Brain Structure Linked to Hallucinations

That is the title of this article I am reviewing today. "Scientists have uncovered differences in the brains of people with schizophrenia who do and do not have hallucinations. Dr. Jon Simons and colleagues at Cambridge University, UK, looked at structural MRI (magnetic resonance imaging) scans of 153 individual brains: 113 scans were from people with schizophrenia and 40 from similar participants without schizophrenia. Among the schizophrenia patients, 78 had a history of hallucinations and 34 did not. The team measured the length of the paracingulate sulcus (PCS), a fold toward the front of the brain, in each scan. This indicated a link between length of the PCS and the tendency to hallucinate. On average, the patients suffering hallucinations had a PCS that was about two centimeters shorter than those without hallucinations, and three centimeters shorter than the non-schizophrenic group. This suggests that a one centimeter reduction in the fold’s length is linked to a 20 percent rise in the chance of hallucinations. The association applied to both auditory and visual hallucinations. Dr. Simons explained that the team selected patients to put into each group such that those two groups were as directly comparable as possible. Factors such as age, sex, medication and even whether participants were left- or right-handed were all taken into account. 'So as close as we can get it,' Dr. Simons said, 'the only difference between those two groups is that one group experiences hallucinations and the other one doesn’t.' The team says this is consistent with an explanation based on “reality monitoring.” The PCS is thought to play a role in distinguishing self-generated information from that perceived in the outside world. Details are published in the journal Nature Communications. In scans of healthy people, Dr. Simons has previously found that variation in the length of the PCS was linked to reality monitoring. He says, 'Schizophrenia is a complex spectrum of conditions that is associated with many differences throughout the brain, so it can be difficult to make specific links between brain areas and the symptoms that are often observed.'" I heard voices I think after I was at the state hospital.  I had been left crazy since I was locked up because the psychiatrist did not  like me and would not help me.  I am not very sure if I heard voices or not.
The article goes on to say: "'By comparing brain structure in a large number of people diagnosed with schizophrenia with and without the experience of hallucinations, we have been able to identify a particular brain region that seems to be associated with a key symptom of the disorder.' Changes in other areas of the brain are likely also important in generating the complex phenomena of hallucinations, he adds. If further work shows that the difference can be detected before the onset of symptoms, it might be possible to offer extra support to people who face that elevated risk.
But hallucinations are just one of the main symptoms of schizophrenia, and patients are diagnosed on the basis of other irregular thought processes. Researcher Dr. Jane Garrison says the PCS is one of the last structural folds to develop in the brain before birth, and varies in size between individuals.
She adds, 'We think that the PCS is involved in brain networks that help us recognize information that has been generated ourselves. People with a shorter PCS seem less able to distinguish the origin of such information, and appear more likely to experience it as having been generated externally.
'Hallucinations are very complex phenomena that are a hallmark of mental illness and, in different forms, are also quite common across the general population. There is likely to be more than one explanation for why they arise, but this finding seems to help explain why some people experience things that are not actually real.'" I have never experienced nothing that is not real.  It would be hard for people that did not to know that what you are hearing or visualizing is not real.
The article ends with: "The team concludes that, 'To be able to pin such a key symptom to a relatively specific part of the brain is quite unusual.' Commenting on the work, Professor Stephen Lawrie of the University of Edinburgh, UK, states, 'There’s quite a strong literature showing that auditory hallucinations are related to dysfunction or structural disruption in language areas of the brain. 'I think the value of this is that it probably helps us think slightly more broadly about hallucinations in schizophrenia, in terms of it not just being about language areas of the brain, but involving a more distributed network of regions, and implicating, in particular, cognitive control or higher-order cognitive functioning.' Professor Lawrie has also studied brain structure in relation to schizophrenia and hallucinations. He says the form and content of hallucinations can vary considerably between patients and believes that different brain changes may reflect these different processes. His work has found indications for a role for the lateral temporal cortex in hallucinations. This type of investigation 'may have relevance for the understanding of the biological basis of the disorder,' he concludes.'" It does have relevance for people that have theses problems when they have this disorder to understand what happened to them.  I do wish that I would like to know why this happened to me and why at that age besides the stress I was going through the first time and second time it happened.

