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Saito J, Hori M, Nemoto T, Katagiri N, Shimoji K, Ito S, Tsujino N, Yamaguchi T, Shiraga N, Aoki S, Mizuno M. Longitudinal study examining abnormal white matter integrity using a tract-specific analysis in individuals with a high risk for psychosis. Psychiatry Clin Neurosci 2017; 71:530-541. [PMID: 28220654 DOI: 10.1111/pcn.12515] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 01/07/2023]
Abstract
AIM Although volume reductions in the grey matter have been previously observed in individuals with an at-risk mental state (ARMS) for psychosis, the features of white matter integrity and their correlation with psychiatric symptoms remain unclear. METHODS Forty-six ARMS subjects were examined using magnetic resonance imaging (MRI) to acquire diffusion tensor imaging (DTI); the subjects were also evaluated using the Scale of Prodromal Symptoms at baseline and at 52 weeks. Sixteen healthy controls also underwent MRI scanning. The DTI results were longitudinally analyzed using a tract-specific analysis to measure the fractional anisotropy (FA) values of the entire corpus callosum (CC), as well as its genu, trunk, and splenium. RESULTS During the 52-week study period, seven patients developed psychosis (ARMS-P) and 39 did not (ARMS-NP). In the entire CC and the genu, trunk, and splenium of the CC, the FA values of the ARMS subjects were each significantly smaller than the respective values of the healthy controls at baseline. In the genu and trunk, the baseline FA values in the ARMS-NP group were, paradoxically, smaller than those of the ARMS-P group at baseline. Regarding the association between the FA values and psychiatric symptoms, a reduction in the FA value in the genu was significantly correlated with a deterioration of negative symptoms among the ARMS subjects. CONCLUSION Abnormal white matter integrity in the CC may predict the long-term outcome of patients with prodromal psychosis, since negative symptoms are associated with poor functioning.
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Affiliation(s)
- Junichi Saito
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Keigo Shimoji
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Shinya Ito
- Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan.,Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Nobuyuki Shiraga
- Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
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Oxidative stress, prefrontal cortex hypomyelination and cognitive symptoms in schizophrenia. Transl Psychiatry 2017; 7:e1171. [PMID: 28934193 PMCID: PMC5538118 DOI: 10.1038/tp.2017.138] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/12/2017] [Accepted: 05/06/2017] [Indexed: 12/13/2022] Open
Abstract
Schizophrenia (SZ) is a neurodevelopmental disorder with a broad symptomatology, including cognitive symptoms that are thought to arise from the prefrontal cortex (PFC). The neurobiological aetiology of these symptoms remains elusive, yet both impaired redox control and PFC dysconnectivity have been recently implicated. PFC dysconnectivity has been linked to white matter, oligodendrocyte (OL) and myelin abnormalities in SZ patients. Myelin is produced by mature OLs, and OL precursor cells (OPCs) are exceptionally susceptible to oxidative stress. Here we propose a hypothesis for the aetiology of cognitive symptomatology in SZ: the redox-induced prefrontal OPC-dysfunctioning hypothesis. We pose that the combination of genetic and environmental factors causes oxidative stress marked by a build-up of reactive oxygen species that, during late adolescence, impair OPC signal transduction processes that are necessary for OPC proliferation and differentiation, and involve AMP-activated protein kinase, Akt-mTOR-P70S6K and peroxisome proliferator receptor alpha signalling. OPC dysfunctioning coincides with the relatively late onset of PFC myelination, causing hypomyelination and disruption of connectivity in this brain area. The resulting cognitive deficits arise in parallel with SZ onset. Hence, our hypothesis provides a novel neurobiological framework for the aetiology of SZ cognitive symptoms. Future research addressing our hypothesis could have important implications for the development of new (combined) antioxidant- and promyelination-based strategies to treat the cognitive symptoms in SZ.
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Carney R, Cotter J, Firth J, Bradshaw T, Yung AR. Cannabis use and symptom severity in individuals at ultra high risk for psychosis: a meta-analysis. Acta Psychiatr Scand 2017; 136:5-15. [PMID: 28168698 PMCID: PMC5484316 DOI: 10.1111/acps.12699] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We aimed to assess whether individuals at ultra high risk (UHR) for psychosis have higher rates of cannabis use and cannabis use disorders (CUDs) than non-UHR individuals and determine whether UHR cannabis users have more severe psychotic experiences than non-users. METHOD We conducted a meta-analysis of studies reporting cannabis use in the UHR group and/or positive or negative symptoms among UHR cannabis users and non-users. Logit event rates were calculated for cannabis use, in addition to odds ratios to assess the difference between UHR and controls. Severity of clinical symptoms in UHR cannabis users and non-users was compared using Hedges' g. RESULTS Thirty unique studies were included (UHR n = 4205, controls n = 667) containing data from cross-sectional and longitudinal studies, and randomised control trials. UHR individuals have high rates of current (26.7%) and lifetime (52.8%) cannabis use, and CUDs (12.8%). Lifetime use and CUDs were significantly higher than controls (lifetime OR: 2.09; CUD OR: 5.49). UHR cannabis users had higher rates of unusual thought content and suspiciousness than non-users. CONCLUSION Ultra high risk individuals have high rates of cannabis use and CUDs, and cannabis users had more severe positive symptoms. Targeting substance use during the UHR phase may have significant benefits to an individual's long-term outcome.
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Affiliation(s)
- R. Carney
- Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK
| | - J. Cotter
- Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK
| | - J. Firth
- Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK
| | - T. Bradshaw
- Division of NursingMidwifery and Social WorkUniversity of ManchesterManchesterUK
| | - A. R. Yung
- Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK,Greater Manchester West Mental Health NHS Foundation TrustManchesterUK
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54
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Progressive Decline in Hippocampal CA1 Volume in Individuals at Ultra-High-Risk for Psychosis Who Do Not Remit: Findings from the Longitudinal Youth at Risk Study. Neuropsychopharmacology 2017; 42:1361-1370. [PMID: 28079061 PMCID: PMC5437892 DOI: 10.1038/npp.2017.5] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/05/2016] [Accepted: 01/04/2017] [Indexed: 01/08/2023]
Abstract
Most individuals identified as ultra-high-risk (UHR) for psychosis do not develop frank psychosis. They continue to exhibit subthreshold symptoms, or go on to fully remit. Prior work has shown that the volume of CA1, a subfield of the hippocampus, is selectively reduced in the early stages of schizophrenia. Here we aimed to determine whether patterns of volume change of CA1 are different in UHR individuals who do or do not achieve symptomatic remission. Structural MRI scans were acquired at baseline and at 1-2 follow-up time points (at 12-month intervals) from 147 UHR and healthy control subjects. An automated method (based on an ex vivo atlas of ultra-high-resolution hippocampal tissue) was used to delineate the hippocampal subfields. Over time, a greater decline in bilateral CA1 subfield volumes was found in the subgroup of UHR subjects whose subthreshold symptoms persisted (n=40) and also those who developed clinical psychosis (n=12), compared with UHR subjects who remitted (n=41) and healthy controls (n=54). No baseline differences in volumes of the overall hippocampus or its subfields were found among the groups. Moreover, the rate of volume decline of CA1, but not of other hippocampal subfields, in the non-remitters was associated with increasing symptom severity over time. Thus, these findings indicate that there is deterioration of CA1 volume in persistently symptomatic UHR individuals in proportion to symptomatic progression.
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55
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Bartholomeusz CF, Cropley VL, Wannan C, Di Biase M, McGorry PD, Pantelis C. Structural neuroimaging across early-stage psychosis: Aberrations in neurobiological trajectories and implications for the staging model. Aust N Z J Psychiatry 2017; 51:455-476. [PMID: 27733710 DOI: 10.1177/0004867416670522] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model. RESULTS In general, grey matter (and, to a lesser extent, white matter) declines across multiple frontal, temporal (especially superior regions), insular and parietal regions during the first episode of psychosis, which has a steeper trajectory than that of age-matched healthy counterparts. Although the ultra-high-risk of psychosis literature is considerably mixed, evidence indicates that certain volumetric structural aberrations predate psychotic illness onset (e.g. prefrontal cortex thinning), while other abnormalities present in ultra-high-risk of psychosis populations are potentially non-psychosis-specific (e.g. hippocampal volume reductions). CONCLUSION We highlight the advantages of longitudinal designs, discuss the implications such studies have on clinical staging and provide directions for future research.
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Affiliation(s)
- Cali F Bartholomeusz
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Vanessa L Cropley
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Cassandra Wannan
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Maria Di Biase
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Patrick D McGorry
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christos Pantelis
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- 4 Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia
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Bernard JA, Orr JM, Mittal VA. Cerebello-thalamo-cortical networks predict positive symptom progression in individuals at ultra-high risk for psychosis. NEUROIMAGE-CLINICAL 2017; 14:622-628. [PMID: 28348953 PMCID: PMC5357699 DOI: 10.1016/j.nicl.2017.03.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/03/2017] [Accepted: 03/04/2017] [Indexed: 01/12/2023]
Abstract
Prospective longitudinal evaluation of adolescents at ultra-high-risk (UHR) for the development of psychosis enables an enriched neurodevelopmental perspective of disease progression in the absence of many of the factors that typically confound research with formally psychotic patients (antipsychotic medications, drug/alcohol dependence). The cerebellum has been linked to cognitive dysfunction and symptom severity in schizophrenia and recent work from our team suggests that it is a promising target for investigation in UHR individuals as well. However, the cerebellum and cerebello-thalamo-cortical networks have not been investigated developmentally or with respect to disease progression in this critical population. Further, to date, the types of longitudinal multimodal connectivity studies that would substantially inform our understanding of this area have not yet been conducted. In the present investigation 26 UHR and 24 healthy control adolescents were administered structured clinical interviews and scanned at baseline and then again at 12-month time points to investigate both functional and structural connectivity development of cerebello-thalamo-cortical networks in conjunction with symptom progression. Our results provide evidence of abnormal functional and structural cerebellar network development in the UHR group. Crucially, we also found that cerebello-thalamo-cortical network development and connectivity at baseline are associated with positive symptom course, suggesting that cerebellar networks may be a biomarker of disease progression. Together, these findings provide support for neurodevelopmental models of psychotic disorders and suggest that the cerebellum and respective networks with the cortex may be especially important for elucidating the pathophysiology of psychosis and highlighting novel treatment targets. The cerebellum is an important target of research across the psychosis spectrum. Cerebellar networks were investigated over 12 months in youth at-risk for psychosis. Network development differs from controls in the at-risk group. Cerebello-cortical network connectivity predicts worsening positive symptoms. Supports neurodevelopmental models of psychosis and implicates the cerebellum.
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Affiliation(s)
- Jessica A Bernard
- Department of Psychology, Texas A&M University, United States; Texas A&M Institute for Neuroscience, Texas A&M University, United States; Department of Psychology & Neuroscience, University of Colorado Boulder, United States
| | - Joseph M Orr
- Department of Psychology, Texas A&M University, United States; Texas A&M Institute for Neuroscience, Texas A&M University, United States; Institute of Cognitive Science, University of Colorado Boulder, United States
| | - Vijay A Mittal
- Department of Psychology & Neuroscience, University of Colorado Boulder, United States; Center for Neuroscience, University of Colorado Boulder, United States; Department of Psychology, Northwestern University, United States
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Tomyshev AS, Lebedeva IS, Akhadov TA, Omel'chenko MA, Ublinskii MV, Semenova NA, Kaleda VG. MRI Study for the Features of Brain Conduction Pathways in Patients with an Ultra-High Risk of Endogenous Psychoses. Bull Exp Biol Med 2017; 162:425-429. [PMID: 28239791 DOI: 10.1007/s10517-017-3631-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Indexed: 11/30/2022]
Abstract
Diffusion parameters of brain tracts (n=18) were studied in 27 men with ultra-high risk of endogenous attack-like psychoses and 27 mentally healthy men of the same age group (fractional anisotropy; and average, radial, and axial diffusion). Correlation analysis was performed between these parameters and severity of mental disorders (SOPS scale). The indexes of radial diffusion and axial diffusion were shown to change in the left anterior thalamic radiation and right posterior cingulum bundle, respectively. Our results are consistent with published data that disturbances in the frontal and temporal lobes play an important role in the pathogenesis of schizophrenia. The degree of mental disorders correlated with diffusion parameters in the left and right anterior cingulum bundle.
