Can Prenatal Choline Supplements Prevent Schizophrenia?

Barbara Geller, MD reviewing Ross RG et al. Am J Psychiatry 2015 Oct 5.

Prenatal and postnatal supplementation was associated with less social withdrawal and inattention — two precursors of schizophrenia — at age 40 months.

Adult schizophrenia is associated with risk variants of a nicotinic acetylcholine receptor gene (CHRNA7) and with inhibition of the P50 electroencephalographic response to repeated auditory signals (prepulse inhibition). Because choline deficiency might impair CHRNA7 functioning, these investigators had previously tested whether dietary choline supplementation during pregnancy and infancy affected prepulse inhibition in infants (NEJM JW Psychiatry Mar 2013 and Am J Psychiatry 2013 January 15 [e-pub]). This follow-up analysis examines the effects on preschoolers' behaviors that are precursors to schizophrenia (e.g., social withdrawal, inattention).

Phosphatidylcholine (PCh; used to avoid the obnoxious odor of GI catabolism of choline to urea) or placebo had been provided to 100 mothers during pregnancy and to their infants until 52 weeks after mothers' last menstrual periods. At offspring age 40 months, 49 children (23 in the PCh group) remained, but dropouts and continuers did not differ on multiple characteristics. Children in the PCh group had significantly less social withdrawal and inattention on a standardized checklist, but inattention did not survive correction for multiple comparisons. Social withdrawal was worse in children with CHRNA7 risk alleles and in those with impaired prepulse inhibition in infancy.

Citation(s):

Ross RG et al. Perinatal phosphatidylcholine supplementation and early childhood behavior problems: Evidence for CHRNA7 moderation. Am J Psychiatry 2015 Oct 5; [e-pub].