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Shetty RM, Pashine A, Shetty S, Mishra H, Walia T, Shetty SR, Desai V, Thosar N. Minor physical anomalies including palatal rugae pattern and palatal dimensions in children with sickle cell disease: A cross-sectional analytical study. Heliyon 2024; 10:e24363. [PMID: 38312689 PMCID: PMC10834466 DOI: 10.1016/j.heliyon.2024.e24363] [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: 01/19/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 02/06/2024] Open
Abstract
Background Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10-18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm-5 mm), and fragmentary rugae (<3 mm). The shape of each primary palatal rugae was identified and categorized as curved, wavy, straight, circular and non-specific. Linear and angular measurements of the palatal rugae patterns and palatal dimensions (width, height, area) were measured and recorded. Results The total number of palatal rugae and fragmentary rugae was lesser in Group SCD than in Group C (p < 0.05). The depth of the palate was significantly increased, whereas the area of the palate significantly decreased in Group SCD. Conclusions The children with SCD showed distinctive palatal rugae patterns and dimensions when compared with normal healthy children that can be attributed as potential MPAs for sickle cell disease. Children with SCD had an under-developed palatal rugae pattern with a deep, narrow and small palate when compared to healthy children.The dimensions of the palatal rugae pattern in SCD showed reduced distance between the incisive papilla and the first and last rugae, indicating a further decrease in the anteroposterior dimensions of the palate. These findings may aid in the early diagnosis and prevention of malocclusion in children with SCD by appropriate interceptive orthodontic treatment.
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Affiliation(s)
- Raghavendra M Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed-to-be-University), Sawangi (Meghe), Wardha, Maharastra, India
| | - Aditi Pashine
- Associate Dentist, MyDentist, Hungerford, United Kingdom
| | - Sunaina Shetty
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hrishikesh Mishra
- Research Division, Sickle Cell Institute Chhattisgarh, Raipur, India
| | - Tarun Walia
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Vijay Desai
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Nilima Thosar
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed-to-be-University), Sawangi (Meghe), Wardha, Maharastra, India
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Increased prevalence of minor physical anomalies in patients with epilepsy. Sci Rep 2022; 12:13707. [PMID: 35962048 PMCID: PMC9374691 DOI: 10.1038/s41598-022-17853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/02/2022] [Indexed: 11/22/2022] Open
Abstract
Our aim was to investigate the rate and topological profile of minor physical anomalies (MPAs) in adult patients with epilepsy with the use of the Méhes Scale, a comprehensive modern scale of dysmorphology. Consecutive epilepsy patients admitted for outpatient evaluation were included. Patients with comorbidities of neurodevelopmental origin (such as autism, severe intellectual disability, attention deficit hyperactivity disorder, schizophrenia, tic disorder, Tourette syndrome, bipolar disorder, specific learning disorder and specific language impairment) were excluded. All participants underwent physical examination with the use of the Méhes Scale for evaluation of MPAs, including 57 minor signs. The frequency and topological profile of MPAs were correlated to clinical patient data using Kruskal–Wallis, chi2 tests and logistic regression model. 235 patients were included, according to the following subgroups: acquired epilepsy (non-genetic, non-developmental etiology) [N = 63], temporal lobe epilepsy with hippocampal sclerosis (TLE with HS) [N = 27], epilepsy with cortical dysgenesis etiology [N = 29], cryptogenic epilepsy [N = 69] and idiopathic generalized epilepsy (IGE) [N = 47]. As controls, 30 healthy adults were recruited. The frequency of MPAs were significantly affected by the type of epilepsy [H(6) = 90.17; p < 0.001]. Pairwise comparisons showed that all patient groups except for acquired epilepsy were associated with increased frequency of MPAs (p < 0.001 in all cases). Furrowed tongue and high arched palate were more common compared to controls in all epilepsy subgroup except for TLE (p < 0.001 or p = 0.001 in all cases). A positive association was detected between the occurrence of MPAs and antiepileptic drug therapy resistance [Exp(B) = 4.19; CI 95% 1.37–12.80; p = 0.012]. MPAs are more common in patients with epilepsy, which corroborates the emerging concept of epilepsy as a neurodevelopmental disorder. Assessment of these signs may contribute to the clarification of the underlying etiology. Moreover, as increased frequency of MPAs may indicate pharmacoresistance, the identification of patients with high number of MPAs could allow evaluation for non-pharmacological treatment in time.
