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Keller GB, Sterzer P. Predictive Processing: A Circuit Approach to Psychosis. Annu Rev Neurosci 2024; 47:85-101. [PMID: 38424472 DOI: 10.1146/annurev-neuro-100223-121214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Predictive processing is a computational framework that aims to explain how the brain processes sensory information by making predictions about the environment and minimizing prediction errors. It can also be used to explain some of the key symptoms of psychotic disorders such as schizophrenia. In recent years, substantial advances have been made in our understanding of the neuronal circuitry that underlies predictive processing in cortex. In this review, we summarize these findings and how they might relate to psychosis and to observed cell type-specific effects of antipsychotic drugs. We argue that quantifying the effects of antipsychotic drugs on specific neuronal circuit elements is a promising approach to understanding not only the mechanism of action of antipsychotic drugs but also psychosis. Finally, we outline some of the key experiments that should be done. The aims of this review are to provide an overview of the current circuit-based approaches to psychosis and to encourage further research in this direction.
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Affiliation(s)
- Georg B Keller
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland;
- Faculty of Natural Science, University of Basel, Basel, Switzerland
| | - Philipp Sterzer
- Department of Psychiatry, University of Basel, Basel, Switzerland
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2
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Shi X, Li M, Yao J, Li MD, Yang Z. Alcohol drinking, DNA methylation and psychiatric disorders: A multi-omics Mendelian randomization study to investigate causal pathways. Addiction 2024; 119:1226-1237. [PMID: 38523595 DOI: 10.1111/add.16465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/05/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND AND AIMS Whether alcohol-related DNA methylation has a causal effect on psychiatric disorders has not been investigated. Furthermore, a comprehensive investigation into the causal relationship and underlying mechanisms linking alcohol consumption and psychiatric disorders has been lacking. This study aimed to evaluate the causal effect of general alcohol intake and pathological drinking behaviors on psychiatric disorders, alcohol-associated DNA methylation on gene expression and psychiatric disorders, and gene expression on psychiatric disorders. DESIGN Two-sample design Mendelian randomization (MR) analysis. Various sensitivity and validation analyses, including colocalization analysis, were conducted to test the robustness of the results. SETTING Genome-wide association study (GWAS) data mainly from GWAS and Sequencing Consortium of Alcohol and Nicotine use (GSCAN), Genetics of DNA Methylation Consortium (GoDMC) and Psychiatric Genomics Consortium (PGC) with European ancestry. PARTICIPANTS The GWAS summary data on general alcohol intake (drinks per week, n = 941 280), pathological drinking behaviors (including alcohol use disorder [AUD, n = 313 959] and problematic alcohol use [PAU, n = 435 563]) and psychiatric disorders (including schizophrenia, major depressive disorder and bipolar disorder, n = 51 710-500 199) were included. Alcohol-related DNA methylation CpG sites (n = 9643) and mQTL data from blood (n = 27 750) and brain (n = 1160), BrainMeta v2 and GTEx V8 eQTL summary data (n = 73-2865) were also included. MEASUREMENTS Genetic variants were selected as instrumental variables for exposures, including drinks per week, AUD, PAU, alcohol-related DNA methylation CpG sites (mQTL) and genes selected (eQTL). FINDINGS Pathological drinking behaviors were associated with an increased risk of psychiatric disorders after removing outliers or controlling for alcohol consumption. MR analysis identified 10 alcohol-related CpG sites with colocalization evidence that were causally associated with psychiatric disorders (P = 1.65 × 10-4-7.52 × 10-22). Furthermore, the expression of genes (RERE, PTK6, GATAD2B, COG8, PDF and GAS5) mapped to these CpG sites in the brain, led by the cortex, were significantly associated with psychiatric disorders (P = 1.19 × 10-2-3.51 × 10-7). CONCLUSIONS Pathological drinking behavior and alcohol-related DNA methylation appear to have a causal effect on psychiatric disorders. The expression of genes regulated by the alcohol-related DNA methylation sites may underpin this association.
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Affiliation(s)
- Xiaoqiang Shi
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Joint Institute of Tobacco and Health, Kunming, Yunnan, China
| | - Meng Li
- Joint Institute of Tobacco and Health, Kunming, Yunnan, China
| | - Jianhua Yao
- Joint Institute of Tobacco and Health, Kunming, Yunnan, China
| | - Ming D Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
| | - Zhongli Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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3
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Ahrens J, Zaher F, Rabin RA, Cassidy CM, Palaniyappan L. Neuromelanin levels in individuals with substance use disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 161:105690. [PMID: 38678736 DOI: 10.1016/j.neubiorev.2024.105690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Dopamine's role in addiction has been extensively studied, revealing disruptions in its functioning throughout all addiction stages. Neuromelanin in the substantia nigra (SN) may reflect dopamine auto-oxidation, and can be quantified using neuromelaninsensitive magnetic resonance imaging (neuromelanin-MRI) in a non-invasive manner.In this pre-registered systematic review, we assess the current body of evidence related to neuromelanin levels in substance use disorders, using both post-mortem and MRI examinations. The systematic search identified 10 relevant articles, primarily focusing on the substantia nigra. An early-stage meta-analysis (n = 6) revealed varied observations ranging from standardized mean differences of -3.55 to +0.62, with a pooled estimate of -0.44 (95 % CI = -1.52, 0.65), but there was insufficient power to detect differences in neuromelanin content among individuals with substance use disorders. Our gap analysis highlights the lack of sufficient replication studies, with existing studies lacking the power to detect a true difference, and a complete lack of neuromelanin studies on certain substances of clinical interest. We provide recommendations for future studies of dopaminergic neurobiology in addictions and related psychiatric comorbidities.
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Affiliation(s)
- Jessica Ahrens
- Douglas Research Centre, Douglas Mental Health Research Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Farida Zaher
- Douglas Research Centre, Douglas Mental Health Research Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Rachel A Rabin
- Douglas Research Centre, Douglas Mental Health Research Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Clifford M Cassidy
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Lena Palaniyappan
- Douglas Research Centre, Douglas Mental Health Research Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Robarts Research Institute, University of Western Ontario, London, Ontario, Canada.
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López-Silva P, Harrow M, Jobe TH, Tufano M, Harrow H, Rosen C. 'Are these my thoughts?': A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations. Schizophr Res 2024; 265:46-57. [PMID: 35945121 DOI: 10.1016/j.schres.2022.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022]
Abstract
The co-occurrence of delusions and other symptoms at the onset of psychosis is a challenge for theories about the aetiology of psychosis. This paper explores the relatedness of delusions about the experience of thinking (thought insertion, thought withdrawal, and thought broadcasting) and auditory verbal hallucinations by describing their trajectories over a 20-year period in individuals diagnosed with schizophrenia, affective and other psychosis, and unipolar depression nonpsychosis. The sample consisted of 407 participants who were recruited at index hospitalization and evaluated over six follow-ups over 20 years. The symptom structure associated with thought insertion included auditory verbal hallucinations, somatic hallucinations, other hallucinations, delusions of thought-dissemination, delusions of control, delusion of self-depreciation, depersonalization and anxiety. The symptom constellation of thought withdrawal included somatic hallucinations, other hallucinations, delusions of thought dissemination, delusions of control, sexual delusions, depersonalization, negative symptoms, depression, and anxiety. The symptom constellation of thought broadcasting included auditory verbal hallucinations, somatic hallucinations, delusions of thought-dissemination, delusion of self-depreciation, fantastic delusions, sexual delusions, and depersonalization. Auditory verbal hallucinations and delusions of self-depreciation were significantly associated with both thought insertion and thought broadcasting. Thought insertion and thought withdrawal were significantly associated with other hallucinations, delusions of control, and anxiety; thought withdrawal and thought broadcasting were significantly related to sexual delusions. We hypothesize that specific symptom constellations over time might be explained as the product of pseudo-coherent realities created to give meaning to the experience of the world and the self of individuals in psychosis based on both prior top-down and ongoing bottom-up elements.
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Affiliation(s)
- Pablo López-Silva
- Faculty of Social Sciences, School of Psychology, Universidad de Valparaíso, Chile
| | - Martin Harrow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Thomas H Jobe
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Michele Tufano
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Helen Harrow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States.
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Yang X, Song Y, Zou Y, Li Y, Zeng J. Neural correlates of prediction error in patients with schizophrenia: evidence from an fMRI meta-analysis. Cereb Cortex 2024; 34:bhad471. [PMID: 38061699 DOI: 10.1093/cercor/bhad471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/19/2024] Open
Abstract
Abnormal processes of learning from prediction errors, i.e. the discrepancies between expectations and outcomes, are thought to underlie motivational impairments in schizophrenia. Although dopaminergic abnormalities in the mesocorticolimbic reward circuit have been found in patients with schizophrenia, the pathway through which prediction error signals are processed in schizophrenia has yet to be elucidated. To determine the neural correlates of prediction error processing in schizophrenia, we conducted a meta-analysis of whole-brain neuroimaging studies that investigated prediction error signal processing in schizophrenia patients and healthy controls. A total of 14 studies (324 schizophrenia patients and 348 healthy controls) using the reinforcement learning paradigm were included. Our meta-analysis showed that, relative to healthy controls, schizophrenia patients showed increased activity in the precentral gyrus and middle frontal gyrus and reduced activity in the mesolimbic circuit, including the striatum, thalamus, amygdala, hippocampus, anterior cingulate cortex, insula, superior temporal gyrus, and cerebellum, when processing prediction errors. We also found hyperactivity in frontal areas and hypoactivity in mesolimbic areas when encoding prediction error signals in schizophrenia patients, potentially indicating abnormal dopamine signaling of reward prediction error and suggesting failure to represent the value of alternative responses during prediction error learning and decision making.
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Affiliation(s)
- Xun Yang
- School of Public Policy and Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yuan Song
- School of Public Policy and Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yuhan Zou
- School of Economics and Business Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yilin Li
- Psychology and Neuroscience Department, University of St Andrews, Forbes 1 DRA, Buchanan Garden, St Andrews, Fife, United Kingdom
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
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Abstract
BACKGROUND AND HYPOTHESIS The neurocomputational framework of predictive processing (PP) provides a promising approach to explaining delusions, a key symptom of psychotic disorders. According to PP, the brain makes inferences about the world by weighing prior beliefs against the available sensory data. Mismatches between prior beliefs and sensory data result in prediction errors that may update the brain's model of the world. Psychosis has been associated with reduced weighting of priors relative to the sensory data. However, delusional beliefs are highly resistant to change, suggesting increased rather than decreased weighting of priors. We propose that this "delusion paradox" can be resolved within a hierarchical PP model: Reduced weighting of prior beliefs at low hierarchical levels may be compensated by an increased influence of higher-order beliefs represented at high hierarchical levels, including delusional beliefs. This may sculpt perceptual processing into conformity with delusions and foster their resistance to contradictory evidence. STUDY DESIGN We review several lines of experimental evidence on low- and high-level processes, and their neurocognitive underpinnings in delusion-related phenotypes and link them to predicted processing. STUDY RESULTS The reviewed evidence supports the notion of decreased weighting of low-level priors and increased weighting of high-level priors, in both delusional and delusion-prone individuals. Moreover, we highlight the role of prefrontal cortex as a neural basis for the increased weighting of high-level prior beliefs and discuss possible clinical implications of the proposed hierarchical predictive-processing model. CONCLUSIONS Our review suggests the delusion paradox can be resolved within a hierarchical PP model.
