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Fernandez-Egea E, Chen S, Sangüesa E, Gassó P, Biria M, Plaistow J, Jarratt-Barnham I, Segarra N, Mas S, Ribate MP, García CB, Fineberg NA, Worbe Y, Cardinal RN, Robbins TW. The role of psychosis and clozapine load in excessive checking in treatment-resistant schizophrenia: longitudinal observational study. Br J Psychiatry 2024; 224:164-169. [PMID: 38652060 PMCID: PMC11039551 DOI: 10.1192/bjp.2024.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND A significant proportion of people with clozapine-treated schizophrenia develop 'checking' compulsions, a phenomenon yet to be understood. AIMS To use habit formation models developed in cognitive neuroscience to investigate the dynamic interplay between psychosis, clozapine dose and obsessive-compulsive symptoms (OCS). METHOD Using the anonymised electronic records of a cohort of clozapine-treated patients, including longitudinal assessments of OCS and psychosis, we performed longitudinal multi-level mediation and multi-level moderation analyses to explore associations of psychosis with obsessiveness and excessive checking. Classic bivariate correlation tests were used to assess clozapine load and checking compulsions. The influence of specific genetic variants was tested in a subsample. RESULTS A total of 196 clozapine-treated individuals and 459 face-to-face assessments were included. We found significant OCS to be common (37.9%), with checking being the most prevalent symptom. In mediation models, psychosis severity mediated checking behaviour indirectly by inducing obsessions (r = 0.07, 95% CI 0.04-0.09; P < 0.001). No direct effect of psychosis on checking was identified (r = -0.28, 95% CI -0.09 to 0.03; P = 0.340). After psychosis remission (n = 65), checking compulsions correlated with both clozapine plasma levels (r = 0.35; P = 0.004) and dose (r = 0.38; P = 0.002). None of the glutamatergic and serotonergic genetic variants were found to moderate the effect of psychosis on obsession and compulsion (SLC6A4, SLC1A1 and HTR2C) survived the multiple comparisons correction. CONCLUSIONS We elucidated different phases of the complex interplay of psychosis and compulsions, which may inform clinicians' therapeutic decisions.
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Affiliation(s)
- Emilio Fernandez-Egea
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Department of Psychiatry, University of Cambridge, UK; and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Shanquan Chen
- Department of Psychiatry and Division of Psychology and Language Sciences, University College London, UK
| | | | - Patricia Gassó
- Department of Basic Clinical Practice, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Marjan Biria
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; and Department of Psychology, University of Cambridge, UK
| | - James Plaistow
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Isaac Jarratt-Barnham
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Medical Sciences Division, University of Oxford, UK
| | - Nuria Segarra
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Sergi Mas
- Department of Basic Clinical Practice, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | | | | | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; and School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Yulia Worbe
- Department of Neurophysiology, Sorbonne Université, France; Department of Neurophysiology, Saint-Antoine Hospital, Paris, France; and Institute du Cerveau et de la Moelle Epinière, Paris, France
| | - Rudolf N. Cardinal
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; and Department of Psychiatry, University of Cambridge, UK
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; and Department of Psychology, University of Cambridge, UK
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Parkin K, Chen S, Biria M, Plaistow J, Beckwith H, Jarratt-Barnham I, Segarra N, Worbe Y, Fineberg NA, Cardinal RN, Robbins TW, Fernandez-Egea E. Clozapine-related obsessive-compulsive symptoms and their impact on wellbeing: a naturalistic longitudinal study. Psychol Med 2023; 53:2936-2945. [PMID: 35469587 PMCID: PMC10235641 DOI: 10.1017/s003329172100492x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Obsessive-compulsive symptoms (OCS) are commonly associated with clozapine treatment but are frequently overlooked by clinicians despite their potential impact on patients' quality of life. In this study, we explored whether OCS severity impacted subjective wellbeing and general functioning, independently of depressive and psychotic symptoms. METHODS We used anonymised electronic healthcare records from a large cohort of patients who were treated with clozapine and assessed annually for OCS, wellbeing, general functioning, and psychopathology using standardised scales as part of routine clinical practice. We used statistical mixed linear model techniques to evaluate the longitudinal influence of OCS severity on wellbeing and general functioning. RESULTS A total of 184 patients were included, with 527 face-to-face assessments and 64.7% evaluated three or more times. Different linear mixed models demonstrated that OCS in patients treated with clozapine were associated with significantly worse wellbeing scores, independently of depression and psychotic symptoms, but OCS did not impair general functioning. Obsessional thinking and hoarding behaviour, but not compulsions, were significantly associated with the impact on wellbeing, which may be attributable to the ego-syntonic nature of the compulsions. CONCLUSIONS Given the frequent occurrence of OCS and their negative impact on wellbeing, we encourage clinicians to routinely assess and treat OCS in patients who are taking clozapine.
