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Biomedical subjects

W G Honer

Publications and source records attributed to W G Honer.

At least 73 records · Page 4Linked to original sources
PubMed1997

Extrapyramidal signs and clinical symptoms in first-episode schizophrenia: response to low-dose risperidone.

The purpose of this study was to determine the prevalence of extrapyramidal signs or symptoms (EPS) and clinical symptoms in first-episode schizophrenia, before any treatment, during and after treatment with a novel antipsychotic, risperidone. Twenty-two (17 men; 5 women) patients were examined using the Extrapyramidal Symptom Rating Scale, Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions-Severity of Illness and Improvement, and Global Assessment of Functioning. Three patients (14%) had distinct EPS at baseline, whereas all were free of EPS after treatment with risperidone. On the maximum dose of risperidone (5-8 mg), 32% of the total sample developed mild akathisia or parkinsonism, both of which diminished with dosage reduction. No clinically significant EPS were observed in patients receiving 2 to 4 mg of risperidone. Analysis of symptom response of the lower (2-4 mg) versus the higher (5-8 mg) doses of risperidone resulted in superior outcome in the 2- to 4-mg group for all three symptom clusters of the PANSS. In addition, 91% of the low-dose group achieved a 20% or greater reduction in total PANSS score compared with 27% for the high-dose group. These findings have clinical relevance directed at the early and longer-term treatment of schizophrenia.

Adolescent↗
PubMed1997

A comprehensive method of assessing routine CT scans in schizophrenia.

Morphological brain abnormalities are common in schizophrenia, although the aetiological and clinical significance of these findings is largely unknown. Substantial between-subject variability suggests that large samples are needed to study the full implications of brain pathomorphology. Computerized tomography (CT) is frequently used routinely in schizophrenia, and large numbers of scans are available for study. This article describes the development and statistical properties of a rapid and simple method of assessing CT scans. The CT Rating Scale for Schizophrenia (CTRSS) is minimally affected by variability in scanning procedures, is reliable, and accurately estimates area and volumetric measures of brain spaces. By promoting the comprehensive assessment of large numbers of routinely obtained scans, the CTRSS would allow the investigation of variables that may systematically affect results (e.g. gender and age) and variables with low prevalence. The CTRSS provides a useful adjunct to technologically more sophisticated methods of assessment such as magnetic resonance imaging (MRI).

Adult↗
PubMed1997

Schizencephaly associated with psychosis.

Schizencephaly is a rare disorder of brain development resulting in the formation of abnormal unilateral or bilateral clefts in the cerebral hemispheres. It is often accompanied by partial seizures, mental retardation, and hemiparesis. Two patients are described with clear psychotic symptoms with either unilateral or bilateral schizencephaly. The implications of the association between schizencephaly and psychosis in these patients for understanding the biology of the psychoses are discussed.

Adult↗
PubMed1997

Clinical features of schizophrenia in a woman with hyperandrogenism.

Ample evidence supports sex differences in the clinical features of schizophrenia. In this regard, estrogen may contribute to later onset and less severe course of illness in women. Direct investigation of hormonal status in schizophrenia is extremely difficult. The present report documents the clinical features of schizophrenia in a young woman with long-standing hyperandrogenism related to polycystic ovarian disease. We postulate that hyperandrogenism contributed to a relatively early onset, olfactory dysfunction, and other clinical features of schizophrenia more commonly associated with men. Additionally, acute estrogen depletion following cessation of oral contraceptives may have precipitated psychosis, while recommencement of oral contraceptives could have contributed to subsequent improvement in symptoms.

Adult↗
PubMed1996

Obstetric complications and age-related changes in brain morphology in schizophrenia.

Birth problems can lead to changes in brain morphology in the general population and an increased prevalence of both birth problems and altered brain morphology are found in patients with schizophrenia. The purpose of this study was to test the hypothesis that these two findings are related. Birth history and the size of ventricular and sulcal spaces from nine regions of the brain were assessed in 80 male subjects with schizophrenia. No differences were found between patients with and those without a history of birth problems for the size of any brain space; however, ventricular size increased significantly with age in patients who had no birth complications but not in patients with a history of birth problems. The size of cortical sulci increased with age in patients with and those without a history of birth problems. These results suggest that region-specific rates of change in size may identify clinically meaningful patients subgroups.

