Schizophrenia is a collection of neurodevelopmental disorders involving alterations in brain circuits during early development. While psychosis occurs late, prevention is key. Recent research integrates genetics, neuroimaging, biomarkers and patient-specific cell cultures to map pathophysiology across stages. This enables early detection, personalized treatment selection and outcome monitoring. Going forward, multidimensional classification systems may integrate these data to transform care through prevention, early intervention and integrated treatment approaches.
What are stem cells? This presentation provides an overview of multiple different stem cells including embryonic stem cells, mesenchymal stem cells, cancer stem cells, induced pluripotent stem cells, hematopoietic stem cells and neural stem cells.
This presentation describes in detail the various types and sources of stem cells. it also describes the stem cell therapies used to treat various diseases.
What are stem cells? This presentation provides an overview of multiple different stem cells including embryonic stem cells, mesenchymal stem cells, cancer stem cells, induced pluripotent stem cells, hematopoietic stem cells and neural stem cells.
This presentation describes in detail the various types and sources of stem cells. it also describes the stem cell therapies used to treat various diseases.
The cell cycle, or cell-division cycle, is the series of events that take place in a cell leading to duplication of its DNA (DNA replication) and division of cytoplasm and organelles to produce two daughter cells.
-Basic Concepts in Genetics
-What is Epigenetic?
-History of Epigenetic
-How do epigenetics work?
-Epigenetics and the Environment
-Epigenetic Inheritance
-Epigenetics in Psychiatry
iPSCs are pluripotent; unlike ESC, iPSCs are not derived from the embryo, but instead created from differentiated cells in the lab through a process – cellular reprogramming.
The cell cycle, or cell-division cycle, is the series of events that take place in a cell leading to duplication of its DNA (DNA replication) and division of cytoplasm and organelles to produce two daughter cells.
-Basic Concepts in Genetics
-What is Epigenetic?
-History of Epigenetic
-How do epigenetics work?
-Epigenetics and the Environment
-Epigenetic Inheritance
-Epigenetics in Psychiatry
iPSCs are pluripotent; unlike ESC, iPSCs are not derived from the embryo, but instead created from differentiated cells in the lab through a process – cellular reprogramming.
Schizophrenia: Theories and Treatmentschloecollier
The different theories of schizophrenia including:
Biological: Neurochemical, Neuroanatomical, Genetics
Cognitive: Abnormal Cognition, Abnormal Perceptions
Social Cultural: Labelling Theory, Family Dysfunction, High Expresses Emotion (EE)
Drug Treatment, Insight Therapy, Family Therapy, Community Care and Cognitive Behavioural Therapy (CBT)
SCHIZOPHRENIA:
slide 1: A long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
slide 14: Types:
• Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations (hearing voices that don't exist) but relatively normal intellectual functioning and expression of emotions. People with paranoid-type schizophrenia can exhibit anger, aloofness, anxiety, and can be argumentative.
• Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh inappropriately for no apparent reason, make illogical statements, or seem preoccupied with their own thoughts or perceptions. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
• Undifferentiated-type schizophrenia is characterized by some symptoms seen in all of the above types, but not enough of any one of them to define it as another particular type of schizophrenia.
• Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no "positive" symptoms (such as delusions, hallucinations, disorganized speech, or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
Catatonic Schizophrenia
This type of schizophrenia includes extremes of behavior, including:
Catatonic excitement - overexcitement or hyperactivity, in which the patient may mimic sounds (echolalia) or movements (achopraxia) around them.
Catatonic stupor - a dramatic reduction in activity in which the patient cannot speak, move or respond. Virtually all movements stops.
Conclusion
It is clear now, through the use of genetic linkage studies and microbiology, that schizophrenia does indeed have a biological explanation. However, the biological explanation is only part of the story. A yet unknown combination of intense stress, sociocultural situations, and cognitive processes may lead to the actual onset of schizophrenia aided by natural precursors. The most compelling explanation seems to be that a genetically inherited biological abnormality gives rise to hallucinations/delusions as a result of intense stress and eventually leads to other negative symptoms in reaction to the hallucinations/ delusions. At any rate, the current understanding of schizophrenia explains that the symptoms, however easily identifiable, are the result of a complex interaction between nature and nurture that can be treated adequately through the use of atypical anti psychotic drugs and psychotherapy.
