151
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Collin G, Seidman LJ, Keshavan MS, Stone WS, Qi Z, Zhang T, Tang Y, Li H, Arnold Anteraper S, Niznikiewicz MA, McCarley RW, Shenton ME, Wang J, Whitfield-Gabrieli S. Functional connectome organization predicts conversion to psychosis in clinical high-risk youth from the SHARP program. Mol Psychiatry 2020; 25:2431-2440. [PMID: 30410064 PMCID: PMC6813871 DOI: 10.1038/s41380-018-0288-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/27/2018] [Accepted: 10/08/2018] [Indexed: 12/23/2022]
Abstract
The emergence of prodromal symptoms of schizophrenia and their evolution into overt psychosis may stem from an aberrant functional reorganization of the brain during adolescence. To examine whether abnormalities in connectome organization precede psychosis onset, we performed a functional connectome analysis in a large cohort of medication-naive youth at risk for psychosis from the Shanghai At Risk for Psychosis (SHARP) study. The SHARP program is a longitudinal study of adolescents and young adults at Clinical High Risk (CHR) for psychosis, conducted at the Shanghai Mental Health Center in collaboration with neuroimaging laboratories at Harvard and MIT. Our study involved a total of 251 subjects, including 158 CHRs and 93 age-, sex-, and education-matched healthy controls. During 1-year follow-up, 23 CHRs developed psychosis. CHRs who would go on to develop psychosis were found to show abnormal modular connectome organization at baseline, while CHR non-converters did not. In all CHRs, abnormal modular connectome organization at baseline was associated with a threefold conversion rate. A region-specific analysis showed that brain regions implicated in early-course schizophrenia, including superior temporal gyrus and anterior cingulate cortex, were most abnormal in terms of modular assignment. Our results show that functional changes in brain network organization precede the onset of psychosis and may drive psychosis development in at-risk youth.
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Affiliation(s)
- Guusje Collin
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. .,McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Larry J. Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA, Dr. Larry Seidman passed away on September 7, 2017 and Dr. Robert McCarley passed away on May 27, 2017. Professors Seidman and McCarley were two of the initiators and principal investigators of the Shanghai At Risk for Psychosis (SHARP) study
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - William S. Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Zhenghan Qi
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA,Department of Linguistics and Cognitive Science, University of Delaware, Newark, DE, USA
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijun Li
- Florida A&M University, Department of Psychology, Tallahassee, FL, USA
| | - Sheeba Arnold Anteraper
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston MA, USA
| | | | - Robert W. McCarley
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA, Dr. Larry Seidman passed away on September 7, 2017 and Dr. Robert McCarley passed away on May 27, 2017. Professors Seidman and McCarley were two of the initiators and principal investigators of the Shanghai At Risk for Psychosis (SHARP) study
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Research and Development, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Susan Whitfield-Gabrieli
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Poitras Center for Affective Disorders, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
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152
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DeLisi LE. What a Clinician Should Know About the Neurobiology of Schizophrenia: A Historical Perspective to Current Understanding. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:368-374. [PMID: 33343248 PMCID: PMC7725146 DOI: 10.1176/appi.focus.20200022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The brain is no doubt the "organ" of psychiatry; yet, over the years, few evidence-based classifications of psychiatric disorders have been based on brain mechanisms. The National Institute of Mental Health notably proposed one such system, known as Research Domain Criteria, although it has not yet influenced any changes in the DSM. Of all the major psychiatric disorders, the brain has been studied most extensively in schizophrenia, with its speculative pathology first documented by Emil Kraepelin as early as the beginning of the 20th century. Subsequently, the revolution in technology over the past 50 years has changed how investigators are able to view the brain before death without performing biopsies. Schizophrenia is thus found to have both structural and functional widespread brain anomalies that likely lead to its clinical deterioration. At the onset of illness, acquiring an MRI scan could be part of the routine evaluation to determine how progressive the disease has so far been. However, this practice is not yet recognized by the American Psychiatric Association in any of its guidelines on the treatment of schizophrenia.
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Affiliation(s)
- Lynn E DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, and Cambridge Health Alliance, Cambridge Hospital, Cambridge, Massachusetts
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153
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Sheffield JM, Huang AS, Rogers BP, Giraldo-Chica M, Landman BA, Blackford JU, Heckers S, Woodward ND. Thalamocortical Anatomical Connectivity in Schizophrenia and Psychotic Bipolar Disorder. Schizophr Bull 2020; 46:1062-1071. [PMID: 32219397 PMCID: PMC7505173 DOI: 10.1093/schbul/sbaa022] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anatomical connectivity between the thalamus and cortex, including the prefrontal cortex (PFC), is abnormal in schizophrenia. Overlapping phenotypes, including deficits in executive cognitive abilities dependent on PFC-thalamic circuitry, suggest dysrupted thalamocortical anatomical connectivity may extend to psychotic bipolar disorder. We tested this hypothesis and examined the impact of illness stage to inform when in the illness course thalamocortical dysconnectivity emerges. METHODS Diffusion-weighted imaging data were collected on 70 healthy individuals and 124 people with a psychotic disorder (schizophrenia spectrum = 75; psychotic bipolar disorder = 49), including 62 individuals in the early stage of psychosis. Anatomical connectivity between major divisions of the cortex and thalamus was quantified using probabilistic tractography and compared between groups. Associations between PFC-thalamic anatomical connectivity and executive cognitive abilities were examined using regression analysis. RESULTS Psychosis was associated with lower PFC-thalamic and elevated somatosensory-thalamic anatomical connectivity. Follow-up analyses established that lower PFC-thalamic and elevated somatosensory-thalamic anatomical connectivity were present in both schizophrenia and psychotic bipolar disorder. Lower PFC-thalamic anatomical connectivity was also present in early-stage and chronic psychosis. Contrary to expectations, lower PFC-thalamic anatomical connectivity was not associated with impaired executive cognitive abilities. CONCLUSIONS Altered thalamocortical anatomical connectivity, especially reduced PFC-thalamic connectivity, is a transdiagnostic feature of psychosis detectable in the early stage of illness. Further work is required to elucidate the functional consequences of the full spectrum of thalamocortical connectivity abnormalities in psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Anna S Huang
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Baxter P Rogers
- Vanderbilt University Institute of Imaging Science, Nashville, TN
| | | | - Bennett A Landman
- Vanderbilt University Institute of Imaging Science, Nashville, TN
- Vanderbilt University School of Engineering, Nashville, TN
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
- Research and Development, Department of Veterans Affairs Medical Center, Nashville, TN
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
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154
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Bryll A, Krzyściak W, Karcz P, Śmierciak N, Kozicz T, Skrzypek J, Szwajca M, Pilecki M, Popiela TJ. The Relationship between the Level of Anterior Cingulate Cortex Metabolites, Brain-Periphery Redox Imbalance, and the Clinical State of Patients with Schizophrenia and Personality Disorders. Biomolecules 2020; 10:E1272. [PMID: 32899276 PMCID: PMC7565827 DOI: 10.3390/biom10091272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/17/2020] [Accepted: 08/28/2020] [Indexed: 01/10/2023] Open
Abstract
Schizophrenia is a complex mental disorder whose course varies with periods of deterioration and symptomatic improvement without diagnosis and treatment specific for the disease. So far, it has not been possible to clearly define what kinds of functional and structural changes are responsible for the onset or recurrence of acute psychotic decompensation in the course of schizophrenia, and to what extent personality disorders may precede the appearance of the appropriate symptoms. The work combines magnetic resonance spectroscopy imaging with clinical evaluation and laboratory tests to determine the likely pathway of schizophrenia development by identifying peripheral cerebral biomarkers compared to personality disorders. The relationship between the level of metabolites in the brain, the clinical status of patients according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision ICD-10, duration of untreated psychosis (DUP), and biochemical indices related to redox balance (malondialdehyde), the efficiency of antioxidant systems (FRAP), and bioenergetic metabolism of mitochondria, were investigated. There was a reduction in the level of brain N-acetyl-aspartate and glutamate in the anterior cingulate gyrus of patients with schisophrenia compared to the other groups that seems more to reflect a biological etiopathological factor of psychosis. Decreased activity of brain metabolites correlated with increased peripheral oxidative stress (increased malondialdehyde MDA) associated with decreased efficiency of antioxidant systems (FRAP) and the breakdown of clinical symptoms in patients with schizophrenia in the course of psychotic decompensation compared to other groups. The period of untreated psychosis correlated negatively with glucose value in the brain of people with schizophrenia, and positively with choline level. The demonstrated differences between two psychiatric units, such as schizophrenia and personality disorders in relation to healthy people, may be used to improve the diagnosis and prognosis of schizophrenia compared to other heterogenous psychopathology in the future. The collapse of clinical symptoms of patients with schizophrenia in the course of psychotic decompensation may be associated with the occurrence of specific schizotypes, the determination of which is possible by determining common relationships between changes in metabolic activity of particular brain structures and peripheral parameters, which may be an important biological etiopathological factor of psychosis. Markers of peripheral redox imbalance associated with disturbed bioenergy metabolism in the brain may provide specific biological factors of psychosis however, they need to be confirmed in further studies.
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Affiliation(s)
- Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Jagiellonian University, Medical College, Medyczna 9, 30-688 Krakow, Poland;
| | - Paulina Karcz
- Department of Electroradiology, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland;
| | - Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University, Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (M.P.)
| | - Tamas Kozicz
- Department of Clinical Genomics, Center for Individualized Medicine, Mayo Clinic, Rochester, MN 55905, USA;
| | - Justyna Skrzypek
- Department of Medical Diagnostics, Jagiellonian University, Medical College, Medyczna 9, 30-688 Krakow, Poland;
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University, Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (M.P.)
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University, Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (M.P.)
| | - Tadeusz J. Popiela
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
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155
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Wang D, Li M, Wang M, Schoeppe F, Ren J, Chen H, Öngür D, Brady RO, Baker JT, Liu H. Individual-specific functional connectivity markers track dimensional and categorical features of psychotic illness. Mol Psychiatry 2020; 25:2119-2129. [PMID: 30443042 PMCID: PMC6520219 DOI: 10.1038/s41380-018-0276-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 12/23/2022]
Abstract
Neuroimaging studies of psychotic disorders have demonstrated abnormalities in structural and functional connectivity involving widespread brain networks. However, these group-level observations have failed to yield any biomarkers that can provide confirmatory evidence of a patient's current symptoms, predict future symptoms, or predict a treatment response. Lack of precision in both neuroanatomical and clinical boundaries have likely contributed to the inability of even well-powered studies to resolve these key relationships. Here, we employed a novel approach to defining individual-specific functional connectivity in 158 patients diagnosed with schizophrenia (n = 49), schizoaffective disorder (n = 37), or bipolar disorder with psychosis (n = 72), and identified neuroimaging features that track psychotic symptoms in a dimension- or disorder-specific fashion. Using individually specified functional connectivity, we were able to estimate positive, negative, and manic symptoms that showed correlations ranging from r = 0.35 to r = 0.51 with the observed symptom scores. Comparing optimized estimation models among schizophrenia spectrum patients, positive and negative symptoms were associated with largely non-overlapping sets of cortical connections. Comparing between schizophrenia spectrum and bipolar disorder patients, the models for positive symptoms were largely non-overlapping between the two disorder classes. Finally, models derived using conventional region definition strategies performed at chance levels for most symptom domains. Individual-specific functional connectivity analyses revealed important new distinctions among cortical circuits responsible for the positive and negative symptoms, as well as key new information about how circuits underlying symptom expressions may vary depending on the underlying etiology and illness syndrome from which they manifest.
