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Garcia-Rizo C, Crespo-Facorro B, Oliveira C, Gómez-Revuelta M, Kirkpatrick B, Son JMV, de la Hoz LC, Garriga M, Garrido-Torres N, Bernardo M, Fernandez-Egea E, Vázquez-Bourgon J. Anthropometry in antipsychotic-naïve first-episode psychosis patients: An exploratory approach to the role of environmental early life events in two independent samples. Schizophr Res 2024; 266:216-226. [PMID: 38428119 DOI: 10.1016/j.schres.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/14/2023] [Accepted: 02/17/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Patients with schizophrenia exhibit a reduced life expectancy mainly due to medical-related pathologies which might have been initiated due to stressful events during fetal development. Indeed, intra-uterus growth patterns predict anthropometric measures in adulthood, describing risk factors for schizophrenia and metabolic disorders. We aim to evaluate anthropometric values in two cohorts of antipsychotic-naïve first-episode episode psychosis (FEP) and correlated them with surrogate markers of the fetal environment such as birth weight (BW) and season of birth. METHODS BW, season of birth, and anthropometric values from 2 cohorts of FEP patients (Barcelona and Santander) were evaluated. In cohort B, 91 patients, and 110 controls while in cohort S, 644 and 235 were included respectively. RESULTS Patients were shorter, slimmer, and with lower BMI compared with controls. In both cohorts, patients, and female patients born in winter displayed the shortest height. Regarding BW, height was significantly associated with the interaction of diagnosis and BW in the whole sample and the male subsample. CONCLUSIONS Our results confirm reduced anthropometric features in FEP at onset while suggesting the influence of winter birth and BW, highlighting the role of early life events in the later outcome of FEP with sex differences.
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Affiliation(s)
- Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Barcelona, Spain; CIBERSAM, ISCIII, Madrid, Spain; Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
| | - Benedicto Crespo-Facorro
- CIBERSAM, ISCIII, Madrid, Spain; Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio-IBIS, Sevilla, Spain.
| | | | - Marcos Gómez-Revuelta
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain
| | | | - Jacqueline Mayoral-van Son
- CIBERSAM, ISCIII, Madrid, Spain; Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio-IBIS, Sevilla, Spain
| | - Laura Cayón de la Hoz
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain
| | - Marina Garriga
- CIBERSAM, ISCIII, Madrid, Spain; Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Barcelona, Spain
| | - Nathalia Garrido-Torres
- CIBERSAM, ISCIII, Madrid, Spain; Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio-IBIS, Sevilla, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Barcelona, Spain; CIBERSAM, ISCIII, Madrid, Spain; Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, CB2 0QQ Cambridge, UK; Cambridge shire and Peterborough NHS Foundation Trust, Huntingdon PE29 3RJ, UK
| | - Javier Vázquez-Bourgon
- CIBERSAM, ISCIII, Madrid, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, Institute of Biomedical Research Valdecilla (IDIVAL), Santander, Spain; Departamento de Medicina y Psiquiatría, Facultad de Medicina, Universidad de Cantabria, Santander, Spain
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Blood and Urinary Biomarkers of Antipsychotic-Induced Metabolic Syndrome. Metabolites 2022; 12:metabo12080726. [PMID: 36005598 PMCID: PMC9416438 DOI: 10.3390/metabo12080726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome (MetS) is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Antipsychotic (AP)-induced MetS (AIMetS) is the most common adverse drug reaction (ADR) of psychiatric pharmacotherapy. Herein, we review the results of studies of blood (serum and plasma) and urinary biomarkers as predictors of AIMetS in patients with schizophrenia (Sch). We reviewed 1440 studies examining 38 blood and 19 urinary metabolic biomarkers, including urinary indicators involved in the development of AIMetS. Among the results, only positive associations were revealed. However, at present, it should be recognized that there is no consensus on the role of any particular urinary biomarker of AIMetS. Evaluation of urinary biomarkers of the development of MetS and AIMetS, as one of the most common concomitant pathological conditions in the treatment of patients with psychiatric disorders, may provide a key to the development of strategies for personalized prevention and treatment of the condition, which is considered a complication of AP therapy for Sch in clinical practice.
