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Wang X, Tian F, Wang S, Cheng B, Qiu L, He M, Wang H, Duan M, Dai J, Jia Z. Gray matter bases of psychotic features in adult bipolar disorder: A systematic review and voxel-based meta-analysis of neuroimaging studies. Hum Brain Mapp 2018; 39:4707-4723. [PMID: 30096212 DOI: 10.1002/hbm.24316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 02/05/2023] Open
Abstract
Psychotic bipolar disorder (P-BD) is a specific subset that presents greater risk of relapse and worse outcomes than nonpsychotic bipolar disorder (NP-BD). To explore the neuroanatomical bases of psychotic dimension in bipolar disorder (BD), a systematic review was carried out based on the gray matter volume (GMV) among P-BD and NP-BD patients and healthy controls (HC). Further, we conducted a meta-analysis of GMV differences between P-BD patients and HC using a whole-brain imaging approach. Our review revealed that P-BD patients exhibited smaller GMVs mainly in the prefronto-temporal and cingulate cortices, the precentral gyrus, and insula relative to HC both qualitatively and quantitatively. Qualitatively the comparison between P-BD and NP-BD patients suggested inconsistent GMV alterations mainly involving the prefrontal cortex, while NP-BD patients showed GMV deficits in local regions compared with HC. The higher proportions of female patients and patients taking psychotropic medication in P-BD and P-BD type I were associated with smaller GMV in the right precentral gyrus, and the right insula, respectively. In conclusions, psychosis in BD might be associated with specific cortical GMV deficits. Gender and psychotropic medication might have effects on the regional GMVs in P-BD patients. It is necessary to distinguish psychotic dimension in neuroimaging studies of BD.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Manxi He
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hongming Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Mingjun Duan
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Jing Dai
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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Fraser MA, Shaw ME, Anstey KJ, Cherbuin N. Longitudinal Assessment of Hippocampal Atrophy in Midlife and Early Old Age: Contrasting Manual Tracing and Semi-automated Segmentation (FreeSurfer). Brain Topogr 2018; 31:949-962. [PMID: 29974288 DOI: 10.1007/s10548-018-0659-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/29/2018] [Indexed: 01/26/2023]
Abstract
It is important to have accurate estimates of normal age-related brain structure changes and to understand how the choice of measurement technique may bias those estimates. We compared longitudinal change in hippocampal volume, laterality and atrophy measured by manual tracing and FreeSurfer (version 5.3) in middle age (n = 244, 47.2[1.4] years) and older age (n = 199, 67.0[1.4] years) individuals over 8 years. The proportion of overlap (Dice coefficient) between the segmented hippocampi was calculated and we hypothesised that the proportion of overlap would be higher for older individuals as a consequence of higher atrophy. Hippocampal volumes produced by FreeSurfer were larger than manually traced volumes. Both methods produced a left less than right volume laterality difference. Over time this laterality difference increased for manual tracing and decreased for FreeSurfer leading to laterality differences in left and right estimated atrophy rates. The overlap proportion between methods was not significantly different for older individuals, but was greater for the right hippocampus. Estimated middle age annualised atrophy rates were - 0.39(1.0) left, 0.07(1.01) right, - 0.17(0.88) total for manual tracing and - 0.15(0.69) left, - 0.20(0.63) right, - 0.18(0.57) total for FreeSurfer. Older age atrophy rates were - 0.43(1.32) left, - 0.15(1.41) right, - 0.30 (1.23) total for manual tracing and - 0.34(0.79) left, - 0.68(0.78) right, - 0.51(0.65) total for FreeSurfer. FreeSurfer reliably segments the hippocampus producing atrophy rates that are comparable to manual tracing with some biases that need to be considered in study design. FreeSurfer is suited for use in large longitudinal studies where it is not cost effective to use manual tracing.
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Affiliation(s)
- Mark A Fraser
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Florey, Building 54, Mills Road, Canberra, ACT, 2601, Australia.
| | - Marnie E Shaw
- College of Engineering & Computer Science, Australian National University, Brian Anderson Building 115, 115 North Road, Canberra, ACT, 2601, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Florey, Building 54, Mills Road, Canberra, ACT, 2601, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Florey, Building 54, Mills Road, Canberra, ACT, 2601, Australia
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Bansal R, Peterson BS. Cluster-level statistical inference in fMRI datasets: The unexpected behavior of random fields in high dimensions. Magn Reson Imaging 2018; 49:101-115. [PMID: 29408478 PMCID: PMC5991838 DOI: 10.1016/j.mri.2018.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/22/2018] [Accepted: 01/27/2018] [Indexed: 02/02/2023]
Abstract
Identifying regional effects of interest in MRI datasets usually entails testing a priori hypotheses across many thousands of brain voxels, requiring control for false positive findings in these multiple hypotheses testing. Recent studies have suggested that parametric statistical methods may have incorrectly modeled functional MRI data, thereby leading to higher false positive rates than their nominal rates. Nonparametric methods for statistical inference when conducting multiple statistical tests, in contrast, are thought to produce false positives at the nominal rate, which has thus led to the suggestion that previously reported studies should reanalyze their fMRI data using nonparametric tools. To understand better why parametric methods may yield excessive false positives, we assessed their performance when applied both to simulated datasets of 1D, 2D, and 3D Gaussian Random Fields (GRFs) and to 710 real-world, resting-state fMRI datasets. We showed that both the simulated 2D and 3D GRFs and the real-world data contain a small percentage (<6%) of very large clusters (on average 60 times larger than the average cluster size), which were not present in 1D GRFs. These unexpectedly large clusters were deemed statistically significant using parametric methods, leading to empirical familywise error rates (FWERs) as high as 65%: the high empirical FWERs were not a consequence of parametric methods failing to model spatial smoothness accurately, but rather of these very large clusters that are inherently present in smooth, high-dimensional random fields. In fact, when discounting these very large clusters, the empirical FWER for parametric methods was 3.24%. Furthermore, even an empirical FWER of 65% would yield on average less than one of those very large clusters in each brain-wide analysis. Nonparametric methods, in contrast, estimated distributions from those large clusters, and therefore, by construct rejected the large clusters as false positives at the nominal FWERs. Those rejected clusters were outlying values in the distribution of cluster size but cannot be distinguished from true positive findings without further analyses, including assessing whether fMRI signal in those regions correlates with other clinical, behavioral, or cognitive measures. Rejecting the large clusters, however, significantly reduced the statistical power of nonparametric methods in detecting true findings compared with parametric methods, which would have detected most true findings that are essential for making valid biological inferences in MRI data. Parametric analyses, in contrast, detected most true findings while generating relatively few false positives: on average, less than one of those very large clusters would be deemed a true finding in each brain-wide analysis. We therefore recommend the continued use of parametric methods that model nonstationary smoothness for cluster-level, familywise control of false positives, particularly when using a Cluster Defining Threshold of 2.5 or higher, and subsequently assessing rigorously the biological plausibility of the findings, even for large clusters. Finally, because nonparametric methods yielded a large reduction in statistical power to detect true positive findings, we conclude that the modest reduction in false positive findings that nonparametric analyses afford does not warrant a re-analysis of previously published fMRI studies using nonparametric techniques.
