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1.
White matter abnormalities in subjects at ultra high-risk for schizophrenia and first-episode schizophrenic patients 总被引:2,自引:0,他引:2
Witthaus H Brüne M Kaufmann C Bohner G Ozgürdal S Gudlowski Y Heinz A Klingebiel R Juckel G 《Schizophrenia Research》2008,102(1-3):141-149
Schizophrenia is associated with neuroanatomical abnormalities. Gray matter decrease seems to predate first schizophrenic episode. Whether white matter abnormalities predate the onset of psychotic symptoms is unclear. We investigated this issue using voxel-based morphometry (VBM) of structural magnetic resonance images to examine individuals with prodromal symptoms who were at ultra high-risk (UHR) of developing schizophrenia and compared them to first-episode schizophrenic patients and healthy controls. White matter volume maps from high-resolution magnetic resonance T1 weighted whole brain images were analyzed in a cross-sectional study using SPM2 in 30 UHR patients, 23 first-episode schizophrenic patients and 29 healthy controls. UHR patients showed significant lower white matter volume in the right superior temporal lobe compared to healthy controls. First-episode patients with schizophrenia showed widespread smaller white matter volume bilaterally compared to UHR patients. This study provides first evidence for smaller white matter volume in the right temporal lobe of UHR patients, one of the key structures in the pathophysiology of schizophrenia. Furthermore, white matter abnormalities seem to progress after transition into schizophrenia. 相似文献
2.
Ozgürdal S Littmann E Hauser M von Reventlow H Gudlowski Y Witthaus H Heinz A Juckel G 《Journal of clinical and experimental neuropsychology》2009,31(4):392-401
As suggested by the neurodevelopmental model, neurocognitive disturbances are core features of schizophrenia spectrum disorders. The aim of the present study was to explore the neurocognitive performance of symptomatically defined high-risk participants as well as first-episode patients on tests of verbal memory, executive functioning, working memory, and attention. The sample consisted of 54 participants at risk for schizophrenia and 37 patients with a first episode of psychosis. The high-risk group exhibited a similar cognitive performance profile to that of the first-episode participants when compared with normative data. The neurocognitive functioning of both patient groups were within standard average range at most of the cognitive domains. Moreover the intellectual functioning of both groups was within higher average level, while decreased "hit rates" could be observed within both subtests "Figures" and "Symbols" of the Continuous Performance Test-Identical Pairs Version (CPT-IP) in the group of first-episode patients. Direct comparison between the clinical groups did show increasing impairments of these parameters in first-episode patients compared to high-risk participants. Results suggest that high-risk participants do perform at average neurocognitive performance levels at all tested domains compared with normative data. Compared to norm values first-episode patients showed decreased attention abilities. 相似文献
3.
Marta Hauser Marion Lautenschlager Yehonala Gudlowski Seza Özgürdal Henning Witthaus Andreas Bechdolf Josef Bäuml Andreas Heinz Georg Juckel 《Patient education and counseling》2009
Objective
To introduce a psychoeducational program for patients of at-risk mental state and its preliminary evaluation.Methods
The psychoeducational program was designed as a purely informative intervention and consisted of seven 1-h sessions. Sixteen at-risk mental state patients (mean age 26 ± 4.9 years, 12 males/4 females, mean score on prodromal psychopathology (Bonn Scale for Assessment of predictive Basis Symptoms [BSABS-P] 18.6 ± 13.3) were investigated.Results
Comparisons of means before and after psychoeducation showed a significant reduction in psychopathology and fatalistic LoC as well as an improvement in knowledge, global functioning and various areas of QoL. A qualitative evaluation of the psychoeducational program also showed advantages from patients’ perspectives.Conclusions
This study provides empirical evidence for benefits of psychoeducation with patients of at-risk mental state for schizophrenia but is exploratory and has some limitations, e.g. the small sample size. Therefore the results have to be replicated in a randomized controlled trial in order to be able to demonstrate conclusively the effectiveness of psychoeducation in the pre-psychotic phase.Practice implications
Results from this preliminary study suggest that psychoeducation is a promising intervention for patients of at-risk mental state for schizophrenia, and therefore worthy of more investigations. 相似文献4.
5.
Uhl I Mavrogiorgou P Norra C Forstreuter F Scheel M Witthaus H Ozgürdal S Gudlowski Y Bohner G Gallinat J Klingebiel R Heinz A Juckel G 《Journal of psychiatric research》2011,45(9):1135-1139
Using proton magnetic resonance spectroscopy biochemical characteristics in early stages of schizophrenia were examined. N-acetylaspartate, choline and creatine were measured in hippocampus, anterior cingulate gyrus (ACC) and medial prefrontal cortex (mPFC) of 24 first episode and 30 ultra-high risk patients. Careful LCModel analyses revealed no differences between the patient groups and 31 healthy controls, casting doubt upon the idea of metabolic changes in early stages of psychosis. 相似文献
6.
