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The neurobiology of severe and repetitive violence in schizophrenia: A 1H MRS study of frontal lobe
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Choline signal from all three areas sampled was associated with earlier onset of non-specific behaviour deviance. Conclusions: The observed associations indicate the frontal lobe dysfunction is implicated in the expression of psychosis in early onset schizophrenia. More generalised changes in neuronal membrane metabolism may be associated with prodromal non-psychotic symptoms.
A.262. THE NEUROBIOLOGY OF SEVERE AND REPETITIVE VIOLENCE IN SCHIZOPHRENIA: A 1H MRS STUDY OF FRONTAL LOBE
N. Tunstall, D. Robertson, H. Critchley, T. van Amelsvoort, E. Daly, D.G.M. Murphy Institute o f Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
Schizophrenia is associated with a significantly increased prevalence of violent crime. However, it is unknown if violent behaviour is related to abnormalities in frontal neural integrity in schizophrenia. Thus, we used 1H MRS in people with a history of severe and repetitive violence and non-violent controls to investigate the neurobiological correlates of violent behaviour. We studied 10 repetitively violent non-psychotic inpatients, 6 violent people with psychosis and 10 non-violent matched controls. Frontal-l-H MRS was obtained with a 1.5 Signa NMR system, using a press PRESS sequence (TR/TE 2000/136ms) after CHESS water suppression. Spectra were processed and analysed using SAGE/IDL software. Compared to controls, non-psychotic violent patients had a significantly (p<0.05) decreased concentration of creatine (Cr) and N-acetlyaspartate (NAA). Moreover, number of violent episodes/month negatively correlated with NAA (p<0.008) and Cr (p <0.02) concentration. Violent schizophrenics had a significant decrease in NAA, and increase in choline (Cho) concentrations, and NAA/Cho negatively correlated with violence (p <0.002). NAA, Cr and Cho are measures of neuronal density, cellular metabolism, and membrane turnover. Thus, repetitive violence in people with schizophrenia is associated with abnormalities in neural integrity of frontal lobe, and the increase in prevalence of violence in people with schizophrenia may have a biological basis.
A.263. V I O L E N C E A N D P S Y C H O S I S : A N MRI AND PROTON MRS STUDY OF MEDIAL TEMPORAL LOBE IN VIOLENT PEOPLE WITH AND WITHOUT SCHIZOPHRENIA N. Tunstall, D. Robertson, H. Critchley, T. van Amelsvoort, E. Daly, D . G . M . Murphy
Institute o f Psychiatry, De Crespigny Park, Denmark Hill. London SE5 8AF, UK
Schizophrenia is associated with an increased prevalence of violent crime, and the neurobiology of violence is poorly understood. Amygdalo-hippocampal complex (AHC) is implicated in the pathology of both psychosis and violence. Thus, we used volumetric magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (IH MRS) to study morphometry and neural integrity of AHC of 12 severely violent Nil of note psychotic people, 8 violent schizophrenics, and 20 controls. We used a 1.5 T GE Signa NMR and acquired a 3-D spoiled grass MRI dataset. MRS data was acquired from the right AHC using a PRESS sequence (TR/TE 2000/136 ms) after CHESS water suppression, and spectra were processed and analysed using SAGE/IDL software. Compared to controls violent people had a significantly ( 1) smaller volume of hippocampus bilaterally, (2) smaller ratio of NAA/Cr+PCr in the AHC, and (3) greater difference in R-L asymmetry of amygdala volume. Also, within violent people there were significant correlations between frequency of violence and R-L asymmetry of hippocampal volume, and ratios of NAA/Cho, and Cho/Cr+PCr in the AHC. Thus, severely and repetitively violent people have neurobiological differences from controls in brain areas known to be implicated in aggressive behaviour and psychosis, and neurobiological abnormalities may account for a significant proportion of violence in people with schizophrenia.
A.264. F R O N T O T E M P O R A L INTEGRITY IN CHILDREN AND ADOLESCENTS AT RISK FOR SCHIZOPHRENIA M.S. Keshavan, M. Zeigler, D. Montrose, S. Spencer, J.A. Sweeney Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15213, USA
Studies of children and adolescent offspring at familial risk for schizophrenia offer an opportunity for identifying the neurobehavioral and biological precursors of this illness. Methods: In this ongoing study, to date, we have examined the behavioral, structural and functional integrity of the frontal and temporal cortex, using Magnetic Resonance Imaging (MRI), Spectroscopy (MRS) and functional MRI in a series of 37 high-risk offspring of a schizophrenic parent (HR-S) and 40 age- and sex-matched healthy controls (HC) without psychiatric family history. Results: The following are our statistically significant observations in HR-S subjects: (i) increased frequency of nonpsychotic Axis I disorder, especially attention deficit hyperactivity disorder (n=6); (ii) elevations in teacher and parent rated Child behavioral Ceck-list ratings on attention, and frontotemporal neurological abnormalities; (iii) attentional impairment
Choline signal from all three areas sampled was associated with earlier onset of non-specific behaviour deviance. Conclusions: The observed associations indicate the frontal lobe dysfunction is implicated in the expression of psychosis in early onset schizophrenia. More generalised changes in neuronal membrane metabolism may be associated with prodromal non-psychotic symptoms.
