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Neuropeptide Y like immunoreactivity with clinical measures J. Peters, J. Gelernter,
in schizophrenia:
Relationships
J. Gurklis, J. Yao, D.P. van Kammen*
Psychiatry Service, Highland Drive VXMC, Pittsburgh, PA 15206, U.S.A.
Neuropeptide Y (NPY), a 36-amino acid peptide, has received attention in the past eight years. This study addressed a) NPY-like immunoreactivity (NPY-li) between patients and controls, b) NPY-li and structural brain changes, c) NPY-li and state-dependent measures and d) NPY-li and the effects of haloperidol withdrawal in schizophrenia. Thirty-five physically healthy, consenting male schizophrenics (DSM-III-R, mean age 34 + 7.8 years, range 21-51 years, mean duration of illness 11 2 6.8 years) received a CTscan and an LP while on haloperidol (mean dose 12 f 8.9 mgday), and an LP after haloperidol withdrawal (mean 35 f 14.2 days, range 10 -57 days). Eleven patients met relapse criteria while drug free. CSF NPY-Ii was significantly elevated in patients compared to drug-free normal controls. CSF NPY-Ii decreased with age and longer duration of illness, and did not correlate with height or weight. Lower CSF NPY-Ii levels correlated with prefrontal sulcal widening. Relationships between NPY-li and positive schizophrenic symptoms were observed only in the clinically stable (nonrelapsed) drug-free patients. Haloperidol withdrawal resulted in a significant CSF NPY-Ii elevation in the 31 patients who completed both procedures. There was no difference in NPY-li between relapsers and nonrelapsers after 6 weeks of haloperidol withdrawal. The results raise the possibility that elevated NPY-li suggest a vulnerability to schizophrenia.
Cerebrospinal fluid concentrations of dopamine and serotonin metabolites in patients with schizophrenia and schizoaffective disorder: The significance of positive and negative symptoms E.D. Risby*, R.R.J. Lewine, R.D. Jewart, M. Stipetic, B.A. Faraj, V.M. Camp, J. Caudle, M. Eccard, S.C. Rische Department of Psychiatry, Emory UniversitySchool of Medicine, Atlanta, GA 30322, USA. The positive and negative symptoms of schizophrenia and schizoaffective disorder may have distinct neuropathologic mechanisms. Brain Magnetic Resonance Imaging (MRI) and lumbar punctures were obtained in 14 drug-free patients with a Research Diagnostic Criteria diagnosis of schizophrenia (n = 7) or schizoaffective disorder (n = 7) and 11 normal control subjects. Patients were grouped based on the predominance of positive (n = 6) or negative (n = 8) symptoms. Cerebrospinal fluid was assayed for dopamine sulfate (DAS04), homovanillic acid (HVA), and 5-hyroxyindoleacetic acid (5HIAA). Patients with predominantly negative symptoms had significantly higher DAS04 (pmol/ml) concentrations that patients with predominantly positive symptoms (6.3 f 3.5 vs 2.3 + 0.5; p, < .004) and normal controls (2.9 2 1.7; p, < .02). DAS04 was positively correlated with the negative symptom cluster of the BPRS (r = .67, p, < .Ol), but did not correlate with HVA. Neither HVA nor SHIM concentrations were significantly different among the three groups. There was a trend, however, for SHIAA concentrations to be lower and the HVA/SHIAA ratio to be higher, in the patients with predominantly positive symptoms compared to controls. There was no difference in the incidence of clinically abnormal MRI’s between the two patient groups. These findings support the hypothesis that the etiology of positive and negative symptoms involves different biochemical mechanisms.