Do we have any solid evidence of clinical utility about the pathophysiology of schizophrenia?

Lawrie, Stephen M.; Olabi, Bayanne; Hall, Jérémy; McIntosh, Andrew M.

doi:10.1002/j.2051-5545.2011.tb00004.x

Cited by 59 publications

(47 citation statements)

References 149 publications

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“…Therefore, clinical detection strategies could be further enhanced by means of objective imaging biomarkers capable of measuring the pathophysiological processes associated with emerging psychosis. 38 In this regard, we detected high cross-validated diagnostic performances (tables 2 and 3) in the pairwise ARMS-T vs HC (BAC = 92.3%) and ARMS-T vs ARMS-NT (84.2%) classification analyses as well as in the multigroup ARMS-T vs rest comparison (80.1%). However, with respect to our previous results, 13 diagnostic performances were lower in the pairwise HC vs ARMS-NT (66.9%) and the multigroup ARMS-NT vs rest (71.4%) analyses, mainly due to 57% nonconverters in the former and 52% in the later comparison being misclassified as HC.…”

Section: Early Recognition Of Psychosis Using Mri-based Methodsmentioning

confidence: 86%

Disease Prediction in the At-Risk Mental State for Psychosis Using Neuroanatomical Biomarkers: Results From the FePsy Study

Koutsouleris

Borgwardt

Meisenzahl

et al. 2011

Schizophrenia Bulletin

148

125

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Background: Reliable prognostic biomarkers are needed for the early recognition of psychosis. Recently, multivariate machine learning methods have demonstrated the feasibility to predict illness onset in clinically defined at-risk individuals using structural magnetic resonance imaging (MRI) data. However, it remains unclear whether these findings could be replicated in independent populations. Methods: We evaluated the performance of an MRI-based classification system in predicting disease conversion in atrisk individuals recruited within the prospective FePsy (Fru¨herkennung von Psychosen) study at the University of Basel, Switzerland. Pairwise and multigroup biomarkers were constructed using the MRI data of 22 healthy volunteers, 16/21 at-risk subjects with/without a subsequent disease conversion. Diagnostic performance was measured in unseen test cases using repeated nested cross-validation. Results: The classification accuracies in the ''healthy controls (HCs) vs converters,'' ''HCs vs nonconverters,'' and ''converters vs nonconverters'' analyses were 92.3%, 66.9%, and 84.2%, respectively. A positive likelihood ratio of 6.5 in the converters vs nonconverters analysis indicated a 40% increase in diagnostic certainty by applying the biomarker to an at-risk population with a transition rate of 43%. The neuroanatomical decision functions underlying these results particularly involved the prefrontal perisylvian and subcortical brain structures. Conclusions: Our findings suggest that the early prediction of psychosis may be reliably enhanced using neuroanatomical pattern recognition operating at the single-subject level. These MRI-based biomarkers may have the potential to identify individuals at the highest risk of developing psychosis, and thus may promote informed clinical strategies aiming at preventing the full manifestation of the disease.

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Section: Early Recognition Of Psychosis Using Mri-based Methodsmentioning

confidence: 86%

Disease Prediction in the At-Risk Mental State for Psychosis Using Neuroanatomical Biomarkers: Results From the FePsy Study

Koutsouleris

Borgwardt

Meisenzahl

et al. 2011

Schizophrenia Bulletin

148

125

View full text Add to dashboard Cite

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“…The literature also reports the broader concept of schizotaxis, to which other elements, such as perinatal complications, birth in the winter season, the older age of the father, head injuries and early childhood trauma, low intelligence, stress or psychoactive substance use are incorporated. All of these factors being a collection of traits and neurobiological and environmental conditions according to the researchers are associated with susceptibility to schizophrenia [36,37,38].…”

Section: Resultsmentioning

confidence: 99%

“…W literaturze dodatkowo znaleźć można szersze pojęcie schizotaksji, do którego włączane są także inne elementy, takie jak: komplikacje okołoporodowe, urodzenie w sezonie zimowym, starszy wiek ojca, urazy głowy i traumy wczesnodziecięce, niska inteligencja, stres czy używanie substancji psychoaktywnych. Wszystkie powyższe czynniki będące zbiorem cech oraz uwarunkowań neurobiologicznych i środowisko-wych według badaczy mają związek z podatnością na schizofrenię [ 36,37,38].…”

