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Tognin S, Riecher-Rössler A, Meisenzahl EM, Wood SJ, Hutton C, Borgwardt SJ, Koutsouleris N, Yung AR, Allen P, Phillips LJ, McGorry PD, Valli I, Velakoulis D, Nelson B, Woolley J, Pantelis C, McGuire P, Mechelli A. Reduced parahippocampal cortical thickness in subjects at ultra-high risk for psychosis. Psychol Med 2014; 44:489-498. [PMID: 23659473 PMCID: PMC3880065 DOI: 10.1017/s0033291713000998] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 04/06/2013] [Accepted: 04/11/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Grey matter volume and cortical thickness represent two complementary aspects of brain structure. Several studies have described reductions in grey matter volume in people at ultra-high risk (UHR) of psychosis; however, little is known about cortical thickness in this group. The aim of the present study was to investigate cortical thickness alterations in UHR subjects and compare individuals who subsequently did and did not develop psychosis. METHOD We examined magnetic resonance imaging data collected at four different scanning sites. The UHR subjects were followed up for at least 2 years. Subsequent to scanning, 50 UHR subjects developed psychosis and 117 did not. Cortical thickness was examined in regions previously identified as sites of neuroanatomical alterations in UHR subjects, using voxel-based cortical thickness. RESULTS At baseline UHR subjects, compared with controls, showed reduced cortical thickness in the right parahippocampal gyrus (p < 0.05, familywise error corrected). There were no significant differences in cortical thickness between the UHR subjects who later developed psychosis and those who did not. CONCLUSIONS These data suggest that UHR symptomatology is characterized by alterations in the thickness of the medial temporal cortex. We did not find evidence that the later progression to psychosis was linked to additional alterations in cortical thickness, although we cannot exclude the possibility that the study lacked sufficient power to detect such differences.
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Affiliation(s)
- S. Tognin
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - A. Riecher-Rössler
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, c/o University Hospital Basel, Petersgraben, Basel, Switzerland
| | - E. M. Meisenzahl
- Departments of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - S. J. Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
- School of Psychology, University of Birmingham, Birmingham, UK
| | - C. Hutton
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, UK
| | - S. J. Borgwardt
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, c/o University Hospital Basel, Petersgraben, Basel, Switzerland
| | - N. Koutsouleris
- Departments of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - A. R. Yung
- Orygen Research Centre, University of Melbourne, Victoria, Australia
| | - P. Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - L. J. Phillips
- Psychological Sciences, University of Melbourne, Victoria, Australia
| | - P. D. McGorry
- Orygen Research Centre, University of Melbourne, Victoria, Australia
| | - I. Valli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - D. Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - B. Nelson
- Orygen Research Centre, University of Melbourne, Victoria, Australia
| | - J. Woolley
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - C. Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - P. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - A. Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
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Tully LM, Lincoln SH, Liyanage-Don N, Hooker CI. Impaired cognitive control mediates the relationship between cortical thickness of the superior frontal gyrus and role functioning in schizophrenia. Schizophr Res 2014; 152:358-64. [PMID: 24388000 DOI: 10.1016/j.schres.2013.12.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/28/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
Structural abnormalities in the lateral prefrontal cortex (LPFC) are well-documented in schizophrenia and recent evidence suggests that these abnormalities relate to functional outcome. Cognitive control mechanisms, reliant on the LPFC, are impaired in schizophrenia and predict functional outcome, thus impaired cognitive control could mediate the relationship between neuroanatomical abnormalities in the LPFC and functional outcome. We used surface-based morphometry to investigate relationships between cortical surface characteristics, cognitive control, and measures of social and role functioning in 26 individuals with schizophrenia and 29 healthy controls. Results demonstrate that schizophrenia participants had thinner cortex in a region of the superior frontal gyrus (BA10). Across all participants, decreased cortical thickness in this region related to decreased cognitive control and decreased role functioning. Moreover, cognitive control fully mediated the relationship between cortical thickness in the superior frontal gyrus and role functioning, indicating that neuroanatomical abnormalities in the LPFC adversely impact role functioning via impaired cognitive control processes.
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Affiliation(s)
- Laura M Tully
- Harvard University, Department of Psychology, 33 Kirkland St., Cambridge, MA 02138, USA.
| | - Sarah Hope Lincoln
- Harvard University, Department of Psychology, 33 Kirkland St., Cambridge, MA 02138, USA
| | - Nadia Liyanage-Don
- Harvard University, Department of Psychology, 33 Kirkland St., Cambridge, MA 02138, USA
| | - Christine I Hooker
- Harvard University, Department of Psychology, 33 Kirkland St., Cambridge, MA 02138, USA
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Shiee N, Bazin PL, Cuzzocreo JL, Ye C, Kishore B, Carass A, Calabresi PA, Reich DS, Prince JL, Pham DL. Reconstruction of the human cerebral cortex robust to white matter lesions: method and validation. Hum Brain Mapp 2013; 35:3385-401. [PMID: 24382742 DOI: 10.1002/hbm.22409] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 11/08/2022] Open
Abstract
Cortical atrophy has been reported in a number of diseases, such as multiple sclerosis and Alzheimer's disease, that are also associated with white matter (WM) lesions. However, most cortical reconstruction techniques do not account for these pathologies, thereby requiring additional processing to correct for the effect of WM lesions. In this work, we introduce CRUISE(+), an automated process for cortical reconstruction from magnetic resonance brain images with WM lesions. The process extends previously well validated methods to allow for multichannel input images and to accommodate for the presence of WM lesions. We provide new validation data and tools for measuring the accuracy of cortical reconstruction methods on healthy brains as well as brains with multiple sclerosis lesions. Using this data, we validate the accuracy of CRUISE(+) and compare it to another state-of-the-art cortical reconstruction tool. Our results demonstrate that CRUISE(+) has superior performance in the cortical regions near WM lesions, and similar performance in other regions.
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Affiliation(s)
- Navid Shiee
- Image Analysis and Communication Laboratory, Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland; Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for Advancement of Military Medicine, Bethesda, Maryland
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Sakamoto K, Sawada K, Fukunishi K, Noritaka I, Sakata-Haga H, Yoshihiro F. Postnatal Change in Sulcal Length Asymmetry in Cerebrum of Cynomolgus Monkeys (Macaca fascicularis). Anat Rec (Hoboken) 2013; 297:200-7. [DOI: 10.1002/ar.22847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 10/29/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Kazuhito Sakamoto
- Department of Anatomy and Developmental Neurobiology; University of Tokushima Graduate School Institute of Health Biosciences; Tokushima Japan
- Shin Nippon Biomedical Laboratories, Ltd; Kagoshima Japan
| | - Kazuhiko Sawada
- Department of Physical Therapy; Faculty of Medical and Health Sciences, Tsukuba International University; Tsuchiura Ibaraki Japan
| | - Katsuhiro Fukunishi
- Department of Anatomy and Developmental Neurobiology; University of Tokushima Graduate School Institute of Health Biosciences; Tokushima Japan
| | - Imai Noritaka
- Shin Nippon Biomedical Laboratories, Ltd; Kagoshima Japan
| | - Hiromi Sakata-Haga
- Department of Anatomy and Developmental Neurobiology; University of Tokushima Graduate School Institute of Health Biosciences; Tokushima Japan
| | - Fukui Yoshihiro
- Department of Anatomy and Developmental Neurobiology; University of Tokushima Graduate School Institute of Health Biosciences; Tokushima Japan
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Benetti S, Pettersson-Yeo W, Hutton C, Catani M, Williams SC, Allen P, Kambeitz-Ilankovic LM, McGuire P, Mechelli A. Elucidating neuroanatomical alterations in the at risk mental state and first episode psychosis: a combined voxel-based morphometry and voxel-based cortical thickness study. Schizophr Res 2013; 150:505-11. [PMID: 24084578 PMCID: PMC3824077 DOI: 10.1016/j.schres.2013.08.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 08/16/2013] [Accepted: 08/21/2013] [Indexed: 12/18/2022]
Abstract
Previous studies have reported alterations in grey matter volume and cortical thickness in individuals at high risk of developing psychosis and patients in the early stages of the disorder. Because these studies have typically focused on either grey matter volume or cortical thickness separately, the relationship between these two types of alterations is currently unclear. In the present investigation we used both voxel-based cortical thickness (VBCT) and voxel-based morphometry (VBM) to examine neuroanatomical differences in 21 individuals with an At Risk Mental State (ARMS) for psychosis, 26 patients with a First Episode of Psychosis (FEP) and 24 healthy controls. Statistical inferences were made at P<0.05 after correction for multiple comparisons. Cortical thinning in the right superior temporal gyrus was observed in both individuals at high risk of developing psychosis and patients with a first episode of the disorder, and therefore is likely to represent a marker of vulnerability. In contrast, the right posterior cingulate cortex showed cortical thinning in FEP patients relative to individuals at high risk, and therefore appears to be implicated in the onset of the disease. These neuroanatomical differences were expressed in terms of cortical thickness but not in terms of grey matter volume, and therefore may reflect specific cortical atrophy as opposed to variations in sulcal and gyral morphology.
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Affiliation(s)
- Stefania Benetti
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK.
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Park HY, Hwang JY, Jung WH, Shin NY, Shim G, Jang JH, Kwon JS. Altered asymmetry of the anterior cingulate cortex in subjects at genetic high risk for psychosis. Schizophr Res 2013; 150:512-8. [PMID: 24035404 DOI: 10.1016/j.schres.2013.08.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 08/15/2013] [Accepted: 08/19/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Many studies have reported that patients with schizophrenia often have structural abnormalities of the anterior cingulate cortex (ACC) and that some of these seem to be of genetic origin, therefore predating the onset of illness. The present study aimed to investigate whether these alterations in the ACC are genetic in origin by comparing the morphological patterns of three groups: normal controls, subjects at genetic high risk (GHR) for psychosis, and patients with schizophrenia. The relationships between morphological variations and executive function were also investigated. METHODS This study examined the magnetic resonance images of cingulate sulcus/paracingulate sulcus (CS/PCS) folding patterns in 222 subjects (103 normal subjects, 30 individuals at GHR, and 89 patients with schizophrenia) and evaluated differences in the morphological and asymmetrical patterns of the ACC among groups. Neurocognitive tests were then performed and differences in cognitive performance were analyzed according to morphological variation. RESULTS Differences in PCS folding were detected; the control group was significantly more likely than were other groups to show a well-developed left PCS (p=0.009) and leftward asymmetry of the PCS (p<0.001). However, neither GHR subjects (p=0.346) nor patients (p=0.784) showed this leftward asymmetry. No statistically significant differences in CS continuity were observed. A more prominent left PCS (p=0.031) and leftward PCS asymmetry (p=0.030) were both associated with higher scores on the working memory task. CONCLUSION The results suggest that GHR subjects have distinct neurodevelopmental anomalies that resemble those of patients with schizophrenia even though they do not display any psychotic symptoms. Certain developmental alterations in the ACC, such as the loss of leftward sulcal asymmetry in patients with schizophrenia, might be related to genetic factors. Additionally, this morphological alteration might partly account for the impaired executive function in schizophrenia.
