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Fang J, Cai R, Hu Y, Wang Y, Ling Y, Lv Y, Fang X, Zhang X, Zhou C. Aberrant brain functional connectivity mediates the effects of negative symptoms on cognitive function in schizophrenia: A structural equation model. J Psychiatr Res 2024; 177:109-117. [PMID: 39004002 DOI: 10.1016/j.jpsychires.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Schizophrenia is a severe psychiatric disorder, characterized by positive symptoms, negative symptoms, and cognitive deficits. Elucidating the mechanism of negative symptom and cognitive deficits could contribute to the treatment and prognosis of schizophrenia. We hypothesized that abnormal functional connectivity would be involved in the indirect effects of negative symptoms on cognitive function. METHODS A total of 150 schizophrenia male patients and 108 healthy controls matched for age, education and gender were enrolled in the study. The scores of Brief Negative Symptom Scale were divided into two factors: motivation and pleasure deficits (MAP) and diminished expression (EXP). Subsequently, a series of classic neurocognitive tests were used to evaluate cognitive functions. Resting-state fMRI data was collected from all participants. The Anatomical Automatic Labeling template was employed to establish regions of interest, thereby constructing the functional connectivity network across the entire brain. Eventually, scores of patients' negative symptoms scale, cognitive function, and strengths of abnormal functional connectivity were incorporated into a structural equation model to explore the interactions among variables. RESULTS MAP exhibited a distinctly and significantly negative impact on cognitive function. The functional connectivity between the left insula and left precuneus, along with that between the left precuneus and right angular gyrus, collectively served as intermediaries, contributing to the indirect effects of MAP and EXP on cognitive function. CONCLUSIONS Our findings demonstrated the moderating role of aberrant brain functional connectivity between negative symptoms and cognitive function, providing clues about the neural correlates of negative symptoms and cognitive deficits in schizophrenia.
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Affiliation(s)
- Jin Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Renliang Cai
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yunshan Hu
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yu Wang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yuru Ling
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yiding Lv
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xinyu Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
| | - Chao Zhou
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
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Chen CS, Vinogradov S. Personalized Cognitive Health in Psychiatry: Current State and the Promise of Computational Methods. Schizophr Bull 2024:sbae108. [PMID: 38934792 DOI: 10.1093/schbul/sbae108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
BACKGROUND Decades of research have firmly established that cognitive health and cognitive treatment services are a key need for people living with psychosis. However, many current clinical programs do not address this need, despite the essential role that an individual's cognitive and social cognitive capacities play in determining their real-world functioning. Preliminary practice-based research in the Early Psychosis Intervention Network early psychosis intervention network shows that it is possible to develop and implement tools that delineate an individuals' cognitive health profile and that help engage the client and the clinician in shared decision-making and treatment planning that includes cognitive treatments. These findings signify a promising shift toward personalized cognitive health. STUDY DESIGN Extending upon this early progress, we review the concept of interindividual variability in cognitive domains/processes in psychosis as the basis for offering personalized treatment plans. We present evidence from studies that have used traditional neuropsychological measures as well as findings from emerging computational studies that leverage trial-by-trial behavior data to illuminate the different latent strategies that individuals employ. STUDY RESULT We posit that these computational techniques, when combined with traditional cognitive assessments, can enrich our understanding of individual differences in treatment needs, which in turn can guide evermore personalized interventions. CONCLUSION As we find clinically relevant ways to decompose maladaptive behaviors into separate latent cognitive elements captured by model parameters, the ultimate goal is to develop and implement approaches that empower clients and their clinical providers to leverage individual's existing learning capacities to improve their cognitive health and well-being.
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Affiliation(s)
- Cathy S Chen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sophia Vinogradov
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
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Black T, Jenkins BW, Laprairie RB, Howland JG. Therapeutic potential of gamma entrainment using sensory stimulation for cognitive symptoms associated with schizophrenia. Neurosci Biobehav Rev 2024; 161:105681. [PMID: 38641090 DOI: 10.1016/j.neubiorev.2024.105681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/27/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
Schizophrenia is a complex neuropsychiatric disorder with significant morbidity. Treatment options that address the spectrum of symptoms are limited, highlighting the need for innovative therapeutic approaches. Gamma Entrainment Using Sensory Stimulation (GENUS) is an emerging treatment for neuropsychiatric disorders that uses sensory stimulation to entrain impaired oscillatory network activity and restore brain function. Aberrant oscillatory activity often underlies the symptoms experienced by patients with schizophrenia. We propose that GENUS has therapeutic potential for schizophrenia. This paper reviews the current status of schizophrenia treatment and explores the use of sensory stimulation as an adjunctive treatment, specifically through gamma entrainment. Impaired gamma frequency entrainment is observed in patients, particularly in response to auditory and visual stimuli. Thus, sensory stimulation, such as music listening, may have therapeutic potential for individuals with schizophrenia. GENUS holds novel therapeutic potential to improve the lives of individuals with schizophrenia, but further research is required to determine the efficacy of GENUS, optimize its delivery and therapeutic window, and develop strategies for its implementation in specific patient populations.