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Babhulkar S, Sail D, Waghmare N, Kadam K. Minor physical anomalies in unipolar depression. ANNALS OF INDIAN PSYCHIATRY 2021. [DOI: 10.4103/aip.aip_132_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Csulak T, Csábi G, Herold R, Vörös V, Jeges S, Hajnal A, Kovács MÁ, Simon M, Herold M, Tóth ÁL, Tényi T. Increased Prevalence of Minor Physical Anomalies Among the Healthy First-Degree Relatives of Bipolar I Patients - Results With the Méhes Scale. Front Psychiatry 2021; 12:672241. [PMID: 33995153 PMCID: PMC8118159 DOI: 10.3389/fpsyt.2021.672241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/07/2021] [Indexed: 11/18/2022] Open
Abstract
Minor physical anomalies are somatic markers of aberrant neurodevelopment, so the higher prevalence of these signs among the relatives of bipolar I patients can confirm minor physical anomalies as endophenotypes. The aim of the study was to evaluate the prevalence of minor physical anomalies in first-degree healthy relatives of patients with bipolar I disorder compared to normal control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 20 first-degree unaffected relatives of patients with the diagnosis of bipolar I disorder and as a comparison 20 matched normal control subjects were examined. Minor physical anomalies were more common in the ear, head, mouth and trunk regions among the relatives of bipolar I patients compared to normal controls. By the differentiation of minor malformations and phenogenetic variants, we have found that both minor malformations and phenogenetic variants were more common among the relatives of bipolar I patients compared to the control group, while individual analyses showed, that one minor malformation (sole crease) and one phenogenetic variant (high arched palate) were more prevalent in the relative group. This is the first report in literature on the increased prevalence of minor physical anomalies among the first-degree unaffected relatives of bipolar I patients. The study support the concept, that minor physical anomalies can be endophenotypic markers of bipolar I affective disorder.
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Affiliation(s)
- Tímea Csulak
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Viktor Vörös
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Sára Jeges
- Faculty of Health Sciences, Institute of Nursing and Patients Care, University of Pécs, Pécs, Hungary
| | - András Hajnal
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Márton Áron Kovács
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Maria Simon
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Márton Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Levente Tóth
- Faculty of Sciences, Institute of Physical Education and Sport Science, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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Varga E, Hajnal A, Soós A, Hegyi P, Kovács D, Farkas N, Szebényi J, Mikó A, Tényi T, Herold R. Minor Physical Anomalies in Bipolar Disorder-A Meta-Analysis. Front Psychiatry 2021; 12:598734. [PMID: 34220563 PMCID: PMC8242170 DOI: 10.3389/fpsyt.2021.598734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/05/2021] [Indexed: 01/27/2023] Open
Abstract
Introduction: Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial. Objectives: The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC). Methods: Four studies, involving 155 patients with BPD, and 187 HC, were involved in the analysis after searching the literature. For the investigation of MPAs in the peripheral (MPA-P) and in the head and facial regions (MPA-CF), two studies involving 121 BPD patients, and 133 HC passed the inclusion criteria. Results: The number of the MPAs in the BPD group was significantly higher compared to HC. Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of the HC. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects. It is important to note that there was a low number of eligible publications included, which caused higher heterogeneity. Conclusions: Low quality of evidence suggests that MPAs are more common in patients with BPD than in HC and the higher rate of MPAs is found predominantly in the head and facial regions.