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Affiliation(s)
- Hye Youn Park
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Dodd S, Maes M, Anderson G, Dean OM, Moylan S, Berk M. Putative neuroprotective agents in neuropsychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2013. [PMID: 23178231 DOI: 10.1016/j.pnpbp.2012.11.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In many individuals with major neuropsychiatric disorders including depression, bipolar disorder and schizophrenia, their disease characteristics are consistent with a neuroprogressive illness. This includes progressive structural brain changes, cognitive and functional decline, poorer treatment response and an increasing vulnerability to relapse with chronicity. The underlying molecular mechanisms of neuroprogression are thought to include neurotrophins and regulation of neurogenesis and apoptosis, neurotransmitters, inflammatory, oxidative and nitrosative stress, mitochondrial dysfunction, cortisol and the hypothalamic-pituitary-adrenal axis, and epigenetic influences. Knowledge of the involvement of each of these pathways implies that specific agents that act on some or multiple of these pathways may thus block this cascade and have neuroprotective properties. This paper reviews the potential of the most promising of these agents, including lithium and other known psychotropics, aspirin, minocycline, statins, N-acetylcysteine, leptin and melatonin. These agents are putative neuroprotective agents for schizophrenia and mood disorders.
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Affiliation(s)
- Seetal Dodd
- School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
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58
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Tognin S, Pettersson-Yeo W, Valli I, Hutton C, Woolley J, Allen P, McGuire P, Mechelli A. Using structural neuroimaging to make quantitative predictions of symptom progression in individuals at ultra-high risk for psychosis. Front Psychiatry 2013; 4:187. [PMID: 24523700 PMCID: PMC3905239 DOI: 10.3389/fpsyt.2013.00187] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/24/2013] [Indexed: 12/23/2022] Open
Abstract
Neuroimaging holds the promise that it may one day aid the clinical assessment of individual psychiatric patients. However, the vast majority of studies published so far have been based on average differences between groups, which do not permit accurate inferences at the level of the individual. We examined the potential of structural Magnetic Resonance Imaging (MRI) data for making accurate quantitative predictions about symptom progression in individuals at ultra-high risk for developing psychosis. Forty people at ultra-high risk for psychosis were scanned using structural MRI at first clinical presentation and assessed over a period of 2 years using the Positive and Negative Syndrome Scale. Using a multivariate machine learning method known as relevance vector regression (RVR), we examined the relationship between brain structure at first clinical presentation, characterized in terms of gray matter (GM) volume and cortical thickness (CT), and symptom progression at 2-year follow-up. The application of RVR to whole-brain CT MRI data allowed quantitative prediction of clinical scores with statistically significant accuracy (correlation = 0.34, p = 0.026; Mean Squared-Error = 249.63, p = 0.024). This prediction was informed by regions traditionally associated with schizophrenia, namely the right lateral and medial temporal cortex and the left insular cortex. In contrast, the application of RVR to GM volume did not allow prediction of symptom progression with statistically significant accuracy. These results provide proof-of-concept that it could be possible to use structural MRI to inform quantitative prediction of symptom progression in individuals at ultra-high risk of developing psychosis. This would enable clinicians to target those individuals at greatest need of preventative interventions thereby resulting in a more efficient use of health care resources.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - William Pettersson-Yeo
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Isabel Valli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Chloe Hutton
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London , London , UK
| | - James Woolley
- Division of Experimental Medicine, Imperial College London , London , UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
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Schultz CC, Fusar-Poli P, Wagner G, Koch K, Schachtzabel C, Gruber O, Sauer H, Schlösser RGM. Multimodal functional and structural imaging investigations in psychosis research. Eur Arch Psychiatry Clin Neurosci 2012; 262 Suppl 2:S97-106. [PMID: 22940744 DOI: 10.1007/s00406-012-0360-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 08/15/2012] [Indexed: 12/15/2022]
Abstract
Substantial pathophysiological questions about the relationship of brain pathologies in psychosis can only be answered by multimodal neuroimaging approaches combining different imaging modalities such as structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), positron emission tomography (PET) and magnetic-resonance spectroscopy. In particular, the multimodal imaging approach has the potential to shed light on the neuronal mechanisms underlying the major brain structural and functional pathophysiological features of schizophrenia and high-risk states such as prefronto-temporal gray matter reduction, altered higher-order cognitive processing, or disturbed dopaminergic and glutamatergic neurotransmission. In recent years, valuable new findings have been revealed in these fields by multimodal imaging studies mostly reflecting a direct and aligned correlation of brain pathologies in psychosis. However, the amount of multimodal studies is still limited, and further efforts have to be made to consolidate previous findings and to extend the scope to other pathophysiological parameters contributing to the pathogenesis of psychosis. Here, investigating the genetic foundations of brain pathology relationships is a major challenge for future multimodal imaging applications in psychosis research.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740 Jena, Germany.
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60
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Wang J, Liu DQ, Zhang H, Zhu WX, Dong ZY, Zang YF. Asymmetry of the Dorsal Anterior Cingulate Cortex: Evidences from Multiple Modalities of MRI. Neuroinformatics 2012; 11:149-57. [DOI: 10.1007/s12021-012-9167-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rais M, Cahn W, Schnack HG, Hulshoff Pol HE, Kahn RS, van Haren NEM. Brain volume reductions in medication-naive patients with schizophrenia in relation to intelligence quotient. Psychol Med 2012; 42:1847-1856. [PMID: 22357376 DOI: 10.1017/s0033291712000098] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Global brain abnormalities such as brain volume loss and grey- and white-matter deficits are consistently reported in first-episode schizophrenia patients and may already be detectable in the very early stages of the illness. Whether these changes are dependent on medication use or related to intelligence quotient (IQ) is still debated. METHOD Magnetic resonance imaging scans were obtained for 20 medication-naive patients with first-episode schizophrenia and 26 matched healthy subjects. Volume measures of total brain grey and white matter, third and lateral ventricles and cortical thickness/surface were obtained. Differences between the groups were investigated, taking into account the effect of intelligence. RESULTS Medication-naive patients showed statistically significant reductions in whole-brain volume and cerebral grey- and white-matter volume together with lateral ventricle enlargement compared to healthy subjects. IQ was significantly lower in patients compared to controls and was positively associated with brain and white-matter volume in the whole group. No significant differences in cortical thickness were found between the groups but medication-naive patients had a significantly smaller surface in the left superior temporal pole, Heschl's gyrus and insula compared to controls. CONCLUSIONS Our findings suggest that brain volume loss is present at illness onset, and can be explained by the reduced surface of the temporal and insular cortex. These abnormalities are not related to medication, but IQ.
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Affiliation(s)
- M Rais
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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Schaeffer EL, Kühn F, Schmitt A, Gattaz WF, Gruber O, Schneider-Axmann T, Falkai P, Schmitt A. Increased cell proliferation in the rat anterior cingulate cortex following neonatal hypoxia: relevance to schizophrenia. J Neural Transm (Vienna) 2012; 120:187-95. [PMID: 22806004 PMCID: PMC3535379 DOI: 10.1007/s00702-012-0859-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 06/29/2012] [Indexed: 01/20/2023]
Abstract
As a consequence of obstetric complications, neonatal hypoxia has been discussed as an environmental factor in the pathophysiology of schizophrenia. However, the biological consequences of hypoxia are unclear. The neurodevelopmental hypothesis of schizophrenia suggests that the onset of abnormal brain development and neuropathology occurs perinatally, whereas symptoms of the disease appear in early adulthood. In our animal model of chronic neonatal hypoxia, we have detected behavioral alterations resembling those known from schizophrenia. Disturbances in cell proliferation possibly contribute to the pathophysiology of this disease. In the present study, we used postnatal rats to investigate cell proliferation in several brain areas following neonatal hypoxia. Rats were repeatedly exposed to hypoxia (89 % N2, 11 % O2) from postnatal day (PD) 4–8. We then evaluated cell proliferation on PD 13 and 39, respectively. These investigations were performed in the anterior cingulate cortex (ACC), caudate-putamen (CPU), dentate gyrus, and subventricular zone. Rats exposed to hypoxia exhibited increased cell proliferation in the ACC at PD 13, normalizing at PD 39. In other brain regions, no alterations have been detected. Additionally, hypoxia-treated rats showed decreased CPU volume at PD 13. The results of the present study on the one hand support the assumption of chronic hypoxia influencing transient cell proliferation in the ACC, and on the other hand reveal normalization during ageing.
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Affiliation(s)
- Evelin L. Schaeffer
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Franziska Kühn
- Department of Psychiatry and Psychotherapy, Georg-August-University, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Angelika Schmitt
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstr. 15, 97080 Würzburg, Germany
| | - Wagner F. Gattaz
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Oliver Gruber
- Department of Psychiatry and Psychotherapy, Georg-August-University, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Georg-August-University, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Georg-August-University, von-Siebold-Str. 5, 37075 Göttingen, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nußbaumstr. 7, 80336 Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, Georg-August-University, von-Siebold-Str. 5, 37075 Göttingen, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nußbaumstr. 7, 80336 Munich, Germany
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Li X, Alapati V, Jackson C, Xia S, Bertisch HC, Branch CA, Delisi LE. Structural abnormalities in language circuits in genetic high-risk subjects and schizophrenia patients. Psychiatry Res 2012; 201:182-9. [PMID: 22512952 PMCID: PMC3361621 DOI: 10.1016/j.pscychresns.2011.07.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 07/18/2011] [Accepted: 07/28/2011] [Indexed: 11/17/2022]
Abstract
Schizophrenia is a severe psychiatric disorder with a strong genetic predisposition. Structural and functional brain deficits throughout the cerebral cortex, particularly in the language-processing associated brain regions, are consistently reported. Recently, increasing evidence from magnetic resonance imaging (MRI) studies suggests that healthy relatives of schizophrenia patients also show structural brain abnormalities in cortical gray matter (GM) volume and thickness, suggesting that this may be associated with an unexpressed genetic liability for the disorder. Unfortunately, the findings are not consistent, which may be caused by different age ranges of the cohorts studied. In the present study, we examined the voxel-based whole brain cortical thickness, area, GM volume densities, and regional cortical thickness-related laterality indices in 14 bilateral regions of interest (ROIs) from known language-processing circuits in 20 schizophrenia patients, 21 young non-psychotic subjects with heightened genetic risk for schizophrenia at the peak ages for development of the disorder, and 48 matched controls. The results showed widespread significant reductions in cortical thickness, cortical GM volume density, and scattered decreases in cortical surface area in the schizophrenia patients compared with those in the high-risk subjects and normal controls. Moreover, the genetic high-risk subjects showed significantly increased regional cortical thickness in 7 of the 14 ROIs in the language-processing pathway when compared with controls. They also had increased GM volume density in scattered regions associated with language-processing when compared with the normal controls. Laterality analyses showed that the spatial distribution of abnormal cortical thickness in the schizophrenia patients, as well as in the high-risk subjects, contributes to a decrease of the normal left-greater-than-right anatomical asymmetry in the inferior orbital frontal area, and a increased left-greater-than-right pattern in the inferior parietal and occipital regions. Together with the existing findings in the literature, the results of the present study suggest that developmental disruption of the anatomical differentiation of the hemispheres provides a basis for understanding the language impairment and symptoms of psychosis, and that these may arise because of abnormal left-right hemispherical communications that interrupt the normal flow of information processing. The early structural deficits in language-processing circuits may precede the appearance of psychotic symptoms and may be an indicator of an increased risk of developing schizophrenia.
