Cortical neuritic plaques and hippocampal neurofibrillary tangles are related to dementia severity in elderly schizophrenia patients

Michael A. Rapp, Michal Schnaider-Beeri, Dushyant P. Purohit, Abraham Reichenberg, Susan R. McGurk, Vahram Haroutunian, Philip D. Harvey

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Cognitive decline has been described in elderly patients with schizophrenia, but the underlying pathology remains unknown. Some studies report increases in plaques and neurofibrillary tangles, but there is no evidence for an increased risk for Alzheimer's disease (AD) in elderly schizophrenics. Models of a decreased cerebral reserve suggest that increases in AD-related neuropathology below the threshold for a neuropathological diagnosis could be related to dementia severity in elderly schizophrenia patients. We tested this hypothesis in 110 autopsy specimens of schizophrenia patients, without a neuropathological diagnosis of AD or other neurodegenerative disorders. Furthermore, we assessed the effects of apolipoprotein E (ApoE) status, a known genetic risk factor for AD. Measures of density of neuritic plaques were obtained in five cortical regions, and the degree of hippocampal neurofibrillary tangles was rated. Dementia severity was measured prior to postmortem using the Clinical Dementia Rating (CDR) scale. multivariate analyses of variance were conducted with the factors dementia severity, by ApoE4 carrier status. Hippocampal neurofibrillary tangles correlated with increased dementia severity (p < .05). Neuritic plaque density increased with greater dementia severity (p < .005), and ApoE4 carrier status (p < .005), and these differences were magnified by the ApoE4 carrier status (p < .01). Even below the threshold for a neuropathological diagnosis of AD, neuritic plaques and hippocampal neurofibrillary tangles are associated with dementia severity in schizophrenia patients, even more so in the presence of genetic risk factors, suggesting that a decreased cerebral reserve in elderly schizophrenics may increase susceptibility for dementia.

Original languageEnglish (US)
Pages (from-to)90-96
Number of pages7
JournalSchizophrenia Research
Volume116
Issue number1
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Keywords

  • Alzheimer's disease
  • Neuropathology
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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