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Affiliation(s)
- Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Meiling Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Franziska Schoeppe
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Jianxun Ren
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Roscoe O Brady
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Justin T Baker
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.
- Institute for Research and Medical Consultations, Imam Abdulahman Bin Faisal University, Dammam, Saudi Arabia.
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
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156
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Jung M, Baik SY, Kim Y, Kim S, Min D, Kim JY, Won S, Lee SH. Empathy and Social Attribution Skills Moderate the Relationship between Temporal Lobe Volume and Facial Expression Recognition Ability in Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:362-374. [PMID: 32702215 PMCID: PMC7383013 DOI: 10.9758/cpn.2020.18.3.362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/21/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022]
Abstract
Objective While impaired facial expression recognition has been closely associated with reduced temporal lobe volume in patients with schizophrenia, this study aimed at examining whether empathy and social attribution affect such a relationship. Methods A total of 43 patients with schizophrenia and 43 healthy controls underwent a facial expression recognition task (FERT) and magnetic resonance imaging. Basic empathy scale and the social attribution task-multiple choice were used to measure empathy and social attribution. Results Patients with schizophrenia showed significant positive correlations between the total temporal lobe volume and the FERT-accuracy (FERT-ACC). Diminished temporal lobe volume predicted the impaired facial emotion recognition ability. Both empathy and social attribution played roles as moderators of the path from the left amygdala volume, left fusiform gyrus volume, both sides of the superior temporal gyrus volume, and left middle temporal gyrus volume to the FERT-ACC. In contrast, empathy alone functioned as a moderator between the right fusiform gyrus volume, right middle temporal gyrus volume, and FERT-ACC. No significant interaction was found for healthy controls. Conclusion Our results suggest that social cognition remediation training on empathy and social attribution, could buffer the negative effects of small temporal lobe volume on interpersonal emotional communication in patients with schizophrenia.
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Affiliation(s)
- Minjee Jung
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea
| | - Seung Yeon Baik
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea
| | - Yourim Kim
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea
| | - Sungkean Kim
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea
| | - Dongil Min
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea
| | - Jeong-Youn Kim
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea
| | - Seunghee Won
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Clinical Emotion and Cognition Research Laboratory, Inje University College of Medicine, Goyang, Korea.,Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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157
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Chen L, Xia C, Sun H. Recent advances of deep learning in psychiatric disorders. PRECISION CLINICAL MEDICINE 2020; 3:202-213. [PMID: 35694413 PMCID: PMC8982596 DOI: 10.1093/pcmedi/pbaa029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 02/05/2023] Open
Abstract
Deep learning (DL) is a recently proposed subset of machine learning methods that has gained extensive attention in the academic world, breaking benchmark records in areas such as visual recognition and natural language processing. Different from conventional machine learning algorithm, DL is able to learn useful representations and features directly from raw data through hierarchical nonlinear transformations. Because of its ability to detect abstract and complex patterns, DL has been used in neuroimaging studies of psychiatric disorders, which are characterized by subtle and diffuse alterations. Here, we provide a brief review of recent advances and associated challenges in neuroimaging studies of DL applied to psychiatric disorders. The results of these studies indicate that DL could be a powerful tool in assisting the diagnosis of psychiatric diseases. We conclude our review by clarifying the main promises and challenges of DL application in psychiatric disorders, and possible directions for future research.
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Affiliation(s)
- Lu Chen
- West China Medical Publishers, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Huaiqiang Sun
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
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158
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Badai J, Bu Q, Zhang L. Review of Artificial Intelligence Applications and Algorithms for Brain Organoid Research. Interdiscip Sci 2020; 12:383-394. [PMID: 32833194 DOI: 10.1007/s12539-020-00386-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/04/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
The human brain organoid is a miniature three-dimensional tissue culture that can simulate the structure and function of the brain in an in vitro culture environment. Although we consider that human brain organoids could be used to understand brain development and diseases, experimental models of human brain organoids are so highly variable that we apply artificial intelligence (AI) techniques to investigate the development mechanism of the human brain. Therefore, this study briefly reviewed commonly used AI applications for human brain organoid-magnetic resonance imaging, electroencephalography, and gene editing techniques, as well as related AI algorithms. Finally, we discussed the limitations, challenges, and future study direction of AI-based technology for human brain organoids.
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Affiliation(s)
- Jiayidaer Badai
- College of Computer Science, Sichuan University, Chengdu, 610065, China
| | - Qian Bu
- Department of Food Engineering, College of Biomass Science and Engineering, Sichuan University, Chengdu, 610065, China
| | - Le Zhang
- College of Computer Science, Sichuan University, Chengdu, 610065, China. .,Medical Big Data Center of Sichuan University, Chengdu, 610065, China. .,PERA Corporation Ltd., Beijing, 100025, China.
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159
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Carnemolla SE, Hsieh JW, Sipione R, Landis BN, Kumfor F, Piguet O, Manuel AL. Olfactory dysfunction in frontotemporal dementia and psychiatric disorders: A systematic review. Neurosci Biobehav Rev 2020; 118:588-611. [PMID: 32818582 DOI: 10.1016/j.neubiorev.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a progressive neurodegenerative disease. Diagnosis of FTD, especially the behavioural variant, is challenging because of symptomatic overlap with psychiatric disorders (depression, schizophrenia, bipolar disorder). Olfactory dysfunction is common in both FTD and psychiatric disorders, and often appears years before symptom onset. This systematic review analysed 74 studies on olfactory function in FTD, depression, schizophrenia and bipolar disorder to identify differences in olfactory dysfunction profiles, focusing on the most common smell measures: odour identification and discrimination. Results revealed that FTD patients were severely impaired in odour identification but not discrimination; in contrast, patients diagnosed with schizophrenia showed impairments in both measures, while those diagnosed with depression showed no olfactory impairments. Findings in bipolar disorder were mixed. Therefore, testing odour identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. Given the high prevalence of odour identification impairments in FTD, and that smell dysfunction predicts neurodegeneration in other diseases, olfactory testing seems a promising avenue towards improving diagnosis between FTD and psychiatric disorders.
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Affiliation(s)
| | - Julien Wen Hsieh
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Rebecca Sipione
- Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Basile N Landis
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Aurélie L Manuel
- The University of Sydney, Brain & Mind Centre, Sydney, Australia.
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160
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Kubota M, Moriguchi S, Takahata K, Nakajima S, Horita N. Treatment effects on neurometabolite levels in schizophrenia: A systematic review and meta-analysis of proton magnetic resonance spectroscopy studies. Schizophr Res 2020; 222:122-132. [PMID: 32505446 DOI: 10.1016/j.schres.2020.03.069] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/29/2020] [Accepted: 03/29/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although there is growing evidence of alterations in the neurometabolite status associated with the pathophysiology of schizophrenia, how treatments influence these metabolite levels in patients with schizophrenia remains poorly studied. METHODS We conducted a literature search using Embase, Medline, and PsycINFO to identify proton magnetic resonance spectroscopy studies that compared neurometabolite levels before and after treatment in patients with schizophrenia. Six neurometabolites (glutamate, glutamine, glutamate + glutamine, gamma-aminobutyric acid, N-acetylaspartate, myo-inositol) and six regions of interest (frontal cortex, temporal cortex, parieto-occipital cortex, thalamus, basal ganglia, hippocampus) were investigated. RESULTS Thirty-two studies (n = 773 at follow-up) were included in our meta-analysis. Our results demonstrated that the frontal glutamate + glutamine level was significantly decreased (14 groups; n = 292 at follow-up; effect size = -0.35, P = 0.0003; I2 = 22%) and the thalamic N-acetylaspartate level was significantly increased (7 groups; n = 184 at follow-up; effect size = 0.47, P < 0.00001; I2 = 0%) after treatment in schizophrenia patients. No significant associations were found between neurometabolite changes and age, gender, duration of illness, duration of treatment, or baseline symptom severity. CONCLUSIONS The current results suggest that glutamatergic neurometabolite levels in the frontal cortex and neuronal integrity in the thalamus in schizophrenia might be modified following treatment.
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Affiliation(s)
- Manabu Kubota
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan; Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Sho Moriguchi
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan; Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T1R8, Canada
| | - Keisuke Takahata
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan; Department of Neuropsychiatry, Keio University Graduate School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shinichiro Nakajima
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T1R8, Canada; Department of Neuropsychiatry, Keio University Graduate School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Nobuyuki Horita
- Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
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161
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Chwa WJ, Tishler TA, Raymond C, Tran C, Anwar F, Villablanca JP, Ventura J, Subotnik KL, Nuechterlein KH, Ellingson BM. Association between cortical volume and gray-white matter contrast with second generation antipsychotic medication exposure in first episode male schizophrenia patients. Schizophr Res 2020; 222:397-410. [PMID: 32487466 PMCID: PMC7572538 DOI: 10.1016/j.schres.2020.03.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/06/2020] [Accepted: 03/31/2020] [Indexed: 01/19/2023]
Abstract
This cross-sectional study examines the differences in cortical volume and gray-to-white matter contrast (GWC) in first episode schizophrenia patients (SCZ) compared to healthy control participants (HC) and in SCZ patients as a function of exposure to second generation antipsychotic medication. We hypothesize 1) SCZ exhibit regionally lower cortical volumes relative to HCs, 2) cortical volume will be greater with longer exposure to second generation antipsychotics prior to the MRI scan, and 3) lower GWC with longer exposure to second generation antipsychotics prior to the MRI scan, suggesting more blurring from greater intracortical myelin. To accomplish this, MRI scans from 71 male SCZ patients treated with second generation oral risperidone and 42 male HCs were examined. 3D T1-weighted MPRAGE images collected at 1.5T were used to estimate cortical volume and GWC by sampling signal intensity at 30% within the cortical ribbon. Average cortical volume and GWC were calculated and compared between SCZ and HC. Cortical volume and GWC in SCZ patients were correlated with duration of medication exposure for the time period prior to the scan. First-episode SCZ patients had significantly lower cortical volume compared to HCs in bilateral temporal, superior and rostral frontal, postcentral gyral, and parahippocampal regions. In SCZ patients, greater cortical volume was associated with (log-transformed) duration of second-generation antipsychotic medication exposure in bilateral precuneus, right lingual, and right superior parietal regions. Lower GWC was correlated with longer duration of medication exposure bilaterally in the superior frontal lobes. In summary, second generation antipsychotics may increase cortical volume and decrease GWC in first episode SCZ patients.
