This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (90)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Neurology  • Dementias  • Schizophrenia  • Alert me on articles by topic  Social Bookmarking   What's this?

Steven E. Arnold, MD; John Q. Trojanowski, MD, PhD; Raquel E. Gur, MD, PhD; Peter Blackwell; Li-Ying Han, MS; Catherine Choi

Arch Gen Psychiatry. 1998;55:225-232.

Background  The cognitive and functional deterioration that is observed in many "poor-outcome" patients with schizophrenia suggests a neurodegenerative process extending into late life. Previous diagnostic studies have excluded known neurodegenerative diseases as explanations for this dementia. However, we hypothesized that relatively small accumulations of age- or disease-related neurodegenerative lesions occurring in an otherwise abnormal brain could result in deterioration in schizophrenia.

Methods  Postmortem studies were conducted using 23 prospectively accrued elderly persons with chronic schizophrenia for whom clinical ratings had been determined before death, 14 elderly control patients with no neuropsychiatric disease, and 10 control patients with Alzheimer disease. Immunohistochemistry and unbiased stereological counting methods were used to quantify common neurodegenerative lesions (ie, neurofibrillary tangles, amyloid plaques, and Lewy bodies) and cellular reactions to a variety of noxious stimuli (ubiquitinated dystrophic neurites, astrocytosis, and microglial infiltrates) in the ventromedial temporal lobe and the frontal and the calcarine (primary visual) cortices.

Results  No statistically significant differences were found between the patients with schizophrenia and the control patients without neuropsychiatric disease for the densities of any of the markers, while both groups exhibited fewer lesions than did the control group with Alzheimer disease. Correlation analyses in the schizophrenia sample failed to identify significant correlations between cognitive and psychiatric ratings and densities of any of the neuropathologic markers.

Conclusions  No significant evidence of neurodegeneration or ongoing neural injury in the cerebral cortex was found in this sample of elderly persons with schizophrenia. Furthermore, the behavioral and cognitive deterioration observed in late life did not correlate with age-related degenerative phenomena.

From the Departments of Psychiatry (Drs Arnold and Gur, Mr Blackwell, and Mss Han and Choi), Neurology (Drs Arnold and Gur), and Pathology and Laboratory Medicine (Dr Trojanowski), University of Pennsylvania School of Medicine, Philadelphia.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Neuroinflammation in Schizophrenia-Related Psychosis: A PET Study
Doorduin et al.
JNM 2009;50:1801-1807.
ABSTRACT | FULL TEXT  

Frontotemporal dementia presenting as schizophrenia-like psychosis in young people: clinicopathological series and review of cases
Velakoulis et al.
Br. J. Psychiatry 2009;194:298-305.
ABSTRACT | FULL TEXT  

Increased cerebrospinal fluid and serum levels of S100B in first-onset schizophrenia are not related to a degenerative release of glial fibrillar acidic protein, myelin basic protein and neurone-specific enolase from glia or neurones.
Steiner et al.
J. Neurol. Neurosurg. Psychiatry 2006;77:1284-1287.
ABSTRACT | FULL TEXT  

Amyloid {beta} Pathology in Alzheimer's Disease and Schizophrenia
Religa et al.
Am. J. Psychiatry 2003;160:867-872.
ABSTRACT | FULL TEXT  

Gene Expression Profile for Schizophrenia: Discrete Neuron Transcription Patterns in the Entorhinal Cortex
Hemby et al.
Arch Gen Psychiatry 2002;59:631-640.
ABSTRACT | FULL TEXT  

Neurotoxicity, Neuroplasticity, and Magnetic Resonance Imaging Morphometry: What Is Happening in the Schizophrenic Brain?
Weinberger and McClure
Arch Gen Psychiatry 2002;59:553-558.
FULL TEXT  

Neuronal nicotinic acetylcholine receptors: involvement in Alzheimer's disease and schizophrenia.
Woodruff-Pak and Gould
Behav Cogn Neurosci Rev 2002;1:5-20.
ABSTRACT  

Dementia as a complication of schizophrenia
de Vries et al.
J. Neurol. Neurosurg. Psychiatry 2001;70:588-596.
ABSTRACT | FULL TEXT  

Increased Neocortical Neurofibrillary Tangle Density in Subjects With Alzheimer Disease and Psychosis
Farber et al.
Arch Gen Psychiatry 2000;57:1165-1173.
ABSTRACT | FULL TEXT  

Late-Onset Schizophrenia and Very-Late-Onset Schizophrenia-Like Psychosis: An International Consensus
Howard et al.
Am. J. Psychiatry 2000;157:172-178.
ABSTRACT | FULL TEXT  

Cognitive Deficits and Psychopathology in Institutionalized versus Community-Dwelling Elderly Schizophrenia Patients
Evans et al.
J Geriatr Psychiatry Neurol 1999;12:11-15.
ABSTRACT  

The neuropathology of schizophrenia: A critical review of the data and their interpretation
Harrison
Brain 1999;122:593-624.
ABSTRACT | FULL TEXT  

Protease resistant prion proteins are not present in sporadic "poor outcome" schizophrenia
Arnold et al.
J. Neurol. Neurosurg. Psychiatry 1999;66:90-92.
ABSTRACT | FULL TEXT  

Senile Degeneration and Cognitive Impairment in Chronic Schizophrenia
Dwork et al.
Am. J. Psychiatry 1998;155:1536-1543.
ABSTRACT | FULL TEXT