ABSTRACT
Although the precise pathogenesis of schizophrenia is unknown, genetic, biomarker and imaging studies suggest involvement of the immune system. In this study, we performed a systematic review and meta-analysis of studies investigating factors related to the immune system in postmortem brains of schizophrenia patients and healthy controls. Forty-one studies were included, reporting on 783 patients and 762 controls. We divided these studies into those investigating histological alterations of cellular composition and those assessing molecular parameters; meta-analyses were performed on both categories. Our pooled estimate on cellular level showed a significant increase in the density of microglia (P=0.0028) in the brains of schizophrenia patients compared with controls, albeit with substantial heterogeneity between studies. Meta-regression on brain regions demonstrated this increase was most consistently observed in the temporal cortex. Densities of macroglia (astrocytes and oligodendrocytes) did not differ significantly between schizophrenia patients and healthy controls. The results of postmortem histology are paralleled on the molecular level, where we observed an overall increase in expression of proinflammatory genes on transcript and protein level (P=0.0052) in patients, while anti-inflammatory gene expression levels were not different between schizophrenia and controls. The results of this meta-analysis strengthen the hypothesis that components of the immune system are involved in the pathogenesis of schizophrenia.
Subject(s)
Brain/pathology , Microglia/pathology , Schizophrenia/pathology , Astrocytes/pathology , Autopsy , Brain/immunology , Case-Control Studies , Cell Count , Humans , Inflammation , Microglia/immunology , Oligodendroglia/pathology , Schizophrenia/immunology , Temporal Lobe/immunology , Temporal Lobe/pathology , TranscriptomeABSTRACT
Auditory verbal hallucinations (avh) are known to occur in relative isolation in various psychiatric disorders and as well in autism spectrum disorder (ASD). Up till now, research into the occurrence of auditory verbal hallucinations in patients who have a psychiatric disorder and ASD has been very limited. In order to give some indication about the effects of such a combination in one individual, we present a case-description of a 37-year-old man diagnosed with both pervasive developmental disorder--not otherwise specified (pdd-nos) and a mild intellectual disability. He was treated at the specialised outpatient 'Voices Clinic' of the University Hospital in Utrecht UMC. The patient responsed well treatment.
