From: "Philip James" <[log in to unmask]>
Subject: hbo-list: Mid brain syndromes
Date: Fri, 17 May 2000 09:27:44 +0
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Dear David
Fetal Hypoxia Linked To Early - Onset Schizophrenia

This is yet another mid brain syndrome linked to the watershed
territory with blood-brain barrier dysfunction in the cerebral
white matter  A recent report has linked depression to abnormalities
of the white matter on MRI. Both disorders can be the intial
presentation of the syndrome of multiple sclerosis in adults
(Personal communication Prof HJ Bauer University of Gottingen)




WESTPORT (Reuters Health) - Hypoxia-associated obstetric complications more
than double an infant's risk of early-onset schizophrenia, according to new
findings from a Finnish birth cohort study.

"We propose that the neurotoxic effects of hypoxia-associated obstetric
complications may reduce the amount of synaptic pruning required in late
adolescence to cross the psychosis threshold, leading to an earlier onset
of schizophrenia," Dr. Tyrone D. Cannon, of the University of California at
Los Angeles, and colleagues explain in the May 1st issue of the American
Journal of Psychiatry.

Dr. Cannon and his team examined the reported link between obstetric
complications and schizophrenia in a cohort born in Helsinki in 1955. From
these individuals, 80 patients with schizophrenia were selected for
analysis, along with 61 of their unaffected siblings and 56 matched
controls. Obstetrics data were taken from prospectively ascertained record,
and all subjects underwent structured psychiatric interviews.

After adjusting for prenatal infection and fetal growth retardation, the
researchers found that hypoxia-associated obstetric complications increased
the risk of early-onset, but not late-onset, schizophrenia, with an odds
ratio of 2.16. This risk increased by an additional 2.16-fold for each
hypoxia-related obstetric complication, "such that the subjects with three
or more such obstetric complications were 10 times more likely to develop
early-onset schizophrenia as were those with none."

The timing of hypoxia-related complications was important, as perinatal but
not prenatal oxygen deprivation was associated with early-onset
schizophrenia.

The odds of early-onset schizophrenia were increased within families, but
this association did not reach statistical significance. This finding
"indicates that the occurrence of fetal hypoxia is independent of genetic
risk for schizophrenia," the authors infer.

"Our findings are consistent with converging epidemiologic evidence that
obstetric complications, hypoxia in particular, increase the risk for
neurodevelopmental compromise and for a form of adult schizophrenia with an
early onset," Dr. Cannon and his team conclude.

"Taken together, the increasing evidence for the specificity of obstetric
complications to early-onset schizophrenia suggests that data in previous
studies that did not separate patients by age at onset may need to be
reanalyzed," they add.

Am J Psychiatry 2000;157:801-807.




Best wishes
PhilipJames

Wolfson Hyperbaric Medicine Unit
University of Dundee
Ninewells Hospital and Medical School
Dundee DD1 9SY


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