Phrenology and schizophrenia

All books that address the history of scientific research on the brain have sections on phrenology. The upshot of book sections on phrenology is that phrenology was the dark ages of brain research. A lot of phrenology was nonsense. But is there a kernel of truth to phrenology? I have been claiming that the negative symptoms of schizophrenia are due to brains being compressed due to hidden osteomalacia arising from dysregulation of calcium homeostasis due to deficiencies in taurine.

Wolfgang Pauli once said ‘the idea is so bad it is neither right or wrong‘. My idea could be wrong. I am not quite certain what imagining techniques are used to detect osteomalacia but the evidence may right now be stored in data banks. Currently skulls are stripped from MRI images. A search of PubMed using the search terms “osteomalacia” and “schizophrenia” turned up three articles which were irrelevant. There is apparently a reduction in brain volumes in schizophrenia which could be due to skulls being compressed due to hidden osteomalacias.

So far brain imaging has only discovered that individuals with brain structures that are all in the normal range of sizes can have schizophrenia. Still brain imaging or at least skull imaging could could be a key to treatment of the negative symptoms of schizophrenia which can be devastating.

Correction of osteomalicias can increase bone mineral density

There can be very large increases in bone mineral densities upon osteomalicias being corrected.

Long-term bone mineral density changes after surgical cure of patients with tumor-induced osteomalicia

L Colangelo , J Pepe, L Nieddu, C Sonato, A Scillitani, D Diacinti, M Angelozzi , C Cipriani, S Minisola

Abstract

Introduction: No systematic data are available regarding long-term bone mineral density (BMD) changes after surgical cure of patients with tumor-induced osteomalacia.

Methods: From October 2001 through April 2018, we studied 10 consecutive patients (mean age ± SD, 45.5 ± 13.8 years; 5 males and 5 females) with tumor-induced osteomalacia. We evaluated BMD when initially presented at our Center and after surgical removal of the tumor.

Results: Basal BMD and corresponding Z-score values (mean values ± SD) measured by DXA were as follows: L1-L4 = 0.692 ± 0.15 g/cm2, Z-score = – 2.80 ± 1.60; femur neck 0.447 ± 0.10 g/cm2, Z-score = – 2.66 ± 0.93; total femur = 0.450 ± 0.08 g/cm2, Z-score = -3.04 ± 0.85). Furthermore, Trabecular Bone Score (TBS) was evaluated in three patients (basal values, 0.990 ± 0.32). Seven patients were intermittently followed after surgical excision of the tumor while supplemented with cholecalciferol and calcium salts; the remaining three were lost to follow-up. There was a striking increase of BMD values that peaked at 26.7 ± 6.50 months: L1-L4 = 1.289 ± 0.247 g/cm2, p < 0.001, Z-score + 1.75 ± 1.42; femur neck = 0.890 ± 0.235 g/cm2, p = 0.028, Z-score = + 0.50 ± 1.40; total femur = 0.834 ± 0.150 g/cm2, p = 0.005, Z-score = – 0.74 ± 1.14. In patients with the greatest bone involvement at lumbar site, there was a striking increase of an average 1.5% (p < 0.01) in respect to baseline Z-score value for each additional month of observation during the first 2-3 years post-surgery. An improvement of trabecular microarchitecture was also documented (TBS, 1.255 ± 0.16).

Conclusion: This is the first case series documenting an impressive increase of BMD at both lumbar and femoral sites, together with an improvement of trabecular microarchitecture as documented by TBS. This is the consequence of huge mineralization of the large amount of osteoid tissue after resolution of the disease.

Bone mineral density and osteomalicias

Low bone mineral density with resulting osteoporosis is very frequently associated with osteomalicias though not always.

Bone mineral density in patients with osteomalicia: is it valuable?

Massoud Saghafi,  Azita Azarian, Kamila Hashemzadeh, Maryam Sahebari, Zahra Rezaieyazdi

Free PMC article

Abstract

Osteomalacia is a generalized bone disorder characterized by impairment of mineralization, leading to accumulation of unmineralized matrix or osteoid in the skeleton. The clinical features of osteomalacia include musculoskeletal vague pain and muscle weakness. In its mild and early stages, osteomalacia may be misdiagnosed with variety of musculoskeletal diseases including osteopenia and osteoporosis, and for early diagnosis high rate of suspicion of osteomalacia is necessary. Our purpose was to determine the amount of bone mineral density (BMD) in patients with osteomalacia and to evaluate the efficiency of bone densitometry in these patients. Diagnosis of our patients was based on history, physical, laboratory and radiological findings and in three patients with bone biopsy and histological approval. BMD (gm/cm(2)) at the lumbar vertebrae (L2-L4) and femoral neck were measured by dual X-ray absorptiometry in 20 patients with osteomalacia (16 females and 4 males, age range 20 to 60 years, mean 39 years) before treatment, comparing with 28 matched healthy individuals, and their T scores were evaluated according to WHO criteria for the diagnosis of osteopenia and osteoporosis. 14 patients with osteomalacia (70%) had BMD in amount of osteoporosis in the lumbar spine, and 12 patients with osteomalacia (60%) had BMD in amount of osteoporosis in their femoral neck. 50% of the patients had T≥ -3. We concluded that bone densitometry may detect osteoporosis in up to 70% of patients with osteomalacia. Middle aged individuals with significant osteoporosis should be evaluated for osteomalacia, beside other causes of secondary osteoporosis. Measurement of BMD in patients with osteomalacia is helpful for assessment of the severity of bone condition and following management.