The following
two stories on new diagnostic tests for schizophrenia look
to be a major development in schizophrenia treatment since
one of the key issues individuals and families have faced
in the past is the difficulties in getting proper diagnosis.
We hope that schizophrenia advocacy groups incorporate this
into their mantra for full insurance coverage for brain
diseases like schizophrenia - and also for programs for
early diagnosis testing for high risk groups (family members
of people with schizophrenia, for example) in light of the
fact that early treatment of schizophrenia is associated
with much better clinical outcomes.
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New
Brain test provides early Prediction/Identification of Schizophrenia
RESEARCHERS in
the UK have claimed a major breakthrough in the treatment
of schizophrenia by using brain-imaging tests to predict
the illness.
Consultant psychiatrist
Dr Stephen Lawrie, of the Royal Edinburgh Hospital and the
division of psychiatry at Edinburgh University’s faculty
of medicine, said his team had picked up specific changes
in the brains of people who would go on to develop schizophrenia.
Their work is
part of a long-term research project involving the testing
of more than 100 people whose relatives have schizophrenia
and so are genetically predisposed to it.
Lawrie said that
of the 162 relatives the team had tested in the past 10
years, 21 had developed schizophrenia. “In those 21
we have seen very definite changes by using pen-and-paper
tests, but more importantly with brain imaging techniques,”
he said.
“We have
identified changes in the brain that can predict schizophrenia
up to five years in advance. These are changes that would
happen before anyone would make a clinical diagnosis.
“The results
are utterly amazing. The obvious implication is that if
we can detect the illness early, we can intervene and maybe
even prevent it.”
A study by the
team, published in the current issue of the journal Brain,
details its finding that scanning found subtle abnormalities
in the brains of patients deemed to be at risk of schizophrenia.
In the study,
patients underwent scanning in a magnetic resonance imaging
(MRI) machine while silently completing sentences. During
the test at-risk subjects showed unique abnormalities in
the fron tal, thalamic (midbrain) and cerebellar (hindbrain)
regions of the brain, yet none “met any diagnostic
criteria for a psychotic illness, was on medication or had
even considered themselves unwell”.
“A crucial
question that no-one has yet been able to address is whether
it is the structural or the functional changes in the brain
that come first,” said Lawrie.
“That will
be important in dictating the best treatments. If the structural
changes are evident first, then you’d be thinking along
the lines of cognitive enhancers or drugs similar to those
prescribed for Alzheimer’s. But if the functional changes
come first, it might be possible to think more about more
psychotherapeutic interventions.
“The treatments
available at best control the symptoms of the illness. In
almost all cases, people with schizophrenia don’t get
back to the work or the studying that they were doing before
they became ill.
“We found
that in almost all the high-risk group who develop schizophrenia,
the first symptoms are anxiety and depression, and that
slowly changes into the typical delusions and hallucinations.
“It’s
possible that if you were to intervene with anti-depressants
or some sort of psychotherapy when people were anxious and
depressed you might be able to treat that, and perhaps prevent
the progression to psychosis.
“Often people
with schizophrenia are diagnosed only when they get into
problems with the law or barricade themselves in their room,
or something dramatic like that.”
Source: Scotland
Sunday Herald, 28 March
Imaging Test
Could Be Used To Diagnose Schizophrenia - 94%+ Accuracy
Yale University
- New Haven, Conn. -- An abnormal pattern in an area of
the brain that governs hearing may be an accurate method
of diagnosing schizophrenia, according to a study by Yale
researchers and collaborators.
"These results
seem to point to a cardinal abnormality in schizophrenia,"
said Godfrey Pearlson, M.D., professor of psychiatry at
Yale School of Medicine, director of the Olin Neuropsychiatry
Research Center at the Institute of Living in Hartford,
and senior author of the study published in Biological Psychiatry.
"Using this imaging test, we were able to identify
patients with schizophrenia with 97 percent accuracy."
Pearlson, Vince
Calhoun and Kent Kiehl later replicated their initial finding
with an independent sample and achieved a 94 percent rate
of accuracy. Calhoun and Kiehl have appointments at the
Olin Center and Yale.
Currently, the
clinical diagnosis of schizophrenia is based on a constellation
of psychiatric symptoms. The mental illness also has been
associated with both structural and functional abnormalities
in neocortical networks including frontal, parietal, and
temporal regions of the brain, but there has been no diagnostic
test for the disorder.
Abnormalities
in auditory cortex structure and function are prominent
features of the brains in persons with schizophrenia, particularly
in the superior temporal gyrus (SRG). Reduction in size
of the SRG may correlate with the severity of auditory hallucinations
and of formal thought disorder. However, all of these previously
documented anatomic differences overlap significantly with
those of healthy controls and are thus not useful for diagnosis.
"Therefore,
this newly reported functional brain change results in almost
total separation of patients and healthy controls in two
independent samples, and thus has possible diagnostic utility,"
Pearlson said.