For young people with schizophrenia, physical and mental exercises offer hope

That is the title of this article I am reviewing today. " Workouts appear to trigger 'Miracle-Gro for the brain' that restores connections between neurons, researchers find.In as little as a few months, antipsychotic medications can tame the delusions and hallucinations that characterize schizophrenia. But the medications do little to reverse the less familiar brain-based problems that accompany the illness. Affecting memory, the speed at which the brain processes information, attention, problem-solving skills and emotional intelligence, these subtle but profound deficits can prove more crippling than schizophrenia's more dramatic and better-known symptoms. 'They tend to be the things that lead people with schizophrenia to go on disability and to become unable to work and to be socially isolated,' said Keith Nuechterlein, a professor at UCLA's Semel Institute for Neuroscience and Human Behavior. 'Families go through a stage almost like mourning because their loved one changes so dramatically.' Schizophrenia affects 1 percent of the population, and research has shown that computer-based brain games sometimes can reverse one-quarter to one-third of the deficits in the areas of memory, thinking skills and social cognition. But Nuechterlein and a team of researchers at a free schizophrenia clinic at UCLA are finding that those benefits increase dramatically if they are turbocharged with aerobic exercise. It's looking like exercising the body along with the mind has the potential to alter the course of schizophrenia, especially if the treatment is applied early in the disorder,' said Joe Ventura, a senior research psychologist at the Semel Institute.'"It has to be early in the disorder.  If they can reverse it with exercise and computer training games I am all for it. Even though I do not do so bad with this disease I remember when I first was delusional with this disease and it was bad and I do not want anyone else to go through what I went through.
The article goes on to say: "In the current issue of Schizophrenia Bulletin, Nuechterlein reports findings from a recent pilot study conducted at UCLA's Aftercare Research Program, which assesses and treats people who have schizophrenia and conducts research on the disease. Preliminary findings from a second, ongoing study were presented April 2 to 6 at the biennial meeting of the Schizophrenia International Research Society by Nuechterlein, Ventura and Sarah McEwen, an assistant research psychologist who serves as the program's director of exercise. The National Institute of Mental Health funded both studies. In the initial study, which lasted 10 weeks, Nuechterlein and his colleagues treated 16 young adults who had recently experienced their first schizophrenic episode. Nine participated in a computerized course of four hours a week of neurocognitive training for perception and memory skills for five weeks and then four hours a week of social cognitive training for emotional intelligence for five weeks. The other seven took the same computer training and added four sessions a week of aerobic exercise for a weekly total of 150 minutes. Study participants wore monitors to ensure that they exercised in their target aerobic zone.
Over the course of the study, the cognitive performance of study participants who only completed brain training did not budge. But those who participated in physical exercise improved significantly.
One test measured how quickly the individual could finish a complicated dot-to-dot drawing, and the average completion time for those who exercised improved from 37 to 25 seconds. (People of the same age without schizophrenia complete the assignment in an average 22 seconds.) On another test, which measures people's challenges in managing their emotions in social situations, the participants who exercised cut the level of such problems in half. In the second study, which lasted six months, 32 people who had just experienced their first episode of schizophrenia trained for four hours a week with the same computer-based brain games as in the pilot study. Half vigorously exercised in addition to participating in the mental training. The researchers expected to see improvements among the exercise participants, but they were surprised by the magnitude of the results. Among those who exercised, performance on a whole battery of cognitive tests improved three times more than among those who did not do so." Exercise helps a lot it seems. Is aerobic exercise the only one that works with this. If it can help these people not feel the full effects of schizophrenia I hope it finally is something that works.
The article ends: "The researchers say the improvements are due to a brain protein called brain-derived neurotrophic growth factor, which is released during aerobic exercise. A kind of Miracle-Gro for the brain, BDNF stimulates the hippocampus -- the brain's center of learning and long-term memory -- to sprout new neurons, and it increases connections between neurons. Those connections are where learning occurs and memories form. 'In adolescence, all humans lose a certain number of connections between neurons, as the brain prunes redundant or less useful synapses,' Nuechterlein explained.'In schizophrenia, the process goes awry, pruning needed as well as unnecessary connections, so important connections are deleted.' McEwen said that in the second study, the amount of BDNF increased 35 percent in the group that had participated in both cognitive training and exercise -- and half of that increase occurred within the first two weeks of the study. In contrast, BDNF levels did not change among those who only received cognitive training. Researchers believe that helping people with schizophrenia as soon as possible after their first psychotic breakdown is most effective because those in the early stages of disease are more able to make long-lasting improvements.  Our hope is to prevent the chronic disability that is so common in schizophrenia from ever occurring, and to return individuals with schizophrenia to regular employment, regular schooling and normal friendship patterns, and to have them resume as much of a full life as possible,' Nuechterlein said. 'This kind of computer training and exercise -- in combination with antipsychotic medication -- might go a long way toward doing that.'" Ir works with those that had a episode one time.  That is good for them because if they keep it up they can work and have a pretty good life right away and not years down the road after they suffered from this disease.