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Affiliation(s)
- Won Jong Chwa
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Todd A. Tishler
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Catalina Raymond
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Cathy Tran
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Faizan Anwar
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - J. Pablo Villablanca
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Kenneth L. Subotnik
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Department of Psychology, University of California Los Angeles, Los Angeles, CA
| | - Benjamin M. Ellingson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
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162
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Talukder MA. Relating diffusion-weighted magnetic resonance imaging of brain white matter to cognitive processing-speed deficits in schizophrenia. Biomed Phys Eng Express 2020; 6:055007. [PMID: 33444238 DOI: 10.1088/2057-1976/aba3ba] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) analyses of diffusion-weighted magnetic resonance imaging (MRI) show that diffusional fractional anisotropy (FA) and kurtosis anisotropy (KA) of water inside brain white matter decrease for schizophrenic patients from that for healthy persons. DTI and DKI are statistical approaches and do not directly point to the underlying neurobiological reasons. In schizophrenia, it is believed that the demyelination of axons-microstructures that constitute the brain white matter-increases lateral diffusion of water and causes defective neural communications, resulting cognitive processing-speed deficits. Here, we use a simple but realistic neurobiological model for brain white matter and solve the Bloch-Torrey equation using numerical finite-element method to find out the underlying reasons of cognitive deficits in schizophrenia. FA and KA are calculated from computationally obtained diffusion-weighted MRI data after a Stejskal-Tanner gradient pulse sequence is applied to a periodic array of tubular axons with circular cross-sections. The calculated FA and KA decrease when the axon walls are more permeable to water, agree with the experimental findings, and correlate with the cognitive processing speeds of healthy persons and schizophrenic patients, and thus, help to understand the underlying reasons of cognitive processing-speed deficits in schizophrenia.
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Affiliation(s)
- Muhammad Anisuzzaman Talukder
- Department of Electrical and Electronic Engineering, Bangladesh University of Engineering and Technology, Dhaka 1205, Bangladesh
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163
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Altamura M, Prete G, Elia A, Angelini E, Padalino FA, Bellomo A, Tommasi L, Fairfield B. Do patients with hallucinations imagine speech right? Neuropsychologia 2020; 146:107567. [PMID: 32698031 DOI: 10.1016/j.neuropsychologia.2020.107567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
A direct relationship between auditory verbal hallucinations (AVHs) and decreased left-hemispheric lateralization in speech perception has been often described, although it has not been conclusively proven. The specific lateralization of AVHs has been poorly explored. However, patients with verbal hallucinations show a weak Right Ear Advantage (REA) in verbal perception compared to non AVHs listeners suggesting that left-hemispheric language area are involved in AVHs. In the present study, 29 schizophrenia patients with AVHs, 31 patients with psychotic bipolar disorder who experienced frequent AVHs, 27 patients with schizophrenia who had never experienced AVHs and 57 healthy controls were required to imagine hearing a voice in one ear alone. In line with previous evidence healthy controls confirmed the expected REA for auditory imagery, and the same REA was also found in non-hallucinator patients. However, in line with our hypothesis, patients with schizophrenia and psychotic bipolar disorder with AVHs showed no lateral bias. Results extend the relationship between abnormal asymmetry for verbal stimuli and AVHs to verbal imagery, suggesting that atypical verbal imagery may reflect a disruption of inter-hemispheric connectivity between areas implicated in the generation and monitoring of verbal imagery and may be predictive of a predisposition for AVHs. Results also indicate that the relationship between AVHs and hemispheric lateralization for auditory verbal imagery is not specific to schizophrenia but may extend to other disorders as well.
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Affiliation(s)
- Mario Altamura
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Giulia Prete
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Antonella Elia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Eleonora Angelini
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Flavia A Padalino
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Luca Tommasi
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Beth Fairfield
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Chieti, Italy.
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164
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Sasabayashi D, Takayanagi Y, Takahashi T, Katagiri N, Sakuma A, Obara C, Katsura M, Okada N, Koike S, Yamasue H, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State. Schizophr Bull 2020; 46:834-845. [PMID: 32162659 PMCID: PMC7342178 DOI: 10.1093/schbul/sbaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan; tel: +81-76-434-7323, fax: +81-76-434-5030, e-mail:
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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165
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Voineskos AN, Jacobs GR, Ameis SH. Neuroimaging Heterogeneity in Psychosis: Neurobiological Underpinnings and Opportunities for Prognostic and Therapeutic Innovation. Biol Psychiatry 2020; 88:95-102. [PMID: 31668548 PMCID: PMC7075720 DOI: 10.1016/j.biopsych.2019.09.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/01/2019] [Accepted: 09/03/2019] [Indexed: 11/22/2022]
Abstract
Heterogeneity in symptom presentation, outcomes, and treatment response has long been problematic for researchers aiming to identify biological markers of schizophrenia or psychosis. However, there is increasing recognition that there may likely be no such general illness markers, which is consistent with the notion of a group of schizophrenia(s) that may have both shared and unique neurobiological pathways. Instead, strategies aiming to capitalize on or leverage such heterogeneity may help uncover neurobiological pathways that may then be used to stratify groups of patients for prognostic purposes or for therapeutic trials. A shift toward larger sample sizes with adequate statistical power to overcome small effect sizes and disentangle the shared variance among different brain-imaging or behavioral variables has become a priority for the field. In addition, recognition that two individuals with the same clinical diagnosis may be more different from each other (at brain, genetic, and behavioral levels) than from another individual in a different disorder or nonclinical control group-coupled with computational advances-has catapulted data-driven efforts forward. Emerging challenges for this new approach include longitudinal stability of new subgroups, demonstration of validity, and replicability. The "litmus test" will be whether computational approaches that are successfully identifying groups of patients who share features in common, more than current DSM diagnostic constructs, also provide better prognostic accuracy over time and in addition lead to enhancements in treatment response and outcomes. These are the factors that matter most to patients, families, providers, and payers.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Grace R Jacobs
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Brain and Mental Health Program, Hospital for Sick Children, Toronto, Canada
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166
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Kim S, Kim YW, Jeon H, Im CH, Lee SH. Altered Cortical Thickness-Based Individualized Structural Covariance Networks in Patients with Schizophrenia and Bipolar Disorder. J Clin Med 2020; 9:jcm9061846. [PMID: 32545747 PMCID: PMC7356298 DOI: 10.3390/jcm9061846] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022] Open
Abstract
Structural covariance is described as coordinated variation in brain morphological features, such as cortical thickness and volume, among brain structures functionally or anatomically interconnected to one another. Structural covariance networks, based on graph theory, have been studied in mental disorders. This analysis can help in understanding the brain mechanisms of schizophrenia and bipolar disorder. We investigated cortical thickness-based individualized structural covariance networks in patients with schizophrenia and bipolar disorder. T1-weighted magnetic resonance images were obtained from 39 patients with schizophrenia, 37 patients with bipolar disorder type I, and 32 healthy controls, and cortical thickness was analyzed via a surface-based morphometry analysis. The structural covariance of cortical thickness was calculated at the individual level, and covariance networks were analyzed based on graph theoretical indices: strength, clustering coefficient (CC), path length (PL) and efficiency. At the global level, both patient groups showed decreased strength, CC and efficiency, and increased PL, compared to healthy controls. In bipolar disorder, we found intermediate network measures among the groups. At the nodal level, schizophrenia patients showed decreased CCs in the left suborbital sulcus and the right superior frontal sulcus, compared to bipolar disorder patients. In addition, patient groups showed decreased CCs in the right insular cortex and the left superior occipital gyrus. Global-level network indices, including strength, CCs and efficiency, positively correlated, while PL negatively correlated, with the positive symptoms of the Positive and Negative Syndrome Scale for patients with schizophrenia. The nodal-level CC of the right insular cortex positively correlated with the positive symptoms of schizophrenia, while that of the left superior occipital gyrus positively correlated with the Young Mania Rating Scale scores for bipolar disorder. Altered cortical structural networks were revealed in patients, and particularly, the prefrontal regions were more altered in schizophrenia. Furthermore, altered cortical structural networks in both patient groups correlated with core pathological symptoms, indicating that the insular cortex is more vulnerable in schizophrenia, and the superior occipital gyrus is more vulnerable in bipolar disorder. Our individualized structural covariance network indices might be promising biomarkers for the evaluation of patients with schizophrenia and bipolar disorder.
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Affiliation(s)
- Sungkean Kim
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA;
| | - Yong-Wook Kim
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea; (Y.-W.K.); (C.-H.I.)
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea;
| | - Hyeonjin Jeon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea;
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea; (Y.-W.K.); (C.-H.I.)
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea;
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Juhwa-ro 170, Ilsanseo-Gu, Goyang 411-706, Korea
- Correspondence: ; Tel.: +82-31-910-7260; Fax: +82-31-910-7268
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167
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A Systematic Characterization of Structural Brain Changes in Schizophrenia. Neurosci Bull 2020; 36:1107-1122. [PMID: 32495122 DOI: 10.1007/s12264-020-00520-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/13/2020] [Indexed: 01/10/2023] Open
Abstract
A systematic characterization of the similarities and differences among different methods for detecting structural brain abnormalities in schizophrenia, such as voxel-based morphometry (VBM), tensor-based morphometry (TBM), and projection-based thickness (PBT), is important for understanding the brain pathology in schizophrenia and for developing effective biomarkers for a diagnosis of schizophrenia. However, such studies are still lacking. Here, we performed VBM, TBM, and PBT analyses on T1-weighted brain MR images acquired from 116 patients with schizophrenia and 116 healthy controls. We found that, although all methods detected wide-spread structural changes, different methods captured different information - only 10.35% of the grey matter changes in cortex were detected by all three methods, and VBM only detected 11.36% of the white matter changes detected by TBM. Further, pattern classification between patients and controls revealed that combining different measures improved the classification accuracy (81.9%), indicating that fusion of different structural measures serves as a better neuroimaging marker for the objective diagnosis of schizophrenia.