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Peltier MR, Fassett MJ, Arita Y, Chiu VY, Shi JM, Takhar HS, Mahfuz A, Garcia GS, Menon R, Getahun D. Women with high plasma levels of PBDE-47 are at increased risk of preterm birth. J Perinat Med 2021; 49:439-447. [PMID: 33554574 DOI: 10.1515/jpm-2020-0349] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/10/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Nearly 100% of North American women have detectable levels of flame retardants such as polybrominated diphenyl ethers (PBDEs) in their plasma. These molecules have structural homology to thyroid hormones and may function as endocrine disruptors. Thyroid dysfunction has previously been associated with increased risk for preterm birth. Therefore, we conducted a multi-center, case-cohort study to evaluate if high plasma concentrations of a common PBDE congener in the first trimester increases the risk of preterm birth and its subtypes. METHODS Pregnant women were recruited at the onset of initiation of prenatal care at Kaiser-Permanente Southern California (KPSC)-West Los Angeles and KPSC-San Diego medical centers. Plasma samples from women whose pregnancies ended preterm and random subset of those delivering at term were assayed for PBDE-47 and thyroid-stimulating hormone (TSH) by immunoassay. Quartile cutoffs were calculated for the patients at term and used to determine if women with exposures in the 4th quartile are at increased risk for preterm birth using logistic regression. RESULTS We found that high concentrations of PBDE-47 in the first trimester significantly increased the odds of both indicated (adjusted odds ratio, adjOR=2.35, 95% confidence interval [CI]: 1.31, 4.21) and spontaneous (adjOR=1.76, 95% CI: 1.02, 3.03) preterm birth. Regardless of pregnancy outcome, TSH concentrations did not differ between women with high and low concentrations of PBDE-47. CONCLUSIONS These results suggest that high plasma concentrations of PBDE-47 in the first trimester, increases the risk of indicated and spontaneous preterm birth.
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Affiliation(s)
- Morgan R Peltier
- Department of Foundations of Medicine, NYU-Long Island School of Medicine, Mineola, NY, USA.,Department of Obstetrics and Gynecology, NYU-Long Island School of Medicine, Mineola, NY, USA
| | - Michael J Fassett
- Department of Obstetrics and Gynecology, Kaiser-Permanente West Los Angeles Medical Center, Los Angeles, CA, USA
| | - Yuko Arita
- Department of Foundations of Medicine, NYU-Long Island School of Medicine, Mineola, NY, USA
| | - Vicki Y Chiu
- Department of Research and Evaluation, Kaiser-Permanente Southern California, Pasadena, CA, USA
| | - Jiaxiao M Shi
- Department of Research and Evaluation, Kaiser-Permanente Southern California, Pasadena, CA, USA
| | - Harpreet S Takhar
- Department of Research and Evaluation, Kaiser-Permanente Southern California, Pasadena, CA, USA
| | - Ali Mahfuz
- Department of Foundations of Medicine, NYU-Long Island School of Medicine, Mineola, NY, USA
| | - Gildy S Garcia
- Department of Research and Evaluation, Kaiser-Permanente Southern California, Pasadena, CA, USA
| | - Ramkumar Menon
- Department of Obstetrics and Gynecology, School of Medicine, The University of Texas Medical Branch-Galveston, Galveston, TX, USA
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser-Permanente Southern California, Pasadena, CA, USA.,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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Preventing childhood and lifelong disability: Maternal dietary supplementation for perinatal brain injury. Pharmacol Res 2018; 139:228-242. [PMID: 30227261 DOI: 10.1016/j.phrs.2018.08.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 07/29/2018] [Accepted: 08/24/2018] [Indexed: 12/30/2022]
Abstract
The majority of brain injuries that lead to cerebral palsy, developmental disability, and mental health disorders have their onset in utero. These lifelong conditions come with great economic and emotional burden as they impact function in nearly all domains of affected individuals' lives. Unfortunately, current therapeutic options are limited. There remains a focus on rescue, rehabilitation, and regeneration after the injury has occurred, rather than aiming to prevent the initial injury. Prevention would imply treating the mother during pregnancy to alter the fetal environment and in turn, treat the fetus. Fear of harming the developing fetus remains as a result of errors of the past such as the release of thalidomide. In this review, we outline evidence from animal studies and clinical trials that have explored maternal dietary supplementation with natural health products (including nutraceuticals and functional foods) for perinatal brain injury prevention. Namely, we discuss magnesium sulphate, creatine, choline, melatonin, resveratrol and broccoli sprouts/sulforaphane. Although clinical trials have only been completed in this realm for magnesium sulphate, results in animal models have been promising, suggesting that this is a productive avenue for further research. Natural health products may provide safe, effective, affordable, and easily accessible prevention of fetal brain injury and resulting lifelong disabilities.