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Affiliation(s)
- Eszter Varga
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - András Hajnal
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Dóra Kovács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Júlia Szebényi
- Department of Dermatology, Venereology and Oncodermatology, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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Trixler D, Tényi T. Iris structure and minor physical anomalies in schizophrenia. Psychiatry Res 2017; 256:412-416. [PMID: 28692922 DOI: 10.1016/j.psychres.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/15/2017] [Accepted: 07/03/2017] [Indexed: 11/20/2022]
Abstract
This study compared five human iris characteristics and minor physical anomalies (MPAs) between patients with schizophrenia (n = 32) and controls (n = 31). Correlations between iris characteristics and MPAs were expected, due to their same ectodermic origin. Iris macro photos were taken and quantified in five categories mentioned before. MPAs were also examined in both groups. Our results show significant differences in the frequency of pigment dots of the iris and total number of MPAs between groups. Other significant differences were found in the extension of concentric furrows, as they were more common in healthy subjects, while Wolfflin nodules occurred significantly more often in patients with schizophrenia. Expected difference in Fuch's crypts could not be observed between groups. Light eye color was positively correlated to pigment dots and Wolfflin nodules, and negatively correlated with concentric furrows. Dark eye color showed positive correlation with concentric furrows, and negative correlation with pigment dots and concentric furrows. A gender effect could also been observed: male individuals showed moderate positive correlations between pigment dots and total MPAs frequency, while this couldn't be observed in the female group. Our findings suggest possible connections between iris characteristics and MPAs, where males are more prone to deviations.
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Affiliation(s)
- Dániel Trixler
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary.
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
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7
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Minor physical anomalies in bipolar I and bipolar II disorders - Results with the Méhes Scale. Psychiatry Res 2017; 249:120-124. [PMID: 28092791 DOI: 10.1016/j.psychres.2017.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 11/21/2022]
Abstract
Minor physical anomalies (MPAs) are external markers of abnormal brain development, so the more common appearence of these signs among bipolar I and bipolar II patients can confirm the possibility of a neurodevelopmental deficit in these illnesses. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with bipolar I and - first in literature - with bipolar II disorders compared to matched healthy control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 30 bipolar I and 30 bipolar II patients, while as a comparison 30 matched healthy control subjects were examined. Significant differences were detected between the three groups comparing the total number of minor physical anomalies, minor malformations and phenogenetic variants and in the cases of the ear and the mouth regions. The individual analyses of the 57 minor physical anomalies by simultaneous comparison of the three groups showed, that in the cases of furrowed tongue and high arched palate were significant differences between the three groups. The results can promote the concept, that a neurodevelopmental deficit may play a role in the etiology of both bipolar I and bipolar II disorders.
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8
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Homberg JR, Kyzar EJ, Scattoni ML, Norton WH, Pittman J, Gaikwad S, Nguyen M, Poudel MK, Ullmann JFP, Diamond DM, Kaluyeva AA, Parker MO, Brown RE, Song C, Gainetdinov RR, Gottesman II, Kalueff AV. Genetic and environmental modulation of neurodevelopmental disorders: Translational insights from labs to beds. Brain Res Bull 2016; 125:79-91. [PMID: 27113433 DOI: 10.1016/j.brainresbull.2016.04.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/25/2016] [Accepted: 04/20/2016] [Indexed: 01/12/2023]
Abstract
Neurodevelopmental disorders (NDDs) are a heterogeneous group of prevalent neuropsychiatric illnesses with various degrees of social, cognitive, motor, language and affective deficits. NDDs are caused by aberrant brain development due to genetic and environmental perturbations. Common NDDs include autism spectrum disorder (ASD), intellectual disability, communication/speech disorders, motor/tic disorders and attention deficit hyperactivity disorder. Genetic and epigenetic/environmental factors play a key role in these NDDs with significant societal impact. Given the lack of their efficient therapies, it is important to gain further translational insights into the pathobiology of NDDs. To address these challenges, the International Stress and Behavior Society (ISBS) has established the Strategic Task Force on NDDs. Summarizing the Panel's findings, here we discuss the neurobiological mechanisms of selected common NDDs and a wider NDD+ spectrum of associated neuropsychiatric disorders with developmental trajectories. We also outline the utility of existing preclinical (animal) models for building translational and cross-diagnostic bridges to improve our understanding of various NDDs.
