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Research breakthrough in schizophrenia

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WHAT comes to mind when you hear ‘schizophrenia’? Hallucinations and delusions? Cognitive impairment? Feeling withdrawn from everyone around you? Apathy? With all the above being symptoms of this mental disorder, and with 1 in every 100 people affected, each individual’s life becomes a relentless battle, struggling with habitual activities, social interaction, and general wellbeing and self-care.
Current treatments help to reduce the severity of symptoms and allow patients to maintain a more functional daily life. However, antipsychotic medications, which are typically required lifelong, are not guaranteed to work for all schizophrenia patients, with only about 4 in 5 people benefitting usually.
Advances in scanning have allowed researchers for the first time to show lower levels of a protein found in the connections between neurons in the living brains of people with schizophrenia.
The researchers, who conducted the scans at the psychiatric imaging facility at the MRC London Institute of Medical Sciences, say these changes could underlie the cognitive difficulties seen in schizophrenia and provide targets for research into new treatments.
Synapses are the junctions between neurons. Neurons communicate across the synapse via neurotransmitters; chemicals that transmit the nerve signal.
Researchers investigated the relationship between synaptic density and schizophrenia, questioning whether a reduction in these brain connections is present in schizophrenia and whether they result from treatment with antipsychotic drugs.
The study was inspired by findings from previous post-mortem studies that demonstrated synaptic reductions in the brains of schizophrenia patients compared to healthy controls.
Measuring synaptic protein levels in living patients was not possible before the development of a new PET (Positron Emission Tomography) radioactive tracer that binds to a specific protein associated with synapses. Being “one of the first centres in the world” to have access to this, Professor Oliver Howes, Head of the Psychiatric Imaging Group at the MRC LMS, and his team grasped this opportunity to investigate synaptic loss in schizophrenic brains through the synaptic marker protein SV2A, which is found on the nerve terminal preceding the synapse and is involved in regulating neurotransmitter release.
The team found lower levels of SV2A in the brains of schizophrenia patients, indicating a reduction of synapses. Certain areas exhibited significantly lower levels, such as the frontal cortex which coordinates use, recall and processing of memory, planning complex cognitive behaviour and personality expression. These findings were supported by the understanding that these areas are associated with some of the major cognitive impairments seen in schizophrenia, thus providing a potential clue that synaptic loss may underlie these problems.
But to test whether the loss was a result of the illness or in fact due to treatment, a preclinical study was conducted in rat models investigating the effect of antipsychotic drugs on the levels of SV2A. They found that the antipsychotics did not contribute to the synaptic loss seen in schizophrenic patients, thereby reinforcing their overall findings.
So, what does this mean for the development of schizophrenia treatment?
If the synaptic loss is an underlying key contributor in the disease, further research into the mechanisms could lead to exploring ways to prevent this loss. Moreover, since microglia, known as the immune cells of the brain, play a role in mediating synaptic pruning, there is also potential to target microglia and see if it could introduce a way of preventing excess synaptic loss; an investigation that the team have already begun.
“The human brain, with its approximately 100 trillion synapses, is an extraordinarily complex organ,” says Dr Ellis Chika Onwordi of the Psychiatric Imaging Group and first author of this study. “Having the means to characterise the distribution of these synapses in the living brain, and to find differences in synaptic distribution between patients with schizophrenia and healthy controls, represents a significant advance in our ability to study the neurobiology of schizophrenia.”
Professor Oliver Howes, who led the study, said: “Our current treatments for schizophrenia only target one aspect of the disease – the psychotic symptoms – but the debilitating cognitive symptoms, such as loss of abilities to plan and remember, often cause much more long-term disability and there’s no treatment for them at the moment. Synaptic loss is thought to underlie these symptoms.
“Our lab at the MRC London Institute of Medical Sciences is one of the few places in the world with this new tracer, which means we’ve been able for the first time to show there are lower levels of a synaptic protein in people with schizophrenia. This suggests that loss of synapses could underlie the development of schizophrenia.
“We need to develop new treatments for schizophrenia. This protein SV2A could be a target for new treatments to restore synaptic function.”
The people with schizophrenia who were scanned had all received antipsychotic medication, so the researchers wanted to exclude this as a factor in the synaptic dysfunction. They gave antipsychotic drugs, haloperidol and olanzapine, to rats for 28 days and found it did not affect the levels of the protein SV2A.
Professor Howes said: “This is reassuring as it’s suggesting that our antipsychotic treatments aren’t leading to loss of brain connections.
“Next we hope to scan younger people in the very early stages to see how synaptic levels change during the development of the illness and whether these changes are established early on or develop over time.”