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Smith GN, Thornton AE, Lang DJ, MacEwan GW, Kopala LC, Su W, Honer WG. Cortical morphology and early adverse birth events in men with first-episode psychosis. Psychol Med 2015; 45:1825-1837. [PMID: 25499574 DOI: 10.1017/s003329171400292x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Reduced cortical gray-matter volume is commonly observed in patients with psychosis. Cortical volume is a composite measure that includes surface area, thickness and gyrification. These three indices show distinct maturational patterns and may be differentially affected by early adverse events. The study goal was to determine the impact of two distinct obstetrical complications (OCs) on cortical morphology. METHOD A detailed birth history and MRI scans were obtained for 36 patients with first-episode psychosis and 16 healthy volunteers. RESULTS Perinatal hypoxia and slow fetal growth were associated with cortical volume (Cohen's d = 0.76 and d = 0.89, respectively) in patients. However, the pattern of associations differed across the three components of cortical volume. Both hypoxia and fetal growth were associated with cortical surface area (d = 0.88 and d = 0.72, respectively), neither of these two OCs was related to cortical thickness, and hypoxia but not fetal growth was associated with gyrification (d = 0.85). No significant associations were found within the control sample. CONCLUSIONS Cortical dysmorphology was associated with OCs. The use of a global measure of cortical morphology or a global measure of OCs obscured important relationships between these measures. Gyrification is complete before 2 years and its strong relationship with hypoxia suggests an early disruption to brain development. Cortical thickness matures later and, consistent with previous research, we found no association between thickness and OCs. Finally, cortical surface area is largely complete by puberty and the present results suggest that events during childhood do not fully compensate for the effects of early disruptive events.
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Affiliation(s)
- G N Smith
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - A E Thornton
- Department of Psychology,Simon Fraser University,Burnaby,Canada
| | - D J Lang
- Department of Radiology,University of British Columbia,Vancouver,Canada
| | - G W MacEwan
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - L C Kopala
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - W Su
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - W G Honer
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
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Kirkpatrick B, Miller B, García-Rizo C, Fernandez-Egea E. Schizophrenia: a systemic disorder. ACTA ACUST UNITED AC 2015; 8:73-9. [PMID: 23518782 DOI: 10.3371/csrp.kimi.031513] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The concept of schizophrenia that is most widely taught is that it is a disorder in which psychotic symptoms are the main problem, and a dysregulation of dopamine signaling is the main feature of pathophysiology. However, this concept limits clinical assessment, the treatments offered to patients, research, and the development of therapeutics. A more appropriate conceptual model is that: 1) schizophrenia is not a psychotic disorder, but a disorder of essentially every brain function in which psychosis is present; 2) it is not a brain disease, but a disorder with impairments throughout the body; 3) for many patients, neuropsychiatric problems other than psychosis contribute more to impairment in function and quality of life than does psychosis; and, 4) some conditions that are considered to be comorbid are integral parts of the illness. In conclusion, students, patients, and family members should be taught this model, along with its implications for assessment, research, and therapeutics.
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Affiliation(s)
- Brian Kirkpatrick
- Department of Psychiatry and Behavioral Sciences, University of Nevada, Reno, NV
| | - Brian Miller
- Department of Psychiatry and Health Behavior, Georgia Health Sciences University, Augusta, GA
| | - Clemente García-Rizo
- Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Good Outcome Schizophrenia Clinic, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK, Huntingdon, UK
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Kalmady SV, Venkatasubramanian G, Shivakumar V, Gautham S, Subramaniam A, Jose DA, Maitra A, Ravi V, Gangadhar BN. Relationship between Interleukin-6 gene polymorphism and hippocampal volume in antipsychotic-naïve schizophrenia: evidence for differential susceptibility? PLoS One 2014; 9:e96021. [PMID: 24787542 PMCID: PMC4008499 DOI: 10.1371/journal.pone.0096021] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 04/02/2014] [Indexed: 12/29/2022] Open
Abstract