Adolescent↗
PubMed1996

Reproductive fitness in familial schizophrenia.

BACKGROUND: Reproductive fitness is an important factor in understanding inheritance in genetic disorders. The purpose of this study was to determine whether fitness is reduced in familial schizophrenia (FS) and if fitness in siblings differs from the norm. METHOD: The number of offspring in 36 subjects with RDC schizophrenia or schizoaffective disorder (SZ) and their 101 siblings from large FS families was compared with age-adjusted census figures. RESULTS: Fitness in the SZ group was significantly reduced: 23% of expected in males and 51% of expected in females. Fitness of unaffected siblings was within census expectations. However, female siblings with schizophrenia spectrum features had increased fitness over census norms. Reduced fitness was correlated with low marital rates, poor functioning and positive symptoms. CONCLUSIONS: These results indicate that reduced fitness is an important genetic force in FS and is likely inherent to the illness. Sex differences are important and would need to be considered when examining maternal and paternal transmission of schizophrenia. The results support a proposed high mutation rate for schizophrenia, consistent with a dynamic mutation mechanism.

Adolescent↗
PubMed1996

Left cerebral hemiatrophy and schizophrenia-like psychosis in an adolescent.

A previous report of cerebral hemiatrophy and schizophrenia added to the list of neurodevelopmental abnormalities associated with schizophrenia. In a new case, the birth history indicated perinatal hemorrhage and prematurity (30-31 weeks of gestation). CT and MR imaging showed reduction in left hemisphere size with ventricular enlargement and mild skull thickening. Loss of periventricular white matter was detected. Changes in skull thickness, size of air cells and volume of the cranial vault may be measurable correlates of putative developmental abnormalities in schizophrenia.

Adolescent↗
PubMed1996

A case study of temporal lobe development in familial schizophrenia.

Case studies of patients with familial schizophrenia may help to define the pathophysiology of this illness and indicate potential candidate genes for genetic linkage studies. In this regard, the clinical, radiological and pathological assessments of a 39-year-old affected man from a pedigree with familial schizophrenia are presented. Brain imaging with CT indicated moderate cortical atrophy, particularly of the temporal lobes. Neuropathological examination revealed granular ependymitis, indicating possible past ventricular pathology. Granular ependymitis was reported to occur in genetic developmental disorders with neuronal migration abnormalities. In the present case, heterotopic clusters of neurons were visualized in the entorhinal cortex, suggesting that temporal lobe development was not entirely normal. This case study suggests that genetic factors could be investigated further as one possible aetiology of certain neurodevelopmental abnormalities observed in schizophrenia.

Adult↗
PubMed1996

Linkage analysis between schizophrenia and the Darier's disease region on 12q.

There have been reports of an association between Darier's disease, an autosomal dominant genodermatosis, and psychiatric illness. Recently the gene causing Darier's disease has been mapped to an area on 12q, between D12S58 and D12S84. The findings of linkage analysis of 4 markers in the Darier's disease region on 12q in five families segregating schizophrenia are presented. They fail to support close linkage between schizophrenia and the Darier's disease region on 12q.

Adult↗
PubMed1996

A centralized system for monitoring clozapine use in British Columbia.

The Clozapine Resource Centre in British Columbia is a centralized information source for all physicians wishing to prescribe clozapine and also performs back-up hematological and compliance monitoring. Laboratories fax weekly hematology results to physicians and to the center. The center enters results in a national database and compiles twice-weekly noncompliance reports; physicians are notified of abnormal results, and caregivers of noncompliance. The centralized system obviates the practice in some jurisdictions of hiring case coordinators to oversee these procedures and may reduce physician reluctance to prescribe clozapine. It improves coordination among monitoring and treatment parties and ensures better continuity of care.