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168
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Abstract
Culture is part of an extensive series of feedback loops, which involve multiple organismic levels including social contexts, cognitive mediations, neural processes, and behavior. Recent studies in neuroscience show that culturally contingent social processes shape some neural pathways. Studying the influence of cultural context on neural processes may yield new insights into psychiatric disorders. New methodologies in the neurosciences offer innovative ways to assess the impact of culture on mental health and illness. However, implementing these methodologies raises important theoretical and ethical concerns, which must be resolved to address patient individuality and the complexity of cultural diversity. This article discusses cultural context as a major influence on (and consequence of) human neural plasticity and advocates a culture-brain-behavior (CBB) interaction model for conceptualizing the relationship between culture, brain, and psychiatric disorders. Recommendations are made for integrating neuroscientific techniques into transcultural psychiatric research by taking a systems approach to evaluating disorders.
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169
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Yang X, Xu Z, Xi Y, Sun J, Liu P, Liu P, Li P, Jia J, Yin H, Qin W. Predicting responses to electroconvulsive therapy in schizophrenia patients undergoing antipsychotic treatment: Baseline functional connectivity among regions with strong electric field distributions. Psychiatry Res Neuroimaging 2020; 299:111059. [PMID: 32135406 DOI: 10.1016/j.pscychresns.2020.111059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/16/2020] [Accepted: 02/21/2020] [Indexed: 01/15/2023]
Abstract
This study explored imaging predictors of electroconvulsive therapy (ECT) outcome in schizophrenia patients based on pre-treatment functional connectivity (FC) within regions with strong ECT electric fields distribution. Forty-seven patients received standard antipsychotic drugs combined with ECT as well as two brain imaging sessions. Regions of interest (ROI) with strong electric field distribution were determined by ECT simulation. Using baseline functional connectivity between ROIs, a model was constructed to predict the percentage reduction of Positive and Negative Syndrome Scale (PANSS) scores. The strong electric fields were distributed in the orbital prefrontal lobe, medial temporal lobe, and other parts of the temporal lobe. Ten functional connectivity features within the electric field distribution areas showed a predictive ability for ECT outcome. The correlation coefficient between the predictive and real values of cross-validation was 0.7165. Among the predictive features, ECT induced a significant decrease in functional connectivity between the right amygdala and the left hippocampus. These results suggest that pretreatment functional connectivity patterns in brain regions with strong electric field distributions during ECT could be potential predictors of the efficacy of ECT augmentation in schizophrenia. These findings may help to improve individualized clinical treatment in the future.
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Affiliation(s)
- Xuejuan Yang
- Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Ziliang Xu
- Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Yibin Xi
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, Shaanxi 710032, China
| | - Jinbo Sun
- Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Peng Liu
- Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Peng Liu
- Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China
| | - Ping Li
- Department of Medical Imaging, Xi'an Mental Health Center, Xi'an, Shaanxi 710061, China
| | - Jie Jia
- Department of early intervention, Xi'an Mental Health Center, Xi'an, Shaanxi 710061, China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, Shaanxi 710032, China.
| | - Wei Qin
- Engineering Research Center of Molecular & Neuroimaging, Ministry of Education, School of Life Science and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi 710126, China.
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170
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Abstract
Olfactory reference syndrome (ORS) describes a constellation of emotional and behavioral symptoms that cause clinically significant distress or impairment arising from the false belief that one is emitting an offensive odor. Despite cases of ORS reported throughout the world over the last century, our knowledge and understanding of ORS remain relatively poor because of the limited literature-mostly case studies and series, but no clinical trials. ORS continues to pose significant diagnostic challenges within our current frameworks of categorizing mental disorders, including the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases. We review the ORS literature and discuss diagnostic parallels and challenges of placing ORS within specific categories. We also review the current research on the neurocircuitry of olfaction and of disorders with potential clinical relevance to patients presenting with ORS. While no primary neuroscientific research has specifically investigated ORS, an overlapping circuitry has been implicated in the neurobiology of obsessive-compulsive, trauma and stressor, and psychotic spectrum disorders, suggesting that the phenomenology of ORS can best be understood through a dimensional, rather than categorical, approach.
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171
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Characteristics of gray matter alterations in never-treated and treated chronic schizophrenia patients. Transl Psychiatry 2020; 10:136. [PMID: 32398765 PMCID: PMC7217843 DOI: 10.1038/s41398-020-0828-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 02/05/2023] Open
Abstract
Though gray matter deficits have been consistently revealed in chronic treated schizophrenia, it is still not clear whether there are different brain alterations between chronic never treated and treated patients. To explore the different patterns of gray matter alterations among chronic never treated patients and those treated with monotherapy, we recruited 35 never-treated chronic schizophrenia patients with illness durations ranging from 5 to 48 years, 20 illness duration-matched risperidone monotherapy and 20 clozapine monotherapy patients, and 55 healthy controls. GM (surface area, cortical thickness, and cortical volume) measures were extracted and compared using ANCOVA across the four groups followed by post hoc tests. Relative to controls, both treated and never-treated chronic schizophrenia patients showed reduced GM mainly involving the bilateral medial and rostral middle frontal, left banks superior temporal sulcus, left fusiform, and left pericalcarine cortex and increased in the left cuneus. Compared with the untreated patient group, the two treated groups showed reductions mainly in the bilateral prefrontal, temporal, and left inferior parietal lobules. The clozapine monotherapy patients demonstrated more severe decreases in the bilateral prefrontal cortex and left cuneus and less severe decreases in the left ventral temporal lobe than risperidone monotherapy patients. These findings provide new insights into the long-term effects of antipsychotic treatment on gray matter alterations in schizophrenia patients. Furthermore, the characteristic findings of reductions in the inferior parietal lobule might be specific for long-term antipsychotic treatment, which could be a possible target for medication development in the future.
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172
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Phang CR, Noman F, Hussain H, Ting CM, Ombao H. A Multi-Domain Connectome Convolutional Neural Network for Identifying Schizophrenia From EEG Connectivity Patterns. IEEE J Biomed Health Inform 2020; 24:1333-1343. [DOI: 10.1109/jbhi.2019.2941222] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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173
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Abstract
PURPOSE OF REVIEW After more than a century of neuroscience research, reproducible, clinically relevant biomarkers for schizophrenia have not yet been established. This article reviews current advances in evaluating the use of language as a diagnostic or prognostic tool in schizophrenia. RECENT FINDINGS The development of computational linguistic tools to quantify language disturbances is rapidly gaining ground in the field of schizophrenia research. Current applications are the use of semantic space models and acoustic analyses focused on phonetic markers. These features are used in machine learning models to distinguish patients with schizophrenia from healthy controls or to predict conversion to psychosis in high-risk groups, reaching accuracy scores (generally ranging from 80 to 90%) that exceed clinical raters. Other potential applications for a language biomarker in schizophrenia are monitoring of side effects, differential diagnostics and relapse prevention. SUMMARY Language disturbances are a key feature of schizophrenia. Although in its early stages, the emerging field of research focused on computational linguistics suggests an important role for language analyses in the diagnosis and prognosis of schizophrenia. Spoken language as a biomarker for schizophrenia has important advantages because it can be objectively and reproducibly quantified. Furthermore, language analyses are low-cost, time efficient and noninvasive in nature.
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174
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Language in schizophrenia: relation with diagnosis, symptomatology and white matter tracts. NPJ SCHIZOPHRENIA 2020; 6:10. [PMID: 32313047 PMCID: PMC7171150 DOI: 10.1038/s41537-020-0099-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/28/2020] [Indexed: 01/04/2023]
Abstract
Language deviations are a core symptom of schizophrenia. With the advances in computational linguistics, language can be easily assessed in exact and reproducible measures. This study investigated how language characteristics relate to schizophrenia diagnosis, symptom, severity and integrity of the white matter language tracts in patients with schizophrenia and healthy controls. Spontaneous speech was recorded and diffusion tensor imaging was performed in 26 schizophrenia patients and 22 controls. We were able to classify both groups with a sensitivity of 89% and a specificity of 82%, based on mean length of utterance and clauses per utterance. Language disturbances were associated with negative symptom severity. Computational language measures predicted language tract integrity in patients (adjusted R2 = 0.467) and controls (adjusted R2 = 0.483). Quantitative language analyses have both clinical and biological validity, offer a simple, helpful marker of both severity and underlying pathology, and provide a promising tool for schizophrenia research and clinical practice.
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de Souza Crippa JA, Zuardi AW, Busatto GF, Sanches RF, Santos AC, Araújo D, Amaro E, Hallak JEC, Ng V, McGuire PK. Cavum septum pellucidum and adhesio interthalamica in schizophrenia: an MRI study. Eur Psychiatry 2020; 21:291-9. [PMID: 16406503 DOI: 10.1016/j.eurpsy.2005.09.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Accepted: 09/13/2005] [Indexed: 11/28/2022] Open
Abstract
AbstractSeveral studies have independently suggested that patients with schizophrenia are more likely to have an enlarged cavum septum pellucidum (CSP) and an absent adhesio interthalamica (AI), respectively. However, neither finding has been consistently replicated and it is unclear whether there is an association between these two midline brain abnormalities. Thus, we compared the prevalence of absent AI and the prevalence, size and volume of CSP in 38 patients with schizophrenia and 38 healthy controls using magnetic resonance imaging (MRI). There were no between group differences in the presence or volume of CSP; however, an enlarged CSP was commoner among patients than controls. There was also a positive correlation between CSP ratings and volumes. No differences in the presence or absence of the AI were found between patients and controls; however, an absent AI was commoner in male patients with schizophrenia than females. There was absolutely no overlap between the presence of a large CSP and an absence of AI. In conclusion, our findings are in line with several case series and other MRI investigations that have shown a higher incidence of putatively developmental brain abnormalities in patients with schizophrenia, particularly in males, and support the neurodevelopmental model of this disorder.
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Affiliation(s)
- José Alexandre de Souza Crippa
- Department of Neuropsychiatry and Medical Psychology, Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Kyriakopoulos M, Bargiotas T, Barker GJ, Frangou S. Diffusion tensor imaging in schizophrenia. Eur Psychiatry 2020; 23:255-73. [DOI: 10.1016/j.eurpsy.2007.12.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 11/19/2007] [Accepted: 12/03/2007] [Indexed: 12/12/2022] Open
Abstract
AbstractDiffusion tensor imaging (DTI) is a magnetic resonance imaging technique that is increasingly being used for the non-invasive evaluation of brain white matter abnormalities. In this review, we discuss the basic principles of DTI, its roots and the contribution of European centres in its development, and we review the findings from DTI studies in schizophrenia. We searched EMBASE, PubMed, PsychInfo, and Medline from February 1998 to December 2006 using as keywords ‘schizophrenia’, ‘diffusion’, ‘tensor’, and ‘DTI’. Forty studies fulfilling the inclusion criteria of this review were included and systematically reviewed. White matter abnormalities in many diverse brain regions were identified in schizophrenia. Although the findings are not completely consistent, frontal and temporal white matter seems to be more commonly affected. Limitations and future directions of this method are discussed.