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Affiliation(s)
- Ravi Bansal
- Institute for the Developing Mind, Children's Hospital Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, USA.
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, CA 90027, USA; Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, USA
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Gill KM, Miller SA, Grace AA. Impaired contextual fear-conditioning in MAM rodent model of schizophrenia. Schizophr Res 2018; 195:343-352. [PMID: 28927551 PMCID: PMC5854517 DOI: 10.1016/j.schres.2017.08.064] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 12/19/2022]
Abstract
The methylazoxymethanol acetate (MAM) rodent neurodevelopmental model of schizophrenia exhibits aberrant dopamine system activation attributed to hippocampal dysfunction. Context discrimination is a component of numerous behavioral and cognitive functions and relies on intact hippocampal processing. The present study explored context processing behaviors, along with dopamine system activation, during fear learning in the MAM model. Male offspring of dams treated with MAM (20mg/kg, i.p.) or saline on gestational day 17 were used for electrophysiological and behavioral experiments. Animals were tested on the immediate shock fear conditioning paradigm, with either different pre-conditioning contexts or varying amounts of context pre-exposure (0-10 sessions). Amphetamine-induced locomotor activity and dopamine neural activity was measured 1-week after fear conditioning. Saline, but not MAM animals, demonstrated enhanced fear responses following a single context pre-exposure in the conditioning context. One week following fear learning, saline rats with 2 or 7min of context pre-exposure prior to fear conditioning also demonstrated enhanced amphetamine-induced locomotor response relative to MAM animals. Dopamine neuron recordings showed fear learning-induced reductions in spontaneous dopamine neural activity in MAM rats that was further reduced by amphetamine. Apomorphine administration confirmed that reductions in dopamine neuron activity in MAM animals resulted from over excitation, or depolarization block. These data show a behavioral insensitivity to contextual stimuli in MAM rats that coincide with a less dynamic dopamine response after fear learning.
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Affiliation(s)
- Kathryn M Gill
- University of Pittsburgh, Pittsburgh, PA 15260, Departments of Neuroscience, Psychiatry and Psychology, USA.
| | - Sarah A Miller
- University of Pittsburgh, Pittsburgh, PA 15260, Departments of Neuroscience, Psychiatry and Psychology, USA
| | - Anthony A Grace
- University of Pittsburgh, Pittsburgh, PA 15260, Departments of Neuroscience, Psychiatry and Psychology, USA
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Diagnosis of Schizophrenia Disorder in MR Brain Images Using Multi-objective BPSO Based Feature Selection with Fuzzy SVM. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0355-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schizophrenia: A review of potential biomarkers. J Psychiatr Res 2017; 93:37-49. [PMID: 28578207 DOI: 10.1016/j.jpsychires.2017.05.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/10/2017] [Accepted: 05/22/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Understanding the biological process and progression of schizophrenia is the first step to developing novel approaches and new interventions. Research on new biomarkers is extremely important when the goal is an early diagnosis (prediction) and precise theranostics. The objective of this review is to understand the research on biomarkers and their effects in schizophrenia to synthesize the role of these new advances. METHODS In this review, we search and review publications in databases in accordance with established limits and specific objectives. We look at particular endpoints such as the category of biomarkers, laboratory techniques and the results/conclusions of the selected publications. RESULTS The investigation of biomarkers and their potential as a predictor, diagnosis instrument and therapeutic orientation, requires an appropriate methodological strategy. In this review, we found different laboratory techniques to identify biomarkers and their function in schizophrenia. CONCLUSION The consolidation of this information will provide a large-scale application network of schizophrenia biomarkers.
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Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder. Am J Geriatr Psychiatry 2017; 25:941-950. [PMID: 28478998 PMCID: PMC6013831 DOI: 10.1016/j.jagp.2017.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/23/2017] [Accepted: 03/21/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. DESIGN Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. SETTING Three community mental health centers in New Hampshire and Massachusetts. PARTICIPANTS Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). MEASUREMENTS Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. RESULTS Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. CONCLUSIONS Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization.
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Abstract
Parkinson disease psychosis (PDP) is a common phenomenon in Parkinson disease (PD) patients treated with dopaminergic drugs, and is associated with high morbidity and mortality. It also correlates with depression and dementia, and can contribute to considerable caregiver stress and burnout. While symptoms can be relieved by decreasing doses or number of anti-PD medications, this may lead to an unacceptable worsening of motor function. When general medical or psychiatric conditions have been ruled out, and decreasing dopaminergic agents is not effective in treating psychosis, therapies include atypical antipsychotics, primarily clozapine and quetiapine. Of these, clozapine is effective but is associated with a poor side-effect profile and the necessity for frequent blood draws. Clinicians prefer quetiapine for its theoretically better safety profile, although there is no evidence for efficacy in treating psychosis. All atypical antipsychotics are associated with increased mortality in this patient population. Cholinesterase inhibitors can ameliorate psychosis symptoms. The serotonin 5-HT2A receptor inverse agonist pimavanserin was recently approved by the US FDA for the treatment of PDP and may prove to be a more targeted therapy without the downsides of atypical antipsychotics.
