Current antipsychotic dose correlates to mononuclear cell counts in the cerebrospinal fluid of psychotic patients
Department of Psychiatry, University of Helsinki, Helsinki, Uusimaa, Finland Psychiatry Research
(Impact Factor: 2.47).
03/2000; 93(1):13-9. DOI: 10.1016/S0165-1781(99)00125-0
Elevated cerebrospinal fluid (CSF) angiotensin I-converting enzyme (ACE) levels have been evidenced in patients with schizophrenia who have been treated with antipsychotics. In order to explore a possible mononuclear cell origin of CSF ACE, the authors determined CSF ACE and CSF mononuclear cell counts from 25 acutely psychotic patients, who had been drug-free for at least 4 months but started on conventional antipsychotic medication within a few days before sampling. No correlations were found between CSF to serum ACE ratio and CSF mononuclear cell counts. However, CSF total mononuclear cell count, CSF lymphocyte count, and CSF mononuclear phagocyte count evidenced significant positive correlations with current dose of antipsychotic medication expressed as chlorpromazine equivalents. The authors conclude that no indication of a relationship between mononuclear cells and CSF ACE activity was found. Surprisingly, a relationship between chlorpromazine dose and CSF mononuclear cell counts was found, which may indicate drug-related changes in cell-mediated immunity. This finding needs replication and further corroboration in well-designed studies.
Available from: Markus J Schwarz
- "Interestingly, there is a recent report that described a correlation between the dose of short term anti-psychotic treatment, the mononuclear cell count in the CSF, the CSF macrophage count, and the total lymphocyte count (Wahlbeck et al., 2000). The correlation was especially found in patients treated with chlorpromazine-like low-potency phenothiazines. "
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ABSTRACT: This chapter discusses the recent advances in immunological research regarding the differentiation between type-1 and type-2 immune response, and specific and unspecific arms of the immune system. The unspecific “innate” immune system shows signs of an overactivation in unmedicated schizophrenic patients. Increased levels of interleukin-6 (IL-6) and activation of the IL-6 system in schizophrenia might be the result of the activation of type-2 monocytes/macrophages. On contrary, several parameters of the specific cellular immune system are blunted. It reviews that a type-1/type-2 imbalance with a shift to the type-2 immune response is associated with schizophrenia. The chapter also discusses that there are indications that the type-1/type-2 imbalance is reflected in differential activation of astrocytes and microglial cells in the CNS that is associated with a different activation of the tryptophane–kynurenine metabolism. During therapy with anti-psychotics, the specific type-1 related immune answer becomes activated, but also the B cell system and the antibody production. In major depression, the activation of the type-1 cellular immune system dominates the immune response. This is the case especially in nonmelancholic depressed patients and during suicidality. Anti-depressant medication seems to influence immune response.
Available from: helsinki.fi
Available from: A. Preda
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ABSTRACT: Auditory hallucinations or voices are experienced by 75% of people diagnosed with schizophrenia. We presumed that auditory cortex of schizophrenia patients who experience hallucinations is tonically "tuned" to internal auditory channels, at the cost of processing external sounds, both speech and nonspeech. Accordingly, we predicted that patients who hallucinate would show less auditory cortical activation to external acoustic stimuli than patients who did not.
At 9 Functional Imaging Biomedical Informatics Research Network (FBIRN) sites, whole-brain images from 106 patients and 111 healthy comparison subjects were collected while subjects performed an auditory target detection task. Data were processed with the FBIRN processing stream. A region of interest analysis extracted activation values from primary (BA41) and secondary auditory cortex (BA42), auditory association cortex (BA22), and middle temporal gyrus (BA21). Patients were sorted into hallucinators (n = 66) and nonhallucinators (n = 40) based on symptom ratings done during the previous week.
Hallucinators had less activation to probe tones in left primary auditory cortex (BA41) than nonhallucinators. This effect was not seen on the right.
Although "voices" are the anticipated sensory experience, it appears that even primary auditory cortex is "turned on" and "tuned in" to process internal acoustic information at the cost of processing external sounds. Although this study was not designed to probe cortical competition for auditory resources, we were able to take advantage of the data and find significant effects, perhaps because of the power afforded by such a large sample.
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