Paul Thompson Profile picture
Nov 10, 2022 12 tweets 5 min read Read on X
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
Glutamate and GABA are involved in controlling dopamine; high doses of antipsychotics can eliminate hallucinations but in the longer team can lead to hypertension, metabolic syndrome
In chromosome 6, the top common schizophrenia risk variant in or near complement C4A gene is involved in stimulating microglia to eliminate pathogens but some think that microglia may devour too many synapses in adolescence #ICP2022
3/4 of the genes now implicated in #schizophrenia are implicated in bipolar disorder and some in major depression but the more schizophrenia-specific ones are involved in brain development; lower IQ is a risk factor for schizophrenia but brilliant people can develop it
Polygenic risk scores for schizophrenia may affect whether bipolar patients develop schizophrenia but a key goal is to understand genetics of medication response
A wonderful thing about this talk is that the speaker asked people to ask questions (including in Turkish, which you can hear here) during the talk; audience member asks if patients can have difficulties w thermoregulation and if deaf or blind people can hallucinate-answer is yes
Neglect, bullying, poor treatment use all worsen a patient’s risk of cognitive decline but schizophrenia need not be progressive
Cities with more cannabis use have more psychosis (lower in Spain and Italy) r=0.8! As much as 30% of psychosis in London is now due to cannabis use (was only 1/3 in 1960!), low in India and Nigeria, high in Trinidad
We need to classify psychosis depending on the cause - can be adversity
Some of us can be briefly psychotic and recover but we may be genetically predisposed to it continuing

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More from @PTenigma

Nov 30, 2022
BREAKING NEWS: New #Alzheimer drug #Lecanemab slows cognitive decline (18-month change in CDR-SB) by 27%, drastically lowers brain amyloid load by 59 centiloids to 23 (below PET amyloid positivity)! NEJM paper: nejm.org/doi/full/10.10… prnewswire.com/news-releases/… #CTAD
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
Read 11 tweets
Nov 11, 2022
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 ! : Image
Do Inflammation and myelin abnormalities play a role? There are many possible mechanisms … ImageImage
Maturational trajectories could be shifted earlier, later, or slowed - as in this review by @PKochunov and Elliot Hong
Read 13 tweets
Nov 10, 2022
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
Read 5 tweets

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