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Give blood and help save lives in Ceredigion

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LOCAL residents are being called upon to help patients in need by giving blood with the Welsh Blood Service.

Donations are still needed daily by hospitals to treat patients with a range of conditions, including mothers and babies during childbirth; cancer patients receiving chemotherapy as part of their treatment; and by patients involved in emergencies.

The Welsh Blood Service has also experienced a sustained period of high demand from hospitals as they continue to reintroduce services such as routine operations that require blood products. This increase means more blood donors are needed to help meet these additional needs.

One donation has multiple uses as it can be split into three products: red cells, platelets and fresh-frozen plasma, meaning one donation can save or improve up to three adults or six babies’ lives.

Across Ceredigion, over 200 donations of blood and blood products are needed each month to provide care to patients at Bronglais General Hospital.

Appointments are available at four locations in Ceredigion – Teifi Leisure Centre Sports Hall Cardigan, Newcastle Emlyn Rugby Club, Aberaeron Memorial Hall and Ysgol Bro Teifi, Llandysul.

Alan Prosser, Welsh Blood Service Director, said: “Every day around 350 donations are needed to help the 20 hospitals in Wales we supply, including Bronglais.

“We’ve always had great support from our donors in the area but we’re urging more residents to consider becoming blood donors and supporting patients in need. We’ve managed to increase our capacity in the area and we’re hoping this will help make it easier for people to donate.

“We are particularly calling on existing O negative, O positive and A positive donors to come forward but if you are a new donor and don’t know your blood type don’t worry, please sign up and we’ll do that bit for you.

“Last month, 304 potentially life saving donations were made in Ceredigion.

“As a Service, we rely on the generosity of people living in Wales to provide vital donations to patients.

“By giving up just one hour of your time, you have a unique opportunity to make a difference to people in your community and beyond.

Additional safety measures are in place at all our donation sessions, all staff wear face masks and every item is cleaned between use.

Alan continued: “If you’ve never donated before, why not try something incredible this week – sign up to donate at one of the sessions in your local area and become a lifesaver.”

Book a lifesaving donation at: welshblood.org.uk or call 0800 252 266 today.

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Werndale Hospital recognised for outstanding patient care in national award

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STAFF at Werndale Hospital near Carmarthen have been recognised for the quality of their patient care. 

The prestigious ‘Private Hospital Group of the Year’ award is presented to an organisation that has shown excellence in its delivery of care, commitment to the community and innovation within healthcare.

Werndale Hospital was also recognised for their initiatives to support staff in their career progression and wellbeing.   

The latest statistics show, 98% of patients at Werndale Hospital were satisfied with their overall level of care, 98% of patients would recommend their care to family and friends, and 98% of patients rated the nursing staff as excellent or very good. 

In addition, independent analysis of Circle hospitals’ hip and knee procedure outcomes of health improvement shows that Circle scored 8.4 versus an independent sector average of 7.8 in the hip category, and a score of 15.4 versus an independent sector average of 13.9 in the knee category.   

The award presented to Circle Health Group, owners of Werndale Hospital, in London in June, also noted the extraordinary contribution the teams at the hospital had made to the community. 

In 2021 alone, Werndale Hospital partnered with Air Ambulance Wales and raised £1,205 to support the charity’s work in the community.  

