Tuesday, 31 March 2009

Another part of the Puzzle

And another "Who ordered THAT?" moment.

Still, that's the best part of Science, when you come across something wholly unexpected, and that challenges previous theories.

From Medical Hypotheses:
Reversal of normal cerebral sexual dimorphism in schizophrenia: evidence and speculations.

Sex differences in epidemiology, clinical course and symptomatology of schizophrenia have been widely documented, but still relatively little is known about the brain sexual dimorphism in this psychiatric disorder. While some neuroanatomical and neuropsychological studies have reported existence of differences between male and female patients in a direction of normal sexual dimorphism, others did not find any effect. A few recent reports point to a peculiar disturbance of normal sexual dimorphism in brain regions implicated in the processing of emotions, including amygdala, orbitofrontal cortex and anterior cingulate.
Based on these preliminary structural and functional neuroimaging data, as well as some clinical reports, it is hypothesized in the present paper that schizophrenia is characterized by a reversed (or at least seriously disturbed) cerebral sexual dimorphism. It is further argued that this phenomenon stems from masculinization and/or un-feminization of females and feminizations and/or un-masculinization of males by sex steroid hormones, such as estrogen and testosterone, during both organizational and activational stages of neurodevelopment.
And from the Fernand-Seguin Research Centre of Louis-H. Lafontaine Hospital :
The brain of a schizophrenic woman possesses masculine qualities while that of a man with the same disease hasfeminine attributes, according to a recent study by Dr. Adrianna Mendrek fromFernand-Seguin Research Centre of Louis-H. Lafontaine Hospital.
"We have noted a masculinization of the female brain and a feminization of the male one in schizophrenics. There is a real sexual reversal in men and women with schizophrenia in terms of neuronal circuits, the dimensions of certain cerebral structures and the production of hormones. We therefore sought to find out whether there are similar differences in terms of cerebral functions," explains Adrianna Mendrek, who is also a researcher associated with the Université de Montréal's Department of Psychiatry.
"We thus studied cerebral activation in people with schizophrenia in terms of emotional processing and cognitive analysis. The results are surprising. When we show a sad photo to men with schizophrenia or when we ask them to perform a spatial skills task, they display cerebral activation similar to that of healthy women performing the same tests. Conversely, women with schizophrenia show cerebral activation similar to that of healthy men."
"These results will help us to better understand this complex disease and revise therapeutic and pharmacological treatment methods. It's still difficult to explain what underlies the sexual reversal mechanisms. Could abnormal production of intrauterine sex hormones be the cause? Could this phenomenon arise from social pressures or differences related to sex and gender in our society? Many questions remain unanswered for now. That's what motivates me to continue my research," concludes Adrianna Mendrek.
I've blogged about Schizophrenia's systematic degradation and degeneration of the brain in a previous post. This data came "out of the blue" though, and we have no good idea what it may mean.

When confronted with a correlation between 2 phenomena, A and B, there's 4 possibilities:
  1. A causes B
  2. B causes A
  3. A and B are both caused by C (some other phenomenon)
  4. It's just coincidence
The probability of the last is low enough to be discarded in anything that makes it this far into publication, on the order of winning a lottery.

So let's look at the others.

Does cross-gendering of the brain directly cause schizophrenia? No, because Transsexuals have the same cross-gendering, and there's lots of evidence to show that they don't suffer the same pattern of neurological degeneration shown in schizophrenia. Many have plenty of other psychological issues due to persecution and mistreatment, but there are enough differentials in the diagnosis to show that transsexuality and schizophrenia have no good correlation. See below though for why if such a correlation did exist, it might be hidden.

Does the neurological degeneration in schizophrenia cause an "unravelling" of the sexing of the brain after birth? It could be. As we have no good handle on the exact mechanism that causes gender brain differences during foetal development, we can't say for sure. Both a genetic pre-disposition and anomalous hormonal environment are very likely to be responsible for sexual differentiation, but exactly how, we don't know. It could very well be that post-birth neural degeneration could "unwind the clock" so to speak, and that schizophrenia could well be a kind of neural un-development, or mimic foetal development in reverse. It could be that a closer study of schizophrenia could tell us a lot about what happens in the womb, and with that understanding may be a key in how to treat this hideous and disabling disease. We may be able to re-stimulate foetal development and reverse the degeneration, though it's unlikely the person will ever be quite the same again.

If so, this leads to a very disquieting thought: there really could be a cure for transsexuality. All we'd have to do is to induce the most extreme form of schizophrenia, eventually reducing the person to a completely mindless cabbage, then re-stimulating foetal development and growing a whole new, non-transsexual personality. Still, if we can do that, we could do the same to anyone, killing off one personality, and making a brand new one more to our liking. Take a Hitler and make them into a Martin Luther King. The trouble is, I think the kind of arrogance and inhumanity that would countenance this "therapy" would be more likely to do the reverse... but I digress.

Are schizophrenia and cross-gendered neurology both caused by the same mechanism? Well, if cross-gendered neurology is caused by genetic pre-disposition and anomalous foetal hormones, then a slightly different or additional genetic pre-disposition and the same or slightly different anomalous foetal hormones could very well be responsible for schizophrenia as well. Again, the trouble is that transsexuals aren't schizophrenic, though it could be that schizophrenics may all be transsexual, just with that hidden by the more obvious symptoms. To analogise, an ingrown toenail may not be diagnosed if a leg is obviously gangrenous.

It could also be that not all transsexuality is congenital, that there are many different mechanisms that can cause the same result. It could be that the same post-birth environmental factors can lead to either neurological cross-gendering alone, or both neurological cross-gendering and neurological degeneration too. It could be that for some, both transsexuals and schizophrenics are made, not born, possibly due to post-birth trauma. There may be many routes all leading to similar outcomes.

If I were to guess... I'd put my money on the "unravelling" hypothesis, but would have side-bets that in a minority of cases at least, post-birth environment would be causal, or more likely, triggering of a congenital disposition. But that's all it is, a guess. We need to do more work here.

If you can put aside the terrible suffering that schizophrenics and those who love them endure... if you can forget the very human consequences to those who are schizophrenic, and for that matter, all who have cross-gendered neurology or other Intersex conditions (yes, Ok, including me, but that's not important in my view)... then DARN this is interesting!


Laserlight said...

5. A is caused by C, B is caused by C+D

Bad hair days said...

not AC/DC?
Hm... I read this on the first of April so I had to check the date (and I received a link to another articel stating it earleyer that day) to be sure it was right. On the other hand: My therapist told me long before that she had cases of GID (in this case its disordered) in schizophrenic clients and THC consuments (wich is known to sometimes trigger schizophrenia) but its gone whene the persons schizophrenia is (i don't know the better term) healed with chemicals or the substance abuse stops. So its no wonder we see avidence for that in the brain activity, too. But while this sexual reversal can be "healed", TS is largley known for that no method ever worked to change gender identity.
The differences that where proven by the postmortem studies are not touched by this, either.
So don't panic and read to much into it.

> And another "Who ordered THAT?" moment

Me. I don't want a biased reasearch ever again, enaugh harm is done on tg, ts and intersexed people (and shizophrenics had a good share of mistreatment, too)

I will wait a day till I blog about it myself. Thate date of the post might discredit it otherwise.