Elevated C-reactive protein levels in schizophrenia inpatients is associated with aggressive behavior.

BACKGROUND: An association between inflammation and behavioral domains of mental disorders is of growing interest. Recent studies reported an association between aggression and inflammation. In this study, we investigated the association between aggressive behavior and inflammatory markers in schizophrenia inpatients. METHODS: Adult schizophrenia inpatients without affective symptoms (n=213) were retrospectively identified and categorized according to their C-reactive protein measurement at admission as either elevated (CRP>1 mg/dL; n=57) or normal (CRP<1 mg/dL; n=156). The following indicators of aggression were compared: PANSS excitement component (PANSS-EC), restraints and suicidal behavior during hospitalization. Univariate comparisons between elevated and normal CRP levels were performed and multivariate analysis was conducted to control for relevant covariates. RESULTS: CRP levels significantly correlated with other laboratory markers indicating increased inflammation including leukocyte count and neutrophil to lymphocyte ratio (r=0.387, P<0.0001 and r=0.356, P<0.0001) respectively. Inpatients with elevated C-reactive protein displayed increased aggressive behavior compared to patients with normal CRP levels (<1 mg/dL). This was manifested by higher rates of restraint during hospitalization (χ(2)=5.22, P=0.031) and increased PANSS-EC score (U=5410.5, P=0.012). Elevated CRP levels were not associated with suicidal behavior. Multivariate analysis revealed that higher PANSS-EC score was associated with elevated CRP after controlling for the covariates age, sex, BMI and smoking. CONCLUSION: This study identified a potential biological correlate (inflammation) of a specific behavioral endophenotype (aggression) in schizophrenia inpatients.

Comparative properties of excitatory and inhibitory inter-laminar neocortical axons.

In recent years it has become increasingly clear that variations in voltage-gated channels, as well as highly diverse geometrical properties, shape the way axons conduct action potentials to their terminals. Numerous cell types in the mammalian neocortex form a dense network of connections, and the properties of their axons may have an effect on the processing performed by this network. We studied the conduction properties of local, inter-laminar axons emanating from regular-spiking (RS) pyramidal neurons and Martinotti type inhibitory neurons (MCs) in layer 5 of the mouse barrel neocortex by comparing the patterns of their antidromic activation from layer 1. Both types of axons had similarly slow conduction velocities ( approximately 0.3 m/s), compatible with thin unmyelinated fibers. In addition, in both types of neurons, subthreshold changes of the somatic membrane potential affected the stimulus threshold for evoking an antidromic spike in layer 1, a distance of 600-800 microm. However, the axons differed considerably in their antidromic activation profiles. 1) The antidromic latency in RS neurons was highly consistent while some MCs display considerable activation-latency jitter; 2) RS neurons displayed a steeper increase in excitability to repeated 40 Hz stimulation; 3) RS neurons displayed a sharp, step-like antidromic activation threshold to both somatic voltage and stimulus intensity, while MCs displayed a gradual recruitment pattern. Morphological differences in the branching pattern of the two types of neurons may account for some of these distinctions. These results suggest differences among excitatory and inhibitory neocortical neurons in the computational tasks of their local axons.

Stroke risk and prevention in Afro-Caribbean populations: improving the rule of halves in hypertension detection and control by primary care - abstract

The Rule of Halves suggests that detection, treatment and control rates of hypertension are only half what they could be, producing a particular burden in black communities because prevalence is high. In the UK with free access to health care, such a `rule' depends on initiatives and effort of primary care teams in blood pressure (BP) screening, case finding and management. As part of our international collaborative project, we assessed the status of the Rule of Halves in our biethnic population sample. Using the Family Health Service population listings (more accurate locally than the Census) as denominators, random samples aged 25 - 79 years were drawn to reflect Afro-Caribbean (AfC) and white European communities. With highly standardized methods and appropriate size cuff, the mean sitting BP is calculated from the 2nd and 3rd readings. With a 65 percent response so far, hypertension prevalence (> 160 and/or 95 mm Hg) is greater in AfCs at 115/311 (37 percent) than in whites at 88/414 (21 percent); while most in both communities knew of their hypertension (80 percent AfC; whites 70 percent), 68 percent AfCs but 48 percent whites were treated; and of these only 22 percent AfCs still had BPs >160/95 mmHg compared with 40 percent whites. However, again, only half of either group (52 percent AfC, 45 percent white) had their BP proper controlled to <150/90mmHg. From these results the Population Attributable Risk (PAR) of stroke was calculated to be 51 percent for AfCs and 37 percent for whites, with 29 percent and 22 percent respectively, of strokes due to poor BP control. Even if there is over-ascertainment here, assuming all non-responders were not hypertensive would only reduce the respective PAR to 48 percent and 28 percent. Thus, there is considerable awareness of hypertension in the AfC community and the Rule of Halves has improved, although little change is seen in whites (AU)