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Affiliation(s)
| | | | - T A Akhadov
- Emergency Children's Surgery and Traumatology Research Institute, Moscow, Russia
| | | | - M V Ublinskii
- Emergency Children's Surgery and Traumatology Research Institute, Moscow, Russia.,N. M. Emanuel Institute of Biochemical Physics, Moscow, Russia
| | - N A Semenova
- Emergency Children's Surgery and Traumatology Research Institute, Moscow, Russia.,N. M. Emanuel Institute of Biochemical Physics, Moscow, Russia.,N. N. Semenov Institute of Chemical Physics, Moscow, Russia
| | - V G Kaleda
- Mental Health Research Center, Moscow, Russia
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Gifford G, Crossley N, Fusar-Poli P, Schnack HG, Kahn RS, Koutsouleris N, Cannon TD, McGuire P. Using neuroimaging to help predict the onset of psychosis. Neuroimage 2017; 145:209-217. [PMID: 27039698 DOI: 10.1016/j.neuroimage.2016.03.075] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/18/2016] [Accepted: 03/28/2016] [Indexed: 02/08/2023] Open
Abstract
The aim of this review is to assess the potential for neuroimaging measures to facilitate prediction of the onset of psychosis. Research in this field has mainly involved people at 'ultra-high risk' (UHR) of psychosis, who have a very high risk of developing a psychotic disorder within a few years of presentation to mental health services. The review details the key findings and developments in this area to date and examines the methodological and logistical challenges associated with making predictions in an individual subject in a clinical setting.
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Affiliation(s)
- George Gifford
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Nicolas Crossley
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Hugo G Schnack
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Philip McGuire
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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DeRosse P, Ikuta T, Karlsgodt KH, Peters BD, Gopin CB, Szeszko PR, Malhotra AK. White Matter Abnormalities Associated With Subsyndromal Psychotic-Like Symptoms Predict Later Social Competence in Children and Adolescents. Schizophr Bull 2017; 43:152-159. [PMID: 27190281 PMCID: PMC5216847 DOI: 10.1093/schbul/sbw062] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Recent data suggest that healthy children and adolescents who report psychotic-like experiences (PLEs) evidence abnormalities in white matter (WM). To date, no study has examined whether WM abnormalities associated with PLEs are predictive of outcome at a later time-point. The present study examined whether abnormalities in WM associated with PLEs in children and adolescents at a baseline assessment were predictive of social functioning at a 12-month follow-up. SUBJECTS AND METHODS Healthy children and adolescents aged 8-18 years (N = 56) were recruited from the community and received a diffusion tensor imaging exam and a clinical exam at baseline. Voxel-wise statistical analysis of fractional anisotropy (FA), using Tract-Based Spatial Statistics, and probabilistic tractography were used to identify WM abnormalities associated with PLEs at baseline. These abnormalities were then examined for association to social problems and social competence in 28 participants at 12-month follow-up. RESULTS Lower FA in regions proximal to the superior longitudinal fasciculus (SLF) and corticospinal tract bilaterally as well as in the left inferior fronto-occipital fasciculus and inferior longitudinal fasciculus were associated with higher levels of PLEs at baseline. Moreover, baseline FA in the SLF, but not baseline severity of PLEs, was significantly predictive of social competence at a 12-month follow-up. In contrast, baseline severity of PLEs, but not baseline FA in the SLF, predicted social problems at 12-month follow-up. DISCUSSION These findings suggest that alterations in WM, which are associated with symptoms of psychosis well below the threshold of clinical significance, may have significant ramifications for later social development.
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Affiliation(s)
- Pamela DeRosse
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY; .,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, University, MS;,These authors contributed equally to the article
| | - Katherine H. Karlsgodt
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Hofstra North Shore–LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY
| | - Bart D. Peters
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY
| | | | - Philip R. Szeszko
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Hofstra North Shore–LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY
| | - Anil K. Malhotra
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Hofstra North Shore–LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY;,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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Bakker G, Caan MWA, Vingerhoets WAM, da Silva- Alves F, de Koning M, Boot E, Nieman DH, de Haan L, Bloemen OJ, Booij J, van Amelsvoort TAMJ. Cortical Morphology Differences in Subjects at Increased Vulnerability for Developing a Psychotic Disorder: A Comparison between Subjects with Ultra-High Risk and 22q11.2 Deletion Syndrome. PLoS One 2016; 11:e0159928. [PMID: 27828960 PMCID: PMC5102447 DOI: 10.1371/journal.pone.0159928] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/11/2016] [Indexed: 01/14/2023] Open
Abstract
Introduction Subjects with 22q11.2 deletion syndrome (22q11DS) and subjects with ultra-high risk for psychosis (UHR) share a risk of approximately 30% to develop a psychotic disorder. Studying these groups helps identify biological markers of pathophysiological processes involved in the development of psychosis. Total cortical surface area (cSA), total cortical grey matter volume (cGMV), cortical thickness (CT), and local gyrification index (LGI) of the cortical structure have a distinct neurodevelopmental origin making them important target markers to study in relation to the development of psychosis. Materials and Methods Structural T1-weighted high resolution images were acquired using a 3 Tesla Intera MRI system in 18 UHR subjects, 18 22q11DS subjects, and 24 matched healthy control (HC) subjects. Total cSA, total cGMV, mean CT, and regional vertex-wise differences in CT and LGI were assessed using FreeSurfer software. The Positive and Negative Syndrome Scale was used to assess psychotic symptom severity in UHR and 22q11DS subjects at time of scanning. Results 22q11DS subjects had lower total cSA and total cGMV compared to UHR and HC subjects. The 22q11DS subjects showed bilateral lower LGI in the i) prefrontal cortex, ii) precuneus, iii) precentral gyrus and iv) cuneus compared to UHR subjects. Additionally, lower LGI was found in the left i) fusiform gyrus and right i) pars opercularis, ii) superior, and iii) inferior temporal gyrus in 22q11DS subjects compared to HC. In comparison to 22q11DS subjects, the UHR subjects had lower CT of the insula. For both risk groups, positive symptom severity was negatively correlated to rostral middle frontal gyrus CT. Conclusion A shared negative correlation between positive symptom severity and rostral middle frontal gyrus CT in UHR and 22q11DS may be related to their increased vulnerability to develop a psychotic disorder. 22q11DS subjects were characterised by widespread lower degree of cortical gyrification linked to early and postnatal neurodevelopmental pathology. No implications for early neurodevelopmental pathology were found for the UHR subjects, although they did have distinctively lower insula CT which may have arisen from defective pruning processes during adolescence. Implications of these findings in relation to development of psychotic disorders are in need of further investigation in longitudinal studies.
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Affiliation(s)
- Geor Bakker
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Matthan W. A. Caan
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wilhelmina A. M. Vingerhoets
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Fabiana da Silva- Alves
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Erik Boot
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- The Dalglish Family 22q Clinic, Toronto, Ontario, Canada
| | - Dorien H. Nieman
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Oswald J. Bloemen
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- GGZ Centraal, Center for Mental Health Care Innova, Amersfoort, The Netherlands
| | - Jan Booij
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Thérèse A. M. J. van Amelsvoort
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Wang C, Ji F, Hong Z, Poh JS, Krishnan R, Lee J, Rekhi G, Keefe RSE, Adcock RA, Wood SJ, Fornito A, Pasternak O, Chee MWL, Zhou J. Disrupted salience network functional connectivity and white-matter microstructure in persons at risk for psychosis: findings from the LYRIKS study. Psychol Med 2016; 46:2771-2783. [PMID: 27396386 PMCID: PMC5358474 DOI: 10.1017/s0033291716001410] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Salience network (SN) dysconnectivity has been hypothesized to contribute to schizophrenia. Nevertheless, little is known about the functional and structural dysconnectivity of SN in subjects at risk for psychosis. We hypothesized that SN functional and structural connectivity would be disrupted in subjects with At-Risk Mental State (ARMS) and would be associated with symptom severity and disease progression. METHOD We examined 87 ARMS and 37 healthy participants using both resting-state functional magnetic resonance imaging and diffusion tensor imaging. Group differences in SN functional and structural connectivity were examined using a seed-based approach and tract-based spatial statistics. Subject-level functional connectivity measures and diffusion indices of disrupted regions were correlated with CAARMS scores and compared between ARMS with and without transition to psychosis. RESULTS ARMS subjects exhibited reduced functional connectivity between the left ventral anterior insula and other SN regions. Reduced fractional anisotropy (FA) and axial diffusivity were also found along white-matter tracts in close proximity to regions of disrupted functional connectivity, including frontal-striatal-thalamic circuits and the cingulum. FA measures extracted from these disrupted white-matter regions correlated with individual symptom severity in the ARMS group. Furthermore, functional connectivity between the bilateral insula and FA at the forceps minor were further reduced in subjects who transitioned to psychosis after 2 years. CONCLUSIONS Our findings support the insular dysconnectivity of the proximal SN hypothesis in the early stages of psychosis. Further developed, the combined structural and functional SN assays may inform the prognosis of persons at-risk for psychosis.
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Affiliation(s)
- C. Wang
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - F. Ji
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - Z. Hong
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. S. Poh
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - R. Krishnan
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Lee
- Research Division,
Institute of Mental Health, Singapore
- Office of Clinical Sciences,
Duke-NUS Medical School, Singapore
| | - G. Rekhi
- Research Division,
Institute of Mental Health, Singapore
| | - R. S. E. Keefe
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
| | - R. A. Adcock
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
- Center for Cognitive Neuroscience,
Duke University, Durham, NC,
USA
| | - S. J. Wood
- School of Psychology,
University of Birmingham, Edgbaston,
UK
- Department of Psychiatry,
Melbourne Neuropsychiatry Centre, University of
Melbourne and Melbourne Health, Victoria,
Australia
| | - A. Fornito
- Monash Clinical and Imaging
Neuroscience, School of Psychology and Psychiatry & Monash
Biomedical Imaging, Monash University,
Australia
| | - O. Pasternak
- Departments of Psychiatry and Radiology,
Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, USA
| | - M. W. L. Chee
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Zhou
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
- Clinical Imaging Research Centre, the Agency for
Science, Technology and Research and National University of
Singapore, Singapore
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62
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Vijayakumar N, Bartholomeusz C, Whitford T, Hermens DF, Nelson B, Rice S, Whittle S, Pantelis C, McGorry P, Schäfer MR, Amminger GP. White matter integrity in individuals at ultra-high risk for psychosis: a systematic review and discussion of the role of polyunsaturated fatty acids. BMC Psychiatry 2016; 16:287. [PMID: 27515430 PMCID: PMC4982267 DOI: 10.1186/s12888-016-0932-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 06/15/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Schizophrenia is thought to be a neurodevelopmental disorder with pathophysiological processes beginning in the brain prior to the emergence of clinical symptoms. Recent evidence from neuroimaging studies using techniques such as diffusion tensor imaging has identified white matter abnormalities that are suggestive of disrupted brain myelination and neuronal connectivity. Identifying whether such effects exist in individuals at high risk for developing psychosis may help with prevention and early intervention strategies. In addition, there is preliminary evidence for a role of lipid biology in the onset of psychosis, along with well-established evidence of its role in myelination of white matter tracts. As such, this article synthesises the literature on polyunsaturated fatty acids (PUFAs) in myelination and schizophrenia, hypothesizing that white matter abnormalities may potentially mediate the relationship between PUFAs and schizophrenia. METHODS Diffusion tensor imaging studies were identified through a systematic search of existing literature. Studies examined white matter integrity in ultra-high risk (UHR) samples, as assessed using structured diagnostic interviews. Data was extracted and summarised as a narrative review. RESULTS Twelve studies met inclusion criteria, and findings identified reduced fractional anisotropy and higher diffusivity. Although the exact location of abnormalities remains uncertain, fronto-temporal and fronto-limbic connections, including the superior longitudinal and uncinate fasiculus, cingulum, and corpus callosum appear to be implicated. Because of preliminary evidence suggesting lipid biology may be relevant for the onset of psychosis, a discussion is provided of the role of polyunsaturated fatty acids (PUFAs) in myelination and risk for psychosis. CONCLUSIONS While the function of PUFAs in myelination is well-established, there is growing evidence of reduced PUFA concentration in UHR samples, highlighting the need for research to examine the relationship between PUFA and white matter integrity in high-risk samples and age-matched healthy controls. Such investigations will help to better understand the pathophysiology of the disorder, and potentially assist in the development of novel treatment and early intervention strategies.