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59
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Rhindress K, Robinson DG, Gallego JA, Wellington R, Malhotra AK, Szeszko PR. Hippocampal subregion volume changes associated with antipsychotic treatment in first-episode psychosis. Psychol Med 2017; 47:1706-1718. [PMID: 28193301 DOI: 10.1017/s0033291717000137] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hippocampal dysfunction is considered central to many neurobiological models of schizophrenia, yet there are few longitudinal in vivo neuroimaging studies that have investigated the relationship between antipsychotic treatment and morphologic changes within specific hippocampal subregions among patients with psychosis. METHOD A total of 29 patients experiencing a first episode of psychosis with little or no prior antipsychotic exposure received structural neuroimaging examinations at illness onset and then following 12 weeks of treatment with either risperidone or aripiprazole in a double-blind randomized clinical trial. In addition, 29 healthy volunteers received structural neuroimaging examinations at baseline and 12-week time points. We manually delineated six hippocampal subregions [i.e. anterior cornu ammonis (CA) 1-3, posterior CA1-3, subiculum, dentate gyrus/CA4, entorhinal cortex, and fimbria] from 3T magnetic resonance images using an established method with high inter- and intra-rater reliability. RESULTS Following antipsychotic treatment patients demonstrated significant reductions in dentate gyrus/CA4 volume and increases in subiculum volume. Healthy volunteers demonstrated non-significant volumetric changes in these subregions across the two time points. We observed a significant quadratic (i.e. inverted U) association between changes in dentate gyrus/CA4 volume and cumulative antipsychotic dosage between the scans. CONCLUSIONS This study provides the first evidence to our knowledge regarding longitudinal in vivo volumetric changes within specific hippocampal subregions in patients with psychosis following antipsychotic treatment. The finding of a non-linear relationship between changes in dentate gyrus/CA4 subregion volume and antipsychotic exposure may provide new avenues into understanding dosing strategies for therapeutic interventions relevant to neurobiological models of hippocampal dysfunction in psychosis.
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Affiliation(s)
- K Rhindress
- Department of Psychiatry,New York University School of Medicine,New York, NY,USA
| | - D G Robinson
- Department of Psychiatry,Hofstra Northwell School of Medicine,Hempstead, NY,USA
| | - J A Gallego
- Department of Psychiatry,Weill Cornell Medical College,White Plains, NY,USA
| | - R Wellington
- Department of Psychology,St John's University,Queens, NY,USA
| | - A K Malhotra
- Department of Psychiatry,Hofstra Northwell School of Medicine,Hempstead, NY,USA
| | - P R Szeszko
- James J. Peters VA Medical Center,Bronx, NY,USA
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Forns-Nadal M, Bergé D, Sem F, Mané A, Igual L, Guinart D, Vilarroya O. Increased nucleus accumbens volume in first-episode psychosis. Psychiatry Res Neuroimaging 2017; 263:57-60. [PMID: 28340425 DOI: 10.1016/j.pscychresns.2017.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 02/13/2017] [Accepted: 03/17/2017] [Indexed: 12/23/2022]
Abstract
Nucleus accumbens has been reported as a key structure in the neurobiology of schizophrenia. Studies analyzing structural abnormalities have shown conflicting results, possibly related to confounding factors. We investigated the nucleus accumbens volume using manual delimitation in first-episode psychosis (FEP) controlling for age, cannabis use and medication. Thirty-one FEP subjects who were naive or minimally exposed to antipsychotics and a control group were MRI scanned and clinically assessed from baseline to 6 months of follow-up. FEP showed increased relative and total accumbens volumes. Clinical correlations with negative symptoms, duration of untreated psychosis and cannabis use were not significant.
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Affiliation(s)
- Mireia Forns-Nadal
- Department of Cognitive Neuroscience and Information Technologies, Internet Interdisciplinary Institute, Open University of Catalonia, Barcelona, Spain
| | - Daniel Bergé
- Neuroscience group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallès, Spain; CIBERSAM, Barcelona, Spain.
| | - Federico Sem
- Department of Applied Mathematics and Analysis of the University of Barcelona, Barcelona, Spain
| | - Anna Mané
- Neuroscience group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; CIBERSAM, Barcelona, Spain
| | - Laura Igual
- Department of Applied Mathematics and Analysis of the University of Barcelona, Barcelona, Spain; Computer Vision Center, Edificio O, Universitat Autònoma de Barcelona, Campus de Bellaterra, s/n, Cerdanyola del Vallès, Spain
| | - Dani Guinart
- Neuroscience group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallès, Spain
| | - Oscar Vilarroya
- Neuroscience group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallès, Spain
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Kalmady SV, Shivakumar V, Arasappa R, Subramaniam A, Gautham S, Venkatasubramanian G, Gangadhar BN. Clinical correlates of hippocampus volume and shape in antipsychotic-naïve schizophrenia. Psychiatry Res Neuroimaging 2017; 263:93-102. [PMID: 28371658 DOI: 10.1016/j.pscychresns.2017.03.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 03/09/2017] [Accepted: 03/20/2017] [Indexed: 01/25/2023]
Abstract
While volume deficit of hippocampus is an established finding in schizophrenia, very few studies have examined large sample of patients without the confounding effect of antipsychotic treatment. Concurrent evaluation of hippocampus shape will offer additional information on the hippocampal aberrations in schizophrenia. In this study, we analyzed the volume and shape of hippocampus in antipsychotic-naïve schizophrenia patients (N=71) in comparison to healthy controls (N=82). Using 3-T MRI data, gray matter (GM) volume (anterior and posterior sub-divisions) and shape of the hippocampus were analyzed. Schizophrenia patients had significant hippocampal GM volume deficits (specifically the anterior sub-division) in comparison to healthy controls. There were significant positive correlations between anterior hippocampus volume and psychopathology scores of positive syndrome. Shape analyses revealed significant inward deformation of bilateral hippocampal surface in patients. In conclusion, our study findings add robust support for volume deficit in hippocampus in antipsychotic-naïve schizophrenia. Hippocampal shape deficits in schizophrenia observed in this study map to anterior CA1 sub-region. The differential relationship of anterior hippocampus (but not posterior hippocampus) with clinical symptoms is in tune with the findings in animal models. Further systematic studies are needed to evaluate the relationship between these hippocampal gray matter deficits with white matter and functional connectivity to facilitate understanding the hippocampal network abnormalities in schizophrenia.