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Affiliation(s)
- Tallan Black
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Bryan W Jenkins
- Division of Behavioral Biology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Robert B Laprairie
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada; Department of Pharmacology, College of Medicine, Dalhousie University, Halifax, NS, Canada
| | - John G Howland
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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de la Salle S, Choueiry J, Payumo M, Devlin M, Noel C, Abozmal A, Hyde M, Baysarowich R, Duncan B, Knott V. Transcranial Alternating Current Stimulation Alters Auditory Steady-State Oscillatory Rhythms and Their Cross-Frequency Couplings. Clin EEG Neurosci 2024; 55:329-339. [PMID: 37306065 PMCID: PMC11020127 DOI: 10.1177/15500594231179679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/02/2023] [Indexed: 06/13/2023]
Abstract
Auditory cortical plasticity deficits in schizophrenia are evidenced with electroencephalographic (EEG)-derived biomarkers, including the 40-Hz auditory steady-state response (ASSR). Aiming to understand the underlying oscillatory mechanisms contributing to the 40-Hz ASSR, we examined its response to transcranial alternating current stimulation (tACS) applied bilaterally to the temporal lobe of 23 healthy participants. Although not responding to gamma tACS, the 40-Hz ASSR was modulated by theta tACS (vs sham tACS), with reductions in gamma power and phase locking being accompanied by increases in theta-gamma phase-amplitude cross-frequency coupling. Results reveal that oscillatory changes induced by frequency-tuned tACS may be one approach for targeting and modulating auditory plasticity in normal and diseased brains.
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Affiliation(s)
- Sara de la Salle
- Clinical Neuroelectrophysiology and Cognitive Research, The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- Faculty of Medicine, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Joëlle Choueiry
- Clinical Neuroelectrophysiology and Cognitive Research, The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mark Payumo
- School of Psychology, Carleton University, Ottawa, ON, Canada
| | - Matt Devlin
- Faculty of Medicine, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Chelsea Noel
- Faculty of Medicine, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Ali Abozmal
- Faculty of Medicine, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Molly Hyde
- Clinical Neuroelectrophysiology and Cognitive Research, The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Renée Baysarowich
- Clinical Neuroelectrophysiology and Cognitive Research, The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Brittany Duncan
- Clinical Neuroelectrophysiology and Cognitive Research, The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
| | - Verner Knott
- Clinical Neuroelectrophysiology and Cognitive Research, The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- Faculty of Medicine, School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Psychology, Carleton University, Ottawa, ON, Canada
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5
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Li X, Wei W, Wang Q, Deng W, Li M, Ma X, Zeng J, Zhao L, Guo W, Hall MH, Li T. Identify Potential Causal Relationships Between Cortical Thickness, Mismatch Negativity, Neurocognition, and Psychosocial Functioning in Drug-Naïve First-Episode Psychosis Patients. Schizophr Bull 2024:sbae026. [PMID: 38635296 DOI: 10.1093/schbul/sbae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Cortical thickness (CT) alterations, mismatch negativity (MMN) reductions, and cognitive deficits are robust findings in first-episode psychosis (FEP). However, most studies focused on medicated patients, leaving gaps in our understanding of the interrelationships between CT, MMN, neurocognition, and psychosocial functioning in unmedicated FEP. This study aimed to employ multiple mediation analysis to investigate potential pathways among these variables in unmedicated drug-naïve FEP. METHODS We enrolled 28 drug-naïve FEP and 34 age and sex-matched healthy controls. Clinical symptoms, neurocognition, psychosocial functioning, auditory duration MMN, and T1 structural magnetic resonance imaging data were collected. We measured CT in the superior temporal gyrus (STG), a primary MMN-generating region. RESULTS We found a significant negative correlation between MMN amplitude and bilateral CT of STG (CT_STG) in FEP (left: r = -.709, P < .001; right: r = -.612, P = .008). Multiple mediation models revealed that a thinner left STG cortex affected functioning through both direct (24.66%) and indirect effects (75.34%). In contrast, the effects of the right CT_STG on functioning were mainly mediated through MMN and neurocognitive pathways. CONCLUSIONS Bilateral CT_STG showed significant association with MMN, and MMN plays a mediating role between CT and cognition. Both MMN alone and its interaction with cognition mediated the effects of structural alterations on psychosocial function. The decline in overall function in FEP may stem from decreased CT_STG, leading to subsequent MMN deficits and neurocognitive dysfunction. These findings underline the crucial role of MMN in elucidating how subtle structural alterations can impact neurocognition and psychosocial function in FEP.