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Affiliation(s)
- Nandita Vijayakumar
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
- Department of Psychology, University of Oregon, Eugene, USA
| | - Cali Bartholomeusz
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Thomas Whitford
- Brain & Mind Research Institute, Central Clinical School, University of Sydney, Sydney, Australia
| | | | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Miriam R. Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - G. Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
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63
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Kochunov P, Ganjgahi H, Winkler A, Kelly S, Shukla DK, Du X, Jahanshad N, Rowland L, Sampath H, Patel B, O'Donnell P, Xie Z, Paciga SA, Schubert CR, Chen J, Zhang G, Thompson PM, Nichols TE, Hong LE. Heterochronicity of white matter development and aging explains regional patient control differences in schizophrenia. Hum Brain Mapp 2016; 37:4673-4688. [PMID: 27477775 DOI: 10.1002/hbm.23336] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 07/21/2016] [Accepted: 07/24/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Altered brain connectivity is implicated in the development and clinical burden of schizophrenia. Relative to matched controls, schizophrenia patients show (1) a global and regional reduction in the integrity of the brain's white matter (WM), assessed using diffusion tensor imaging (DTI) fractional anisotropy (FA), and (2) accelerated age-related decline in FA values. In the largest mega-analysis to date, we tested if differences in the trajectories of WM tract development influenced patient-control differences in FA. We also assessed if specific tracts showed exacerbated decline with aging. METHODS Three cohorts of schizophrenia patients (total n = 177) and controls (total n = 249; age = 18-61 years) were ascertained with three 3T Siemens MRI scanners. Whole-brain and regional FA values were extracted using ENIGMA-DTI protocols. Statistics were evaluated using mega- and meta-analyses to detect effects of diagnosis and age-by-diagnosis interactions. RESULTS In mega-analysis of whole-brain averaged FA, schizophrenia patients had lower FA (P = 10-11 ) and faster age-related decline in FA (P = 0.02) compared with controls. Tract-specific heterochronicity measures, that is, abnormal rates of adolescent maturation and aging explained approximately 50% of the regional variance effects of diagnosis and age-by-diagnosis interaction in patients. Interactive, three-dimensional visualization of the results is available at www.enigma-viewer.org. CONCLUSION WM tracts that mature later in life appeared more sensitive to the pathophysiology of schizophrenia and were more susceptible to faster age-related decline in FA values. Hum Brain Mapp 37:4673-4688, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Habib Ganjgahi
- Department of Statistics, University of Warwick, Warwick, United Kingdom
| | | | - Sinead Kelly
- Imaging Genetics Center, Keck School of Medicine of USC, Marina del Rey, California
| | - Dinesh K Shukla
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Neda Jahanshad
- Imaging Genetics Center, Keck School of Medicine of USC, Marina del Rey, California
| | - Laura Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Hemalatha Sampath
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Binish Patel
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Patricio O'Donnell
- Neuroscience Research Unit, Worldwide Research and Development, Pfizer Inc, 610 Main Street, Cambridge, Massachusetts, 02139
| | - Zhiyong Xie
- Neuroscience Research Unit, Worldwide Research and Development, Pfizer Inc, 610 Main Street, Cambridge, Massachusetts, 02139
| | - Sara A Paciga
- Enterprise Scientific Technology Operations, Worldwide Research and Development, Pfizer Inc, Eastern Point Rd, Groton, Connecticut, 06340
| | - Christian R Schubert
- Enterprise Scientific Technology Operations, Worldwide Research and Development, Pfizer Inc, Eastern Point Rd, Groton, Connecticut, 06340.,Biogen, Cambridge, Massachusetts, 02142
| | - Jian Chen
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, Maryland, 21250
| | - Guohao Zhang
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, Maryland, 21250
| | - Paul M Thompson
- Imaging Genetics Center, Keck School of Medicine of USC, Marina del Rey, California
| | - Thomas E Nichols
- Department of Statistics, University of Warwick, Warwick, United Kingdom
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
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64
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Bakker G, Caan MWA, Schluter RS, Bloemen OJN, da Silva-Alves F, de Koning MB, Boot E, Vingerhoets WAM, Nieman DH, de Haan L, Booij J, van Amelsvoort TAMJ. Distinct white-matter aberrations in 22q11.2 deletion syndrome and patients at ultra-high risk for psychosis. Psychol Med 2016; 46:2299-2311. [PMID: 27193339 DOI: 10.1017/s0033291716000970] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Patients with a deletion at chromosome 22q11.2 (22q11DS) have 30% lifetime risk of developing a psychosis. People fulfilling clinical criteria for ultra-high risk (UHR) for psychosis have 30% risk of developing a psychosis within 2 years. Both high-risk groups show white-matter (WM) abnormalities in microstructure and volume compared to healthy controls (HC), which have been related to psychotic symptoms. Comparisons of WM pathology between these two groups may specify WM markers related to genetic and clinical risk factors. METHOD Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were assessed using diffusion tensor magnetic resonance imaging (MRI), and WM volume with structural MRI, in 23 UHR patients, 21 22q11DS patients, and 33 HC. RESULTS Compared to UHR patients 22q11DS patients had (1) lower AD and RD in corpus callosum (CC), cortical fasciculi, and anterior thalamic radiation (ATR), (2) higher FA in CC and ATR, and (3) lower occipital and superior temporal gyrus WM volume. Compared to HC, 22q11DS patients had (1) lower AD and RD throughout cortical fasciculi and (2) higher FA in ATR, CC and inferior fronto-occipital fasciculus. Compared to HC, UHR patients had (1) higher mean MD, RD, and AD in CC, ATR and cortical fasciculi, (2) no differences in FA. CONCLUSIONS UHR and 22q11DS patients share a susceptibility for developing psychosis yet were characterized by distinct patterns of WM alterations relative to HC. While UHR patients were typified by signs suggestive of aberrant myelination, 22q11DS subjects showed signs suggestive of lower axonal integrity.
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Affiliation(s)
- G Bakker
- Department of Psychiatry & Psychology,University of Maastricht,The Netherlands
| | - M W A Caan
- Department of Radiology,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - R S Schluter
- Department of Radiology,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - O J N Bloemen
- Department of Psychiatry & Psychology,University of Maastricht,The Netherlands
| | - F da Silva-Alves
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - M B de Koning
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - E Boot
- Department of Nuclear Medicine,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - W A M Vingerhoets
- Department of Psychiatry & Psychology,University of Maastricht,The Netherlands
| | - D H Nieman
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - L de Haan
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - J Booij
- Department of Nuclear Medicine,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
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Hyperactivity of caudate, parahippocampal, and prefrontal regions during working memory in never-medicated persons at clinical high-risk for psychosis. Schizophr Res 2016; 173:1-12. [PMID: 26965745 PMCID: PMC4836956 DOI: 10.1016/j.schres.2016.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Deficits in working memory (WM) are a core feature of schizophrenia (SZ) and other psychotic disorders. We examined brain activity during WM in persons at clinical high risk (CHR) for psychosis. METHODS Thirty-seven CHR and 34 healthy control participants underwent functional MRI (fMRI) on a 3.0T scanner while performing an N-back WM task. The sample included a sub-sample of CHR participants who had no lifetime history of treatment with psychotropic medications (n=11). Data were analyzed using SPM8 (2-back>0-back contrast). Pearson correlations between brain activity, symptoms, and WM performance were examined. RESULTS The total CHR group and medication-naive CHR sub-sample were comparable to controls in most demographic features and in N-back WM performance, but had significantly lower IQ. Relative to controls, medication-naïve CHR showed hyperactivity in the left parahippocampus (PHP) and the left caudate during performance of the N-back WM task. Relative to medication-exposed CHR, medication naïve CHR exhibited hyperactivity in the left caudate and the right dorsolateral prefrontal cortex (DLPFC). DLPFC activity was significantly negatively correlated with WM performance. PHP, caudate and DLPFC activity correlated strongly with symptoms, but results did not withstand FDR-correction for multiple comparisons. When all CHR participants were combined (regardless of medication status), only trend-level PHP hyperactivity was observed in CHR relative to controls. CONCLUSIONS Medication-naïve CHR exhibit hyperactivity in regions that subserve WM. These regions are implicated in studies of schizophrenia and risk for psychosis. Results emphasize the importance of medication status in the interpretation of task - induced brain activity.
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66
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Tamnes CK, Agartz I. White Matter Microstructure in Early-Onset Schizophrenia: A Systematic Review of Diffusion Tensor Imaging Studies. J Am Acad Child Adolesc Psychiatry 2016; 55:269-79. [PMID: 27015717 DOI: 10.1016/j.jaac.2016.01.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 12/16/2015] [Accepted: 01/20/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Neurodevelopmental processes and neural connectivity are thought to play pivotal roles in schizophrenia. This article reviews diffusion tensor imaging (DTI) studies of brain white matter connections and microstructure and their development in patients with early-onset schizophrenia (EOS), that is, schizophrenia with an age of onset before 18 years. METHOD A systematic literature search revealed 21 original case-control DTI studies of children and/or adolescents with EOS. RESULTS Nearly all studies report significantly lower regional fractional anisotropy (FA) in patients with EOS than in healthy control participants. However, the anatomical locations and extent of these differences are highly variable across studies. Furthermore, consistent evidence for associations between DTI indices and age of onset, medication variables, and measures of symptomatology and cognition in EOS is lacking. Only 3 available studies have investigated cross-sectional age-related differences or longitudinal changes in DTI measures in adolescents with EOS. The results are mixed, with different studies indicating diverging, converging, or parallel developmental FA trajectories between patients and controls. CONCLUSION The study of brain structural connectivity, as inferred from DTI, and its development in EOS may inform us on the origin and ontogeny of schizophrenia. We suggest some directions for future research in this field and argue for increased focus on developmental questions. Specifically, further investigations of age of onset effects and multimethod longitudinal studies of structural and functional connectivity development before, at, and after onset of schizophrenia and related syndromes in children and adolescents are called for.