Juckel G Gudlowski Y Müller D Ozgürdal S Brüne M Gallinat J Frodl T Witthaus H Uhl I Wutzler A Pogarell O Mulert C Hegerl U Meisenzahl EM 《Psychiatry research》2008,158(1):79-82
Serotonergic dysfunction appears to be involved in the pathogenesis of schizophrenia. The loudness dependence of auditory evoked potentials (LDAEP) has been suggested to be a valid indicator of the brain serotonin system's activity in humans. Patients with schizophrenia showed weaker LDAEP, indicating high serotonergic activity, in comparison to healthy controls. Thus, we were able again to demonstrate electrophysiological evidence for an upregulated serotonergic system in schizophrenia. 相似文献
7.
Henning Witthaus Ute Mendes Martin Brüne Seza ?zgürdal Georg Bohner Yehonala Gudlowski Peter Kalus Nancy Andreasen Andreas Heinz Randolf Klingebiel Georg Juckel 《Journal of psychiatry & neuroscience : JPN》2010,35(1):33-40
Background
Accumulating evidence from postmortem and magnetic resonance imaging (MRI) studies suggests that abnormalities of medial temporal lobe structures are critically involved in the pathogenesis of schizophrenia. It is still unclear, however, whether certain abnormalities are already present in individuals at ultra high-risk (UHR) for transition into psychosis. Recent studies involving patients at UHR showed contradictory results for hippocampal volume, and only 1 study reported that amygdalar volume was unchanged between healthy patients and those at UHR. Furthermore, no subregions of the hippocampus have been investigated in people at UHR.Methods
We recruited 29 UHR patients, 23 first-episode patients and 29 age-and sex-matched healthy controls. We measured hippocampal and amygdalar volumes from MRI scans by use of BRAINS2 to manually trace the regions of interest. The hippocampi were divided in 2 regions: head and corpus/tail.Results
Patients at UHR had significantly smaller volumes of the hippocampus corpus and tail bilaterally, but not of the head, compared with healthy controls. Group differences for the right hippocampus corpus and tail volume remained significant after we controlled for whole brain volume and other covariates. We found that UHR patients who later developed psychosis had smaller right hippocampus corpus and tail volumes than did those who did not develop psychosis. First-episode patients had significantly smaller left amygdalar volumes than did healthy individuals or those at UHR.Limitations
Our study had a small sample size, and we were unable to control for the effects of medication.Conclusion
Our findings suggest that parts of the hippocampal–amygdalar complex are involved in the pathogenesis of schizophrenia. Reduction of hippocampus corpus and tail volumes may be indicative of the prodromal phase of schizophrenia and represent risk factors for transition into psychosis. Further investigations are needed to determine whether structural changes of the left amygdala play a role during transition from the prodromal phase to the first manifest episode of schizophrenia. 相似文献8.
9.
Stephan Rauchensteiner Wolfram Kawohl Seza OzgurdalEckhard Littmann Yehonala GudlowskiHenning Witthaus Andreas HeinzGeorg Juckel 《Psychiatry research》2011,185(3):334-339
This exploratory study aims to examine the differential effects of a computer-based cognitive training in ‘prodromal’ patients (mean age 27.20 years, S.D. 5.31 years) compared with patients with full-blown schizophrenia (mean age 30.13 years, S.D. 7.77 years). Ten patients at risk for schizophrenia and 16 patients suffering from schizophrenia underwent a computerized cognitive training program (Cogpack). Cognitive functioning before and after a total of 10 training sessions was assessed by different tests controlling for memory, attention, and logical thinking. Prodromal patients turned out to be able to significantly improve their long-term memory functions and their attention after cognitive training with the Cogpack software package whereas in the group of patients with schizophrenia no improvement occurred (e.g. continuous performance test, identical pairs-subtest ‘shapes’: improvement from 0.73 to 0.88 in persons at risk of schizophrenia vs. no improvement in patients with schizophrenia (0.55 to 0.53). Cognitive training using Cogpack is helpful for the improvement of cognitive functioning in persons at risk of schizophrenia. Thus, the application of cognitive training should be provided as early as possible in the prodromal phases of schizophrenia in order to use the full rehabilitative potential of the patients. These results should be confirmed by further investigations including larger sample sizes. 相似文献
10.
M. Zink F. Schirmbeck F. Rausch S. Eifler H. Elkin X. Solojenkina S. Englisch M. Wagner W. Maier M. Lautenschlager A. Heinz Y. Gudlowski B. Janssen W. Gaebel T. M. Michel F. Schneider M. Lambert D. Naber G. Juckel S. Krueger‐Oezguerdal T. Wobrock A. Hasan M. Riedel H. Müller J. Klosterkötter A. Bechdolf 《Acta psychiatrica Scandinavica》2014,130(3):214-226