophrenia spectrum. We first outline the current state of pharmacological treatment of the symptoms of schizophrenia and point to unmet clinical needs. These relate particularly to the debilitating negative symptoms and social cognitive deficits that are frequently observed in patients suffering from schizophrenia. We argue that new treatments are needed to alleviate these impairments. As OXT has been proposed and investigated as a putative treatment, we will then summarise evidence from studies in patients with schizophrenia that have investigated the effects of OXT at several levels, i.e. at the levels of clinical symptoms, social cognitive function as assessed with experimental and neuropsychological tasks, and brain function as assessed using functional magnetic resonance imaging (fMRI). Finally, we will introduce the concept of the schizophrenia spectrum and highlight the importance of studying OXT effects in subclinical spectrum samples, such as in people with high levels of schizotypal personality. We conclude that the evidence of beneficial effects of OXT in schizophrenia is inconsistent, calling for further research in this field.
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Affiliation(s)
- Ulrich Ettinger
- Department of Psychology, University of Bonn, Bonn, Germany.
| | - René Hurlemann
- Department of Psychiatry, Division of Medical Psychology, University of Bonn - Medical Center, Bonn, Germany
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience (NACN) Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Strauss GP, Gold JM. A Psychometric Comparison of the Clinical Assessment Interview for Negative Symptoms and the Brief Negative Symptom Scale. Schizophr Bull 2016; 42:1384-1394. [PMID: 27174556 PMCID: PMC5049528 DOI: 10.1093/schbul/sbw046] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In 2005, the National Institute of Mental Health held a consensus development conference on negative symptoms of schizophrenia. Among the important conclusions of this meeting were that there are at least 5 commonly accepted domains of negative symptoms (blunted affect, alogia, avolition, anhedonia, asociality) and that new rating scales were needed to adequately assess these constructs. Two next-generation negative symptom scales resulted from this meeting: the Brief Negative Symptom Scale (BNSS) and Clinical Assessment Interview for Negative Symptoms (CAINS). Both measures are becoming widely used and studies have demonstrated good psychometric properties for each scale. The current study provides the first direct psychometric comparison of these scales. Participants included 65 outpatients diagnosed with schizophrenia or schizoaffective disorder who completed clinical interviews, questionnaires, and neuropsychological testing. Separate raters completed the BNSS and CAINS within the same week. Results indicated that both measures had good internal consistency, convergent validity, and discriminant validity. High correspondence was observed between CAINS and BNSS blunted affect and alogia items. Moderate convergence occurred for avolition and asociality items, and low convergence was seen among anhedonia items. Findings suggest that both scales have good psychometric properties, but that there are important distinctions among the items related to motivation and pleasure.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, State University of New York at Binghamton, Binghamton, NY;
| | - James M Gold
- Department of Psychiatry and Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
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Brambilla M, Cotelli M, Manenti R, Dagani J, Sisti D, Rocchi M, Balestrieri M, Pini S, Raimondi S, Saviotti FM, Scocco P, de Girolamo G. Oxytocin to modulate emotional processing in schizophrenia: A randomized, double-blind, cross-over clinical trial. Eur Neuropsychopharmacol 2016; 26:1619-28. [PMID: 27527256 DOI: 10.1016/j.euroneuro.2016.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/25/2016] [Accepted: 08/01/2016] [Indexed: 12/19/2022]
Abstract
Deficits in social cognition, including emotional processing, are hallmarks of schizophrenia and antipsychotic agents seem to be ineffectual to improve these symptoms. However, oxytocin does seem to have beneficial effects on social cognition. The aim of this study was to examine the effects of four months of treatment with intranasal oxytocin, in 31 patients with schizophrenia, on distinct aspects of social cognition. This was assessed using standardized and experimental tests in a randomized, double-blind, placebo-controlled, cross-over trial. All patients underwent clinical and experimental assessment before treatment, four months after treatment and at the end of treatment. Social cognition abilities were assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Reading the Mind in the Eyes task (RMET). Furthermore, an Emotional Priming Paradigm (EPP) was developed to examine the effects of oxytocin on implicit perceptual sensitivity to affective information and explicit facial affect recognition. We found that oxytocin improved performance on MSCEIT compared to placebo in Branch 3-Understanding Emotion (p-value=0.004; Cohen׳s d=1.12). In the EPP task, we observed a significant reduction of reaction times for facial affect recognition (p-value=0.021; Cohen׳s d=0.88). No effects were found for implicit priming or for theory of mind abilities. Further study is required in order to highlight the potential for possible integration of oxytocin with antipsychotic agents as well as to evaluate psycho-social treatment as a multi-dimensional approach to increase explicit emotional processing abilities and compensate social cognition deficits related to schizophrenia.
