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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recently, there has been growing interest in using functional magnetic resonance imaging (fMRI) for the evaluation of psychopharmacological drugs. fMRI studies in healthy human volunteers and psychiatric patients focus on cerebral activity following acute drug administration (single challenge) and on adaptive effects on neural networks due to long-term medication. In our own fMRI studies, the effects of olanzapine or amisulpride in never treated or medication-free schizophrenic patients using robust motor, visual, and acoustic tasks was longitudinally examined. In agreement with previous reports in the literature it could be shown that, in contrast to traditional neuroleptics, atypical drugs do not decrease the activation of the sensorimotor cortex but rather normalize the reduced frontoparietal activation as well as the neuropsychological test results. This encourages the assumption that atypical antipsychotics seem to support the recovery or normalization of frontoparietal brain dysfunction in schizophrenia. However, with these new opportunities additional methodological considerations and limitations emerge.
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PMID:[Functional magnetic resonance imaging and antipsychotics. Overview and own data]. 1561 67

To determine whether neuropsychiatric manifestations in patients with systemic lupus erythematosus (SLE) are influenced by antibodies against the human N-methyl-D-aspartate (NMDA) receptor types NR2a or NR2b. A decapeptide was synthesized containing a sequence motif present in the extracellular ligand-binding domain of NMDA receptors NR2a and NR2b, bound by the monoclonal murine anti-DNA antibody R4A. In an ELISA with the murine monoclonal R4v as positive control, plasma samples of 57 patients with SLE were examined for the anti-peptide (anti-NR2) antibody after the patients had been subjected to comprehensive psychological and cognitive testing. Poor performance on the Visual Paired Associates test (immediate), the Grooved Pegboard test, as well as high scores on the Beck Depression Inventory, and scales D-2 (depression), Pd-4 (psychopathic deviate), Sc-8 (schizophrenia), and Ma-9 (hypomania) of the MMPI-2 were significantly associated with elevated levels of anti-NR2 antibodies. The findings in several domains indicate an association between anti-NR2 antibodies and depressed mood in addition to decreased short-time memory and learning. Antibodies to NMDA receptors thus may represent one of several mechanisms for cerebral dysfunction in patients with SLE.
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PMID:Neuropsychiatric disturbances in SLE are associated with antibodies against NMDA receptors. 1580 72

Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close to the patient, has been replaced by a double who is physically very similar to the original. CS is relatively rare, occurring predominantly in course of schizophrenia, particularly of the paranoid sub-type, and less frequently in association with schizoaffective and affective disorder. Recent years have witnessed a sharp increase in the number of published CS cases with an organic etiology; however, CS was considered to have its origins in psychodynamic conflict. We present a patient with the CS and brain SPECT findings whom without psychiatric disorder. As an evaluation of brain SPECT, there have been found a significantly decreased blood flow in bilateral parietal regions and slightly decreased blood flow in bilateral posterior frontal regions. Cerebral dysfunction is proposed to be a central role in CS development. Unilateral right hemisphere lesions occur more frequently than the left; however, the majority of CS cases show bilateral involvement. Pathology involves many parts of the brain, most notably frontal and parietal cortex. Our findings support that frontoparietal dysfunction could be important in the pathogenesis of CS. We reviewed the neurobiology of CS and discussed our findings in this article. CS studies will give a better understanding of the neurobiological basis of psychotic experiences and may contribute to develop a paradigm on researches about other psychotic disorders.
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PMID:[Frontoparietal hypoperfusion in Capgras syndrome: a case report and review]. 1636 48

Zygmunt A. Piotrowski (1904-1985), one of the early pioneers with the Rorschach technique, developed a method for Rorschach analysis described in the text, Perceptanalysis. Based on clinical, teaching, research, and supervisory experiences, the author selected three aspects of the text for review for their enduring contributions to clinical personality analysis. The three areas are: (a) the scientific and philosophical framework of the system; (b) the Human Movement response, M; and (c) the shading responses--light shading, c'R, and dark shading, c'R. The reader is also introduced to other works by Piotrowski, including scales for cerebral dysfunction and schizophrenia.
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PMID:Piotrowski's enduring contributions to the Rorschach: a review of Perceptanalysis. 1637 Aug 8

