Evidence map›Paper›PMID 42440202›Full record

ReviewCurrent environmental health reports2026

Lead (Pb) and the NMDA Receptor Hypofunction Hypothesis: A Comparative Review of Non-Essential Metal Exposures in Schizophrenia.

Jennifer S Smith, Kendall P Dean, Justin A Colacino, Dana C Dolinoy, Alexis J Handal

Abstract readReview
In one paragraph

Review in Current environmental health reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jennifer S SmithDepartment of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48105, USA. smitjen@umich.edu.
Kendall P DeanCellular and Molecular Biology Program, University of Michigan Medical School, Ann Arbor, MI, 48109-5632, USA.
Justin A ColacinoDepartment of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48105, USA.
Dana C DolinoyDepartment of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48105, USA.
Alexis J HandalDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48105, USA.

Funding

Strategic Vision & Impact on Environmental HealthP30ES017885 · NIEHS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Dana Dolinoy · 2011 to 2026
$21.3M
CELLULAR AND MOLECULAR BIOLOGY AT MICHIGANT32GM007315 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI PUTHENVEEDU, MANOJKUMAR A · 1985 to 2021
$12.8M
ENVIRONMENTAL TOXICOLOGY PRE/POST DOCTORAL RES.TRAININGT32ES007062 · NIEHS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Justin Adam Colacino · 1985 to 2026
$10.5M
Risk of Alzheimer's Disease and Related Dementias from Perinatal Lead Exposure: Brain Region and Cell Type EffectsR01AG072396 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Kelly Bakulski, Justin Adam Colacino · 2022 to 2026
$3.7M
NIA NIH HHS R01 AG072396NIEHS NIH HHS P30 ES017885NIEHS NIH HHS R01 AG072396NIEHS NIH HHS T32 ES007062NIGMS NIH HHS T32 GM007315NIH HHS T32GM007315
6 · The paper itself

Abstract

purpose of reviewSchizophrenia (SCZ) is a debilitating neuropsychiatric disorder characterized by hallucinations, delusions, paranoia, and anhedonia [1, 2]. Strong biological plausibility supports a disease-specific relationship between metal and metalloid exposures and SCZ, particularly through disruption of metal ion coordination within with the N-methyl-D-aspartate receptor (NMDAr), a key regulator of neurodevelopment and synaptic plasticity [3-5]. This review synthesizes existing epidemiological evidence linking metal exposure to SCZ and integrates these findings with longstanding hypotheses implicating NMDAr hypofunction as a core neurobiological mechanism underlying the disorder. RECENT

findingsFifteen studies met inclusion criteria, including thirteen identified through systematic database searches and two identified through external sources. Overall, findings demonstrated positive associations between metal exposures and schizophrenia-related outcomes. Lead (Pb) emerged as the most consistently associated metal across studies (associated with SCZ in 8 of 10 studies evaluating Pb). Additional metals and metalloids associated with SCZ included Cd (associated with SCZ in 4 of 9 studies evaluating Cd), Cr (associated with SCZ in 3 out of 5 studies evaluating Cr), U (associated with SCZ in 2 of 2 studies evaluating U), and As (associated with SCZ in 2 of 6 studies evaluating As). The following metals were each also associated with SCZ in 1 of 1 study evaluating them: W, Sb, Ba, and Cs. Dysregulation of essential metals including Se, Fe, Cu, Ca, Mn, and Zn were also associated with SCZ, suggesting that both toxic metal burden and disruption of essential metal homeostasis may contribute to disease risk. Current epidemiological evidence supports an association between metal biomarker levels and SCZ, with Pb most consistently implicated. These findings may be consistent with the NMDAr hypofunction hypothesis. However, inconsistent exposure assessment, variable diagnostic criteria, and limited consideration of developmental timing constrain causal inference. Future research incorporating standardized exposure metrics, improved temporal resolution, and gene-environment frameworks is needed to clarify causal relationships and identify vulnerable populations.

Indexed as

Environmental ExposureEnvironmental PollutantsLeadReceptors, N-Methyl-D-AspartateSchizophreniaHumansMetalsEnvironmental PollutantsLeadMetalsReceptors, N-Methyl-D-AspartateEnvironmental exposureGlutamateLead (Pb)MetalsNMDA receptorSchizophrenia

Identifiers

PMID42440202
PMCPMC13364937

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.