Heat Intolerance in Patients With Chronic Schizophrenia Maintained With Antipsychotic Drugs

Hermesh, Haggai; Shiloh, Roni; Epstein, Yoram; Manaim, Hillel; Weizman, Abraham; Munitz, Hanan

doi:10.1176/appi.ajp.157.8.1327

Cited by 76 publications

(35 citation statements)

References 10 publications

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“…Thus, hypothetically, schizophrenia might be associated with a secondary or even a primary thermoregulatory dysfunction. This hypothesis is corroborated by accrued data which suggest that both drug-free and medicated schizophrenia patients may exhibit abnormal body/ core thermoregulation (Laborit 1979;Levinson and Simpson 1986;Dilsaver 1988;Heh et al 1988;Lazarus et al 1989;Cape 1994;Maeir et al 1994;Dixit et al 1997;Schwaninger et al 1998;Hermesh et al 2000aHermesh et al ,b, 2001Chong and Castle 2004).…”

Section: Introductionmentioning

confidence: 81%

“…Findings from preliminary studies in which we examined such putative thermoregulatory dysfunction in schizophrenia indicate, that untreated overtly psychotic schizophrenia patients exhibit substantial and significantly higher core (Hermesh et al 2000b;Shiloh et al 2001), body (Shiloh et al 2000), and corneal (Shiloh et al 2003a(Shiloh et al ,b, 2005) temperature compared to both healthy comparison subjects and antipsychotic drug (APD)-treated patients. Moreover, some data suggest that schizophrenia patients' mental status may also correlate with their core temperature (Shiloh et al 2003b(Shiloh et al , 2007.…”

Section: Introductionmentioning

confidence: 98%

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Altered thermoregulation in ambulatory schizophrenia patients: A naturalistic study

Shiloh

Weizman

Stryjer³

et al. 2009

The World Journal of Biological Psychiatry

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Ambulatory schizophrenia patients without a concomitant infectious/inflammatory process exhibit altered thermoregulation manifested by a substantial (about 0.2 C) and significantly lower oral temperature compared to healthy comparison subjects as well as a potential exaggerated increase in oral temperature during transitory infectious/inflammatory processes. The relevance of these phenomena to the pathophysiology of schizophrenia as well as the potential immune-mediated pathologies in schizophrenia merit further investigation.

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Section: Introductionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 98%

Altered thermoregulation in ambulatory schizophrenia patients: A naturalistic study

Shiloh

Weizman

Stryjer³

et al. 2009

The World Journal of Biological Psychiatry

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“…8 Because heat removal is primarily dependent on CBF 8 and the arterio-venous temperature difference across the brain, 8,9 reduced cerebral perfusion relative to cerebral metabolism may indicate decreased central heat removal (i.e., higher BT). 10 Previous studies have suggested that schizophrenia patients have dysfunctional thermoregulation, [11][12][13][14][15][16][17] and these data suggest that patients with schizophrenia may exhibit abnormal BT.…”

Section: Introductionmentioning

confidence: 99%

Altered Coupling of Regional Cerebral Blood flow and Brain Temperature in Schizophrenia Compared with Bipolar Disorder and Healthy Subjects

Ota

Sato

Sakai

et al. 2014

J Cereb Blood Flow Metab

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Previous studies have suggested that schizophrenia patients have dysfunctional thermoregulation. The aim of this study was to examine whether brain temperature (BT) in schizophrenia patients differs from that in patients with bipolar disorder and healthy subjects by using magnetic resonance imaging. We also evaluated the possible relationship between BT and cerebral blood flow (CBF). We analyzed the temperature of lateral ventricles as the mean BT using diffusion-weighted imaging (DWI) thermometry, and evaluated the relationships between the BT and the CBF using pseudo-continuous arterial spin labeling (pCASL) among 3 diagnostic groups, 22 male patients with schizophrenia, 19 male patients with bipolar disorder, and 23 healthy male subjects. There were significant positive correlations between BT in the lateral ventricles and CBF in both the patients with bipolar disorder and healthy subjects. By contrast, there were significant negative correlations in patients with schizophrenia. We could not detect the significant difference in the surrogates of BT among three diagnostic groups. We showed that patients with schizophrenia, but not those with bipolar disorder, have dysfunctional thermoregulation in the brain. Brain temperature is highly dependent on cerebral metabolism and CBF, and thus uncoupling of cerebral metabolism and CBF may occur in schizophrenics.

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“…Most clinical studies use rectal temperature as an indicator of core body temperature (Dauch and Bauer, 1990 ;Freedman and Woodward, 1996 ;Hermesh et al, 2000 ;Shiloh et al, 2001 ;Weibel et al, 1997) although corneal (Rysa and Sarvaranta, 1974), tympanic (Sato et al, 1996) or axillary (Henker and Coyne, 1995 ;Lefrant et al, 2003 ;Lodha et al, 2000) temperatures may also correlate with core body temperature. Among these, corneal temperature can be measured by non-invasive procedures and thus, can be used more easily with some patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Corneal temperature in schizophrenia patients

Shiloh

Munitz

Portuguese

et al. 2005

Int. J. Neuropsychopharm.

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Most data imply that dopaminergic transmission is essential for proper hypothalamic-mediated core temperature regulation. Altered central dopaminergic transmission is suggested to be involved in the pathophysiology of schizophrenia. Thus, hypothetically, schizophrenia patients might be at increased risk of developing thermoregulatory dysregulation manifested by alterations in core temperature, as well as in peripheral tissue, the temperature of which has been shown to correlate with core temperature (e.g. cornea). Previous small pilot studies of ours showed that schizophrenia patients may exhibit corneal temperature abnormalities. Hence, we assessed corneal temperature in a controlled sample of drug-free ( n =11) and medicated ( n =28) schizophrenia patients compared to healthy comparison subjects ( n =9), using a FLIR thermal imaging camera. Drug-free schizophrenia patients exhibited significantly higher corneal temperature compared to healthy subjects, typical antipsychotic drug (APD)-treated patients ( n =16) and atypical APD-treated patients ( n =12) (37.08+/-1.46 degrees C vs. 33.37+/-2.51 degrees C, 31.08+/-1.43 degrees C and 31.67+/-0.44 degrees C respectively, p <0.0001; p <0.001 vs. each group separately). The healthy comparison subjects and the atypical APD-treated patients exhibited comparable corneal temperatures and these two groups exhibited higher corneal temperatures compared to the typical APD-treated patients ( p <0.01 and p =0.051 respectively). In conclusion, this study indicates that drug-free schizophrenia patients exhibit substantially higher corneal temperature compared to healthy comparison subjects or medicated patients, and that APDs may decrease corneal temperature either to normal (atypical APD) or to subnormal (typical APD) values. The relevance of these phenomena to the pathophysiology of schizophrenia, the biological mechanism underlying drug-induced corneal temperature alterations, the possible role of temperature-lowering drugs (neuroleptics or non-neuroleptics) on schizophrenic psychosis as well as the role of corneal temperature as a tool to evaluate adherence to APD treatment merit further investigation via larger samples of both medicated and drug-free schizophrenia patients compared to matched controlled subjects.

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Heat Intolerance in Patients With Chronic Schizophrenia Maintained With Antipsychotic Drugs

Cited by 76 publications

References 10 publications

Altered thermoregulation in ambulatory schizophrenia patients: A naturalistic study

Altered thermoregulation in ambulatory schizophrenia patients: A naturalistic study

Altered Coupling of Regional Cerebral Blood flow and Brain Temperature in Schizophrenia Compared with Bipolar Disorder and Healthy Subjects

Corneal temperature in schizophrenia patients

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