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Affiliation(s)
- Sunil Vasu Kalmady
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Rashmi Arasappa
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Aditi Subramaniam
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - S Gautham
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Bangalore N Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Tandon N, Nanda P, Padmanabhan JL, Mathew IT, Eack SM, Narayanan B, Meda SA, Bergen SE, Ruaño G, Windemuth A, Kocherla M, Petryshen TL, Clementz B, Sweeney J, Tamminga C, Pearlson G, Keshavan MS. Novel gene-brain structure relationships in psychotic disorder revealed using parallel independent component analyses. Schizophr Res 2017; 182:74-83. [PMID: 27789186 DOI: 10.1016/j.schres.2016.10.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/14/2016] [Accepted: 10/16/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Schizophrenia, schizoaffective disorder, and psychotic bipolar disorder overlap with regard to symptoms, structural and functional brain abnormalities, and genetic risk factors. Neurobiological pathways connecting genes to clinical phenotypes across the spectrum from schizophrenia to psychotic bipolar disorder remain largely unknown. METHODS We examined the relationship between structural brain changes and risk alleles across the psychosis spectrum in the multi-site Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) cohort. Regional MRI brain volumes were examined in 389 subjects with a psychotic disorder (139 schizophrenia, 90 schizoaffective disorder, and 160 psychotic bipolar disorder) and 123 healthy controls. 451,701 single-nucleotide polymorphisms were screened and processed using parallel independent component analysis (para-ICA) to assess associations between genes and structural brain abnormalities in probands. RESULTS 482 subjects were included after quality control (364 individuals with psychotic disorder and 118 healthy controls). Para-ICA identified four genetic components including several risk genes already known to contribute to schizophrenia and bipolar disorder and revealed three structural components that showed overlapping relationships with the disease risk genes across the three psychotic disorders. Functional ontologies representing these gene clusters included physiological pathways involved in brain development, synaptic transmission, and ion channel activity. CONCLUSIONS Heritable brain structural findings such as reduced cortical thickness and surface area in probands across the psychosis spectrum were associated with somewhat distinct genes related to putative disease pathways implicated in psychotic disorders. This suggests that brain structural alterations might represent discrete psychosis intermediate phenotypes along common neurobiological pathways underlying disease expression across the psychosis spectrum.
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Affiliation(s)
- Neeraj Tandon
- Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Ctr, Boston, MA, USA; Baylor College of Medicine, Texas Medical Center, Houston, TX, USA.
| | - Pranav Nanda
- Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Ctr, Boston, MA, USA; College of Physicians & Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Jaya L Padmanabhan
- Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Ctr, Boston, MA, USA
| | - Ian T Mathew
- Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Ctr, Boston, MA, USA
| | - Shaun M Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
| | - Balaji Narayanan
- Olin Neuropsychiatry Research Center, Hartford, CT, USA; Department of Psychiatry and Neurobiology, Yale University, New Haven, CT, USA
| | - Shashwath A Meda
- Olin Neuropsychiatry Research Center, Hartford, CT, USA; Department of Psychiatry and Neurobiology, Yale University, New Haven, CT, USA
| | - Sarah E Bergen
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | | | | | | | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Brett Clementz
- Department of Psychology, Department of Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | | | | | - Godfrey Pearlson
- Olin Neuropsychiatry Research Center, Hartford, CT, USA; Department of Psychiatry and Neurobiology, Yale University, New Haven, CT, USA
| | - Matcheri S Keshavan
- Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Ctr, Boston, MA, USA
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Francis AN, Mothi SS, Mathew IT, Tandon N, Clementz B, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS. Callosal Abnormalities Across the Psychosis Dimension: Bipolar Schizophrenia Network on Intermediate Phenotypes. Biol Psychiatry 2016; 80:627-35. [PMID: 26954565 PMCID: PMC5218825 DOI: 10.1016/j.biopsych.2015.12.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 11/24/2015] [Accepted: 12/15/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND The corpus callosum has been implicated in the pathogenesis of schizophrenia and bipolar disorder. However, it is unclear whether corpus callosum alterations are related to the underlying familial diathesis for psychotic disorders. We examined the corpus callosum and its subregion volumes and their relationship to cognition, psychotic symptoms, and age in probands with schizophrenia (SZ), psychotic bipolar disorder (PBD), and schizoaffective disorder; their first-degree relatives; and healthy control subjects. METHODS We present findings from morphometric and neurocognitive analyses of 1381 subjects (SZ probands, n = 224; PBD probands, n = 190; schizoaffective disorder probands, n = 142; unaffected relatives, n = 483 [SZ relatives, n = 195; PBD relatives, n = 175; schizoaffective disorder relatives, n = 113]; control subjects, n = 342). Magnetization prepared rapid acquisition gradient-echo T1 scans across five sites were obtained using 3-tesla magnets. Image processing was done using FreeSurfer Version 5.1. Neurocognitive function was measured using the Brief Assessment of Cognition in Schizophrenia scale. RESULTS Anterior and posterior splenial volumes were significantly reduced across the groups. The SZ and PBD probands showed robust and significant reductions, whereas relatives showed significant reductions of intermediate severity. The splenial volumes were positively but differentially correlated with aspects of cognition in the probands and their relatives. Proband groups showed a significant age-related decrease in the volume of the anterior splenium compared with control subjects. Among the psychosis groups, the anterior splenium in probands with PBD showed a stronger correlation with psychotic symptoms, as shown by the Positive and Negative Syndrome Scale. All five subregions showed significantly high familiality. CONCLUSIONS The splenial volumes were significantly reduced across the psychosis dimension. However, this volume reduction impacts cognition and clinical manifestation of the illnesses differentially.
