U devotes research to unlock the secrets of schizophrenia

Jamie VanGeest

D Editor’s Note: This is part two of a three-part series on schizophrenia. Wednesday’s story will profile a Twin Cities organization that reaches out to homeless people with mental illnesses such as schizophrenia.

1iagnosed with paranoid schizophrenia in his teens, Sam Yeager, 54, of Minneapolis has participated in four of psychiatry professor Steve Olson’s studies, including medication studies and a weight-loss study.

Yeager used to struggle with blackouts, anxiety and paranoia, but said he has benefited from the medication given to him in the drug studies.

He said he enjoys the extra money made from participating in the studies and getting to work with Olson.

When asked how schizophrenia has impacted his life, Yeager said he’s not sure because he’s always had it.

Olson conducts clinical trials on old and new antipsychotic medications that treat depression.

One of the keys to treating people with schizophrenia is finding medications that treat the symptoms while keeping the side effects to a minimum, Olson said.

One of Olson’s studies, “Comparisons for Atypicals for First Episode,” looked at people experiencing initial symptoms of the illness. These participants were displaying symptoms of the disease that are harder to treat, such as a monotone voice or a loss or decrease in the ability to make plans, speak or express emotion or find pleasure in everyday life.

Olson gave participants three new antipsychotic medicines. Researchers found two-thirds of the patients responded well to the medication, and found no major differences in results between the three medicines.

One issue that occurred during the “Comparisons for Atypicals for First Episode” study, which often comes up when medication is involved, is participants not taking it on a regular basis, Olson said. Two-thirds of the study’s participants didn’t take the medication for as long as they were supposed to, he said.

People with schizophrenia tend to take their antipsychotic medication for four to six months and then quit, he said.

Side effects including weight gain and excessive daytime drowsiness caused some of the study’s participants to stop taking medicine, Olson said.

People also quit if the medicine they were assigned does not work for them, he said.

“Medication needs to be taken continuously and indefinitely to keep the illness from coming back,” Olson said.

Olson is researching a new medicine and trying to find out whether it is easier for patients to take the drug consistently.

Putting your finger on it

An indicator for schizophrenia could be found at a person’s fingertips.

John Vuchetich, an assistant professor in the psychiatry department, studies whether the structure of the vessels between the nail and the knuckle are an indicator for schizophrenia.

People with schizophrenia often have a network of vessels that are easy to view near the nail. This is called nail-fold plexus visibility, Vuchetich said.

Most people are high in nail-fold plexus visibility when they are children, but the vessels become less visible as they get older, he said. People who have symptoms that are hard to treat tend to be high in nail-fold plexus into adulthood.

To identify the vessels, Vuchetich places a drop of immersion oil on the participant’s finger and places the finger under a microscope.

Not a lot is known about how the brain functions in people with all types of schizophrenia and this method is effective in identifying those with harder-to-treat symptoms, he said.

Vuchetich is comparing the brains of people who exhibit high nail-fold plexus visibility with those whose vessels are harder to see.

So far he has found that people who have more visible vessels do poorer on neuropsychological tests than those with less visible vessels.

Another finding of Vuchetichs’ is that first-degree relatives, such as parents or siblings, of those who are high in nail-fold plexus visibility, also have high visibility. This might demonstrate a genetic link Vuchetich might research in the future.

An eye for research

Kelvin Lim is a psychiatry professor and a researcher at the University’s Center for Magnetic Resonance Research, where schizophrenia is examined from the inside out.

The center has four types of magnetic resonance imaging machines, each with increasing magnetic power. The typical MRI machine in a doctor’s office is 1.5 tesla. Tesla describes the strength of the magnetic field in the machines, Lim said.

The center has 3 tesla, 4 tesla, 7 tesla and 9.4 tesla MRI machines. Lim estimated there are four or five 7-tesla MRI machines in the United States and two or three 9.4-tesla machines in the world.

“We’re very unique in that situation by having some of the strongest magnets in the world doing our research,” Lim said.

Using these machines, researchers are able to get the closest possible look at how schizophrenia affects the brain.

With diffusion tensor imaging, which allows the viewing of tissues in the brain, Lim looks at the white matter, or the brain wiring, and compares it with non-schizophrenic brains to see whether there are differences.

The imaging found people with schizophrenia tend to have a lack of organization in their white matter.

Other white matter gene studies have found abnormalities in genes associated with the development of the brain’s myelin sheaths. Myelin sheaths insulate the neurons in the brain and increase the speed of signals passed between neurons.

Additionally, each of the University’s machines is capable of performing a functional MRI, in which researchers can see how the brain functions while working on various tasks. Using this information, the center plans to soon test how well the memory of a schizophrenic patient works.