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Affiliation(s)
- Xiaobo Li
- Department of Radiology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
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Rimol LM, Nesvåg R, Hagler DJ, Bergmann O, Fennema-Notestine C, Hartberg CB, Haukvik UK, Lange E, Pung CJ, Server A, Melle I, Andreassen OA, Agartz I, Dale AM. Cortical volume, surface area, and thickness in schizophrenia and bipolar disorder. Biol Psychiatry 2012; 71:552-60. [PMID: 22281121 DOI: 10.1016/j.biopsych.2011.11.026] [Citation(s) in RCA: 242] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 11/22/2011] [Accepted: 11/22/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Magnetic resonance imaging studies have shown that structural brain abnormalities are present in both schizophrenia and bipolar disorder. Most previous studies have focused on brain tissue volumes, but advances in neuroimaging data processing have made it possible to separate cortical area and cortical thickness. The purpose of the present study was to provide a more complete picture of cortical morphometric differences in schizophrenia and bipolar disorder, decomposing cortical volume into its constituent parts, cortical thickness and cortical area. METHODS We analyzed magnetic resonance imaging images from a sample of 173 patients with schizophrenia, 139 patients with bipolar disorder, and 207 healthy control subjects. Maps of cortical volume, area, and thickness across the continuous cortical surface were generated within groups and compared between the groups. RESULTS There were widespread reductions in cortical volume in schizophrenia relative to healthy control subjects and patients with bipolar disorder type I. These reductions were mainly driven by cortical thinning, but there were also cortical area reductions in more circumscribed regions, which contributed to the observed volume reductions. CONCLUSIONS The current surface-based methodology allows for a distinction between cortical thinning and reduction in cortical area and reveals that cortical thinning is the most important factor in volume reduction in schizophrenia. Cortical area reduction was not observed in bipolar disorder type I and may be unique to schizophrenia.
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Affiliation(s)
- Lars M Rimol
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway.
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Koch K, Schultz CC, Wagner G, Schachtzabel C, Reichenbach JR, Sauer H, Schlösser RGM. Disrupted white matter connectivity is associated with reduced cortical thickness in the cingulate cortex in schizophrenia. Cortex 2012; 49:722-9. [PMID: 22402338 DOI: 10.1016/j.cortex.2012.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 10/21/2011] [Accepted: 02/02/2012] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Both impaired white matter connectivity and alterations in gray matter morphometry have repeatedly been reported in schizophrenia. Neurodevelopmental models propose a close linkage between gray matter alterations and white matter deficits. However, there are no studies investigating alterations in cortical thickness in relation to white matter connectivity changes. METHODS This combined diffusion tensor imaging (DTI) - surface based morphometry study examined a potential linkage between disruption in white matter connectivity and alterations in cortical thickness. Cortical thickness was analyzed using the FreeSurfer software package (version 4.0.5, http://surfer.nmr.harvard.edu) in a sample of 19 patients with schizophrenia and 20 healthy controls. RESULTS Whole brain node-by-node correlational analysis revealed a highly significant association ( r= -.8, p < .0001) between disturbed white matter connectivity in the superior temporal cortex and diminished cortical thickness in the posterior part of the cingulate cortex (Brodmann area 23/31). CONCLUSIONS This result indicates a significant linkage between disturbed white matter connectivity and reduced cortical thickness in a relevant node of the default mode network that is held to be of high pathophysiological relevance in schizophrenia. The result moreover provides support for the assumption of a neurodevelopmental pathogenesis of the disorder.
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Affiliation(s)
- Kathrin Koch
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jahnstr. 3, Jena, Germany.
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Bora E, Fornito A, Yücel M, Pantelis C. The effects of gender on grey matter abnormalities in major psychoses: a comparative voxelwise meta-analysis of schizophrenia and bipolar disorder. Psychol Med 2012; 42:295-307. [PMID: 21835091 DOI: 10.1017/s0033291711001450] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recent evidence from genetic and familial studies revitalized the debate concerning the validity of the distinction between schizophrenia and bipolar disorder. Comparing brain imaging findings is an important avenue to examine similarities and differences and, therefore, the validity of the distinction between these conditions. However, in contrast to bipolar disorder, most patient samples in studies of schizophrenia are predominantly male. This a limiting factor for comparing schizophrenia and bipolar disorder since male gender is associated with more severe neurodevelopmental abnormalities, negative symptoms and cognitive deficits in schizophrenia. METHOD We used a coordinate-based meta-analysis technique to compare grey matter (GM) abnormalities in male-dominated schizophrenia, gender-balanced schizophrenia and bipolar disorder samples based on published voxel-based morphometry (VBM) studies. In total, 72 English-language, peer reviewed articles published prior to January 2011 were included. All reports used VBM for comparing schizophrenia or bipolar disorder with controls and reported whole-brain analyses in standard stereotactic space. RESULTS GM reductions were more extensive in male-dominated schizophrenia compared to gender-balanced bipolar disorder and schizophrenia. In gender-balanced samples, GM reductions were less severe. Compared to controls, GM reductions were restricted to dorsal anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex in schizophrenia and ACC and bilateral fronto-insular cortex in bipolar disorder. CONCLUSIONS When gender is controlled, GM abnormalities in bipolar disorder and schizophrenia are mostly restricted to regions that have a role in emotional and cognitive aspects of salience respectively. Dorsomedial and dorsolateral prefrontal cortex were the only regions that showed greater GM reductions in schizophrenia compared to bipolar disorder.
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Affiliation(s)
- E Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - A Fornito
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - M Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
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Schultz CC, Koch K, Wagner G, Nenadic I, Schachtzabel C, Güllmar D, Reichenbach JR, Sauer H, Schlösser RGM. Reduced anterior cingulate cognitive activation is associated with prefrontal-temporal cortical thinning in schizophrenia. Biol Psychiatry 2012; 71:146-53. [PMID: 21967959 DOI: 10.1016/j.biopsych.2011.08.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 08/17/2011] [Accepted: 08/17/2011] [Indexed: 12/25/2022]
Abstract
BACKGROUND The anterior cingulate cortex plays a central role in altered processes of cognitive control in schizophrenia. However, the cortical foundations of disturbed anterior cingulate cognitive activation are poorly understood. Therefore, this study investigated the association of anterior cingulate cognitive activation and cortical thickness in schizophrenia combining functional magnetic resonance imaging (fMRI) and surface-based morphometry. METHODS Fifty-three patients with schizophrenia according to DSM-IV and 53 age- and sex-matched healthy subjects were included and underwent fMRI and high-resolution T1-weighted MRI. fMRI data was analyzed using SPM5. Cortical thickness was calculated using an automated computerized algorithm (Freesurfer Software). Statistical cortical maps were created correlating anterior cingulate activation and cortical thickness on a node-by-node basis covering the entire cortex in schizophrenia and healthy control subjects. RESULTS Patients demonstrated a significantly reduced anterior cingulate cognitive activation. Significantly differing associations of anterior cingulate activation and cortical thickness were found in a pattern of dorsolateral prefrontal, superior frontal-anterior cingulate, and superior temporal cortical regions, where patients but not healthy control subjects demonstrated a significant association of reduced anterior cingulate activation and cortical thinning. A direct comparison of cortical thickness between the diagnostic groups revealed a significantly reduced cortical thickness of these prefrontotemporal regions in schizophrenia. CONCLUSIONS To our best knowledge, this is the first study indicating that prefrontotemporal cortical thinning constitutes a relevant cortical pathomechanism for altered cognitive activation in schizophrenia. Our data additionally reveal a profound disruption of structural and functional integration in the prefrontotemporal system in schizophrenia.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University Jena, Jena, Germany
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The visual cortex in schizophrenia: alterations of gyrification rather than cortical thickness—a combined cortical shape analysis. Brain Struct Funct 2011; 218:51-8. [DOI: 10.1007/s00429-011-0374-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
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Bennett M. Schizophrenia: susceptibility genes, dendritic-spine pathology and gray matter loss. Prog Neurobiol 2011; 95:275-300. [DOI: 10.1016/j.pneurobio.2011.08.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 08/12/2011] [Accepted: 08/15/2011] [Indexed: 02/01/2023]
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Waters-Metenier S, Toulopoulou T. Putative structural neuroimaging endophenotypes in schizophrenia: a comprehensive review of the current evidence. FUTURE NEUROLOGY 2011. [DOI: 10.2217/fnl.11.35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The genetic contribution to schizophrenia etiopathogenesis is underscored by the fact that the best predictor of developing schizophrenia is having an affected first-degree relative, which increases lifetime risk by tenfold, as well as the observation that when both parents are affected, the risk of schizophrenia increases to approximately 50%, compared with 1% in the general population. The search to elucidate the complex genetic architecture of schizophrenia has employed various approaches, including twin and family studies to examine co-aggregation of brain abnormalities, studies on genetic linkage and studies using genome-wide association to identify genetic variations associated with schizophrenia. ‘Endophenotypes’, or ‘intermediate phenotypes’, are potentially narrower constructs of genetic risk. Hypothetically, they are intermediate in the pathway between genetic variation and clinical phenotypes and can supposedly be implemented to assist in the identification of genetic diathesis for schizophrenia and, possibly, in redefining clinical phenomenology.
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Affiliation(s)
- Sheena Waters-Metenier
- Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, London, UK
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Reduced cortical thickness is associated with the glutamatergic regulatory gene risk variant DAOA Arg30Lys in schizophrenia. Neuropsychopharmacology 2011; 36:1747-53. [PMID: 21508934 PMCID: PMC3138664 DOI: 10.1038/npp.2011.56] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In light of current etiological concepts the glutamatergic system plays an essential role for the pathophysiology of the disorder, offering multiple options for new treatment strategies. The D-amino oxidase activator (DAOA) gene is closely connected to the glutamatergic system and its therapeutic and pathophysiological relevance for schizophrenia is therefore intensively debated. In a further step to shed light on the role of DAOA in schizophrenia, we aimed to investigate the association of the functional DAOA Arg30Lys (rs2391191) variant and cortical thickness in schizophrenia. Cortical thickness was computed by an automated surface-based technique (FreeSurfer) in 52 genotyped patients with schizophrenia and 42 healthy controls. Cortical thickness of the entire cortex was compared between risk carriers and non-risk carriers regarding the Arg30Lys polymorphism in patients and healthy controls on the basis of a node-by-node procedure and an automated clustering approach. Risk carriers with schizophrenia show significantly thinner cortex in two almost inversely arranged clusters on the left and right hemisphere comprising middle temporal, inferior parietal, and lateral occipital cortical areas. The clusters encompass an area of 1174 mm(2) (left) and 1156 mm(2) (right). No significant effect was observed in healthy controls.The finding of our study that the Arg30Lys risk variant is associated with a distinct cortical thinning provides new evidence for the pathophysiological impact of DAOA in schizophrenia. The affected areas are mostly confined to cortical regions with a crucial role in the ToM network and visual processing, which both can be influenced by glutamatergic modulation. Our finding thus underlines the importance of DAOA and related glutamatergic processes as a putative target for therapeutic interventions in schizophrenia.