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Wake R, Miyaoka T, Kawakami K, Tsuchie K, Inagaki T, Horiguchi J, Yamamoto Y, Hayashi T, Kitagaki H. Characteristic brain hypoperfusion by 99mTc-ECD single photon emission computed tomography (SPECT) in patients with the first-episode schizophrenia. Eur Psychiatry 2020; 25:361-5. [DOI: 10.1016/j.eurpsy.2009.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 12/14/2009] [Accepted: 12/14/2009] [Indexed: 11/29/2022] Open
Abstract
AbstractObjectiveIn this study, we evaluated brain perfusion in patients with first-episode medicated schizophrenia using the new analytical method, statistical parametric mapping (SPM) applied to single photon emission computed tomography (SPECT).MethodWe performed SPECT with 99-Tc-ethyl cysteinate dimer (99mTc-ECD) of the brain and magnetic resonance imaging (MRI) in patients with schizophrenia (n = 30) and control subjects matched for age and gender (n = 37). A voxel-by-voxel group analysis was performed using SPM2 (Z > 3.0, P < 0.001, uncorrected for multiple comparisons).ResultIn comparison with control subjects, the volumes of the bilateral frontal areas were found to be decreased on MRI. Blood flow was found to be reduced in the bilateral temporal areas in the patients with schizophrenia on SPECT.ConclusionIn this study, patients with first-episode schizophrenia appeared to have significant bilateral temporal hypoperfusion, although temporal volumes were not significantly decreased in comparison with control subjects. Abnormality of temporal lobe blood flow in schizophrenia may show that functional changes occur earlier than structural changes, and may assist in the diagnosis of schizophrenia.
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Abstract
Schizophrenia (Sz) is a chronic mental disorder characterized by disturbances in thought (such as delusions and confused thinking), perception (hearing voices), and behavior (lack of motivation). The lifetime prevalence of Sz is between 0.3% and 0.7%, with late adolescence and early adulthood, the peak period for the onset of psychotic symptoms. Causal factors in Sz include environmental and genetic factors and especially their interaction. About 50% of individuals with a diagnosis of Sz have lifelong impairment.
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Wang J, Jiang Y, Tang Y, Xia M, Curtin A, Li J, Sheng J, Zhang T, Li C, Hui L, Zhu H, Biswal BB, Jia Q, Luo C, Wang J. Altered functional connectivity of the thalamus induced by modified electroconvulsive therapy for schizophrenia. Schizophr Res 2020; 218:209-218. [PMID: 31956007 DOI: 10.1016/j.schres.2019.12.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/29/2019] [Accepted: 12/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) has been shown to be effective in schizophrenia (SZ), particularly in drug-refractory cases or when rapid symptom relief is needed. However, its precise mechanisms of action remain largely unclear. To clarify the mechanisms underlying modified electroconvulsive therapy (mECT) for SZ, we conducted a longitudinal cohort study evaluating functional connectivity of the thalamus before and after mECT treatment using sub-regions of thalamus as regions of interest (ROIs). METHODS Twenty-one SZ individuals taking only antipsychotics (DSZ group) for 4 weeks and 21 SZ patients receiving a regular course of mECT combining with antipsychotics (MSZ group) were observed in parallel. All patients underwent magnetic resonance imaging scans at baseline (t1) and follow-up (t2, ~4 weeks) time points. Data were compared to a matched healthy control group (HC group) consisting of 23 persons who were only scanned at baseline. Group differences in changes of thalamic functional connectivity between two SZ groups over time, as well as in functional connectivity among two SZ groups and HC group were assessed. RESULTS Significant interaction of group by time was found in functional connectivity of the right thalamus to right putamen during the course of about 4-week treatment. Post-hoc analysis showed a significantly enhanced functional connectivity of the right thalamus to right putamen in the MSZ group contrasting to the DSZ group. In addition, a decreased and an increased functional connectivity of the thalamus to sensory cortex were observed within the MSZ and DSZ group after 4-week treatment trial, respectively. CONCLUSION Our findings suggest that changes in functional connectivity of the thalamus may be associated with the brain mechanisms of mECT for schizophrenia.
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Affiliation(s)
- Junjie Wang
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Yuchao Jiang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China.
| | - Mengqing Xia
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Adrian Curtin
- School of Biomedical Engineering & Health Sciences, Drexel University, Philadelphia, PA 19104, USA; Med-X Institute, Shanghai Jiaotong University, Shanghai 200300, China
| | - Jin Li
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Jianhua Sheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, China; Brain Science and Technology Research Center, Shanghai Jiaotong University, Shanghai 200030, China; Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiaotong University, Shanghai 200030, China
| | - Li Hui
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China
| | - Hongliang Zhu
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China
| | - Bharat B Biswal
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Qiufang Jia
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China.
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, China; Brain Science and Technology Research Center, Shanghai Jiaotong University, Shanghai 200030, China; Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiaotong University, Shanghai 200030, China
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Wang SM, Ouyang WC, Wu MY, Kuo LC. Relationship between motor function and psychotic symptomatology in young-adult patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2020; 270:373-382. [PMID: 30976916 DOI: 10.1007/s00406-019-01004-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/21/2019] [Indexed: 12/29/2022]
Abstract
Motor abnormalities have been indicated to be a core manifestation of schizophrenia and not just motor side-effects of antipsychotics. However, little is known about whether all of the complete motor function, including fine motor function, muscle strength, and balance is linked to psychotic symptoms. Therefore, this study was to investigate association between complete motor function and psychotic symptoms in young-adult schizophrenia patients who had no extrapyramidal motor symptoms, which were assessed using the Extrapyramidal Symptom Rating Scale. Seventy schizophrenia patients were recruited. Fine motor function, muscle strength, and balance were assessed using The McCarron Assessment of Neuromuscular Development. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. Given gender differences in muscle power, the correlation between muscle strength and psychotic symptoms was analyzed by gender separately. Partial correlation controlling for effects of the chlorpromazine equivalent dosage of antipsychotics was conducted. Better fine motor function was correlated with less-severe negative symptoms (r = - 0.49, p < 0.001) in the total sample. In men, better muscle strength was correlated with more severe positive symptoms and less-severe negative symptoms (r = 0.41, p = 0.008; r = - 0.55, p < 0.001). The link between motor function and psychotic symptoms may support the cerebellar and basal ganglia hypotheses of schizophrenia, proposing that diverse schizophrenia symptoms may share the same neural deficiency, that is, dysfunction of cerebellum or basal ganglia. Considering the moderate-to-strong association between muscle strength and psychotic symptoms, muscle strength might be a powerful physical predictor of psychotic progression.
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Affiliation(s)
- Shu-Mei Wang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yi Wu
- Graduate Institute of Counseling Psychology and Rehabilitation Counseling, College of Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan. .,Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
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Nagaoka A, Kunii Y, Hino M, Izumi R, Nagashima C, Takeshima A, Sainouchi M, Nawa H, Kakita A, Yabe H. ALDH4A1 expression levels are elevated in postmortem brains of patients with schizophrenia and are associated with genetic variants in enzymes related to proline metabolism. J Psychiatr Res 2020; 123:119-127. [PMID: 32065947 DOI: 10.1016/j.jpsychires.2020.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The molecular mechanisms underlying schizophrenia remain largely unclear, and we recently identified multiple proteins significantly altered in the postmortem prefrontal cortex (PFC) of schizophrenia patients amongst which aldehyde dehydrogenase 4 family member A1 (ALDH4A1) was especially elevated. In this study, we aimed to investigate the expression of ALDH4A1 in the PFC and superior temporal gyrus (STG) and to elucidate functional correlations between schizophrenia risk alleles and molecular expression profiles in the postmortem brains of patients with schizophrenia. METHODS The levels of ALDH4A1 protein expression in the PFC and STG in postmortem brains from 24 patients with schizophrenia, 8 patients with bipolar disorder, and 32 controls were assessed using enzyme-linked immunosorbent assay. Moreover, we explored the associations between ALDH4A1 expression and genetic variants in enzymes associated with proline metabolism, including ALDH4A1 (schizophrenia [n = 22], bipolar disorder [n = 6], controls [n = 11]). RESULTS ALDH4A1 levels were significantly elevated in both the PFC and STG in patients with schizophrenia and tended to elevate in patients with bipolar disorder. Furthermore, ALDH4A1 expression levels in the PFC were significantly associated with the following three single-nucleotide polymorphisms: rs10882639, rs33823, rs153508. We also found partial coexpression of ALDH4A1 in mitochondria in a subset of putative astrocytes of postmortem brain. LIMITATIONS Our study population was relatively small, particularly for a genetic study. CONCLUSION These findings indicate that altered expression of ALDH4A1 may reflect the potential molecular mechanisms underlying the pathogenesis of schizophrenia and bipolar disorder, and may aid in the development of novel drug therapies.
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Affiliation(s)
- Atsuko Nagaoka
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 960-1295, Fukushima, Japan
| | - Yasuto Kunii
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 960-1295, Fukushima, Japan; Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, 969-3492, Fukushima, Japan.
| | - Mizuki Hino
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 960-1295, Fukushima, Japan
| | - Ryuta Izumi
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 960-1295, Fukushima, Japan
| | - Chisato Nagashima
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 960-1295, Fukushima, Japan
| | - Akari Takeshima
- Department of Pathology, Brain Research Institute, Niigata University, 951-8585, Niigata, Japan
| | - Makoto Sainouchi
- Department of Pathology, Brain Research Institute, Niigata University, 951-8585, Niigata, Japan
| | - Hiroyuki Nawa
- Department of Molecular Neurobiology, Brain Research Institute, Niigata University, 951-8585, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, 951-8585, Niigata, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 960-1295, Fukushima, Japan
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Celik M, Kalenderoglu A, Sevgi Karadag A, Bekir Egilmez O, Han-Almis B, Şimşek A. Decreases in ganglion cell layer and inner plexiform layer volumes correlate better with disease severity in schizophrenia patients than retinal nerve fiber layer thickness: Findings from spectral optic coherence tomography. Eur Psychiatry 2020; 32:9-15. [DOI: 10.1016/j.eurpsy.2015.10.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 01/30/2023] Open
Abstract
AbstractBackgroundOptic coherence tomography (OCT) is a new, contactless and fast neuroimaging method. Previous studies have observed thinning of the retinal nerve fibre layer (RNFL) in many neurodegenerative diseases, and researchers have suggested that correlations exist between the thinning of the RNFL and the neurodegeneration detected with other imaging methods or the severity of illness. More recently, OCT has been used in patients with schizophrenia. RNFL thinning has also been detected in these patients. With more sophisticated devices, segmentation of the retina and measurements of the ganglion cell layer (GCL) and internal plexiform layer (IPL) can be performed.MethodsWe measured the RNFL thickness and the GCL and IPL volumes in 40 treatment refractory patients with schizophrenia, 41 treatment responsive refractory patients and 41 controls using spectral-OCT, and we evaluated the correlations between the disease severity and OCT measurements.ResultsThe global RNFL thickness and GCL and IPL volumes were decreased in the patients with schizophrenia compared with the controls. In addition, the GCL and IPL volumes were lower in the treatment refractory patients with schizophrenia compared to the treatment responsive patients. Using parameters such as the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scores, the disease duration and number of hospitalizations, correlations between the GCL and IPL volumes and disease severity were stronger than the correlations between the RNFL and the disease parameters.ConclusionOur findings suggest that OCT can be used to detect neurodegeneration in schizophrenia and that the GCL and IPL volumes can also be used to monitor the progression of neurodegeneration.