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Affiliation(s)
- Alan N Francis
- Brain Imaging Center, McLean Hospital, Harvard Medical School, Belmont, Massachusetts.
| | - Suraj S Mothi
- Beth Israel Deaconess Medical Center, Harvard University, Boston
| | - Ian T Mathew
- Beth Israel Deaconess Medical Center, Harvard University, Boston
| | - Neeraj Tandon
- Beth Israel Deaconess Medical Center, Harvard University, Boston
| | - Brett Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford; Yale University School of Medicine, New Haven, Connecticut
| | - John A Sweeney
- University of Texas Southwestern Medical Center, Dallas, Texas
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64
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Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder. PLoS One 2016; 11:e0157635. [PMID: 27391238 PMCID: PMC4938526 DOI: 10.1371/journal.pone.0157635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 06/02/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ) or schizoaffective disorder (SAD), a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category. METHODS The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0) and 71 patients with SAD (F25). We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping. RESULTS SAD patients had a longer duration of stay than patients with SZ (p = .02). Mean total costs were significantly higher for SAD patients (p = .023). Further, we found a significant difference in mean personnel costs (p = .02) between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12) but a marginal difference of mean infrastructure costs (p = .05) between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD. CONCLUSION We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.
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Madre M, Canales-Rodríguez EJ, Ortiz-Gil J, Murru A, Torrent C, Bramon E, Perez V, Orth M, Brambilla P, Vieta E, Amann BL. Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: a systematic review. Acta Psychiatr Scand 2016; 134:16-30. [PMID: 27028168 DOI: 10.1111/acps.12564] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The neurobiological basis and nosological status of schizoaffective disorder remains elusive and controversial. This study provides a systematic review of neurocognitive and neuroimaging findings in the disorder. METHODS A comprehensive literature search was conducted via PubMed, ScienceDirect, Scopus and Web of Knowledge (from 1949 to 31st March 2015) using the keyword 'schizoaffective disorder' and any of the following terms: 'neuropsychology', 'cognition', 'structural neuroimaging', 'functional neuroimaging', 'multimodal', 'DTI' and 'VBM'. Only studies that explicitly examined a well defined sample, or subsample, of patients with schizoaffective disorder were included. RESULTS Twenty-two of 43 neuropsychological and 19 of 51 neuroimaging articles fulfilled inclusion criteria. We found a general trend towards schizophrenia and schizoaffective disorder being related to worse cognitive performance than bipolar disorder. Grey matter volume loss in schizoaffective disorder is also more comparable to schizophrenia than to bipolar disorder which seems consistent across further neuroimaging techniques. CONCLUSIONS Neurocognitive and neuroimaging abnormalities in schizoaffective disorder resemble more schizophrenia than bipolar disorder. This is suggestive for schizoaffective disorder being a subtype of schizophrenia or being part of the continuum spectrum model of psychosis, with schizoaffective disorder being more skewed towards schizophrenia than bipolar disorder.
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Affiliation(s)
- M Madre
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | | | - J Ortiz-Gil
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain.,Hospital General de Granollers, Granollers, Catalonia, Spain
| | - A Murru
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - E Bramon
- Division of Psychiatry, University College London, London, UK
| | - V Perez
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain.,CIBERSAM, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Psiquiatria, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Orth
- Department of Neurology, Ulm University, Ulm, Germany
| | - P Brambilla
- Department of Neurosciences and Mental Health, Psychiatric Clinic, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioural Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - E Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - B L Amann
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
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Buoli M, Caldiroli A, Cumerlato Melter C, Serati M, de Nijs J, Altamura AC. Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review. Psychiatry Clin Neurosci 2016; 70:227-44. [PMID: 26969211 DOI: 10.1111/pcn.12386] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). METHODS We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included. RESULTS BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated anti- S accharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. CONCLUSION Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cumerlato Melter
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica de Nijs
- Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Cariaga-Martinez A, Saiz-Ruiz J, Alelú-Paz R. From Linkage Studies to Epigenetics: What We Know and What We Need to Know in the Neurobiology of Schizophrenia. Front Neurosci 2016; 10:202. [PMID: 27242407 PMCID: PMC4862989 DOI: 10.3389/fnins.2016.00202] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 04/25/2016] [Indexed: 01/15/2023] Open
Abstract
Schizophrenia is a complex psychiatric disorder characterized by the presence of positive, negative, and cognitive symptoms that lacks a unifying neuropathology. In the present paper, we will review the current understanding of molecular dysregulation in schizophrenia, including genetic and epigenetic studies. In relation to the latter, basic research suggests that normal cognition is regulated by epigenetic mechanisms and its dysfunction occurs upon epigenetic misregulation, providing new insights into missing heritability of complex psychiatric diseases, referring to the discrepancy between epidemiological heritability and the proportion of phenotypic variation explained by DNA sequence difference. In schizophrenia the absence of consistently replicated genetic effects together with evidence for lasting changes in gene expression after environmental exposures suggest a role of epigenetic mechanisms. In this review we will focus on epigenetic modifications as a key mechanism through which environmental factors interact with individual's genetic constitution to affect risk of psychotic conditions throughout life.
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Affiliation(s)
- Ariel Cariaga-Martinez
- Laboratory for Neuroscience of Mental Disorders Elena Pessino, Department of Medicine and Medical Specialties, School of Medicine, Alcalá University Madrid, Spain
| | - Jerónimo Saiz-Ruiz
- Department of Psychiatry, Ramón y Cajal Hospital, IRYCISMadrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)Madrid, Spain
| | - Raúl Alelú-Paz
- Laboratory for Neuroscience of Mental Disorders Elena Pessino, Department of Medicine and Medical Specialties, School of Medicine, Alcalá UniversityMadrid, Spain; Department of Psychiatry, Ramón y Cajal Hospital, IRYCISMadrid, Spain
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Pina-Camacho L, Del Rey-Mejías Á, Janssen J, Bioque M, González-Pinto A, Arango C, Lobo A, Sarró S, Desco M, Sanjuan J, Lacalle-Aurioles M, Cuesta MJ, Saiz-Ruiz J, Bernardo M, Parellada M. Age at First Episode Modulates Diagnosis-Related Structural Brain Abnormalities in Psychosis. Schizophr Bull 2016; 42:344-57. [PMID: 26371339 PMCID: PMC4753597 DOI: 10.1093/schbul/sbv128] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Brain volume and thickness abnormalities have been reported in first-episode psychosis (FEP). However, it is unclear if and how they are modulated by brain developmental stage (and, therefore, by age at FEP as a proxy). This is a multicenter cross-sectional case-control brain magnetic resonance imaging (MRI) study. Patients with FEP (n = 196), 65.3% males, with a wide age at FEP span (12-35 y), and healthy controls (HC) (n = 157), matched for age, sex, and handedness, were scanned at 6 sites. Gray matter volume and thickness measurements were generated for several brain regions using FreeSurfer software. The nonlinear relationship between age at scan (a proxy for age at FEP in patients) and volume and thickness measurements was explored in patients with schizophrenia spectrum disorders (SSD), affective psychoses (AFP), and HC. Earlier SSD cases (ie, FEP before 15-20 y) showed significant volume and thickness deficits in frontal lobe, volume deficits in temporal lobe, and volume enlargements in ventricular system and basal ganglia. First-episode AFP patients had smaller cingulate cortex volume and thicker temporal cortex only at early age at FEP (before 18-20 y). The AFP group also had age-constant (12-35-y age span) volume enlargements in the frontal and parietal lobe. Our study suggests that age at first episode modulates the structural brain abnormalities found in FEP patients in a nonlinear and diagnosis-dependent manner. Future MRI studies should take these results into account when interpreting samples with different ages at onset and diagnosis.