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Affiliation(s)
- Christian K Tamnes
- Research Group for Lifespan Changes in Brain and Cognition, University of Oslo, Norway.
| | - Ingrid Agartz
- NORMENT (Norwegian Centre for Mental Disorders Research), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway and with Diakonhjemmet Hospital, Oslo, Norway
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67
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Rigucci S, Santi G, Corigliano V, Imola A, Rossi-Espagnet C, Mancinelli I, De Pisa E, Manfredi G, Bozzao A, Carducci F, Girardi P, Comparelli A. White matter microstructure in ultra-high risk and first episode schizophrenia: A prospective study. Psychiatry Res Neuroimaging 2016; 247:42-48. [PMID: 26651180 DOI: 10.1016/j.pscychresns.2015.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/29/2015] [Accepted: 11/15/2015] [Indexed: 01/01/2023]
Abstract
There is increasing evidence of white matter (WM) pathology in schizophrenia, but its role at the very early stage of the disorder remains unclear. In an exploration of WM microstructure in ultra-high risk (UHR) subjects and first episode schizophrenia (FES), 34 FES, 27 UHR and 26 healthy control (HC) subjects underwent a magnetic resonance imaging (MRI) tract based spatial statistics (TBSS) investigation. Whole brain fractional anisotropy (FA), mean diffusivity (MD), radial (RD) and axial diffusivity (AD) values were extracted. UHR subjects who later developed psychosis showed lower FA compared with HC in the corpus callosum (CC), the left superior and inferior longitudinal fasciculus, the left inferior fronto-occipital fasciculs (IFO), and the forceps; RD was significantly higher in the CC, the forceps, the anterior thalamic radiation bilaterally, and the cingulum bundle. FES, compared to HC, showed a significant FA reduction of the CC, the superior and inferior longitudinal fasciculi bilaterally, the IFO bilaterally, the corona radiate bilaterally, and the forceps; while RD was found to be significantly increased in the left superior longitudinal fasciculus. UHR who later developed psychosis had WM abnormalities affecting brain pathways that are crucial for intra- and inter-hemispheric connections.
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Affiliation(s)
- Silvia Rigucci
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Giulia Santi
- Faculty of Medicine and Pharmacy, Department of Physiology, Sapienza University of Rome, Rome, Italy
| | - Valentina Corigliano
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Annamaria Imola
- Faculty of Medicine and Pharmacy, Department of Physiology, Sapienza University of Rome, Rome, Italy
| | - Camilla Rossi-Espagnet
- Unit of Neuroradiology, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Iginia Mancinelli
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora De Pisa
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giovanni Manfredi
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Alessandro Bozzao
- Unit of Neuroradiology, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Filippo Carducci
- Faculty of Medicine and Pharmacy, Department of Physiology, Sapienza University of Rome, Rome, Italy
| | - Paolo Girardi
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna Comparelli
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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68
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Monin A, Fournier M, Baumann PS, Cuénod M, Do KQ. Role of Redox Dysregulation in White Matter Anomalies Associated with Schizophrenia. HANDBOOK OF BEHAVIORAL NEUROSCIENCE 2016. [DOI: 10.1016/b978-0-12-800981-9.00028-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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69
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McGuire P, Sato JR, Mechelli A, Jackowski A, Bressan RA, Zugman A. Can neuroimaging be used to predict the onset of psychosis? Lancet Psychiatry 2015; 2:1117-22. [PMID: 26521769 DOI: 10.1016/s2215-0366(15)00308-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/19/2015] [Accepted: 06/29/2015] [Indexed: 12/27/2022]
Abstract
The onset of psychotic disorders is preceded by a high-risk phase characterised by attenuated or brief psychotic symptoms and a marked decline in functioning. About a third of individuals presenting with these features develop a psychotic disorder within 3 years. A fundamental challenge in the clinical management of this population is that it is not possible to predict whether an individual at high risk will go on to develop psychosis on the basis of their presenting features. Consequently, preventive interventions that might reduce the risk of progression to psychosis cannot be selectively offered to those patients for whom they would be most useful. However, neuroimaging investigation suggests that the structure, function, and chemistry of the brain in high-risk individuals who become psychotic differ from those in individuals who do not become psychotic. In this Personal View, we review these findings and discuss the main challenges for translating them into clinical practice. The development of techniques that allow clinicians to tailor interventions to the level of risk is a major translational goal for research in this field.
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Affiliation(s)
- Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; OASIS, South London and Maudsley NHS Trust, London, UK.
| | - Joao R Sato
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo Andre, Brazil
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; OASIS, South London and Maudsley NHS Trust, London, UK
| | - Andrea Jackowski
- Department of Psychiatry of the Federal University of São Paulo, São Paulo, Brazil
| | - Rodrigo A Bressan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Department of Psychiatry of the Federal University of São Paulo, São Paulo, Brazil
| | - Andre Zugman
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; OASIS, South London and Maudsley NHS Trust, London, UK; Department of Psychiatry of the Federal University of São Paulo, São Paulo, Brazil
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70
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Savadjiev P, Seidman LJ, Thermenos H, Keshavan M, Whitfield-Gabrieli S, Crow TJ, Kubicki M. Sexual dimorphic abnormalities in white matter geometry common to schizophrenia and non-psychotic high-risk subjects: Evidence for a neurodevelopmental risk marker? Hum Brain Mapp 2015; 37:254-61. [PMID: 26467751 DOI: 10.1002/hbm.23026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/30/2015] [Accepted: 10/04/2015] [Indexed: 12/23/2022] Open
Abstract
The characterization of neurodevelopmental aspects of brain alterations require neuroimaging methods that reflect correlates of neurodevelopment, while being robust to other progressive pathological processes. Newly developed neuroimaging methods for measuring geometrical features of the white matter fall exactly into this category. Our recent work shows that such features, measured in the anterior corpus callosum in diffusion MRI data, correlate with psychosis symptoms in patients with adolescent onset schizophrenia and subside a reversal of normal sexual dimorphism. Here, we test the hypothesis that similar developmental deviations will also be present in nonpsychotic subjects at familial high risk (FHR) for schizophrenia, due to genetic predispositions. Demonstrating such changes would provide a strong indication of neurodevelopmental deviation extant before, and independent of pathological changes occurring after disease onset. We examined the macrostructural geometry of corpus callosum white matter in diffusion MRI data of 35 non-psychotic subjects with genetic (familial) risk for schizophrenia, and 26 control subjects, both male and female. We report a reversal of normal sexual dimorphism in callosal white matter geometry consistent with recent results in adolescent onset schizophrenia. This pattern may be indicative of an error in neurogenesis and a possible trait marker of schizophrenia.
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Affiliation(s)
- Peter Savadjiev
- Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Larry J Seidman
- Massachusetts Mental Health Center, Division of Public Psychiatry, Boston, Massachusetts.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Heidi Thermenos
- Massachusetts Mental Health Center, Division of Public Psychiatry, Boston, Massachusetts.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Tim J Crow
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry and Radiology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
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71
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Schizophrenia and bipolar disorder: The road from similarities and clinical heterogeneity to neurobiological types. Clin Chim Acta 2015; 449:49-59. [DOI: 10.1016/j.cca.2015.02.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 01/06/2023]
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72
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Wright SN, Hong LE, Winkler AM, Chiappelli J, Nugent K, Muellerklein F, Du X, Rowland LM, Wang DJJ, Kochunov P. Perfusion shift from white to gray matter may account for processing speed deficits in schizophrenia. Hum Brain Mapp 2015; 36:3793-804. [PMID: 26108347 DOI: 10.1002/hbm.22878] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 05/23/2015] [Accepted: 06/04/2015] [Indexed: 12/16/2022] Open
Abstract
Reduced speed of cerebral information processing is a cognitive deficit associated with schizophrenia. Normal information processing speed (PS) requires intact white matter (WM) physiology to support information transfer. In a cohort of 107 subjects (47/60 patients/controls), we demonstrate that PS deficits in schizophrenia patients are explained by reduced WM integrity, which is measured using diffusion tensor imaging, mediated by the mismatch in WM/gray matter blood perfusion, and measured using arterial spin labeling. Our findings are specific to PS, and testing this hypothesis for patient-control differences in working memory produces no explanation. We demonstrate that PS deficits in schizophrenia can be explained by neurophysiological alterations in cerebral WM. Whether the disproportionately low WM integrity in schizophrenia is due to illness or secondary due to this disorder deserves further examination.
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Affiliation(s)
- Susan N Wright
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Anderson M Winkler
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, University of Oxford, Oxford, United Kingdom
| | - Joshua Chiappelli
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Katie Nugent
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Florian Muellerklein
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Xioming Du
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Laura M Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Psychology, University of Maryland, Baltimore County, Maryland
| | - Danny J J Wang
- Department of Neurology, University of California, Los Angeles, California
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Physics, University of Maryland, Baltimore County, Maryland
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73
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Bernard JA, Orr JM, Mittal VA. Abnormal hippocampal-thalamic white matter tract development and positive symptom course in individuals at ultra-high risk for psychosis. NPJ SCHIZOPHRENIA 2015; 1. [PMID: 26120591 PMCID: PMC4479398 DOI: 10.1038/npjschz.2015.9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background/Objectives: Abnormal development of the hippocampus has been reported in adolescents at ultra-high risk (UHR) for psychosis and thalamic abnormalities have been found. However, the white matter connections between the hippocampus and the thalamus have not been studied. The connections between these regions are of key importance to our understanding of the pathophysiology of psychosis. Methods: Twenty-six UHR and 21 healthy age-matched controls were tested at a baseline assessment and 12 months later. Symptoms were assessed at both the time points and all the participants underwent diffusion tensor imaging scans. We used tractography to trace the white matter connections in each individual between the thalamus and hippocampus and then extracted fractional anisotropy (FA) to assess white matter structural integrity. Results: There was a significant group by time interaction indicating that FA decreased in UHR, and increased in controls over 12 months. Across both groups, baseline FA of the thalamic–hippocampal tract was predictive of positive symptoms at 12-month follow-up. Critically, this pattern remained significant in UHR individual group alone. At baseline, those with higher FA, indicative of abnormal white matter development, show higher positive symptoms 1 year later. Conclusions: Here, we provide evidence to indicate that there are differences in white matter development in hippocampal–thalamic connections, both of which are important nodes in networks associated with schizophrenia. Furthermore, abnormal developmental patterns in UHR individuals are associated with positive symptom course.
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Affiliation(s)
- Jessica A Bernard
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Joseph M Orr
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Vijay A Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA ; Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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74
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Abstract
Neuroimaging studies have identified patterns of brain abnormalities in various stages of schizophrenia, but whether these abnormalities reflect primary factors associated with the causes of illness or secondary phenomena such as medications has been unclear. Recent work conducted within the prodromal risk paradigm suggests that progressive change in brain structure and function occurs around the time when clinically high-risk individuals transition into full-blown psychosis, effects that cannot be explained by exposure to medications or illness chronicity. This article reviews recent work bearing on the question of the timing of onset and course of brain changes, focusing on structural MRI, diffusion tensor imaging, and resting state connectivity MRI, in association with the onset and course of psychosis. We conclude with a consideration of potential mechanisms underlying progressive tissue changes during the prodromal phase of schizophrenia and implications for prevention.