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183
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Eom TY, Han SB, Kim J, Blundon JA, Wang YD, Yu J, Anderson K, Kaminski DB, Sakurada SM, Pruett-Miller SM, Horner L, Wagner B, Robinson CG, Eicholtz M, Rose DC, Zakharenko SS. Schizophrenia-related microdeletion causes defective ciliary motility and brain ventricle enlargement via microRNA-dependent mechanisms in mice. Nat Commun 2020; 11:912. [PMID: 32060266 PMCID: PMC7021727 DOI: 10.1038/s41467-020-14628-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/22/2020] [Indexed: 01/11/2023] Open
Abstract
Progressive ventricular enlargement, a key feature of several neurologic and psychiatric diseases, is mediated by unknown mechanisms. Here, using murine models of 22q11-deletion syndrome (22q11DS), which is associated with schizophrenia in humans, we found progressive enlargement of lateral and third ventricles and deceleration of ciliary beating on ependymal cells lining the ventricular walls. The cilia-beating deficit observed in brain slices and in vivo is caused by elevated levels of dopamine receptors (Drd1), which are expressed in motile cilia. Haploinsufficiency of the microRNA-processing gene Dgcr8 results in Drd1 elevation, which is brought about by a reduction in Drd1-targeting microRNAs miR-382-3p and miR-674-3p. Replenishing either microRNA in 22q11DS mice normalizes ciliary beating and ventricular size. Knocking down the microRNAs or deleting their seed sites on Drd1 mimicked the cilia-beating and ventricular deficits. These results suggest that the Dgcr8-miR-382-3p/miR-674-3p-Drd1 mechanism contributes to deceleration of ciliary motility and age-dependent ventricular enlargement in 22q11DS.
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Affiliation(s)
- Tae-Yeon Eom
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Seung Baek Han
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Jieun Kim
- Center for In Vivo Imaging and Therapeutics, Cellular Imaging Shared Resource, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Jay A Blundon
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Yong-Dong Wang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Jing Yu
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Kara Anderson
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Damian B Kaminski
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Sadie Miki Sakurada
- Center for Advanced Genome Engineering, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Shondra M Pruett-Miller
- Center for Advanced Genome Engineering, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Linda Horner
- Cellular Imaging Shared Resource, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Ben Wagner
- Cellular Imaging Shared Resource, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Camenzind G Robinson
- Cellular Imaging Shared Resource, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Matthew Eicholtz
- Electrical and Electronics Systems Research Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
- Department of Computer Science, Florida Southern College, Lakeland, FL, 33801, USA
| | - Derek C Rose
- Electrical and Electronics Systems Research Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - Stanislav S Zakharenko
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
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Abstract
Psychotic disorders are severe, debilitating, and even fatal. The development of targeted and effective interventions for psychosis depends upon on clear understanding of the timing and nature of disease progression to target processes amenable to intervention. Strong evidence suggests early and ongoing neuroprogressive changes, but timing and inflection points remain unclear and likely differ across cognitive, clinical, and brain measures. Additionally, granular evidence across modalities is particularly sparse in the "bridging years" between first episode and established illness-years that may be especially critical for improving outcomes and during which interventions may be maximally effective. Our objective is the systematic, multimodal characterization of neuroprogression through the early course of illness in a cross-diagnostic sample of patients with psychosis. We aim to (1) interrogate neurocognition, structural brain measures, and network connectivity at multiple assessments over the first eight years of illness to map neuroprogressive trajectories, and (2) examine trajectories as predictors of clinical and functional outcomes. We will recruit 192 patients with psychosis and 36 healthy controls. Assessments will occur at baseline and 8- and 16-month follow ups using clinical, cognitive, and imaging measures. We will employ an accelerated longitudinal design (ALD), which permits ascertainment of data across a longer timeframe and at more frequent intervals than would be possible in a single cohort longitudinal study. Results from this study are expected to hasten identification of actionable treatment targets that are closely associated with clinical outcomes, and identify subgroups who share common neuroprogressive trajectories toward the development of individualized treatments.
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Kaleda VG, Bozjko OV, Akhadov TA, Tomyshev AS, Tikhonov DV, Lebedeva IS, Savvateeva NY. [Neuroanatomical brain profile of juvenile shiftlike schizophrenia: morphometry of grey matter in the prefrontal cortex and subcortical structures]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 119:7-11. [PMID: 31626164 DOI: 10.17116/jnevro20191190817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM To determine neuroanatomical peculiarities of grey matter in some regions of the prefrontal cortex and several subcortical structures in patients with juvenile shift like schizophrenia (F20 ICD-10). MATERIAL AND METHODS Forty-three young male patients and 54 mentally healthy men without family history of mental diseases underwent structural MRI with T1 high resolution images. RESULTS As compared to mentally healthy subjects, there was a decrease of grey matter thickness in all tested regions of the prefrontal cortex in patients. No between-group differences in subcortical structures volumes were found. No correlations between structural changes and psychopathological symptoms were observed. CONCLUSION Structural abnormalities of the frontal lobes in juvenile shift like schizophrenia are not associated with severity of psychopathological symptoms.
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Affiliation(s)
- V G Kaleda
- Mental Health Research Center, Moscow, Russia
| | - O V Bozjko
- Mental Health Research Center, Moscow, Russia
| | - T A Akhadov
- Research Institute of emergency child surgery and traumatology, Moscow, Russia
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Magdalon J, Mansur F, Teles E Silva AL, de Goes VA, Reiner O, Sertié AL. Complement System in Brain Architecture and Neurodevelopmental Disorders. Front Neurosci 2020; 14:23. [PMID: 32116493 PMCID: PMC7015047 DOI: 10.3389/fnins.2020.00023] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/10/2020] [Indexed: 01/18/2023] Open
Abstract
Current evidence indicates that certain immune molecules such as components of the complement system are directly involved in neurobiological processes related to brain development, including neurogenesis, neuronal migration, synaptic remodeling, and response to prenatal or early postnatal brain insults. Consequently, complement system dysfunction has been increasingly implicated in disorders of neurodevelopmental origin, such as schizophrenia, autism spectrum disorder (ASD) and Rett syndrome. However, the mechanistic evidence for a causal relationship between impaired complement regulation and these disorders varies depending on the disease involved. Also, it is still unclear to what extent altered complement expression plays a role in these disorders through inflammation-independent or -dependent mechanisms. Furthermore, pathogenic mutations in specific complement components have been implicated in the etiology of 3MC syndrome, a rare autosomal recessive developmental disorder. The aims of this review are to discuss the current knowledge on the roles of the complement system in sculpting brain architecture and function during normal development as well as after specific inflammatory insults, such as maternal immune activation (MIA) during pregnancy, and to evaluate the existing evidence associating aberrant complement with developmental brain disorders.
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Affiliation(s)
- Juliana Magdalon
- Center for Experimental Research, Hospital Israelita Albert Einstein, São Paulo, Brazil.,School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil
| | - Fernanda Mansur
- Center for Experimental Research, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - André Luiz Teles E Silva
- Center for Experimental Research, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, Brazil
| | - Vitor Abreu de Goes
- Center for Experimental Research, Hospital Israelita Albert Einstein, São Paulo, Brazil.,School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil
| | - Orly Reiner
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Andréa Laurato Sertié
- Center for Experimental Research, Hospital Israelita Albert Einstein, São Paulo, Brazil
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187
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Predicting response to electroconvulsive therapy combined with antipsychotics in schizophrenia using multi-parametric magnetic resonance imaging. Schizophr Res 2020; 216:262-271. [PMID: 31826827 DOI: 10.1016/j.schres.2019.11.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/04/2019] [Accepted: 11/25/2019] [Indexed: 12/23/2022]
Abstract
Electroconvulsive therapy (ECT) has been shown to be effective in schizophrenia, particularly when rapid symptom reduction is needed or in cases of resistance to drug treatment. However, there are no markers available to predict response to ECT. Here, we examine whether multi-parametric magnetic resonance imaging (MRI)-based radiomic features can predict response to ECT for individual patients. A total of 57 treatment-resistant schizophrenia patients, or schizophrenia patients with an acute episode or suicide attempts were randomly divided into primary (42 patients) and test (15 patients) cohorts. We collected T1-weighted structural MRI and diffusion MRI for 57 patients before receiving ECT and extracted 600 radiomic features for feature selection and prediction. To predict a continuous improvement in symptoms (ΔPANSS), the prediction process was performed with a support vector regression model based on a leave-one-out cross-validation framework in primary cohort and was tested in test cohort. The multi-parametric MRI-based radiomic model, including four structural MRI feature from left inferior frontal gyrus, right insula, left middle temporal gyrus and right superior temporal gyrus respectively and six diffusion MRI features from tracts connecting frontal or temporal gyrus possessed a low root mean square error of 15.183 in primary cohort and 14.980 in test cohort. The Pearson's correlation coefficients between predicted and actual values were 0.671 and 0.777 respectively. These results demonstrate that multi-parametric MRI-based radiomic features may predict response to ECT for individual patients. Such features could serve as prognostic neuroimaging biomarkers that provide a critical step toward individualized treatment response prediction in schizophrenia.