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Affiliation(s)
- Xiaojing Li
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Wei Wei
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Wei Deng
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Mingli Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Jinkun Zeng
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Wanjun Guo
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Mei-Hua Hall
- Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Tao Li
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
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Molina JL, Joshi YB, Nungaray JA, Sprock J, Attarha M, Biagianti B, Thomas ML, Swerdlow NR, Light GA. Early auditory processing abnormalities alter individual learning trajectories and sensitivity to computerized cognitive training in schizophrenia. Psychol Med 2024:1-8. [PMID: 38587021 DOI: 10.1017/s0033291724000783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND Auditory system plasticity is a promising target for neuromodulation, cognitive rehabilitation and therapeutic development in schizophrenia (SZ). Auditory-based targeted cognitive training (TCT) is a 'bottom up' intervention designed to enhance the speed and accuracy of auditory information processing, which has been shown to improve neurocognition in certain SZ patients. However, the dynamics of TCT learning as a function of training exercises and their impact on neurocognitive functioning and therapeutic outcomes are unknown. METHODS Forty subjects (SZ, n = 21; healthy subjects (HS), n = 19) underwent comprehensive clinical, cognitive, and auditory assessments, including measurements of auditory processing speed (APS) at baseline and after 1-h of TCT. SZ patients additionally completed 30-hours of TCT and repeated assessments ~10-12 weeks later. RESULTS SZ patients were deficient in APS at baseline (d = 0.96, p < 0.005) relative to HS. After 1-h of TCT, analyses revealed significant main effects of diagnosis (d = 1.75, p = 0.002) and time (d = 1.04, p < 0.001), and a diagnosis × time interaction (d = 0.85, p = 0.02) on APS. APS learning effects were robust after 1-h in SZ patients (d = 1.47, p < 0.001) and persisted throughout the 30-h of training. Baseline APS was associated with verbal learning gains after 30-h of TCT (r = 0.51, p = 0.02) in SZ. CONCLUSIONS TCT learning metrics may have prognostic utility and aid in the prospective identification of individuals likely to benefit from TCT. Future experimental medicine studies may advance predictive algorithms that enhance TCT-related clinical, cognitive and functional outcomes.
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Affiliation(s)
- Juan L Molina
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Yash B Joshi
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - John A Nungaray
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Joyce Sprock
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Mouna Attarha
- Department of R&D, Posit Science Corporation, San Francisco, CA, USA
| | - Bruno Biagianti
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
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Dondé C, Fivel L, Haesebaert F, Poulet E, Mondino M, Brunelin J. Mechanistic account of the left auditory cortex for tone-matching in schizophrenia: A pilot transcranial random noise stimulation (tRNS) sham-controlled study. Asian J Psychiatr 2024; 92:103879. [PMID: 38157711 DOI: 10.1016/j.ajp.2023.103879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Deficits in the ability to match tones following brief delay and their contribution to higher-order cognitive alterations have been repeatedly documented in schizophrenia. The aim was to explore if left fronto-temporal high-frequency transcranial random noise stimulation (hf-tRNS), with electrodes placed over brain regions involved in tone-matching would significantly modulate performances in participants with schizophrenia. METHODS In a randomized, double-blind sham-controlled study, 10 participants with schizophrenia were allocated to receive ten sessions of either active or sham hf-tRNS. The anode was placed over the left prefrontal cortex and the cathode over the left temporoparietal junction. A tone-matching task was administered before and after the hf-tRNS. RESULTS We calculated the changes in tone-matching performance before and after hf-tRNS session in each group. A significant between-group difference was observed for the difficult tone-matching conditions (W= 14.500, p = 0.032), with tone-matching improvement in the sham group and no improvement in the active group. DISCUSSION hf-tRNS could disrupt the test-retest learning effect in the tone-matching task in individuals with schizophrenia. It is likely that this disruption resulted from cathodal-induced inhibition of the functional coupling between auditory cortical areas that correlates with tone-matching performance in patients. CONCLUSION The findings contribute to our understanding of hf-tRNS effects on early auditory processing in schizophrenia.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, Grenoble institute Neurosciences, F-38000 Grenoble, France; Adult Psychiatry Department, University Hospital Grenoble Alpes, F-38000 Grenoble, France.