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Affiliation(s)
- Michela Brambilla
- Neuropsychology Unit, IRCCS Saint John of God Clinical Research Centre, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Saint John of God Clinical Research Centre, Brescia, Italy.
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Saint John of God Clinical Research Centre, Brescia, Italy
| | - Jessica Dagani
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Saint John of God Clinical Research Centre, Brescia, Italy
| | - Davide Sisti
- Department of Biomolecular Science, University of Urbino, Italy
| | - Marco Rocchi
- Department of Biomolecular Science, University of Urbino, Italy
| | | | - Stefano Pini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Raimondi
- Department of Mental Health, ASST Garda (Brescia), Italy
| | | | - Paolo Scocco
- Department of Mental Health (ULSS 16), Padua, Italy
| | - Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Saint John of God Clinical Research Centre, Brescia, Italy
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Lee MR, Wehring HJ, McMahon RP, Liu F, Linthicum J, Verbalis JG, Buchanan RW, Strauss GP, Rubin LH, Kelly DL. Relationship of plasma oxytocin levels to baseline symptoms and symptom changes during three weeks of daily oxytocin administration in people with schizophrenia. Schizophr Res 2016; 172:165-8. [PMID: 26879587 PMCID: PMC4821731 DOI: 10.1016/j.schres.2016.02.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 10/22/2022]
Abstract
Several clinical studies have found an inverse relationship between clinical symptoms and peripheral oxytocin (OT) levels in people with schizophrenia. As oxytocin is a putative treatment for schizophrenia, the effect of repeated dosing of OT on OT levels, clinical symptoms and the relationship between the two is of interest. In a, randomized, double blind, parallel group 3 week study (N=28) with daily administration of intranasal OT (20 IU twice daily) or placebo (PBO), we examined the effect of OT administration on the correlation between the change in peripheral OT levels and change in clinical symptoms in patients with schizophrenia. At baseline, there were no significant treatment group differences in OT levels. There were no significant associations between baseline OT levels and any symptom measures. After 3 weeks of OT/PBO dosing, there was no significant difference in the magnitude of change in OT levels between the two treatment groups. Correlations between changes in peripheral OT levels and changes in the BPRS total and negative symptom scores were not different between treatment groups. Larger studies are needed to examine the effect of exogenous OT on peripheral OT levels and the relationship between the latter and clinical symptoms. Clinical Trials.gov=NCT00884897.
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Affiliation(s)
- Mary R. Lee
- National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Bethesda, MD,Corresponding author: , National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Bethesda, MD 20892-1108
| | - Heidi J. Wehring
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Robert P. McMahon
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Fang Liu
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Jared Linthicum
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Joseph G. Verbalis
- Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University Medical Center
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Gregory P. Strauss
- Department of Psychology, State University of New York at Binghamton, Binghamton, NY
| | - Leah H. Rubin
- Women’s Mental Health Research Program, University of Illinois at Chicago
| | - Deanna L. Kelly
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
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Abstract
Schizophrenia is a heterogeneous, debilitating disorder characterized by three distinct sets of clinical features: positive symptoms, negative symptoms, and cognitive deficits. Extant antipsychotic drugs have been most successful at treating the positive symptoms of patients with schizophrenia but have minimal therapeutic effects on negative symptoms and cognitive deficits, which are the symptoms that best predict the poor prognosis of these patients. Therefore, there has been a major effort towards identifying compounds that alleviate these symptoms. Oxytocin (OT) is a nonapeptide that regulates peripheral reproductive-relevant functions, and also acts as a neurotransmitter in the brain. Converging evidence from both preclinical and clinical research suggests that OT may have therapeutic efficacy for the positive symptoms, negative symptoms, and cognitive deficits of schizophrenia. In the majority of the small, randomized, placebo-controlled clinical trials conducted to date, OT has shown particular promise in its potential to treat the intractable negative symptoms and social cognitive deficits exhibited by most of the patients with this debilitating disorder. In this leading article, we summarize the clinical evidence relevant to (1) endogenous OT and schizophrenia, and (2) the putative therapeutic effects of OT on each of the three clinical domains.
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Affiliation(s)
- Paul D Shilling
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - David Feifel
- Department of Psychiatry, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103-8218, USA.
