Structural brain abnormalities in early-onset schizophrenia

Ferrari, Maria Cristina Lombardo; Kimura, Luci; Nita, Luciana M.; Elkis, Hélio

doi:10.1590/s0004-282x2006000500008

Cited by 7 publications

(2 citation statements)

References 26 publications

(25 reference statements)

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“…Indeed, ketamine-induced release of glutamate in anterior cingulated cortex (ACC) is correlated with positive psychotic symptom scores in healthy human subjects ( r = 0.72) (Stone et al, 2012). Furthermore, NMDAR antagonists play known roles in neurodegenration and excitotoxicity, including apoptosis of mature corticolimbic pyramidal cells (Zhou et al, 2007; Farber and Olney, 2003; Horváth et al, 1997; Wozniak et al, 1998), thus offering NMDAR hypofunction as a possible basis for brain atrophy observed in schizophrenia (Rais et al, 2012; Andreone, et al, 2007; Rais et al, 2008; Goldman et al, 2007; Ferrari et al, 2006). …”

Section: Evidence For Nmdar Dysfunctionmentioning

confidence: 99%

Reviewing the ketamine model for schizophrenia

2013

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The observation that antagonists of the N-methyl-D-aspartate glutamate receptor (NMDAR), such as phencyclidine (PCP) and ketamine, transiently induce symptoms of acute schizophrenia had led to a paradigm shift from dopaminergic to glutamatergic dysfunction in pharmacological models of schizophrenia. The glutamate hypothesis can explain negative and cognitive symptoms of schizophrenia better than the dopamine hypothesis, and has the potential to explain dopamine dysfunction itself. The pharmacological and psychomimetic effects of ketamine, which is safer for human subjects than phencyclidine, are herein reviewed. Ketamine binds to a variety of receptors, but principally acts at the NMDAR, and convergent genetic and molecular evidence point to NMDAR hypofunction in schizophrenia. Furthermore, NMDAR hypofunction can explain connectional and oscillatory abnormalities in schizophrenia in terms of both weakened excitation of inhibitory -aminobutyric acidergic (GABAergic) interneurons that synchronize cortical networks and disinhibition of principal cells. Individuals with prenatal aberrations of NMDAR might experience the onset of schizophrenia towards the completion of synaptic pruning in adolescence, when network connectivity drops below a critical value. We conclude that ketamine challenge is useful for studying the positive, negative, and cognitive symptoms, dopaminergic and GABAergic dysfunction, age of onset, functional dysconnectivity, and abnormal cortical oscillations observed in acute schizophrenia.

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Section: Evidence For Nmdar Dysfunctionmentioning

confidence: 99%

Reviewing the ketamine model for schizophrenia

2013

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“…Volumetric magnetic resonance imaging (MRI) studies of patients with schizophrenia have demonstrated an overall reduction in grey matter; an increase in white matter; decreased size of the amygdala, hippocampus, and parahippocampus; an overall reduction in brain volume; and larger lateral ventricles relative to a control group. [35][36][37] …”

Section: Patient Symptoms and Schizophreniamentioning

confidence: 99%

Case Report: Schizophrenia Discovered during the Patient Interview in a Man with Shoulder Pain Referred for Physical Therapy

Shah

Nakamura²

2010

Physiotherapy Canada

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Purpose: The purpose of this case report is to demonstrate the importance of a thorough patient interview. The case involves a man referred for physical therapy for a musculoskeletal dysfunction; during the patient interview, a psychiatric disorder was recognized that was later identified as schizophrenia. A secondary purpose is to educate physical therapists on the recognizable signs and symptoms of schizophrenia. Client description: A 19-year-old male patient with chronic shoulder, elbow, and wrist pain was referred for physical therapy. During the interview, the patient reported that he was receiving signals from an electronic device implanted in his body. Measures and outcome: The physical therapist's initial assessment identified a disorder requiring medical referral. Further management of the patient's musculoskeletal dysfunction was not appropriate at this time. Intervention: The patient was referred for further medical investigation, as he was demonstrating signs suggestive of a psychiatric disorder. The patient was diagnosed with schizophrenia by a psychiatrist and was prescribed Risperdal. Implications: This case study reinforces the importance of a thorough patient interview by physical therapists to rule out non-musculoskeletal disorders. Patients seeking neuromusculoskeletal assessment and treatment may have undiagnosed primary or secondary psychiatric disorders that require recognition by physical therapists and possible medical referral.Key Words: patient interview, physical therapy assessment, psychiatric disorder, referral source, schizophrenia Shah N, Nakamura Y. Case report: schizophrenia discovered during the patient interview in a man with shoulder pain referred for physical therapy. Physiother Can. 2010;62:308-315 RÉ SUMÉObjectif : L'objectif de cette é tude de cas consiste à dé montrer l'importance de ré aliser des entrevues en profondeur avec les patients. Le cas é tudié concerne un homme dirigé vers la physiothé rapie en raison d'une dysfonction musculosquelettique. Au cours de l'entrevue avec ce patient, un problè me psychiatrique a é té dé celé ; par la suite, de la schizophré nie a é té diagnostiqué e. Le deuxiè me objectif de cette é tude de cas est d'é duquer et de sensibiliser les physiothé rapeutes aux signes et aux symptô mes aisé ment reconnaissables de la schizophré nie. Description du client : Le patient est un jeune homme de 19 ans qui souffre de douleurs chroniques à l'é paule, au coude et au poignet et qui avait é té dirigé en physiothé rapie. Au cours de l'entrevue, le patient a dé claré qu'il recevait des signaux provenant d'un appareil é lectronique implanté dans son corps. Mesures et ré sultats : L'é valuation pré liminaire du physiothé rapeute a permis d'identifier un problè me qui né cessitait que le patient soit redirigé vers un mé decin. Une gestion plus poussé e de la dysfonction musculosquelettique de ce patient a é té jugé e inapproprié e à cette é tape. Intervention : Le patient a é té dirigé vers une investigation mé dicale plus approfondie, puisqu'il m...

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