Data were collected
from two locations. One group consisted of 17 outpatients
with chronic schizophrenia matched with 17 healthy persons
in Vancouver, B.C. Another group consisted of eight patients
and eight healthy persons in Hartford, Conn.
"These results
have the potential to provide a powerful, quantitative clinical
tool for the assessment of schizophrenia," Pearlson
said.
Citation: Biological
Psychiatry, Vol. 55 (8): 842-849, April 15, 2004
Source: Yale
University - Press Release
14%
of Schizophrenia Cases Are Caused by Flu During Pregnancy,
Research Suggests
A recent research
study by Columbia University identified that approximately
14% of schizophrenia cases seem to have been caused by influenza
during pregnancy.
The study indicated
that Flu during the first trimester of pregnancy increased
risk of developing schizophrenia in the child by approx.
700%, while flu during the third trimester increased schizophrenia
risk for the child by 300%.
"This is
the first time that this association has been shown using"
blood tests that confirmed influenza infection during pregnancy,
lead author Dr. Alan S. Brown, from Columbia University
in New York, told Reuters Health. "It provides what
I think is the strongest evidence to date linking (prenatal)
influenza exposure with schizophrenia."
The findings
reinforce recommendations that women of childbearing age
be vaccinated against influenza. However, Dr. Brown Continued,
because the mechanism underlying the schizophrenia connection
is unknown, "we may not want to give the vaccine during
pregnancy," he said. Until more is known, "it's
possible that vaccination (during pregnancy) could have
a harmful effect."
The safest approach
to pregnancy (with regard to avoiding schizophrenia) seems
to be to become pregnant only after taking a vaccination
shot. The annual vaccination shots typically become available
in early Fall (Sept./October in North America) so the October/November
timeframe would seem to be best for beginning a pregnancy.
Make extra efforts to avoid exposure of mother to influenza
and other viruses during pregnancy. At minimum, some researchers
are suggesting all pregnant mothers get a flu shot during
the flu season (and prior to becoming pregnant) to reduce
the probability of getting the flu during pregnancy.
Reducing
Schizophrenia Risks During Pregnancy
Source: Flu
During Pregnancy Linked to Schizophrenia, and Presentation
at the American Psychiatric Association annual meeting in
New York (May 1 to 7).
New
Harvard Schizophrenia Study Initiated - Volunteers Needed
Researchers at
Harvard Medical School are studying a new way of treating
schizophrenia. Current medications only treat the symptoms
of schizophrenia, not the cause. The treatment we are studying
may result in a more lasting improvement of symptoms by
normalizing a biological process that is thought to be irregular
in this disorder. This treatment involves taking an FDA-approved
medication, in addition to the subject’s current medication.
We are recruiting
subjects who are:
- schizophrenic
- 18-25 years old
- taking risperidone (Risperdal)
- Live in the Boston Area
Compensation
up to $250 will be provided to the participants.
For more information,
please call Andrea at 617-998-5010
The study will
take place in Boston, so participants must live close enough
to come in for weekly visits. The study will last approximately
7 months. For six months, study participants will be taking
the study drug (tiagabine) or placebo. For three months
the visits to our office will be weekly, then only once
a month for an additional three months. There will also
be an MRI scan at the beginning and end of the study. The
study is a double-blind, placebo-controlled, add-on design.
Participants must be 18-25 years old, schizophrenic, and
on risperidone.
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NIMH
Trials launched to test treatment of cognitive dysfunction
in schizophrenia
One persistent
problem that schizophrenia.com discussion group members
report are cognitive impairments due to negative symptoms:
trouble concentrating, memory problems, etc.
The National
Institute of Mental Health (NIMH), of the National Institutes
of Health (NIH), has awarded a four-year, $9 million contract
to the University of California, Los Angeles (UCLA) and
five other academic medical centers to create a network
of Treatment Units for Research on Neurocognition and Schizophrenia
(TURNS). The research will test the effectiveness of new
drug treatments for the cognitive deficits of schizophrenia.
The project will be directed by Stephen R. Marder, M.D.,
at UCLA with investigators at Harvard's Massachusetts General
Hospital, Boston, the University of North Carolina, Chapel
Hill, the University of Maryland, Baltimore, Duke University,
Durham, Washington University, St. Louis, and Nathan Klein
Institute, New York.
This article
indicates that "the National Institute of Mental Health
(NIMH), of the National Institutes of Health (NIH), has
awarded a four-year, $9 million contract to the University
of California, Los Angeles (UCLA) and five other academic
medical centers to create a network of Treatment Units for
Research on Neurocognition and Schizophrenia (TURNS). The
research will test the effectiveness of new drug treatments
for the cognitive deficits of schizophrenia. "
For a List of
all the Active Schizophrenia-related clinical trials being
conducted by the NIMH see the following web page:
http://www.nimh.nih.gov/studies/1schpsydis.cfm
We Encourage
Participation in these trials and research studies so that
improved care can more quickly come to people with schizophrenia.
Early
Schizophrenia Screening Test 