| | - Laure Fivel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Fréderic Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Emmanuel Poulet
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Jérôme Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, F-69500 Bron, France; Centre Hospitalier Le Vinatier, F-69500 Bron, France.
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Meiron O, Yaniv A, Rozenberg S, David J. Transcranial direct-current stimulation of the prefrontal cortex enhances working memory and suppresses pathological gamma power elevation in schizophrenia. Expert Rev Neurother 2024; 24:217-226. [PMID: 38084398 DOI: 10.1080/14737175.2023.2294150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/07/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND This investigation examines the clinical benefits of prefrontal cortex transcranial direct current stimulation (tDCS) treatment of working memory (WM) dysfunction in chronic schizophrenia patients. RESEARCH DESIGN AND METHODS 34 schizophrenia (SZ) patients were evaluated at baseline, and 29 patients were randomly assigned to either active tDCS intervention or sham tDCS intervention. tDCS intervention applied 10 consecutive sessions (20 minutes, 2 mA, two sessions a day) over 5 days. WM performance (N = 25), symptom severity (N = 29), and resting EEG (N = 17) were assessed from pre- to post-tDCS intervention. Additionally, symptom severity was noted over a 12-week follow-up period. RESULTS WM accuracy significantly improved in the active tDCS group while WM accuracy in the sham tDCS group was unchanged. Significant symptom-severity reduction was sustained for one week after active tDCS intervention. Sustained resting gamma stability (RGS) was noted from baseline to post tDCS in the active-treatment group versus a significant elevation in pathological gamma power in the sham-tDCS group. CONCLUSIONS Examining treatment effects on RGS in SZ could be critical in identifying effective novel treatment strategies that promote left-DLPFC excitability and enhance WM functioning. Further empirical support is warranted to support the clinical benefits over longer periods of time. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04637724. ETHICS APPROVAL REGISTRATION NO 337-19.
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Affiliation(s)
- Oded Meiron
- The Faculty of Education, Bar-Ilan University, Ramat Gan, Israel
- The Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
| | - Asaf Yaniv
- The Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
| | - Sylvie Rozenberg
- Community Mental Health Center, Herzog Medical Center, Jerusalem, Israel
| | - Jonathan David
- The Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
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Fujitani S, Kunii N, Nagata K, Takasago M, Shimada S, Tada M, Kirihara K, Komatsu M, Uka T, Kasai K, Saito N. Auditory prediction and prediction error responses evoked through a novel cascade roving paradigm: a human ECoG study. Cereb Cortex 2024; 34:bhad508. [PMID: 38183184 DOI: 10.1093/cercor/bhad508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 01/07/2024] Open
Abstract
Auditory sensory processing is assumed to occur in a hierarchical structure including the primary auditory cortex (A1), superior temporal gyrus, and frontal areas. These areas are postulated to generate predictions for incoming stimuli, creating an internal model of the surrounding environment. Previous studies on mismatch negativity have indicated the involvement of the superior temporal gyrus in this processing, whereas reports have been mixed regarding the contribution of the frontal cortex. We designed a novel auditory paradigm, the "cascade roving" paradigm, which incorporated complex structures (cascade sequences) into a roving paradigm. We analyzed electrocorticography data from six patients with refractory epilepsy who passively listened to this novel auditory paradigm and detected responses to deviants mainly in the superior temporal gyrus and inferior frontal gyrus. Notably, the inferior frontal gyrus exhibited broader distribution and sustained duration of deviant-elicited responses, seemingly differing in spatio-temporal characteristics from the prediction error responses observed in the superior temporal gyrus, compared with conventional oddball paradigms performed on the same participants. Moreover, we observed that the deviant responses were enhanced through stimulus repetition in the high-gamma range mainly in the superior temporal gyrus. These features of the novel paradigm may aid in our understanding of auditory predictive coding.
