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
@suheyla_cetin notes that many diffusion MRI studies are done worldwide but not with the same scanning protocols ! … #ICP2022
The scanner effects can be over 30 times larger than the effects of aging on the microstructure metrics ! #ICP2022 🧠 @suheyla_cetin notes there are methods to fix this …
@suheyla_cetin notes that @PKochunov and Elliot aging offer 3 hypotheses about what happens in schizophrenia: not attaining peak maturation, slowed development, and|or faster brain aging; these are not mutually exclusive
And, @ it looks like all 3 happen BUT…. @suheyla_cetin notes that:
There are 3 clusters of tracts doing distinct things, with different patterns !! #ICP2022
Amanda Lyall continues: large studies led by their group and by @enigmabrains Schizophrenia working group support these altered trajectories and differential patterns for different sectors or white matter @sineadykelly analyzed worldwide data to show consistent abnormalities
Those with shorter duration of illness showed the largest deviation from the healthy mean, in free water metrics developed by Ofer Pasternak; could it be atrophy ? Amanda Lyall explains that..
Rather than atrophy an inflammatory or immune activation could occur earlier in the illness but atrophy may contribute to abnormalities in those over age 45 (she showed inflammatory metics linked to free water metrics!)
And in females a higher IQ seems to be protective (as a cognitive reserve?) against the long term effects of schizophrenia in that the association with positive symptoms is greater in women with lower IQ (except from talk right now by Amanda Lyall at #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
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
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