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Affiliation(s)
- Predrag Petrovic
- Center for Psychiatry Research (CPF), Center for Cognitive and Computational Neuropsychiatry (CCNP), Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Philipp Sterzer
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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Lv M, Wang X, Wang Z, Li X, Wang L, Tan Y, Zhang XY. Alcohol drinking in male patients with chronic schizophrenia: prevalence and its relationship to clinical symptoms. Front Psychiatry 2023; 14:1164968. [PMID: 37520222 PMCID: PMC10372417 DOI: 10.3389/fpsyt.2023.1164968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/19/2023] [Indexed: 08/01/2023] Open
Abstract
Background It is common practice to associate schizophrenia (SCZ) patients with substance use. The most commonly used substances in China are tobacco and alcohol. However, few studies have focused on alcohol consumption itself in patients with SCZ. Thus the purpose of this study was to detect the prevalence of alcohol use and associated clinical factors in Chinese patients with SCZ. Methods A total of 616 male inpatients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for SCZ participated in this study. A detailed questionnaire, including data on alcohol consumption was used to collect demographic and clinical information on all patients. The five-factor model of the positive and negative syndrome scale (PANSS) was adopted to assess psychiatric symptoms. Results In this study, 31.49% of SCZ inpatients had a history of alcohol use, and 82.9% of these patients abstained from alcohol use after the onset of SCZ. Compared to nondrinkers, patients who drank were more likely to smoke (p = 0.004), more likely to have suicide attempts (p = 0.002) and suicidal ideation (p = 0.001), more severe positive (p < 0.001) and depressive symptoms (p = 0.034), but less severe negative symptoms (p = 0.04). Conclusion These findings suggest that alcohol use is common during the lifetime of SCZ patients and that alcohol use may be associated with clinical symptoms in SCZ patients.
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Affiliation(s)
- Menghan Lv
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Xuan Wang
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Xiaohong Li
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Tangmose K, Rostrup E, Bojesen KB, Sigvard A, Glenthøj BY, Nielsen MØ. Clinical response to treatment with a partial dopamine agonist is related to changes in reward processing. Psychiatry Res 2023; 326:115308. [PMID: 37399765 DOI: 10.1016/j.psychres.2023.115308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023]
Abstract
Aberrant neuronal coding of reward processing has been linked to psychosis. It remains unresolved how treatment with a partial dopamine agonist affects reward processing, and whether treatment affects reward processing differently in patients responding and not responding to treatment. Here, 33 antipsychotic-naïve psychosis patients and 33 matched healthy controls underwent functional magnetic resonance imaging before and after patients received aripiprazole monotherapy for six weeks. Processing of motivational salient events and negative outcome evaluation (NOE) was examined using a monetary incentive delay task. Psychopathology was assessed with the Positive and Negative Syndrome Scale, and responders were identified by having ≥30% reduction in positive symptoms (N=21). At baseline, patients displayed an increased NOE signal in the caudate and dorsolateral prefrontal cortex compared to healthy controls. In the caudate, the NOE signal was normalized at follow-up, and normalization was driven by responders. In responders only, there was a significant improvement in the motivational salience signal in the caudate at follow-up. Motivational salience and NOE signals in the caudate may be associated with a dopaminergic mechanism in patients characterized as responders which may not be the case in non-responders. Likewise, non-dopaminergic mechanism may underly abnormal NOE processing in dorsolateral prefrontal cortex.
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Affiliation(s)
- Karen Tangmose
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, University of Copenhagen, Rigshospitalet, Glostrup, Denmark
| | - Kirsten Borup Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Anne Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Fromm SP, Wieland L, Klettke A, Nassar MR, Katthagen T, Markett S, Heinz A, Schlagenhauf F. Computational mechanisms of belief updating in relation to psychotic-like experiences. Front Psychiatry 2023; 14:1170168. [PMID: 37215663 PMCID: PMC10196365 DOI: 10.3389/fpsyt.2023.1170168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/07/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Psychotic-like experiences (PLEs) may occur due to changes in weighting prior beliefs and new evidence in the belief updating process. It is still unclear whether the acquisition or integration of stable beliefs is altered, and whether such alteration depends on the level of environmental and belief precision, which reflects the associated uncertainty. This motivated us to investigate uncertainty-related dynamics of belief updating in relation to PLEs using an online study design. Methods We selected a sample (n = 300) of participants who performed a belief updating task with sudden change points and provided self-report questionnaires for PLEs. The task required participants to observe bags dropping from a hidden helicopter, infer its position, and dynamically update their belief about the helicopter's position. Participants could optimize performance by adjusting learning rates according to inferred belief uncertainty (inverse prior precision) and the probability of environmental change points. We used a normative learning model to examine the relationship between adherence to specific model parameters and PLEs. Results PLEs were linked to lower accuracy in tracking the outcome (helicopter location) (β = 0.26 ± 0.11, p = 0.018) and to a smaller increase of belief precision across observations after a change point (β = -0.003 ± 0.0007, p < 0.001). PLEs were related to slower belief updating when participants encountered large prediction errors (β = -0.03 ± 0.009, p = 0.001). Computational modeling suggested that PLEs were associated with reduced overall belief updating in response to prediction errors (βPE = -1.00 ± 0.45, p = 0.028) and reduced modulation of updating at inferred environmental change points (βCPP = -0.84 ± 0.38, p = 0.023). Discussion We conclude that PLEs are associated with altered dynamics of belief updating. These findings support the idea that the process of balancing prior belief and new evidence, as a function of environmental uncertainty, is altered in PLEs, which may contribute to the development of delusions. Specifically, slower learning after large prediction errors in people with high PLEs may result in rigid beliefs. Disregarding environmental change points may limit the flexibility to establish new beliefs in the face of contradictory evidence. The present study fosters a deeper understanding of inferential belief updating mechanisms underlying PLEs.
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Affiliation(s)
- Sophie Pauline Fromm
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lara Wieland
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Arne Klettke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthew R. Nassar
- Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Neuroscience, Brown University, Providence, RI, United States
| | - Teresa Katthagen
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
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Gibbs-Dean T, Katthagen T, Tsenkova I, Ali R, Liang X, Spencer T, Diederen K. Belief updating in psychosis, depression and anxiety disorders: A systematic review across computational modelling approaches. Neurosci Biobehav Rev 2023; 147:105087. [PMID: 36791933 DOI: 10.1016/j.neubiorev.2023.105087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
Alterations in belief updating are proposed to underpin symptoms of psychiatric illness, including psychosis, depression, and anxiety. Key parameters underlying belief updating can be captured using computational modelling techniques, aiding the identification of unique and shared deficits, and improving diagnosis and treatment. We systematically reviewed research that applied computational modelling to probabilistic tasks measuring belief updating in stable and volatile (changing) environments, across clinical and subclinical psychosis (n = 17), anxiety (n = 9), depression (n = 9) and transdiagnostic samples (n = 9). Depression disorders related to abnormal belief updating in response to the valence of rewards, evidenced in both stable and volatile environments. Whereas psychosis and anxiety disorders were associated with difficulties adapting to changing contingencies specifically, indicating an inflexibility and/or insensitivity to environmental volatility. Higher-order learning models revealed additional difficulties in the estimation of overall environmental volatility across psychosis disorders, showing increased updating to irrelevant information. These findings stress the importance of investigating belief updating in transdiagnostic samples, using homogeneous experimental and computational modelling approaches.
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Affiliation(s)
- Toni Gibbs-Dean
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Teresa Katthagen
- Department of Psychiatry and Neuroscience CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Iveta Tsenkova
- Psychological Medicine, Institute of Psychiatry, Psychology and neuroscience, King's College London, UK
| | - Rubbia Ali
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Xinyi Liang
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Thomas Spencer
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kelly Diederen
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Faustmann TJ, Paschali M, Kojda G, Schilbach L, Kamp D. [Antipsychotic Treatment of Alcohol Withdrawal Syndrome with Focus on Delirium Tremens: a Systematic Review]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2023. [PMID: 36958342 DOI: 10.1055/a-2029-6387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
BACKGROUND Delirium tremens (DT) is a common complication of alcohol withdrawal. Pharmacological treatment of hospitalized patients with DT is important in addiction medicine but also in other medical disciplines where DT can occur as a complication of hospitalization. Patients suffering from DT require treatment with benzodiazepines (short-acting benzodiazepines for elderly patients to reduce accumulation), and in cases of psychotic symptoms, treatment with antipsychotics. Benzodiazepines are a first-line treatment for DT. A specific guideline for the use of antipsychotics has yet to be developed. This review discusses the current guidelines and literature on the antipsychotic treatment options in DT. AIM Systematic presentation of relevant antipsychotics for the treatment of DT. METHODS A systematic literature search was conducted using Scopus and PubMed. The last search was conducted on May 22nd 2022. Original articles and reviews on antipsychotic treatment in alcohol withdrawal and DT were included in this review. Further, international guidelines were also considered. The review was registered using the PROSPERO database (https://www.crd.york.ac.uk/prospero/); CRD42021264611. RESULTS Haloperidol is mainly recommended for use in the intensive care unit. There is little literature on the use of atypical antipsychotics to treat DT. Treatment with antipsychotics always should be combined with benzodiazepines, and physicians should watch out for complications like neuroleptic malignant syndrome, QTc interval prolongation, extrapyramidal symptoms and withdrawal seizures resulting from lowering the threshold for seizures. CONCLUSION Antipsychotic treatment should depend on the experience of the physician. Beside haloperidol, no other clear recommendations are available.
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Affiliation(s)
- Timo Jendrik Faustmann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
- Abteilung für Allgemeine Psychiatrie 2, LVR-Klinikum Düsseldorf, Düsseldorf, Germany
| | - Myrella Paschali
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
- Abteilung für Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Düsseldorf, Germany
| | - Georg Kojda
- Institut für Pharmakologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Leonhard Schilbach
- Abteilung für Allgemeine Psychiatrie 2, LVR-Klinikum Düsseldorf, Düsseldorf, Germany
- Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, München, Germany
| | - Daniel Kamp
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
- Abteilung für Allgemeine Psychiatrie 2, LVR-Klinikum Düsseldorf, Düsseldorf, Germany
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12
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Tangmose K, Rostrup E, Bojesen KB, Sigvard A, Jessen K, Johansen LB, Glenthøj BY, Nielsen MØ. Reward disturbances in antipsychotic-naïve patients with first-episode psychosis and their association to glutamate levels. Psychol Med 2023; 53:1629-1638. [PMID: 37010221 DOI: 10.1017/s0033291721003305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Aberrant anticipation of motivational salient events and processing of outcome evaluation in striatal and prefrontal regions have been suggested to underlie psychosis. Altered glutamate levels have likewise been linked to schizophrenia. Glutamatergic abnormalities may affect the processing of motivational salience and outcome evaluation. It remains unresolved, whether glutamatergic dysfunction is associated with the coding of motivational salience and outcome evaluation in antipsychotic-naïve patients with first-episode psychosis. METHODS Fifty-one antipsychotic-naïve patients with first-episode psychosis (22 ± 5.2 years, female/male: 31/20) and 52 healthy controls (HC) matched on age, sex, and parental education underwent functional magnetic resonance imaging and magnetic resonance spectroscopy (3T) in one session. Brain responses to motivational salience and negative outcome evaluation (NOE) were examined using a monetary incentive delay task. Glutamate levels were estimated in the left thalamus and anterior cingulate cortex using LCModel. RESULTS Patients displayed a positive signal change to NOE in the caudate (p = 0.001) and dorsolateral prefrontal cortex (DLPFC; p = 0.003) compared to HC. No group difference was observed in motivational salience or in levels of glutamate. There was a different association between NOE signal in the caudate and DLPFC and thalamic glutamate levels in patients and HC due to a negative correlation in patients (caudate: p = 0.004, DLPFC: p = 0.005) that was not seen in HC. CONCLUSIONS Our findings confirm prior findings of abnormal outcome evaluation as a part of the pathophysiology of schizophrenia. The results also suggest a possible link between thalamic glutamate and NOE signaling in patients with first-episode psychosis.