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Affiliation(s)
- Shigeta Fujitani
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Naoto Kunii
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
- Department of Neurosurgery, Jichi Medical University, Shimotsuke 329-0498, Japan
| | - Keisuke Nagata
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Megumi Takasago
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Seijiro Shimada
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
- Office for Mental Health Support, Center for Research on Counseling and Support Services, The University of Tokyo, Tokyo 113-0033, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
- Disability Services Office, The University of Tokyo, Tokyo 113-0033, Japan
| | - Misako Komatsu
- Institution of Innovative Research, Tokyo Institute of Technology, Tokyo 226-8503, Japan
- Laboratory for Molecular Analysis of Higher Brain Function, Center for Brain Science, RIKEN, Saitama 351-0198, Japan
| | - Takanori Uka
- Department of Integrative Physiology, Graduate School of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
- International Research Center for Neurointelligence at University of Tokyo Institutes for Advanced Study, Tokyo 113-0033, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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10
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Abplanalp SJ, Braff DL, Light GA, Joshi YB, Nuechterlein KH, Green MF. Clarifying directional dependence among measures of early auditory processing and cognition in schizophrenia: leveraging Gaussian graphical models and Bayesian networks. Psychol Med 2024:1-10. [PMID: 38287656 DOI: 10.1017/s0033291724000023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
BACKGROUND Research using latent variable models demonstrates that pre-attentive measures of early auditory processing (EAP) and cognition may initiate a cascading effect on daily functioning in schizophrenia. However, such models fail to account for relationships among individual measures of cognition and EAP, thereby limiting their utility. Hence, EAP and cognition may function as complementary and interacting measures of brain function rather than independent stages of information processing. Here, we apply a data-driven approach to identifying directional relationships among neurophysiologic and cognitive variables. METHODS Using data from the Consortium on the Genetics of Schizophrenia 2, we estimated Gaussian Graphical Models and Bayesian networks to examine undirected and directed connections between measures of EAP, including mismatch negativity and P3a, and cognition in 663 outpatients with schizophrenia and 630 control participants. RESULTS Chain structures emerged among EAP and attention/vigilance measures in schizophrenia and control groups. Concerning differences between the groups, object memory was an influential variable in schizophrenia upon which other cognitive domains depended, and working memory was an influential variable in controls. CONCLUSIONS Measures of EAP and attention/vigilance are conditionally independent of other cognitive domains that were used in this study. Findings also revealed additional causal assumptions among measures of cognition that could help guide statistical control and ultimately help identify early-stage targets or surrogate endpoints in schizophrenia.
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Affiliation(s)
- Samuel J Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David L Braff
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Gregory A Light
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Yash B Joshi
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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11
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Dondé C, Dubertret C, Fond G, Andre M, Berna F, Boyer L, Capdevielle D, Chereau I, Coulon N, Dorey JM, Leignier S, Llorca PM, Misdrahi D, Passerieux C, Pignon B, Rey R, Schorr B, Schürhoff F, Urbach M, Polosan M, Mallet J. History of learning disorders is associated with worse cognitive and functional outcomes in schizophrenia: results from the multicentric FACE-SZ cross-sectional dataset. Eur Arch Psychiatry Clin Neurosci 2023; 273:1773-1783. [PMID: 36583738 DOI: 10.1007/s00406-022-01544-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
Schizophrenia is associated with early neurodevelopmental disorders, including most frequently learning disorders (LD), among them dyslexia and dyspraxia. Despite the demonstrated links between schizophrenia and LD, specific clinical patterns of the schizophrenia with a history of LD subgroup remain unknown. The aim of the present study was to investigate cognitive impairment, symptoms and functional outcome associated with a history of LD in a large cross-sectional, multicentric, sample of schizophrenia subjects. 492 community-dwelling subjects with schizophrenia (75.6% male, mean age 30.8 years) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. The 51 (10.4%) subjects identified with a history of LD had significantly impaired general cognitive ability (Wechsler Adult Intelligence Scale Full Scale Total IQ: Cohen's d = 0.50, p = 0.001), processing speed (d = 0.19), verbal comprehension (d = 0.29), working memory (d = 0.31), cognitive inhibition and flexibility (d = 0.26), central executive functioning (d = 0.26), phonemic verbal fluency (d = 0.22) and premorbid intellectual ability (d = 0.48), as well as with a worse functional outcome (Global Assessment of Functioning, d = 0.21), independently of age, sex, education level, symptoms, treatments, and addiction comorbidities. These results indicate that a history of LD is associated with later cognitive impairment and functional outcome in schizophrenia. This suggests that history of LD is a relevant clinical marker to discriminate subgroups of patients with schizophrenia with different profiles in a precision psychiatry framework.