Background Various lines of evidence including epidemiological, genetic and foetal pathogenetic models suggest a compelling role for Interleukin-6 (IL-6) in the pathogenesis of schizophrenia. IL-6 mediated inflammatory response triggered by maternal infection or stress induces disruption of prenatal hippocampal development which might contribute towards psychopathology during adulthood. There is a substantial lack of knowledge on how genetic predisposition to elevated IL-6 expression effects hippocampal structure in schizophrenia patients. In this first-time study, we evaluated the relationship between functional polymorphism rs1800795 of IL-6 and hippocampal gray matter volume in antipsychotic-naïve schizophrenia patients in comparison with healthy controls. Methodology We examined antipsychotic-naïve schizophrenia patients [N = 28] in comparison with healthy controls [N = 37] group matched on age, sex and handedness. Using 3 Tesla – MRI, bilateral hippocampi were manually segmented by blinded raters with good inter-rater reliability using a valid method. Additionally, Voxel-based Morphometry (VBM) analysis was performed using hippocampal mask. The IL-6 level was measured in blood plasma using ELISA technique. SNP rs1800795 was genotyped using PCR and DNA sequencing. Psychotic symptoms were assessed using Scale for Assessment of Positive Symptoms and Scale for Assessment of Negative Symptoms. Results Schizophrenia patients had significantly deficient left and right hippocampal volumes after controlling for the potential confounding effects of age, sex and total brain volume. Plasma IL-6 levels were significantly higher in patients than controls. There was a significant diagnosis by rs1800795 genotype interaction involving both right and left hippocampal volumes. Interestingly, this effect was significant only in men but not in women. Conclusion Our first time observations suggest a significant relationship between IL-6 rs1800795 and reduced hippocampal volume in antipsychotic-naïve schizophrenia. Moreover, this relationship was antithetical in healthy controls and this effect was observed in men but not in women. Together, these observations support a “differential susceptibility” effect of rs1800795 in schizophrenia pathogenesis mediated through hippocampal volume deficit that is of possible neurodevelopmental origin.
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Affiliation(s)
- Sunil Vasu Kalmady
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
- * E-mail:
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - S. Gautham
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Aditi Subramaniam
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Dania Alphonse Jose
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Arindam Maitra
- National Institute of Biomedical Genomics, Kalyani, India
| | - Vasanthapuram Ravi
- Department of Neurovirology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Bangalore N. Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Eide MG, Moster D, Irgens LM, Reichborn-Kjennerud T, Stoltenberg C, Skjærven R, Susser E, Abel K. Degree of fetal growth restriction associated with schizophrenia risk in a national cohort. Psychol Med 2013; 43:2057-2066. [PMID: 23298736 DOI: 10.1017/s003329171200267x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Accumulating evidence suggests that fetal growth restriction may increase risk of later schizophrenia but this issue has not been addressed directly in previous studies. We examined whether the degree of fetal growth restriction was linearly related to risk of schizophrenia, and also whether maternal pre-eclampsia, associated with both placental dysfunction and poor fetal growth, was related to risk of schizophrenia. METHOD A population-based cohort of single live births in the Medical Birth Registry of Norway (MBRN) between 1967 and 1982 was followed to adulthood (n=873 612). The outcome was schizophrenia (n=2207) registered in the National Insurance Scheme (NIS). The degree of growth restriction was assessed by computing sex-specific z scores (standard deviation units) of ‘ birth weight for gestational age’ and ‘ birth length for gestational age’. Analyses were adjusted for potential confounders. Maternal pre-eclampsia was recorded in the Medical Birth Registry by midwives or obstetricians using strictly defined criteria. RESULTS The odds ratio (OR) for schizophrenia increased linearly with decreasing birth weight for gestational age z scores (p value for trend=0.005). Compared with the reference group (z scores 0.01–1.00), the adjusted OR [95% confidence interval (CI)] for the lowest z-score category (<x3.00) was 2.0 (95% CI 1.2–3.5). A similar pattern was observed for birth length for gestational age z scores. Forty-nine individuals with schizophrenia were identified among 15 622 births with pre-eclampsia. The adjusted OR for schizophrenia following maternal pre-eclampsia was 1.3 (95% CI 1.0–1.8). CONCLUSIONS Associations of schizophrenia risk with degree of fetal growth restriction and pre-eclampsia suggest future research into schizophrenia etiology focusing on mechanisms that influence fetal growth, including placental function.
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Affiliation(s)
- M G Eide
- Norwegian Institute of Public Health, Bergen, Norway.