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Affiliation(s)
- Karen Tangmose
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Kirsten B Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Anne Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Jessen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Louise Baruël Johansen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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13
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Paranormal believers show reduced resting EEG beta band oscillations and inhibitory control than skeptics. Sci Rep 2023; 13:3258. [PMID: 36828909 PMCID: PMC9958009 DOI: 10.1038/s41598-023-30457-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/23/2023] [Indexed: 02/26/2023] Open
Abstract
Paranormal believers' thinking is frequently biased by intuitive beliefs. Lack of inhibition of these tempting beliefs is considered a key element in paranormal believers' thinking. However, the brain activity related to inhibitory control in paranormal believers is poorly understood. We examined EEG activities at resting state in alpha, beta, and gamma bands with inhibitory control in paranormal believers and skeptics. The present study shows that paranormal belief is related to the reduced power of the alpha, beta, and gamma frequency bands, and reduced inhibitory control. This study may contribute to understanding the differences between believers and skeptics in brain activity related to inhibitory control in paranormal believers.
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14
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Pelz P, Genauck A, Lorenz RC, Wüstenberg T, Wackerhagen C, Charlet K, Gleich T, Geisel O, Heinz A, Müller CA, Beck A. Effects of baclofen on insular gain anticipation in alcohol-dependent patients - a randomized, placebo-controlled, pharmaco-fMRI pilot trial. Psychopharmacology (Berl) 2023; 240:171-183. [PMID: 36538099 PMCID: PMC9816215 DOI: 10.1007/s00213-022-06291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
RATIONALE One hallmark of addiction is an altered neuronal reward processing. In healthy individuals (HC), reduced activity in fronto-striatal regions including the insula has been observed when a reward anticipation task was performed repeatedly. This effect could indicate a desensitization of the neural reward system due to repetition. Here, we investigated this hypothesis in a cohort of patients with alcohol use disorder (AUD), who have been treated with baclofen or a placebo. The efficacy of baclofen in AUD patients has been shown to have positive clinical effects, possibly via indirectly affecting structures within the neuronal reward system. OBJECTIVES Twenty-eight recently detoxified patients (13 receiving baclofen (BAC), 15 receiving placebo (PLA)) were investigated within a longitudinal, double-blind, and randomized pharmaco-fMRI design with an individually adjusted daily dosage of 30-270 mg. METHODS Brain responses were captured by functional magnetic resonance imaging (fMRI) during reward anticipation while participating in a slot machine paradigm before (t1) and after 2 weeks of individual high-dose medication (t2). RESULTS Abstinence rates were significantly higher in the BAC compared to the PLA group during the 12-week high-dose medication phase. At t1, all patients showed significant bilateral striatal activation. At t2, the BAC group showed a significant decrease in insular activation compared to the PLA group. CONCLUSIONS By affecting insular information processing, baclofen might enable a more flexible neuronal adaptation during recurrent reward anticipation, which could resemble a desensitization as previously observed in HC. This result strengthens the modulation of the reward system as a potential mechanism of action of baclofen. TRIAL REGISTRATION Identifier of the main trial (the BACLAD study) at clinical.gov: NCT0126665.
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Affiliation(s)
- Patricia Pelz
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Alexander Genauck
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Bernstein Center for Computational Neuroscience Berlin (BCCN), Unter Den Linden 6, 10099, Berlin, Germany
| | - Robert C Lorenz
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzallee 94, 14195, Berlin, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Research Council Field of Focus IV, Core Facility for Neuroscience of Self-Regulation (CNSR), Heidelberg University, Hauptstr. 51, Building 3011, 69117, Heidelberg, Germany
| | - Carolin Wackerhagen
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Katrin Charlet
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Section On Clinical Genomics and Experimental Therapeutics (CGET), National Institute On Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892-1540, USA
| | - Tobias Gleich
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Epilepsy-Center Berlin-Brandenburg, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Herzbergstr. 79, 10365, Berlin, Germany
| | - Olga Geisel
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christian A Müller
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Anne Beck
- Department of Psychiatry and Neurosciences | CCM, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Health and Medical University, Campus Potsdam, Olympischer Weg 1, 14471, Potsdam, Germany
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15
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Brandt L, Liu S, Heim C, Heinz A. The effects of social isolation stress and discrimination on mental health. Transl Psychiatry 2022; 12:398. [PMID: 36130935 PMCID: PMC9490697 DOI: 10.1038/s41398-022-02178-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Social isolation and discrimination are growing public health concerns associated with poor physical and mental health. They are risk factors for increased morbidity and mortality and reduced quality of life. Despite their detrimental effects on health, there is a lack of knowledge regarding translation across the domains of experimental research, clinical studies, and real-life applications. Here, we review and synthesize evidence from basic research in animals and humans to clinical translation and interventions. Animal models indicate that social separation stress, particularly in early life, activates the hypothalamic-pituitary-adrenal axis and interacts with monoaminergic, glutamatergic, and GABAergic neurotransmitter systems, inducing long-lasting reductions in serotonin turnover and alterations in dopamine receptor sensitivity. These findings are of particular importance for human social isolation stress, as effects of social isolation stress on the same neurotransmitter systems have been implicated in addictive, psychotic, and affective disorders. Children may be particularly vulnerable due to lasting effects of social isolation and discrimination stress on the developing brain. The effects of social isolation and loneliness are pronounced in the context of social exclusion due to discrimination and racism, during widespread infectious disease related containment strategies such as quarantine, and in older persons due to sociodemographic changes. This highlights the importance of new strategies for social inclusion and outreach, including gender, culture, and socially sensitive telemedicine and digital interventions for mental health care.
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Affiliation(s)
- Lasse Brandt
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Shuyan Liu
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Christine Heim
- Department of Medical Psychology, Charité - Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany.
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16
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Dopamine, Psychosis, and Symptom Fluctuation: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10091713. [PMID: 36141325 PMCID: PMC9498563 DOI: 10.3390/healthcare10091713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
It has been hypothesized since the 1960s that the etiology of schizophrenia is linked to dopamine. In the intervening 60 years, sophisticated brain imaging techniques, genetic/epigenetic advances, and new experimental animal models of schizophrenia have transformed schizophrenia research. The disease is now conceptualized as a heterogeneous neurodevelopmental disorder expressed phenotypically in four symptom domains: positive, negative, cognitive, and affective. The aim of this paper is threefold: (a) to review recent research into schizophrenia etiology, (b) to review papers that elicited subjective evidence from patients as to triggers and repressors of symptoms such as auditory hallucinations or paranoid thoughts, and (c) to address the potential role of dopamine in schizophrenia in general and, in particular, in the fluctuations in schizophrenia symptoms. The review also includes new discoveries in schizophrenia research, pointing to the involvement of both striatal neurons and glia, signaling pathway convergence, and the role of stress. It also addresses potential therapeutic implications. We conclude with the hope that this paper opens up novel avenues of research and new possibilities for treatment.
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17
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Nour MM, Liu Y, Dolan RJ. Functional neuroimaging in psychiatry and the case for failing better. Neuron 2022; 110:2524-2544. [PMID: 35981525 DOI: 10.1016/j.neuron.2022.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/06/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
Psychiatric disorders encompass complex aberrations of cognition and affect and are among the most debilitating and poorly understood of any medical condition. Current treatments rely primarily on interventions that target brain function (drugs) or learning processes (psychotherapy). A mechanistic understanding of how these interventions mediate their therapeutic effects remains elusive. From the early 1990s, non-invasive functional neuroimaging, coupled with parallel developments in the cognitive neurosciences, seemed to signal a new era of neurobiologically grounded diagnosis and treatment in psychiatry. Yet, despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition. Likewise, functional neuroimaging plays no role in clinical decision making. Here, we offer a critical commentary on this impasse and suggest how the field might fare better and deliver impactful neurobiological insights.
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Affiliation(s)
- Matthew M Nour
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK; Wellcome Trust Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK; Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK.
| | - Yunzhe Liu
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK; State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Chinese Institute for Brain Research, Beijing 102206, China
| | - Raymond J Dolan
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK; Wellcome Trust Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK; State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
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18
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Liu X, Vigorito M, Huang W, Khan MAS, Chang SL. The Impact of Alcohol-Induced Dysbiosis on Diseases and Disorders of the Central Nervous System. J Neuroimmune Pharmacol 2022; 17:131-151. [PMID: 34843074 DOI: 10.1007/s11481-021-10033-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/11/2021] [Indexed: 12/29/2022]
Abstract
The human digestive tract contains a diverse and abundant microbiota that is important for health. Excessive alcohol use can disrupt the balance of these microbes (known as dysbiosis), leading to elevated blood endotoxin levels and systemic inflammation. Using QIAGEN Ingenuity Pathway Analysis (IPA) bioinformatics tool, we have confirmed that peripheral endotoxin (lipopolysaccharide) mediates various cytokines to enhance the neuroinflammation signaling pathway. The literature has identified alcohol-mediated neuroinflammation as a possible risk factor for the onset and progression of neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD), and psychiatric disorders such as addiction to alcohol and other drugs. In this review, we discuss alcohol-use-induced dysbiosis in the gut and other body parts as a causal factor in the progression of Central Nervous System (CNS) diseases including neurodegenerative disease and possibly alcohol use disorder.
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Affiliation(s)
- Xiangqian Liu
- Institute of Neuroimmune Pharmacology, Seton Hall University, South Orange, NJ, 07079, USA
- Department of Histology and Embryology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R. China
| | - Michael Vigorito
- Institute of Neuroimmune Pharmacology, Seton Hall University, South Orange, NJ, 07079, USA
- Department of Psychology, Seton Hall University, South Orange, NJ, 07079, USA
| | - Wenfei Huang
- Institute of Neuroimmune Pharmacology, Seton Hall University, South Orange, NJ, 07079, USA
- Department of Biological Sciences, Seton Hall University, South Orange, NJ, 07079, USA
| | - Mohammed A S Khan
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School and Shriners Hospital for Children, Boston, MA, 02114, USA.
| | - Sulie L Chang
- Institute of Neuroimmune Pharmacology, Seton Hall University, South Orange, NJ, 07079, USA.
- Department of Biological Sciences, Seton Hall University, South Orange, NJ, 07079, USA.
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19
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Fradkin SI, Silverstein SM. Resistance to Depth Inversion Illusions: A Biosignature of Psychosis with Potential Utility for Monitoring Positive Symptom Emergence and Remission in Schizophrenia. Biomark Neuropsychiatry 2022. [DOI: 10.1016/j.bionps.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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20
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Kunas SL, Stuke H, Heinz A, Ströhle A, Bermpohl F. Evidence for a hijacked brain reward system but no desensitized threat system in quitting-motivated smokers: An fMRI study. Addiction 2022; 117:701-712. [PMID: 34312937 DOI: 10.1111/add.15651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/14/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Several aspects of how quitting-motivated tobacco use disorder (TUD) subjects and never-smokers differ in terms of reward and threat processing remain unresolved. We aimed to examine aberrant reward and threat processes in TUD and the association with smoking characteristics. DESIGN A between- and within-subjects functional magnetic resonance imaging (fMRI) experiment with a 2 (groups) × 4 (stimulus type) factorial design. The experimental paradigm had four conditions: pictures of (1) cigarettes served as drug-related-positive cues, (2) food as alternative reward cues, (3) long-term consequences of smoking as drug-related-negative cues and (4) neutral pictures as control. SETTING/PARTICIPANTS Adult participants (n = 38 TUD subjects and n = 42 never-smokers) were recruited in Berlin, Germany. MEASUREMENTS As contrasts of primary interest, the interactions of group × stimulus-type were assessed. Significance threshold correction for multiple testing was carried out with the family-wise error method. Correlation analyses were used to test the association with smoking characteristics. FINDINGS The 2 × 2 interaction of smoking status and stimulus type revealed activations in the brain reward system to drug-related-positive cues in TUD subjects (between-subjects effect: P-values ≤ 0.036). As a response to drug-related-negative cues, TUD subjects showed no reduced activation of the aversive brain network. Within the TUD group, a significant negative association was found between response of the aversive brain system to drug-related-negative cues (within-subjects effect: P-values ≤ 0.021) and the number of cigarettes smoked per day (right insula r = -0.386, P = 0.024; left insula r = -0.351, P = 0.042; right ACC r = -0.359, P = 0.037). CONCLUSIONS Moderate smokers with tobacco use disorder appear to have altered brain reward processing of drug-related-positive (but not negative) cues compared with never smokers.