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Affiliation(s)
- Yoonho Chung
- Deparment of Psychology, Yale University, New Haven CT
| | - Tyrone D. Cannon
- Deparment of Psychology, Yale University, New Haven CT
- Department of Psychiatry, Yale University, New Haven CT
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75
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Katagiri N, Pantelis C, Nemoto T, Zalesky A, Hori M, Shimoji K, Saito J, Ito S, Dwyer DB, Fukunaga I, Morita K, Tsujino N, Yamaguchi T, Shiraga N, Aoki S, Mizuno M. A longitudinal study investigating sub-threshold symptoms and white matter changes in individuals with an 'at risk mental state' (ARMS). Schizophr Res 2015; 162:7-13. [PMID: 25638727 DOI: 10.1016/j.schres.2015.01.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 12/20/2014] [Accepted: 01/02/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND Evidence supports disruption in white matter (WM) connectivity in established schizophrenia, however, it is unclear when these abnormalities occur during the course of illness and if they are progressive. Here we investigated whether WM abnormalities predate illness onset by examining a group of individuals with an 'at risk mental state' (ARMS) and assess whether there is evidence of progressive change. We hypothesized that WM abnormalities are associated with symptom change. METHODS Sixteen healthy controls and 41 ARMS subjects at baseline underwent Diffusion Tensor Imaging (DTI). Sub-threshold positive symptoms were measured using the Scale of Prodromal Symptoms (SOPS). Imaging and symptoms were re-administered in the ARMS group after one year (52weeks). Fractional anisotropy (FA) value differences between ARMS and control groups at baseline were localized using the method of Tract-Based Spatial Statistics (TBSS). RESULTS At baseline, FA was significantly reduced in a sub-region of the corpus callosum (CC) in the ARMS group as a whole compared to controls. This reduction was also found in the 34 individuals who did not transition (ARMS-N) during the one-year follow-up. However, the ARMS-N group showed a significant improvement in sub-threshold positive symptoms at follow-up, which was correlated with an increase in FA in the same CC region (r=-0.664, p<0.001). DISCUSSION There was a significant FA reduction in the CC in individuals at high risk for psychosis regardless of transition status at one year. This suggests that WM abnormalities in the CC may represent a biological vulnerability to psychosis. Improvement in sub-threshold positive symptoms was associated with improvement in measures of WM integrity in the CC. This may suggest that neurobiological 'resilience' is associated with improved outcomes, although this notion requires future study.
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Affiliation(s)
- Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Melbourne, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Melbourne, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan.
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Melbourne, Australia; Melbourne School of Engineering, The University of Melbourne, Melbourne, Australia
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keigo Shimoji
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Junichi Saito
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Shinya Ito
- Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Dominic B Dwyer
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Melbourne, Australia
| | - Issei Fukunaga
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keiko Morita
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Nobuyuki Shiraga
- Department of Radiology, Toho University School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
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76
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Bois C, Whalley HC, McIntosh AM, Lawrie SM. Structural magnetic resonance imaging markers of susceptibility and transition to schizophrenia: a review of familial and clinical high risk population studies. J Psychopharmacol 2015; 29:144-54. [PMID: 25049260 DOI: 10.1177/0269881114541015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a growing consensus that a symptomatology as complex and heterogeneous as schizophrenia is likely to be produced by widespread perturbations of brain structure, as opposed to isolated deficits in specific brain regions. Structural brain-imaging studies have shown that several features of the brain, such as grey matter, white matter integrity and the morphology of the cortex differ in individuals at high risk of the disorder compared to controls, but to a lesser extent than in patients, suggesting that structural abnormalities may form markers of vulnerability to the disorder. Research has had some success in delineating abnormalities specific to those individuals that transition to psychosis, compared to those at high risk that do not, suggesting that a general risk for the disorder can be distinguished from alterations specific to frank psychosis. In this paper, we review cross-sectional and longitudinal studies of individuals at familial or clinical high risk of the disorder. We conclude that the search for reliable markers of schizophrenia is likely to be enhanced by methods which amalgamate structural neuroimaging data into a coherent framework that takes into account the widespread distribution of brain alterations, and relates this to leading hypotheses of schizophrenia.
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Affiliation(s)
- C Bois
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
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77
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Schmidt A, Diwadkar VA, Smieskova R, Harrisberger F, Lang UE, McGuire P, Fusar-Poli P, Borgwardt S. Approaching a network connectivity-driven classification of the psychosis continuum: a selective review and suggestions for future research. Front Hum Neurosci 2015; 8:1047. [PMID: 25628553 PMCID: PMC4292722 DOI: 10.3389/fnhum.2014.01047] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/15/2014] [Indexed: 01/07/2023] Open
Abstract
Brain changes in schizophrenia evolve along a dynamic trajectory, emerging before disease onset and proceeding with ongoing illness. Recent investigations have focused attention on functional brain interactions, with experimental imaging studies supporting the disconnection hypothesis of schizophrenia. These studies have revealed a broad spectrum of abnormalities in brain connectivity in patients, particularly for connections integrating the frontal cortex. A critical point is that brain connectivity abnormalities, including altered resting state connectivity within the fronto-parietal (FP) network, are already observed in non-help-seeking individuals with psychotic-like experiences. If we consider psychosis as a continuum, with individuals with psychotic-like experiences at the lower and psychotic patients at the upper ends, individuals with psychotic-like experiences represent a key population for investigating the validity of putative biomarkers underlying the onset of psychosis. This paper selectively addresses the role played by FP connectivity in the psychosis continuum, which includes patients with chronic psychosis, early psychosis, clinical high risk, genetic high risk, as well as the general population with psychotic experiences. We first discuss structural connectivity changes among the FP pathway in each domain in the psychosis continuum. This may provide a basis for us to gain an understanding of the subsequent changes in functional FP connectivity. We further indicate that abnormal FP connectivity may arise from glutamatergic disturbances of this pathway, in particular from abnormal NMDA receptor-mediated plasticity. In the second part of this paper we propose some concepts for further research on the use of network connectivity in the classification of the psychosis continuum. These concepts are consistent with recent efforts to enhance the role of data in driving the diagnosis of psychiatric spectrum diseases.
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Affiliation(s)
- André Schmidt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University Detroit, Michigan, USA
| | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | | | - Undine E Lang
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland ; Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
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78
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Canu E, Agosta F, Filippi M. A selective review of structural connectivity abnormalities of schizophrenic patients at different stages of the disease. Schizophr Res 2015; 161:19-28. [PMID: 24893909 DOI: 10.1016/j.schres.2014.05.020] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 05/02/2014] [Accepted: 05/09/2014] [Indexed: 12/22/2022]
Abstract
Schizophrenia has long been hypothesized to result from a disconnection syndrome due to a disruption of the association fibers of the brain. However, only with the advent of in vivo neuroimaging, a formal disconnectivity hypothesis for schizophrenia has been developed. Diffusion tensor MRI, a non-invasive technique which is sensitive to features of tissue microstructure and to the anatomy of the white matter fibers, has gained a crucial role in the field. Here, we provide a state-of-the-art review of structural connectivity abnormalities detected in schizophrenia and discuss the most relevant findings at preclinical, first episode drug-naïve, and chronic stages. Imaging studies showed white matter alterations from the preclinical to the chronic stage of the disease, which involve the corticospinal tracts, interhemispheric connections, long association white matter tracts, cerebello-thalamo-cortical circuit, and limbic system. Such abnormalities were found to be associated with the psychiatric and cognitive manifestations of the disease and to predict, at least partially, the patient clinical evolution and response to treatment.
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Affiliation(s)
- Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
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79
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Prasad KM, Upton CH, Schirda CS, Nimgaonkar VL, Keshavan MS. White matter diffusivity and microarchitecture among schizophrenia subjects and first-degree relatives. Schizophr Res 2015; 161:70-5. [PMID: 25454798 PMCID: PMC4277717 DOI: 10.1016/j.schres.2014.09.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 09/27/2014] [Accepted: 09/30/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Impairments in structural and functional connections are demonstrated in schizophrenia. Certain disconnectional patterns may be biomarkers of elevated risk for schizophrenia. Convergent examination of multiple diffusion parameters and cognitive performance better illustrates pathophysiological significance of such disconnectional patterns. METHODS Diffusion Tensor Imaging data on 39 early-course schizophrenia subjects, 21 adolescent/young adult first-degree relatives (FDR) of schizophrenia subjects and 29 healthy controls (HC) were examined for threshold-free clusters of fractional anisotropy (FA) and radial diffusivity (RD) differences correcting for multiple comparisons. Regression models examined the variance contributed by anisotropy differences, age and sex. Group-wise differences on sustained attention, verbal memory and executive functions were examined and correlated with diffusivity measures controlling for age and sex. RESULTS Schizophrenia subjects showed significantly decreased FA and increased RD in the forceps minor and superior longitudinal fasciculus (SLF) compared to HC. FDR showed decreased forceps minor FA compared to HC, and decreased SLF RD compared to HC and schizophrenia subjects. Quantitative RD differences were 2-3 fold higher compared to FA. Besides, forceps minor RD was inversely correlated with sustained attention in schizophrenia. CONCLUSIONS Schizophrenia and FDR subjects show different patterns of white matter diffusivity compared to HC. While forceps minor changes may be a disease marker, SLF changes may be risk markers. In addition, RD may be a more robust risk marker than FA.
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Affiliation(s)
- Konasale M. Prasad
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States, Corresponding author at: Room 422, Ste 431, Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213, United States. Tel.: +1 412 586 9014. (K.M. Prasad)
| | - Catherine H. Upton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Claudiu S. Schirda
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Vishwajit L. Nimgaonkar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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80
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Peters BD, Karlsgodt KH. White matter development in the early stages of psychosis. Schizophr Res 2015; 161:61-9. [PMID: 24893908 PMCID: PMC4250450 DOI: 10.1016/j.schres.2014.05.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/06/2014] [Accepted: 05/09/2014] [Indexed: 12/19/2022]
Abstract
Schizophrenia has been conceptualized as a disorder of both neurodevelopment and a disorder of connectivity. One important aspect of the neurodevelopmental hypothesis is that schizophrenia is no longer thought to have discrete illness time points, but rather a long trajectory of brain changes, spanning many years, across a series of stages of the disease including the prodrome, first episode, and chronic period. As the disease progresses, there is a complex relationship between age related changes and disease related changes. Therefore, neural changes, and specifically white matter based connectivity changes, in schizophrenia may be best conceptualized based on a lifespan trajectory. In this selective review, we discuss healthy changes in white matter integrity that occur with age, as well as changes that occur across illness stages. We further propose a set of models that might explain lifespan changes in white matter integrity in schizophrenia, with the conclusion that the evidence most strongly supports a pattern of disrupted maturation during adolescence, with the potential for later changes that may be a result of disease neurotoxicity, abnormal or excessive aging effects, as well as medication, cohort or other effects. Thus, when considering white matter integrity in psychosis, it is critical to consider age in addition to other contributing factors including disease specific effects. Discovery of the factors driving healthy white matter development across the lifespan and deviations from the normal developmental trajectory may provide insights relevant to the discovery of early treatment interventions.
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Affiliation(s)
- Bart D. Peters
- Division of Psychiatry Research, Zucker Hillside Hospital, NorthShore-LIJ Health System, Glen Oaks, NY
| | - Katherine H. Karlsgodt
- Division of Psychiatry Research, Zucker Hillside Hospital, NorthShore-LIJ Health System, Glen Oaks, NY,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY,Department of Psychiatry, Hofstra NorthShore-LIJ School of Medicine, Hempstead, NY
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81
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DeRosse P, Ikuta T, Peters BD, Karlsgodt KH, Szeszko PR, Malhotra AK. Adding insult to injury: childhood and adolescent risk factors for psychosis predict lower fractional anisotropy in the superior longitudinal fasciculus in healthy adults. Psychiatry Res 2014; 224:296-302. [PMID: 25277095 PMCID: PMC4253644 DOI: 10.1016/j.pscychresns.2014.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/03/2014] [Accepted: 09/01/2014] [Indexed: 12/21/2022]
Abstract
Although epidemiological studies provide strong support for demographic and environmental risk factors in psychotic disorders, few data examine how these risk factors relate to the putative aberrant neurodevelopment associated with illness. The present study examined how the accumulation of risk factors including low IQ, low parental socioeconomic status (SES), history of adolescent cannabis use and childhood trauma, and high levels of subclinical psychotic-like experiences (PLEs) contributed to aberrant neurodevelopmental outcomes in 112 otherwise healthy adults recruited from the community. Participants were studied with diffusion tensor imaging (DTI), and voxel-wise statistical analysis of fractional anisotropy (FA) using tract-based spatial statistics (TBSS) was used to examine the relation between cumulative risk (CR) for psychosis and white matter (WM) integrity across the whole brain. Analyses revealed that higher CR was significantly associated with lower FA in a cluster in the left superior longitudinal fasciculus (SLF). These results suggest that risk factors previously associated with psychotic disorders are associated with WM integrity even in otherwise healthy adults and may provide insight into how previously identified risk factors contribute to the structural brain abnormalities associated with psychotic illness. Prospective longitudinal studies examining the effect of risk factors on the developmental trajectory of brain WM are warranted.