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Affiliation(s)
- Judith R Homberg
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Evan J Kyzar
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; The International Stress and Behavior Society (ISBS) and ZENEREI Research Center, Slidell, LA, USA
| | - Maria Luisa Scattoni
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanita, Rome, Italy
| | | | - Julian Pittman
- Department of Biological and Environmental Sciences, Troy University, Troy, AL, USA
| | - Siddharth Gaikwad
- The International Stress and Behavior Society (ISBS) and ZENEREI Research Center, Slidell, LA, USA
| | - Michael Nguyen
- The International Stress and Behavior Society (ISBS) and ZENEREI Research Center, Slidell, LA, USA; New York University School of Medicine, NY, NY, USA
| | - Manoj K Poudel
- The International Stress and Behavior Society (ISBS) and ZENEREI Research Center, Slidell, LA, USA
| | - Jeremy F P Ullmann
- Centre for Advanced Imaging, University of Queensland, Brisbane, Queensland, Australia; Department of Neurology, Boston Children's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - David M Diamond
- Department of Psychology, University of South Florida, Tampa, FL, USA; J.A. Haley Veterans Hospital, Research and Development Service, Tampa, FL, USA
| | - Aleksandra A Kaluyeva
- The International Stress and Behavior Society (ISBS) and ZENEREI Research Center, Slidell, LA, USA
| | - Matthew O Parker
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
| | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Cai Song
- Research Institute of Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, Guangdong, China; Graduate Institute of Neural and Cognitive Sciences, China Medical University Hospital, Taichung, Taiwan
| | - Raul R Gainetdinov
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Skolkovo Institute of Science and Technology, Skolkovo, Moscow Region, Russia
| | | | - Allan V Kalueff
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia.
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Hajnal A, Csábi G, Herold R, Jeges S, Halmai T, Trixler D, Simon M, Tóth ÁL, Tényi T. Minor physical anomalies are more common among the first-degree unaffected relatives of schizophrenia patients - Results with the Méhes Scale. Psychiatry Res 2016; 237:224-8. [PMID: 26803362 DOI: 10.1016/j.psychres.2016.01.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/28/2015] [Accepted: 01/15/2016] [Indexed: 02/05/2023]
Abstract
Minor physical anomalies are external markers of abnormal brain development,so the more common appearance of these signs among the relatives of schizophrenia patients can confirm minor physical anomalies as intermediate phenotypes. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in the first-degree unaffected relatives of patients with schizophrenia compared to matched normal control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 20 relatives of patients with the diagnosis of schizophrenia and as a comparison 20 matched normal control subjects were examined. Minor physical anomalies were more common in the head and mouth regions among the relatives of schizophrenia patients compared to normal controls. By the differentiation of minor malformations and phenogenetic variants, we have found that only phenogenetic variants were more common in the relatives of schizophrenia patients compared to the control group, however individual analyses showed, that one minor malformation (flat forehead) was more prevalent in the relative group. The results can promote the concept, that minor physical anomalies can be endophenotypic markers of the illness.
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Affiliation(s)
- András Hajnal
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, University of Pécs, Faculty of Medicine, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Sára Jeges
- Institute of Nursing and Patients Care, Faculty of Health Sciences, University of Pécs, Hungary
| | - Tamás Halmai
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Hungary
| | - Dániel Trixler
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Maria Simon
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Ákos Levente Tóth
- Institute of Physical Education and Sport Science, Faculty of Sciences, University of Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary.
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Dyshniku F, Murray ME, Fazio RL, Lykins AD, Cantor JM. Minor Physical Anomalies as a Window into the Prenatal Origins of Pedophilia. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:2151-2159. [PMID: 26058490 DOI: 10.1007/s10508-015-0564-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 04/30/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
Evidence is steadily accumulating to support a neurodevelopmental basis for pedophilia. This includes increased incidence of non-right-handedness, which is a result primarily of prenatal neural development and solidified very early in life. Minor physical anomalies (MPAs; superficial deviations from typical morphological development, such as un-detached earlobes) also develop only prenatally, suggesting them as another potential marker of atypical physiological development during the prenatal period among pedophiles. This study administered the Waldrop Physical Anomaly Scale to assess the prevalence of MPAs in a clinical sample of men referred for assessment following a sexual assault, or another illegal or clinically significant sexual behavior. Significant associations emerged between MPA indices and indicators of pedophilia, including penile responses to depictions of children, number of child victims, and possession of child pornography. Moreover, greater sexual attraction to children was associated with an elevated craniofacial-to-peripheral anomalies ratio. The overall sample demonstrated a greater number of MPAs relative to prior samples of individuals with schizophrenia as well as to healthy controls.