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Affiliation(s)
- Stefanie L Kunas
- Campus Charité Mitte, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heiner Stuke
- Campus Charité Mitte, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Campus Charité Mitte, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Ströhle
- Campus Charité Mitte, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Bermpohl
- Campus Charité Mitte, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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21
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Azzali S, Pelizza L, Scazza I, Paterlini F, Garlassi S, Chiri LR, Poletti M, Pupo S, Raballo A. Examining subjective experience of aberrant salience in young individuals at ultra-high risk (UHR) of psychosis: A 1-year longitudinal study. Schizophr Res 2022; 241:52-58. [PMID: 35086058 DOI: 10.1016/j.schres.2021.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/29/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022]
Abstract
Aberrant salience (AS) is considered as a predisposing factor in early psychosis. Although it has been frequently examined in the general population as a measure of vulnerability to psychotic disorder, empirical evidence on AS in prodromal phases of psychosis is still relatively scarce. Thus, the aims of this research were (1) to investigate any significant association of AS with functioning, psychopathology and treatment components of an "early intervention in psychosis" program in a sample of young community help-seekers at Ultra-High Risk (UHR) of psychosis along a 1-year follow-up period, and (2) to longitudinally monitor the stability of AS across the 1 year of follow-up. Participants (87 UHR), aged 13-35 years, completed the Aberrant Salience Inventory (ASI), the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the brief version of the Schizotypal Personality Questionnaire (SPQ-B) at baseline and after the 1 year of follow-up. Spearman correlation analyses among psychopathological parameters and specialized treatment components were performed. A multiple linear regression analysis was also carried out. After a 1-year follow-up period, UHR subjects had a statistically relevant decrease in ASI total scores. This was significantly related to the number of individual cognitive-behavioral therapy (CBT) sessions and the number of family psychoeducational sessions offered to UHR participants and their family members during the same 12-month period. In conclusion, AS is clinically relevant in UHR individuals. However, it seems to improve over time along with the delivery of tailored, specialized psychosocial interventions for early psychosis.
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Affiliation(s)
- Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia (RE), Italy
| | - Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia (RE), Italy; Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1, 43100 Parma (PR), Italy.
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia (RE), Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia (RE), Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia (RE), Italy
| | - Luigi Rocco Chiri
- Department of Primary Care, Azienda USL di Parma, Strada del Quartiere n. 2, 43100 Parma (PR), Italy
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia (RE), Italy
| | - Simona Pupo
- Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100 Reggio Emilia (RE), Italy; Service of Anesthesiology and Resuscitation, Azienda Ospedaliera-Universitaria di Parma, Via Gramsci n. 14, 43100 Parma (PR), Italy
| | - Andrea Raballo
- Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Sant'Andrea delle Fratte, 06156 Perugia (PG), Italy; Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Sant'Andrea delle Fratte, 06156 Perugia (PG), Italy
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22
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Katthagen T, Fromm S, Wieland L, Schlagenhauf F. Models of Dynamic Belief Updating in Psychosis-A Review Across Different Computational Approaches. Front Psychiatry 2022; 13:814111. [PMID: 35492702 PMCID: PMC9039658 DOI: 10.3389/fpsyt.2022.814111] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/18/2022] [Indexed: 11/20/2022] Open
Abstract
To understand the dysfunctional mechanisms underlying maladaptive reasoning of psychosis, computational models of decision making have widely been applied over the past decade. Thereby, a particular focus has been on the degree to which beliefs are updated based on new evidence, expressed by the learning rate in computational models. Higher order beliefs about the stability of the environment can determine the attribution of meaningfulness to events that deviate from existing beliefs by interpreting these either as noise or as true systematic changes (volatility). Both, the inappropriate downplaying of important changes as noise (belief update too low) as well as the overly flexible adaptation to random events (belief update too high) were theoretically and empirically linked to symptoms of psychosis. Whereas models with fixed learning rates fail to adjust learning in reaction to dynamic changes, increasingly complex learning models have been adopted in samples with clinical and subclinical psychosis lately. These ranged from advanced reinforcement learning models, over fully Bayesian belief updating models to approximations of fully Bayesian models with hierarchical learning or change point detection algorithms. It remains difficult to draw comparisons across findings of learning alterations in psychosis modeled by different approaches e.g., the Hierarchical Gaussian Filter and change point detection. Therefore, this review aims to summarize and compare computational definitions and findings of dynamic belief updating without perceptual ambiguity in (sub)clinical psychosis across these different mathematical approaches. There was strong heterogeneity in tasks and samples. Overall, individuals with schizophrenia and delusion-proneness showed lower behavioral performance linked to failed differentiation between uninformative noise and environmental change. This was indicated by increased belief updating and an overestimation of volatility, which was associated with cognitive deficits. Correlational evidence for computational mechanisms and positive symptoms is still sparse and might diverge from the group finding of instable beliefs. Based on the reviewed studies, we highlight some aspects to be considered to advance the field with regard to task design, modeling approach, and inclusion of participants across the psychosis spectrum. Taken together, our review shows that computational psychiatry offers powerful tools to advance our mechanistic insights into the cognitive anatomy of psychotic experiences.
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Affiliation(s)
- Teresa Katthagen
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sophie Fromm
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Lara Wieland
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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23
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Yuan L, Ma X, Li D, Li Z, Ouyang L, Fan L, Yang Z, Zhang Z, Li C, He Y, Chen X. Abnormal Brain Network Interaction Associated With Positive Symptoms in Drug-Naive Patients With First-Episode Schizophrenia. Front Psychiatry 2022; 13:870709. [PMID: 35656348 PMCID: PMC9152123 DOI: 10.3389/fpsyt.2022.870709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Positive symptoms are marked features of schizophrenia, and emerging evidence has suggested that abnormalities of the brain network underlying these symptoms may play a crucial role in the pathophysiology of the disease. We constructed two brain functional networks based on the positive and negative correlations between positive symptom scores and brain connectivity in drug-naive patients with first-episode schizophrenia (FES, n = 45) by using a machine-learning approach (connectome-based predictive modeling, CPM). The accuracy of the model was r = 0.47 (p = 0.002). The positively and negatively associated network strengths were then compared among FES subjects, individuals at genetic high risk (GHR, n = 41) for schizophrenia, and healthy controls (HCs, n = 48). The results indicated that the positively associated network contained more cross-subnetwork connections (96.02% of 176 edges), with a focus on the default-mode network (DMN)-salience network (SN) and the DMN-frontoparietal task control (FPT) network. The negatively associated network had fewer cross-subnetwork connections (71.79% of 117 edges) and focused on the sensory/somatomotor hand (SMH)-Cingulo opercular task control (COTC) network, the DMN, and the visual network with significantly decreased connectivity in the COTC-SMH network in FES (FES < GHR, p = 0.01; FES < HC, p = 0.01). Additionally, the connectivity strengths of the right supplementary motor area (SMA) (p < 0.001) and the right precentral gyrus (p < 0.0001) were reduced in FES. To the best of our knowledge, this is the first study to generate two brain networks associated with positive symptoms by utilizing CPM in FES. Abnormal segregation, interactions of brain subnetworks, and impaired SMA might lead to salience attribution abnormalities and, thus, as a result, induce positive symptoms in schizophrenia.
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Affiliation(s)
- Liu Yuan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiaoqian Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - David Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zongchang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Lijun Ouyang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Lejia Fan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zihao Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zhenmei Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Chunwang Li
- Department of Radiology, Hunan Children's Hospital, Changsha, China
| | - Ying He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiaogang Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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24
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Kesby JP, Murray GK, Knolle F. Neural Circuitry of Salience and Reward Processing in Psychosis. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 3:33-46. [PMID: 36712572 PMCID: PMC9874126 DOI: 10.1016/j.bpsgos.2021.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 02/01/2023] Open
Abstract
The processing of salient and rewarding stimuli is integral to engaging our attention, stimulating anticipation for future events, and driving goal-directed behaviors. Widespread impairments in these processes are observed in psychosis, which may be associated with worse functional outcomes or mechanistically linked to the development of symptoms. Here, we summarize the current knowledge of behavioral and functional neuroimaging in salience, prediction error, and reward. Although each is a specific process, they are situated in multiple feedback and feedforward systems integral to decision making and cognition more generally. We argue that the origin of salience and reward processing dysfunctions may be centered in the subcortex during the earliest stages of psychosis, with cortical abnormalities being initially more spared but becoming more prominent in established psychotic illness/schizophrenia. The neural circuits underpinning salience and reward processing may provide targets for delaying or preventing progressive behavioral and neurobiological decline.
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Affiliation(s)
- James P. Kesby
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia,Address correspondence to James Kesby, Ph.D.
| | - Graham K. Murray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Franziska Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany,Franziska Knolle, Ph.D.
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25
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Castiajo P, Pinheiro AP. Attention to voices is increased in non-clinical auditory verbal hallucinations irrespective of salience. Neuropsychologia 2021; 162:108030. [PMID: 34563552 DOI: 10.1016/j.neuropsychologia.2021.108030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022]
Abstract
Alterations in the processing of vocal emotions have been associated with both clinical and non-clinical auditory verbal hallucinations (AVH), suggesting that changes in the mechanisms underpinning voice perception contribute to AVH. These alterations seem to be more pronounced in psychotic patients with AVH when attention demands increase. However, it remains to be clarified how attention modulates the processing of vocal emotions in individuals without clinical diagnoses who report hearing voices but no related distress. Using an active auditory oddball task, the current study clarified how emotion and attention interact during voice processing as a function of AVH proneness, and examined the contributions of stimulus valence and intensity. Participants with vs. without non-clinical AVH were presented with target vocalizations differing in valence (neutral; positive; negative) and intensity (55 decibels (dB); 75 dB). The P3b amplitude was larger in response to louder (vs. softer) vocal targets irrespective of valence, and in response to negative (vs. neutral) vocal targets irrespective of intensity. Of note, the P3b amplitude was globally increased in response to vocal targets in participants reporting AVH, and failed to be modulated by valence and intensity in these participants. These findings suggest enhanced voluntary attention to changes in vocal expressions but reduced discrimination of salient and non-salient cues. A decreased sensitivity to salience cues of vocalizations could contribute to increased cognitive control demands, setting the stage for an AVH.