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Navarro D, Alvarado M, Morte B, Berbel D, Sesma J, Pacheco P, Morreale de Escobar G, Bernal J, Berbel P. Late maternal hypothyroidism alters the expression of Camk4 in neocortical subplate neurons: a comparison with Nurr1 labeling. Cereb Cortex 2013; 24:2694-706. [PMID: 23680840 DOI: 10.1093/cercor/bht129] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Maternal thyroid hormones (THs) are essential for normal offspring's neurodevelopment even after onset of fetal thyroid function. This is particularly relevant for preterm children who are deprived of maternal THs following birth, are at risk of suffering hypothyroxinemia, and develop attention-deficit/hyperactivity disorder. Expression of neocortical Ca(2+)/calmodulin kinase IV (Camk4), a genomic target of thyroid hormone, and nuclear receptor-related 1 protein (Nurr1), a postnatal marker of cortical subplate (SP) cells, was studied in euthyroid fetuses and in pups born to dams thyroidectomized in late gestation (LMH group, a model of prematurity), and compared with control and developmentally hypothyroid pups (C and MMI groups, respectively). In LMH pups, the extinction of heavy Camk4 expression in an SP was 1-2 days delayed postnatally compared with C pups. The heavy Camk4 and Nurr1 expression in the SP was prolonged in MMI pups, whereas heavy Camk4 and Nurr1 expression in layer VIb remains at P60. The abnormal expression of Camk4 in the cortical SP and in layer VIb might cause altered cortical connectivity affecting neocortical function.
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Affiliation(s)
- D Navarro
- Department Histology and Anatomy, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - M Alvarado
- Department Histology and Anatomy, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz 91100, México
| | - B Morte
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC) and Universidad Autónoma de Madrid, Madrid, Spain Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain
| | - D Berbel
- Department Histology and Anatomy, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - J Sesma
- Department Histology and Anatomy, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - P Pacheco
- Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz 91100, México
| | - G Morreale de Escobar
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC) and Universidad Autónoma de Madrid, Madrid, Spain Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain
| | - J Bernal
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC) and Universidad Autónoma de Madrid, Madrid, Spain Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain
| | - P Berbel
- Department Histology and Anatomy, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
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The Cerebral Palsy Demonstration Project: a multidimensional research approach to cerebral palsy. Semin Pediatr Neurol 2011; 18:31-9. [PMID: 21575839 DOI: 10.1016/j.spen.2011.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cerebral palsy is the most common cause of physical impairment in pediatrics. As a heterogeneous disorder in all its disparate aspects it defies a simplistic research approach that seeks to further our understanding of its mechanisms, outcomes and treatments. Within NeuroDevNet, with its focus on abnormal brain development, cerebral palsy was selected as one of the three neurodevelopmental disabilities to be the focus of a dedicated demonstration project. The Cerebral Palsy Demonstration Project will feature a multi-dimensional approach utilizing epidemiologic, imaging, genetics, animal models and stem cell modalities that will at all times emphasize clinical relevance, translation into practice, and potential synergies between investigators now segregated by both academic disciplines and geographic distance. The objective is to create a national platform of varied complementary and inter-digitated efforts. The specific research plan to enable this will be outlined in detail.
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11
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Moilanen K, Jokelainen J, Jones PB, Hartikainen AL, Järvelin MR, Isohanni M. Deviant intrauterine growth and risk of schizophrenia: a 34-year follow-up of the Northern Finland 1966 Birth Cohort. Schizophr Res 2010; 124:223-30. [PMID: 20933367 DOI: 10.1016/j.schres.2010.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Revised: 09/05/2010] [Accepted: 09/08/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Low birth weight conveys a modest risk for schizophrenia. The effects of high birth weight and deviant birth length are less clear. METHODS We linked perinatal data from 10,934 subjects from the Northern Finland 1966 Birth Cohort (n = 12 058) to the Finnish Hospital Discharge Register where we identified 111 cases of DSM-III-R schizophrenia up to age 35 years. Adjusted odds ratios between the risk of schizophrenia and birth weight, birth length and ponderal index and the risk of schizophrenia were analyzed. RESULTS Both low (OR 2.5; 95% CI 1.2-5.1) and high birth weight (OR 2.4; 95% CI 1.1-4.9) increased the risk of later schizophrenia. In addition, short (OR 2.6; 95% CI 1.1-5.9) and long babies had an elevated risk of schizophrenia as adults (OR 1.8; 95% CI 1.0-3.5). A reverse J-shape curve described the associations between birth weight, length and schizophrenia. CONCLUSIONS Deviant intrauterine growth of the fetus in either direction was associated with increased risk of schizophrenia.
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Affiliation(s)
- Kristiina Moilanen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, PO Box 5000, FIN-90014 Oulu, Finland.
