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Cerebrospinal fluid abnormalities in first- and multi-episode schizophrenia-spectrum disorders: impact of clinical and demographical variables.

ABSTRACT: Multiple lines of evidence indicate that immunological and inflammatory alterations contribute at least in a subgroup to the pathophysiology of schizophrenia. In this retrospective chart review, we investigated whether clinical factors contribute to altered cerebrospinal fluid (CSF) findings in schizophrenia-spectrum disorders. Clinical data from electronic medical records of patients with psychotic disorders (ICD-10: F20-F29) who received routine CSF diagnostics at the Department of Psychiatry and Psychotherapy, LMU Munich, Germany, were included. Chi² tests for dichotomous outcomes and independent t tests for continuous outcomes were used to compare differences between groups. A total of 331 patients were included in the analyses (43.2% female and 56.8% male). The mean age was 37.67 years (±15.58). The mean duration of illness was 71.96 months (±102.59). In all, 40% (128/320) were first-episode psychosis (FEP) patients and 60% (192/320) were multi-episode psychosis (MEP) patients. Elevated CSF protein levels were found in 19.8% and elevated CSF/serum albumin ratios (Q_Alb) in 29.4% of the cases. Pleocytosis was found in 6.1% of patients. MEP patients showed significantly higher mean Q_Alb compared with FEP patients (t_(304.57) = -2.75, p = 0.006), which did not remain significant after correcting for age. Q_Alb elevation occurred more frequently in men (X²₍₁₎ = 14.76, p = <0.001). For treatment resistance, family history, and cMRI alterations, no significant differences in CSF-related outcomes were detected. Our work extends other retrospective cohorts confirming a relevant degree of CSF alterations in schizophrenia-spectrum disorders and shows the difficulty to relate these alterations to clinical and disease course trajectories. More research is needed to develop treatment response predictors from CSF analyses.

SUBMITTER: Oviedo-Salcedo T

PROVIDER: S-EPMC8654913 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Cerebrospinal fluid abnormalities in first- and multi-episode schizophrenia-spectrum disorders: impact of clinical and demographical variables.

Oviedo-Salcedo Tatiana T Wagner Elias E Campana Mattia M Gagsteiger Anna A Strube Wolfgang W Eichhorn Peter P Louiset Marie-Luise ML Luykx Jurjen J de Witte Lot D LD Kahn René S RS Benros Michael E ME Falkai Peter P Hasan Alkomiet A

Translational psychiatry 20211208 1

Multiple lines of evidence indicate that immunological and inflammatory alterations contribute at least in a subgroup to the pathophysiology of schizophrenia. In this retrospective chart review, we investigated whether clinical factors contribute to altered cerebrospinal fluid (CSF) findings in schizophrenia-spectrum disorders. Clinical data from electronic medical records of patients with psychotic disorders (ICD-10: F20-F29) who received routine CSF diagnostics at the Department of Psychiatry ...[more]

PMID: 34880213

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Project description:BackgroundLittle is known about neural oscillatory dynamics in first-episode psychosis. Pathophysiology of functional connectivity can be measured through network activity of alpha oscillations, reflecting long-range communication between distal brain regions.MethodsResting magnetoencephalographic activity was collected from 31 individuals with first-episode schizophrenia spectrum psychosis and 22 healthy control individuals. Activity was projected to the realistic cortical surface, based on structural magnetic resonance imaging. The first principal component of activity in 40 Brodmann areas per hemisphere was Hilbert transformed within the alpha range. Non-negative matrix factorization was applied to single-trial alpha phase-locking values from all subjects to determine alpha networks. Within networks, energy and entropy were compared.ResultsFour cortical alpha networks were pathological in individuals with first-episode schizophrenia spectrum psychosis. The networks involved the bilateral anterior and posterior cingulate; left auditory, medial temporal, and cingulate cortex; right inferior frontal gyrus and widespread areas; and right posterior parietal cortex and widespread areas. Energy and entropy were associated with the Positive and Negative Syndrome Scale total and thought disorder factors for the first three networks. In addition, the left posterior temporal network was associated with positive and negative factors, and the right inferior frontal network was associated with the positive factor.ConclusionsMachine learning network analysis of resting alpha-band neural activity identified several aberrant networks in individuals with first-episode schizophrenia spectrum psychosis, including the left temporal, right inferior frontal, right posterior parietal, and bilateral cingulate cortices. Abnormal long-range alpha communication is evident at the first presentation for psychosis and may provide clues about mechanisms of dysconnectivity in psychosis and novel targets for noninvasive brain stimulation.

Dataset Information

Cerebrospinal fluid abnormalities in first- and multi-episode schizophrenia-spectrum disorders: impact of clinical and demographical variables.

Publications

Cerebrospinal fluid abnormalities in first- and multi-episode schizophrenia-spectrum disorders: impact of clinical and demographical variables.

Similar Datasets

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