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Affiliation(s)
- Paula Castiajo
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Ana P Pinheiro
- Faculdade de Psicologia, CICPSI, Universidade de Lisboa, Lisboa, Portugal; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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26
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Varchmin L, Montag C, Treusch Y, Kaminski J, Heinz A. Traumatic Events, Social Adversity and Discrimination as Risk Factors for Psychosis - An Umbrella Review. Front Psychiatry 2021; 12:665957. [PMID: 34744806 PMCID: PMC8569921 DOI: 10.3389/fpsyt.2021.665957] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 09/17/2021] [Indexed: 12/17/2022] Open
Abstract
Exposure to childhood trauma is a well-known risk factor for severe mental disorders including schizophrenia and other non-affective psychoses. Beyond childhood trauma, there is increasing evidence that bullying, social exclusion, and discrimination during adolescence and adulthood may increase the risk of developing a psychotic disorder, and that such forms of traumatization may also underlie the elevated psychosis risk among migrants or persons with a visible minority status. In this umbrella review, we systematically assess meta-analyses regarding trauma and social adversity. A systematic literature review yielded 11 meta-analyses that met inclusion criteria and could be summarized quantitatively with a random effect model. Furthermore, six meta-analyses were evaluated qualitatively. Heterogeneity and publication bias were apparent in several meta-analyses. We observed that most significant social risk factors for psychosis were vulnerability for racist discrimination [OR = 3.90 (3.25-4.70)], migration [OR = 2.22 (1.75-2.80)], and childhood adversities [OR = 2.81 (2.03-3.83)]. Furthermore, social factors increasing the risk for psychosis were variation/impairment of parental communication, aversive adult life events, bullying, and factors associated with social isolation and discrimination. In spite of these environmental risk factors, there is a lack of evidence regarding treatment of trauma and psychosis, although some psychotherapeutic and art therapy approaches appear to be promising. Beyond individual interventions, stigmatization, racism, and other forms of discrimination need to be targeted to increase solidarity and communal support.
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Affiliation(s)
- Leonie Varchmin
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, University Clinic of the Charité in St. Hedwig Hospital, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
| | - Yvonne Treusch
- Hochschule Döpfer (HSD) Döpfer, University of Applied Science, Cologne, Germany
| | - Jakob Kaminski
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
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27
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Tsujimoto Y, Nakamura Y, Banno M, Kohmura K, Tsujimoto H, Kataoka Y. Humour-based interventions for people with schizophrenia. Cochrane Database Syst Rev 2021; 10:CD013367. [PMID: 34644398 PMCID: PMC8514248 DOI: 10.1002/14651858.cd013367.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Humour-based interventions are defined as any intervention that promotes health and wellness by stimulating a playful discovery, expression, or appreciation of the absurdity or incongruity of life's situations. Humour-based interventions can be implemented in different settings, including hospitals, nursing homes and day care centres. They have been posed as an adjunct to usual care for people with schizophrenia, but a summary of the evidence is lacking. OBJECTIVES To examine the effects of humour-based interventions as an add-on intervention to standard care for people with schizophrenia. SEARCH METHODS On 31 July 2019 and 10 February 2021 we searched the Cochrane Schizophrenia Group's study-based register of trials, which is based on CENTRAL, CINAHL, ClinicalTrials.Gov, Embase, ISRCTN, MEDLINE, PsycINFO, PubMed, and WHO ICTRP. SELECTION CRITERIA We included all randomised controlled trials comparing humour-based interventions with active controls, other psychological interventions, or standard care for people with schizophrenia. We excluded studies fulfilling our prespecified selection criteria but without useable data from further quantitative synthesis. DATA COLLECTION AND ANALYSIS Two review authors independently inspected citations, selected studies, extracted data and appraised study quality, following the guidance from the Cochrane Handbook for Systematic Reviews of Interventions. For binary outcomes we calculated risk ratios (RRs) and their 95% confidence intervals (CIs). For continuous outcomes we calculated the mean differences (MDs) and their 95% CIs. We assessed risks of bias for included studies and created summary of findings tables using the GRADE approach. MAIN RESULTS We included three studies in this review for qualitative synthesis, although one study did not report any relevant outcomes. We therefore include two studies (n = 96) in our quantitative synthesis. No data were available on the following prespecified primary outcomes: clinically-important change in general mental state, clinically-important change in negative symptoms, clinically-important change in overall quality of life, and adverse effects. As compared with active control, humour-based interventions may not improve the average endpoint score of a general mental state scale (Positive and Negative Syndrome Scale (PANSS) total score: MD -1.70, 95% CI -17.01 to 13.61; 1 study, 30 participants; very low certainty of evidence); positive symptoms (PANSS positive symptom score: MD 0.00, 95% CI -2.58 to 2.58; 1 study, 30 participants; low certainty of evidence), negative symptoms (PANSS negative symptom score: MD -0.70, 95% CI -4.22 to 2.82; 1 study, 30 participants; very low certainty of evidence) and anxiety (State-Trait Anxiety Inventory (STAI): MD -2.60, 95% CI -5.76 to 0.56; 1 study, 30 participants; low certainty of evidence). Due to the small sample size, we remain uncertain about the effect of humour-based interventions on leaving the study early as compared with active control (no event, 1 study, 30 participants; very low certainty of evidence). On the other hand, humour-based interventions may reduce depressive symptoms (Beck Depression Inventory (BDI): MD -6.20, 95% CI -12.08 to -0.32; 1 study, 30 participants; low certainty of evidence). Compared with standard care, humour-based interventions may not improve depressive symptoms (BDI second edition: MD 0.80, 95% CI -2.64 to 4.24; 1 study, 59 participants; low certainty of evidence). We are uncertain about the effect of humour-based interventions on leaving the study early for any reason compared with standard care (risk ratio 0.38, 95% CI 0.08 to 1.80; 1 study, 66 participants; very low certainty of evidence). AUTHORS' CONCLUSIONS We are currently uncertain whether the evidence supports the use of humour-based interventions in people with schizophrenia. Future research with rigorous and transparent methodology investigating clinically important outcomes is warranted.
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Affiliation(s)
- Yasushi Tsujimoto
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
- Department of Nephrology and Dialysis, Kyoritsu Hospital, Kawanishi, Japan
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yuri Nakamura
- Department of Clinical Psychology, Kawasaki Univrsity of Medical Welfare, Okayama, Japan
| | - Masahiro Banno
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Psychiatry, Seichiryo Hospital, Nagoya, Japan
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Kohmura
- Department of Psychiatry, Seichiryo Hospital, Nagoya, Japan
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiraku Tsujimoto
- Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Yuki Kataoka
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Internal Medicine, Kyoto Min-iren Asukai Hospital, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
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28
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Fleming KA, Cofresí RU, Bartholow BD. Transfer of incentive salience from a first-order alcohol cue to a novel second-order alcohol cue among individuals at risk for alcohol use disorder: electrophysiological evidence. Addiction 2021; 116:1734-1746. [PMID: 33338310 PMCID: PMC8172423 DOI: 10.1111/add.15380] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/29/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS In susceptible individuals, cues associated with drug use are theorized to take on incentive-motivational properties, including the ability to reinforce higher-order, drug-related associative learning. This study aimed to test this prediction among people varying in risk for alcohol use disorder. DESIGN, SETTING AND PARTICIPANTS Repeated-measures experiment with a measured individual difference variable at a University psychology laboratory in Missouri, USA. One hundred and six young adults (96 contributed complete data) were pre-selected to represent the upper and lower quartiles of self-reported sensitivity to alcohol's acute effects. MEASUREMENTS Participants completed a second-order Pavlovian conditioning paradigm in which an initially neutral visual cue (second-order conditional stimulus; CS2 ) predicted onset of an olfactory cue (first-order conditional stimulus; CS1 ). Olfactory cues were isolated from alcoholic beverages, sweets and non-comestible substances, each presumed to have a natural history of first-order conditioning. Event-related potential responses to the CS2 across its conditioning and extinction, and to the CS1 , provided neurophysiological indices of incentive salience (IS). FINDINGS The IS of the alcohol CS1 was higher among participants low in alcohol sensitivity (LS), relative to their higher-sensitivity (HS) peers. The IS of the CS2 paired with the alcohol CS1 increased across the CS2 conditioning phase among LS but not HS participants. Also, LS (but not HS) individuals also experienced increases in alcohol craving following alcohol CS1 exposure, and this change was correlated with increases in the IS of the CS2 paired with the alcohol CS1 . CONCLUSIONS Alcoholic beverage odor, a proximal cue for alcohol consumption, appears to reinforce conditioning of neurophysiological responses to a novel cue among low alcohol sensitivity (LS) individuals but not high alcohol sensitivity individuals, providing the first evidence that the LS phenotype may be associated with differences in the conditioned reinforcing properties of alcohol-related cues. These findings support the idea that the LS phenotype may increase alcohol use disorder risk via susceptibility to incentive salience sensitization.
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Affiliation(s)
- Kimberly A. Fleming
- Psychiatric and Behavioral Health Institute, Allegheny Health Network
- Department of Psychiatry, Drexel University College of Medicine
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29
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Möller TJ, Georgie YK, Schillaci G, Voss M, Hafner VV, Kaltwasser L. Computational models of the "active self" and its disturbances in schizophrenia. Conscious Cogn 2021; 93:103155. [PMID: 34130210 DOI: 10.1016/j.concog.2021.103155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
The notion that self-disorders are at the root of the emergence of schizophrenia rather than a symptom of the disease, is getting more traction in the cognitive sciences. This is in line with philosophical approaches that consider an enactive self, constituted through action and interaction with the environment. We thereby analyze different definitions of the self and evaluate various computational theories lending to these ideas. Bayesian and predictive processing are promising approaches for computational modeling of the "active self". We evaluate their implementation and challenges in computational psychiatry and cognitive developmental robotics. We describe how and why embodied robotic systems provide a valuable tool in psychiatry to assess, validate, and simulate mechanisms of self-disorders. Specifically, mechanisms involving sensorimotor learning, prediction, and self-other distinction, can be assessed with artificial agents. This link can provide essential insights to the formation of the self and new avenues in the treatment of psychiatric disorders.
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Affiliation(s)
- Tim Julian Möller
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany.
| | - Yasmin Kim Georgie
- Department of Computer Science, Humboldt-Universität zu Berlin, Germany.
| | - Guido Schillaci
- The BioRobotics Institute and Dept. of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Martin Voss
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité University Medicine and St. Hedwig Hospital, Berlin, Germany.
| | | | - Laura Kaltwasser
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany.
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30
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Yaple ZA, Tolomeo S, Yu R. Abnormal prediction error processing in schizophrenia and depression. Hum Brain Mapp 2021; 42:3547-3560. [PMID: 33955106 PMCID: PMC8249895 DOI: 10.1002/hbm.25453] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/01/2021] [Accepted: 04/11/2021] [Indexed: 11/19/2022] Open
Abstract
To make adaptive decisions under uncertainty, individuals need to actively monitor the discrepancy between expected outcomes and actual outcomes, known as prediction errors. Reward‐based learning deficits have been shown in both depression and schizophrenia patients. For this study, we compiled studies that investigated prediction error processing in depression and schizophrenia patients and performed a series of meta‐analyses. In both groups, positive t‐maps of prediction error tend to yield striatum activity across studies. The analysis of negative t‐maps of prediction error revealed two large clusters within the right superior and inferior frontal lobes in schizophrenia and the medial prefrontal cortex and bilateral insula in depression. The concordant posterior cingulate activity was observed in both patient groups, more prominent in the depression group and absent in the healthy control group. These findings suggest a possible role in dopamine‐rich areas associated with the encoding of prediction errors in depression and schizophrenia.
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Affiliation(s)
| | - Serenella Tolomeo
- Department of Psychology, National University of Singapore, Singapore
| | - Rongjun Yu
- Department of Management, Hong Kong Baptist University, Hong Kong, China.,Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Department of Physics, Hong Kong Baptist University, Hong Kong, China
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31
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Schmack K, Bosc M, Ott T, Sturgill JF, Kepecs A. Striatal dopamine mediates hallucination-like perception in mice. Science 2021; 372:eabf4740. [PMID: 33795430 DOI: 10.1126/science.abf4740] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
Hallucinations, a central symptom of psychotic disorders, are attributed to excessive dopamine in the brain. However, the neural circuit mechanisms by which dopamine produces hallucinations remain elusive, largely because hallucinations have been challenging to study in model organisms. We developed a task to quantify hallucination-like perception in mice. Hallucination-like percepts, defined as high-confidence false detections, increased after hallucination-related manipulations in mice and correlated with self-reported hallucinations in humans. Hallucination-like percepts were preceded by elevated striatal dopamine levels, could be induced by optogenetic stimulation of mesostriatal dopamine neurons, and could be reversed by the antipsychotic drug haloperidol. These findings reveal a causal role for dopamine-dependent striatal circuits in hallucination-like perception and open new avenues to develop circuit-based treatments for psychotic disorders.