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Palaniyappan L, Mallikarjun P, Joseph V, White TP, Liddle PF. Regional contraction of brain surface area involves three large-scale networks in schizophrenia. Schizophr Res 2011; 129:163-8. [PMID: 21497489 DOI: 10.1016/j.schres.2011.03.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/05/2011] [Accepted: 03/20/2011] [Indexed: 12/28/2022]
Abstract
In schizophrenia, morphological changes in the cerebral cortex have been primarily investigated using volumetric or cortical thickness measurements. In healthy subjects, as the brain size increases, the surface area expands disproportionately when compared to the scaling of cortical thickness. In this structural MRI study, we investigated the changes in brain surface area in schizophrenia by constructing relative areal contraction/expansion maps showing group differences in surface area using Freesurfer software in 57 patients and 41 controls. We observed relative areal contraction affecting Default Mode Network, Central Executive Network and Salience Network, in addition to other regions in schizophrenia. We confirmed the surface area reduction across these three large-scale brain networks by undertaking further region-of-interest analysis of surface area. We also observed a significant hemispheric asymmetry in the surface area changes, with the left hemisphere showing a greater reduction in the areal contraction maps. Our findings suggest that a fundamental disturbance in cortical expansion is likely in individuals who develop schizophrenia.
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Affiliation(s)
- Lena Palaniyappan
- Division of Psychiatry, University of Nottingham, A Floor, South Block, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
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Abdul-Rahman MF, Qiu A, Sim K. Regionally specific white matter disruptions of fornix and cingulum in schizophrenia. PLoS One 2011; 6:e18652. [PMID: 21533181 PMCID: PMC3077390 DOI: 10.1371/journal.pone.0018652] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 03/12/2011] [Indexed: 11/25/2022] Open
Abstract
Limbic circuitry disruptions have been implicated in the psychopathology and cognitive deficits of schizophrenia, which may involve white matter disruptions of the major tracts of the limbic system, including the fornix and the cingulum. Our study aimed to investigate regionally specific abnormalities of the fornix and cingulum in schizophrenia using diffusion tensor imaging (DTI). We determined the fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) profiles along the fornix and cingulum tracts using a fibertracking technique and a brain mapping algorithm, the large deformation diffeomorphic metric mapping (LDDMM), in the DTI scans of 33 patients with schizophrenia and 31 age-, gender-, and handedness-matched healthy controls. We found that patients with schizophrenia showed reduction in FA and increase in RD in bilateral fornix, and increase in RD in left anterior cingulum when compared to healthy controls. In addition, tract-based analysis revealed specific loci of these white matter differences in schizophrenia, that is, FA reductions and AD and RD increases occur in the region of the left fornix further from the hippocampus, FA reductions and RD increases occur in the rostral portion of the left anterior cingulum, and RD and AD increases occur in the anterior segment of the left middle cingulum. In patients with schizophrenia, decreased FA in the specific loci of the left fornix and increased AD in the right cingulum adjoining the hippocampus correlated with greater severity of psychotic symptoms. These findings support precise disruptions of limbic-cortical integrity in schizophrenia and disruption of these structural networks may contribute towards the neural basis underlying the syndrome of schizophrenia and clinical symptomatology.
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Affiliation(s)
| | - Anqi Qiu
- Division of Bioengineering, National University of Singapore, Singapore, Singapore
- Clinical Imaging Research Center, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, the Agency for Science, Technology and Research, Singapore, Singapore
- * E-mail:
| | - Kang Sim
- Research Department, Institute of Mental Health, Singapore, Singapore
- Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore
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Disrupted axonal fiber connectivity in schizophrenia. Biol Psychiatry 2011; 69:80-9. [PMID: 21035793 PMCID: PMC4881385 DOI: 10.1016/j.biopsych.2010.08.022] [Citation(s) in RCA: 363] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 08/17/2010] [Accepted: 08/18/2010] [Indexed: 12/22/2022]
Abstract
BACKGROUND Schizophrenia is believed to result from abnormal functional integration of neural processes thought to arise from aberrant brain connectivity. However, evidence for anatomical dysconnectivity has been equivocal, and few studies have examined axonal fiber connectivity in schizophrenia at the level of whole-brain networks. METHODS Cortico-cortical anatomical connectivity at the scale of axonal fiber bundles was modeled as a network. Eighty-two network nodes demarcated functionally specific cortical regions. Sixty-four direction diffusion tensor-imaging coupled with whole-brain tractography was performed to map the architecture via which network nodes were interconnected in each of 74 patients with schizophrenia and 32 age- and gender-matched control subjects. Testing was performed to identify pairs of nodes between which connectivity was impaired in the patient group. The connectional architecture of patients was tested for changes in five network attributes: nodal degree, small-worldness, efficiency, path length, and clustering. RESULTS Impaired connectivity in the patient group was found to involve a distributed network of nodes comprising medial frontal, parietal/occipital, and the left temporal lobe. Although small-world attributes were conserved in schizophrenia, the cortex was interconnected more sparsely and up to 20% less efficiently in patients. Intellectual performance was found to be associated with brain efficiency in control subjects but not in patients. CONCLUSIONS This study presents evidence of widespread dysconnectivity in white-matter connectional architecture in a large sample of patients with schizophrenia. When considered from the perspective of recent evidence for impaired synaptic plasticity, this study points to a multifaceted pathophysiology in schizophrenia encompassing axonal as well as putative synaptic mechanisms.
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Baharnoori M, Bartholomeusz C, Boucher AA, Buchy L, Chaddock C, Chiliza B, Föcking M, Fornito A, Gallego JA, Hori H, Huf G, Jabbar GA, Kang SH, El Kissi Y, Merchán-Naranjo J, Modinos G, Abdel-Fadeel NA, Neubeck AK, Ng HP, Novak G, Owolabi O, Prata DP, Rao NP, Riecansky I, Smith DC, Souza RP, Thienel R, Trotman HD, Uchida H, Woodberry KA, O'Shea A, DeLisi LE. The 2nd Schizophrenia International Research Society Conference, 10-14 April 2010, Florence, Italy: summaries of oral sessions. Schizophr Res 2010; 124:e1-62. [PMID: 20934307 PMCID: PMC4182935 DOI: 10.1016/j.schres.2010.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 08/30/2010] [Accepted: 09/01/2010] [Indexed: 01/06/2023]
Abstract
The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10-15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.
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Affiliation(s)
- Moogeh Baharnoori
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, Quebec, Canada H4H 1R3, phone (514) 761-6131 ext 3346,
| | - Cali Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Level 2-3, Alan Gilbert Building, 161 Barry St, Carlton South, Victoria 3053, Australia, phone +61 3 8344 1878, fax +61 3 9348 0469,
| | - Aurelie A. Boucher
- Brain and Mind Research Institute, 100 Mallett Street, Camperdown NSW 2050, Australia, phone +61 (0)2 9351 0948, fax +61 (0)2 9351 0652,
| | - Lisa Buchy
- Douglas Hospital Research Centre, 6875 LaSalle Blvd, Verdun, Québec, Canada, H4H 1R3 phone: 514-761-6131 x 3386, fax: 514-888-4064,
| | - Christopher Chaddock
- PO67, Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, phone 020 7848 0919, mobile 07734 867854 fax 020 7848 0976,
| | - Bonga Chiliza
- Department of Psychiatry, University of Stellenbosch, Tygerberg, 7505, South Africa, phone: +27 (0)21 9389227, fax +27 (0)21 9389738,
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland, phone +353 1 809 3857, fax +353 1 809 3741,
| | - Alex Fornito
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Downing Site, Downing St, Cambridge, UK, CB2 3EB, phone +44 (0) 1223 764670, fax +44 (0) 1223 336581,
| | - Juan A. Gallego
- The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd St, Glen Oaks, NY 11004, phone 718-470-8177, fax 718-343-1659,
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, NCNP, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, JAPAN, phone: +81 42 341 2711; fax: +81 42 346 1744,
| | - Gisele Huf
- National Institute of Quality Control in Health - Oswaldo Cruz Foundation.Av. Brasil 4365 Manguinhos Rio de Janeiro RJ BRAZIL 21045-900, phone + 55 21 38655112, fax + 55 21 38655139,
| | - Gul A. Jabbar
- Clinical Research Coordinator, Harvard Medical School Department of Psychiatry, 940 Belmont Street 2-B, Brockton, MA 02301, office (774) 826-1624, cell (845) 981-9514, fax (774) 286-1076,
| | - Shi Hyun Kang
- Seoul National Hospital, 30-1 Junggok3-dong Gwangjin-gu, Seoul, 143-711, Korea, phone +82-2-2204-0326, fax +82-2-2204-0394,
| | - Yousri El Kissi
- Psychiatry department, Farhat Hached Hospital. Ibn Jazzar Street, 4002 Sousse. Tunisia. phone + 216 98468626, fax + 216 73226702,
| | - Jessica Merchán-Naranjo
- Adolescent Unit. Department of Psychiatry. Hospital General Universitario Gregorio Marañón. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. C/Ibiza 43, C.P:28009, phone +34 914265005, fax +34 914265004,
| | - Gemma Modinos
- Department of Psychosis Studies (PO67), Institute of Psychiatry, King's College London, King's Health Partners, De Crespigny Park, SE5 8AF London, United Kingdo, phone +44 (0)20 78480917, fax +44 (0)20 78480976,
| | - Nashaat A.M. Abdel-Fadeel
- Minia University, Egypt, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, phone 617 953 0414, fax 617-998-5007, ,
| | - Anna-Karin Neubeck
- Project Manager at Karolinska Institute, Skinnarviksringen 12, 117 27 Stockholm, Sweden, phone +46708777908,
| | - Hsiao Piau Ng
- Singapore Bioimaging Consortium, A*STAR, Singapore; Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, phone 857-544-0192, fax 617-525-6150,
| | - Gabriela Novak
- University of Toronto, Medical Sciences Building, Room 4345, 1 King's College Circle, Toronto, Ontario, M5S 1A8, phone (416) 946-8219, fax (416) 971-2868,
| | - Olasunmbo.O. Owolabi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Science University of Ilorin, Ilorin, Nigeria, phone +2348030764811,
| | - Diana P. Prata
- Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK, phone +44(0)2078480917, fax +44(0)2078480976,
| | - Naren P. Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, 560029 Karnataka, India, phone +91 9448342379,
| | - Igor Riecansky
- Address: Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Sienkiewiczova 1, 813 71 Bratislava, Slovakia, phone +421-2-52 92 62 76, fax +421-2-52 96 85 16,
| | - Darryl C. Smith
- 3336 Mt Pleasant St. NW #2, Washington, DC 20010, phone 202.494.3892,
| | - Renan P. Souza
- Centre for Addiction and Mental Health 250 College St R31 Toronto - Ontario - Canada M5T1R8, phone +14165358501 x4883, fax +14169794666,
| | - Renate Thienel
- Postdoctoral Research Fellow, PRC Brain and Mental Health, University of Newcastle, Mc Auley Centre Level 5, Mater Hospital, Edith Street, Waratah NSW 2298, phone +61 (2) 40335636,
| | - Hanan D. Trotman
- 36 Eagle Row, Atlanta, GA 30322, phone 404-727-8384, fax 404-727-1284,
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Psychopharmacology Research Program, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan, phone +81.3.3353.1211(x62454), fax +81.3.5379.0187,
| | - Kristen A. Woodberry
- Landmark Center 2 East, 401 Park Drive, Boston, MA 02215, phone 617-998-5022, fax 617-998-5007,
| | - Anne O'Shea
- Coordinator of reports. Harvard Medical School, VA Boston Healthcare System, 940 Belmont Street, Brockton, MA 02301, phone 774-826-1374, anne_o’
| | - Lynn E. DeLisi
- VA Boston Healthcare System and Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, phone 774-826-1355, fax 774-826-2721
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Schultz CC, Koch K, Wagner G, Roebel M, Nenadic I, Gaser C, Schachtzabel C, Reichenbach JR, Sauer H, Schlösser RGM. Increased parahippocampal and lingual gyrification in first-episode schizophrenia. Schizophr Res 2010; 123:137-44. [PMID: 20850277 DOI: 10.1016/j.schres.2010.08.033] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 08/17/2010] [Accepted: 08/22/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Cerebral gyrification is attributed to a large extent to genetic and intrauterine/perinatal factors. Hence, investigating gyrification might offer important evidence for disturbed neurodevelopmental mechanisms in schizophrenia. As an extension of recent ROI analyses of gyrification in schizophrenia the present study is the first to compare on a node-by-node basis mean curvature as a sensitive parameter for the identification of local gyrification changes of the whole cortex in first-episode schizophrenia. METHODS A group of 54 patients with first-episode schizophrenia according to DSM-IV and 54 age and gender matched healthy control subjects were included. All participants underwent high-resolution T1-weighted MRI scans on a 1.5 T scanner. Mean curvature was calculated dividing the sum of the principal curvatures by two at each point of the curved surface as implemented in the Freesurfer Software package. Statistical cortical maps were created to estimate gyrification differences between groups based on a clustering approach. RESULTS A significantly increased gyrification was observed in first-episode schizophrenia patients relative to controls in a right parahippocampal-lingual cortex area. The cluster encompassed a surface area of 750 mm². A further analysis of cortical thickness of this cluster demonstrated concurrent significant reduced cortical thickness of this area. CONCLUSIONS This is the first study to reveal an aberrant gyrification of the medial surface in first-episode schizophrenia. This finding is in line with substantial evidence showing medial temporal lobe abnormalities in schizophrenia. The present morphometric data provide further support for an early disruption of cortical maturation in schizophrenia.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University Jena, Philosophenweg 3, 07740 Jena, Germany.