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Strauss GP, Vertinski M, Vogel SJ, Ringdahl EN, Allen DN. Negative symptoms in bipolar disorder and schizophrenia: A psychometric evaluation of the brief negative symptom scale across diagnostic categories. Schizophr Res 2016; 170:285-9. [PMID: 26742510 DOI: 10.1016/j.schres.2015.12.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 12/16/2022]
Abstract
Past studies have demonstrated that the Brief Negative Symptom Scale (BNSS) has excellent psychometric properties in patients with schizophrenia. In the current study, we extended this literature by examining psychometric properties of the BNSS in outpatients diagnosed with bipolar disorder (n=46), outpatients with schizophrenia (n=50), and healthy controls (n=27). Participants completed neuropsychological testing and a clinical interview designed to assess negative, positive, disorganized, mood, and general psychiatric symptoms. Results indicated differences among the 3 groups in the severity of all BNSS items, with SZ and BD scoring higher than CN; however, SZ and BD only differed on blunted affect and alogia items, not anhedonia, avolition, or asociality. BD patients with a history of psychosis did not differ from those without a history of psychosis on negative symptom severity. The BNSS had excellent internal consistency in SZ, BD, and CN groups. Good convergent and discriminant validity was apparent in SZ and BD groups, as indicated by relationships between the BNSS and other clinical rating scales. These findings support the validity of the BNSS in broadly defined serious mental illness populations.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, State University of New York at Binghamton, United States
| | - Mary Vertinski
- Department of Psychology, University of Nevada, Las Vegas, United States
| | - Sally J Vogel
- Department of Psychology, University of Nevada, Las Vegas, United States
| | - Erik N Ringdahl
- Department of Psychology, University of Nevada, Las Vegas, United States
| | - Daniel N Allen
- Department of Psychology, University of Nevada, Las Vegas, United States.
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Tonacci A, Billeci L, Tartarisco G, Ruta L, Muratori F, Pioggia G, Gangemi S. [Formula: see text]Olfaction in autism spectrum disorders: A systematic review. Child Neuropsychol 2015; 23:1-25. [PMID: 26340690 DOI: 10.1080/09297049.2015.1081678] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Olfactory function is a well-known early biomarker for neurodegeneration and neural functioning in the adult population, being supported by a number of brain structures that could be dysfunctioning in neurodegenerative processes. Evidence has suggested that atypical sensory and, particularly, olfactory processing is present in several neurodevelopmental conditions, including autism spectrum disorders (ASDs). In this paper, we present data obtained by a systematic literature review, conducted according to PRISMA guidelines, regarding the possible association between olfaction and ASDs, and analyze them critically in order to evaluate the occurrence of olfactory impairment in ASDs, as well as the possible usefulness of olfactory evaluation in such conditions. The results obtained in this analysis suggested a possible involvement of olfactory impairment in ASDs, underlining the importance of olfactory evaluation in the clinical assessment of ASDs. This assessment could be potentially included as a complementary evaluation in the diagnostic protocol of the condition. Methods for study selection and inclusion criteria were specified in advance and documented in PROSPERO protocol #CRD42014013939.
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Affiliation(s)
- Alessandro Tonacci
- a National Research Council of Italy - Institute of Clinical Physiology , IFC-CNR, Pisa Unit , Pisa , Italy
| | - Lucia Billeci
- a National Research Council of Italy - Institute of Clinical Physiology , IFC-CNR, Pisa Unit , Pisa , Italy
| | - Gennaro Tartarisco
- b National Research Council of Italy - Institute of Clinical Physiology , IFC-CNR, Messina Unit , Messina , Italy
| | - Liliana Ruta
- b National Research Council of Italy - Institute of Clinical Physiology , IFC-CNR, Messina Unit , Messina , Italy.,c Department of Developmental Neuroscience , Stella Maris Scientific Institute , Calambrone, Pisa , Italy
| | - Filippo Muratori
- c Department of Developmental Neuroscience , Stella Maris Scientific Institute , Calambrone, Pisa , Italy
| | - Giovanni Pioggia
- b National Research Council of Italy - Institute of Clinical Physiology , IFC-CNR, Messina Unit , Messina , Italy
| | - Sebastiano Gangemi
- d Department of Clinical and Experimental Medicine, School and Division of Allergy and Clinical Immunology , University Hospital "G. Martino" , Messina , Italy
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Plasma oxytocin levels predict social cue recognition in individuals with schizophrenia. Schizophr Res 2015; 162:47-51. [PMID: 25673435 PMCID: PMC4339097 DOI: 10.1016/j.schres.2015.01.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 12/18/2022]
Abstract
Lower endogenous levels of the neuropeptide oxytocin may be an important biological predictor of social cognition impairments in schizophrenia (SZ). Prior studies have demonstrated that lower-level social cognitive processes (e.g., facial affect perception) are significantly associated with reduced plasma oxytocin levels in SZ; however, it is unclear whether higher-level social cognition, which requires inferential processes and knowledge not directly presented in the stimulus, is associated with endogenous oxytocin. The current study explored the association between endogenous oxytocin levels and lower- and higher-level social cognition in 40 individuals diagnosed with SZ and 22 demographically matched healthy controls (CN). All participants received the Social Cue Recognition Test (SCRT), which presents participants with videotaped interpersonal vignettes and subsequent true/false questions related to concrete or abstract aspects of social interactions in the vignettes. Results indicated that SZ had significantly higher plasma oxytocin concentrations than CN. SZ and CN did not differ on SCRT hits, but SZ had more false positives and lower sensitivity scores than CN. Higher plasma oxytocin levels were associated with better sensitivity scores for abstract items in CN and fewer false positives for concrete items in individuals with SZ. Findings indicate that endogenous oxytocin levels predict accurate encoding of lower-level socially relevant information in SZ.