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Affiliation(s)
- Pamela DeRosse
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004, USA.
| | - Toshikazu Ikuta
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Bart D. Peters
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Katherine H. Karlsgodt
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Philip R. Szeszko
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Anil K. Malhotra
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA,Hofstra North Shore – LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA
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82
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Ribolsi M, Daskalakis ZJ, Siracusano A, Koch G. Abnormal asymmetry of brain connectivity in schizophrenia. Front Hum Neurosci 2014; 8:1010. [PMID: 25566030 PMCID: PMC4273663 DOI: 10.3389/fnhum.2014.01010] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/26/2014] [Indexed: 01/09/2023] Open
Abstract
Recently, a growing body of data has revealed that beyond a dysfunction of connectivity among different brain areas in schizophrenia patients (SCZ), there is also an abnormal asymmetry of functional connectivity compared with healthy subjects. The loss of the cerebral torque and the abnormalities of gyrification, with an increased or more complex cortical folding in the right hemisphere may provide an anatomical basis for such aberrant connectivity in SCZ. Furthermore, diffusion tensor imaging studies have shown a significant reduction of leftward asymmetry in some key white-matter tracts in SCZ. In this paper, we review the studies that investigated both structural brain asymmetry and asymmetry of functional connectivity in healthy subjects and SCZ. From an analysis of the existing literature on this topic, we can hypothesize an overall generally attenuated asymmetry of functional connectivity in SCZ compared to healthy controls. Such attenuated asymmetry increases with the duration of the disease and correlates with psychotic symptoms. Finally, we hypothesize that structural deficits across the corpus callosum may contribute to the abnormal asymmetry of intra-hemispheric connectivity in schizophrenia.
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Affiliation(s)
- Michele Ribolsi
- Dipartimento di Medicina dei Sistemi, Clinica Psichiatrica, Università di Roma Tor Vergata , Rome , Italy ; Laboratorio di Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS , Rome , Italy
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto , Toronto, ON , Canada
| | - Alberto Siracusano
- Dipartimento di Medicina dei Sistemi, Clinica Psichiatrica, Università di Roma Tor Vergata , Rome , Italy
| | - Giacomo Koch
- Laboratorio di Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS , Rome , Italy
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83
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Jalbrzikowski M, Villalon-Reina JE, Karlsgodt KH, Senturk D, Chow C, Thompson PM, Bearden CE. Altered white matter microstructure is associated with social cognition and psychotic symptoms in 22q11.2 microdeletion syndrome. Front Behav Neurosci 2014; 8:393. [PMID: 25426042 PMCID: PMC4227518 DOI: 10.3389/fnbeh.2014.00393] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 10/22/2014] [Indexed: 12/26/2022] Open
Abstract
22q11.2 Microdeletion Syndrome (22q11DS) is a highly penetrant genetic mutation associated with a significantly increased risk for psychosis. Aberrant neurodevelopment may lead to inappropriate neural circuit formation and cerebral dysconnectivity in 22q11DS, which may contribute to symptom development. Here we examined: (1) differences between 22q11DS participants and typically developing controls in diffusion tensor imaging (DTI) measures within white matter tracts; (2) whether there is an altered age-related trajectory of white matter pathways in 22q11DS; and (3) relationships between DTI measures, social cognition task performance, and positive symptoms of psychosis in 22q11DS and typically developing controls. Sixty-four direction diffusion weighted imaging data were acquired on 65 participants (36 22q11DS, 29 controls). We examined differences between 22q11DS vs. controls in measures of fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD), using both a voxel-based and region of interest approach. Social cognition domains assessed were: Theory of Mind and emotion recognition. Positive symptoms were assessed using the Structured Interview for Prodromal Syndromes. Compared to typically developing controls, 22q11DS participants showed significantly lower AD and RD in multiple white matter tracts, with effects of greatest magnitude for AD in the superior longitudinal fasciculus. Additionally, 22q11DS participants failed to show typical age-associated changes in FA and RD in the left inferior longitudinal fasciculus. Higher AD in the left inferior fronto-occipital fasciculus (IFO) and left uncinate fasciculus was associated with better social cognition in 22q11DS and controls. In contrast, greater severity of positive symptoms was associated with lower AD in bilateral regions of the IFO in 22q11DS. White matter microstructure in tracts relevant to social cognition is disrupted in 22q11DS, and may contribute to psychosis risk.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles Los Angeles, CA, USA
| | - Julio E Villalon-Reina
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Marina del Rey, CA, USA
| | - Katherine H Karlsgodt
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research Manhasset, NY, USA ; Division of Psychiatric Research, Zucker Hillside Hospital Glen Oaks, NY, USA ; Psychiatry, Hofstra Northshore-LIJ School of Medicine Hempstead, NY, USA
| | - Damla Senturk
- Department of Biostatistics, School of Public Health, University of California at Los Angeles Los Angeles, CA, USA
| | - Carolyn Chow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles Los Angeles, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Marina del Rey, CA, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles Los Angeles, CA, USA ; Department of Psychology, University of California at Los Angeles Los Angeles, CA, USA
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84
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Mittal VA, Dean DJ, Bernard JA, Orr JM, Pelletier-Baldelli A, Carol EE, Gupta T, Turner J, Leopold DR, Robustelli BL, Millman ZB. Neurological soft signs predict abnormal cerebellar-thalamic tract development and negative symptoms in adolescents at high risk for psychosis: a longitudinal perspective. Schizophr Bull 2014; 40:1204-15. [PMID: 24375457 PMCID: PMC4193696 DOI: 10.1093/schbul/sbt199] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION There is an emerging consensus that neurological soft signs (NSS) may not be "soft" at all but rather may reflect neuropathy, particularly in the cerebellum and thalamus. However, our understanding of connective tract abnormalities is limited, and to date, there have been no investigations examining NSS and longitudinal white matter development during the prodrome. Mapping the correlates of NSS in ultrahigh-risk (UHR) youth offers potential for highlighting a viable biomarker as well as for advancing understanding of pathogenic processes during the adolescent risk period. METHODS A total of 68 (33 UHR and 35 healthy control) adolescents were assessed with an NSS inventory, structured interviews, and diffusion tensor imaging. Fractional anisotropy (FA) of theoretically relevant cerebellar-thalamic tracts was calculated (left/right superior cerebellar peduncles [SCPs]). Twelve months later, a subset of 30 (15 UHR and 15 control) participants returned for follow-up diffusion tension imaging/clinical assessments. RESULTS UHR youth exhibited elevated NSS across domains. While there were no group differences in the integrity of the SCPs at baseline, controls showed a normative increase while the UHR group showed a decrease in FA over 12 months. NSS predicted a longitudinal decrease in cerebellar-thalamic FA and elevations in negative but not positive symptoms 12 months later. DISCUSSION Findings of abnormal white matter development provide direct empirical evidence to support prominent neurodevelopmental theories. The predictive relationships between NSS and longitudinal cerebellar-thalamic tract integrity and negative symptom course provide insight into the role of cognitive dysmetria in the high-risk period and inform on a unique biomarker tied to core features underlying psychosis.
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Affiliation(s)
- Vijay A. Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO;,Center for Neuroscience, University of Colorado Boulder, Boulder, CO;,*To whom correspondence should be addressed; Department of Psychology and Neuroscience, University of Colorado at Boulder, 345 UCB, Boulder, CO 80309-0345, US; tel: 310-923-2822, fax: 303-492-4616, e-mail:
| | - Derek J. Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO;,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Jessica A. Bernard
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Joseph M. Orr
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO
| | - Andrea Pelletier-Baldelli
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO;,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Emily E. Carol
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Tina Gupta
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Jessica Turner
- Department of Psychology, Georgia State University, Atlanta, GA
| | - Daniel R. Leopold
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO;,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Briana L. Robustelli
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Zachary B. Millman
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO
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85
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Wheeler AL, Voineskos AN. A review of structural neuroimaging in schizophrenia: from connectivity to connectomics. Front Hum Neurosci 2014; 8:653. [PMID: 25202257 PMCID: PMC4142355 DOI: 10.3389/fnhum.2014.00653] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 08/05/2014] [Indexed: 11/13/2022] Open
Abstract
In patients with schizophrenia neuroimaging studies have revealed global differences with some brain regions showing focal abnormalities. Examining neurocircuitry, diffusion-weighted imaging studies have identified altered structural integrity of white matter in frontal and temporal brain regions and tracts such as the cingulum bundles, uncinate fasciculi, internal capsules and corpus callosum associated with the illness. Furthermore, structural co-variance analyses have revealed altered structural relationships among regional morphology in the thalamus, frontal, temporal and parietal cortices in schizophrenia patients. The distributed nature of these abnormalities in schizophrenia suggests that multiple brain circuits are impaired, a neural feature that may be better addressed with network level analyses. However, even with the advent of these newer analyses, a large amount of variability in findings remains, likely partially due to the considerable heterogeneity present in this disorder.
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Affiliation(s)
- Anne L Wheeler
- Kimel Family Translational Imaging Genetics Laboratory, Centre for Addiction and Mental Health, Research Imaging Centre Toronto, ON, Canada ; Department of Psychiatry, University of Toronto Toronto, ON, Canada
| | - Aristotle N Voineskos
- Kimel Family Translational Imaging Genetics Laboratory, Centre for Addiction and Mental Health, Research Imaging Centre Toronto, ON, Canada ; Department of Psychiatry, University of Toronto Toronto, ON, Canada
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86
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Clemm von Hohenberg C, Pasternak O, Kubicki M, Ballinger T, Vu MA, Swisher T, Green K, Giwerc M, Dahlben B, Goldstein JM, Woo TUW, Petryshen TL, Mesholam-Gately RI, Woodberry KA, Thermenos HW, Mulert C, McCarley RW, Seidman LJ, Shenton ME. White matter microstructure in individuals at clinical high risk of psychosis: a whole-brain diffusion tensor imaging study. Schizophr Bull 2014; 40:895-903. [PMID: 23737549 PMCID: PMC4059424 DOI: 10.1093/schbul/sbt079] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The study of individuals at clinical high risk (CHR) for psychosis provides an important opportunity for unraveling pathological mechanisms underlying schizophrenia and related disorders. A small number of diffusion tensor magnetic resonance imaging (DTI) studies in CHR samples have yielded anatomically inconsistent results. The present study is the first to apply tract-based spatial statistics (TBSS) to perform a whole-brain DTI analysis in CHR subjects. METHODS A total of 28 individuals meeting CHR criteria and 34 healthy controls underwent DTI. TBSS was used for a group comparison of fractional anisotropy (FA), as well as axial, radial, and mean diffusivity (AD, RD, and MD). Conversion to psychosis was monitored during a mean follow-up period of 12.3 months. RESULTS The rate of conversion to psychosis was relatively low (4%). TBSS revealed increased MD in several clusters in the right hemisphere, most notably in the superior longitudinal fasciculus (SLF), posterior corona radiata, and corpus callosum (splenium and body). Increased RD was restricted to a smaller area in the posterior parietal lobe. CONCLUSION We present further evidence that white matter microstructure is abnormal in CHR individuals, even in a sample in which the vast majority do not transition to psychosis over the following year. In accord with previous studies on CHR individuals and patients with early-onset schizophrenia, our findings suggest an important pathological role for the parietal lobe and especially the SLF. The latter is known to undergo particularly dynamic microstructural changes during adolescence and early adulthood, a critical phase for the development of psychotic illness.
