Junzo Iida

Brain imaging in childhood- and adolescence-onset schizophrenia associated with obsessive-compulsive symptoms

Objective: Childhood‐ and adolescence‐onset schizophrenic patients with obsessive‐compulsive symptoms (OCS) constitute a specific subgroup of schizophrenia. We performed magnetic resonance imaging in this group seeking evidence of neurodevelopmental insults.

Minor physical anomalies in childhood and adolescent onset schizophrenia.

Abstract A modified version of the Waldrop scale (WS) was used to assess the prevalence of minor physical anomalies in schizophrenic patients (n = 71) and healthy controls (n = 65). The mean total WS score was 3.32 (SD 1.98) for the schizophrenic patients, significantly higher than that for the controls (2.19, SD 1.18). Minor physical anomalies were compared between two schizophrenic groups, divided on the basis of age at onset, early onset schizophrenia (EOS, onset under age 18 years) group and late onset schizophrenia (LOS, onset at or above age 20 years) group. The mean total WS score was 3.92 (SD 1.86) in the EOS group, significantly higher than the 2.59 (SD 1.79) in the LOS group. Minor physical anomalies are an indirect index for early prenatal central nervous system (CNS) maldevelopment; the present study indicated association between minor physical anomalies and EOS, thus a relationship between early prenatal CNS maldevelopment and EOS. These results support the hypothesis that EOS constitutes a subset of schizophrenia in which neurodevelopmental damage is largely involved.

Clinical features of childhood-onset schizophrenia with obsessive-compulsive symptoms during the prodromal phase.

Abstract Thirty‐nine patients with schizophrenia, diagnosed according to DSM‐III‐R, who were under 15 years of age, were studied in two groups; 16 subjects with obsessive‐compulsive symptoms during the prodromal phase, and 23 with no obsessive‐compulsive disorders. The group with obsessive‐compulsive symptoms during the prodromal phase was characterized by a higher ratio of males, higher incidences of perinatal and brain computed tomography (CT) abnormalities, fewer hereditary factors, longer duration of the prodromal phase, and a higher incidence of insidious onset and negative symptoms compared with the group without such prodromal symptoms. Schizophrenic patients with obsessive‐compulsive symptoms during the prodromal phase were clinically distinct from those without, which suggests the possibility of subtype categorization.

Lower prefrontal activity in adults with obsessive-compulsive disorder as measured by near-infrared spectroscopy

Recent developments in near-infrared spectroscopy (NIRS) have enabled the non-invasive elucidation of the neurobiological underpinnings of psychiatric disorders. Functional neuroimaging studies in human patients have suggested that the frontal cortex and subcortical structures may play a role in the pathophysiology of obsessive-compulsive disorder (OCD). Here we used NIRS to investigate neurobiological function in 12 patients with OCD and 12 age- and sex-matched, healthy control subjects. The relative concentrations of oxyhemoglobin (oxy-Hb) were measured with prefrontal probes every 0.1 s, during performance of a Stroop color-word task, using 24-channel NIRS. Oxy-Hb changes in the prefrontal cortex of the OCD group were significantly smaller than those in the control group, especially in the left lateral prefrontal cortex. These results suggest that patients with OCD have reduced prefrontal hemodynamic responses as measured by NIRS.

Effects of osmotic-release methylphenidate in attention-deficit/hyperactivity disorder as measured by event-related potentials

Aim:  Attention‐deficit/hyperactivity disorder (ADHD) is a relatively common central nervous system disorder in school‐age children, which may involve a specific disorder in cognition and/or information processing. Event‐related potentials (ERP) are commonly used as physiological measures of cognitive function as they are easily measured and non‐invasive. Thus, in the present study, we examined the effects of osmotic‐release methylphenidate (MPH) (Concerta), a common treatment for childhood attention‐deficit/hyperactivity disorder (ADHD), in ADHD children as measured by ERP.

The reliability and validity of the Oppositional Defiant Behavior Inventory.

The aim of this study was to develop an evaluation scale for use as a supplementary tool for the diagnosis of oppositional defiant disorder (ODD). The subjects were 98 Japanese children (91 males and 7 females), aged 6–15 years, diagnosed with attention deficit/hyperactivity disorder (ADHD) or ODD. Internal consistency, test-retest reliability, concurrent validity and divergent validity of the oppositional defiant behavior inventory (ODBI), an evaluation scale of oppositional defiant tendency, were examined. Cronbach’s α coefficient of the ODBI was 0.925. The correlation coefficient between the test and the retest was 0.820 (p < 0.0001). Both the ODBI scores (test and retest) were correlated with the number of items that matched the ODD diagnostic criteria of DSM-IV (r = 0.660, 0.659, p < 0.001), and with the ODD-scale of Disruptive Behavior Disorders Rating Scale (r = 0.725, 0.654, p < 0.001). Compared with the ADHD group or controls, the ADHD and ODD group showed a significantly higher ODBI score at p < 0.0001. The concurrent use of this scale with clinical examination is expected to increase the accuracy of the diagnosis of ODD.