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Affiliation(s)
- Fiona Dyshniku
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Michelle E Murray
- Sexual Behaviours Clinic, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
| | - Rachel L Fazio
- Sexual Behaviours Clinic, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.
| | - Amy D Lykins
- School of Behavioural, Cognitive, and Social Sciences, University of New England, Armidale, NSW, Australia
| | - James M Cantor
- Sexual Behaviours Clinic, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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11
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Tényi T, Halmai T, Antal A, Benke B, Jeges S, Tényi D, Tóth ÁL, Csábi G. Minor physical anomalies are more common in schizophrenia patients with the history of homicide. Psychiatry Res 2015; 225:702-5. [PMID: 25500346 DOI: 10.1016/j.psychres.2014.11.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 10/09/2014] [Accepted: 11/06/2014] [Indexed: 10/24/2022]
Abstract
Minor physical anomalies may be external markers of abnormal brain development, so the more common appearance of these signs in homicidal schizophrenia might suggest the possibility of a more seriously aberrant neurodevelopment in this subgroup. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with schizophrenia with the history of committed or attempted homicide comparing them to patients with schizophrenia without homicide in their history and to normal control subjects. Using a list of 57 minor physical anomalies, 44 patients with the diagnosis of schizophrenia were examined with the history of committed or attempted homicide, as a comparison 22 patients with the diagnosis of schizophrenia without the history of any kind of homicide and violence and 21 normal control subjects were examined. Minor physical anomalies are more common in homicidal schizophrenia patients compared to non-homicidal schizophrenia patients and normal controls, which could support a stronger neurodevelopmental component of etiology in this subgroup of schizophrenia. The higher rate of minor physical anomalies found predominantly in the head and mouth regions in homicidal schizophrenia patients might suggest the possibility of a more seriously aberrant brain development in the case of homicidal schizophrenia.
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Affiliation(s)
- Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2, H-7623 Pécs, Hungary.
| | - Tamás Halmai
- Forensic Psychiatric Mental Institution, Budapest, Hungary
| | - Albert Antal
- Forensic Psychiatric Mental Institution, Budapest, Hungary
| | - Bálint Benke
- Forensic Psychiatric Mental Institution, Budapest, Hungary
| | - Sára Jeges
- Institute of Nursing and Patients Care, Faculty of Health Sciences, University of Pécs, Hungary
| | - Dalma Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2, H-7623 Pécs, Hungary
| | - Ákos Levente Tóth
- Institute of Physical Education and Sport Science, Faculty of Sciences, University of Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, University of Pécs, Faculty of Medicine, Pécs, Hungary
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Akabaliev VH, Sivkov ST, Mantarkov MY. Minor physical anomalies in schizophrenia and bipolar I disorder and the neurodevelopmental continuum of psychosis. Bipolar Disord 2014; 16:633-41. [PMID: 24798215 DOI: 10.1111/bdi.12211] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 11/26/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Minor physical anomalies (MPAs) have been investigated by numerous studies in patients with schizophrenia in support of the neurodevelopmental hypothesis of the disorder, but have rarely been examined in patients with bipolar disorder or in direct comparisons between the two conditions. The main objective of the present study was to compare the prevalence of MPAs in psychiatrically healthy controls, patients with bipolar I disorder, and patients with schizophrenia. METHODS A slightly modified version of the Waldrop Physical Anomaly Scale was used to assess MPAs in psychiatrically healthy controls (n = 103), patients with bipolar I disorder (n = 61), and patients with schizophrenia (n = 128). RESULTS In five out of six topographic regions (mouth, feet, head, eyes, and ears) there was a pattern of lowest regional MPA scores in controls, intermediate in bipolar I disorder, and highest in schizophrenia. The cephalofacial composite score and the total MPA score showed the same pattern, with all between-group differences being statistically significant. Seven individual MPAs in the discriminant analysis model contributed independently to the prediction of the triple-dependent status of 'psychiatrically healthy control, bipolar I disorder patient, schizophrenia patient': high/arched palate, fine electric hair, large gap between first and second toes, third toe ≥ second toe, epicanthus, malformed ears, and furrowed tongue. CONCLUSIONS Our findings support the existence of a continuum of neurodevelopmental adversity within the clinical spectrum of psychosis, with bipolar I disorder occupying an intermediate position between psychiatric health and schizophrenia.