Adverse Drug Reaction Reporting Systems↗
PubMed1996

Search for unstable DNA in schizophrenia families with evidence for genetic anticipation.

Evidence for genetic anticipation has recently become an important subject of research in clinical psychiatric genetics. Renewed interest in anticipation was evoked by molecular genetic findings of a novel type of mutation termed "unstable DNA." The unstable DNA model can be construed as the "best fit" for schizophrenia twin and family epidemiological data. We have performed a large-scale Southern blot hybridization, asymmetrical PCR-based, and repeat expansion-detection screening for (CAG)n/(CTG)n and (CCG)n/(CGG)n expansions in eastern Canadian schizophrenia multiplex families demonstrating genetic anticipation. There were no differences in (CAG)n/(CTG)n and (CCG)n/(CGG)n pattern distribution either between affected and unaffected individuals or across generations. Our findings do not support the hypothesis that large (CAG)n/(CTG)n or (CCG)n/(CGG)n expansions are the major etiologic factor in schizophrenia. A separate set of experiments directed to the analysis of small (30-130 trinucleotides), Huntington disease-type expansions in individual genes is required in order to fully exclude the presence of (CAG)n/(CTG)n- or (CCG)n/(CGG)n-type unstable mutation.

Blotting, Southern↗
PubMed1995

The temporal lobes, reversed asymmetry and the genetics of schizophrenia.

Mechanisms determining temporal lobe structural asymmetries may be involved in the pathogenesis of schizophrenia. To investigate the temporal lobes in familial schizophrenia, computed tomographic scans were obtained from 51 subjects (seven families). Enlargement of sylvian fissures and temporal lobe sulcal spaces was observed in family members with schizophrenia. The posterior one-third of the sylvian fissure was larger on the left side in subjects with schizophrenia, and larger on the right side in unaffected individuals. This disturbed pattern of posterior sylvian fissure asymmetry suggests that adjacent language regions may be affected in schizophrenia. An intermediate degree of disturbance in subjects who had schizophrenia-related illnesses or were obligate carriers suggests that genetic factors may be important determinants of temporal lobe asymmetries in familial schizophrenia.

Adult↗
PubMed1995

Developmental abnormalities and cortical sulcal enlargement in psychosis.

Neurodevelopmental abnormalities and cortical sulcal enlargement both occur in schizophrenia. To test the hypothesis that these abnormalities were related, CT scans from 164 psychotic patients (80 with schizophrenia) were reviewed. Neurodevelopmental abnormalities were observed in 11%. Abnormalities were equally prevalent in schizophrenia and other psychotic disorders. Cortical sulcal enlargement was observed in 39% of patients with schizophrenia, and was not associated with developmental abnormalities. Different mechanisms may contribute to distinct structural abnormalities.

Adolescent↗
PubMed1995

Olfactory identification ability in pre- and postmenopausal women with schizophrenia.

Previously we reported olfactory deficits in young male but not female patients with schizophrenia. In the present report, olfactory identification ability in pre- and postmenopausal women with schizophrenia and normal control subjects was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). Additionally, serum estradiol levels were measured on the same 2 days as smell testing was completed. Olfactory deficits were observed in pre- and postmenopausal women with schizophrenia but were more pronounced in the postmenopausal patients. Regarding estradiol levels, women with schizophrenia had lower estradiol levels than did normal control subjects. The findings of this study indicate that olfactory deficits do exist in women with schizophrenia and may be accentuated by estrogen depletion.

Adult↗
PubMed1995

Regional cortical anatomy and clozapine response in refractory schizophrenia.

Regional measures of cortical sulcal and ventricular enlargement on computed tomography scan were studied in a clinical sample of patients treated with clozapine. Cortical sulci were significantly enlarged in clozapine nonresponders compared to responders. The Clinical Global Impressions score at discharge was related to the size of the posterior frontal and lateral temporal sulci, with large sulci predicting a poorer response to clozapine treatment.

Adult↗