Top Research Papers on Schizophrenia

Schizophrenia, characterised by psychotic symptoms and in many cases social and occupational decline, remains an aetiological and therapeutic challenge. Contrary to popular belief, the disorder is modestly more common in men than in women. Nor is the outcome uniformly poor. A division of symptoms into positive, negative, and disorganisation syndromes is supported by factor analysis. Catatonic symptoms are not specific to schizophrenia and so-called first rank symptoms are no longer considered diagnostically important. Cognitive impairment is now recognised as a further clinical feature of the ...

A range of mechanistically plausible neuroimaging biomarkers for disease risk, diagnosis, target engagement, and treatment response in schizophrenia are discussed, including dopamine hyperactivity, N-methyl-d-aspartate receptor hypofunction, hippocampalhyperactivity, immune dysregulation, dysconnectivity, and cortical gray matter volume loss.

Earlier and broader use of clozapine in patients with TRS is an important measure to improve outcomes of patients with this most severe form of the illness, and studies indicate that response rates are higher when clozAPine is initiated earlier in the treatment course.

The NMDA-R hypofunction model of schizophrenia started with the clinical observation of the precipitation of psychotic symptoms in patients with schizophrenia exposed to PCP or ketamine, and the genetic literature directly supports a non- specific etiological role for glutamatergic dysfunction.

Current advances in evaluating the use of language as a diagnostic or prognostic tool in schizophrenia are reviewed, suggesting an important role for language analyses in the diagnosis and prognosis of schizophrenia.

Specific regions of gray and white matter changes are observed in patients with schizophrenia; gray matter changes being more significant after the onset of psychosis; these pathological changes may be implicated in the impairment of executive functioning, attention, and working memory.

Substantive progress in biological understanding will require parallel advances in functional genomics and proteomics applied to the brain across developmental stages and for these efforts to succeed in identifying disease mechanisms and defining novel strata they will need to be combined with sufficiently granular phenotypic data.

Background: Inflammation plays a major role in the onset and maintenance of schizophrenia. The objective of the present work was to synthetize in a narrative review the recent findings in the field of inflammation in schizophrenia and their application in daily practice.

This large-scale collaborative study suggests advanced structural brain ageing in SZ, and among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose).

This randomized clinical trial examines the efficacy and safety of lumateperone for the short-term treatment of adults with schizophrenia.

It is found that the genetic architecture of schizophrenia in Africans generally reflects that of Europeans but that the greater genetic variation in Africa provides more power to detect relationships of genes to phenotypes.

The hypothesis that vitamin D deficiency during early life may increase the risk of schizophrenia remains plausible and warrants ongoing research.

This review and position paper covers the historical and modern concepts of the paradigm of positive and negative symptoms in schizophrenia, as well as a detailed comparison of the assessment tools and psychometric tests used for the evaluation of negative symptoms.

The estimated burden of schizophrenia in the US doubled between 2013 and 2019 and was $343.2 billion in 2019, highlighting the importance of effective strategies and treatment options to improve the management of this difficult-to-treat patient population.

Patients and their siblings show similar microstate abnormalities compared to healthy controls, suggesting that the dynamics of microstate classes C and D are a candidate endophenotype for schizophrenia.

Electroencephalography (EEG) microstate analysis is a method wherein spontaneous EEG activity is segmented at sub-second levels to analyze quasi-stable states. In particular, four archetype microstates and their features are known to reflect changes in brain state in neuropsychiatric diseases. However, previous studies have only reported differences in each microstate feature and have not determined whether microstate features are suitable for schizophrenia classification. Therefore, it is necessary to validate microstate features for schizophrenia classification. Nineteen microstate features,...

The temporal mechanisms implicated in schizophrenia-like and antidepressant-like effects of NMDA blockade in rats are described, and it is postulate that such effects may indicate that NMDA receptor antagonists induce similar mechanistic effects, and only the basal pre-drug state of the organism delimitates the overall outcome.

The efficacy of antipsychotic drugs for maintenance treatment in schizophrenia was clear and hospitalisation was reduced and underpowered data revealed no evidence of a difference between groups for the outcome 'Death due to suicide'.

The abnormalities in the distribution of sensorimotor-supramodal hierarchical processing topography in the cerebellum and cerebellar-cerebral circuits in schizophrenia are investigated using a novel gradient-based resting-state functional connectivity (FC) analysis.

A new cross-validated neuroimaging biomarker that reflects striatal dysfunctioning can be used to distinguish patients with schizophrenia from healthy controls, and is associated with treatment response to antipsychotics.

This bibliometric study mapped out a fundamental knowledge structure consisting of countries, institutions, authors, journals, and articles in the research field of SCZ and inflammation over the past 30 years to provide a comprehensive perspective about the wider landscape of this research area.