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Sivkov S, Akabaliev V, Mantarkov M, Ahmed-Popova F, Akabalieva K. Discriminating value of total minor physical anomaly score on the Waldrop scale between patients with bipolar I disorder and normal controls. Psychiatry Res 2013; 210:451-6. [PMID: 23890698 DOI: 10.1016/j.psychres.2013.06.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 07/23/2012] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
Abstract
Minor physical anomalies (MPAs) are slight structural aberrations indicative of abnormal neurodevelopment. Most studies of MPAs in bipolar disorder have yielded limited results. We attempted to assess the potential value of MPAs as a classifying test in the status bipolar I patients vs. normal controls. Sixty one bipolar I patients and 103 controls were evaluated for MPAs using a slightly modified version of the Waldrop scale. The specificity, sensitivity and predictive value of different total MPA (MPA-T) scores were determined. The cut-off MPA-T scores that optimally discriminated patients from controls (exhibiting the most balanced sets of sensitivity, specificity, positive and negative predictive values) were MPA-T ≥ 4 and MPA-T ≥ 5. These values set a "border zone" in which bipolar I patients began to prevail significantly over controls. The latter presented most frequently with MPA-T ≤ 3 and rarely with MPA-T ≥ 6. Bipolar I patients prevailed among outliers (subjects with significantly higher MPA-T scores). Our data establish MPA-T score as a reliable index in distinguishing between bipolar I patients and normal controls and are consistent with the hypothesis of abnormal neurodevelopment in bipolar disorder.
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Affiliation(s)
- Stefan Sivkov
- Department of Anatomy, Histology and Embryology, Medical University, Plovdiv, Bulgaria
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Minor physical anomalies in patients with bipolar I disorder and normal controls. J Affect Disord 2011; 135:193-200. [PMID: 21846578 DOI: 10.1016/j.jad.2011.07.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 07/19/2011] [Accepted: 07/19/2011] [Indexed: 02/02/2023]
Abstract
BACKGROUND The neurodevelopmental hypothesis is well established in schizophrenia but has received modest empirical support in bipolar disorder. In schizophrenia it is partly based on the higher prevalence of minor physical anomalies (MPAs), established by many well controlled studies. No studies with comparable designs have been performed in bipolar disorder. The present study aims to establish the rate and topographic distribution of MPAs in bipolar I patients. METHODS The subjects were 61 patients (25 men, 36 women) with bipolar I disorder and 103 normal subjects (49 men, 54 women) who were examined for MPAs using a modified version of the Waldrop Physical Anomaly Scale. RESULTS The bipolar I patients showed significantly higher regional MPA scores in 3 distinct regions - mouth, feet and head, as well as in the overall scores for the craniofacial complex, the periphery and the total MPA score. Differences were statistically significant for 3 anomalies - high/steepled palate, big gap between I and II toes and furrowed tongue that made significant contribution to the prediction of the patient-control status in a discriminant analysis model. CONCLUSIONS Our data suggest that aberrant processes of neurodevelopment may contribute to the etiology of bipolar I disorder. The field is open for further research using modern instruments and designs in order to identify potential biological markers for bipolar disorder.
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Minor physical anomalies: potentially informative vestiges of fetal developmental disruptions in schizophrenia. Int J Dev Neurosci 2010; 29:245-50. [DOI: 10.1016/j.ijdevneu.2010.10.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 10/18/2010] [Accepted: 10/18/2010] [Indexed: 01/31/2023] Open
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Culav-Sumić J, Jukić V. Minor physical anomalies in women with recurrent unipolar depression. Psychiatry Res 2010; 176:22-5. [PMID: 20071035 DOI: 10.1016/j.psychres.2008.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 08/16/2008] [Accepted: 10/23/2008] [Indexed: 10/20/2022]
Abstract
According to earlier observations, minor physical anomalies (MPAs) are more prevalent in psychotic disorders, especially in schizophrenia, and represent an indicator of abnormal fetal development. Limited research has been conducted on these structural abnormalities among patients with unipolar depression, with and without psychotic features. We hypothesized that the mean total MPA score would be greater in patients with psychotic depression than depressive patients without psychosis and control subjects. An extended scale of MPAs was used to detect the presence or absence of 51 MPAs in women with recurrent unipolar depression with psychotic symptoms (n=50), women with recurrent unipolar depression without psychotic symptoms (n=50) and healthy female controls (n=50). Women with recurrent depression had significantly more MPAs than controls. With regard to MPAs of specific body regions, depressive patients had significantly higher rates of MPAs in the mouth area than control subjects. Higher rates of MPAs were not significantly related to psychotic features of depression. The study results are indicative of possible early neurodevelopmental disturbance in recurrent unipolar depression.