Association between minor physical anomalies and lateral ventricular enlargement in childhood and adolescent onset schizophrenia

Objective: The primary purpose of this study was to investigate the association between morphological abnormalities of brain and minor physical anomalies (MPAs) in childhood and adolescent onset schizophrenia.

Isolation and characterization of a new immortal rat astrocyte with a high expression of NGF mRNA.

We have established a new line of immortalized rat astrocytes through transfection of plasmid pSV3-neo encoding the large T antigen of simian virus 40 into normal astrocytes. One of these immortalized astrocytes (ACT-57) with a flat and polygonal cell shape, exhibited stable growth in a chemically defined medium (modified N-2 medium) as well as in medium containing ordinary serum. ACT-57, retained a detectable level of expression of glial fibrillary acidic protein (GFAP) and its mRNA, and exhibited a stronger expression of nerve growth factor (NGF) mRNA than that of normal rat astrocytes or C6 glioma cells. NGF mRNA was significantly up-regulated by phorbol ester (12-O-tetradecanoylphorbol 13-acetate, TPA) and gamma-amino-n-butyric acid (GABA) but not by hydrocortisone. None of stimulants (TPA, dibutyryl cyclic AMP (db-cAMP), hydrocortisone, L-glutamate, carbacol, GABA, dopamine, or isoproterenol) changed the expression level of either brain-derived neurotrophic factor (BDNF) or neurotrophin-3 (NT-3). There was a discrete difference between ACT-57 and normal astrocytes in the response to GABA and isoproterenol. These findings imply that normal cortical astrocytes possess a functional heterogeneity whereas the clonal astrocyte, ACT-57, does not, indicating that ACT-57 cells may be useful for in vitro studies of neuron-astrocyte interactions involving the induction of neurotrophic factors such as NGF.

Differential patterns of blood oxygenation in the prefrontal cortex between patients with methamphetamine-induced psychosis and schizophrenia

Despite some slight differences in symptomatology, differential diagnosis of methamphetamine-induced psychosis (MAP) versus schizophrenia can be challenging because both disorders present a large overlap in their clinical symptoms. However, a recent study has shown that near-infrared spectroscopy (NIRS) performed during a cognitive task can be a powerful tool to differentiate between these two disorders. Here, we evaluated verbal fluency task performance during NIRS in 15 patients diagnosed with MAP and 19 with schizophrenia matched for age and sex. We used prefrontal probes and a 24-channel NIRS machine to measure the relative concentrations of oxyhaemoglobin every 0.1 s during the task. For each patient, the neurocognitive function and clinical psychopathology were evaluated using the Positive and Negative Symptom Scale (PANSS), and the Brief Assessment of Cognition in Schizophrenia (BACS). Oxyhaemoglobin changes in the prefrontal cortex were significantly higher in the MAP group compared to those in the schizophrenia group, particularly in the right dorsolateral prefrontal cortex. In contrast, we found no significant difference in PANSS and BACS scores. Our findings suggest that NIRS measurement could be applied to differentiate patients with MAP from those with schizophrenia, even in cases where clinical symptoms are similar.

Factors of good outcome after discharge from support house (engoryou) for schizophrenia.

To restore mentally disabled persons to social activities, it is necessary to establish an appropriate facility and support system according to the severity of disorder. In the present study, in an attempt to obtain a guide to identifying conditions on which the use of the support house (engoryou) is effective, patients who had been discharged from the support house were divided into different groups by evaluation at discharge. The first group consisted of 30 patients who underwent continued social rehabilitation (recovery group); the second group consisted of 25 patients with discontinued social rehabilitation (the re‐hospitalization group), and their demographic factors were compared. The findings are summarized as follows: (i) the recovery group had a significantly shorter total hospitalization period and a smaller number of hospitalizations before entry into the facility, as compared to the re‐hospitalization group; (ii) the recovery group was significantly better than the re‐hospitalization group in terms of the score of ‘thought disorder’, although there was no difference in total Brief Psychiatric Rating Scale (BPRS) score, at the time of entry into the facility; (iii) the recovery group was better than the re‐hospitalization group in terms of the Rehabilitation Evaluation Hall and Baker (REHAB) items ‘speech skills’ and ‘self‐care’ at the time of entry into the facility; (iv) the re‐hospitalization group experienced relapse of symptoms, mainly positive ones, at the time of the discontinuation of the use of the facility or re‐admission. These findings suggest that to make good use of the support house, the improvement of thought disturbance and self‐care must be managed appropriately and the prolongation of hospital stay must be prevented before entry into the facility.