Advanced Bone Age and Minor Physical Abnormalities and their relation to Schizophrenia

ACADEMIA Letters

Advanced Bone Age and Minor Physical Abnormalities

and their relation to Schizophrenia

Andrew Flocchini Jordan James

Minor physical anomalies (MPAs) have been studied in many psychological disorders and are commonly found in individuals with schizophrenia with an increased frequency.[1] While a correlation between an increased number of MPAs and various psychological disorders has been established, the cause of these MPAs has remained unexplained. We researched numer- ous studies for the possible cause of MPAs. These studies presented a theory that advanced bone ossification can cause under development in various parts of the body.

It is known that by week 8 of embryonic development the major organs and body structures are in their permanent place. In one study of bone age in adolescents with schizophrenia, there was a correlation between older bone age versus chronological age than when compared to normal individuals.[2] Early ossification during embryonic development could be the cause of the MPAs and older bone age found in adolescents with schizophrenia.

Corresponding Author: Andrew Flocchini, andrewflocchini@gmail.com

Citation: Flocchini, A., James, J. (2021). Advanced Bone Age and Minor Physical Abnormalities and their relation to Schizophrenia. Academia Letters, Article 3809. https://doi.org/10.20935/AL3809.

FIG 1

Males tend to have earlier onset schizophrenia and generally have an increased number of MPAs when compared to females who generally have later onset schizophrenia. During normal embryonic development, female embryos begin the ossification process before that of males and also complete the process prior to that of their male counterparts.[3] Early bone ossification in male embryos could halt the development of organs and structures which result in MPAs.

A studied MPA with male schizophrenic individuals is a 2D:4D finger length ratio of a normal female.[4] Early bone ossification in males could cause irregular finger length.

In normal embryonic development, the palate calcifies at week 7.[5] Studies show that a common MPA in individuals with schizophrenia is a malformed palate.[6] Early ossification could harden the tissue of the palate arresting normal development resulting in an MPA.

Other studies show that wide-spaced toes is another common MPA in individuals with schizophrenia. At nearly 8 weeks, the embryo has a wide-spaced toe that has yet to assume

Corresponding Author: Andrew Flocchini, andrewflocchini@gmail.com

Citation: Flocchini, A., James, J. (2021). Advanced Bone Age and Minor Physical Abnormalities and their relation to Schizophrenia. Academia Letters, Article 3809. https://doi.org/10.20935/AL3809.

its final position. By week 9 in normal development, the toe has assumed its final position.[7] Early ossification occurring during or prior to week 9 could lead to the toe to remain out of place and stop further movement which would result in a wide-spaced toe.

A study shows individuals with schizophrenia often have an irregular scan path resulting in longer than normal fixations when tracking a moving object.[8] Eye development occurs during the 4th to 8th week of development.[9] An irregular scan path MPA in schizophrenic individuals could be the result of immature development of the eye at the time of bone ossifi- cation.

According to Dr. Ganesh, there are two different types of schizophrenia. By looking at figure 1, the top set are brain images showing schizophrenia symptoms as it is commonly known.[10] The below set of brain images compares schizophrenia symptoms that are dif- ferent from the majority. The two left images are of male brains with schizophrenia, and the two right images are of female brains. By examining these images one can see that the male temporal lobe is more adversely affected as compared to the female brain with type 1 schizophrenia. With type 2 schizophrenia both male and female brain images are nearly the same. Schizophrenia 2 occurs in about 35% of all schizophrenia cases. (Figure 1) (Figure 2) compares bone age to chronological age in individuals with schizophrenia. The chart shows that there is a majority of male schizophrenic individuals with older bone age, however, there are approximately 30% who have normal bone age. (Figure 2) According to Hugdahl, 30% of schizophrenics do not have auditory hallucinations.[11] 32 % do not have impaired eye- tracking. Schizophrenia 2 could be the result of individuals with normal bone age.

