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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53582#.VMnd2CzQrzE
Affiliation(s)
1The University of Adelaide, Adelaide, Australia.
2The Queen Elizabeth Hospital, Woodville, Australia.
3Basil Hetzel Institute for Translational Health Research, Woodville, Australia.
4Youth in Mind Research Institute, Norwood, Australia.
2The Queen Elizabeth Hospital, Woodville, Australia.
3Basil Hetzel Institute for Translational Health Research, Woodville, Australia.
4Youth in Mind Research Institute, Norwood, Australia.
ABSTRACT
Background:
Neuroscience can assist clinical understanding and therapy by finding
neurobiological markers for mental illness symptoms. Objectives: To
quantify biomarkers for schizophrenia and schizoaffective disorder and
relate these to discrete symptoms of psychosis. Methods: Within a
case-control design with multiple exclusion criteria to exclude organic
causes and confounding variables, 67 DSM IV-R diagnosed and 67 control
participants from a defined hospital, clinic and community catchment
area were investigated for candidate markers. Participants underwent
protocol-based diagnostic-checking and symptom rating via Brief
Psychiatric Rating Scale and Positive and Negative Syndrome Scale,
functional-rating scales, biological sample-collection and
sensory-processing assessment. Blood and urine samples were analysed for
monoamine neurotransmitters, their metabolites, vitamin cofactors and
intermediate-substances related to oxidative stress and metabolism of
monoamines. Neurocognitive assessment of visual and auditory processing
was conducted at both peripheral and central levels. Biomarkers were
defined by Receiver Operating Curve (ROC) analysis. Spearman’s analysis
explored correlations between discrete symptoms and the biomarkers.
Results: Receiver Operating Curve (ROC) analysis identified twenty-one
biomarkers: elevated urinary dopamine, noradrenaline, adrenaline and
hydroxy pyrroline-2-one as a marker of oxidative stress. Other
biomarkers were deficits in vitamins D, B6 and folate, elevation of
serum B12 and free serum copper to zinc ratio, along with deficits in
dichotic listening, distance vision, visual and auditory speed of
processing, visual and auditory working memory and six middle ear
acoustic reflex parameters. Discrete symptoms such as delusions,
hostility, suicidality and auditory hallucinations were
biomarker-defined and symptom biomarker correlations assumed an
understandable pattern in terms of the catecholamines and their
relationship to biochemistry, brain function and disconnectivity.
Conclusions: In the absence of a full diagnosis,
biomarker-symptom-signatures inform psychiatry about the structure of
psychosis and provide an understandable pattern that points in the
direction of a new neurobiological system of symptom-formation and
treatment.
Cite this paper
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