National Institute of Mental Health and Neuro Sciences' department of psychiatry have embarked on a novel research initiative on imaging genomics in schizophrenia.

The research project led by Dr Ganesan Venkatasubramanian, assistant professor, department of psychiatry is based on an integrated model to explain the pathogenesis of schizophrenia. It looks at the Neuro Immuno Metabolic Hypothesis in schizophrenia patients.

Schizophrenia, which is a serious mental disorder causing a huge impact on the population, reports a prevalence rate of one percent in the Indian population. While about 10 per cent of the case s can be cured, likely to have only one episode of symptoms. At least 60 per cent of the patients, the symptoms can be controlled and in 30 per cent of the cases face a drug resistant phase. The disorder commonly occurs during the peri-adolesecence and lasts for a life time. Though this disorder has a genetic basis, it is also influenced by many environmental variables. The drugs are affordable, but there is need for considerable awareness for faster diagnosis and treatment, stated Dr Venkatasubramanian.

This new imaging genomics research initiative research will focus on examining the relationship of brain abnormalities in schizophrenia (using functional MRI or fMRI) with the immuno-metabolic aberrations. Furthermore, the correlates of these deficits with relevant genes will be analyzed.

Last year, NIMHANS's department of psychiatry had reported a major finding in the prestigious American Journal of Psychiatry describing insulin resistance and deficient Insulin-like Growth Factor 1 in never-treated Schizophrenia patients. The clinical study which was again moderated by Dr Venkatasubramanian provided ample evidence and correlation of the plasma insulin growth factor (IGF) -1 which is potentially involved in the pathogenesis of Schizophrenia. "The current Neuro Immuno Metabolic Hypothesis study is in fact an extension of research on insulin system abnormalities in schizophrenia" informed Dr Venkatasubramanian. The research is also a first-of-its-kind study in schizophrenia in the world, he added.

The research which is a Department of Biotechnology supported effort came about after Dr Venkatasubramanian bagged the Innovative Young Biotechnologist award instituted by Government of India. The award which carries a research funding of Rs 25 lakh is being utilized for the study that spans for a three year period. The research will examine about 100 patients at NIMHANS who are diagnosed as schizophrenia and prescribed medication. In this study, the patients will be examined before being started on treatment as well as will be re-examined after three months of treatment.

In order to have a parallel clinical services and a systematic evaluation to assess the impact and clinical utility of these theoretical concepts, NIMHANS has set up the Metabolic Clinic in the department of psychiatry run by Dr Venkatasubramanian and his team. Metabolic disorders like insulin resistance, menstrual irregularities as well as associated poly cystic ovarian changes (PCOC) are common in schizophrenia patients.

These adverse changes happen mainly due to antipsychotic treatment. In fact, the prevalence of metabolic disorders, primarily insulin abnormalities and PCOC among schizophrenia patients undergoing medication are as high as 50 percent. This new research initiative as well as parallel systematic clinical evaluations are expected to throw further light on the neuro-immuno-metabolic abnormalities schizophrenia which can potentially help in formulating better treatment strategies, informed Dr Venkatasubramanian.