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Strauss GP, Keller WR, Koenig JI, Sullivan SK, Gold JM, Buchanan RW. Endogenous oxytocin levels are associated with the perception of emotion in dynamic body expressions in schizophrenia. Schizophr Res 2015; 162:52-6. [PMID: 25620121 PMCID: PMC4339450 DOI: 10.1016/j.schres.2015.01.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 10/24/2022]
Abstract
Lower endogenous oxytocin levels have been associated with impaired social cognition in schizophrenia, particularly facial affect identification. Little is known about the relationship between oxytocin and other forms of emotion perception. In the current study, 41 individuals with schizophrenia (SZ) and 22 demographically matched healthy controls (CN) completed a forced-choice affective body expression classification task. Stimuli included dynamic videos of male and female actors portraying 4 discrete emotions: happiness, sadness, anger, and neutral. Plasma oxytocin levels were determined via radioimmunoassay. Results indicated that SZ had significantly higher plasma oxytocin concentrations than CN. SZ were also less accurate at identifying expressions of happiness and sadness; however, there were no group differences for anger or neutral stimuli. A group×sex interaction was also present, such that female CN were more accurate than male CN, whereas male SZ were more accurate than female SZ. Higher endogenous oxytocin levels were associated with better total recognition in both SZ and CN; this association was specific to females in SZ. Findings indicate that sex plays an important role in identifying emotional expressions in body gestures in SZ, and that individual differences in endogenous oxytocin predict emotion perception accuracy.
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Affiliation(s)
- Gregory P. Strauss
- State University of New York at Binghamton, Department of Psychology,Correspondence concerning this article should be addressed to Gregory P. Strauss, Ph.D., . Phone: +1-607-777-5408. Fax: +1-607-777-4890. State University of New York at Binghamton, Department of Psychology, PO Box 6000, Binghamton, New York, USA, 13902-6000
| | - William R. Keller
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center
| | - James I. Koenig
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center
| | - Sara K. Sullivan
- State University of New York at Binghamton, Department of Psychology
| | - James M. Gold
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center
| | - Robert W. Buchanan
- University of Maryland School of Medicine, Department of Psychiatry and Maryland Psychiatric Research Center
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Rich ME, Caldwell HK. A Role for Oxytocin in the Etiology and Treatment of Schizophrenia. Front Endocrinol (Lausanne) 2015; 6:90. [PMID: 26089815 PMCID: PMC4453483 DOI: 10.3389/fendo.2015.00090] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/15/2015] [Indexed: 01/12/2023] Open
Abstract
Schizophrenia is a chronic debilitating neuropsychiatric disorder estimated to affect 51 million people worldwide. Several symptom domains characterize schizophrenia, including negative symptoms, such as social withdrawal and anhedonia, cognitive impairments, such as disorganized thinking and impaired memory, and positive symptoms, such as hallucinations and delusions. While schizophrenia is a complex neuropsychiatric disorder with no single "cause," there is evidence that the oxytocin (Oxt) system may be dysregulated in some individuals. Further, treatment with intranasal Oxt reduces some of the heterogeneous symptoms associated with schizophrenia. Since Oxt is known for its modulatory effects on a variety of social and non-social behaviors, it is perhaps not surprising that it may contribute to some aspects of schizophrenia and could also be a useful therapeutic agent. In this review, we highlight what is known about Oxt's contributions to schizophrenia and schizophrenia-related behaviors and discuss its potential as a therapeutic agent.
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Affiliation(s)
- Megan Elizabeth Rich
- Laboratory of Neuroendocrinology and Behavior, Department of Biological Sciences, The School of Biomedical Sciences, Kent State University, Kent, OH, USA
| | - Heather Kingsley Caldwell
- Laboratory of Neuroendocrinology and Behavior, Department of Biological Sciences, The School of Biomedical Sciences, Kent State University, Kent, OH, USA
- *Correspondence: Heather Kingsley Caldwell, Laboratory of Neuroendocrinology and Behavior, Department of Biological Sciences, The School of Biomedical Sciences, Kent State University, PO Box 5190, 121 Cunningham Hall, Kent, OH 44242, USA,
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