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Affiliation(s)
- K Schmack
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA.
| | - M Bosc
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - T Ott
- Departments of Neuroscience and Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - J F Sturgill
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - A Kepecs
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA.
- Departments of Neuroscience and Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Gleich T, Spitta G, Butler O, Zacharias K, Aydin S, Sebold M, Garbusow M, Rapp M, Schubert F, Buchert R, Heinz A, Gallinat J. Dopamine D2/3 receptor availability in alcohol use disorder and individuals at high risk: Towards a dimensional approach. Addict Biol 2021; 26:e12915. [PMID: 32500613 DOI: 10.1111/adb.12915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 12/14/2022]
Abstract
Alcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine-related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying 18 F-fallypride positron emission tomography (18 F-PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low-risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future.
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Affiliation(s)
- Tobias Gleich
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Gianna Spitta
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Oisin Butler
- Max Planck Institute for Human Development Center for Lifespan Psychology Berlin Germany
| | - Kristin Zacharias
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Semiha Aydin
- Physikalisch‐Technische Bundesanstalt (PTB) Berlin Germany
| | - Miriam Sebold
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
- Department for Social and Preventive Medicine University of Potsdam Potsdam Germany
| | - Maria Garbusow
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Michael Rapp
- Max Planck Institute for Human Development Center for Lifespan Psychology Berlin Germany
| | | | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Juergen Gallinat
- Department of Psychiatry and Psychotherapy University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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[ICD-11: changes in the diagnostic criteria of substance dependence]. DER NERVENARZT 2021; 93:51-58. [PMID: 33591416 PMCID: PMC8763741 DOI: 10.1007/s00115-021-01071-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 12/15/2022]
Abstract
Hintergrund In der ICD(International Classification of Diseases)-11 ändern sich die Kriterien für die Diagnose der Substanzabhängigkeit. Ziel der Arbeit (Fragestellung) Erörterung der Vor- und Nachteile der neu verfassten Diagnosekriterien. Material und Methoden Diskussion unter Berücksichtigung neurobiologischer, sozialer und klinischer Forschungsergebnisse. Ergebnisse Im ICD-11 werden wie bisher Abhängigkeitserkrankungen und schädlicher Gebrauch unterschieden. Zur Diagnose der Abhängigkeit werden die ehemals 6 Diagnosekriterien in 3 Paaren gebündelt, von denen künftig 2 erfüllt sein müssen. Innerhalb der Paare genügt ein erfülltes Kriterium, damit das Paar als bejaht gilt. Unter Bezugnahme wissenschaftlicher Erkenntnisse im Suchtbereich zeigen sich Vor- und Nachteile. Hierbei könnte sich die Spezifität der Diagnosestellung gegenüber dem ICD-10 verschlechtern, da pro Paar nur ein Kriterium erfüllt sein muss und somit die Möglichkeit besteht, dass nicht problematisches Konsumverhalten inkorrekt pathologisiert und falsch diagnostiziert wird. Das erscheint als problematisch, da die Definition des ICD-10 „Anhaltender Konsum trotz eindeutiger schädlicher Folgen“, im ICD-11 weiter gefasst wird als „Oft fortgeführter Konsum trotz Auftreten von Problemen“. Dies könnte dazu führen, dass das Kriterium einfach deshalb erfüllt wird, weil der Konsum einer Substanz in einem bestimmten Land illegal ist. In der bisher größten multinationalen Studie in 10 Ländern zur Konkordanz der Diagnosesysteme wurde unter Verwendung der ICD-11 die Alkoholabhängigkeit ca. 10 % häufiger gestellt als mittels ICD-10. Schlussfolgerung In der ICD-11 werden die Diagnosen der Substanzabhängig und des Missbrauchs als klinisch sinnvolle Syndrome aufrechterhalten. Ob die diagnostischen Neuerungen in der Praxis hilfreich sind oder beispielsweise negative soziale Auswirkungen für die Betroffenen im Sinne unangemessener Pathologisierung mit sich bringen, ist systematisch zu prüfen.
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Grover T, Gupta R, Arora G, Bal CS, Ambekar A, Basu Ray S, Vaswani M, Sharma A. Dopamine transporter availability in alcohol and opioid dependent subjects - a 99mTc-TRODAT-1SPECT imaging and genetic association study. Psychiatry Res Neuroimaging 2020; 305:111187. [PMID: 32947183 DOI: 10.1016/j.pscychresns.2020.111187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 09/05/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
Abstract
Drug dependence associated with increased dopamine neurotransmission and neuroplastic changes is influenced by Dopamine transporters (DAT) which are modulated by genetic and epigenetic factors. This study assesses DAT availability in relation to the 40bp DAT1 VNTR (genetic) and DAT1 promoter methylation (epigenetic) changes in patients with alcohol dependence (AD) and opioid dependence (OD). A total of 60 subjects (n=20 each of AD, OD and controls) were recruited. SPECT/CT imaging using 99mTc-TRODAT-1 was performed for measuring striatal DAT availability and DNA screened to check DAT1promoter methylation and 40bp VNTR polymorphism. SPECT/CT imaging revealed significant decrease in DAT availability in the striatum and putamen and significant increase in DAT1 promoter methylation in AD compared to control and OD. The 40bp VNTR distribution was similar in all three groups with 10repeat and 9repeat alleles being the most common. The AD individuals with DAT1promoter methylation showed significantly lower TRODAT-1 uptake compared to the ones with no methylation. AD individuals homozygous for the 10repeat VNTR also showed reduced DAT availability. This is the first imaging study using 99mTc-TRODAT-1 from India documenting significantly reduced striatal DAT availability, increased DAT methylation and frequency of 10repeat individuals associated with decreased DAT availability in AD.
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Affiliation(s)
- Tripti Grover
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi 110029, India
| | - Ranjan Gupta
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi 110029, India
| | | | | | - Atul Ambekar
- National Drug Dependence Treatment Center, Department of Psychiatry, AIIMS, New Delhi 110029, India
| | - Subrata Basu Ray
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi 110029, India
| | - Meera Vaswani
- National Drug Dependence Treatment Center, Department of Psychiatry, AIIMS, New Delhi 110029, India; University of Minnesota, USA
| | - Arundhati Sharma
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi 110029, India.
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Heinz A, Mascarell Maricic L, Liu S, Walter H, Schumann G, Beck A. [The IMAGEN cohort: perspectives and problems of longitudinal research]. DER NERVENARZT 2020; 92:228-233. [PMID: 33245403 DOI: 10.1007/s00115-020-01034-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Genetic risk factors for major mental disorders identified in psychiatric research show a substantial overlap. Therefore, it has been suggested that neurobiological research should focus on intermediate phenotypes that reflect shared aspects of different mental disorders due to overlapping genetic effects and environmental factors. Longitudinal studies are required to assess the interaction between genetic variability and modifying environmental factors and to investigate the effects on intermediate phenotypes and (mediated by them) on the expression of individual mental disorders. OBJECTIVE Discussion of the possibilities and limitations of longitudinal cohort studies using the IMAGEN study as an example. MATERIAL AND METHODS The results of the European IMAGEN study are presented with a focus on addiction. RESULTS The longitudinal assessments of the IMAGEN cohort revealed that neuroimaging data indicating a low activation of the dopaminergic reinforcement system detected at the age of 14 years are predictive for increased drug use. In addition to genetic factors, environmental influences such as maternal smoking during pregnancy were correlated with this low activation. CONCLUSION Longitudinal neurobiological basic research can validate the effects of candidate genes and reveal relevant environmental factors. Relevant modifiable factors indicated by the IMAGEN study and related datasets include drug use during pregnancy, trauma and other experiences of violence, social disadvantage and exclusion.
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Affiliation(s)
- A Heinz
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. .,Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Berlin, Deutschland.
| | - L Mascarell Maricic
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - S Liu
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - H Walter
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - G Schumann
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - A Beck
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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Mascarell Maričić L, Walter H, Rosenthal A, Ripke S, Quinlan EB, Banaschewski T, Barker GJ, Bokde ALW, Bromberg U, Büchel C, Desrivières S, Flor H, Frouin V, Garavan H, Itterman B, Martinot JL, Martinot MLP, Nees F, Orfanos DP, Paus T, Poustka L, Hohmann S, Smolka MN, Fröhner JH, Whelan R, Kaminski J, Schumann G, Heinz A. The IMAGEN study: a decade of imaging genetics in adolescents. Mol Psychiatry 2020; 25:2648-2671. [PMID: 32601453 PMCID: PMC7577859 DOI: 10.1038/s41380-020-0822-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 04/10/2020] [Accepted: 06/12/2020] [Indexed: 11/17/2022]
Abstract
Imaging genetics offers the possibility of detecting associations between genotype and brain structure as well as function, with effect sizes potentially exceeding correlations between genotype and behavior. However, study results are often limited due to small sample sizes and methodological differences, thus reducing the reliability of findings. The IMAGEN cohort with 2000 young adolescents assessed from the age of 14 onwards tries to eliminate some of these limitations by offering a longitudinal approach and sufficient sample size for analyzing gene-environment interactions on brain structure and function. Here, we give a systematic review of IMAGEN publications since the start of the consortium. We then focus on the specific phenotype 'drug use' to illustrate the potential of the IMAGEN approach. We describe findings with respect to frontocortical, limbic and striatal brain volume, functional activation elicited by reward anticipation, behavioral inhibition, and affective faces, and their respective associations with drug intake. In addition to describing its strengths, we also discuss limitations of the IMAGEN study. Because of the longitudinal design and related attrition, analyses are underpowered for (epi-) genome-wide approaches due to the limited sample size. Estimating the generalizability of results requires replications in independent samples. However, such densely phenotyped longitudinal studies are still rare and alternative internal cross-validation methods (e.g., leave-one out, split-half) are also warranted. In conclusion, the IMAGEN cohort is a unique, very well characterized longitudinal sample, which helped to elucidate neurobiological mechanisms involved in complex behavior and offers the possibility to further disentangle genotype × phenotype interactions.
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Affiliation(s)
- Lea Mascarell Maričić
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Annika Rosenthal
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Erin Burke Quinlan
- Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, House W34, 3.OG, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Büchel
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | - Sylvane Desrivières
- Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, 68131, Mannheim, Germany
| | - Vincent Frouin
- NeuroSpin, CEA, Université Paris-Saclay, F-91191, Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, 05405, USA
| | - Bernd Itterman
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging& Psychiatry", University Paris Sud, University Paris Descartes-Sorbonne Paris Cité, and Maison de Solenn, Paris, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging & Psychiatry", University Paris Sud, University Paris Descartes, Sorbonne Université, and AP-HP, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | | | - Tomáš Paus
- Rotman Research Institute, Baycrest and Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, M6A 2E1, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, TechnischeUniversität Dresden, Dresden, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, TechnischeUniversität Dresden, Dresden, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Jakob Kaminski
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Gunter Schumann
- Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
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Edemann-Callesen H, Barak S, Hadar R, Winter C. Choosing the Optimal Brain Target for Neuromodulation Therapies as Alcohol Addiction Progresses—Insights From Pre-Clinical Studies. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00316-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Purpose of the Review
Development of addiction involves a transition from reward-driven to habitual behavior, mediated by neuroplastic changes. Based on preclinical findings, this article article reviews the current knowledge on the use of neuromodulation therapies to target alcohol addiction and essentially reduce relapse.
