Disordered water homeostasis and cognitive impairment in schizophrenia

Emsley, Robin; Spangenberg, Judora J.; Roberts, Mimi C.; Taljaard, Frans J. J.; Chalton, D. O.

doi:10.1016/0006-3223(93)90155-7

Cited by 13 publications

(15 citation statements)

References 16 publications

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“…However, structural differences in other brain regions of these polydipsic hyponatremic schizophrenia patients were not assessed. Interestingly, hyponatremic patients presented with poorer neuropsychological functioning compared to patients without a water imbalance [12-15]. Polydipsic hyponatremic schizophrenia patients scored lower on the Mini-Mental State Examination (MMSE) [14] with significant impairments in visual memory and information processing [12], intelligence, learning/memory, and facial discrimination [15] compared to control patients.…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, hyponatremic patients presented with poorer neuropsychological functioning compared to patients without a water imbalance [12-15]. Polydipsic hyponatremic schizophrenia patients scored lower on the Mini-Mental State Examination (MMSE) [14] with significant impairments in visual memory and information processing [12], intelligence, learning/memory, and facial discrimination [15] compared to control patients. Thus, it is considered that the structural changes in the anterior hippocampus, as well as in the associated prefrontal/limbic brain regions contribute to the underlying pathophysiology in polydipsic hyponatremic schizophrenia [11,15].…”

Section: Introductionmentioning

confidence: 99%

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Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia

et al. 2012

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BackgroundPolydipsia frequently occurs in schizophrenia patients. The excessive water loading in polydipsia occasionally induces a hyponatremic state and leads to water intoxication. Whether polydipsia in schizophrenic patients correlates with neuropsychological impairments or structural brain changes is not clear and remains controversial.MethodsEight polydipsic schizophrenia patients, eight nonpolydipsic schizophrenia patients, and eight healthy controls were recruited. All subjects underwent magnetic resonance imaging (MRI) and neuropsychological testing. Structural abnormalities were analyzed using a voxel-based morphometry (VBM) approach, and patients’ neuropsychological function was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J).ResultsNo significant differences were found between the two patient groups with respect to the clinical characteristics. Compared with healthy controls, polydipsic patients showed widespread brain volume reduction and neuropsychological impairment. Furthermore, the left insula was significantly reduced in polydipsic patients compared with nonpolydipsic patients. These nonpolydipsic patients performed intermediate to the other two groups in the neuropsychological function test.ConclusionsIt is possible that polydipsia or the secondary hyponatremia might induce left insula volume reduction. Furthermore, this structural brain change may indirectly induce more severe neuropsychological impairments in polydipsic patients. Thus, we suggest that insula abnormalities might contribute to the pathophysiology of polydipsic patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia

et al. 2012

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“…Wyniki dostępnych badań informują, że osoby chore na schizofrenię z polidypsją psychogenną i hiponatremią w porównaniu do pacjentów z polidypsją bez hiponatremii osiągają istotnie statystycznie niższe wyniki w teście MMSE [27], mają większe deficyty w zakresie przetwarzania informacji [28,29], pamięci wzrokowej [28] słuchowej, operacyjnej, fluencji słownej i funkcji wykonawczych [29].…”

Section: Czynniki Ryzyka Polidypsji Psychogennejunclassified

“…The results of the available studies demonstrate that schizophrenia patients with psychogenic polydipsia and hyponatremia, as compared to people with polydipsia without hyponatremia, achieve statistically significantly lower results in the MMSE test [27], have greater information processing deficits [28,29], visual memory [28], auditory and operating memory, verbal fluency and executive functions [29].…”