Weak electric current to the brain may improve thinking in people with schizophrenia

That is the title of this article I am writing about. "Lightly stimulating the brain with electricity may improve short-term memory in people with schizophrenia, according to a new study by researchers at the Johns Hopkins University School of Medicine. The procedure, known as transcranial direct current stimulation, involves placing sponge-covered electrodes on the head and passing a weak electrical current between them. It is widely regarded as safe, and the procedure is being studied as a treatment for depression and Alzheimer's-related memory loss, and to enhance recovery following strokes. David Schretlen, Ph.D., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, reasoned that this type of brain stimulation might ease some of the cognitive difficulties that afflict people with schizophrenia. "Cognitive impairment is as ubiquitous as hallucinations in schizophrenia, yet medications only treat the hallucinations. So even with medication, affected individuals often remain very disabled," Schretlen says. His hope is that transcranial direct current stimulation could give people with schizophrenia a shot at leading a more normal life." I do not know if people with mental illness will try this for their cognitive symptoms. I know that some of them get upset when they have difficulties.
The article goes on to say: "To test that possibility, Schretlen and five Johns Hopkins colleagues targeted a brain region called the left dorsolateral prefrontal cortex, which plays an important role in short-term or working memory and is abnormal in people with schizophrenia. Interestingly, parents, siblings and children of people with schizophrenia show some of the same abnormalities to a lesser degree. Schretlen recruited 11 participants: five adults with confirmed schizophrenia and six of their close relatives. Each participant received two 30-minute treatments -- one using a negative electrical charge, which the researchers thought might prove beneficial -- and the other using a positive charge as a control. During and after each treatment, participants completed a battery of cognitive tests. On tests of verbal and visual working memory, participants performed significantly better after receiving a negative charge, and the effects were "surprisingly strong," says Schretlen." The results seem very good.  How much does working memory improve? Two thirty minute treatments sound like something a person would try if it makes them better.
The article ends with: "Schretlen also tested participants' verbal fluency, or word retrieval, during the treatment. People with schizophrenia often struggle to find the right words, Schretlen explains. Because the prefrontal cortex contains a brain region responsible for word retrieval, Schretlen thought transcranial direct current stimulation might help. To test that theory, he gave participants a minute to list things they could buy in a supermarket. Most people taking the test rattle off items in categories, naming fruits, then vegetables, then dairy products, for example. Schretlen found that while participants did not rattle off more words, they did better at the challenging task of switching between categories after a negatively charged treatment. The stimulation "was associated with better performance on working memory and subtle changes in word retrieval," Schretlen says.
Schretlen is now studying transcranial direct current stimulation in a larger sample of patients using repeated sessions of stimulation, which he hopes will induce lasting benefits. 'What's nice about transcranial direct current stimulation is that it's so benign. There are no bad side effects,' Schretlen says. 'If it enables people with schizophrenia to think more clearly, it would make a huge contribution to the treatment of this devastating illness.'" It would be beneficial to people with mental illness. Switching between categories that does sound good if they could not do that at first. Hopefully this does help.