Recent Findings
To date, only a limited number of preclinical studies have investigated the use of neuromodulation in alcohol addiction, with the focus being on targeting the brain reward system. However, as addiction develops, additional circuits are recruited. Therefore, a differential setup may be required when seeking to alter the chronic alcohol-dependent brain, as opposed to treating earlier phases of alcohol addiction.
Summary
To promote enduring relapse prevention, the choice of brain target should match the stage of the disorder. Further studies are needed to investigate which brain areas should be targeted by neuromodulating strategies, in order to sufficiently alter the behavior and pathophysiology as alcohol addiction progresses.
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Abstract
Abstract
Purpose of Review
Losing and regaining control over alcohol intake varies as a function of individual-level predictors across the lifespan. Specifically, the interplay of protective and risk factors for losing and regaining control, particularly in real-life settings, is thus far poorly understood. Individual differences in cognition, affect, emotion regulation, social factors, and personality traits, together with individual differences in brain structure and function, and biological markers of stress exposure may have different effects on alcohol consumption in different age groups. We will review current evidence for age-specific effects for losing and regaining control over alcohol intake and propose a framework for investigation across age groups.
Recent Findings
We find evidence for differences in relative impact of psychosocial predictors of alcohol consumption as a function of age that varies by gender. There is theoretical reason to assume that predictors vary in the time course of their taking effect: While e.g., early trauma and personality traits may be conceptualized as more distant antecedents of alcohol consumption, cognition, affect and emotion regulation can be conceptualized as co-correlates, where variation over periods of months may go along with changes in alcohol consumption. At the same time, craving, current stressors, and priming events may serve as short-term or immediate causes of alcohol consumption.
Summary
We propose a combination of longitudinal age cohorts to (i) identify individual-level differences (using latent growth curve models) and profiles (using latent growth mixture models) of the psychosocial and biological variables of interest that predict regaining or losing control, and ambulatory assessments every 2 days, in order to (ii) investigate effects of triggers and risk factors on current alcohol consumption. This approach will allow us to characterize age-related differences in the interplay between these factors in real-life settings.
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Abstract
Abstract
Purpose of Review
Alcohol use disorder (AUD) is a burdening chronic condition that is characterized by high relapse rates despite severe negative consequences. There has been a recent emergence of interest in (neuro)therapeutic intervention strategies that largely involve the detrimental change in mechanisms linked to addiction disorders. Most prominently, the latter include habitual decision-making, cue-induced behavioral tendencies, as well as the amplifying effects of stressful events on drinking behavior. This article discusses these learning mechanisms and modification thereof as possible targets of (neuro)therapeutic interventions for AUD.
Recent Findings
Psychological therapies that target dysregulated neurocognitive processes underlying addictive behavior may hold promise as effective treatments for AUD.
Summary
Despite the progression in psychological and neuroscience research in the field of AUD, many behavioral interventions fail to systematically integrate and apply such findings into treatment development. Future research should focus on the targeted modification of the aforementioned processes.
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Howes OD, Hird EJ, Adams RA, Corlett PR, McGuire P. Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis. Biol Psychiatry 2020; 88:304-314. [PMID: 32430200 DOI: 10.1016/j.biopsych.2020.03.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 01/24/2023]
Abstract
The aberrant salience hypothesis proposes that striatal dopamine dysregulation causes misattribution of salience to irrelevant stimuli leading to psychosis. Recently, new lines of preclinical evidence on information coding by subcortical dopamine coupled with computational models of the brain's ability to predict and make inferences about the world (predictive processing) provide a new perspective on this hypothesis. We review these and summarize the evidence for dopamine dysfunction, reward processing, and salience abnormalities in people at clinical high risk of psychosis (CHR) relative to findings in patients with psychosis. This review identifies consistent evidence for dysregulated subcortical dopamine function in people at CHR, but also indicates a number of areas where neurobiological processes are different in CHR subjects relative to patients with psychosis, particularly in reward processing. We then consider how predictive processing models may explain psychotic symptoms in terms of alterations in prediction error and precision signaling using Bayesian approaches. We also review the potential role of environmental risk factors, particularly early adverse life experiences, in influencing the prior expectations that individuals have about their world in terms of computational models of the progression from being at CHR to frank psychosis. We identify a number of key outstanding questions, including the relative roles of prediction error or precision signaling in the development of symptoms and the mechanism underlying dopamine dysfunction. Finally, we discuss how the integration of computational psychiatry with biological investigation may inform the treatment for people at CHR of psychosis.
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Affiliation(s)
- Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom; Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
| | - Emily J Hird
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Rick A Adams
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom
| | - Philip R Corlett
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
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Kirschner M, Rabinowitz A, Singer N, Dagher A. From apathy to addiction: Insights from neurology and psychiatry. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109926. [PMID: 32171904 DOI: 10.1016/j.pnpbp.2020.109926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/21/2022]
Abstract
The tendency to engage in addictive behaviors has long been tied to the actions of the dopamine system. Early theories were based on the fact that all addictive drugs and behaviors (such as gambling) increase dopamine levels in the striatum, and the evidence that dopamine signaled reward or reward prediction error. However, with a changing emphasis of addiction away from purely pharmacological models that emphasize tolerance and withdrawal, towards one of behavioral dyscontrol, is there still a place for abnormal dopamine signaling in addiction? Here we recast the dopamine theory of addiction based on the idea that tonic dopamine may index a continuous phenotype that goes from apathy to impulsivity and compulsivity. Higher tonic dopamine signaling would make individuals vulnerable to drug reinforcement and cue-induced craving. We relate this to computational models of dopamine signaling, and review clinical and neuroimaging evidence from Parkinson's Disease, schizophrenia and bipolar disorder in support of this model.
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Affiliation(s)
- Matthias Kirschner
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Arielle Rabinowitz
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Neomi Singer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada.
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Weilnhammer V, Röd L, Eckert AL, Stuke H, Heinz A, Sterzer P. Psychotic Experiences in Schizophrenia and Sensitivity to Sensory Evidence. Schizophr Bull 2020; 46:927-936. [PMID: 32090246 PMCID: PMC7345814 DOI: 10.1093/schbul/sbaa003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Perceptual inference depends on an optimal integration of current sensory evidence with prior beliefs about the environment. Alterations of this process have been related to the emergence of positive symptoms in schizophrenia. However, it has remained unclear whether delusions and hallucinations arise from an increased or decreased weighting of prior beliefs relative to sensory evidence. To investigate the relation of this prior-to-likelihood ratio to positive symptoms in schizophrenia, we devised a novel experimental paradigm which gradually manipulates perceptually ambiguous visual stimuli by disambiguating stimulus information. As a proxy for likelihood precision, we assessed the sensitivity of individual participants to sensory evidence. As a surrogate for the precision of prior beliefs in perceptual stability, we measured phase duration in ambiguity. Relative to healthy controls, patients with schizophrenia showed a stronger increment in congruent perceptual states for increasing levels of disambiguating stimulus evidence. Sensitivity to sensory evidence correlated positively with the individual patients' severity of perceptual anomalies and hallucinations. Moreover, the severity of such experiences correlated negatively with phase duration. Our results indicate that perceptual anomalies and hallucinations are associated with a shift of perceptual inference toward sensory evidence and away from prior beliefs. This reduced prior-to-likelihood ratio in sensory processing may contribute to the phenomenon of aberrant salience, which has been suggested to give rise to the false inferences underlying psychotic experiences.
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Affiliation(s)
- Veith Weilnhammer
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lukas Röd
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anna-Lena Eckert
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Heiner Stuke
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Philipp Sterzer
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
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Knolle F, Garofalo S, Viviani R, Justicia A, Ermakova AO, Blank H, Williams GB, Arrondo G, Ramachandra P, Tudor-Sfetea C, Bunzeck N, Duezel E, Robbins TW, Barker RA, Murray GK. Altered subcortical emotional salience processing differentiates Parkinson's patients with and without psychotic symptoms. NEUROIMAGE-CLINICAL 2020; 27:102277. [PMID: 32540629 PMCID: PMC7298672 DOI: 10.1016/j.nicl.2020.102277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/30/2020] [Accepted: 05/05/2020] [Indexed: 01/03/2023]
Abstract
Emotional salience processing differentiates PD patients with and without psychosis. Enhanced striatal, hippocampal and midbrain responses in PD patients with psychosis. Indication for ‘jumping to conclusions’ bias in the same PD patients with psychosis. Aberrant top-down and salience processing associated with PD psychosis. Similar deficits as proposed in ‘aberrant salience hypothesis’ of schizophrenia.
Objective Current research does not provide a clear explanation for why some patients with Parkinson’s Disease (PD) develop psychotic symptoms. The ‘aberrant salience hypothesis’ of psychosis has been influential and proposes that dopaminergic dysregulation leads to inappropriate attribution of salience to irrelevant/non-informative stimuli, facilitating the formation of hallucinations and delusions. The aim of this study is to investigate whether non-motivational salience is altered in PD patients and possibly linked to the development of psychotic symptoms. Methods We investigated salience processing in 14 PD patients with psychotic symptoms, 23 PD patients without psychotic symptoms and 19 healthy controls. All patients were on dopaminergic medication for their PD. We examined emotional salience using a visual oddball fMRI paradigm that has been used to investigate early stages of schizophrenia spectrum psychosis, controlling for resting cerebral blood flow as assessed with arterial spin labelling fMRI. Results We found significant differences between patient groups in brain responses to emotional salience. PD patients with psychotic symptoms had enhanced brain responses in the striatum, dopaminergic midbrain, hippocampus and amygdala compared to patients without psychotic symptoms. PD patients with psychotic symptoms showed significant correlations between the levels of dopaminergic drugs they were taking and BOLD signalling, as well as psychotic symptom scores. Conclusion Our study suggests that enhanced signalling in the striatum, dopaminergic midbrain, the hippocampus and amygdala is associated with the development of psychotic symptoms in PD, in line with that proposed in the ‘aberrant salience hypothesis’ of psychosis in schizophrenia.
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Affiliation(s)
- F Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Neuroradiology, Technical University Munich, Munich, Germany.
| | - S Garofalo
- University of Bologna, Department of Psychology, Bologna, Italy
| | - R Viviani
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria; Psychiatry and Psychotherapy Clinic III, University of Ulm, Ulm, Germany
| | - A Justicia
- Department of Psychiatry, University of Cambridge, Cambridge, UK; IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - A O Ermakova
- Faculty of Natural Sciences, Imperial College London, UK
| | - H Blank
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G B Williams
- Department of Clinical Neuroscience and WT-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - G Arrondo
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - P Ramachandra
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - C Tudor-Sfetea
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - N Bunzeck
- Institute of Psychology I, University of Lübeck, Lübeck, Germany
| | - E Duezel
- Otto-von-Guericke University Magdeburg, Institute of Cognitive Neurology and Dementia Research, Magdeburg, Germany; German Centre for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - T W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - R A Barker
- Department of Clinical Neuroscience and WT-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - G K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Katthagen T, Kaminski J, Heinz A, Buchert R, Schlagenhauf F. Striatal Dopamine and Reward Prediction Error Signaling in Unmedicated Schizophrenia Patients. Schizophr Bull 2020; 46:1535-1546. [PMID: 32318717 PMCID: PMC7751190 DOI: 10.1093/schbul/sbaa055] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Increased striatal dopamine synthesis capacity has consistently been reported in patients with schizophrenia. However, the mechanism translating this into behavior and symptoms remains unclear. It has been proposed that heightened striatal dopamine may blunt dopaminergic reward prediction error signaling during reinforcement learning. In this study, we investigated striatal dopamine synthesis capacity, reward prediction errors, and their association in unmedicated schizophrenia patients (n = 19) and healthy controls (n = 23). They took part in FDOPA-PET and underwent functional magnetic resonance imaging (fMRI) scanning, where they performed a reversal-learning paradigm. The groups were compared regarding dopamine synthesis capacity (Kicer), fMRI neural prediction error signals, and the correlation of both. Patients did not differ from controls with respect to striatal Kicer. Taking into account, comorbid alcohol abuse revealed that patients without such abuse showed elevated Kicer in the associative striatum, while those with abuse did not differ from controls. Comparing all patients to controls, patients performed worse during reversal learning and displayed reduced prediction error signaling in the ventral striatum. In controls, Kicer in the limbic striatum correlated with higher reward prediction error signaling, while there was no significant association in patients. Kicer in the associative striatum correlated with higher positive symptoms and blunted reward prediction error signaling was associated with negative symptoms. Our results suggest a dissociation between striatal subregions and symptom domains, with elevated dopamine synthesis capacity in the associative striatum contributing to positive symptoms while blunted prediction error signaling in the ventral striatum related to negative symptoms.