Unravelling MGB axis signalling in the context of an evolving dimensional framework in schizophrenia may provide a more complete understanding of the neurobiological architecture of this complex condition and offers the possibility of translational interventions.

The current knowledge on the link between blood levels of sex-hormones in women during the various stages of the female reproductive life and the course of schizophrenia is presented and the clinical approach to women with schizophrenia at these different stages is attempted.

Importance A significant need exists for new antipsychotic medications with different mechanisms of action, greater efficacy, and better tolerability than existing agents. Xanomeline is a dual M 1 /M 4 preferring muscarinic receptor agonist with no direct D 2 dopamine receptor blocking activity. KarXT combines xanomeline with the peripheral muscarinic receptor antagonist trospium chloride with the goal of reducing adverse events due to xanomeline-related peripheral muscarinic receptor activation. In prior trials, xanomeline-trospium chloride was effective in reducing symptoms of psychosis and ...

Converging evidence indicates that genetic and environmental risk factors for schizophrenia underlie disruption of glutamatergic and dopaminergic function, however, while genetic influences may directly underlie glutamatorgic dysfunction, few genetic risk variants directly implicate the dopamine system, indicating that aberrant dopamine signalling is likely to be predominantly due to other factors.

This European Psychiatric Association (EPA) guidance recommends the use of persistent negative symptoms (PNS) construct in the context of clinical trials and highlights the need for further efforts to make the definition of PNS consistent across studies in order to exclude as much as possible secondary negative symptoms.

This abnormal cortical hierarchy organization suggests cascading impairments from the disruption of the somatosensory−motor system and inefficient integration of bottom-up sensory information with attentional demands and executive control processes partially account for high-level cognitive deficits characteristic of schizophrenia.

Findings support ongoing efforts to develop pharmacological interventions that target the glutamate system and could suggest that glutamatergic compounds may be more effective in specific patient subgroups or illness stages.

Schizophrenia is a leading cause of global disability. Current pharmacotherapy for the disease predominantly uses one mechanism - dopamine D2 receptor blockade - but often shows limited efficacy and poor tolerability. These limitations highlight the need to better understand the aetiology of the disease to aid the development of alternative therapeutic approaches. Here, we review the latest meta-analyses and other findings on the neurobiology of prodromal, first-episode and chronic schizophrenia, and the link to psychotic symptoms, focusing on imaging evidence from people with the disorder. Th...

This Review summarizes the evidence for a polygenic architecture of schizophrenia that involves a large number of risk alleles across the whole range of population frequencies and suggests a substantial overlap between schizophrenia and psychiatric, behavioural and cognitive traits, which could influence future disease classifications and mechanistic research.

Recommendations for the treatment of undifferentiated negative symptoms (including both primary and secondary negative symptoms) are provided and although it has proven difficult to formulate an evidence-based recommendation for the choice of an antipsychotic, a switch to a second-generation antipsychotics should be considered.

The dopamine system and the circuits that regulate it, focusing on the hippocampus, medial prefrontal cortex, thalamic nuclei, and medial septum, and the impact of stress are discussed.

In some cases, antipsychotic polypharmacy may produce better results than other forms of treatment augmentation, such as benzodiazepines, and this is likely to hold true for combining other partial dopamine D2 agonists with clozapine as well, although currently scant data exist.

This review first describes the clinical presentation and natural history of cognitive deficits in schizophrenia, then considers aetiological factors, highlighting how a range of similar genetic and environmental factors are associated with both cognitive function and schizophrenia.

The reviews showed that PWS had higher impairment in different cognitive domains compared to healthy controls and people with affective disorders, and greater impairment of cognition was reported in processing speed, verbal memory, and working memory domains.

An overview of the current understanding of the genetics of schizophrenia is provided, remaining challenges are outlined, and future directions of research are summarised, to address current challenges.

The results point toward general network impairment within upper cortical layers as a core substrate associated with schizophrenia symptomatology, and upper-layer neuron vulnerability in schizophrenia is corroborated.

The evidence for aberrant rhythmic activity in schizophrenia is assessed through evaluating studies that have utilized Electro/Magnetoencephalography to examine neural oscillations during sensory and cognitive tasks as well as during resting‐state measurements.

It is found that Succinivibrio and Corynebacterium were associated with the severity of symptoms for the first time, which may provide some new biomarkers for the diagnosis of SZ.

A metagenome-wide association study of schizophrenia (SZ) in human cohorts is presented and SZ-associated specific gut-brain functional modules and pathways including SCFAs and neurotransmitters including neurotransmitter levels in peripheral tissues in recipient mice are identified.