Corpus callosum abnormalities and potential age effect in men with schizophrenia: an MRI comparative study.

The goal of this investigation was to evaluate corpus callosum (CC) morphometry in schizophrenia. In consideration of possible confounders such as age, gender and handedness, our study sample was restricted to right-handed male subjects, aged 18-55 years. In addition, we controlled for age at onset, illness duration and exposure to antipsychotic medication. Midsagittal CC linear and area Magnetic Resonance Imaging (MRI) measurements were performed on 50 subjects with schizophrenia and 50 healthy controls. After controlling for midsagittal cortical brain area and age, Analysis of Covariance (ANCOVA) revealed an overall effect of diagnosis on CC splenium width and CC anterior midbody area and a diagnosis by age interaction. Independent Student t tests revealed a smaller CC splenium width in the 36- to 45-year-old age group among the patients with schizophrenia and a smaller CC anterior midbody area in the 18- to 25-year-old age group among the patients with schizophrenia compared with controls. Age, age at onset, illness duration and psychopathology ratings did not show any significant correlations with the whole CC MRI measurements. A negative correlation was found between CC rostrum area and the estimated lifetime neuroleptic consumption. The results are discussed in terms of the possibility that CC structural changes may underlie the functional impairments, frequently reported in schizophrenia, of the associated cortical regions.

Neurological soft signs and cerebral measurements investigated by means of MRI in schizophrenic patients.

Neurophysiologic research has shown a Neurological Soft Sign (NSS) characteristic prevalence in schizophrenic patients, and correlations between NSS and the most frequently cerebral alterations. The aim of this study was to investigate, by means of MRI, the quantitative alterations of cortical and subcortical structures and their correlation with NSS in a sample of schizophrenic patients. Linear measures of lateral ventricular (Evans ratio), third ventricular (Third Ventricular Width), hippocampal (Interuncal Index) and cerebellar (Verm Cerebellar Atrophy) atrophy were made on magnified MR images of 33 patients with a DSM IV diagnoses of chronic schizophrenia. NSS were evaluated with the Buchanan and Heinrichs's Neurological Evaluation Scale (NES). Lateral ventricular enlargement showed to be correlated with right stereoagnosia item (p=0.001). Hippocampal atrophy, with right stereoagnosia item (p=0.023), with forefinger-right thumb opposition (p=0.004), forefinger-left thumb opposition (p=0.029 and face-hand extinction (0.26). Third ventricle enlargement showed to be correlated with forefinger-right thumb opposition (p=0.001), forefinger-left thumb opposition(p=0.021) and total sensorial integration (p=0.012). Cerebellar atrophy showed to be correlated with rhythmic drumming item (p=0.042), forefinger-right thumb opposition (p=0.007), forefinger-left thumb opposition (p=0.026), left specular movements (p=0.049), face-hand extinction (p=0.001), right-left confusion (p=0.005) and with left forefinger-nose index (p=0.032). Results obtained confirm the correlation between NSS and neuroanatomical alterations in schizophrenia.

[Tardive dyskinesia: diagnosis, assessment and treatment]. / Discinesia tardiva: diagnosi, valutazione e terapia.

Tardive dyskinesia is a potentially fatal side effect of antipsychotics. In the classic form is characterized by involuntary hyperkinetic movements, especially those affecting the mimic and mastication muscles. The main hypothesis considers that the pathophysiological basis of the disorder is an overexpression of D2 receptors in the striatum, in response to dopamine block neuroleptics-mediated, especially the older ones. Because fortunately not all patients undergo this severe adverse effects, many efforts have been conducted in trying to delineate the risk factors so as to try to prevent tardive dyskinesia by administering lower doses of neuroleptics in vulnerable groups. Advanced age, female sex, smoking habits, diabetes mellitus, alcohol abuse are known as risk factors. The instead the role of the type of psychiatric disorder, instead, is still debated. Since there was a direct relationship between cumulative dose of antipsychotic and treatment duration, recent studies are aimed at identifying factors that contribute to increased plasma concentrations of the drug, such as genetic polymorphisms of metabolizer enzymes that encode for enzymatic variants with decreased activity.