pubmed.ncbi.nlm.nih.gov

Cortical neuritic plaques and hippocampal neurofibrillary tangles are related to dementia severity in elderly schizophrenia patients - PubMed

Cortical neuritic plaques and hippocampal neurofibrillary tangles are related to dementia severity in elderly schizophrenia patients

Michael A Rapp et al. Schizophr Res. 2010 Jan.

Abstract

Cognitive decline has been described in elderly patients with schizophrenia, but the underlying pathology remains unknown. Some studies report increases in plaques and neurofibrillary tangles, but there is no evidence for an increased risk for Alzheimer's disease (AD) in elderly schizophrenics. Models of a decreased cerebral reserve suggest that increases in AD-related neuropathology below the threshold for a neuropathological diagnosis could be related to dementia severity in elderly schizophrenia patients. We tested this hypothesis in 110 autopsy specimens of schizophrenia patients, without a neuropathological diagnosis of AD or other neurodegenerative disorders. Furthermore, we assessed the effects of apolipoprotein E (ApoE) status, a known genetic risk factor for AD. Measures of density of neuritic plaques were obtained in five cortical regions, and the degree of hippocampal neurofibrillary tangles was rated. Dementia severity was measured prior to postmortem using the Clinical Dementia Rating (CDR) scale. multivariate analyses of variance were conducted with the factors dementia severity, by ApoE4 carrier status. Hippocampal neurofibrillary tangles correlated with increased dementia severity (p<.05). Neuritic plaque density increased with greater dementia severity (p<.005), and ApoE4 carrier status (p<.005), and these differences were magnified by the ApoE4 carrier status (p<.01). Even below the threshold for a neuropathological diagnosis of AD, neuritic plaques and hippocampal neurofibrillary tangles are associated with dementia severity in schizophrenia patients, even more so in the presence of genetic risk factors, suggesting that a decreased cerebral reserve in elderly schizophrenics may increase susceptibility for dementia.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest. MAR has received speaker honoraria from Servier, Inc., Janssen, Inc., and Glaxo Smith Kline, Inc.

Similar articles

Cited by

References

    1. Akbarian S, Bunney WE, Jr., Potkin SG, Wigal SB, Hagman JO, Sandman CA, Jones EG. Altered distribution of nicotinamide–adenine dinucleotide phosphate–diphorase cells in frontal lobe of schizophrenics implies disturbances of cortical development. Arch. Gen. Psychiat. 1993;50:169–177. - PubMed
    1. Akbarian S, Kim JJ, Potkin SG, Hetrick WP, Bunney WE, Jr., Jones EG. Maldistribution of interstitial neurons in prefrontal white matter of the brain of the schizophrenic patients. Arch. Gen. Psychiat. 1996;53:425–436. - PubMed
    1. Alzheimer A. Beiträge zur Pathologischen Anatomie der Hirnrinde und zur anatomischen Grundlage der Psychosen. Mschr. Psychiat. Neurol. 1897;2:82–112.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Third Edition, Revised. Washington, DC: American Psychiatric Association; 1987.
    1. Arnold SE, Franz BR, Trojanowski JQ. Elderly patients with schizophrenia exhibit infrequent neurodegenerative lesions. Neurobiol. Aging. 1994;15:299–303. - PubMed

Publication types

MeSH terms

Substances