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Affiliation(s)
- Clément Dondé
- Fondation Fondamental, Créteil, France.
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France.
- Psychiatry Department, CH Alpes-Isère, 38000, Saint-Egrève, France.
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France
- School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, AP-HM, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Myrtille Andre
- Fondation Fondamental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Fabrice Berna
- Fondation Fondamental, Créteil, France
- Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Strasbourg, France
| | - Laurent Boyer
- Fondation Fondamental, Créteil, France
- School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, AP-HM, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation Fondamental, Créteil, France
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Nathalie Coulon
- Fondation Fondamental, Créteil, France
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Jean-Michel Dorey
- Fondation Fondamental, Créteil, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Sylvain Leignier
- Fondation Fondamental, Créteil, France
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - David Misdrahi
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- Aquitaine Institute for Cognitive and Integrative Neuroscience, UMR 5287-INCIA, University of Bordeaux, CNRS, Bordeaux, France
| | - Christine Passerieux
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78157, Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Baptiste Pignon
- Fondation Fondamental, Créteil, France
- UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie Génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de Psychiatrie, Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique, Université Paris-Est, Créteil, France
| | - Romain Rey
- Fondation Fondamental, Créteil, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Benoît Schorr
- Fondation Fondamental, Créteil, France
- Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Strasbourg, France
| | - Franck Schürhoff
- Fondation Fondamental, Créteil, France
- UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie Génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de Psychiatrie, Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique, Université Paris-Est, Créteil, France
| | - Mathieu Urbach
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78157, Le Chesnay, France
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
- Psychiatry Department, CH Alpes-Isère, 38000, Saint-Egrève, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
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12
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Sklar AL, Matinrazm S, Ren X, Chlpka L, Curtis M, Coffman BA, Salisbury DF. Longitudinal Investigation of Auditory Dynamic Range Deficits in Early Psychosis and its Relationship to Negative Symptoms. Schizophr Bull 2023; 49:1508-1517. [PMID: 37260356 PMCID: PMC10686334 DOI: 10.1093/schbul/sbad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND HYPOTHESIS Despite accounting for significant disease morbidity in schizophrenia, the neuropathological basis of negative symptoms remains poorly understood and options for treatment limited. Our recent study identified robust associations between diminished auditory cortex (AC) dynamic range and social functioning impairments and negative symptoms in first episode psychosis (FESz). The current investigation examined the progression of these relationships 4-8 months from baseline testing. STUDY DESIGN Twenty-six FESz and 38 healthy controls (HC) were tested at baseline and follow-up. Magnetoencephalography (MEG) was recorded during binaural presentation of tones (75, 80, and 85 dB). Assessments included the MATRICS cognitive consensus battery (MCCB) and Global Functioning: Role and Social scales (GFR/GFS) and the Positive and Negative Syndrome Scale. STUDY RESULTS Overall, FESz exhibited a blunted response to increasing tone intensity relative to HC. While this deficit did not change over time at the group level, recovery of right hemisphere AC dynamic range (85-75 dB response) among FESz individuals was associated with reductions in negative symptoms (ρ = -0.50). Diminished dynamic range was also associated with impaired GFS (ρ = 0.65), GFR (ρ = 0.51), and MCCB (ρ = 0.49) at baseline and increased negative symptoms at baseline (ρ = -0.53) and follow-up (ρ = -0.51). CONCLUSION Despite persistent dynamic range impairment in FESz as a group, individual recovery of this AC response property was associated with significant reduction in negative symptoms. Identification of a functional neural deficit that tracts progression of negative symptoms during a critical period for disease modification is essential to the management of these devastating and historically treatment refractory symptoms.
