Minor physical anomalies
Encyclopedia
Minor physical anomalies (MPAs) are relatively minor (typically painless and, in themselves, harmless) congenital physical abnormalities consisting of features such as low-seated ears, single transverse palmar crease, telecanthus
, micrognathism
a furrowed tongue. While MPAs may have a genetic basis, they might also be caused by factors in the fetal environment: anoxia
, bleeding, or infection
. MPAs have been linked to disorders of pregnancy
and are thought by some to be a marker for insults to the fetal neural development towards the end of the first trimester. Thus, in the neurodevelopmental literature, they are seen as indirect indications of inferferences with brain development. In studies of children and adolescents with conduct problems, such markers have been linked to some extent to impulsivity
and aggressiveness.
MPAs have been studied in autism
, down syndrome
, and in schizophrenia
. A 2008 meta-analysis
found that MPAs are significantly increased in the autistic population. A 1998 study found that 60% of its schizophrenic sample and 38% of their siblings had 6 or more minor physical anomalies (especially in the craniofacial
area), while only 5% of the control group showed that many.
Some Minor Physical Anomalies related to schizophrenia
have a hypoxic contribution to their formation.
These anomalies are thought to reflect changes in the brain as both are derived from the ectoderm
.
Several minor physical anomalies are attributable in part by hypoxia
. The most often cited minor physical anomaly: high arched palate, is described in articles as a microform of a cleft palate,
The vaulted palate caused by nasal obstruction and consequent mouth breathing, without the lateralising effect of the tongue can produce hypoxia
at night but is not reported as contributing to schizophrenia.
Other malformations are reported only sporadically. Capillary Malformation is induced by RASA1 mutation and can be changed by hypoxia: A study in the American Journal of Psychiatry by Trixler et al.: found hemangiomas to be highly significant in schizophrenia, and one of the authors said hemangiomas would include any birthmark which hadn't faded by adulthood - as this was suspected as abnormal (although he added the correlation wasn't high)(Pers. Comm).
Exotropia
is reported as having low correlation and high significance as well. It can be caused by perinatal hypoxia:
Psychiatry, V 155, Iss 12.
Telecanthus
Telacanthus refers to increased distance between the medial canthi of the eyes, while the inter-pupillary distance is normal...
, micrognathism
Micrognathism
Micrognathism is a condition where the jaw is undersized. It is also sometimes called "Mandibular hypoplasia". It is common in infants, but is usually self-corrected during growth, due to the jaws increasing in size. It may be a cause of abnormal tooth alignment and in severe cases can hamper...
a furrowed tongue. While MPAs may have a genetic basis, they might also be caused by factors in the fetal environment: anoxia
Hypoxia (medical)
Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise...
, bleeding, or infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
. MPAs have been linked to disorders of pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
and are thought by some to be a marker for insults to the fetal neural development towards the end of the first trimester. Thus, in the neurodevelopmental literature, they are seen as indirect indications of inferferences with brain development. In studies of children and adolescents with conduct problems, such markers have been linked to some extent to impulsivity
Impulsivity
Impulsivity is a personality trait characterized by the inclination of an individual to initiate behavior without adequate forethought as to the consequences of their actions, acting on the spur of the moment. Eysenck and Eysenck related impulsivity to risk-taking, lack of planning, and making up...
and aggressiveness.
MPAs have been studied in autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
, down syndrome
Down syndrome
Down syndrome, or Down's syndrome, trisomy 21, is a chromosomal condition caused by the presence of all or part of an extra 21st chromosome. It is named after John Langdon Down, the British physician who described the syndrome in 1866. The condition was clinically described earlier in the 19th...
, and in schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
. A 2008 meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
found that MPAs are significantly increased in the autistic population. A 1998 study found that 60% of its schizophrenic sample and 38% of their siblings had 6 or more minor physical anomalies (especially in the craniofacial
Craniofacial
Craniofacial may be used to describe certain congenital malformations, injuries, surgeons who subspecialize in this area, multi-disciplinary medical-surgical teams that treat and do research on disorders affecting this region, and organizations with interest in...
area), while only 5% of the control group showed that many.
Some Minor Physical Anomalies related to schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
have a hypoxic contribution to their formation.
These anomalies are thought to reflect changes in the brain as both are derived from the ectoderm
Ectoderm
The "ectoderm" is one of the three primary germ cell layers in the very early embryo. The other two layers are the mesoderm and endoderm , with the ectoderm as the most exterior layer...
.
Several minor physical anomalies are attributable in part by hypoxia
Hypoxia (medical)
Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise...
. The most often cited minor physical anomaly: high arched palate, is described in articles as a microform of a cleft palate,
The vaulted palate caused by nasal obstruction and consequent mouth breathing, without the lateralising effect of the tongue can produce hypoxia
Hypoxia (medical)
Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise...
at night but is not reported as contributing to schizophrenia.
Other malformations are reported only sporadically. Capillary Malformation is induced by RASA1 mutation and can be changed by hypoxia: A study in the American Journal of Psychiatry by Trixler et al.: found hemangiomas to be highly significant in schizophrenia, and one of the authors said hemangiomas would include any birthmark which hadn't faded by adulthood - as this was suspected as abnormal (although he added the correlation wasn't high)(Pers. Comm).
Exotropia
Exotropia
Exotropia is a form of strabismus where the eyes are deviated outward. It is the opposite of esotropia. People with exotropia often experience crossed diplopia. Intermittent exotropia is a fairly common condition. "Sensory exotropia" occurs in the presence of poor vision...
is reported as having low correlation and high significance as well. It can be caused by perinatal hypoxia:
Further reading
- Habel, A, Elhadt, N, Sommerlad, B, Powell, J (2005) 'Delayed detection of cleft palate: an audit of newborn examination', Archive of Diseases in Childhood, 91, p238.
Psychiatry, V 155, Iss 12.
- Raine, A. (2002). Annotation: The role of prefrontal deficits, low autonomic arousal, and early health factors in the development of antisocial and aggressive behavior in children. Journal of Child Psychology and Psychiatry, 43(4), 417-434.