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Affiliation(s)
- Christian Clemm von Hohenberg
- *To whom correspondence should be addressed; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, 1249 Boylston Street, Boston, MA 02215; tel: +1-617-525-6105, fax: +1-617-525-6150, e-mail:
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,Department of Radiology, Harvard Medical School, Boston, MA
| | - Thomas Ballinger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Mai-Anh Vu
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Tali Swisher
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Katie Green
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Michelle Giwerc
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Brian Dahlben
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jill M. Goldstein
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Departments of Psychiatry and Medicine, Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Tsung-Ung W. Woo
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA
| | - Tracey L. Petryshen
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research and Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Raquelle I. Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Kristen A. Woodberry
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert W. McCarley
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Clinical Neuroscience Division, Laboratory of Neuroscience, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, MA
| | | | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,Department of Radiology, Harvard Medical School, Boston, MA;,Clinical Neuroscience Division, Laboratory of Neuroscience, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, MA
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87
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Kochunov P, Hong LE. Neurodevelopmental and neurodegenerative models of schizophrenia: white matter at the center stage. Schizophr Bull 2014; 40:721-8. [PMID: 24870447 PMCID: PMC4059450 DOI: 10.1093/schbul/sbu070] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Schizophrenia is a disorder of cerebral disconnectivity whose lifetime course is modeled as both neurodevelopmental and neurodegenerative. The neurodevelopmental models attribute schizophrenia to alterations in the prenatal-to-early adolescent development. The neurodegenerative models identify progressive neurodegeneration as its core attribute. Historically, the physiology, pharmacology, and treatment targets in schizophrenia were conceptualized in terms of neurons, neurotransmitter levels, and synaptic receptors. Much of the evidence for both models was derived from studies of cortical and subcortical gray matter. We argue that the dynamics of the lifetime trajectory of white matter, and the consistency of connectivity deficits in schizophrenia, support white matter integrity as a promising phenotype to evaluate the competing evidence for and against neurodevelopmental and neurodegenerative heuristics. We develop this perspective by reviewing normal lifetime trajectories of white and gray matter changes. We highlighted the overlap between the age of peak of white matter development and the age of onset of schizophrenia and reviewed findings of white matter abnormalities prior to, at the onset, and at chronic stages of schizophrenia. We emphasized the findings of reduced white matter integrity at the onset and findings of accelerated decline in chronic stages, but the developmental trajectory that precedes the onset is largely unknown. We propose 4 probable lifetime white matter trajectory models that can be used as the basis for separation between the neurodevelopmental and neurodegenerative etiologies. We argue that a combination of the cross-sectional and longitudinal studies of white matter integrity in patients may be used to bridge the neurodevelopment and degeneration heuristics to advance schizophrenia research.
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Affiliation(s)
- Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD.
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88
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89
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Andreou C, Faber PL, Leicht G, Schoettle D, Polomac N, Hanganu-Opatz IL, Lehmann D, Mulert C. Resting-state connectivity in the prodromal phase of schizophrenia: insights from EEG microstates. Schizophr Res 2014; 152:513-20. [PMID: 24389056 DOI: 10.1016/j.schres.2013.12.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/22/2013] [Accepted: 12/10/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Resting-state EEG microstates are thought to reflect the momentary local states and interactions of distributed neural networks in the brain. Several changes in resting-state EEG microstates have been described in acutely ill patients with schizophrenia, but it is not known whether these represent trait or state abnormalities. The present study aimed to investigate this issue by assessing EEG microstate characteristics in high-risk individuals (HR) and clinically stable first-episode patients with schizophrenia (SZ) with low symptom levels, compared to each other and healthy controls (HC). METHOD Participants were 18 HR, 18 SZ, and 22 HC subjects. 64-channel resting-state EEG recordings were used for microstate analyses. Microstates were clustered into four classes (A-D) according to their topography. Temporal parameters and topographies of microstates were compared among groups. RESULTS Microstate class A displayed higher coverage and occurrence in HR than SZ and HC, while microstate class B covered significantly more time in SZ compared to both HR and HC. Microstate class B displayed an aberrant spatial configuration in SZ, and to a lesser extent also in HR, compared to HC, with patients exhibiting significantly higher activity in the vicinity of the left posterior cingulate. DISCUSSION Microstate abnormalities observed in HR were similar to those previously reported in acutely ill patients with schizophrenia. Moreover, there was evidence that HR and SZ might share specific disturbances in brain functional connectivity. These findings raise the possibility that certain abnormalities in resting-state EEG microstates might be associated with an increased risk for psychosis.
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Affiliation(s)
- Christina Andreou
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
| | - Pascal L Faber
- The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, CH-8032 Zurich, Switzerland
| | - Gregor Leicht
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Daniel Schoettle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Nenad Polomac
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Ileana L Hanganu-Opatz
- Developmental Neurophysiology, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Dietrich Lehmann
- The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, CH-8032 Zurich, Switzerland
| | - Christoph Mulert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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90
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Smallman RP, Barkus E, Azadbakht H, Embleton KV, Haroon HA, Lewis SW, Morris DM, Parker GJ, Rushe TM. MRI diffusion tractography study in individuals with schizotypal features: a pilot study. Psychiatry Res 2014; 221:49-57. [PMID: 24239094 DOI: 10.1016/j.pscychresns.2013.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 09/30/2013] [Accepted: 10/25/2013] [Indexed: 10/26/2022]
Abstract
Diffusion tensor imaging (DTI) studies have identified changes in white matter tracts in schizophrenia patients and those at high risk of transition. Schizotypal samples represent a group on the schizophrenia continuum that share some aetiological risk factors but without the confounds of illness. The aim of the current study was to compare tract microstructural coherence as measured by fractional anisotropy (FA) between 12 psychometrically defined schizotypes and controls. We investigated bilaterally the uncinate and arcuate fasciculi (UF and AF) via a probabilistic tractography algorithm (PICo), with FA values compared between groups. Partial correlations were also examined between measures of subclinical hallucinatory/delusional experiences and FA values. Participants with schizotypal features were found to have increased FA values in the left hemisphere UF only. In the whole sample there was a positive correlation between FA values and measures of hallucinatory experience in the right AF. These findings suggest subtle changes in microstructural coherence are found in individuals with schizotypal features, but are not similar to changes predominantly observed in clinical samples. Correlations between mild hallucinatory experience and FA values could indicate increasing tract coherence could be associated with symptom formation.
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Affiliation(s)
- Richard P Smallman
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester M13 9PT, UK; School of Psychological Sciences, University of Manchester, Manchester, UK.
| | - Emma Barkus
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | | | - Karl V Embleton
- School of Psychological Sciences, University of Manchester, Manchester, UK; Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Hamied A Haroon
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Shôn W Lewis
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - David M Morris
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Geoffrey J Parker
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Teresa M Rushe
- School of Psychology, Queen's University Belfast, Belfast, UK
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91
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Bernier D, Cookey J, McAllindon D, Bartha R, Hanstock CC, Newman AJ, Stewart SH, Tibbo PG. Multimodal neuroimaging of frontal white matter microstructure in early phase schizophrenia: the impact of early adolescent cannabis use. BMC Psychiatry 2013; 13:264. [PMID: 24131511 PMCID: PMC3852698 DOI: 10.1186/1471-244x-13-264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 10/14/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A disturbance in connectivity between different brain regions, rather than abnormalities within the separate regions themselves, could be responsible for the clinical symptoms and cognitive dysfunctions observed in schizophrenia. White matter, which comprises axons and their myelin sheaths, provides the physical foundation for functional connectivity in the brain. Myelin sheaths are located around the axons and provide insulation through the lipid membranes of oligodendrocytes. Empirical data suggests oligodendroglial dysfunction in schizophrenia, based on findings of abnormal myelin maintenance and repair in regions of deep white matter. The aim of this in vivo neuroimaging project is to assess the impact of early adolescent onset of regular cannabis use on brain white matter tissue integrity, and to differentiate this impact from the white matter abnormalities associated with schizophrenia. The ultimate goal is to determine the liability of early adolescent use of cannabis on brain white matter, in a vulnerable brain. METHODS/DESIGN Young adults with schizophrenia at the early stage of the illness (less than 5 years since diagnosis) will be the focus of this project. Four magnetic resonance imaging measurements will be used to assess different cellular aspects of white matter: a) diffusion tensor imaging, b) localized proton magnetic resonance spectroscopy with a focus on the neurochemical N-acetylaspartate, c) the transverse relaxation time constants of regional tissue water, d) and of N-acetylaspartate. These four neuroimaging indices will be assessed within the same brain region of interest, that is, a large white matter fibre bundle located in the frontal region, the left superior longitudinal fasciculus. DISCUSSION We will expand our knowledge regarding current theoretical models of schizophrenia with a more comprehensive multimodal neuroimaging approach to studying the underlying cellular abnormalities of white matter, while taking into consideration the important confounding variable of early adolescent onset of regular cannabis use.
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Affiliation(s)
- Denise Bernier
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J, Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada.
| | - Jacob Cookey
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada
| | - David McAllindon
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, 100 Perth Drive, London N6A 5K8, Ontario, Canada
| | - Christopher C Hanstock
- Department of Biomedical Engineering, University of Alberta, 8308-114 Street, Edmonton T6G 2V2, Alberta, Canada
| | - Aaron J Newman
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Building, Room 3030, Halifax B3H 2E2, Nova Scotia, Canada,Department of Psychology and Neuroscience, Dalhousie University, Box 15000, Life Sciences Centre, B3H 4R2 Halifax, Nova Scotia, Canada
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92
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Kubicki M, Shenton ME, Maciejewski PK, Pelavin PE, Hawley KJ, Ballinger T, Swisher T, Jabbar GA, Thermenos HW, Keshavan MS, Seidman LJ, DeLisi LE. Decreased axial diffusivity within language connections: a possible biomarker of schizophrenia risk. Schizophr Res 2013; 148:67-73. [PMID: 23800617 PMCID: PMC3755869 DOI: 10.1016/j.schres.2013.06.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 05/27/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
Abstract
Siblings of patients diagnosed with schizophrenia are at elevated risk for developing this disorder. The nature of such risk associated with brain abnormalities, and whether such abnormalities are similar to those observed in schizophrenia, remain unclear. Deficits in language processing are frequently reported in increased risk populations. Interestingly, white matter pathology involving fronto-temporal language pathways, including arcuate fasciculus (AF), uncinate fasciculus (UF), and inferior occipitofrontal fasciculus (IOFF), are frequently reported in schizophrenia. In this study, high spatial and directional resolution diffusion MRI data was obtained on a 3T magnet from 33 subjects with increased familial risk for developing schizophrenia, and 28 control subjects. Diffusion tractography was performed to measure white matter integrity within AF, UF, and IOFF. To understand these abnormalities, Fractional Anisotropy (FA, a measure of tract integrity) and Trace (a measure of overall diffusion), were combined with more specific measures of axial diffusivity (AX, a putative measure of axonal integrity) and radial diffusivity (RD, a putative measure of myelin integrity). Results revealed a significant decrease in Trace within IOFF, and a significant decrease in AX in all tracts. FA and RD anomalies, frequently reported in schizophrenia, were not observed. Moreover, AX group effect was modulated by age, with increased risk subjects demonstrating a deviation from normal maturation trajectory. Findings suggest that familial risk for schizophrenia may be associated with abnormalities in axonal rather than myelin integrity, and possibly associated with disruptions in normal brain maturation. AX should be considered a possible biomarker of risk for developing schizophrenia.