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Affiliation(s)
- Katherine Parkin
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Shanquan Chen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marjan Biria
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - James Plaistow
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Helen Beckwith
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Isaac Jarratt-Barnham
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Nuria Segarra
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Yulia Worbe
- Sorbonne Université, Paris 05, France
- Department of Neurophysiology, Saint-Antoine Hospital, Paris, France
- INSERM U 1127, CNRS UMR 7225, Institute du Cerveau et de la Moelle Epinière, Paris, France
| | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Rudolf N. Cardinal
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Emilio Fernandez-Egea
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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3
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Arrondo G, Segarra N, Metastasio A, Ziauddeen H, Spencer J, Reinders NR, Dudas RB, Robbins TW, Fletcher PC, Murray GK. Reduction in ventral striatal activity when anticipating a reward in depression and schizophrenia: a replicated cross-diagnostic finding. Front Psychol 2015; 6:1280. [PMID: 26379600 PMCID: PMC4549553 DOI: 10.3389/fpsyg.2015.01280] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 08/11/2015] [Indexed: 11/17/2022] Open
Abstract
In the research domain framework (RDoC), dysfunctional reward expectation has been proposed to be a cross-diagnostic domain in psychiatry, which may contribute to symptoms common to various neuropsychiatric conditions, such as anhedonia or apathy/avolition. We used a modified version of the Monetary Incentive Delay (MID) paradigm to obtain functional MRI images from 22 patients with schizophrenia, 24 with depression and 21 controls. Anhedonia and other symptoms of depression, and overall positive and negative symptomatology were also measured. We hypothesized that the two clinical groups would have a reduced activity in the ventral striatum when anticipating reward (compared to anticipation of a neutral outcome) and that striatal activation would correlate with clinical measures of motivational problems and anhedonia. Results were consistent with the first hypothesis: two clusters in both the left and right ventral striatum were found to differ between the groups in reward anticipation. Post-hoc analysis showed that this was due to higher activation in the controls compared to the schizophrenia and the depression groups in the right ventral striatum, with activation differences between depression and controls also seen in the left ventral striatum. No differences were found between the two patient groups, and there were no areas of abnormal cortical activation in either group that survived correction for multiple comparisons. Reduced ventral striatal activity was related to greater anhedonia and overall depressive symptoms in the schizophrenia group, but not in the participants with depression. Findings are discussed in relation to previous literature but overall are supporting evidence of reward system dysfunction across the neuropsychiatric continuum, even if the specific clinical relevance is still not fully understood. We also discuss how the RDoC approach may help to solve some of the replication problems in psychiatric fMRI research.
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Affiliation(s)
- Gonzalo Arrondo
- Department of Psychiatry, University of Cambridge Cambridge, UK
| | - Nuria Segarra
- Department of Psychiatry, University of Cambridge Cambridge, UK
| | | | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge Cambridge, UK ; Wellcome Trust-MRC Institute of Metabolic Science Cambridge, UK ; Cambridgeshire and Peterborough NHS Foundation Trust UK
| | - Jennifer Spencer
- Department of Psychiatry, University of Cambridge Cambridge, UK ; Cambridgeshire and Peterborough NHS Foundation Trust UK
| | | | - Robert B Dudas
- Department of Psychiatry, University of Cambridge Cambridge, UK ; Cambridgeshire and Peterborough NHS Foundation Trust UK ; Psychiatric Liaison Service, Ipswich Hospital Norfolk and Suffolk NHS Foundation Trust, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge Cambridge, UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge Cambridge, UK
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge Cambridge, UK ; Wellcome Trust-MRC Institute of Metabolic Science Cambridge, UK ; Cambridgeshire and Peterborough NHS Foundation Trust UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge Cambridge, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge Cambridge, UK ; Cambridgeshire and Peterborough NHS Foundation Trust UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge Cambridge, UK
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Chuang JY, Murray GK, Metastasio A, Segarra N, Tait R, Spencer J, Ziauddeen H, Dudas RB, Fletcher PC, Suckling J. Brain structural signatures of negative symptoms in depression and schizophrenia. Front Psychiatry 2014; 5:116. [PMID: 25221526 PMCID: PMC4145726 DOI: 10.3389/fpsyt.2014.00116] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/12/2014] [Indexed: 02/02/2023] Open
Abstract
Negative symptoms occur in several major mental health disorders with undetermined mechanisms and unsatisfactory treatments; identification of their neural correlates might unveil the underlying pathophysiological basis and pinpoint the therapeutic targets. In this study, participants with major depressive disorder (n = 24), schizophrenia (n = 22), and healthy controls (n = 20) were assessed with 10 frequently used negative symptom scales followed by principal component analysis (PCA) of the scores. A linear model with the prominent components identified by PCA was then regressed on gray and white-matter volumes estimated from T1-weighted magnetic resonance imaging. In depressed patients, negative symptoms such as blunted affect, alogia, withdrawal, and cognitive impairment, assessed mostly via clinician-rated scales were inversely associated with gray matter volume in the bilateral cerebellum. In patients with schizophrenia, anhedonia, and avolition evaluated via self-rated scales inversely related to white-matter volume in the left anterior limb of internal capsule/anterior thalamic radiation and positively in the left superior longitudinal fasiculus. The pathophysiological mechanisms underlying negative symptoms might differ between depression and schizophrenia. These results also point to future negative symptom scale development primarily focused on detecting and monitoring the corresponding changes to brain structure or function.