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Affiliation(s)
| | - Ángel Del Rey-Mejías
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain;,Department of Methodology, School of Psychology, Universidad Complutense, Madrid, Spain
| | - Joost Janssen
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Miquel Bioque
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Barcelona, Spain
| | - Ana González-Pinto
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Psychiatry, Hospital Universitario de Álava (Sede Santiago), EHU/University of the Basque Country, Vitoria, Spain
| | - Celso Arango
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Antonio Lobo
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Medicine and Psychiatry, Hospital Clínico, University of Zaragoza, IIS Aragón, Zaragoza, Spain
| | - Salvador Sarró
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,FIDMAG Hermanas Hospitalarias,Barcelona, Spain
| | - Manuel Desco
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Madrid, Spain;,Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Julio Sanjuan
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Psychiatry, Hospital Clinic, University of Valencia, INCLIVA, Valencia, Spain
| | - Maria Lacalle-Aurioles
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Madrid, Spain;,Laboratory of Cerebrovascular Research, Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Jerónimo Saiz-Ruiz
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Psychiatry, Hospital Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - Miguel Bernardo
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Barcelona, Spain;,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Mara Parellada
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
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69
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Peters H, Shao J, Scherr M, Schwerthöffer D, Zimmer C, Förstl H, Bäuml J, Wohlschläger A, Riedl V, Koch K, Sorg C. More Consistently Altered Connectivity Patterns for Cerebellum and Medial Temporal Lobes than for Amygdala and Striatum in Schizophrenia. Front Hum Neurosci 2016; 10:55. [PMID: 26924973 PMCID: PMC4756145 DOI: 10.3389/fnhum.2016.00055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/05/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Brain architecture can be divided into a cortico-thalamic system and modulatory "subcortical-cerebellar" systems containing key structures such as striatum, medial temporal lobes (MTLs), amygdala, and cerebellum. Subcortical-cerebellar systems are known to be altered in schizophrenia. In particular, intrinsic functional brain connectivity (iFC) between these systems has been consistently demonstrated in patients. While altered connectivity is known for each subcortical-cerebellar system separately, it is unknown whether subcortical-cerebellar systems' connectivity patterns with the cortico-thalamic system are comparably altered across systems, i.e., if separate subcortical-cerebellar systems' connectivity patterns are consistent across patients. METHODS To investigate this question, 18 patients with schizophrenia (3 unmedicated, 15 medicated with atypical antipsychotics) and 18 healthy controls were assessed by resting-state functional magnetic resonance imaging (fMRI). Independent component analysis of fMRI data revealed cortical intrinsic brain networks (NWs) with time courses representing proxies for cortico-thalamic system activity. Subcortical-cerebellar systems' activity was represented by fMRI-based time courses of selected regions-of-interest (ROIs; i.e., striatum, MTL, amygdala, cerebellum). Correlation analysis among ROI- and NWs-time courses yielded individual connectivity matrices [i.e., connectivity between NW and ROIs (allROIs-NW, separateROI-NW), only NWs (NWs-NWs), and only ROIs (allROIs-allROIs)] as main outcome measures, which were classified by support-vector-machine-based (SVM) leave-one-out cross-validation. Differences in classification accuracy were statistically evaluated for consistency across subjects and systems. RESULTS Correlation matrices based on allROIs-NWs yielded 91% classification accuracy, which was significantly superior to allROIs-allROIs and NWs-NWs (56 and 74%, respectively). Considering separate subcortical-cerebellar systems, cerebellum-NWs and MTL-NWs reached highest accuracy values with 91 and 85%, respectively, while those of striatum-NW and amygdala-NW were significantly lower with about 65% classification accuracy. CONCLUSION RESULTS provide initial evidence for differential consistency of altered intrinsic connectivity patterns between subcortical-cerebellar systems and the cortico-thalamic system. Data suggest that differential dysconnectivity patterns between subcortical-cerebellar and cortical systems might reflect different disease states or patient subgroups.
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Affiliation(s)
- Henning Peters
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität MünchenMünchen, Germany
| | - Junming Shao
- School of Computer Science and Engineering, University of Electronic Science and Technology of ChinaChengdu, China
- Big Data Research Center, University of Electronic Science and Technology of ChinaChengdu, China
- Center for Information in BioMedicine, University of Electronic Science and Technology of ChinaChengdu, China
| | - Martin Scherr
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Dirk Schwerthöffer
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
| | - Hans Förstl
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Josef Bäuml
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Afra Wohlschläger
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
| | - Valentin Riedl
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
- Department of Nuclear Medicine, Technische Universität MünchenMünchen, Germany
| | - Kathrin Koch
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
| | - Christian Sorg
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
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Flore G, Di Ruberto G, Parisot J, Sannino S, Russo F, Illingworth EA, Studer M, De Leonibus E. Gradient COUP-TFI Expression Is Required for Functional Organization of the Hippocampal Septo-Temporal Longitudinal Axis. Cereb Cortex 2016; 27:1629-1643. [DOI: 10.1093/cercor/bhv336] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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71
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Tondo L, Vázquez GH, Baethge C, Baronessa C, Bolzani L, Koukopoulos A, Mazzarini L, Murru A, Pacchiarotti I, Pinna M, Salvatore P, Sani G, Selle V, Spalletta G, Girardi P, Tohen M, Vieta E, Baldessarini RJ. Comparison of psychotic bipolar disorder, schizoaffective disorder, and schizophrenia: an international, multisite study. Acta Psychiatr Scand 2016; 133:34-43. [PMID: 26096273 DOI: 10.1111/acps.12447] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.