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Gutiérrez-Galve L, Wheeler-Kingshott CA, Altmann DR, Price G, Chu EM, Leeson VC, Lobo A, Barker GJ, Barnes TR, Joyce EM, Ron MA. Changes in the frontotemporal cortex and cognitive correlates in first-episode psychosis. Biol Psychiatry 2010; 68:51-60. [PMID: 20452574 PMCID: PMC3025327 DOI: 10.1016/j.biopsych.2010.03.019] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 03/04/2010] [Accepted: 03/08/2010] [Indexed: 01/03/2023]
Abstract
BACKGROUND Loss of cortical volume in frontotemporal regions has been reported in patients with schizophrenia and their relatives. Cortical area and thickness are determined by different genetic processes, and measuring these parameters separately may clarify disturbances in corticogenesis relevant to schizophrenia. Our study also explored clinical and cognitive correlates of these parameters. METHODS Thirty-seven patients with first-episode psychosis (34 schizophrenia, 3 schizoaffective disorder) and 38 healthy control subjects matched for age and sex took part in the study. Imaging was performed on an magnetic resonance imaging 1.5-T scanner. Area and thickness of the frontotemporal cortex were measured using a surface-based morphometry method (Freesurfer). All subjects underwent neuropsychologic testing that included measures of premorbid and current IQ, working and verbal memory, and executive function. RESULTS Reductions in cortical area, more marked in the temporal cortex, were present in patients. Overall frontotemporal cortical thickness did not differ between groups, although regional thinning of the right superior temporal region was observed in patients. There was a significant association of both premorbid IQ and IQ at disease onset with area, but not thickness, of the frontotemporal cortex, and working memory span was associated with area of the frontal cortex. These associations remained significant when only patients with schizophrenia were considered. CONCLUSIONS Our results suggest an early disruption of corticogenesis in schizophrenia, although the effect of subsequent environmental factors cannot be excluded. In addition, cortical abnormalities are subject to regional variations and differ from those present in neurodegenerative diseases.
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Affiliation(s)
- Leticia Gutiérrez-Galve
- University College London Institute of Neurology, London, United Kingdom,Hospital Clínico Universitario and Universidad de Zaragoza, Centro de Investigación Biomédica en Red de Salud Mental and Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | | | - Daniel R. Altmann
- University College London Institute of Neurology, London, United Kingdom,Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gary Price
- University College London Institute of Neurology, London, United Kingdom
| | - Elvina M. Chu
- University College London Institute of Neurology, London, United Kingdom
| | - Verity C. Leeson
- University College London Institute of Neurology, London, United Kingdom
| | - Antonio Lobo
- Hospital Clínico Universitario and Universidad de Zaragoza, Centro de Investigación Biomédica en Red de Salud Mental and Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
| | - Gareth J. Barker
- King's College London, Institute of Psychiatry, Department of Clinical Neuroscience, Centre for Neuroimaging Sciences, London, United Kingdom
| | - Thomas R.E. Barnes
- Imperial College Faculty of Medicine, Charing Cross Campus, London, United Kingdom
| | - Eileen M. Joyce
- University College London Institute of Neurology, London, United Kingdom
| | - María A. Ron
- University College London Institute of Neurology, London, United Kingdom,Address correspondence to Maria A. Ron, Ph.D., FRCP, FRCPsych, University College London Institute of Neurology, London WC1N 3BG, United Kingdom
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78
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Roiz-Santiáñez R, Pérez-Iglesias R, Quintero C, Tordesillas-Gutiérrez D, Mata I, Ayesa R, Sánchez JMR, Gutiérrez A, Sanchez E, Vázquez-Barquero JL, Crespo-Facorro B. Insular cortex thinning in first episode schizophrenia patients. Psychiatry Res 2010; 182:216-22. [PMID: 20488679 DOI: 10.1016/j.pscychresns.2010.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 01/11/2010] [Accepted: 03/06/2010] [Indexed: 11/24/2022]
Abstract
Overall and regional cortical thinning has been observed at the first break of schizophrenia. Due to the fact that structural abnormalities in the insular cortex have been described in schizophrenia, we investigated insular thickness anomalies in first episode schizophrenia. Participants comprised 118 schizophrenia patients and 83 healthy subjects. Magnetic resonance imaging brain scans (1.5T) were obtained, and images were analyzed by using BRAINS2. The contribution of sociodemographic, cognitive and clinical characterictics was controlled. Schizophrenia patients demonstrated a significant right insular thinning, and a significant group by gender interaction was found for left insular thickness. Post-hoc comparisons revealed that male schizophrenia patients had a significant left insular thinning compared with healthy male subjects. There were no significant associations between insular thickness, the severity of symptoms at baseline and cognitive measurements and premorbid variables. The fact that insular thinning is already present at early phases of the illness and is independent of intervening variables offers evidence for the potential of these changes to be a biological marker of the illness.
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Affiliation(s)
- Roberto Roiz-Santiáñez
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
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79
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Von Economo neuron density in the anterior cingulate cortex is reduced in early onset schizophrenia. Acta Neuropathol 2010; 119:771-8. [PMID: 20309567 DOI: 10.1007/s00401-010-0673-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 03/10/2010] [Accepted: 03/13/2010] [Indexed: 10/24/2022]
Abstract
The anterior cingulate cortex (ACC) represents a phylogenetically ancient region of the mammalian brain that has undergone recent adaptive changes in humans. It contains a large spindle-shaped cell type, referred to as von Economo neuron (VEN) that has been shown to be involved in the pathophysiology of various neuropsychiatric disorders. Schizophrenia is a group of disorders that is, in part, characterised by a disruption of neuronal migration in early ontogeny and presumably secondary degeneration after the first psychotic episode in some patients. Accordingly, we tested the hypothesis that the density of VENs is reduced in a neurodevelopmental subtype of schizophrenia, which we defined by an early onset of the disorder. The density of VENs was estimated in layer Vb of Brodmann's area 24 in 20 subjects diagnosed with schizophrenia. The results were compared with 19 specimens from patients with bipolar disorder as a clinical control and 22 non-psychiatric samples. The density of VENs did not differ between the three groups. However, the VEN density in the right ACC correlated with the age at onset, and inversely with the duration of the illness in schizophrenia, but not in bipolar disorder. Thus, patients with early onset schizophrenia (and longer duration of illness) had a reduced VEN density. Age, sex, postmortem interval, brain weight, and cortical thickness had no significant impact on the results. These findings suggest that VENs in the ACC are involved in neurodevelopmental and perhaps neurodegenerative processes specific to schizophrenia.
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80
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Schultz CC, Koch K, Wagner G, Roebel M, Nenadic I, Schachtzabel C, Reichenbach JR, Sauer H, Schlösser RGM. Complex pattern of cortical thinning in schizophrenia: results from an automated surface based analysis of cortical thickness. Psychiatry Res 2010; 182:134-40. [PMID: 20418074 DOI: 10.1016/j.pscychresns.2010.01.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Revised: 01/12/2010] [Accepted: 01/14/2010] [Indexed: 11/15/2022]
Abstract
A considerable body of evidence from structural brain imaging studies suggests that patients with schizophrenia have significant alterations of gray matter density. Additionally, recently developed surface-based analysis approaches demonstrate reduced cortical thickness in patients with schizophrenia. However, the number of studies employing this relatively new method is still limited. Specifically, little is known about changes in cortical thickness in schizophrenia patients whose duration of illness is relatively short. Therefore, the present study sought to examine cortical thickness in a large sample of patients with adult onset schizophrenia and an average duration of illness of 4.4 years, using an automated analysis method over the entire cortex. A significantly decreased cortical thickness in prefrontal and temporolimbic regions as well as parieto-occipital cortical areas was hypothesized. A sample of 58 patients with schizophrenia and 58 age- and sex-matched healthy controls was investigated using high-resolution magnetic resonance imaging (MRI) and an automated algorithm for extraction of the cortical surface in order to assess local cortical thinning across the entire cerebrum. Significant reduction of cortical thickness in schizophrenia was found in a spatially complex pattern of focal anatomical regions. This pattern comprised the dorsolateral prefrontal cortex as well as the medial prefrontal cortex, lateral temporal cortices, left entorhinal cortex, posterior cingulate cortex, precuneus and lingual cortex, bilaterally. A complex fronto-temporo-parietal pattern of reduced cortical thickness in schizophrenia was observed. This pattern is consistent with a disruption of neurofunctional networks previously implicated in the pathophysiology of schizophrenia.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University Jena, Philosophenweg 3, Jena, Germany.