Cognitive deficits predict functioning in schizophrenia; however, little is known as to whether the association is present in other mental disorders. If specific cognitive deficits uniquely predict functional impairment in schizophrenia the association of select aspects of brain dysfunction with daily living would suggest an intervention target and perhaps a means by which to improve the functioning of schizophrenia patients. The relationship of cognition and functioning was investigated in schizophrenia (n=39), bipolar affective disorder (n=27), and nonpsychiatric control (n=38) participants to determine whether the associations varied across groups. We examined verbal memory, verbal learning, verbal fluency, vigilance, executive functioning, symptomatology, and generalized cognitive functioning for associations with social function. Correlational analyses revealed particular cognitive domains (e.g., verbal memory) to be associated with social functioning in schizophrenia, bipolar, and control subjects; however generalized cognitive function and symptomatology were also associated with social functioning in patients. Multiple regression analyses revealed that in schizophrenia poor verbal memory predicted worse social functioning even after the effects of generalized cognitive dysfunction were considered. Verbal memory indices failed to account for variance in social function in bipolar patients and control subjects after consideration of generalized cognitive function. Bipolar patients with worse planning and problem solving tended to have worse social functioning. Therefore, unlike schizophrenia patients who may fail to process verbally mediated material, bipolar patients' difficulty with logical approaches to problems in daily living may have the greatest impact on their community function.
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PMID:Does cognition predict community function only in schizophrenia?: a study of schizophrenia patients, bipolar affective disorder patients, and community control subjects. 1644 48

Neurodevelopmental changes may underlie the brain dysfunction seen in schizophrenia. While advances have been made in our understanding of the genetics of schizophrenia, little is known about how non-genetic factors interact with genes for schizophrenia. The present analysis of genes potentially associated with schizophrenia is based on the observation that hypoxia prevails in the embryonic and fetal brain, and that interactions between neuronal genes, molecular regulators of hypoxia, such as hypoxia-inducible factor 1 (HIF-1), and intrinsic hypoxia occur in the developing brain and may create the conditions for complex changes in neurodevelopment. Consequently, we searched the literature for currently hypothesized candidate genes for susceptibility to schizophrenia that may be subject to ischemia-hypoxia regulation and/or associated with vascular expression. Genes were considered when at least two independent reports of a significant association with schizophrenia had appeared in the literature. The analysis showed that more than 50% of these genes, particularly AKT1, BDNF, CAPON, CCKAR, CHRNA7, CNR1, COMT, DNTBP1, GAD1, GRM3, IL10, MLC1, NOTCH4, NRG1, NR4A2/NURR1, PRODH, RELN, RGS4, RTN4/NOGO and TNF, are subject to regulation by hypoxia and/or are expressed in the vasculature. Future studies of genes proposed as candidates for susceptibility to schizophrenia should include their possible regulation by physiological or pathological hypoxia during development as well as their potential role in cerebral vascular function.
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PMID:Gene regulation by hypoxia and the neurodevelopmental origin of schizophrenia. 1663 32

To date, every published study of the antisaccade task has replicated the finding that schizophrenia patients make an increased number of errors. This finding has been interpreted as support for frontal and/or basal ganglia dysfunction in schizophrenia, primarily because neurological patients with pathology in these brain regions also make large numbers of errors on the antisaccade task. Here, we compared the performance of schizophrenia patients and nonpsychiatric controls on an antisaccade task and on two neuropsychological tests, the Wisconsin Card Sorting Test, which is assumed to tap frontal lobe functioning, and the interference condition of the Stroop Test, which is thought to tap dorsolateral prefrontal cortex/anterior cingulate functioning. We examined the pattern of intercorrelations among these tasks. Schizophrenia patients made significantly more errors on the antisaccade task, made more perseverative errors and achieved fewer categories on the Wisconsin Card Sorting Test, and were significantly slower during the interference condition of the Stroop Test than were nonpsychiatric controls. Antisaccade errors were significantly correlated with interference performance on the Stroop in schizophrenia patients and in controls, but were not significantly correlated with the measures of Wisconsin Card Sorting Test performance in either group. The pattern of intercorrelation suggests that these tasks should not be thought of as representing a unitary variable of "frontal cortical integrity". Although aspects of these tasks tap the ability to inhibit prepotent responses, each task is also behaviorally complex. The multifaceted nature of these tasks makes it difficult to isolate which brain regions are part of the network underlying the specific act of inhibiting a prepotent response (for example, the reflexive saccade toward the novel peripheral target) and which regions participate in aspects of task performance that are related to non-inhibitory components (for example, executing an antisaccade). A broadly distributed network is undoubtedly involved in both processes. Parsing the various components of cognitively complex tasks may help to clarify both the specific behaviors that are anomalous and their underlying neural substrates. We also address the complexity of inferring localized brain dysfunction in schizophrenia patients based on seemingly analogous behavioral deficits in neurological populations.
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PMID:The antisaccade task and neuropsychological tests of prefrontal cortical integrity in schizophrenia: empirical findings and interpretative considerations. 1663 52

