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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on June 25, 2010, at 20:18:11
Well seems there are some changes seen in brains of neonates not expected for schizophrenia. Phillipa
From Medscape Medical News
Schizophrenia-Related Brain Abnormalities Seen in At-Risk Neonates
Megan BrooksAuthors and Disclosures
June 24, 2010 Results of a new study provide the first evidence that early neonatal brain development may be abnormal in males at increased genetic risk for schizophrenia, the researchers say."The hope would be that eventually we would be able to identify kids at risk for schizophrenia very early on," John H. Gilmore, MD, professor of psychiatry and director of the University of North Carolina Schizophrenia Research Center in Chapel Hill, told Medscape Psychiatry.
Schizophrenia is associated with abnormalities in brain structure and white matter, but little is known about when these abnormalities arise, Dr. Gilmore and colleagues point out in the June 1 online issue of the American Journal of Psychiatry.
To investigate, they obtained prenatal ultrasound scans and neonatal structural magnetic resonance imaging and diffusion tensor imaging in 26 offspring of mothers with schizophrenia or schizoaffective disorder and 26 comparison offspring of mothers without schizophrenia or other psychiatric illness. There were 12 male and 14 female offspring in each group.
According to the researchers, there were no significant prenatal differences between the high-risk and comparison infants in either lateral ventricle width or head circumference. Overall, the high-risk neonates had nonsignificantly larger intracranial, cerebral spinal fluid (CSF), and lateral ventricle volumes.
Sex Differences
In subgroup analyses, male high-risk offspring had significantly larger intracranial volumes (7.4% difference; P = .04) than male comparison infants. They also had significantly larger total gray matter volume (5.3% difference; P = .03), total CSF volume (12.3% difference; P = .03), cortical gray matter volume (5.9% difference; P = .04), and lateral ventricle volume (21.2% difference; P = .05). These differences, however, were not significant when adjusted for intracranial volume.
Female high-risk neonates, on the other hand, had brain volumes similar to those of female comparison neonates, which fits with the overall pattern of schizophrenia, the researchers say, which is more common and often more severe in males.
There were no group differences in diffusion tensor properties in any of the white matter tracts studied. Diffusion tensor imaging has revealed "widespread abnormalities of white matter" in adults with schizophrenia, the researchers note. That they failed to see the same in their study suggests that these specific abnormalities may arise after the neonatal period.
"We hypothesized," Dr. Gilmore noted, "that we would see enlarged lateral ventricles, which we did see (in males), but we also thought we might see reduced cortical gray matter volumes because that's what we see in adults, so it was a little surprising that we saw enlargement at birth."
The larger cortical gray matter volumes, he and his colleagues note in their report, are "reminiscent of the macrocephaly observed in autism, perhaps implicating similar early developmental trajectories in these disorders, which have some overlapping behavioral features."
"This is really the first study looking at kids at high risk for schizophrenia at birth," Dr. Gilmore noted. "We will follow them longitudinally to see how their development progresses through childhood."
"The importance of this study," he added, "is that it suggests that brain development, at least in some kids at high risk for schizophrenia, is different at birth, and we could start thinking about preventive strategies very early in childhood."
Limitations
The relatively small number of study subjects, which had 0.8 power to detect differences in gray matter volume of about 10%, is 1 limitation of the study.
The fact that most of the mothers of the high-risk infants took antipsychotics during pregnancy is another. Studies in nonhuman primates suggest that long-term antipsychotic exposure can affect cortical gray matter volume.
Mothers of high-risk infants were also more likely to have smoked tobacco or used illicit substances while pregnant, which could have confounded the results. Although there were no differences in volumes between the high-risk neonates exposed to maternal smoking and those not exposed.
The study was supported by grants from the National Institute of Mental Health and the Foundation of Hope. Dr. Gilmore and several colleagues disclose having received grant support and serving in various advisory roles for various drug companies.
Am J Psychiatry. Published online June 1, 2010.
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