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Compton MT, Walker EF. Physical manifestations of neurodevelopmental disruption: are minor physical anomalies part of the syndrome of schizophrenia? Schizophr Bull 2009; 35:425-36. [PMID: 18990714 PMCID: PMC2659308 DOI: 10.1093/schbul/sbn151] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The well-documented excess of minor physical anomalies (MPAs) among individuals with schizophrenia generally supports the neurodevelopmental model, which posits that both genetic and environmental factors contribute to structural and functional brain changes in the intrauterine and perinatal periods that predispose one to developing schizophrenia. This review synthesizes select areas of research findings on MPAs to address the question, Are MPAs part of the syndrome of schizophrenia? Although MPAs are not specific to schizophrenia, their presence in some patients indicates that aberrations in the development of the nervous system contribute to risk for the disorder. The broadly defined, heterogeneous MPA construct may be of limited value in further elucidating the specific pathophysiology of schizophrenia, though particular anomalies, such as those pertaining to nasal volumes, palatal abnormalities, or craniofacial morphology, may be informative. Given the availability of more sophisticated microarray technologies, and in light of recent findings on spontaneous mutations in patients with schizophrenia, it is possible that MPAs will prove to be useful in identifying etiologic subtypes and/or the loci of genetic risk factors. It remains to be determined whether MPAs-which, of course, are fixed markers present throughout childhood and adolescence well before the onset of the prodrome and psychosis-may have utility in terms of risk stratification for future preventive efforts. Taken together, research findings on MPAs indicate that these minor anomalies are indeed part of some schizophrenia syndromes, representing a stable systemic or physical set of manifestations of the underlying neurodevelopmental processes that lead to the illness.
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Affiliation(s)
- Michael T. Compton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine,To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Drive, SE, Room No. 333, Atlanta, GA 30303; tel: 404-778-1486, fax: 404-616-3241, e-mail:
| | - Elaine F. Walker
- Department of Psychology, Graduate School of Arts and Sciences of Emory University
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Tényi T, Trixler M, Csábi G. Minor physical anomalies in affective disorders. A review of the literature. J Affect Disord 2009; 112:11-8. [PMID: 18508129 DOI: 10.1016/j.jad.2008.04.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 04/28/2008] [Accepted: 04/28/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND The increased frequency of MPAs may be external markers of abnormal brain development in affective disorders. METHODS A MEDLINE, psychInfo and Web of Science search was evaluated to collect all publications on the prevalence of minor physical anomalies in bipolar affective disorder and unipolar major depression. AIMS As reports on the prevalence of MPAs in affective disorders were controversial, were based on highly different number of patients and were evaluated by the use of scales with different sensitivities, we considered as important to review the current state of knowledge and to recommend directions to further research. RESULTS 14 publications on 12 studies were found after a careful literature search. 5 studies have dealt with the prevalence of MPAs in bipolar affective disorder, 3 have reported on examinations among patients with unipolar major depression, while 5 publications on 3 studies combined patients with bipolar affective disorder, schizoaffective disorder and unipolar major depression. 1 study was published on the prevalence of MPAs among mood disorders, without the differentiation of the data of patients with bipolar affective disorder and unipolar major depression. LIMITATIONS Few studies with relatively small size were published, there is no data on the distinction between bipolar I and bipolar II disorders. CONCLUSION The reviewed data suggest a higher probability of the role of an aberrant neurodevelopment in bipolar affective disorder and a smaller in unipolar major depression.
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Affiliation(s)
- Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Hungary.
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