A cerebral basis for the acquisition and retention of procedural knowledge in schizophrenia was examined with 1.5 T functional MRI during an embedded sequence Serial Reaction Time Task (SRTT) in 10 chronic medicated patients and 15 healthy controls. Comparable procedural learning was observed in both groups, suggesting that the impairment reported in previous schizophrenia samples may not be robust. Consistent with previous fMRI reports, procedural learning in the control group was associated with activity in the dorsal striatum, anterior cingulate, parietal cortex and frontal cortex. Greater procedural learning related activity was observed in the control relative to the schizophrenia group in the bilateral frontal, left parietal and bilateral caudate regions. Patients did not activate frontal or parietal areas while responding to the embedded sequence within the SRTT, but greater activation during procedural learning was observed relative to the control sample in the right anterior cingulate, left globus pallidus and the right superior temporal gyrus. Thus, despite comparable instantiation of procedural learning in schizophrenia, the cerebral activation associated with this cognitive skill was abnormal. The paucity of activity in bilateral frontal cortex, left parietal cortex and bilateral caudate nucleus may represent cerebral dysfunction associated with schizophrenia, whereas the hyperactivation of the right superior temporal gyrus, the right anterior cingulate cortex and the left globus pallidus may represent a compensatory cerebral action capable of facilitating near-normal task performance. The results are thus consistent with a neurodevelopmental pathology impinging on fronto-subcortical circuitry.
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PMID:Procedural learning in schizophrenia investigated with functional magnetic resonance imaging. 1694 6

The social brain hypothesis is a useful heuristic for understanding schizophrenia. It focuses attention on the core Bleulerian concept of autistic alienation and is consistent with well-replicated findings of social brain dysfunction in schizophrenia as well as contemporary theories of human cognitive and brain evolution. The contributions of Heidegger, Merleau-Ponty and Wittgenstein allow us to arrive at a new "philosophy of interpersonal relatedness", which better reflects the "embodied mind" and signifies the end of Cartesian dualistic thinking. In this paper I review the evolution, development and neurobiology of the social brain - the anatomical and functional substrate for adaptive social behaviour and cognition. Functional imaging identifies fronto-temporal and fronto-parietal cortical networks as comprising the social brain, while the discovery of "mirror neurons" provides an understanding of social cognition at a cellular level. Patients with schizophrenia display abnormalities in a wide range of social cognition tasks such as emotion recognition, theory of mind and affective responsiveness. Furthermore, recent research indicates that schizophrenia is a disorder of functional and structural connectivity of social brain networks. These findings lend support to the claim that schizophrenia represents a costly by-product of social brain evolution in Homo sapiens. Individuals with this disorder find themselves seriously disadvantaged in the social arena and vulnerable to the stresses of their complex social environments. This state of "disembodiment" and interpersonal alienation is the core phenomenon of schizophrenia and the root cause of intolerable suffering in the lives of those affected.
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PMID:The social brain hypothesis of schizophrenia. 1718 81

Symptom heterogeneity within conventional diagnostic groups is fostering a growing focus on narrower symptom profiles to identify psychological and biological mechanisms in psychopathology. Positive symptoms of schizophrenia are associated with context maintenance deficits, which in turn have been linked to frontal-lobe function. Frontal- and temporal-lobe brain dysfunction is also well documented in schizophrenia. The present study (N=36) examined how context and memory deficits are associated with subclinical symptoms in schizotypy by investigating the relationship between symptom reports, neuropsychological performance, and several facets of recognition memory. Context maintenance was probed via lures suggested by presented verbal material. Frontal brain function and positive symptom schizotypy predicted accuracy for lures, whereas posterior brain function and low positive affect predicted accuracy for distracters. This pattern of findings establishes continuity in disruption of context maintenance in clinical and subclinical populations.
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PMID:Semantic associations, lateralized frontal function, and context maintenance in schizotypy. 1701 1


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