Section: Wyniki I Dyskusjaunclassified

Review paper. Neuropsychological dimension of schizophrenia - evaluation possibilities and therapeutic implications

Makarewicz

Karakuła-Juchnowicz

Łobejko

2017

Current Problems of Psychiatry

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Introduction: In the last decades, researchers' attention has been focused on cognitive dysfunction in schizophrenia. Numerous studies indicate the existence of neurodegenerative deficits in schizophrenia including, but not limited to, motor functions, learning and memory, executive functions, attention, language, spatial skills and general intelligence.Method: A review of available literature on the topic of the past two decades, available in the Pubmed, EBSCO, SCOPUS databases has been made using the keywords: schizophrenia, cognition, early intervention.Results: Cognitive dysfunction is an important feature of the prodromal phase and the first episode of schizophrenia. Researchers have thus proposed to initiate early therapeutic interventions for people with so-called risky mental conditions. The article includes the reference to research on neurocognitive disorders essence in schizophrenia, the definition and review of methods used to identify specific cognitive deficits and issues related to risk of developing psychosis and early therapeutic intervention in high-risk states.Conclusions: Researchers report the importance of detecting cognitive disorders in the early stages of schizophrenia. This broadens the range of therapeutic interventions and enables early intervention in the increased risk of psychosis.

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“…A variety of promising biomarkers have been evalu ated, but few have passed through the rigorous screens of broader replication and demonstrated clinical utility. 1,2 We argue in this editorial that such difficulties are unsur prising, given the construction of current studies and the fact that such disorders typically develop in adolescence and young adulthood. This "critical period" 3 for risk and onset of major youth mental illnesses, such as psychosis, coincides with deeply interlaced neurobiological, clinical, affective and cognitive development, not to mention profound changes in social interactions and exposures.…”

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confidence: 97%

Dynamic endophenotypes and longitudinal trajectories: capturing changing aspects of development in early psychosis

Shah

Chakravarty

Joober

et al. 2016

jpn

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The search for replicable markers -biological, psycho logical, social or their combinations -for psychiatric ill nesses carries on. In psychosis, attention has been directed to atrisk and firstepisode populations, given the possibility that following markers in young people will avoid the con founds of chronicity and exposure to pharmacological treat ments. A variety of promising biomarkers have been evalu ated, but few have passed through the rigorous screens of broader replication and demonstrated clinical utility. 1,2We argue in this editorial that such difficulties are unsur prising, given the construction of current studies and the fact that such disorders typically develop in adolescence and young adulthood. This "critical period" 3 for risk and onset of major youth mental illnesses, such as psychosis, coincides with deeply interlaced neurobiological, clinical, affective and cognitive development, not to mention profound changes in social interactions and exposures. We explore the implica tions of this backdrop, including how it should inform both the search for biomarkers and the design of future studies. Critical periods, neurobiology and mental healthAdolescence to early adulthood, the age range when the early course of psychotic illness is most likely to emerge, is a win dow in which much is dynamic. At a neurobiological level, this includes neurons and synapses, neurotransmission, tro phic factors and longterm potentiation, among other phe nomena.4 However, it is also a period of sexual maturation, exposure to novel social and physical environments, different forms of stress, new models and contexts for learning, and de veloping cognitive abilities, reasoning and affective states. 5Whether adaptive or maladaptive, changes in brain structure and function are believed to occur in response to these inter nal and external stimuli and demands. For example, the fre quency and type of stressful life events change as children enter adolescence; 6 with these changes come further altera tions in neurobiology that may denote increased sensitization to such stimuli.7 If more persistently dysregulated during a critical window, the longterm setpoints of neurobiological processes or pathways may become distorted. Neurodevelop ment that results from interactions between endogenous neu robiological elements and exogenous environmental factors could thus profoundly alter brain processes, leading to differ ential trajectories and clinical outcomes.

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Do we have any solid evidence of clinical utility about the pathophysiology of schizophrenia?

Cited by 59 publications

References 149 publications

Disease Prediction in the At-Risk Mental State for Psychosis Using Neuroanatomical Biomarkers: Results From the FePsy Study

Disease Prediction in the At-Risk Mental State for Psychosis Using Neuroanatomical Biomarkers: Results From the FePsy Study

Review paper. Neuropsychological dimension of schizophrenia - evaluation possibilities and therapeutic implications

Dynamic endophenotypes and longitudinal trajectories: capturing changing aspects of development in early psychosis

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