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Affiliation(s)
- M Kubicki
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - ME Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Brockton, MA, United States
| | | | - PE Pelavin
- Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - KJ Hawley
- Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - T Ballinger
- Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - T Swisher
- Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - GA Jabbar
- Harvard Medical School, Boston, MA, USA
| | - HW Thermenos
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA
| | - MS Keshavan
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA
| | - LJ Seidman
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA
| | - LE DeLisi
- VA Boston Healthcare System, Brockton, MA, United States,Harvard Medical School, Boston, MA, USA
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93
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Jenkins TA. Perinatal complications and schizophrenia: involvement of the immune system. Front Neurosci 2013; 7:110. [PMID: 23805069 PMCID: PMC3691516 DOI: 10.3389/fnins.2013.00110] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 06/01/2013] [Indexed: 11/13/2022] Open
Abstract
The neurodevelopmental hypothesis of schizophrenia suggests that, at least in part, events occurring within the intrauterine or perinatal environment at critical times of brain development underlies emergence of the psychosis observed during adulthood, and brain pathologies that are hypothesized to be from birth. All potential risks stimulate activation of the immune system, and are suggested to act in parallel with an underlying genetic liability, such that an imperfect regulation of the genome mediates these prenatal or early postnatal environmental effects. Epidemiologically based animal models looking at environment and with genes have provided us with a wealth of knowledge in the understanding of the pathophysiology of schizophrenia, and give us the best possibility for interventions and treatments for schizophrenia.
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Affiliation(s)
- Trisha A Jenkins
- School of Medical Sciences, Health Innovations Research Institute, RMIT University Bundoora, VIC, Australia
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94
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Braskie MN, Kohannim O, Jahanshad N, Chiang MC, Barysheva M, Toga AW, Ringman JM, Montgomery GW, McMahon KL, de Zubicaray GI, Martin NG, Wright MJ, Thompson PM. Relation between variants in the neurotrophin receptor gene, NTRK3, and white matter integrity in healthy young adults. Neuroimage 2013; 82:146-53. [PMID: 23727532 DOI: 10.1016/j.neuroimage.2013.05.095] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 05/20/2013] [Accepted: 05/22/2013] [Indexed: 01/10/2023] Open
Abstract
The NTRK3 gene (also known as TRKC) encodes a high affinity receptor for the neurotrophin 3'-nucleotidase (NT3), which is implicated in oligodendrocyte and myelin development. We previously found that white matter integrity in young adults is related to common variants in genes encoding neurotrophins and their receptors. This underscores the importance of neurotrophins for white matter development. NTRK3 variants are putative risk factors for schizophrenia, bipolar disorder, and obsessive-compulsive disorder hoarding, suggesting that some NTRK3 variants may affect the brain. To test this, we scanned 392 healthy adult twins and their siblings (mean age, 23.6 ± 2.2 years; range: 20-29 years) with 105-gradient 4-Tesla diffusion tensor imaging (DTI). We identified 18 single nucleotide polymorphisms (SNPs) in the NTRK3 gene that have been associated with neuropsychiatric disorders. We used a multi-SNP model, adjusting for family relatedness, age, and sex, to relate these variants to voxelwise fractional anisotropy (FA) - a DTI measure of white matter integrity. FA was optimally predicted (based on the highest false discovery rate critical p), by five SNPs (rs1017412, rs2114252, rs16941261, rs3784406, and rs7176429; overall FDR critical p=0.028). Gene effects were widespread and included the corpus callosum genu and inferior longitudinal fasciculus - regions implicated in several neuropsychiatric disorders and previously associated with other neurotrophin-related genetic variants in an overlapping sample of subjects. NTRK3 genetic variants, and neurotrophins more generally, may influence white matter integrity in brain regions implicated in neuropsychiatric disorders.
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Affiliation(s)
- Meredith N Braskie
- Imaging Genetics Center, Laboratory of Neuro Imaging, Dept. of Neurology, UCLA School of Medicine, Los Angeles, CA 90095, USA
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95
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Ahmed AO, Buckley PF, Hanna M. Neuroimaging schizophrenia: a picture is worth a thousand words, but is it saying anything important? Curr Psychiatry Rep 2013; 15:345. [PMID: 23397252 DOI: 10.1007/s11920-012-0345-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Schizophrenia is characterized by neurostructural and neurofunctional aberrations that have now been demonstrated through neuroimaging research. The article reviews recent studies that have attempted to use neuroimaging to understand the relation between neurological abnormalities and aspects of the phenomenology of schizophrenia. Neuroimaging studies show that neurostructural and neurofunctional abnormalities are present in people with schizophrenia and their close relatives and may represent putative endophenotypes. Neuroimaging phenotypes predict the emergence of psychosis in individuals classified as high-risk. Neuroimaging studies have linked structural and functional abnormalities to symptoms; and progressive structural changes to clinical course and functional outcome. Neuroimaging has successfully indexed the neurotoxic and neuroprotective effects of schizophrenia treatments. Pictures can inform about aspects of the phenomenology of schizophrenia including etiology, onset, symptoms, clinical course, and treatment effects but this assertion is tempered by the scientific and practical limitations of neuroimaging.
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Affiliation(s)
- Anthony O Ahmed
- Department of Psychiatry and Health Behavior, Georgia Health Sciences University, 997 Saint Sebastian Way, Augusta, GA 30912, USA.
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96
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Emsell L, Leemans A, Langan C, Van Hecke W, Barker GJ, McCarthy P, Jeurissen B, Sijbers J, Sunaert S, Cannon DM, McDonald C. Limbic and callosal white matter changes in euthymic bipolar I disorder: an advanced diffusion magnetic resonance imaging tractography study. Biol Psychiatry 2013; 73:194-201. [PMID: 23158457 DOI: 10.1016/j.biopsych.2012.09.023] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 09/21/2012] [Accepted: 09/21/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND White matter microstructural changes detected using diffusion tensor imaging have been reported in bipolar disorder. However, findings are heterogeneous, which may be related to the use of analysis techniques that cannot adequately model crossing fibers in the brain. We therefore sought to identify altered diffusion anisotropy and diffusivity changes using an improved high angular resolution fiber-tracking technique. METHODS Diffusion magnetic resonance imaging data was obtained from 35 prospectively confirmed euthymic bipolar disorder type 1 patients (age 22-59) and 43 control subjects (age 22-59) drawn from a sample of 120 age- and gender-matched demographically similar case-control pairs. Tractography using a constrained spherical deconvolution approach to account for crossing fibers was implemented. Changes in fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity between patient and control groups in subdivisions of the corpus callosum, cingulum, and fornix were measured as indicators of trait differences in white matter microstructural organization in bipolar disorder. RESULTS Patients had significantly reduced fractional anisotropy and increased mean diffusivity and radial diffusivity in all divisions of the corpus callosum, left fornix, and subgenual cingulum compared with control subjects. Axial diffusivity was increased in the fornix bilaterally and right dorsal-anterior cingulum. CONCLUSIONS By using an improved fiber-tracking method in a clinically homogeneous population, we were able to localize trait diffusivity changes to specific subdivisions of limbic fiber pathways, including the fornix. Our findings extend previous reports of altered limbic system microstructural disorganization as a trait feature of bipolar disorder.
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Affiliation(s)
- Louise Emsell
- Department of Radiology, University Hospital of the KU Leuven, Radiology/MIRC, UZ Herestraat 49, Box 7003, Leuven 3000, Belgium.
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97
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Samartzis L, Dima D, Fusar-Poli P, Kyriakopoulos M. White Matter Alterations in Early Stages of Schizophrenia: A Systematic Review of Diffusion Tensor Imaging Studies. J Neuroimaging 2013; 24:101-10. [DOI: 10.1111/j.1552-6569.2012.00779.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 09/18/2012] [Accepted: 10/06/2012] [Indexed: 12/15/2022] Open
Affiliation(s)
- Lampros Samartzis
- Department of Psychosis Studies; Institute of Psychiatry; King's Health Partners, King's College London; London UK
- Athalassa Psychiatric Hospital; Cyprus Mental Health Services; Nicosia Cyprus
| | - Danai Dima
- Department of Psychosis Studies; Institute of Psychiatry; King's Health Partners, King's College London; London UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies; Institute of Psychiatry; King's Health Partners, King's College London; London UK
| | - Marinos Kyriakopoulos
- Department of Psychosis Studies; Institute of Psychiatry; King's Health Partners, King's College London; London UK
- National and Specialist Children's Inpatient Unit; South London and Maudsley NHS Foundation Trust; London UK
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98
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Francis AN, Bhojraj TS, Prasad KM, Montrose D, Eack SM, Rajarethinam R, van Elst LT, Keshavan MS. Alterations in the cerebral white matter of genetic high risk offspring of patients with schizophrenia spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry 2013; 40:187-92. [PMID: 22910323 PMCID: PMC3635091 DOI: 10.1016/j.pnpbp.2012.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 07/23/2012] [Accepted: 08/04/2012] [Indexed: 12/01/2022]
Abstract
Alterations in white matter (WM) may be seen in young relatives at risk and may underlie vulnerability to schizophrenia. We were interested in exploring which of the WM regions were altered in adolescent offspring at familial risk for schizophrenia. We examined structural alterations in the offspring of subjects with schizophrenia or schizoaffective disorder (HR; n=65; 36 males) and healthy controls (HC; n=80: 37 males) matched for age and education. MRI images were collected using a GE 1.5 T scanner at the University of Pittsburgh Medical Center. Image processing was done using FreeSurfer (MGH) by an experienced rater blind to clinical data. We used multivariate analysis of covariance, with intracranial volume (p>0.05) and age as covariates. High Risk offspring had significant reductions in total WM, hemispheric WM and WM within left parietal and left cingulate cortices. Male offspring had more pronounced right hemisphere WM reductions than females.
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Affiliation(s)
- Alan N Francis
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tejas S Bhojraj
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | | | - Shaun M Eack
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,University of Pittsburgh Medical Center, Pittsburgh, PA
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99
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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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100
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Wood SJ, Reniers RLEP, Heinze K. Neuroimaging findings in the at-risk mental state: a review of recent literature. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:13-8. [PMID: 23327751 DOI: 10.1177/070674371305800104] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The at-risk mental state (ARMS) has been the subject of much interest during the past 15 years. A great deal of effort has been expended to identify neuroimaging markers that can inform our understanding of the risk state and to help predict who will transition to frank psychotic illness. Recently, there has been an explosion of neuroimaging literature from people with an ARMS, which has meant that reviews and meta-analyses lack currency. Here we review papers published in the past 2 years, and contrast their findings with previous reports. While it is clear that people in the ARMS do show brain alterations when compared with healthy control subjects, there is an overall lack of consistency as to which of these alterations predict the development of psychosis. This problem arises because of variations in methodology (in patient recruitment, region of interest, method of analysis, and functional task employed), but there has also been too little effort put into replicating previous research. Nonetheless, there are areas of promise, notably that activation of the stress system and increased striatal dopamine synthesis seem to mark out patients in the ARMS most at risk for later transition. Future studies should focus on these areas, and on network-level analysis, incorporating graph theoretical approaches and intrinsic connectivity networks.
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Affiliation(s)
- Stephen J Wood
- Professor of Adolescent Brain Development and Mental Health, School of Psychology, University of Birmingham, Edgbaston, England.
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