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188
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Symptomatic psychosis risk and physiological fluctuation in functional MRI data. Schizophr Res 2020; 216:339-346. [PMID: 31810761 DOI: 10.1016/j.schres.2019.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 10/11/2019] [Accepted: 11/19/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Physiological brain pulsations have been shown to play a critical role in maintaining interstitial homeostasis in the glymphatic brain clearance mechanism. We investigated whether psychotic symptomatology is related to the physiological variation of the human brain using fMRI. METHODS The participants (N = 277) were from the Northern Finland Birth Cohort 1986. Psychotic symptoms were evaluated with the Positive Symptoms Scale of the Structured Interview for Prodromal Syndromes (SIPS). We used the coefficient of variation of BOLD signal (CVBOLD) as a proxy for physiological brain pulsatility. The CVBOLD-analyses were controlled for motion, age, sex, and educational level. The results were also compared with fMRI and voxel-based morphometry (VBM) meta-analyses of schizophrenia patients (data from the Brainmap database). RESULTS At the global level, participants with psychotic-like symptoms had higher CVBOLD in cerebrospinal fluid (CSF) and white matter (WM), when compared to participants with no psychotic symptoms. Voxel-wise analyses revealed that CVBOLD was increased, especially in periventricular white matter, basal ganglia, cerebellum and parts of the cortical structures. Those brain regions, which included alterations of physiological fluctuation in symptomatic psychosis risk, overlapped <6% with the regions that were found to be affected in the meta-analyses of previous fMRI and VBM studies in schizophrenia patients. Motion did not vary as a function of SIPS. CONCLUSIONS Psychotic-like symptoms were associated with elevated CVBOLD in a variety of brain regions. The CVBOLD findings may produce new information about cerebral physiological fluctuations that have been out of reach in previous fMRI and VBM studies.
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189
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Anteraper SA, Collin G, Guell X, Scheinert T, Molokotos E, Henriksen MT, Mesholam-Gately R, Thermenos HW, Seidman LJ, Keshavan MS, Gabrieli JDE, Whitfield-Gabrieli S. Altered resting-state functional connectivity in young children at familial high risk for psychotic illness: A preliminary study. Schizophr Res 2020; 216:496-503. [PMID: 31801673 PMCID: PMC7239744 DOI: 10.1016/j.schres.2019.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 01/05/2023]
Abstract
Multiple lines of evidence suggest that illness development in schizophrenia and other psychotic disorders predates the first psychotic episode by many years. In this study, we examined a sample of 15 pre-adolescent children, ages 7 through 12 years, who are at familial high-risk (FHR) because they have a parent or sibling with a history of schizophrenia or related psychotic disorder. Using multi-voxel pattern analysis (MVPA), a data-driven fMRI analysis, we assessed whole-brain differences in functional connectivity in the FHR sample as compared to an age- and sex-matched control (CON) group of 15 children without a family history of psychosis. MVPA analysis yielded a single cluster in right posterior superior temporal gyrus (pSTG/BA 22) showing significant group-differences in functional connectivity. Post-hoc characterization of this cluster through seed-to-voxel analysis revealed mostly reduced functional connectivity of the pSTG seed to a set of language and default mode network (DMN) associated brain regions including Heschl's gyrus, inferior temporal gyrus extending into fusiform gyrus, (para)hippocampus, thalamus, and a cerebellar cluster encompassing mainly Crus I/II. A height-threshold of whole-brain p < .001 (two-sided), and FDR-corrected cluster-threshold of p < .05 (non-parametric statistics) was used for post-hoc characterization. These findings suggest that abnormalities in functional communication in a network encompassing right STG and associated brain regions are present before adolescence in at-risk children and may be a risk marker for psychosis. Subsequent changes in this functional network across development may contribute to either disease manifestation or resilience in children with a familial vulnerability for psychosis.
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Affiliation(s)
- Sheeba Arnold Anteraper
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychology, Northeastern University, Boston, MA, USA; Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, MA, USA.
| | - Guusje Collin
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Corresponding author
| | - Xavier Guell
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Timothy Scheinert
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Elena Molokotos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Maria Toft Henriksen
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Raquelle Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Heidi W. Thermenos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - John D. E. Gabrieli
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Susan Whitfield-Gabrieli
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Psychology, Northeastern University, Boston, MA, USA
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190
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Zhang Y, Dai Z, Chen Y, Sim K, Sun Y, Yu R. Altered intra- and inter-hemispheric functional dysconnectivity in schizophrenia. Brain Imaging Behav 2020; 13:1220-1235. [PMID: 30094555 DOI: 10.1007/s11682-018-9935-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Despite convergent evidence suggesting that schizophrenia is a disorder of brain dysconnectivity, it remains unclear whether intra- or inter-hemispheric deficits or their combination underlie the dysconnection. This study examined the source of the functional dysconnection in schizophrenia. Resting-state fMRI was performed in 66 patients with schizophrenia and 73 matched healthy controls. Functional brain networks were constructed for each participant and further partitioned into intra- and inter-hemispheric connections. We examined how schizophrenia altered the intra-hemispheric topological properties and the inter-hemispheric nodal strength. Although several subcortical and cingulate regions exhibited hemispheric-independent aberrations of regional efficiency, the optimal small-world properties in the hemispheric networks and their lateralization were preserved in patients. A significant deficit in the inter-hemispheric connectivity was revealed in most of the hub regions, leading to an inter-hemispheric hypo-connectivity pattern in patients. These abnormal intra- and inter-hemispheric network organizations were associated with the clinical features of schizophrenia. The patients in the present study received different medications. These findings provide new insights into the nature of dysconnectivity in schizophrenia, highlighting the dissociable processes between the preserved intra-hemispheric network topology and altered inter-hemispheric functional connectivity.
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Affiliation(s)
- Yuan Zhang
- Key Laboratory for Biomedical Engineering of the Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Zhejiang, 310000, China.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Zhongxiang Dai
- Department of Computer Science, National University of Singapore, Singapore, Singapore
| | - Yu Chen
- School of Computer Engineering, Nanyang Technological University, Singapore, Singapore
| | - Kang Sim
- Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore.,Department of Research, Institute of Mental Health, Singapore, Singapore
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of the Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Zhejiang, 310000, China.
| | - Rongjun Yu
- Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore, 117570, Singapore. .,Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore.
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191
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Gifford G, Crossley N, Kempton MJ, Morgan S, Dazzan P, Young J, McGuire P. Resting state fMRI based multilayer network configuration in patients with schizophrenia. Neuroimage Clin 2020; 25:102169. [PMID: 32032819 PMCID: PMC7005505 DOI: 10.1016/j.nicl.2020.102169] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/18/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023]
Abstract
Novel methods for measuring large-scale dynamic brain organisation are needed to provide new biomarkers of schizophrenia. Using a method for modelling dynamic modular organisation (Mucha et al., 2010), evidence suggests higher 'flexibility' (switching between multilayer network communities) to be a feature of schizophrenia (Braun et al., 2016). The current study compared flexibility between 55 patients with schizophrenia and 72 controls (the COBRE Dataset). In addition, novel methods of 'between resting state network synchronisation' (BRSNS) and the probability of transition from one community to another were used to further describe group differences in dynamic community structure. There was significantly higher schizophrenia group flexibility scores in cerebellar (F (1124) = 9.33, p (FDR) = 0.017), subcortical (F (1124) = 13.14, p (FDR) = 0.005), and fronto-parietal task control (F (1124) = 7.19, p (FDR) = 0.033) resting state networks (RSNs), as well as in the left thalamus (MNI XYZ: -2, -13, 12; F(1, 124) = 17.1, p (FDR) < 0.001) and the right crus I (MNI XYZ: 35, -67, -34; F (1, 124) = 19.65, p (FDR) < 0.001). Flexibility in the left thalamus reflected transitions between communities covering default mode and sensory-somatomotor RSNs. BRSNS scores suggested altered dynamic inter-RSN modular configuration in schizophrenia. This study suggests less stable community structure in a schizophrenia group at an RSN and node level and provides novel methods of exploring dynamic community structure. Mediation of group differences by mean time window correlation did however suggest flexibility to be no better as a schizophrenia biomarker than simpler measures and a range of methodological choices affected results.
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Affiliation(s)
- George Gifford
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.
| | - Nicolas Crossley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago 8330077, Chile
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Sarah Morgan
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK; The Alan Turing Institute, London NW1 2DB, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Jonathan Young
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
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192
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Nemoto K, Shimokawa T, Fukunaga M, Yamashita F, Tamura M, Yamamori H, Yasuda Y, Azechi H, Kudo N, Watanabe Y, Kido M, Takahashi T, Koike S, Okada N, Hirano Y, Onitsuka T, Yamasue H, Suzuki M, Kasai K, Hashimoto R, Arai T. Differentiation of schizophrenia using structural MRI with consideration of scanner differences: A real-world multisite study. Psychiatry Clin Neurosci 2020; 74:56-63. [PMID: 31587444 PMCID: PMC6972978 DOI: 10.1111/pcn.12934] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/07/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022]
Abstract
AIM Neuroimaging studies have revealed that patients with schizophrenia exhibit reduced gray matter volume in various regions. With these findings, various studies have indicated that structural MRI can be useful for the diagnosis of schizophrenia. However, multisite studies are limited. Here, we evaluated a simple model that could be used to differentiate schizophrenia from control subjects considering MRI scanner differences employing voxel-based morphometry. METHODS Subjects were 541 patients with schizophrenia and 1252 healthy volunteers. Among them, 95 patients and 95 controls (Dataset A) were used for the generation of regions of interest (ROI), and the rest (Dataset B) were used to evaluate our method. The two datasets were comprised of different subjects. Three-dimensional T1-weighted MRI scans were taken for all subjects and gray-matter images were extracted. To differentiate schizophrenia, we generated ROI for schizophrenia from Dataset A. Then, we determined volume within the ROI for each subject from Dataset B. Using the extracted volume data, we calculated a differentiation feature considering age, sex, and intracranial volume for each MRI scanner. Receiver-operator curve analyses were performed to evaluate the differentiation feature. RESULTS The area under the curve ranged from 0.74 to 0.84, with accuracy from 69% to 76%. Receiver-operator curve analysis with all samples revealed an area under the curve of 0.76 and an accuracy of 73%. CONCLUSION We moderately successfully differentiated schizophrenia from control using structural MRI from differing scanners from multiple sites. This could be useful for applying neuroimaging techniques to clinical settings for the accurate diagnosis of schizophrenia.