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Affiliation(s)
- Jie-Yu Chuang
- Department of Psychiatry, University of Cambridge , Cambridge , UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| | | | - Nuria Segarra
- Department of Psychiatry, University of Cambridge , Cambridge , UK
| | - Roger Tait
- Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK
| | - Jenny Spencer
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK ; Wellcome Trust MRC, Institute of Metabolic Science, University of Cambridge , Cambridge , UK
| | - Robert B Dudas
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK ; Norfolk and Suffolk NHS Foundation Trust , Norfolk , UK
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
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Cuesta MJ, Pino O, Guilera G, Rojo JE, Gómez-Benito J, Purdon SE, Franco M, Martínez-Arán A, Segarra N, Tabarés-Seisdedos R, Vieta E, Bernardo M, Crespo-Facorro B, Mesa F, Rejas J. Brief cognitive assessment instruments in schizophrenia and bipolar patients, and healthy control subjects: a comparison study between the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and the Screen for Cognitive Impairment in Psychiatry (SCIP). Schizophr Res 2011; 130:137-42. [PMID: 21652178 DOI: 10.1016/j.schres.2011.05.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 05/20/2011] [Accepted: 05/23/2011] [Indexed: 10/18/2022]
Abstract
Cognitive impairment in schizophrenia and psychosis is ubiquitous and acknowledged as a core feature of clinical expression, pathophysiology, and prediction of functioning. However, assessment of cognitive functioning is excessively time-consuming in routine practice, and brief cognitive instruments specific to psychosis would be of value. Two screening tools have recently been created to address this issue, i.e., the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and the Screen for Cognitive Impairment in Psychiatry (SCIP). The aim of this research was to examine the comparative validity of these two brief instruments in relation to a global cognitive score. 161 patients with psychosis (96 patients diagnosed with schizophrenia and 65 patients diagnosed with bipolar disorder) and 76 healthy control subjects were tested with both instruments to examine their concurrent validity relative to a more comprehensive neuropsychological assessment battery. Scores from the B-CATS and the SCIP were highly correlated in the three diagnostic groups, and both scales showed good to excellent concurrent validity relative to a Global Cognitive Composite Score (GCCS) derived from the more comprehensive examination. The SCIP-S showed better predictive value of global cognitive impairment than the B-CATS. Partial and semi-partial correlations showed slightly higher percentages of both shared and unique variance between the SCIP-S and the GCCS than between the B-CATS and the GCCS. Brief instruments for assessing cognition in schizophrenia and bipolar disorders, such as the SCIP-S and B-CATS, seem to be reliable and promising tools for use in routine clinical practice.
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Affiliation(s)
- Manuel J Cuesta
- Psychiatric Hospitalization Unit, Hospital Virgen del Camino, Pamplona-Iruña, Spain.
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Segarra N, Bernardo M, Gutierrez F, Justicia A, Fernadez-Egea E, Allas M, Safont G, Contreras F, Gascon J, Soler-Insa PA, Menchon JM, Junque C, Keefe RSE. Spanish validation of the Brief Assessment in Cognition in Schizophrenia (BACS) in patients with schizophrenia and healthy controls. Eur Psychiatry 2011; 26:69-73. [PMID: 20435446 DOI: 10.1016/j.eurpsy.2009.11.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 11/01/2009] [Accepted: 11/02/2009] [Indexed: 10/19/2022] Open
Abstract
Neurocognitive impairment is a core feature of schizophrenia and is closely associated with functional outcome. The importance of cognitive assessment is broadly accepted today, and an easy-to-use, internationality validated cognitive assessment tool is needed by researchers and in daily clinical practice. The Brief Assessment of Cognition in Schizophrenia (BACS) has been validated in English, French, Japanese and Italian. It is as sensitive to cognitive dysfunction as a standard test battery, with the advantage of requiring less than 35minutes to complete. In our study, we tested the psychometric characteristics of a Spanish version of the BACS in 117 patients with schizophrenia-spectrum disorders and 36 healthy controls. All BACS cognitive subtests discriminated between patients and controls (P<.001), and the concurrent validity between the BACS and a traditional neuropsychological test battery was similar to that reported in other languages. We conclude that the BACS can facilitate the comparison of the cognitive performance of patients with schizophrenia in many different countries.
