Stephen Lawrie’s Keynote right now at #ICP2022: reviews 14 MRI studies of brain changes over time in schizophrenia and sees about half a standard deviation progression in brain volume loss; inactivity and sedation contributes to GM loss?
And genomic risk markers for schizophrenia account for 20% of the risk for schizophrenia at the population level; polygenic risk score for SCZ is negatively assoc w/ cortical thickness in the UK Biobank #ICP2022
But alcohol and drug use and child abuse are associated with lower hippocampal and amygdala volume and may contribute to MRI findings in schizophrenia #ICP2022
brain differences are associated with antipsychotic use but the most severely ill patients get the highest doses for longest; in a randomized trial many people drop out making inferences harder
Be careful using MRI machine learning and family history to predict schizophrenia in young at risk people; using schizotypal features may also help early detection but not always accurate; 80 percent accuracy means be careful #ICP2022
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Randy Bateman notes that lecanemab reverses amyloid levels; 20 centiloid drop in amyloid levels at 3 months and 50 centiloid drop by 1 year on neuroimaging measures #CTAD2022
..also slows decreases in the rate of tau accumulation in the temporal lobes which is important for cognition #CTAD2022
Marek Kubicki’s plenary now starting at 6pm: diffusion imaging in schizophrenia shows brain microstructural abnormalities, but what is the underlying biology ? #ICP2022 a 🧵 if I can keep up with his talk ! :
Do Inflammation and myelin abnormalities play a role? There are many possible mechanisms …
Maturational trajectories could be shifted earlier, later, or slowed - as in this review by @PKochunov and Elliot Hong
Schizophrenia research pioneer Robin Murray’s Keynote: excess dopamine synthesis in schizophrenia leads to the loss of ability to screen out unimportant stimuli; reading too much significance into unimportant things, “aberrant salience” #ICP2022
Stress or drug abuse also releases more dopamine: dopamine blocker medication can alleviate symptoms; with CBT (cognitive behavioral therapy) this can be successful in first episode psychosis up to 80% of the time #ICP2022
Many schizophrenia patients look back and develop insight but others may never regain insight; patiently talking with our patients is what good psychiatrists do