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Affiliation(s)
- L Tondo
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA.,Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - G H Vázquez
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA.,Department of Neuroscience, Palermo University, Buenos Aires, Argentina
| | - C Baethge
- Department of Psychiatry, University of Köln, Köln, Germany
| | - C Baronessa
- Viarnetto Psychiatric Clinic, Lugano, Switzerland
| | - L Bolzani
- Viarnetto Psychiatric Clinic, Lugano, Switzerland
| | - A Koukopoulos
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - L Mazzarini
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy
| | - A Murru
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - I Pacchiarotti
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - M Pinna
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - P Salvatore
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA.,Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy
| | - G Sani
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - V Selle
- Viarnetto Psychiatric Clinic, Lugano, Switzerland
| | - G Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - P Girardi
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - M Tohen
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - E Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - R J Baldessarini
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA
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Wang L, Alpert KI, Calhoun VD, Cobia DJ, Keator DB, King MD, Kogan A, Landis D, Tallis M, Turner MD, Potkin SG, Turner JA, Ambite JL. SchizConnect: Mediating neuroimaging databases on schizophrenia and related disorders for large-scale integration. Neuroimage 2016; 124:1155-1167. [PMID: 26142271 PMCID: PMC4651768 DOI: 10.1016/j.neuroimage.2015.06.065] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/19/2015] [Accepted: 06/23/2015] [Indexed: 02/02/2023] Open
Abstract
SchizConnect (www.schizconnect.org) is built to address the issues of multiple data repositories in schizophrenia neuroimaging studies. It includes a level of mediation--translating across data sources--so that the user can place one query, e.g. for diffusion images from male individuals with schizophrenia, and find out from across participating data sources how many datasets there are, as well as downloading the imaging and related data. The current version handles the Data Usage Agreements across different studies, as well as interpreting database-specific terminologies into a common framework. New data repositories can also be mediated to bring immediate access to existing datasets. Compared with centralized, upload data sharing models, SchizConnect is a unique, virtual database with a focus on schizophrenia and related disorders that can mediate live data as information is being updated at each data source. It is our hope that SchizConnect can facilitate testing new hypotheses through aggregated datasets, promoting discovery related to the mechanisms underlying schizophrenic dysfunction.
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Affiliation(s)
- Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Kathryn I Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM, USA; University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA; Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA; Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
| | - Derin J Cobia
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David B Keator
- Brain Imaging Center, University of California, Irvine, CA, USA
| | | | - Alexandr Kogan
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Drew Landis
- The Mind Research Network, Albuquerque, NM, USA
| | - Marcelo Tallis
- Information Sciences Institute, University of Southern California, Marina del Rey, CA, USA
| | - Matthew D Turner
- Department of Computer Science, Georgia State University, Atlanta, GA, USA; Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - Steven G Potkin
- Brain Imaging Center, University of California, Irvine, CA, USA; Department of Psychiatry & Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Jessica A Turner
- The Mind Research Network, Albuquerque, NM, USA; Department of Psychology, Georgia State University, Atlanta, GA, USA; Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - Jose Luis Ambite
- Information Sciences Institute, University of Southern California, Marina del Rey, CA, USA; Digital Government Research Center, University of Southern California, Los Angeles, CA, USA; Department of Computer Science, University of Southern California, Los Angeles, CA, USA
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73
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Sex and diagnosis specific associations between DNA methylation of the oxytocin receptor gene with emotion processing and temporal-limbic and prefrontal brain volumes in psychotic disorders. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2015; 1:141-151. [PMID: 26977453 DOI: 10.1016/j.bpsc.2015.10.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The oxytocin (OT) system, including receptor epigenetic mechanisms, has been shown to influence emotion processing, especially in females. Whether OT receptor (OXTR) epigenetic alterations occur across psychotic disorders in relation to illness-related disturbances in social cognition and brain anatomy is unknown. METHODS Participants with affective and nonaffective psychotic disorders (92 women, 75 men) and healthy controls (38 women, 37 men) from the Chicago site of the BSNIP study completed the Penn Emotion Recognition Test (ER-40), a facial emotion recognition task. We measured cytosine methylation at site -934 upstream of the OXTR start codon in DNA from whole blood, and for the first time their relationship with plasma OT levels assessed by enzyme-immunoassay. Volumes of brain regions supporting social cognition were measured from MRI scans using FreeSurfer. RESULTS Patients with prototypic schizophrenia features showed higher levels of DNA methylation than those with prototypic bipolar features. Methylation was higher in women than men, and was associated with poorer emotion recognition only in female patients and controls. Greater methylation was associated with smaller volumes in temporal-limbic and prefrontal regions associated previously with social cognition, but only in healthy women and females with schizophrenia. CONCLUSION DNA methylation of the OXTR site -934 was higher in schizophrenia spectrum than bipolar patients. Among patients, it was linked to behavioral deficits in social cognition and neuroanatomic structures known to support emotion processing only in schizophrenia spectrum individuals.