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Affiliation(s)
- Alfredo L Sklar
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
| | - Sayna Matinrazm
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
| | - Xi Ren
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
| | - Lydia Chlpka
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
| | - Mark Curtis
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
| | - Brian A Coffman
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
| | - Dean F Salisbury
- University of Pittsburgh School of Medicine, Department of Psychiatry Pittsburgh, PA
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13
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Valt C, Quarto T, Tavella A, Romanelli F, Fazio L, Arcara G, Altamura M, Barrasso G, Bellomo A, Blasi G, Brudaglio F, Carofiglio A, D'Ambrosio E, Padalino FA, Rampino A, Saponaro A, Semisa D, Suma D, Pergola G, Bertolino A. Reduced magnetic mismatch negativity: a shared deficit in psychosis and related risk. Psychol Med 2023; 53:6037-6045. [PMID: 36321391 DOI: 10.1017/s003329172200321x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Abnormal auditory processing of deviant stimuli, as reflected by mismatch negativity (MMN), is often reported in schizophrenia (SCZ). At present, it is still under debate whether this dysfunctional response is specific to the full-blown SCZ diagnosis or rather a marker of psychosis in general. The present study tested MMN in patients with SCZ, bipolar disorder (BD), first episode of psychosis (FEP), and in people at clinical high risk for psychosis (CHR). METHODS Source-based MEG activity evoked during a passive auditory oddball task was recorded from 135 patients grouped according to diagnosis (SCZ, BD, FEP, and CHR) and 135 healthy controls also divided into four subgroups, age- and gender-matched with diagnostic subgroups. The magnetic MMN (mMMN) was analyzed as event-related field (ERF), Theta power, and Theta inter-trial phase coherence (ITPC). RESULTS The clinical group as a whole showed reduced mMMN ERF amplitude, Theta power, and Theta ITPC, without any statistically significant interaction between diagnosis and mMMN reductions. The mMMN subgroup contrasts showed lower ERF amplitude in all the diagnostic subgroups. In the analysis of Theta frequency, SCZ showed significant power and ITPC reductions, while only indications of diminished ITPC were observed in CHR, but no significant decreases characterized BD and FEP. CONCLUSIONS Significant mMMN alterations in people experiencing psychosis, also for diagnoses other than SCZ, suggest that this neurophysiological response may be a feature shared across psychotic disorders. Additionally, reduced Theta ITPC may be associated with risk for psychosis.
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Affiliation(s)
- Christian Valt
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Tiziana Quarto
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Humanities, University of Foggia, Foggia, Italy
| | | | | | - Leonardo Fazio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Medicine and Surgery, LUM University, Casamassima, Italy
| | | | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Barrasso
- Department of Mental Health, ASL Barletta-Andria-Trani, Andria, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Bari University Hospital, Bari, Italy
| | - Flora Brudaglio
- Department of Mental Health, ASL Barletta-Andria-Trani, Andria, Italy
| | | | - Enrico D'Ambrosio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Bari University Hospital, Bari, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience - King's College London, London, UK
| | | | - Antonio Rampino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Bari University Hospital, Bari, Italy
| | | | | | - Domenico Suma
- Department of Mental Health, ASL Brindisi, Brindisi, Italy
| | - Giulio Pergola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Bari University Hospital, Bari, Italy
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14
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Joshi YB, Gonzalez CE, Molina JL, MacDonald LR, Min Din J, Minhas J, Leposke T, Nordberg B, Li F, Talledo J, Sprock J, Swerdlow NR, Light GA. Mismatch negativity predicts initial auditory-based targeted cognitive training performance in a heterogeneous population across psychiatric disorders. Psychiatry Res 2023; 327:115215. [PMID: 37406367 DOI: 10.1016/j.psychres.2023.115215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 07/07/2023]
Abstract
Auditory-based targeted cognitive training (ATCT) programs are emerging pro-cognitive therapeutic interventions which aim to improve auditory processing to attenuate cognitive impairment in a "bottom up" manner. Biomarkers of early auditory information processing (EAIP) like mismatch negativity (MMN) and P3a have been used successfully to predict gains from a full 40 h course of ATCT in schizophrenia (SZ). Here we investigated the ability of EAIP biomarkers to predict ATCT performance in a group of subjects (n = 26) across SZ, MDD, PTSD and GAD diagnoses. Cognition was assessed via the MATRICS Consensus Cognitive Battery (MCCB) and MMN/P3a were collected prior to completing 1 h of "Sound Sweeps," a representative ATCT exercise. Baseline and final performance over the first two levels of cognitive training served as the primary dependent variables. Groups had similar MMN, but the SZ group had attenuated P3a. MMN and MCCB cognitive domain t-scores, but not P3a, were strongly correlated with most ATCT performance measures, and explained up to 61% of variance in ATCT performance. Diagnosis was not a significant predictor for ATCT performance. These data suggest that MMN can predict ATCT performance in heterogeneous neuropsychiatric populations and should be considered in ATCT studies across diagnostically diverse cohorts.