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Affiliation(s)
- N Segarra
- Schizophrenia Clinic Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic de, Barcelona, Spain
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7
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Rojo E, Pino O, Guilera G, Gómez-Benito J, Purdon SE, Crespo-Facorro B, Cuesta MJ, Franco M, Martínez-Arán A, Segarra N, Tabarés-Seisdedos R, Vieta E, Bernardo M, Mesa F, Rejas J. Neurocognitive diagnosis and cut-off scores of the Screen for Cognitive Impairment in Psychiatry (SCIP-S). Schizophr Res 2010; 116:243-51. [PMID: 19744832 DOI: 10.1016/j.schres.2009.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 07/20/2009] [Accepted: 08/09/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To demonstrate the ability of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) to discriminate between cognitively-impaired individuals and those with adequate functioning in a sample of schizophrenic and bipolar patients, as well as in a control group. METHODS The SCIP-S, together with a full neuropsychological battery, was administered to three groups: patients with schizophrenia, patients diagnosed with bipolar disorder I, and controls. The battery scores were used to perform a standardization with respect to the control group and this served to determine the comparison groups (cognitively impaired versus unimpaired) for each of the subtests of the SCIP-S. A full analysis of decision validity was conducted on the basis of receiver operating characteristic curves (sensitivity and specificity, +LR and -LR, PPV and NPV). RESULTS All the subtests yielded adequate values for sensitivity and specificity with the proposed cut-off points, while the total score of the SCIP (<70) was associated with a sensitivity of 87.9 and specificity of 80.6. CONCLUSIONS The SCIP-S shows adequate decision validity as a screening tool for cognitive deficit in patients diagnosed with schizophrenia or bipolar disorder.
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Affiliation(s)
- Emilio Rojo
- Department of Psychiatry, Benito Menni CASM, Granollers Hospital General, Granollers, Barcelona, Spain
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8
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Valdés M, Bernardo M, Segarra N, Parramón G, Teresa Plana M, Rami L, Salamero M, Bargalló N. La amplificación somatosensorial en la esquizofrenia está relacionada con la preservación del rendimiento neuropsicológico. Revista de Psiquiatría y Salud Mental 2008; 1:3-9. [DOI: 10.1016/s1888-9891(08)72510-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 09/16/2008] [Indexed: 11/29/2022]
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9
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Rametti G, Segarra N, Junqué C, Bargalló N, Caldú X, Ibarretxe N, Bernardo M. Left posterior hippocampal density reduction using VBM and stereological MRI procedures in schizophrenia. Schizophr Res 2007; 96:62-71. [PMID: 17604968 DOI: 10.1016/j.schres.2007.04.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 04/27/2007] [Accepted: 04/29/2007] [Indexed: 11/15/2022]
Abstract
Structural deficits in the hippocampus have been implicated in the pathophysiology of schizophrenia. However the role played by structural impairments in the hippocampus in the memory deficits of schizophrenic patients remains unclear. Magnetic resonance imaging was used in this study to investigate left, right, anterior and posterior hippocampal volume and density in 28 schizophrenic patients and 33 normal controls. Voxel-based morphometry analysis showed that schizophrenics had significantly lower density in the right and posterior hippocampus than controls. MRI stereological analysis revealed significant differences in left posterior hippocampus than controls. MRI stereological analysis revealed significant differences in anterior and posterior on both sides, with the left posterior region predominating. Schizophrenics showed significant impairments in verbal learning and long term retention (P<0.001). The correlation analyses between hippocampal density and memory variables yielded a significant correlation between forgetting and density of the anterior hippocampus. These findings support the hypothesis of a regional atrophy within the hippocampus in schizophrenic patients.
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Affiliation(s)
- Giuseppina Rametti
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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Pujol P, Huguet J, Drobnic F, Banquells M, Ruiz O, Galilea P, Segarra N, Aguilera S, Burnat A, Mateos J, Postaire E. The effect of fermented milk containinglactobacillus caseion the immune response to exercise. ACTA ACUST UNITED AC 2000. [DOI: 10.1080/15438620009512557] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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