In addition to the charitable work, Werndale Hospital was recognised for it’s commitment to support staff through a series of wellbeing initiatives and career development opportunities. The judges were particularly impressed with the launch of the ‘Be Heard’ survey at the hospital.   

The survey looks to empower staff to feedback on everything from the working environment at the hospital through to their own career ambitions. Building directly on the feedback from this survey, the ‘Grow Your Own’ campaign was launched which supported staff to work towards specific qualifications from nursing degrees with partnered universities through to bespoke management programmes and MBA qualifications.   

As a direct result of this support for staff at what is a challenging time for healthcare workers, Werndale Hospital and Circle Heath Group were recognised as being a Top 20 Best Large Company to work for.   

At the heart of Werndale Hospital’s approach to treating patients is a commitment to the community they serve.  

 Paolo Pieri, CEO of Circle Health Group, said:  “The award is a testament to what an amazing year 2021 was for Werndale Hospital with considerable investment into the facilities and services on offer to patients in west Wales. I couldn’t be prouder of what our staff and doctors have achieved.”  

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Give blood, save lives – Do something memorable this National Blood Donor Week

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THE WELSH BLOOD SERVICE is urging people to consider becoming blood donors to help save lives this National Blood Donor Week.

Over 350 blood donations are needed every day across Wales. The donations play a vital role in saving lives by supporting a range of treatments, from helping recovering accident victims and patients with blood cancers to supporting mothers and newborn babies during childbirth. 

The Welsh Blood Service supports 20 hospitals across the country and relies on donations from blood, platelet and bone marrow donors to help patients in need.

Supporting the call is 65-year-old Howard Provis, one of Wales’ longest serving donors with nearly 50 years of dedication to the service. Howard has been donating platelets since the age of 18 and has recently made his 1,000 th donation which has helped save the lives of thousands of people across Wales.

Encouraging more people to come forward following his own experience, Howard explains, “With a background in first aid and first responding, I have seen people in many situations that have required blood. For me being able to give blood or platelets has given some of those people a second chance to live or spend precious extra time with their families and friends.

“Tomorrow, it could be me that needs a blood or platelet donation, or my wife, family or a friend. The thought that my donation today could potentially save someone’s life tomorrow has inspired me to keep supporting the Welsh Blood Service.”

Speaking of Howard’s achievement Alan Prosser, Director of the Welsh Blood Service explains, “Howard is one of only a handful of donors to reach this incredible milestone, and his donations will have helped patients in need from hospitals across the whole of Wales.

“His commitment to helping others is truly inspirational, and we hope his story encourages others to start their own lifesaving journey this National Blood Donor Week.”

National Blood Donor Week is an opportunity for blood services across the UK to raise awareness of the lifesaving importance of blood donation and encourage those who have never donated to give it a go.

The week also incorporates World Blood Donor Day (June 14), a day of celebration and thanks to the thousands of people who give up their time freely to donate and help people in need.

Alan continues, “We must say a huge thank you to every single donor who has supported us over the past two years. It has been a challenging period, but the generosity of people across Wales has been unwavering.

“As our Service works towards a post-covid collection service, we hope more people will step forward and join our lifesaving team. Following changes to UK donation guidelines, more people than ever before can safely donate, which means there has never been a better time to give it a go.”

June 14 is also the one-year anniversary of the landmark changes introduced following the recommendations made by the FAIR (For the Assessment of Individualised Risk) steering group.

These pioneering changes to donation rules have meant that all donors, regardless of gender, are now asked a set of questions, meaning that more people than ever before, including those from the LGBTQ+ community are potentially eligible to donate.

You can book your first or next blood donation appointment by visiting www.wbs.wales/nbdw22 and if you are 17-30, you can also consider signing up to the Welsh Bone Marrow Donor Registry.

For those who cannot donate, you can still become a Welsh Blood Service supporter. 

Sharing their social media posts, encouraging your friends, family and colleagues to raise awareness of the importance of donating blood, platelets and bone marrow.

To learn more about donating blood, platelets and bone marrow, or to book, visit www.welshblood.org.uk.

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