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Season of birth interacts with measures of inbreeding in multiplex schizophrenia pedigrees: evidence from genetic isolates in Daghestan

100%
Bulayeva K., McGrath J.
Open Medicine
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2006
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vol. 1
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issue 4
392-398
EN
While the season-of-birth effect is one of the most consistent epidemiological features of schizophrenia, there is a lack of consistency with respect to the interaction between season of birth and family history of schizophrenia. Apart from family history, measures related to consanguinity can be used as proxy markers of genomic heterogeneity. Thus, these measures may provide an alternate, indirect index of genetic susceptibility. We had the opportunity to explore the interaction between season of birth and measure of consanguinity in well-described genetic isolates in Daghestan, some of which are known for their relatively high prevalence of schizophrenia. Our previous population-genetic study showed Daghestan has an extremely high genetic diversity between the ethnic populations and a low genetic diversity within them. The isolates selected for this study include some with more than 200 and some with less than 100 generations of demographical history since their founding. Based on pedigrees of multiply-affected families, we found that among individuals with schizophrenia, the measure of consanguinity was significantly higher in the parents of those born in winter/spring compared to those born in summer/autumn. Furthermore, compared to summer/autumn born, winter/spring born individuals with schizophrenia had an earlier age-of-onset, and more prominent auditory hallucinations. Our results suggest that the offspring of consanguineous marriages, and thus those with reduced allelic heterogeneity, may be more susceptible to the environmental factor(s) underpinning the season-of-the effect in schizophrenia.
2
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Withdrawal related adverse effects of antipsychotic medication in a patient with first-episode schizophrenia

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Barteček R., Kašpárek T., Češková E.
Open Medicine
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2011
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vol. 6
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issue 5
662-664
EN
Withdrawal-emergent adverse effects of antipsychotics are an infrequently identified condition which can appear during antipsychotic dose reduction and medication change. In this paper, we present the case of severe extrapyramidal symptoms after a dose reduction of risperidone is presented. A patient, 23 years of age, was admitted to a health care facility due to an unexpected change in his behavior, with paranoid delusions, incoherent thinking, and significant anxiety. An initial risperidone treatment was soon changed to zuclopenhixol. Subsequently, severe extrapyramidal symptoms appeared, after which the medication was switched back to resperidone. Following this treatment, the patient left the health care facility and stopped the medication of his own volition. Psychotic symptoms and massive extrapyramidal symptoms again occurred. These symptoms subsided only slowly during a subsequent treatment with olanzapine. The development of adverse neurological effects together with a worsening of productive psychotic symptomatology may be explained by withdrawal of antipsychotic medication. These symptoms are often attributed to new medications, which are prematurely discontinued after the appearance of an adverse effect, but which are potentially beneficial to a patient, provided that enough time for a spontaneous subsidence of withdrawal-emergent effects is given. Any change in antipsychotic treatment should be carefully considered and thoroughly planned.
3
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99mTc-ECD SPECT at rest and activation in young patients with schizophrenia

88%
Nocuń A., Pawęzka J., Chrapko B., Szymona K., Smoleń A., Karakuła H.
Open Medicine
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2012
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vol. 7
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issue 1
51-58
EN
The aim of the study was to localize brain parts involved in executive functions in patients with schizophrenia by means of 99mTc-ECD single photon emission computed tomography (SPECT) with 3-dimensional automatic software. We examined 12 men with schizophrenia (mean age 29±3.9 years). Brain perfusion SPECT was performed at rest and during Wisconsin Card Sorting Test (WCST). Two types of quantitative SPECT analysis were applied; voxel-based and volume of interest (VOI)-based. With voxel-based approach, rest and activation SPECT were compared. VOI-based analysis allowed for correlation of regional cerebral blood flow (rCBF) in 20 VOIs with WCST scores. In voxel-based analysis, the patterns of rCBF decrease and increase after activation varied between patients, with combinations of different brain regions involved. In VOI-based approach, the only statistically significant difference between activation and rest was rCBF decrease in the left basal ganglia (p=0.028). The thalami and right temporal cortex correlated with the greatest number of WCST scores, followed by left occipital cortex and left cerebellum. In conclusion, our results suggest that patterns of WCST activation and deactivation vary between patients with schizophrenia. Among the network of involved brain structures, right temporal cortex and thalami appear to play the major role.
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