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Bakhshi K, Chance S. The neuropathology of schizophrenia: A selective review of past studies and emerging themes in brain structure and cytoarchitecture. Neuroscience 2015; 303:82-102. [DOI: 10.1016/j.neuroscience.2015.06.028] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 06/16/2015] [Accepted: 06/17/2015] [Indexed: 01/12/2023]
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Samudra N, Ivleva EI, Hubbard NA, Rypma B, Sweeney JA, Clementz BA, Keshavan MS, Pearlson GD, Tamminga CA. Alterations in hippocampal connectivity across the psychosis dimension. Psychiatry Res 2015; 233:148-57. [PMID: 26123450 PMCID: PMC4784701 DOI: 10.1016/j.pscychresns.2015.06.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/24/2015] [Accepted: 06/08/2015] [Indexed: 01/13/2023]
Abstract
Recent evidence demonstrates that hippocampal hyperactivity helps mediate psychosis. Using resting state functional magnetic resonance imaging (rsfMRI), we examined hippocampal connectivity alterations in individuals with psychosis (PS) versus healthy controls (HC). Because of its putative greater involvement in psychiatric disorders, we hypothesized that the anterior hippocampus network would show greater dysconnectivity in psychosis. We tested rsfMRI connectivity in 88 PS (including 21 with schizophrenia; 40 with schizoaffective disorder; 27 with psychotic bipolar I disorder) and 65 HC. Seed-based voxel-wise connectivity analyses were carried out using whole, anterior, and posterior hippocampal seeds. No significant differences in functional hippocampal connectivity were found across the three conventional diagnoses. PS were then contrasted with HC, showing strong reductions in anterior hippocampal connectivity to anterior neocortical regions, including medial frontal and anterior cingulate cortices, as well as superior temporal gyrus, precuneus, thalamus and cerebellum. Posterior hippocampal seeds also demonstrated decreased connectivity in PS, with fewer dysconnected regions and a posterior/cerebellar distribution. Whole hippocampal outcomes were consistent with anterior/posterior hippocampal connectivity changes. Connectivity alterations did not correlate with cognition, clinical symptoms, or medication effect variables. Our results suggest a psychosis network of decreased hippocampal connectivity with limbic and frontal contributions, independent of diagnostic categories.
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Affiliation(s)
- Niyatee Samudra
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | | | - Bart Rypma
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States; Center for Brain Health, UT Dallas, Dallas, TX, United States
| | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Brett A Clementz
- Department of Psychology, University of Georgia, Athens, GA, United States
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Hospital, Harvard Medical School, Boston, MA, United States
| | - Godfrey D Pearlson
- Department of Psychiatry, Institute of Living/Hartford Hospital, Yale School of Medicine, New Haven, CT, United States
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Tamminga CA, Zukin RS. Schizophrenia: Evidence implicating hippocampal GluN2B protein and REST epigenetics in psychosis pathophysiology. Neuroscience 2015. [PMID: 26211447 DOI: 10.1016/j.neuroscience.2015.07.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The hippocampus is strongly implicated in the psychotic symptoms of schizophrenia. Functionally, basal hippocampal activity (perfusion) is elevated in schizophrenic psychosis, as measured with positron emission tomography (PET) and with magnetic resonance (MR) perfusion techniques, while hippocampal activation to memory tasks is reduced. Subfield-specific hippocampal molecular pathology exists in human psychosis tissue which could underlie this neuronal hyperactivity, including increased GluN2B-containing NMDA receptors in hippocampal CA3, along with increased postsynaptic density protein-95 (PSD-95) along with augmented dendritic spines on the pyramidal neuron apical dendrites. We interpret these observations to implicate a reduction in the influence of a ubiquitous gene repressor, repressor element-1 silencing transcription factor (REST) in psychosis; REST is involved in the age-related maturation of the NMDA receptor from GluN2B- to GluN2A-containing NMDA receptors through epigenetic remodeling. These CA3 changes in psychosis leave the hippocampus liable to pathological increases in neuronal activity, feedforward excitation and false memory formation, sometimes with psychotic content.
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Affiliation(s)
- C A Tamminga
- UT Southwestern Medical School, Dallas, TX, United States.
| | - R S Zukin
- Albert Einstein School of Medicine, New York, NY, United States
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Hippocampal, amygdala and nucleus accumbens volume in first-episode schizophrenia patients and individuals at high familial risk: A cross-sectional comparison. Schizophr Res 2015; 165:45-51. [PMID: 25864953 DOI: 10.1016/j.schres.2015.03.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 03/21/2015] [Accepted: 03/22/2015] [Indexed: 11/21/2022]
Abstract
It is unknown whether brain changes occur prior to onset of schizophrenia or after it develops. Prospective familial high risk studies provide a good method to investigate this. In the Edinburgh High Risk Study, structural MRI scans of 150 young individuals at familial high risk of schizophrenia, 34 patients with first-episode schizophrenia and 36 matched controls were obtained. Of the high risk participants with scans suitable for analysis, 17 developed schizophrenia after the scans were taken, whilst 57 experienced isolated or sub-clinical psychotic symptoms, and 70 remained well. We used Freesurfer to extract volumetric measurements of the hippocampus, amygdala and nucleus accumbens with the aim of assessing whether any alterations found were present in all those at high risk, or selectively in the high risk cohort based on future clinical outcome, or only in those experiencing their first-episode of psychosis. We found no significant differences in any examined regions between controls and those at high risk, or between those at high risk who later developed schizophrenia and those who remained well. However, patients with first-episode schizophrenia demonstrated significant volumetric reductions in the bilateral hippocampus, left amygdala, and right nucleus accumbens compared to high risk individuals and healthy controls, which were not significantly associated with the intake of anti-psychotic medication or duration of illness. We found that patients had significantly smaller left amygdalae and bilateral hippocampus compared to HR[ill]. Our findings suggest that volumetric reductions of the hippocampus, amygdala and nucleus accumbens occur early in the first-episode of psychosis. The apparent absence of high risk versus control differences we found using Freesurfer is at odds with our previous studies conducted on the same sample, and possible methodological reasons for these apparent discrepancies are discussed.
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Pearlson GD. Etiologic, Phenomenologic, and Endophenotypic Overlap of Schizophrenia and Bipolar Disorder. Annu Rev Clin Psychol 2015; 11:251-81. [DOI: 10.1146/annurev-clinpsy-032814-112915] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Godfrey D. Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Connecticut 06510;
- Olin Neuropsychiatry Research Center, Hartford Healthcare Corporation, Hartford, Connecticut 06106
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Abstract
The Kraepelinian dichotomy between schizophrenia (SZ) and bipolar disorder (BD) is being challenged by recent epidemiological and biological studies. We performed a comparative review of neuroimaging features in both conditions at several scales: whole-brain and regional volumes, brain activity, connectivity, and networks. Structural volumetric neuroimaging studies suggest a common pattern of volume decreases, but networks studies reveal a clearer distinction between BD and SZ with an altered connectivity generalized to all brain networks in SZ and restricted to limbic, paralimbic, and interhemispheric networks in BD.
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