As we are getting further from the 20th century many historical facts become clearer and clearer. Looking at the past century in perspective helps us to figure out our way forward. Jung and Frankl urged humanity to assimilate the devastation of the two World Wars by taking personal responsibility, and become aware of our projections, such as nationalism. They insist that reason is not enough to prevent future tragedies. These post-World War issues were never dealt with by humanity, just swept under the rug, as in the second half of the 20th century psychiatry identified
with psychopharmacology. Moreover, psychology's self-imposed limitation to the cognitive domain alone, neglecting the study of emotion or introspection is setting the stage for the 21st century repetition of history. The idea is that the current trajectories of both psychiatry and psychology are unsustainable as they direct us towards polarization, thus opening the way for the terrible enantiodromia. The events world-wide such as geographical fragmentation and failure of the nation states are proofs that we, humans have not dealt with our dormant demons.
PAGE Running head SCHIZOPHRENIA 1SchizophreniaVernessa.docxkarlhennesey
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Running head: SCHIZOPHRENIA
1
Schizophrenia
Vernessa Combs
PSY350: Physiological Psychology
December 10, 2019
Schizophrenia
The topic selected was schizophrenia. This is a severe and chronic mental disorder affecting the way humans think, feel and behave. Although this mental disorder is not very common, it has disabling symptoms.
Schizophrenia has continuously been viewed as a disorder that occurs in neurodevelopment. It is associated with a microdeletion syndrome of a chromosome. Neurons migrate to the pial surface from the brain's ventricular zone. "Migration of the neuron cell body is mediated via microtubule-based transport organized by the centrosome. First, the centrosome moves up the microtubule, followed by the nucleus and the cell body” (Pearlson, 2015). Neuronal migrations are reportedly caused by Reelin.
The etiology of schizophrenia is unknown, however, several risk factors have been associated with its development. These include environmental and genetic factors. Genetic factors are, however, insufficient to account for the development of the disease. They must be accompanied by other factors for the disease to develop. "Because the concordance rate for monozygotic twins only approaches 50%, genetic makeup alone is not sufficient for the development of schizophrenia, and non-genetic or sporadic forms of the disorder must exist” (Miyamoto et al, 2013).
Environmental factors that play an important role in the etiology of schizophrenia include obstetric complications such as hypoxia, preeclampsia, and premature birth. Other environmental factors include maternal viral infections and stress occurring in neurodevelopment. Stress during neurodevelopment may be caused by other factors such as microbial infections.
The pathology of schizophrenia includes the transcriptional dysregulation at the cerebral cortex and chromosomal conformations. “Anatomic, neurotransmitter and immune system abnormalities have been implicated in the pathophysiology of schizophrenia” (Miyamoto et al, 2013). Differences have been observed in the brains of people with schizophrenia compared to the brains of people without the disease in neuroimaging studies. The medial temporal areas of the brain have a decreased volume while the ventricles are larger. Structural abnormalities such as volume reductions and ventricular enlargements have been associated with the disease.
The dopaminergic system abnormalities are also associated with schizophrenia. The immune system is also disturbed in people with the disease. “Overactivation of the immune system (eg, from prenatal infection or postnatal stress) may result in overexpression of inflammatory cytokines and subsequent alteration of brain structure and function” (Nuckols et al, 2013). Anatomic abnormalities may also be observed in the hippocampus.
In the prefrontal cortex, there has been a reported increase in neuronal density. One of the areas of the prefrontal cortex, area 9, has been found to h ...
Due to the indicative synaptic elimination as a core phenomenon co-occurring or predicating schizophreniform pathogenesis and the temporal comorbidity of anomalous self-experience, we posit that the neurobiological etiology of formal thought disorder in schizophrenia arises from robust loss of synaptic density at young adulthood mediated by dysregulation of Rho GTPase proteins marked by overzealous targeting from the innate immune system complement cascade.