Corresponding Author: Andrew Flocchini, andrewflocchini@gmail.com

Citation: Flocchini, A., James, J. (2021). Advanced Bone Age and Minor Physical Abnormalities and their relation to Schizophrenia. Academia Letters, Article 3809. https://doi.org/10.20935/AL3809.

FIG 2

The percentage of schizophrenia 2, approximately 35%, is comparable to the percentage of schizophrenic individuals with normal bone age, approximately 30%. This is also comparable to the 32% of individuals not having an irregular scan path and also the approximate 30% of schizophrenics who do not have auditory hallucinations. This leads us to believe that bone age and schizophrenia 2 may be closely related and that schizophrenia 2 may be manifesting in individuals who have a normal or near-normal bone age. Further research comparing the bone age of type 2 schizophrenic males to type 1 schizophrenic males would need to be done in order to see if there is a correlation. An individual with schizophrenia and a normal bone age may then also have a decreased number of the MPAs described above, this could be the result of a normal bone ossification timeline which allowed the proper development of these physiological features resulting in a decreased rate of MPAs that would otherwise be affected by early bone ossification during the early stages of development.

Corresponding Author: Andrew Flocchini, andrewflocchini@gmail.com

Citation: Flocchini, A., James, J. (2021). Advanced Bone Age and Minor Physical Abnormalities and their relation to Schizophrenia. Academia Letters, Article 3809. https://doi.org/10.20935/AL3809.

References

1. Green M, Satz P, Christenson C. Minor Physical Anomalies in Schizophrenia Patients, Bipolar Patients, and Their Siblings. Schizophrenia Bulletin. 1994;20(3):433-440.

2. Katz, Nachum, et al. “Bone Age in Adolescents with Schizophrenia and Obsessive- Compulsive Disorder.” Schizophrenia Research, vol. 33, no. 1-2, 1998, pp. 119–122., doi:10.1016/s0920-9964(98)00055-3. (Fig 2)

3. Dye F. Human life before birth. 2nd ed. Boca Raton, FL: CRC Press; 2019: 67-194.

4. Narayanaswamy J, Kalmady S, Narayan V, Rao N, Venkatasubramanian G, Divakaran A. Family History Correlates of Digit Ratio Abnormalities in Schizophrenia. Indian Journal of Psychological Medicine. 2012;34(4):355.

5. Dye F. Human life before birth. 2nd ed. Boca Raton, FL: CRC Press; 2019: 67-194.

6. Green M, Satz P, Christenson C. Minor Physical Anomalies in Schizophrenia Patients, Bipolar Patients, and Their Siblings. Schizophrenia Bulletin. 1994;20(3):433-440. Ar- ticle· Literature Review in Schizophrenia Bulletin 35(2):425-36 · December 2008.

7. Dye F. Human life before birth. 2nd ed. Boca Raton, FL: CRC Press; 2019: 67-194.

8. MoritaK,MiuraK,KasaiK,HashimotoR.Eyemovementcharacteristicsinschizophre- nia: A recent update with clinical implications. Neuropsychopharmacology Reports. 2019;40(1):2-9.

9. Dye F. Human life before birth. 2nd ed. Boca Raton, FL: CRC Press; 2019: 67-194.

10. Chand, Ganesh B, et al. “Two Distinct Neuroanatomical Subtypes of SCHIZOPHRE- NIA Revealed Using Machine Learning.” Brain, vol. 143, no. 3, 2020, pp. 1027– 1038., doi:10.1093/brain/awaa025

11. HugdahlK.Auditoryhallucinationsinschizophrenia:theroleofcognitive,brainstruc- tural and genetic disturbances in the left temporal lobe. Frontiers in Human Neuro- science. 2008;1.

Corresponding Author: Andrew Flocchini, andrewflocchini@gmail.com

Citation: Flocchini, A., James, J. (2021). Advanced Bone Age and Minor Physical Abnormalities and their relation to Schizophrenia. Academia Letters, Article 3809. https://doi.org/10.20935/AL3809.