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Affiliation(s)
- Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuya Shimokawa
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Masashi Tamura
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hidenaga Yamamori
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Japan Community Health Care Organization, Osaka Hospital, Osaka, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Life Grow Brilliant Mental Clinic, Osaka, Japan
| | - Hirotsugu Azechi
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Noriko Kudo
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Yoshiyuki Watanabe
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shinsuke Koike
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behavior (CiSHuB), The University of Tokyo, Tokyo, Japan
| | - Naohiro Okada
- The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiaki Onitsuka
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kiyoto Kasai
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behavior (CiSHuB), The University of Tokyo, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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193
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Kutepov IE, Dobriyan VV, Zhigalov MV, Stepanov MF, Krysko AV, Yakovleva TV, Krysko VA. EEG analysis in patients with schizophrenia based on Lyapunov exponents. INFORMATICS IN MEDICINE UNLOCKED 2020. [DOI: 10.1016/j.imu.2020.100289] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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194
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195
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Shao X, Yan C, Sun D, Fu C, Tian C, Duan L, Zhu G. Association Between Glutathione Peroxidase-1 (GPx-1) Polymorphisms and Schizophrenia in the Chinese Han Population. Neuropsychiatr Dis Treat 2020; 16:2297-2305. [PMID: 33116528 PMCID: PMC7547781 DOI: 10.2147/ndt.s272278] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/07/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The dopamine and oxidative stress hypotheses are leading theories of the pathoetiology of schizophrenia (SCZ). Glutathione Peroxidase 1 (GPx-1), a major antioxidant enzyme, and the most abundantly expressed member of the GPx family, plays an important role in metabolic dopamine changes, which are closely related to neurological and psychiatric disorders. The impact of GPx-1 polymorphisms has rarely been explored in the field of SCZ. Here, we explored the possible relationship between GPx-1 gene polymorphisms and SCZ in Chinese Han subjects by using the polymerase chain reaction-restriction fragment length polymorphism method. METHODS DNA from 786 patients (360 patients with schizophrenia and 426 healthy controls) was genotyped for the single-nucleotide polymorphisms rs1800668 C/T and rs1050450 C/T in GPx-1 using polymerase chain reaction-restriction fragment length polymorphism analysis. Analysis of the association between GPx-1 and SCZ was performed using SPSS 22.0, while Haploview 4.2 software and SHEsis software were used to perform linkage disequilibrium analysis and haplotype analysis. RESULTS The results indicated that the GPx-1 polymorphisms rs1050450 and rs1800668 were associated with SCZ. We found that the C-allele of rs1800668 C/T may be a protection factor against SCZ in general, but in particular, for males. Furthermore, the CT and TC (GPx-1 rs1800668 C/T and rs1050450 C/T) haplotypes may be susceptible to SCZ in the population. Finally, no significant differences in allelic or genotypic frequencies of rs1050450 were detected between cases and controls from whole or stratification analyses by gender. CONCLUSION GPx-1 polymorphisms are related to SCZ in Chinese Han subjects. Our results suggested that GPx-1 may be a potential gene that influences SCZ.
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Affiliation(s)
- Xiaojun Shao
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Ci Yan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Dongxue Sun
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Chunfeng Fu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Chunsheng Tian
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Li Duan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Gang Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China.,Central Laboratory, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China
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196
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Driver DI, Thomas S, Gogtay N, Rapoport JL. Childhood-Onset Schizophrenia and Early-onset Schizophrenia Spectrum Disorders: An Update. Child Adolesc Psychiatr Clin N Am 2020; 29:71-90. [PMID: 31708054 DOI: 10.1016/j.chc.2019.08.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The clinical severity, impact on development, and poor prognosis of childhood-onset schizophrenia may represent a more homogeneous group. Positive symptoms in children are necessary for the diagnosis, and hallucinations are more often multimodal. In healthy children and children with a variety of other psychiatric illnesses, hallucinations are not uncommon and diagnosis should not be based on these alone. Childhood-onset schizophrenia is an extraordinarily rare illness that is poorly understood but seems continuous with the adult-onset disorder. Once a diagnosis is confirmed, aggressive medication treatment combined with family education and individual counseling may prevent further deterioration.
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Affiliation(s)
- David I Driver
- Child Psychiatry Branch, National Institutes of Mental Health (NIMH), National Institutes Health (NIH), Building 10, Room 4N313C, 10 Center Drive, Bethesda, MD 20814, USA.
| | - Shari Thomas
- Healthy Foundations Group, 4350 East West Highway, Suite 200, Bethesda, Maryland 20814, USA
| | - Nitin Gogtay
- National Institutes Health (NIH), NSC Building, Room 6104, 6001 Executive Boulevard, Rockville, MD 20852, USA
| | - Judith L Rapoport
- National Institutes Health (NIH), Building 10-CRC, Room 6-5332, 10 Center Drive, Bethesda, MD 20814, USA
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197
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Abstract
Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia. The consistent sex differences found, such as onset age, generic brain anomalies, and hormonal involvement, are not specific to schizophrenia or necessarily to psychopathology. It is suggested that in working with those diagnosed as meeting the current criteria for schizophrenia, clinicians adopt a transdiagnostic framework informed by sex and gender role processes.
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Affiliation(s)
- Richard Lewine
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States.
| | - Mara Hart
- Department of Psychiatry, Worcester Recovery Center and Hospital, Worcester, MA, United States
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198
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Oh J, Oh BL, Lee KU, Chae JH, Yun K. Identifying Schizophrenia Using Structural MRI With a Deep Learning Algorithm. Front Psychiatry 2020; 11:16. [PMID: 32116837 PMCID: PMC7008229 DOI: 10.3389/fpsyt.2020.00016] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/08/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Although distinctive structural abnormalities occur in patients with schizophrenia, detecting schizophrenia with magnetic resonance imaging (MRI) remains challenging. This study aimed to detect schizophrenia in structural MRI data sets using a trained deep learning algorithm. METHOD Five public MRI data sets (BrainGluSchi, COBRE, MCICShare, NMorphCH, and NUSDAST) from schizophrenia patients and normal subjects, for a total of 873 structural MRI data sets, were used to train a deep convolutional neural network. RESULTS The deep learning algorithm trained with structural MR images detected schizophrenia in randomly selected images with reliable performance (area under the receiver operating characteristic curve [AUC] of 0.96). The algorithm could also identify MR images from schizophrenia patients in a previously unencountered data set with an AUC of 0.71 to 0.90. The deep learning algorithm's classification performance degraded to an AUC of 0.71 when a new data set with younger patients and a shorter duration of illness than the training data sets was presented. The brain region contributing the most to the performance of the algorithm was the right temporal area, followed by the right parietal area. Semitrained clinical specialists hardly discriminated schizophrenia patients from healthy controls (AUC: 0.61) in the set of 100 randomly selected brain images. CONCLUSIONS The deep learning algorithm showed good performance in detecting schizophrenia and identified relevant structural features from structural brain MRI data; it had an acceptable classification performance in a separate group of patients at an earlier stage of the disease. Deep learning can be used to delineate the structural characteristics of schizophrenia and to provide supplementary diagnostic information in clinical settings.
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Affiliation(s)
- Jihoon Oh
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Baek-Lok Oh
- Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | - Kyong-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyongsik Yun
- Computation and Neural Systems, California Institute of Technology, Pasadena, CA, United States.,Bio-Inspired Technologies and Systems, Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, United States
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Brusov OS, Karpova NS, Faktor MI, Sizov SV, Oleichik IV. [Reduction of plasma procoagulant activity in patients with schizophrenia during pharmacotherapy: thrombodynamic parameters of coagulation before and after treatment]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:51-55. [PMID: 31793543 DOI: 10.17116/jnevro201911910151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM To detect plasma procoagulant activity in patients with schizophrenia at admission to the hospital in a state of exacerbation before (point 1) and after (point 2) pharmacotherapy and evaluate plasma and platelet hemostasis abnormalities. MATERIAL AND METHODS The study included 80 women, aged from 16 to 57 years, median age 28 years, with schizophrenia with continuous, paroxysmal-progressive or paroxysmal course (F20.00, F20.01, F20.02 according to ICD-10). In 42 of 80 patients, depressive disorders in the structure of schizophrenia were observed. The thrombodynamic test (TD) was performed on T-2 Trombodynamis device according to the manufacturer's instructions (Hemacore LLC, Moscow, Russia). Blood for the TD test was taken in admission to the hospital (point 1) and on discharge (point 2). All patients received standard pharmacotherapy according to their condition. RESULTS For the first time, it was established that in the whole group of patients (n=46) thrombodynamic indicators of the rate of growth of the clot: initial velocity (Vin), stationary velocity (Vst) and adjusted for spontaneous clots velocity (V) and the amount of clot for 30 minutes test TD (ClotSize, CS) were significantly higher compared to normal values. The mean time of occurrence of spontaneous thrombosis (Tsp) was significantly less than 30 min (p<0.0001), indicating rapid, spontaneous thrombosis. Other parameters of TD did not differ significantly from the norm. As a result of treatment, the initial growth rate of the clot from the activator (Vi) decreased from 58,5 μm/min to 54,5 μm/min; V speed from 37,4 μm/min to 33,5 μm/min; CS clot size from 1249 μm to 1219 μm; clot density - from 24 874 units up to 23 658 units. All these changes are significant. Such dynamics of plasma hemostasis clearly indicates a significant decrease in the coagulation activity of the blood plasma of patients as a result of treatment. An increase in the time of appearance of spontaneous clots after treatment (from 23.5 minutes to 30.5 minutes) indicates a decrease in the procoagulant activity of platelet microparticles after treatment, i.e. the reduction of platelet activation as a result of treatment. CONCLUSION Our studies have shown for the first time that treatment of patients with antidepressants and antipsychotics reduces the generation of spontaneous clots. The treatment of patients with schizophrenia is accompanied by a decrease in the activity of plasma and platelet hemostasis. This is of great practical importance, since hypercoagulation of spontaneous clots in schizophrenic patients aggravates their chronic inflammatory disorders and affects their resistance to treatment.
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Affiliation(s)
- O S Brusov
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - N S Karpova
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - M I Faktor
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - S V Sizov
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - I V Oleichik
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
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The effect of second-generation antipsychotics on basal ganglia and thalamus in first-episode psychosis patients. Eur Neuropsychopharmacol 2019; 29:1408-1418. [PMID: 31708330 DOI: 10.1016/j.euroneuro.2019.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/29/2019] [Accepted: 10/15/2019] [Indexed: 01/14/2023]
Abstract
Patients who have recently experienced a first of episode psychosis (FEP) exhibit considerable heterogeneity in subcortical brain volumes. These results become even more divergent when exploring the effect of antipsychotic medication among other clinical and cognitive features. We aimed to contrast volumetric measures in basal ganglia and thalamus in patients with a FEP treated with different second-generation antipsychotics. T1-weighted magnetic resonance images were obtained and subcortical structures were extracted with MAGeT-Brain. Relationships with cognitive functioning were also explored with a Global Cognitive Index obtained, on average, within one month from the scan. Subgroups included: risperidone (n = 26), aripiprazole (n = 22), olanzapine (n = 19) and controls (n = 80). The olanzapine subgroup displayed significant enlargement of the right globus pallidus volume compared with all other groups. Moreover, despite not exhibiting poorer cognitive capacity than the rest of patients, results from a stepwise multiple-regression linear regression analysis identified a significant negative association between right globus pallidus volume and scores on the Global Cognitive Index among these patients. To our knowledge, this is the first study to associate treatment with olanzapine with an increase in globus pallidus volume in a sample of FEP patients with a relatively short time of antipsychotic monotherapy. Such enlargement was also found to be associated with poorer global cognitive functioning. Exploration of the biological underpinnings of this early medication-induced enlargement should be the focus of future investigations since it may lend insight towards achieving a better clinical outcome for these patients.
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