A.262. THE NEUROBIOLOGY OF SEVERE AND REPETITIVE VIOLENCE IN SCHIZOPHRENIA: A 1H MRS STUDY OF FRONTAL LOBE
N. Tunstall, D. Robertson, H. Critchley, T. van Amelsvoort, E. Daly, D.G.M. Murphy Institute o f Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
Schizophrenia is associated with a significantly increased prevalence of violent crime. However, it is unknown if violent behaviour is related to abnormalities in frontal neural integrity in schizophrenia. Thus, we used 1H MRS in people with a history of severe and repetitive violence and non-violent controls to investigate the neurobiological correlates of violent behaviour. We studied 10 repetitively violent non-psychotic inpatients, 6 violent people with psychosis and 10 non-violent matched controls. Frontal-l-H MRS was obtained with a 1.5 Signa NMR system, using a press PRESS sequence (TR/TE 2000/136ms) after CHESS water suppression. Spectra were processed and analysed using SAGE/IDL software. Compared to controls, non-psychotic violent patients had a significantly (p<0.05) decreased concentration of creatine (Cr) and N-acetlyaspartate (NAA). Moreover, number of violent episodes/month negatively correlated with NAA (p<0.008) and Cr (p <0.02) concentration. Violent schizophrenics had a significant decrease in NAA, and increase in choline (Cho) concentrations, and NAA/Cho negatively correlated with violence (p <0.002). NAA, Cr and Cho are measures of neuronal density, cellular metabolism, and membrane turnover. Thus, repetitive violence in people with schizophrenia is associated with abnormalities in neural integrity of frontal lobe, and the increase in prevalence of violence in people with schizophrenia may have a biological basis.
A.263. V I O L E N C E A N D P S Y C H O S I S : A N MRI AND PROTON MRS STUDY OF MEDIAL TEMPORAL LOBE IN VIOLENT PEOPLE WITH AND WITHOUT SCHIZOPHRENIA N. Tunstall, D. Robertson, H. Critchley, T. van Amelsvoort, E. Daly, D . G . M . Murphy
Institute o f Psychiatry, De Crespigny Park, Denmark Hill. London SE5 8AF, UK
Schizophrenia is associated with an increased prevalence of violent crime, and the neurobiology of violence is poorly understood. Amygdalo-hippocampal complex (AHC) is implicated in the pathology of both psychosis and violence. Thus, we used volumetric magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (IH MRS) to study morphometry and neural integrity of AHC of 12 severely violent Nil of note psychotic people, 8 violent schizophrenics, and 20 controls. We used a 1.5 T GE Signa NMR and acquired a 3-D spoiled grass MRI dataset. MRS data was acquired from the right AHC using a PRESS sequence (TR/TE 2000/136 ms) after CHESS water suppression, and spectra were processed and analysed using SAGE/IDL software. Compared to controls violent people had a significantly ( 1) smaller volume of hippocampus bilaterally, (2) smaller ratio of NAA/Cr+PCr in the AHC, and (3) greater difference in R-L asymmetry of amygdala volume. Also, within violent people there were significant correlations between frequency of violence and R-L asymmetry of hippocampal volume, and ratios of NAA/Cho, and Cho/Cr+PCr in the AHC. Thus, severely and repetitively violent people have neurobiological differences from controls in brain areas known to be implicated in aggressive behaviour and psychosis, and neurobiological abnormalities may account for a significant proportion of violence in people with schizophrenia.
A.264. F R O N T O T E M P O R A L INTEGRITY IN CHILDREN AND ADOLESCENTS AT RISK FOR SCHIZOPHRENIA M.S. Keshavan, M. Zeigler, D. Montrose, S. Spencer, J.A. Sweeney Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15213, USA
Studies of children and adolescent offspring at familial risk for schizophrenia offer an opportunity for identifying the neurobehavioral and biological precursors of this illness. Methods: In this ongoing study, to date, we have examined the behavioral, structural and functional integrity of the frontal and temporal cortex, using Magnetic Resonance Imaging (MRI), Spectroscopy (MRS) and functional MRI in a series of 37 high-risk offspring of a schizophrenic parent (HR-S) and 40 age- and sex-matched healthy controls (HC) without psychiatric family history. Results: The following are our statistically significant observations in HR-S subjects: (i) increased frequency of nonpsychotic Axis I disorder, especially attention deficit hyperactivity disorder (n=6); (ii) elevations in teacher and parent rated Child behavioral Ceck-list ratings on attention, and frontotemporal neurological abnormalities; (iii) attentional impairment