Instituto Nacional de Psiquiatría (México)
XXIV Reunión Anual de Investigación
5 de octubre del 2009
Perspectivas en la fisiopatología de la psicosis
Presenta: Dr. Alfonso Escobar
A guideline for discontinuing antiepileptic drugs in seizure-free patients – ...Dr. Rafael Higashi
Aula apresentada por Dr. Rafael Higashi, médico neurologista sobre quando retirar droga antiepilética. A guideline for discontinuing antiepileptic drugs in seizure-free patients – Summary Statement
Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.
The First Appearance of Persistent Dementia and Psychosis after a Generalized...CrimsonpublishersPPrs
The First Appearance of Persistent Dementia and
Psychosis after a Generalized Sepsis by C Lazzari in Psychology and Psychotherapy: Research Study_Crimson Publishers
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. This year alone
100,000
young people will have a first
episode of schizophrenia.
5%of people with schizophrenia will die
by suicide.
3. One Hundred Years of Schizophrenia
A century ago we had large public institutions for
severe mental illness, tuberculosis and leprosy.
Of these three, today only mental illness, especially
schizophrenia, remains unchanged in prevalence
and disability .
Sustained recovery is less than 14% within the first 5
years following a psychotic episode.
Thomas Insel; Rethinking Schizophrenia; Nature vol 468, November 201; doi:10.1038/nature09552
6. The Brain Out of the Picture
Upbringing determines the output
Late 19th and early 20th century paradigm
7. Biochemical Paradigm
From blaming the mother to blaming
neurotransmitters
Second half of the 20th century
Schizophrenia a “dopamine disorder”
1954 discovery of Chlorpromazine
Psychopharmacology
The biochemical trinity:
-dopamine
-serotonin
- norepinephrine
12. Events Shaping the New
Concept of Schizophrenia
2003 Human Genome Project results were
published.
2009 Human Epigenome Project
published results.
2009 Human Connectome Project began.
Techniques
Novel neuroimaging Techniques
Discovery of the Ultramicrotome
Cultured Patient Specific Neurons
13. Computational Paradigm and
Its Meaning For Schizophrenia
Schizophrenia is a collection of
neurodevelopmental disorders that involve
alterations in brain circuits during early
development.
Psychosis is a late occurrence in schizophrenia.
Preventive approaches seen as the main
intervention.
Thomas Insel; Rethinking Schizophrenia; Nature vol 468, November 201; doi:10.1038/nature09552
14. Schizophrenia: A Case for
Prevention and Early Detection
Birth cohort studies demonstrate that
individuals who develop schizophrenia
differ from the general population on a
range of developmental indices some of
which occur as early as the first year of
life.
Joy Welham,2 Matti Isohanni,3 Peter Jones,4 and John McGrath; The Antecedents of Schizophrenia: A
Review of Birth Cohort Studies; Schizophr Bull. 2009 May; 35(3): 603–623, . doi: 10.1093/schbul/sbn084
17. Learning from Neurodegenerative
Disorders
Inneurodegenerative disorders such as
Parkinson’s disease, Alzheimer’s disease and
Huntington’s disease changes in the brain
precede changes in behavior , sometimes by
more than a decade.
InParkinson’s disease symptoms only emerge
after 80% of dopamine cells have been lost.
Thomas Insel; Rethinking Schizophrenia; Nature vol 468, November 201; doi:10.1038/nature09552
18. Learning From Medicine
Prevention, Prevention, Prevention
Over the past few decades preventive
efforts led to:
60%reduction in mortality due to
coronary artery disease (1.1 million death
averted each year).
AIDS was declared a chronic disease.
23. Early Brain Development is
Affected in Schizophrenia
-neuronal proliferation
-neuronal differentiation
-neuronal migration
-synapse formation
-myelination
24.
25. More Realistic Perspective on
Genes in Schizophrenia
There
is no gene for schizophrenia, bipolar disorder,
depression or anxiety and there will never be one.
Genesdo not code for psychiatric illnesses or for
behaviors or for symptoms of psychiatric illnesses.
Genesoperate at a very basic cellular level. They
code for proteins that may lead to subtle
molecular abnormalities in cells.
27. Genes are Risk Factors for
Mental Illness
Genes do not respect the boundaries of psychiatric
disorders or even the boundaries of medical
disciplines.