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81
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Quantification of cerebral cannabinoid receptors subtype 1 (CB1) in healthy subjects and schizophrenia by the novel PET radioligand [11C]OMAR. Neuroimage 2010; 52:1505-13. [PMID: 20406692 DOI: 10.1016/j.neuroimage.2010.04.034] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 04/07/2010] [Accepted: 04/12/2010] [Indexed: 01/05/2023] Open
Abstract
Several studies have examined the link between the cannabinoid CB1 receptor and several neuropsychiatric illnesses, including schizophrenia. As such, there is a need for in vivo imaging tracers so that the relationship between CB1 and schizophrenia (SZ) can be further studied. In this paper, we present our first human studies in both healthy control patients and patients with schizophrenia using the novel PET tracer, [(11)C]OMAR (JHU75528), we have shown its utility as a tracer for imaging human CB1 receptors and to investigate normal aging and the differences in the cannabinoid system of healthy controls versus patients with schizophrenia. A total of ten healthy controls and nine patients with schizophrenia were included and studied with high specific activity [(11)C]OMAR. The CB1 binding (expressed as the distribution volume; V(T)) was highest in the globus pallidus and the cortex in both controls and patients with schizophrenia. Controls showed a correlation with the known distribution of CB1 and decline of [(11)C]OMAR binding with age, most significantly in the globus pallidus. Overall, we observed elevated mean binding in patients with schizophrenia across all regions studied, and this increase was statistically significant in the pons (p<0.05), by the Students t-test. When we ran a regression of the control subjects V(T) values with age and then compared the patient data to 95% prediction limits of the linear regression, three patients fell completely outside for the globus pallidus, and in all other regions there were at least 1-3 patients outside of the prediction intervals. There was no statistically significant correlations between PET measures and the individual Brief Psychiatry Rating Score (BPRS) subscores (r=0.49), but there was a significant correlation between V(T) and the ratio of the BPRS psychosis to withdrawal score in the frontal lobe (r=0.60), and middle and posterior cingulate regions (r=0.71 and r=0.79 respectively). In conclusion, we found that [(11)C] OMAR can image human CB1 receptors in normal aging and schizophrenia. In addition, our initial data in subjects with schizophrenia seem to suggest an association of elevated binding specific brain regions and symptoms of the disease.
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82
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Schultz CC, Koch K, Wagner G, Roebel M, Schachtzabel C, Gaser C, Nenadic I, Reichenbach JR, Sauer H, Schlösser RGM. Reduced cortical thickness in first episode schizophrenia. Schizophr Res 2010; 116:204-9. [PMID: 19926451 DOI: 10.1016/j.schres.2009.11.001] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 10/20/2009] [Accepted: 11/02/2009] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Previous morphometric studies are suggesting altered cortical thickness mainly in prefronto-temporal regions in first episode schizophrenia. In an extension of these earlier studies, we used an entire cortex vertex-wise approach and an automated clustering for the detection and exact quantification of cortical thickness alterations in first episode schizophrenia. METHODS A group of 54 patients with first episode schizophrenia according to DSM-IV and 54 age and gender matched healthy control subjects were included. All participants underwent high-resolution T1-weighted MRI scans on a 1.5 T scanner. Cortical thickness was estimated as the distance between the gray-white matter border and the pial surface using an automated computerized algorithm (Freesurfer Software). Statistical cortical maps were created to estimate differences of cortical thickness between groups based on this entire cortex analysis. RESULTS Significant cortical thinning was observed in first episode schizophrenia patients relative to controls in a number of cortical areas including the dorsolateral and frontopolar cortices, the anterior cingulate cortex, a ventrolateral-orbitofrontal cluster, as well as the superior temporal cortices and superior parietal lobe. Cortical thinning within these regions was on average 4.4-5.7% with strongest reductions in orbitofrontal regions (7.1%). CONCLUSIONS The present findings suggest widespread reduction of cortical thickness, mostly in heteromodal cortices of fronto-temporal networks to be present at an early stage of schizophrenia. Taken together, the present morphometric data in first episode schizophrenia provide further evidence for potential neurodevelopmental deficits and disruption of cortical maturation in this disorder.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University Jena, Philosophenweg 3, 07740 Jena, Germany.
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83
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Levitt JJ, Bobrow L, Lucia D, Srinivasan P. A selective review of volumetric and morphometric imaging in schizophrenia. Curr Top Behav Neurosci 2010; 4:243-81. [PMID: 21312403 DOI: 10.1007/7854_2010_53] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Brain imaging studies have long supported that schizophrenia is a disorder of the brain, involving many discrete and widely spread regions. Generally, studies have shown decreases in cortical gray matter (GM) volume. Here, we selectively review recent papers studying GM volume changes in schizophrenia subjects, both first-episode (FE) and chronic, in an attempt to quantify and better understand differences between healthy and patient groups. We focused on the cortical GM of the prefrontal cortex, limbic and paralimbic structures, temporal lobe, and one subcortical structure (the caudate nucleus). We performed a search of the electronic journal database PsycINFO using the keywords "schizophrenia" and "MRI," and selected for papers published between 2001 and 2008. We then screened for only those studies utilizing manual or manually edited tracing methodologies for determining regions of interest (ROIs). Each region of interest was indexed independently; thus, one paper might yield results for numerous brain regions. Our review found that in almost all ROIs, cortical GM volume was decreased in the patient populations. The only exception was the caudate nucleus - most studies reviewed showed no change, while one study showed an increase in volume; this region, however, is particularly sensitive to medication effects. The reductions were seen in both FE and chronic schizophrenia. These results clearly support that schizophrenia is an anatomical disorder of the brain, and specifically that schizophrenia patients tend to have decreased cortical GM in regions involved in higher cognition and emotional processing. That these reductions were found in both FE and chronic subjects supports that brain abnormalities are present at the onset of illness, and are not simply a consequence of chronicity. Additional studies assessing morphometry at different phases of the illness, including prodromal stages, together with longitudinal studies will elucidate further the role of progression in this disorder.
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Affiliation(s)
- James J Levitt
- Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Brockton Campus, 116A4, 940 Belmont Street, Brockton, MA 02301, USA.
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84
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Janssen J, Reig S, Alemán Y, Schnack H, Udias JM, Parellada M, Graell M, Moreno D, Zabala A, Balaban E, Desco M, Arango C. Gyral and sulcal cortical thinning in adolescents with first episode early-onset psychosis. Biol Psychiatry 2009; 66:1047-54. [PMID: 19717139 DOI: 10.1016/j.biopsych.2009.07.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 07/10/2009] [Accepted: 07/19/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Psychosis is associated with volumetric decreases of cortical structures. Whether these volumetric decreases imply abnormalities in cortical thickness, surface, or cortical folding is not clear. Due to differences in cytoarchitecture, cortical gyri and sulci might be differentially affected by psychosis. Therefore, we examined differences in gyral and sulcal cortical thickness, surface, folding, and volume between a minimally treated male adolescent population with early-onset first-episode psychosis (EOP) and a healthy control group, with surface-based morphometry. METHODS Magnetic resonance imaging brain scans were obtained from 49 adolescent EOP patients and 34 healthy control subjects. Subjects were younger than 18 years (age range 12 years-18 years), and EOP patients had a duration of positive symptoms of <6 months. RESULTS Early-onset first-episode psychosis was associated with local bilateral cortical thinning and volume deficits in both the gyri and sulci of the superior temporal cortex and the inferior, middle, medial, and superior prefrontal cortex. In the pars triangularis and opercularis cortex of patients, gyral cortical thickness was thinner, whereas sulcal thickness was not. Patients exhibited cortical thinning together with a decreased degree of cortical folding in the right superior frontal cortex. CONCLUSIONS Cortical thinning of both gyri and sulci seem to underlie most cortical volume deficits in adolescent patients with EOP. Except for the right superior frontal region, the degree of cortical folding was normal in regions showing decreased cortical thickness, suggesting that the process of cortical thinning in adolescent patients with EOP primarily takes place after the formation of cortical folds.
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Affiliation(s)
- Joost Janssen
- Department of Experimental Medicine and Surgery, Hospital General Universitario Gregorio Marañón, CIBERSAM, Spain.
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85
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Hao Y, Yan Q, Liu H, Xu L, Xue Z, Song X, Kaneko Y, Jiang T, Liu Z, Shan B. Schizophrenia patients and their healthy siblings share disruption of white matter integrity in the left prefrontal cortex and the hippocampus but not the anterior cingulate cortex. Schizophr Res 2009; 114:128-35. [PMID: 19643580 DOI: 10.1016/j.schres.2009.07.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 06/22/2009] [Accepted: 07/01/2009] [Indexed: 12/23/2022]
Abstract
Healthy siblings of schizophrenia patients have an almost 9-fold higher risk for developing the illness than the general population. Disruption of white matter (WM) integrity as indicated by reduced fractional anisotropy (FA) derived from diffusion tensor imaging (DTI), is believed to be the key substrate of schizophrenia. However, it remains unclear whether schizophrenia patients and their healthy siblings share a specific pattern of disruption of WM integrity that may be related to the disease risk. The objective of this study is to determine whether a specific brain regional pattern of disruption of WM integrity is shared by schizophrenia patients and their healthy siblings. We investigated brain white matter abnormalities by voxel-based analysis of white matter FA data acquired from diffusion tensor imaging in 34 pairs of schizophrenia patients and their healthy siblings, as well as in 32 healthy controls. Both schizophrenia patients and their healthy siblings showed reduced white matter FA in the left prefrontal cortex and the hippocampus in comparison to healthy controls, without significant difference between patients and siblings. In marked contrast, only schizophrenia patients exhibited reduced white matter FA in the left anterior cingulate cortex in comparison to both siblings and controls, without significant difference between siblings and controls. Thus, schizophrenia patients and their healthy siblings share disruption of WM integrity in the left prefrontal cortex and the hippocampus that may be related to higher risk of healthy siblings to develop schizophrenia, which may be eventually attributed to additional disruption of WM integrity in the left anterior cingulate cortex.
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Affiliation(s)
- Yihui Hao
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, PR China
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86
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Fornito A, Yücel M, Dean B, Wood SJ, Pantelis C. Anatomical abnormalities of the anterior cingulate cortex in schizophrenia: bridging the gap between neuroimaging and neuropathology. Schizophr Bull 2009; 35:973-93. [PMID: 18436528 PMCID: PMC2728810 DOI: 10.1093/schbul/sbn025] [Citation(s) in RCA: 184] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The anterior cingulate cortex (ACC) is a functionally heterogeneous region involved in diverse cognitive and emotional processes that support goal-directed behaviour. Structural magnetic resonance imaging (MRI) and neuropathological findings over the past two decades have converged to suggest abnormalities in the region may represent a neurobiological basis for many of the clinical manifestations of schizophrenia. However, while each approach offers complimentary information that can provide clues regarding underlying patholophysiological processes, the findings from these 2 fields are seldom integrated. In this article, we review structural neuroimaging and neuropathological studies of the ACC, focusing on the unique information they provide. The available imaging data suggest grey matter reductions in the ACC precede psychosis onset in some categories of high-risk individuals, show sub-regional specificity, and may progress with illness duration. The available post-mortem findings indicate these imaging-related changes are accompanied by reductions in neuronal, synaptic, and dendritic density, as well as increased afferent input, suggesting the grey matter differences observed with MRI arise from alterations in both neuronal and non-neuronal tissue compartments. We discuss the potential mechanisms that might facilitate integration of these findings and consider strategies for future research.