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Berbel P, Bernal J. Hypothyroxinemia: a subclinical condition affecting neurodevelopment. Expert Rev Endocrinol Metab 2010; 5:563-575. [PMID: 30780800 DOI: 10.1586/eem.10.37] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Hypothyroxinemia with low levels of circulating free thyroxine and normal levels of thyrotropin, which is usually caused by iodine deficiency, may affect pregnant women even in apparently iodine-sufficient areas, and it is debated whether it increases the risk of neurodevelopmental abnormalities in children born to them. Epidemiological observations indeed indicate that this is the case. Animal models show abnormal brain cortical cytoarchitecture in pups born to mildly hypothyroxinemic dams. In regions where the availability and use of iodized salt is inadequate (where <90% of households use iodized salt), the WHO and the International Council for Control of Iodine Deficiency Disorders (ICCIDD) recommend iodine supplementation so that the total iodine intake is 250 µg/day to prevent iodine deficiency during gestation and lactation.
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Affiliation(s)
- Pere Berbel
- a Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Campus de Sant Joan, Apartado de Correos 18, Sant Joan d'Alacant, 03550 Alicante, Spain.
| | - Juan Bernal
- b Instituto de Investigaciones Biomédicas, CSIC-UAM, Centro de Investigación Biomédica en Enfermedades Raras, CIBERER, Arturo Duperier 4, 28029 Madrid, Spain
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Berbel P, Navarro D, Ausó E, Varea E, Rodríguez AE, Ballesta JJ, Salinas M, Flores E, Faura CC, de Escobar GM. Role of late maternal thyroid hormones in cerebral cortex development: an experimental model for human prematurity. Cereb Cortex 2010; 20:1462-75. [PMID: 19812240 PMCID: PMC2871377 DOI: 10.1093/cercor/bhp212] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Hypothyroxinemia affects 35-50% of neonates born prematurely (12% of births) and increases their risk of suffering neurodevelopmental alterations. We have developed an animal model to study the role of maternal thyroid hormones (THs) at the end of gestation on offspring's cerebral maturation. Pregnant rats were surgically thyroidectomized at embryonic day (E) 16 and infused with calcitonin and parathormone (late maternal hypothyroidism [LMH] rats). After birth, pups were nursed by normal rats. Pups born to LMH dams, thyroxine treated from E17 to postnatal day (P) 0, were also studied. In developing LMH pups, the cortical lamination was abnormal. At P40, heterotopic neurons were found in the subcortical white matter and in the hippocampal stratum oriens and alveus. The Zn-positive area of the stratum oriens of hippocampal CA3 was decreased by 41.5% showing altered mossy fibers' organization. LMH pups showed delayed learning in parallel to decreased phosphorylated cAMP response element-binding protein (pCREB) and phosphorylated extracellular signal-regulated kinase 1/2 (pERK1/2) expression in the hippocampus. Thyroxine treatment of LMH dams reverted abnormalities. In conclusion, maternal THs are still essential for normal offspring's neurodevelopment even after onset of fetal thyroid function. Our data suggest that thyroxine treatment of premature neonates should be attempted to compensate for the interruption of the maternal supply.
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Affiliation(s)
- P Berbel
- Instituto de Neurociencias, Universidad Miguel Hernández and Consejo Superior de Investigaciones Científicas, Sant Joan d'Alacant, Alicante, Spain.
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Lin HC, Tang CH, Lee HC. Association between paternal schizophrenia and low birthweight: a nationwide population-based study. Schizophr Bull 2009; 35:624-30. [PMID: 18628271 PMCID: PMC2669574 DOI: 10.1093/schbul/sbn082] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using a nationwide population-based dataset, the aim of the present study was to investigate the association between paternal schizophrenia and the risk of low birthweight (LBW). This study linked the 2001 Taiwan National Health Insurance Research Dataset with Taiwan's birth and death certificate registries. In total, 220 465 singleton live births were included. The key dependent variable was whether or not an infant's father was diagnosed with schizophrenia, while the independent variable of interest was whether an infant had LBW. Multivariate logistic regression analysis was performed to explore the relationship between paternal schizophrenia and the risk of LBW, after adjusting for the infant and parents' characteristics. The results show that infants whose fathers had schizophrenia were more likely to have LBW than those whose fathers did not (12.6% vs 8.0%). Infants whose fathers had schizophrenia were found to be 1.58 (95% confidence interval = 1.10-2.52, P < .05) times more likely to have LBW than their counterparts whose fathers did not have schizophrenia, following adjustment for gestational week at birth, parity, paternal age and highest educational level, family monthly incomes, and marital status. We conclude that the offspring whose fathers had a diagnosis of schizophrenia had increased risk of LBW compared with those whose fathers had no schizophrenia. This finding paves the way for further studies and suggests that there may be potential benefit to early intervention to prevent LBW in pregnant women with husbands with schizophrenia.