Healing plants inspire new compounds for psychiatric drugs

That is the title of this article I am writing about.  "Treatments used by traditional healers in Nigeria have inspired scientists at Northwestern University to synthesize four new chemical compounds that could one day lead to better therapies for people with psychiatric disorders.

In a paper published online in the journal Angewandte Chemie International Edition, the scientists detail how they created these natural compounds by completing the first total syntheses of two indole alkaloids -- alstonine and serpentine. These alkaloids, found in various plant species used by healers in Nigeria to treat people with conditions such as schizophrenia and bipolar disorder, have antipsychotic properties that have potential to improve mental disorder treatments.  The current drugs used for schizophrenia effectively treat delusions and hallucinations but are only partially effective for cognitive impairment. Early experimental research of these new compounds in animal models shows promise in improving cognitive impairment, the Northwestern scientists said.  'After billions of years of evolution, nature has given us a great starting point for generating new types of molecules that could end up being used as innovative drugs," said Karl Scheidt, lead author of the paper. "We've learned how to make these natural products in the lab and can now evaluate what are the most effective parts of these natural products for potential therapies'" That sounds good if they can use what nature has provided great.  If it can help with negative symptoms to that would be a big help.
The article goes on to say: "Scheidt is a professor of chemistry at Northwestern University's Weinberg College of Arts and Sciences and professor of pharmacology at Northwestern University Feinberg School of Medicine. He collaborated on this study with Dr. Herbert Meltzer, professor in psychiatry and behavioral sciences, pharmacology and physiology at Feinberg. They are both members of Northwestern's Chemistry of Life Processes Institute (CLP), which helps foster collaboration between schools and lowers the barriers to scientific discovery.  Meltzer, who has spent much of his career researching drug therapies now in use for schizophrenia and bipolar disorder, approached Scheidt about the possibility of creating these compounds. Meltzer's longtime research goal is to improve treatment outcomes and develop knowledge of brain mechanisms in mental disorders. Scheidt's expertise is in designing novel methods and strategies for the construction of complex natural products with important biological attributes.  'The synthesis of these alkaloids, which we have now just achieved, was exceedingly difficult," said Meltzer, second author of the paper and an attending physician at Northwestern Memorial Hospital. "Karl Scheidt's expertise in the synthesis of natural products was crucial to the success of this project and is the first step in getting a new drug ready for clinical trials.'  Traditional healers boil these special plants and produce an extract that they administer to people with symptoms of mental illness. However, this extract isn't pure, and it contains other compounds and materials that may not be beneficial to people with mental disorders."  If they can use what works and get rid of the rest that would be very beneficial to people with mental illness.  They are both in research of drug therapies so hopefully between the two of them they create a drug that works and does not have as many side effects as present drugs do.
The article ends: "'Nature did not intend this plant to produce an antipsychotic drug on its own,' Meltzer said.  The collaborative work to create the compounds took place in the Center for Molecular Innovation and Drug Discovery (CMIDD) at Northwestern, using high-level purification resources and state-of-the-art research instrumentation and equipment. Scheidt is the director of CMIDD.
Through an efficient and stereo-selective synthesis, Scheidt and his team created four separate but related natural products. Now a template exists to continue making these compounds as needed for future studies and ultimately for use in clinical drug trials.  'We can make multi-gram quantities of any of the compounds we want,' Scheidt said. 'We built the assembly line and are now uniquely positioned to explore their potential.'  Meltzer is already using these compounds in animal studies in his lab to better understand how they affect brain biology and chemistry in the schizophrenia disease model. Early results from his lab show that the compounds may increase the ability of other antipsychotic drugs to improve cognitive impairment." It sounds really well in the early stages.  We can only hope that it works better than what is available today. We all know that they have to use what is available in a plant that works and not use everything. Hopefully it works with people.