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Affiliation(s)
- Alex Fornito
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia.
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia,ORYGEN Research Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Brian Dean
- The Rebecca L Cooper Research Laboratories, The Mental Health Research Institute, Parkville, Victoria, Australia,Departments of Pathology and Psychiatry, The University of Melbourne, Victoria, Australia,Department of Psychological Medicine, Monash University, Victoria, Australia
| | - Stephen J. Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia,Howard Florey Institute, The University of Melbourne, Victoria, Australia
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Smiley JF, Rosoklija G, Mancevski B, Mann JJ, Dwork AJ, Javitt DC. Altered volume and hemispheric asymmetry of the superficial cortical layers in the schizophrenia planum temporale. Eur J Neurosci 2009; 30:449-63. [PMID: 19656176 DOI: 10.1111/j.1460-9568.2009.06838.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In vivo structural MRI studies in schizophrenia auditory cerebral cortex have reported smaller volumes and, less consistently, have reported altered hemispheric asymmetry of volumes. We used autopsy brains from 19 schizophrenia and 18 nonpsychiatric male subjects to measure the volume asymmetry of the planum temporal (PT). We then used the most recently autopsied 11 schizophrenia and 10 nonpsychiatric brains to measure the widths and fractional volumes of the upper (I-III) and lower (IV-VI) layers. Measurements of whole PT gray matter volumes did not show significant changes in schizophrenia. Nevertheless, laminar volume measurements revealed that the upper layers of the PT comprise a smaller fraction of the total cortex in schizophrenia than in nonpsychiatric brains. Subdivision of the PT showed that this change was especially prominent caudally, beyond Heschl's gyrus, whereas similar but less pronounced changes were found in the rostral PT and Heschl's gyrus. Complementary measures of laminar widths showed that the altered fractional volume in the caudal left PT was due mainly to approximately 8% thinner upper layers. However, the caudal right PT had a different profile, with thicker lower layers and comparatively unchanged upper layers. Thus, in the present study, laminar measurements provided a more sensitive method for detecting changes than measurement of whole PT volumes. Besides findings in schizophrenia, our cortical width measurements revealed normal hemispheric asymmetries consistent with previous reports. In schizophrenia, the thinner upper layers of the caudal PT suggest disrupted corticocortical processing, possibly affecting the multisensory integration and phonetic processing of this region.
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Affiliation(s)
- John F Smiley
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
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88
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Corpus callosum size and shape in first-episode affective and schizophrenia-spectrum psychosis. Psychiatry Res 2009; 173:77-82. [PMID: 19447585 DOI: 10.1016/j.pscychresns.2008.09.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 08/20/2008] [Accepted: 09/17/2008] [Indexed: 11/23/2022]
Abstract
Reductions in the size of the anterior callosum have been described for both first-episode and established schizophrenia and bipolar affective disorder, but never in individuals with psychotic bipolar disorder. We recruited 110 first-episode psychosis subjects (74 schizophrenia spectrum and 36 affective psychosis) and 36 age- and gender-matched controls. The callosum was extracted from a mid-sagittal slice from T1-weighted magnetic resonance images, and total area, length and curvature of the callosum were compared. The schizophrenia-spectrum group showed reductions in thickness of the genu across schizophreniform and schizoaffective disorder and schizophrenia, and the schizoaffective disorder group also showed an increase in thickness in the splenium and isthmus. None of these changes were seen in the affective disorder group, although a non-significant increase in the region of the isthmus and splenium was seen, particularly in the depressed group. Psychotic affective disorders do not show the anterior callosal reductions that are seen in the schizophrenia-spectrum group at first episode. The schizoaffective patients show additional posterior callosal expansions that may be a marker of an affective diathesis. This suggests that schizoaffective disorder may represent two interacting illness processes or be mid-way along a continuum of these two broad categories of illness at first psychosis.
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89
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Borgwardt SJ, Dickey C, Hulshoff Pol H, Whitford TJ, DeLisi LE. Workshop on defining the significance of progressive brain change in schizophrenia: December 12, 2008 American College of Neuropsychopharmacology (ACNP) all-day satellite, Scottsdale, Arizona. The rapporteurs' report. Schizophr Res 2009; 112:32-45. [PMID: 19477100 DOI: 10.1016/j.schres.2009.04.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 04/19/2009] [Accepted: 04/21/2009] [Indexed: 10/20/2022]
Abstract
In 1990 a satellite session of the American College of Neuropsychopharmacology (ACNP) Annual Meeting was held that focused on the question of whether progressive changes in brain structure occur in schizophrenia and this session raised considerable controversy. Eighteen years later, on December 12, 2008, after much data have since accumulated on this topic, a group of approximately 45 researchers gathered after the annual ACNP meeting to participate in a similar workshop on several unresolved questions still remaining: (1) How strong and consistent is the evidence? (2) Is there anatomic specificity to changes and is it disease specific or subject specific? (3) What is the time course? (4) What is the underlying pathophysiology (i.e. is it central to the disease process or is it due to neuroleptic treatment or other epiphenomena? (5) What is its clinical significance? and (6) Are there treatment implications? The day was chaired by Lynn E. DeLisi and co-chaired by Stephen J. Wood. Christos Pantelis and Jeffrey A. Lieberman extensively helped with its planning. The ACNP assisted in its organization as an official satellite of its annual meeting and several pharmaceutical companies provided support with unrestricted educational grants. The following is a summary of the sessions as recounted by rapporteurs whose job was to record as closely as possible the outcome of discussions on the above outlined questions.
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Affiliation(s)
- Stefan J Borgwardt
- University Hospital Basel, Psychiatric Outpatient Department, Petersgraben 4, Basel, Switzerland
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90
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Fornito A, Yücel M, Patti J, Wood SJ, Pantelis C. Mapping grey matter reductions in schizophrenia: an anatomical likelihood estimation analysis of voxel-based morphometry studies. Schizophr Res 2009; 108:104-13. [PMID: 19157788 DOI: 10.1016/j.schres.2008.12.011] [Citation(s) in RCA: 265] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 11/28/2008] [Accepted: 12/06/2008] [Indexed: 01/27/2023]
Abstract
Voxel-based morphometry (VBM) is a popular tool for mapping neuroanatomical changes in schizophrenia patients. Several recent meta-analyses have identified the brain regions in which patients most consistently show grey matter reductions, although they have not examined whether such changes reflect differences in grey matter concentration (GMC) or grey matter volume (GMV). These measures assess different aspects of grey matter integrity, and may therefore reflect different pathological processes. In this study, we used the Anatomical Likelihood Estimation procedure to analyse significant differences reported in 37 VBM studies of schizophrenia patients, incorporating data from 1646 patients and 1690 controls, and compared the findings of studies using either GMC or GMV to index grey matter differences. Analysis of all studies combined indicated that grey matter reductions in a network of frontal, temporal, thalamic and striatal regions are among the most frequently reported in literature. GMC reductions were generally larger and more consistent than GMV reductions, and were more frequent in the insula, medial prefrontal, medial temporal and striatal regions. GMV reductions were more frequent in dorso-medial frontal cortex, and lateral and orbital frontal areas. These findings support the primacy of frontal, limbic, and subcortical dysfunction in the pathophysiology of schizophrenia, and suggest that the grey matter changes observed with MRI may not necessarily result from a unitary pathological process.
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Affiliation(s)
- A Fornito
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia.
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91
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92
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Nelson B, Fornito A, Harrison BJ, Yücel M, Sass LA, Yung AR, Thompson A, Wood SJ, Pantelis C, McGorry PD. A disturbed sense of self in the psychosis prodrome: linking phenomenology and neurobiology. Neurosci Biobehav Rev 2009; 33:807-17. [PMID: 19428493 DOI: 10.1016/j.neubiorev.2009.01.002] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2008] [Revised: 01/09/2009] [Accepted: 01/12/2009] [Indexed: 11/29/2022]
Abstract
Interest in the early phase of psychotic disorders has risen dramatically in recent years. Neurobiological investigations have focused specifically on identifying brain changes associated with the onset of psychosis. The link between these neurobiological findings and the complex phenomenology of the early psychosis period is not well understood. In this article, we re-cast some of these observations, primarily from neuroimaging studies, in the context of phenomenological models of "the self" and disturbance thereof in psychotic illness. Specifically, we argue that disturbance of the basic or minimal self ("ipseity"), as articulated in phenomenological literature, may be associated with abnormalities in midline cortical structures as observed in neuroimaging studies of pre-onset and early psychotic patients. These findings are discussed with regards to current ideas on the neural basis of self-referential mental activity, including the notion of a putative "default-mode" of brain function, and its relation to distinguishing between self- and other-generated stimuli. Further empirical work examining the relationship between neurobiological and phenomenological variables may be of value in identifying risk markers for psychosis onset.
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Affiliation(s)
- B Nelson
- ORYGEN Youth Health Research Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia.
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93
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Segall JM, Turner JA, van Erp TG, White T, Bockholt HJ, Gollub RL, Ho BC, Magnotta V, Jung RE, McCarley RW, Schulz SC, Lauriello J, Clark VP, Voyvodic JT, Diaz MT, Calhoun VD. Voxel-based morphometric multisite collaborative study on schizophrenia. Schizophr Bull 2009; 35:82-95. [PMID: 18997157 PMCID: PMC2643956 DOI: 10.1093/schbul/sbn150] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Regional gray matter (GM) abnormalities are well known to exist in patients with chronic schizophrenia. Voxel-based morphometry (VBM) has been previously used on structural magnetic resonance images (MRI) data to characterize these abnormalities. Two multisite schizophrenia studies, the Functional Biomedical Informatics Research Network and the Mind Clinical Imaging Consortium, which include 9 data collection sites, are evaluating the efficacy of pooling structural imaging data across imaging centers. Such a pooling of data could yield the increased statistical power needed to elucidate effects that may not be seen with smaller samples. VBM analyses were performed to evaluate the consistency of patient versus control gray matter concentration (GMC) differences across the study sites, as well as the effects of combining multisite data. Integration of data from both studies yielded a large sample of 503 subjects, including 266 controls and 237 patients diagnosed with schizophrenia, schizoaffective or schizophreniform disorder. The data were analyzed using the combined sample, as well as analyzing each of the 2 multisite studies separately. A consistent pattern of reduced relative GMC in schizophrenia patients compared with controls was found across all study sites. Imaging center-specific effects were evaluated using a region of interest analysis. Overall, the findings support the use of VBM in combined multisite studies. This analysis of schizophrenics and controls from around the United States provides continued supporting evidence for GM deficits in the temporal lobes, anterior cingulate, and frontal regions in patients with schizophrenia spectrum disorders.