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Affiliation(s)
- Herng-Ching Lin
- School of Health Care Administration
- To whom correspondence should be addressed; Department of Psychiatry, School of Medicine, Taipei Medical University and Hospital, 250 Wu-Hsing St., Taipei 110, Taiwan; e-mail:
| | | | - Hsin-Chien Lee
- Department of Psychiatry and Sleep Center
- Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan
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Kirkpatrick B, Messias E, Harvey PD, Fernandez-Egea E, Bowie CR. Is schizophrenia a syndrome of accelerated aging? Schizophr Bull 2008; 34:1024-32. [PMID: 18156637 PMCID: PMC2632500 DOI: 10.1093/schbul/sbm140] [Citation(s) in RCA: 223] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Schizophrenia is associated with a number of anatomical and physiological abnormalities outside of the brain, as well as with a decrease in average life span estimated at 20% in the United States. Some studies suggest that this increased mortality is not entirely due to associated causes such as suicide and the use of psychotropic medications. In this article, in order to focus greater attention on the increased mortality associated with schizophrenia, we present a special case of the hypothesis that physiological abnormalities associated with schizophrenia make a contribution to the increased mortality of schizophrenia: specifically, the hypothesis that schizophrenia is a syndrome of accelerated aging. Evidence consistent with this hypothesis comes from several areas. The biological plausibility of the hypothesis is supported by the existence of established syndromes of accelerated aging and by the sharing of risk factors between schizophrenia and other age-related conditions. We propose methods for testing the hypothesis.
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Affiliation(s)
- Brian Kirkpatrick
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA, USA.
| | - Erick Messias
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA
| | - Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
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Watson PE, McDonald BW. Seasonal variation of nutrient intake in pregnancy: effects on infant measures and possible influence on diseases related to season of birth. Eur J Clin Nutr 2007; 61:1271-80. [PMID: 17299488 DOI: 10.1038/sj.ejcn.1602644] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine, firstly, if there was any seasonal effect on nutrient intake during pregnancy and birth measures, secondly, if there was any relationship between maternal nutrient intake and infant birth measures according to season and thirdly, to consider the hypothesis that seasonal change in nutrient intake during pregnancy might affect health in later life of some women's offspring. DESIGN Pilot study to determine number of days required to characterize group intake followed by a prospective cohort study. SETTING Patients attending a city ante-natal clinic in the lower North Island, New Zealand. SUBJECTS A total of 214 healthy mostly European pregnant women volunteers, entering the second trimester of pregnancy, of whom 10 miscarried and seven withdrew. METHODS Subjects were visited in months 4 and 7 of pregnancy, and months 2, 6 and 12 after birth. Height, weight and skinfolds were measured and questionnaires to determine personal details administered at these times. Subjects recorded 8 days of weighed diets in both the fourth and seventh month. Health records were used to supply infant measures. RESULTS Significant (P</=0.05) seasonal variations in fat, carbohydrate, vitamin C and D, B vitamins, beta-carotene, sodium, potassium, calcium, phosphorous, sulfur, sodium, chloride, zinc and selenium intakes were found. No significant 'main effect' difference in gestational age, infant birthweight, and head circumference was found with season. However, there were significant interactions (P</=0.05) for each birth season between birth measures and specific maternal nutrients at months 4 and 7 of pregnancy. CONCLUSION The significant seasonal variations in nutrient intake in pregnant women, and significant influence of nutrient intake on birth measures in different seasons, suggests seasonal nutrient variation may also affect fetal development at a cellular level. This supports our hypothesis that the development of conditions related to season of birth, including schizophrenia, multiple sclerosis, type I diabetes and longevity, may be influenced by seasonal variation in nutrient intake during pregnancy.