Work Proceeds to Address Cognitive Impairment in Schizophrenia

That is the title of this article I am writing about today. “The better- known symptoms of schizophrenia are devastating enough: hallucinations, delusions, agitated body movements, the inability to experience pleasure.  Yet even when these facets are controlled with antipsychotic drugs, cognitive deficits that make it hard to maintain relationships or hold a job can still consign patients to a life in the shadows, with few friends or little contact with family.  Those impairments – which include things like working memory, processing speed or the ability to interpret the emotion on someone’s face – affect 98% of schizophrenia patients to varying degrees according to a study at Sunday’s lunchtime session ‘Recognizing Cognitive Impairment in Schizophrenia: Neurobiology and Clinical Implications.’ Part of the US Psychiatric and Mental Health Congress in Orlando Florida.  Speakers Henry A. Nasrallah, MD, chairman of the Department if Neurology and Psychiatry, St. Louis University School of Medicine; Richard S. E. Keefe, PhD, Professor if Psychiatry and Behavioral Science, Duke University Medical Center; and John M. Kane, MD, chairman, Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine; discussed background implications, and current research efforts by academia and the pharmaceutical community to find treatments for cognitive impairments in schizophrenia.”  These are bad negative symptoms to have.  It does make it hard to hold friends when you cannot read emotions on someone’s face. I work on my memory that is one thing I do not want to lose.
The article goes on to say: “Cognitive impairment is a core feature of schizophrenia, not a secondary element of the disease, Dr Nasrallah said. Its near universal appearance among patients is made more complicated by the fact that fewer than half are aware of these deficits, and thus interactions with everyone from family, to strangers, to prospective employers are marked by failures to connect. ‘They may interpret a neutral facial expression as threatening,’ Dr Nasrallah said.  For decades, schizophrenia research focused on managing symptoms that could cause the patient immediate harm, or harm to others.  Only in the 1990s did cognition come back into focus, Dr Nasrallah said, and it’s long overdue, for these deficits that keep patients from fully taking their place in the world. ‘It’s a huge unmet need,’ he said; if this area is not addressed, most schizophrenia patients will remain on disability.  For years, there was debate whether cognitive deficits were caused by the disease or antipsychotic drugs that controlled its symptoms.  That has been settled, Dr Nasrallah said.  Cognitive decline is present early, and it picks up speed in the period before psychosis occurs, although improper dosing of some therapies can make the deficits worse.”  It is not the medicine that causes this.  It could hinder someone trying to work. I myself can never read people.
The article goes on to say: “ Dr Nasrallah and the later speakers suggested the knowledge of how early cognitive decline happens, and the fact that the loss of brain tissue at the onset of schizophrenia has now been documented, could provide an opportunity for clinician and researchers to create therapies to halt the worst effects. The ultimate goal, Dr Kane said later, would be to tailor treatment to a patient’s genetic profile.  Why is treating cognitive impairment just as important as treating symptoms like hallucinations? As Dr Keefe explained, these deficits contribute to functional outcomes, and they are the reason why schizophrenia is third-leading cause of life-years on disability for persons aged 15 to 44 years old. (They first is unipolar depression, the second I alcoholism). Data are compelling and sad. ‘Two-thirds of these patients never marry,’ Dr Keefe said.  Some 20% are homeless at any one time.  Fewer than 15% hold competitive employment.  Most chilling, 40% of individuals with severe mental illness are incarcerated, Dr Keefe said.  ( A study in The American Journal of Managed Care earlier this year linked prior authorization policies in Medicaid in certain states with higher incarceration rates for persons with schizophrenia.)  Cognitive impairment, Dr Keefe said, cause persons with schizophrenia to lead, ‘impoverished, challenging lives.’” If they can help more people with schizophrenia to work and lead content lives then I am all for it.
The article ends with: “As an example, he discussed how if an average person is given 16 words, he can remember 10, while a person with schizophrenia can only recall 6. ‘Try developing an intimate relationship when you can’t remember the things that he other person told you, things that re keys to your intimacy,’Dr Keefe said.  MATRICS.  As Dr kane explained, the age of onset of schizophrenia comes as a patient’s peers are moving into the world, making connections, finding jobs, are getting married. ‘ All of that delayed in someone with cognitive impairment,’ Dr Kane said.  Right now there aren’t any FDA approved treatments for cognitive impairment, but much work is going on to change that. Promoted by the National Institute of Mental Health, the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) project seeks to speed up the process of developing therapies to treat cognitive impairment in schizophrenia.  According to Dr Kane, MATRICS represents a collaboration among government, academia and the pharmaceutical sector, it was also described in a 2006 journal article as a ‘consensus-building’ process to agree not only on what are the best molecular targets for drug development, but also what the standards should be for measuring progress in cognition.  The project developed the MATRICS Consensus Cognitive Battery, or MCCB, which take 75 minutes to complete and measures not only cognition but also functional improvement as a co-primary endpoint.  As for therapies, Dr Kane said. ‘Pharmacologic interventions that target molecular mechanisms beyond  dopamine are in development to address cognitive impairment.’  Numerous potential therapies are being studied" That is good news. I hope they can find something that will help us all.