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Affiliation(s)
| | - Jessica A. Turner
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA
| | | | - Tonya White
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | - Randy L. Gollub
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Beng C. Ho
- Department of Psychiatry, University of Iowa, Iowa City, IA
| | - Vince Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA
| | | | | | | | - John Lauriello
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | | | | | - Michele T. Diaz
- Brain Imaging and Analysis Center, Duke University, Durham, NC
| | - Vince D. Calhoun
- Deptartment of ECE, University of New Mexico, Albuquerque, NM,Department of Psychiatry, Yale University, New Haven, CT,To whom correspondence should be addressed; The Mind Research Network, 1101 Yale Boulvard NE, Albuquerque, NM 87131; tel: 505-272-1817, fax: 505-272-8002 e-mail:
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94
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Fornito A, Yung AR, Wood SJ, Phillips LJ, Nelson B, Cotton S, Velakoulis D, McGorry PD, Pantelis C, Yücel M. Anatomic abnormalities of the anterior cingulate cortex before psychosis onset: an MRI study of ultra-high-risk individuals. Biol Psychiatry 2008; 64:758-65. [PMID: 18639238 DOI: 10.1016/j.biopsych.2008.05.032] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Revised: 04/30/2008] [Accepted: 05/29/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Abnormalities of the anterior cingulate cortex (ACC) are frequently implicated in the pathophysiology of psychotic disorders, but whether such changes are apparent before psychosis onset remains unclear. In this study, we characterized prepsychotic ACC abnormalities in a sample of individuals at ultra-high-risk (UHR) for psychosis. METHODS Participants underwent baseline magnetic resonance imaging and were followed-up over 12-24 months to ascertain diagnostic outcomes. Baseline ACC morphometry was then compared between UHR individuals who developed psychosis (UHR-P; n = 35), those who did not (UHR-NP; n = 35), and healthy control subjects (n = 33). RESULTS Relative to control subjects, UHR-P individuals displayed bilateral thinning of a rostral paralimbic ACC region that was negatively correlated with negative symptoms, whereas UHR-NP individuals displayed a relative thickening of dorsal and rostral limbic areas that was correlated with anxiety ratings. Baseline ACC differences between the two UHR groups predicted time to psychosis onset, independently of symptomatology. Subdiagnostic comparisons revealed that changes in the UHR-P group were driven by individuals subsequently diagnosed with a schizophrenia spectrum psychosis. CONCLUSIONS These findings indicate that anatomic abnormalities of the ACC precede psychosis onset and that baseline ACC differences distinguish between UHR individuals who do and do not subsequently develop frank psychosis. They also indicate that prepsychotic changes are relatively specific to individuals who develop a schizophrenia spectrum disorder, suggesting they may represent a diagnostically specific risk marker.
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Affiliation(s)
- Alex Fornito
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, Carlton South, Victoria, Australia.
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95
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Fujiwara H, Shimizu M, Hirao K, Miyata J, Namiki C, Sawamoto N, Fukuyama H, Hayashi T, Murai T. Female specific anterior cingulate abnormality and its association with empathic disability in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1728-34. [PMID: 18694798 DOI: 10.1016/j.pnpbp.2008.07.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 07/13/2008] [Accepted: 07/14/2008] [Indexed: 11/19/2022]
Abstract
Evidence suggests that impairments of empathy are present in schizophrenia and that such deficits lead to social dysfunction. However, the relationship between brain morphological abnormalities of the disorder and empathic disabilities has not been fully investigated. As the anterior cingulate cortex (ACC) is one of the critical structures for empathy processing, the pathology of this structure might be a major source of social dysfunction, including interpersonal miscommunication in schizophrenia. In addition, as recent studies suggest that different facets of empathic ability depend on different subdivisions of the ACC, pathology of each subdivision would affect the empathic disability of schizophrenia differentially. Structural MRI data were acquired at 3.0 T from 24 schizophrenic patients and 20 healthy participants, and the volumes of ventral and dorsal ACC were measured and compared between the groups. Subjects' empathic abilities were evaluated using a multidimensional questionnaire, the Interpersonal Reactivity Index (IRI). The relationships of structural abnormalities with empathic disabilities were investigated, by correlating ACC subdivisional volumes with each IRI subscale score. Female schizophrenic patients exhibited volume reductions in the ventral ACC bilaterally and in the left dorsal ACC compared with healthy subjects. Schizophrenic patients performed poorly on fantasy and personal distress subscales of the IRI. Furthermore, volumes of the left dorsal ACC were inversely correlated with personal distress subscale scores within female patients with schizophrenia. These results suggest that pathology of specific ACC subdivisions would have an impact on specific empathic disabilities in schizophrenia, with potential gender specificity.
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Affiliation(s)
- Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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96
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Gold JM, Waltz JA, Prentice KJ, Morris SE, Heerey EA. Reward processing in schizophrenia: a deficit in the representation of value. Schizophr Bull 2008; 34:835-47. [PMID: 18591195 PMCID: PMC2518641 DOI: 10.1093/schbul/sbn068] [Citation(s) in RCA: 385] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patients with schizophrenia demonstrate deficits in motivation and learning that suggest impairment in different aspects of the reward system. In this article, we present the results of 8 converging experiments that address subjective reward experience, the impact of rewards on decision making, and the role of rewards in guiding both rapid and long-term learning. All experiments compared the performance of stably treated outpatients with schizophrenia and demographically matched healthy volunteers. Results to date suggest (1) that patients have surprisingly normal experiences of positive emotion when presented with evocative stimuli, (2) that patients show reduced correlation, compared with controls, between their own subjective valuation of stimuli and action selection, (3) that decision making in patients appears to be compromised by deficits in the ability to fully represent the value of different choices and response options, and (4) that rapid learning on the basis of trial-to-trial feedback is severely impaired whereas more gradual learning may be surprisingly preserved in many paradigms. The overall pattern of findings suggests compromises in the orbital and dorsal prefrontal structures that play a critical role in the ability to represent the value of outcomes and plans. In contrast, patients often (but not always) approach normal performance levels on the slow learning achieved by the integration of reinforcement signals over many trials, thought to be mediated by the basal ganglia.
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Affiliation(s)
- James M Gold
- Maryland Psychiatric Research Center, Baltimore, MD 21228, USA.
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97
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Calabrese DR, Wang L, Harms MP, Ratnanather JT, Barch DM, Cloninger CR, Thompson P, Miller MI, Csernansky JG. Cingulate gyrus neuroanatomy in schizophrenia subjects and their non-psychotic siblings. Schizophr Res 2008; 104:61-70. [PMID: 18692994 PMCID: PMC4256942 DOI: 10.1016/j.schres.2008.06.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Revised: 06/10/2008] [Accepted: 06/16/2008] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND METHODS In vivo neuroimaging studies have provided evidence of decreases in the gray matter volume of the cingulate gyrus in subjects with schizophrenia as compared to healthy controls. To investigate whether these changes might be related to heritable influences, we used high-resolution magnetic resonance imaging and labeled cortical mantle distance mapping to measure gray matter volume, as well as thickness and the area of the gray/white interface, in the anterior and posterior segments of the cingulate gyrus in 28 subjects with schizophrenia and their non-psychotic siblings, and in 38 healthy control subjects and their siblings. RESULTS There was a significant effect of group status on posterior cingulate cortex (PCC) gray matter volume (p=0.02). Subjects with schizophrenia and their non-psychotic siblings showed similar reductions of gray matter volume (approximately 10%) in the PCC compared to healthy control subjects and their siblings. In turn, trend level effects of group status were found for thickness (p=0.08) and surface area (p=0.11) of the PCC. In the combined group of schizophrenia subjects and their siblings, a direct correlation was observed between PCC gray matter volume and negative symptoms. However, the reduction in PCC gray matter volume in schizophrenia subjects and their siblings was proportionate to an overall reduction in whole cerebral volume, i.e., the effect of group on the volume of the PCC became non-significant when cerebral volume was included as a covariate (p=0.4). There was no significant effect of group on anterior cingulate cortex volume, thickness, or area. CONCLUSIONS Our findings suggest that decreases in the gray matter volume of the PCC occur in schizophrenia subjects and their siblings. The presence of such decreases in the non-psychotic siblings of schizophrenia subjects suggests that heritable factors may be involved in the development of cortical abnormalities in schizophrenia.
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Affiliation(s)
- Daniel R. Calabrese
- Department of Psychiatry, Washington, University School of Medicine, St. Louis, MO
| | - Lei Wang
- Department of Psychiatry, Washington, University School of Medicine, St. Louis, MO
| | - Michael P. Harms
- Department of Psychiatry, Washington, University School of Medicine, St. Louis, MO
| | - J. Tilak Ratnanather
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD
- Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD
| | - Deanna M. Barch
- Department of Psychiatry, Washington, University School of Medicine, St. Louis, MO
- Department of Psychology, Washington University, St. Louis, MO
| | - C. Robert Cloninger
- Department of Psychiatry, Washington, University School of Medicine, St. Louis, MO
| | - Paul Thompson
- Division of Biostatistics, Washington, University School of Medicine, St. Louis, MO
| | - Michael I. Miller
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD
- Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD
| | - John G. Csernansky
- Department of Psychiatry, Washington, University School of Medicine, St. Louis, MO
- Department of Anatomy and Neurobiology, Washington, University School of Medicine, St. Louis, MO
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98
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Ellison-Wright I, Glahn DC, Laird AR, Thelen SM, Bullmore E. The anatomy of first-episode and chronic schizophrenia: an anatomical likelihood estimation meta-analysis. Am J Psychiatry 2008; 165:1015-23. [PMID: 18381902 PMCID: PMC2873788 DOI: 10.1176/appi.ajp.2008.07101562] [Citation(s) in RCA: 470] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to map gray matter changes in first-episode schizophrenia and to compare these with the changes in chronic schizophrenia. They postulated that the data would show a progression of changes from hippocampal deficits in first-episode schizophrenia to include volume reductions in the amygdala and cortical gray matter in chronic schizophrenia. METHOD A systematic search was conducted for voxel-based structural MRI studies of patients with first-episode schizophrenia and chronic schizophrenia in relation to comparison groups. Meta-analyses of the coordinates of gray matter differences were carried out using anatomical likelihood estimation. Maps of gray matter changes were constructed, and subtraction meta-analysis was used to compare them. RESULTS A total of 27 articles were identified for inclusion in the meta-analyses. A marked correspondence was observed in regions affected by both first-episode schizophrenia and chronic schizophrenia, including gray matter decreases in the thalamus, the left uncus/amygdala region, the insula bilaterally, and the anterior cingulate. In the comparison of first-episode schizophrenia and chronic schizophrenia, decreases in gray matter volume were detected in first-episode schizophrenia but not in chronic schizophrenia in the caudate head bilaterally; decreases were more widespread in cortical regions in chronic schizophrenia. CONCLUSIONS Anatomical changes in first-episode schizophrenia broadly coincide with a basal ganglia-thalamocortical circuit. These changes include bilateral reductions in caudate head gray matter, which are absent in chronic schizophrenia. Comparing first-episode schizophrenia and chronic schizophrenia, the authors did not find evidence for the temporolimbic progression of pathology from hippocampus to amygdala, but there was evidence for progression of cortical changes.
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Affiliation(s)
- Ian Ellison-Wright
- Avon and Wiltshire Mental Health Partnership NHS Trust, Beechlydene Ward, Fountain Way, Wilton Rd., Salisbury SP2 7EP, United Kingdom.
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