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Affiliation(s)
- P E Watson
- Institute of Food Nutrition and Human Health, Massey University, Albany Campus, Auckland, New Zealand
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McNamara RK, Carlson SE. Role of omega-3 fatty acids in brain development and function: potential implications for the pathogenesis and prevention of psychopathology. Prostaglandins Leukot Essent Fatty Acids 2006; 75:329-49. [PMID: 16949263 DOI: 10.1016/j.plefa.2006.07.010] [Citation(s) in RCA: 328] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The principle omega-3 fatty acid in brain, docosahexaenoic acid (DHA), accumulates in the brain during perinatal cortical expansion and maturation. Animal studies have demonstrated that reductions in perinatal brain DHA accrual are associated with deficits in neuronal arborization, multiple indices of synaptic pathology including deficits in serotonin and mesocorticolimbic dopamine neurotransmission, neurocognitive deficits, and elevated behavioral indices of anxiety, aggression, and depression. In primates and humans, preterm delivery is associated with deficits in fetal cortical DHA accrual, and children/adolescents born preterm exhibit deficits in cortical gray matter maturation, neurocognitive deficits particularly in the realm of attention, and increased risk for attention-deficit/hyperactivity disorder (ADHD) and schizophrenia. Individuals diagnosed with ADHD or schizophrenia exhibit deficits in cortical gray matter maturation, and medications found to be efficacious in the treatment of these disorders increase cortical and striatal dopamine neurotransmission. These associations in conjunction with intervention trials showing enhanced cortical visual acuity and cognitive outcomes in preterm and term infants fed DHA, suggest that perinatal deficits in brain DHA accrual may represent a preventable neurodevelopmental risk factor for the subsequent emergence of psychopathology.
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Affiliation(s)
- Robert K McNamara
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0559, USA.
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Spauwen J, Krabbendam L, Lieb R, Wittchen HU, van Os J. Early maternal stress and health behaviours and offspring expression of psychosis in adolescence. Acta Psychiatr Scand 2004; 110:356-64. [PMID: 15458559 DOI: 10.1111/j.1600-0447.2004.00429.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE It has been suggested that influences operating early in life may affect the risk of postpubertal psychosis outcomes. This hypothesis was tested using a broad outcome of psychotic symptoms expressed in adolescence (prevalence: 15.6%). METHOD Findings are based on a longitudinal, population-based cohort study of 963 adolescents aged 15-20 years and their parents in the area of Munich, Germany. Trained psychologists assessed adolescents with the Munich-Composite International Diagnostic Interview. Independently, direct diagnostic interviews were conducted with the parents. RESULTS A range of medical complications of pregnancy and delivery, including lower birth weight, were not associated with the psychosis outcome. However, a number of maternal health behaviours and experiences did show associations, independent of confounders. CONCLUSION Not maternally reported medical complications of pregnancy and delivery, but maternal prenatal health behaviours predicted expression of psychosis along a continuum in adolescence. This effect may either be direct or constitute a proxy for later postnatal maternal behaviours associated with psychosis risk in the offspring.
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Affiliation(s)
- J Spauwen
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, 6200 MD Maastricht, The Netherlands
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Abstract
The prevalence of diabetes is increased in patients with schizophrenia. Although many reasons, including hereditary and lifestyle factors, contribute to this association, recently there has been heightened interest in the subject because of the link between the use of the newer atypical anti-psychotic drugs and the development of diabetes. These drugs cause significant weight gain and this may be one of the mechanisms by which they increase incident diabetes. The increased prevalence of diabetes among people with schizophrenia has implications for the delivery of care by psychiatrists, diabetologists and primary care.
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Affiliation(s)
- R I G Holt
- Endocrinology & Metabolism Sub-division, Fetal Origins of Adult Disease Division, School of Medicine, University of Southampton, Southampton, UK.
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Smith GN, Lang DJ, Kopala LC, Lapointe JS, Falkai P, Honer WG. Developmental abnormalities of the hippocampus in first-episode schizophrenia. Biol Psychiatry 2003; 53:555-61. [PMID: 12679232 DOI: 10.1016/s0006-3223(02)01977-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The human hippocampus becomes visible during the first trimester and folds to form the hippocampal fissure (HF) in the second trimester. The walls of this fissure fuse by 30 weeks, although small residual cavities can occur if development is disrupted. The primary purpose of this study was to determine if hippocampal fissures are evident in schizophrenia. A second goal was to assess the association between HF size and premorbid and clinical features of the illness. METHODS Magnetic resonance imaging scans were obtained on 33 patients with first-episode schizophrenia and 19 healthy volunteers. Hippocampal fissures were measured using semi-automated procedures, and hippocampi were manually traced. Birth history and premorbid functioning were assessed using maternal report. RESULTS Patients had a significantly larger mean HF volume and a nonsignificantly smaller hippocampal volume. Hippocampal fissure size was significantly associated with poor educational achievement and with anxiety-depression symptoms during the onset of illness. Smaller hippocampal size was associated with poor premorbid adjustment. CONCLUSIONS Larger HF size and an association between low educational achievement and enlarged HFs suggest abnormal neurodevelopment in schizophrenia. The association between HF size and anxiety-depression symptoms suggests that hippocampal abnormalities underlying HF dilatation may be a predisposing factor for increased stress sensitivity.
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Affiliation(s)
- Geoffrey N Smith
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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