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Affiliation(s)
- Teresa Katthagen
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; tel: +49-(0)-30-450-517389, fax: +49-(0)-30-450-517962, e-mail:
| | - Jakob Kaminski
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Berlin Institute of Health, Berlin, Germany,Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Berlin Institute of Health, Berlin, Germany,Cluster of Excellence NeuroCure, Charité-Universitätsmedizin, Berlin, Germany
| | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany,Bernstein Center for Computational Neuroscience, Berlin, Germany
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45
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Modinos G, Allen P, Zugman A, Dima D, Azis M, Samson C, Bonoldi I, Quinn B, Gifford GWG, Smart SE, Antoniades M, Bossong MG, Broome MR, Perez J, Howes OD, Stone JM, Grace AA, McGuire P. Neural Circuitry of Novelty Salience Processing in Psychosis Risk: Association With Clinical Outcome. Schizophr Bull 2020; 46:670-679. [PMID: 32227226 PMCID: PMC7147595 DOI: 10.1093/schbul/sbz089] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Psychosis has been proposed to develop from dysfunction in a hippocampal-striatal-midbrain circuit, leading to aberrant salience processing. Here, we used functional magnetic resonance imaging (fMRI) during novelty salience processing to investigate this model in people at clinical high risk (CHR) for psychosis according to their subsequent clinical outcomes. Seventy-six CHR participants as defined using the Comprehensive Assessment of At-Risk Mental States (CAARMS) and 31 healthy controls (HC) were studied while performing a novelty salience fMRI task that engaged an a priori hippocampal-striatal-midbrain circuit of interest. The CHR sample was then followed clinically for a mean of 59.7 months (~5 y), when clinical outcomes were assessed in terms of transition (CHR-T) or non-transition (CHR-NT) to psychosis (CAARMS criteria): during this period, 13 individuals (17%) developed a psychotic disorder (CHR-T) and 63 did not. Functional activation and effective connectivity within a hippocampal-striatal-midbrain circuit were compared between groups. In CHR individuals compared to HC, hippocampal response to novel stimuli was significantly attenuated (P = .041 family-wise error corrected). Dynamic Causal Modelling revealed that stimulus novelty modulated effective connectivity from the hippocampus to the striatum, and from the midbrain to the hippocampus, significantly more in CHR participants than in HC. Conversely, stimulus novelty modulated connectivity from the midbrain to the striatum significantly less in CHR participants than in HC, and less in CHR participants who subsequently developed psychosis than in CHR individuals who did not become psychotic. Our findings are consistent with preclinical evidence implicating hippocampal-striatal-midbrain circuit dysfunction in altered salience processing and the onset of psychosis.
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Affiliation(s)
- Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,To whom correspondence should be addressed; Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AF London, UK; tel: +44(0)2078480927, fax: +44(0)2078480976, e-mail:
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Psychology, University of Roehampton, London, UK
| | - Andre Zugman
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Danai Dima
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Psychology, School of Arts and Social Sciences, City, University of London, London, UK
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Carly Samson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Beverly Quinn
- CAMEO Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - George W G Gifford
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Sophie E Smart
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Jesus Perez
- CAMEO Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK,Department of Psychiatry, University of Cambridge, Cambridge, UK,Department of Neuroscience, Instituto de Investigacion Biomedica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - James M Stone
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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Henssler J, Brandt L, Müller M, Liu S, Montag C, Sterzer P, Heinz A. Migration and schizophrenia: meta-analysis and explanatory framework. Eur Arch Psychiatry Clin Neurosci 2020; 270:325-335. [PMID: 31161262 DOI: 10.1007/s00406-019-01028-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 12/14/2022]
Abstract
Systematic reviews and meta-analyses suggest that there are increased rates of schizophrenia and related psychoses in first- and second-generation migrants and refugees. Here, we present a meta-analysis on the incidence of non-affective psychotic disorders among first- and second-generation migrants. We found substantial evidence for an increased relative risk of incidence among first- and second-generation migrants compared to the native population. As heterogeneity of included studies was high, effect estimates should be interpreted with caution and as guiding values rather than exact risk estimates. We interpret our findings in the context of social exclusion and isolation stress, and provide an explanatory framework that links cultural differences in verbal communication and experienced discrimination with the emergence of psychotic experiences and their neurobiological correlates. In this context, we discuss studies observing stress-dependent alterations of dopamine neurotransmission in studies among migrants versus non-migrants as well as in subjects with psychotic disorders. We suggest that social stress effects can impair contextualization of the meaning of verbal messages, which can be accounted for in Bayesian terms by a reduced precision of prior beliefs relative to sensory data, causing increased prediction errors and resulting in a shift towards the literal or "concrete" meaning of words. Compensatory alterations in higher-level beliefs, e.g., in the form of generalized interpretations of ambiguous interactions as hostile behavior, may contribute to psychotic experiences in migrants. We thus suggest that experienced discrimination and social exclusion is at the core of increased rates of psychotic experiences in subjects with a migration background.
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Affiliation(s)
- Jonathan Henssler
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lasse Brandt
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Shuyan Liu
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Berlin School of Mind and Brain, Berlin, Germany.,Bernstein Center of Computational Neuroscience Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. .,Berlin School of Mind and Brain, Berlin, Germany. .,Bernstein Center of Computational Neuroscience Berlin, Berlin, Germany.
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Abstract
Perceptual disturbances in psychosis, such as auditory verbal hallucinations, are associated with increased baseline activity in the associative auditory cortex and increased dopamine transmission in the associative striatum. Perceptual disturbances are also associated with perceptual biases that suggest increased reliance on prior expectations. We review theoretical models of perceptual inference and key supporting physiological evidence, as well as the anatomy of associative cortico-striatal loops that may be relevant to auditory perceptual inference. Integrating recent findings, we outline a working framework that bridges neurobiology and the phenomenology of perceptual disturbances via theoretical models of perceptual inference.
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48
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Deserno L, Boehme R, Mathys C, Katthagen T, Kaminski J, Stephan KE, Heinz A, Schlagenhauf F. Volatility Estimates Increase Choice Switching and Relate to Prefrontal Activity in Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:173-183. [DOI: 10.1016/j.bpsc.2019.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/11/2019] [Accepted: 10/06/2019] [Indexed: 12/28/2022]
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49
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Tanaka M, Watanabe Y. RNA Editing of Serotonin 2C Receptor and Alcohol Intake. Front Neurosci 2020; 13:1390. [PMID: 32009879 PMCID: PMC6971223 DOI: 10.3389/fnins.2019.01390] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/10/2019] [Indexed: 01/30/2023] Open
Abstract
Serotonin 2C receptor (5-HT2 CR) belongs to the superfamily of seven transmembrane domain receptors coupled to G proteins (GPCR). It is broadly distributed in the CNS and its expression is relatively high in the limbic system including the amygdala, nucleus accumbens (NAc), hippocampus, and hypothalamus. Based on its expression patterns and numerous pharmacological studies, 5-HT2 CR is thought to be involved in various brain functions including emotion, appetite, and motor behavior. Here, we review 5-HT2 CR and its relationship with alcohol intake with a particular focus on the involvement of 5-HT2 CR mRNA editing and its association with alcohol preference in mice. RNA editing is a post-transcriptional modification mechanism. In mammals, adenosine is converted to inosine by the deamination enzymes ADAR1 and ADAR2. 5-HT2 CR is the only GPCR subjected to RNA editing within the coding region. It has five editing sites in exon 5 that encode the second intracellular loop. Consequently, three amino acids residues (I156, N158, and I160) of the unedited receptor (INI) may be altered to differently edited isoforms, resulting in a change of receptor activity such as 5-HT potency and G-protein coupling. 5-HT2 CR in the NAc is involved in enhanced alcohol drinking after chronic alcohol exposure and alterations in 5-HT2 CR mRNA editing is important in determining the alcohol preference using different strains of mice and genetically modified mice. RNA editing of this receptor may participate in the development of alcoholism.
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Affiliation(s)
- Masaki Tanaka
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshihisa Watanabe
- Department of Basic Geriatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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50
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Wulff S, Nielsen MØ, Rostrup E, Svarer C, Jensen LT, Pinborg L, Glenthøj BY. The relation between dopamine D 2 receptor blockade and the brain reward system: a longitudinal study of first-episode schizophrenia patients. Psychol Med 2020; 50:220-228. [PMID: 30642415 DOI: 10.1017/s0033291718004099] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psychotic symptoms have been linked to salience abnormalities in the brain reward system, perhaps caused by a dysfunction of the dopamine neurotransmission in striatal regions. Blocking dopamine D2 receptors dampens psychotic symptoms and normalises reward disturbances, but a direct relationship between D2 receptor blockade, normalisation of reward processing and symptom improvement has not yet been demonstrated. The current study examined the association between blockade of D2 receptors in the caudate nucleus, alterations in reward processing and the psychopathology in a longitudinal study of antipsychotic-naïve first-episode schizophrenia patients. METHODS Twenty-two antipsychotic-naïve first-episode schizophrenia patients (10 males, mean age 23.3) and 23 healthy controls (12 males, mean age 23.5) were examined with single-photon emission computed tomography using 123I-labelled iodobenzamide. Reward disturbances were measured with functional magnetic resonance imaging (fMRI) using a modified version of the monetary-incentive-delay task. Patients were assessed before and after 6 weeks of treatment with amisulpride. RESULTS In line with previous results, patients had a lower fMRI response at baseline (0.2 ± 0.5 v. 0.7 ± 0.6; p = 0.008), but not at follow-up (0.5 ± 0.6 v. 0.6 ± 0.7), and a change in the fMRI signal correlated with improvement in Positive and Negative Syndrome Scale positive symptoms (ρ = -0.435, p = 0.049). In patients responding to treatment, a correlation between improvement in the fMRI signal and receptor occupancy was found (ρ = 0.588; p = 0.035). CONCLUSION The results indicate that salience abnormalities play a role in the reward system in schizophrenia. In patients responding to a treatment-induced blockade of dopamine D2 receptors, the psychotic symptoms may be ameliorated by normalising salience abnormalities in the reward system.
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Affiliation(s)
- Sanne Wulff
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Physiology, Functional Imaging Unit, Nuclear Medicine and PET, Rigshospitalet Glostrup, University of Copenhagen, København, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Rigshospitalet, University of Copenhagen, København, Denmark
| | - Lars Thorbjørn Jensen
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Lars Pinborg
- Neurobiology Research Unit, Rigshospitalet, University of Copenhagen, København, Denmark
| | - Birte Yding Glenthøj
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
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