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Dietary Supplement Offers Hope for Schizophrenia Prevention
Deborah Brauser
Medscape.com
Jan 18, 2013
Perinatal supplementation of the essential nutrient choline may lead to a lower risk of children developing schizophrenia, new research suggests.
The randomized controlled trial included 93 healthy pregnant women, half of whom received choline supplementation during their last 2 trimesters of pregnancy. Their newborns also received choline soon after delivery. Results showed that the offspring who received choline perinatally had a significantly lower rate of a physiologic risk factor for schizophrenia at the age of 33 days compared with their counterparts who had received matching placebo. In addition, the supplements were found to be safely tolerated by all mothers and infants.
"We thought that if we could get a good intervention prenatally or early postnatally, we could decrease risk for the disorder," lead author Randy Ross, MD, professor of psychiatry at the University of Colorado Denver School of Medicine, told Medscape Medical News.
"This is really a first step towards trying to develop a prevention strategy," explained Dr. Ross. He added that his takeaway message from the study is that finding ways to prevent a disease "may be much more effective than treating it after it comes on."
The study was published online January 15 in the American Journal of Psychiatry (AJP).
Examining Cerebral Inhibition
According the investigators, "several" maternal risk factors for schizophrenia are associated with decreased availability of choline for a fetus. Therefore, pregnant women are often advised to increase their intake of foods rich in choline, such as eggs and meat.
"Basic research indicates that choline supplementation during pregnancy facilitates cognitive functioning in offspring," Robert Freedman, MD, coauthor of the study and editor of AJP, explained in a release.
The study included 93 pregnant women from the Denver area. Beginning in their second trimester, the women were randomly assigned to receive either 3600 mg of phosphatidylcholine each morning and 2700 mg of the supplement each evening (n = 46) or matching placebo (n = 47).
In addition, after delivery, the offspring received either 100 mg daily of the choline supplement or placebo for 13 weeks.
In a normally developed brain, a full response is given to a first clicking sound, followed by a more inhibited response to a second click that comes shortly thereafter. However, patients with schizophrenia commonly have deficient inhibition.
Because full schizophrenia does not usually appear before adolescence, the investigators used measured responses to paired clicks in all the infants as a basis for representing risk for the disorder. Measurements were made by placing electrophysiologic sensors on each baby's head during sleep.
Results at the 5-week postnatal checkup showed that significantly more of the infants who were exposed perinatally to choline supplementation showed a normal inhibition response to the repeated sounds than did the infants who were unexposed (76% vs 43%, respectively).
An Idea Worth Pursuing
In addition, "a CHRNA7 genotype associated with schizophrenia was correlated with diminished...inhibition in the placebo-treated infants, but not in the choline-treated infants," report the investigators.
This means that the supplement "activates timely development of cerebral inhibition, even in the presence of gene mutations that otherwise delay it," they add.
There were no between-group differences in inhibition at the 13-week postnatal checkup.
There were also no treatment-related effects on delivery, birth, infant development, or maternal or infant health.
"Genes associated with schizophrenia are common, so prevention has to be applied to the entire population, and it has to be safe," said Dr. Freedman.
The finding that choline supplementation "ameliorates some of the pathophysiology associated with risk for schizophrenia now requires longer-term follow-up to assess whether it decreases risk for the later development of illness as well," he noted.
"To me, these results basically say that this whole idea is worth pursuing. And that's always exciting," added Dr. Ross.
The study was funded by the Institute for Children's Mental Disorders, the Anschultz Family Foundation, and grants from the National Institute of Mental Health. One of the investigators reports having equity in ICVRx and part ownership in 8 patents. The other study authors, including Dr. Ross and Dr. Freedman, have disclosed no relevant financial relationships.
Am J Psychiatry. Published online January 15, 2013. Abstract
Deborah Brauser
Medscape.com
Jan 18, 2013
Perinatal supplementation of the essential nutrient choline may lead to a lower risk of children developing schizophrenia, new research suggests.
The randomized controlled trial included 93 healthy pregnant women, half of whom received choline supplementation during their last 2 trimesters of pregnancy. Their newborns also received choline soon after delivery. Results showed that the offspring who received choline perinatally had a significantly lower rate of a physiologic risk factor for schizophrenia at the age of 33 days compared with their counterparts who had received matching placebo. In addition, the supplements were found to be safely tolerated by all mothers and infants.
"We thought that if we could get a good intervention prenatally or early postnatally, we could decrease risk for the disorder," lead author Randy Ross, MD, professor of psychiatry at the University of Colorado Denver School of Medicine, told Medscape Medical News.
"This is really a first step towards trying to develop a prevention strategy," explained Dr. Ross. He added that his takeaway message from the study is that finding ways to prevent a disease "may be much more effective than treating it after it comes on."
The study was published online January 15 in the American Journal of Psychiatry (AJP).
Examining Cerebral Inhibition
According the investigators, "several" maternal risk factors for schizophrenia are associated with decreased availability of choline for a fetus. Therefore, pregnant women are often advised to increase their intake of foods rich in choline, such as eggs and meat.
"Basic research indicates that choline supplementation during pregnancy facilitates cognitive functioning in offspring," Robert Freedman, MD, coauthor of the study and editor of AJP, explained in a release.
The study included 93 pregnant women from the Denver area. Beginning in their second trimester, the women were randomly assigned to receive either 3600 mg of phosphatidylcholine each morning and 2700 mg of the supplement each evening (n = 46) or matching placebo (n = 47).
In addition, after delivery, the offspring received either 100 mg daily of the choline supplement or placebo for 13 weeks.
In a normally developed brain, a full response is given to a first clicking sound, followed by a more inhibited response to a second click that comes shortly thereafter. However, patients with schizophrenia commonly have deficient inhibition.
Because full schizophrenia does not usually appear before adolescence, the investigators used measured responses to paired clicks in all the infants as a basis for representing risk for the disorder. Measurements were made by placing electrophysiologic sensors on each baby's head during sleep.
Results at the 5-week postnatal checkup showed that significantly more of the infants who were exposed perinatally to choline supplementation showed a normal inhibition response to the repeated sounds than did the infants who were unexposed (76% vs 43%, respectively).
An Idea Worth Pursuing
In addition, "a CHRNA7 genotype associated with schizophrenia was correlated with diminished...inhibition in the placebo-treated infants, but not in the choline-treated infants," report the investigators.
This means that the supplement "activates timely development of cerebral inhibition, even in the presence of gene mutations that otherwise delay it," they add.
There were no between-group differences in inhibition at the 13-week postnatal checkup.
There were also no treatment-related effects on delivery, birth, infant development, or maternal or infant health.
"Genes associated with schizophrenia are common, so prevention has to be applied to the entire population, and it has to be safe," said Dr. Freedman.
The finding that choline supplementation "ameliorates some of the pathophysiology associated with risk for schizophrenia now requires longer-term follow-up to assess whether it decreases risk for the later development of illness as well," he noted.
"To me, these results basically say that this whole idea is worth pursuing. And that's always exciting," added Dr. Ross.
The study was funded by the Institute for Children's Mental Disorders, the Anschultz Family Foundation, and grants from the National Institute of Mental Health. One of the investigators reports having equity in ICVRx and part ownership in 8 patents. The other study authors, including Dr. Ross and Dr. Freedman, have disclosed no relevant financial relationships.
Am J Psychiatry. Published online January 15, 2013. Abstract