Living with Schizophrenia

It’s 2 o’clock in the morning. The wind blows leaves and dust against the window on to my apartment. I don’t know this as I had awakened to the sound of tapping and wind crossing my door. I walk out into the dark living room cautiously. The chilled air I could feel in the room as the wind whistled through the seams of the window and front entrance, building thought upon thoughts of all the wrong scenarios I could imagine. “Someone is trying to break in. I forgot to chain the door closed. The cat from two doors down is scratching at my door way.” I eventually look out the window, anger subsiding, fear dissipating, and the voices subsiding as well. This is a slight scenario of living with a schizoaffective disorder, living for years knowing you may never know the truth, or be cured of your diagnosis, being told who you are and how to change your life; yet as I struggle on, I wonder how much of that is righteous information.
At this present time I come to realize that I have fears, not paranoia, (living with false beliefs or delusions that someone is plotting against you or someone else), and I also came to believe that the schizoaffective disorder can be lived with, taking prescribed medications and having support. I do know I want to experience a new life, one that keeps me smiling and caring. I have headaches, though they’re not constant and are not about the schizophrenia and I know they don’t cause the auditory hallucinations nor are caused by side effects from the medication, yet I do know they’re apart of the wonderland I experience day to day.
These days I write on my computer, read occasionally and keep the company of relatives and several friends who accept my character, as well as my illness. I stay from the “nightlife” as this caused me troubles when I was younger. I isolate at times and I cope with the slightened depression which occurs by watching television and hoping laughter lifts the dark gray cloud away. I work for a mental Health Center, that’s great support and a great strength giver, meeting new people, and having the opportunity to share my life with others, and learn as well about mental health and what is being done for clients with mental illness. I keep a check on my thoughts, often time quizzing co-workers especially, about my attitude and emotional being. Its work that pays for itself in the long run, making new friends, keeping a check on your reality and facing the same without fear or boundaries.
Controlling your world, so you’ll feel better as time goes by, without depending on drugs or alcohol, without other ill feelings of morose. You can also check us out at http://mhcd.org/blog
Written by Donald S.