Diagnostic Specificity and Neuroanatomical Validity of Neurological Abnormalities in First-Episode Psychoses

Keshavan, Matcheri S.; Sanders, Richard D.; Sweeney, John A.; Diwadkar, Vaibhav A.; Goldstein, Gérald; Pettegrew, Jay W.; Schooler, Nina R.

doi:10.1176/appi.ajp.160.7.1298

Cited by 151 publications

(131 citation statements)

References 41 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…Neurological examinations were carried out by a trained rater using the Neurological evaluation scale (NES) (Heinrichs and Buchanan, 1988) modified to include the 13 most reliable items published previously by our group (Keshavan et al, 2003a). This scale yields two subscale scores: the cognitive-perceptual and Repetitive motor NES (Sanders et al, 2000).…”

Section: Subjectsmentioning

confidence: 99%

Psychopathology among offspring of parents with schizophrenia: Relationship to premorbid impairments

Keshavan¹,

Montrose²,

Rajarethinam³

et al. 2008

Schizophrenia Research

Self Cite

103

View full text Add to dashboard Cite

Introduction-A broad range of psychopathology, including externalizing disorders is seen in offspring at genetic risk for schizophrenia. However, it is unclear whether such psychopathology may underlie a higher predisposition to the premorbid antecedents of schizophrenia. We examined the prevalence and correlates of psychopathology in an ongoing study of offspring genetically at risk for schizophrenia.Methods-Seventy five consenting high risk offspring (HR: offspring, age 15.68±3.27 years; male/female 34/41) and 82 matched comparison subjects (40 males and 42 females; age 15.92±3.0 years) participated in this study. Diagnoses were ascertained using structured psychiatric interviews and consensus meetings, including all available clinical information.Results-Sixty (60%) of the HR offspring had one or more lifetime diagnosis of axis I psychiatric disorder. HR subjects with axis I psychopathology had significantly more soft neurological signs, poorer premorbid adjustment, and higher schizotypy scores as measured by Chapman psychosis proneness scales. Among those with psychopathology, HR subjects with externalizing disorders showed the most abnormal scores in schizotypy.Discussion-A substantial proportion of HR offspring of parents with schizophrenia manifest a broad range of childhood psychiatric disorders. Psychopathology, especially externalizing disorders such as attention deficit hyperactivity disorder (ADHD) may represent a subgroup with an increased risk for schizophrenia spectrum disorders. This possibility needs to be examined by prospective follow-up studies, and would be of considerable importance to early diagnosis and intervention efforts in schizophrenia.

show abstract

Section: Subjectsmentioning

confidence: 99%

Psychopathology among offspring of parents with schizophrenia: Relationship to premorbid impairments

Keshavan¹,

Montrose²,

Rajarethinam³

et al. 2008

Schizophrenia Research

Self Cite

103

View full text Add to dashboard Cite

show abstract

“…MRI studies of schizophrenia report approximately 2% less global gray matter (GM) volume in patients (Wright et al, 2000) and disproportionately less focal GM volume in many (perhaps especially heteromodal association cortex (HASC) regions (Baumann and Bogerts, 1999;Bucahanan et al, 2004;Falkai et al, 2001;Keshavan et al, 2003;Mesulam, 2004;Pearlson et al, 1996;Schlaepfer et al, 1994;Wright et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

A large scale (N=400) investigation of gray matter differences in schizophrenia using optimized voxel-based morphometry

Meda

Giuliani

Calhoun

et al. 2008

Schizophrenia Research

111

View full text Add to dashboard Cite

Background-Many studies have employed voxel-based morphometry (VBM) of MRI images as an automated method of investigating cortical gray matter differences in schizophrenia. However, results from these studies vary widely, likely due to different methodological or statistical approaches.Objective-To use VBM to investigate gray matter differences in schizophrenia in a sample significantly larger than any published to date, and to increase statistical power sufficiently to reveal differences missed in smaller analyses.Methods-Magnetic resonance whole brain images were acquired from four geographic sites, all using the same model 1.5T scanner and software version, and combined to form a sample of 200 patients with both first episode and chronic schizophrenia and 200 healthy controls, matched for age, gender and scanner location. Gray matter concentration was assessed and compared using optimized VBM.Results-Compared to the healthy controls, schizophrenia patients showed significantly less gray matter concentration in multiple cortical and subcortical regions, some previously unreported. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Overall, we found lower concentrations of gray matter in regions identified in prior studies, most of which reported only subsets of the affected areas. NIH Public AccessConclusions-Gray matter differences in schizophrenia are most comprehensively elucidated using a large, diverse and representative sample.

show abstract

“…Subtle neurological abnormalities are more common in patients with schizophrenia than in healthy controls [44][45][46][47][48][49][50] or patients with other psychotic disorders, 50 and they are generally stable over time. [51][52] These so-called neurological 'soft' signs (NSSs) are present at an early stage in the illness 49,50,[53][54][55] and are considered to be nonspecific markers of neurodevelopmental abnormality.…”

Section: Neurological 'Soft' Signs and Treatment Outcomementioning

confidence: 99%

“…[51][52] These so-called neurological 'soft' signs (NSSs) are present at an early stage in the illness 49,50,[53][54][55] and are considered to be nonspecific markers of neurodevelopmental abnormality. 56 Alternatively, it has been proposed that NSSs are secondary to psychiatric symptoms such as impaired attention, or even to the sideeffects of antipsychotic medication.…”

Section: Neurological 'Soft' Signs and Treatment Outcomementioning

confidence: 99%

Changing the course of schizophrenia - predictors of treatment outcome revisited

et al. 2007

View full text Add to dashboard Cite

<p>Multiple factors play a role in determining the outcome of schizophrenia. However, the role of these factors is poorly understood, and research findings so far have been inconclusive and sometimes contradictory. Various demographic and baseline clinical factors have been reported to be associated with treatment outcome. Also, early symptom reduction after initiation of antipsychotic therapy is closely related to later treatment response. However, associations as such do not necessarily imply predictive value, and none of these factors can be regarded as clinically useful in predicting treatment outcome. This article discusses selected aspects of treatment outcome and its prediction in schizophrenia, focusing particularly on early treatment response, ethnicity, neurological soft signs, and the predictive value of a discriminant functional analysis model utilising a combination of putative predictors. Such a model holds promise, and it is to be hoped that future refinements will lead to a clinically useful model for predicting outcome.</p>

show abstract

Diagnostic Specificity and Neuroanatomical Validity of Neurological Abnormalities in First-Episode Psychoses

Cited by 151 publications

References 41 publications

Psychopathology among offspring of parents with schizophrenia: Relationship to premorbid impairments

Psychopathology among offspring of parents with schizophrenia: Relationship to premorbid impairments

A large scale (N=400) investigation of gray matter differences in schizophrenia using optimized voxel-based morphometry

Changing the course of schizophrenia - predictors of treatment outcome revisited

Contact Info

Product

Resources

About