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Baroreflex sensitivity is associated with markers of hippocampal gliosis and dysmyelination in patients with psychosis

Clinical Autonomic Research (2023)Cite this article

Abstract

Purpose

Hippocampal dysfunction plays a key role in the pathology of psychosis. Given hippocampal sensitivity to changes in cerebral perfusion, decreased baroreflex function could contribute to psychosis pathogenesis. This study had two aims: (1) To compare baroreflex sensitivity in participants with psychosis to two control groups: participants with a nonpsychotic affective disorder and participants with no history of psychiatric disease; (2) to examine the relationship between hippocampal neurometabolites and baroreflex sensitivities in these three groups. We hypothesized that baroreflex sensitivity would be reduced and correlated with hippocampal neurometabolite levels in participants with psychosis, but not in the control groups.

Methods

We assessed baroreflex sensitivity during the Valsalva maneuver separated into vagal and adrenergic components. Metabolite concentrations for cellular processes were quantitated in the entire multivoxel hippocampus using H1-MR spectroscopic (MRS) imaging and were compared with baroreflex sensitivities in the three groups.

Results

Vagal baroreflex sensitivity (BRS-V) was reduced in a significantly larger proportion of participants with psychosis compared with patients with nonpsychotic affective disorders, whereas participants with psychosis had increased adrenergic baroreflex sensitivity (BRS-A) compared with participants with no history of psychiatric disease. Only in psychotic cases were baroreflex sensitivities associated with hippocampal metabolite concentrations. Specifically, BRS-V was inversely correlated with myo-inositol, a marker of gliosis, and BRS-A was positively correlated with energy dependent dysmyelination (choline, creatine) and excitatory activity (GLX).

Conclusions

Abnormal baroreflex sensitivity is common in participants with psychosis and is associated with MRS markers of hippocampal pathology. Future longitudinal studies are needed to examine causality.

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Fig. 1
Fig. 2

Data availability

Data available by request.

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Acknowledgements

This work was supported by R01MH110418 (PI: Malaspina) and R01DK122853 (PI: Robinson-Papp)

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Authors and Affiliations

  1. Center for Headache and Facial Pain, Department of Neurology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1139, New York City, NY, 10029, USA

    Bridget Mueller

  2. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA

    Jessica Robinson-Papp

  3. Department of Population Health Science and Policy, Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA

    Maria Suprun

  4. Department of Pediatrics, Allergy and Immunology, New York City, NY, USA

    Maria Suprun & Mayte Suarez-Farinas

  5. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA

    Mayte Suarez-Farinas

  6. Department of Radiology, New York University Grossman School of Medicine, New York City, NY, USA

    Eyal Lotan & Oded Gonen

  7. Department of Neuroscience and Physiology, New York City, NY, USA

    Oded Gonen

  8. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA

    Dolores Malaspina

  9. Department of Genetics and Genomic Sciences, New York City, NY, USA

    Dolores Malaspina

  10. Department of Neuroscience, New York City, NY, USA

    Dolores Malaspina

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  1. Bridget Mueller
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  2. Jessica Robinson-Papp
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Mueller, B., Robinson-Papp, J., Suprun, M. et al. Baroreflex sensitivity is associated with markers of hippocampal gliosis and dysmyelination in patients with psychosis. Clin Auton Res (2023). https://doi.org/10.1007/s10286-023-00929-x

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Keywords

  • Baroreflex
  • Hippocampus
  • Inflammation
  • H1-MR spectroscopic (MRS)