Section: Psychogenic Polydipsia Risk Factorsmentioning

confidence: 99%

Hiponatremia in the practice of a psychiatrist. Part 2: psychogenic polydipsia

Gerhant

Słotwiński

Hołownia

et al. 2017

Current Problems of Psychiatry

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Objective. The study is the second part of the literature review on hyponatremia in patients with diagnosed mental disorders. This article focuses on psychogenic polydipsia as, along with the SIADH, one of the two most common causes of hyponatremia in the mentioned group of patients.Method: The literature review was based on searching the Medline, the Google Scholar and the Ebsco databases in Polish and English by entering the following phrases: psychogenic polydipsia, the psychosis -intermittent hyponatremia -polydipsia syndrome, water intoxication.Discussion: Psychogenic polydipsia occurs in up to 25% of patients treated for mental disorders. It most frequently concerns patients with schizophrenia. 30% of patients with psychogenic polydipsia suffer from hyponatremia with or without symptoms of water intoxication. In the etiology of psychogenic polydipsia, the influence of dopaminergic and noradrenergic neurotransmission has been considered, as well as angiotensin, which is claimed to have dipsogenic properties. In order to reduce the severity of the disorder, attempts have been made to administer the following groups of medications: β-blockers, opioid receptor antagonists, angiotensin convertase inhibitors and angiotensin receptor antagonists. Other methods include replacing classic antipsychotic drugs with clozapine. There are also reports of a reduced severity of polydipsia with hyponatremia after introducing risperidone and olanzapine. Preventing episodes of water intoxication in patients with psychogenic polydipsia requires the monitoring of their body weight and a suitable reduction of fluid intake by them.Results: Mentally ill patients, especially those with chronic schizophrenia, should be monitored for psychogenic polydipsia and the concomitant hyponatremia. Keywords: psychogenic polydipsia, hyponatremia, water intoxication StreszczenieCel. Praca jest drugą częścią przeglądu literatury na temat hiponatremii u pacjentów z rozpoznaniem zaburzeń psychicznych. W niniejszym artykule skoncentrujemy uwagę na polidypsji psychogennej jako jednej z dwóch, obok zespołu SIADH, najczęstszych przyczyn hiponatremii w tej grupie chorych.Metoda: Przeglądu literatury dokonaliśmy przeszukując bazy danych Medline, Google Scholar i Ebsco w języku polskim i angielskim, wpisując hasła: polidypsja psychogenna, zespół psychoza -hiponatremia przerywana -polidypsja, zatrucie wodne.Omówienie: Polidypsja psychogenna występuje nawet u 25% pacjentów leczonych z powodu zaburzeń psychicznych. Najczęściej dotyczy pacjentów chorych na schizofrenię. U 30 % pacjentów z polidypsją psychogenną występuje hiponatremia z objawami lub bez objawów zatrucia wodnego. W etiologii polidypsji psychogennej rozważano znaczenie neuroprzekaźnictwa dopaminergicznego, noradrenergicznego, jak również angiotensyny, której przypisuje się właściwości dipsogenne. W celu zmniejszenia jej nasilenia podejmowano próby stosowania takich grup leków jak: β-blokery, antagoniści receptorów opioidowych, inhibitory konwertazy angiotensyny czy antagoniści receptoró...

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“…Administration of methylphenidate – a dopamine-mimetic and dopamine-releasing psychostimulant drug [55, 56] – to schizophrenics induces psychotic exacerbations and enhances VP release in polydipsic patients, especially in those with chronic hyponatremia [4]. Whether polydipsic schizophrenics with intermittent hyponatremia suffer from a neurobiologically distinct syndrome [57] with more severe structural brain abnormalities [58] and cognitive impairment [59, 60] remains to be elucidated by prospective studies in this particular subgroup of schizophrenic patients.…”

Section: Discussionmentioning

confidence: 99%

Absence of a Difference in the Neurosecretory Activity of Supraoptic Nucleus Vasopressin Neurons of Neuroleptic-Treated Schizophrenic Patients

Malidelis

Panayotacopoulou²,

Heerikhuize³

et al. 2005

Neuroendocrinology

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Dysfunction in water intake and metabolism has frequently been reported in schizophrenia. The general population of schizophrenics under neuroleptic treatment secretes lower amounts of vasopressin than controls at comparable values of plasma osmolality. The purpose of the present study was to investigate the synthetic activity of vasopressin neurons of the dorsolateral supraoptic nucleus in schizophrenia on postmortem material using a battery of histochemical activity markers. Our material consisted of formalin-fixed and paraffin-embedded hypothalami from 5 schizophrenic patients under neuroleptic treatment and from 5 matched controls, obtained from The Netherlands’ Brain Bank. DSM-III or DSM-IV criteria were used for the clinical diagnosis. The histochemical markers used to study the neuronal activity of the magnocellular vasopressin-synthesizing neurons were: cell size, size of the Golgi apparatus, and expression of vasopressin and tyrosine hydroxylase mRNA by in situ hybridization. Morphometric evaluation and statistical analysis (Mann-Whitney U test) were performed. Our results showed no statistically significant differences in any of the neuronal activity markers between schizophrenic patients and controls. Therefore, the neurosecretory activity of vasopressin neurons of the dorsolateral part of the supraoptic nucleus does not appear to be changed in schizophrenic patients under medication. Since our sample did not include patients with reported polydipsia or hyponatremia, prospective investigation is needed to evaluate the above-mentioned neuronal activity markers in such a particular subgroup of schizophrenic patients.

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Disordered water homeostasis and cognitive impairment in schizophrenia

Cited by 13 publications

References 16 publications

Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia

Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia

Hiponatremia in the practice of a psychiatrist. Part 2: psychogenic polydipsia

Absence of a Difference in the Neurosecretory Activity of Supraoptic Nucleus Vasopressin Neurons of Neuroleptic-Treated Schizophrenic Patients

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