Forinstance most risk genes for schizophrenia are
present also in bipolar disorder, schizoaffective
disorder, ASD, Alzheimer’s disease and anxiety.
28. Several Hundred Loci (genes) Can
Contribute To the Development of
Schizophrenia.
There
are vulnerability genes as well as resilience
genes.
The chance that two patients with schizophrenia
will have exactly the same combination of
mutations is small.
30. Copy Number Variation (CNV)
Velo-Cardio-Facial Syndrome (VCFS) -33%
chance for schizophrenia
Genetic Marker 22q11.2 one of the highest risk
factors for schizophrenia
31. CNVs Can Explain Non-inherited
Schizophrenia
Spontaneous genetic mutations or “de
novo” mutations play a significant role in
schizophrenia.
Thefunction of the mutated gene and
when the gene is expressed are critically
important in determining the risk for
schizophrenia.
32.
33. Research Domain Criteria (RDoC)
RDoC is an experimental approach to the
classification of mental disorders that incorporates
multiple dimensions: behavior, thought patterns,
neurobiological measures, and genetics.
The
aim of the project is to develop a more
accurate diagnostic system.
41. Schizophrenia and Metabolism
Normally the brain uses glucose as its main energy source,
with ketone bodies as an alternative.
In schizophrenia brain energy supply is scarce due to
mitochondrial dysfunction.
The brain shifts its energy supply towards ketone bodies, and
fatty acid metabolism.
Liver metabolism is shifted towards producing the necessary
ketone bodies.
J Yang, T Chen, L Sun, Z Zhao, X Qi, K Zhou, Y Cao, X Wang, Y Qiu, M Su, A Zhao, P Wang, P Yang, J Wu, G
Feng, L He, W Jia and C Wan
42.
43. Metabolic Biomarkers in
Schizophrenia
The following set of metabolic biomarkers
have identical sensitivity and specificity as
the MSE:
Glycerate
Eicosenoic acid
Beta-hydroxybutirate
Pyruvate
Cysteine
Urine beta hydroxybutirate
Potential Metabolite Markers of Schizophrenia; J. Yang et al.; Molecular Psychiatry(213)
18, 67-78; doi:10.1038/mp.131
45. Neuropsychological Screening Tests for
the Prodromal Phase of Schizophrenia
Severalneuropsychological deficits have been
detected in the prodromal phase of schizophrenia.
Neuropsychological instruments developed:
-Structured Interview for Prodromal Symptoms (SIPS)
-Neurocognitive Test Batteries for at Risk Mental
states (ARMS)
-Cognitive Perceptive Basic Symptoms (COPER)
Positive predictive power for conversion to psychosis
75%
48. Patient Specific Cultured Neurons
Exposed to Loxapine
Cultured neurons from patients with schizophrenia present with
decreased neuronal connectivity.
Adding Loxapine resulted in improvement in neuronal
connectivity
Modeling Schizophrenia Using Human Induced Pluripotent Stem Cells;Kristen J. Bernnand et al.; Nature
473, 221-225 (12 May 2011) doi:10.1038/nature09915
49. Integration of Care
Currently the care is fragmented into medical
care separated from psychiatric care.
Both are isolated from psychosocial interventions
such as supportive employment, family education.
Recovery After Initial Episode of Schizophrenia
(RAISE) project is developing a best-practice
approach to bundled services.
Thomas Insel; Rethinking Schizophrenia; Nature vol 468, November 201; doi:10.1038/nature09552
51. Redefining Schizophrenia
NorthAmerican Prodrome Longitudinal
Study (NAPLS)
Working on a combination of
-neurocognitive testing
-neuroimaging
-plasma biomarkers
52. Future Biological Treatment
Algorithm
Dx by MSE
Determine the
verified by
affected
Schizophrenia
domain of
metabolomic
schizophrenia
panel
Staging of the
illness (fMRI
+connectomics)
Choosing best Assessment of
therapy Tx efficacy
(cultured (dendritic spine
patient specific density
neurons) measurement)
53. A vision for schizophrenia over
the next decade
Thomas Insel; Rethinking Schizophrenia; Nature vol 468, November 201; doi:10.1038/nature09552