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Affiliation(s)
- Yash B Joshi
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA.
| | - Christopher E Gonzalez
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA
| | - Juan L Molina
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA
| | - Laura R MacDonald
- University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Jenny Min Din
- University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Jessica Minhas
- University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Taylor Leposke
- University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Bethany Nordberg
- University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Francesca Li
- University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Jo Talledo
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA
| | - Joyce Sprock
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA
| | - Neal R Swerdlow
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA
| | - Gregory A Light
- VA San Diego Healthcare System, La Jolla, CA, USA; University of California, San Diego, Department of Psychiatry, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, La Jolla, CA, USA
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15
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Nemani K, Goff DC. Dose Finding for d-Serine Enhancement of Plasticity in Schizophrenia. Biol Psychiatry 2023; 94:106-107. [PMID: 37380254 DOI: 10.1016/j.biopsych.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Katlyn Nemani
- Nathan Kline Institute for Psychiatric Research and the New York University Grossman School of Medicine, New York, New York
| | - Donald C Goff
- Nathan Kline Institute for Psychiatric Research and the New York University Grossman School of Medicine, New York, New York.
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16
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Sehatpour P, Iosifescu DV, De Baun HM, Shope C, Mayer MR, Gangwisch J, Dias E, Sobeih T, Choo TH, Wall MM, Medalia A, Saperstein AM, Kegeles LS, Girgis RR, Carlson M, Kantrowitz JT. Dose-Dependent Augmentation of Neuroplasticity-Based Auditory Learning in Schizophrenia: A Double-Blind, Placebo-Controlled, Randomized, Target Engagement Clinical Trial of the NMDA Glutamate Receptor Agonist d-serine. Biol Psychiatry 2023; 94:164-173. [PMID: 36958998 PMCID: PMC10313776 DOI: 10.1016/j.biopsych.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Patients with schizophrenia show reduced NMDA glutamate receptor-dependent auditory plasticity, which is rate limiting for auditory cognitive remediation (AudRem). We evaluate the utility of behavioral and neurophysiological pharmacodynamic target engagement biomarkers, using a d-serine+AudRem combination. METHODS Forty-five participants with schizophrenia or schizoaffective disorder were randomized to 3 once-weekly AudRem visits + double-blind d-serine (80, 100, or 120 mg/kg) or placebo in 3 dose cohorts of 12 d-serine and 3 placebo-treated participants each. In AudRem, participants indicated which paired tone was higher in pitch. The primary outcome was plasticity improvement, operationalized as change in pitch threshold between AudRem tones [(test tone Hz - reference tone Hz)/reference tone Hz] between the initial plateau pitch threshold (mean of trials 20-30 of treatment visit 1) to pitch threshold at the end of visit(s). Target engagement was assessed by electroencephalography outcomes, including mismatch negativity (pitch primary). RESULTS There was a significant overall treatment effect for plasticity improvement (p = .014). Plasticity improvement was largest within the 80 and 100 mg/kg groups (p < .001, d > 0.67), while 120 mg/kg and placebo-treated participants showed nonsignificant within-group changes. Plasticity improvement was seen after a single treatment and was sustained on subsequent treatments. Target engagement was demonstrated by significantly larger mismatch negativity (p = .049, d = 1.0) for the 100 mg/kg dose versus placebo. CONCLUSIONS Our results demonstrate sufficient proof of principle for continued development of both the d-serine+AudRem combination and our target engagement methodology. The ultimate utility is dependent on the results of an ongoing larger, longer study of the combination for clinically relevant outcomes.
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Affiliation(s)
- Pejman Sehatpour
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York; Nathan Kline Institute, Orangeburg, New York
| | - Dan V Iosifescu
- Nathan Kline Institute, Orangeburg, New York; Psychiatry, New York University Grossman School of Medicine, New York, New York
| | - Heloise M De Baun
- Area Psychosis, New York State Psychiatric Institute, New York, New York
| | | | - Megan R Mayer
- Area Psychosis, New York State Psychiatric Institute, New York, New York
| | - James Gangwisch
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Elisa Dias
- Nathan Kline Institute, Orangeburg, New York; Psychiatry, New York University Grossman School of Medicine, New York, New York
| | | | - Tse-Hwei Choo
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Melanie M Wall
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alice Medalia
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alice M Saperstein
- Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lawrence S Kegeles
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Ragy R Girgis
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Marlene Carlson
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Joshua T Kantrowitz
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York; Nathan Kline Institute, Orangeburg, New York.
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Govani V, Shastry A, Iosifescu D, Govil P, Mayer M, Sobeih T, Choo T, Wall M, Sehatpour P, Kantrowitz J. Augmentation of learning in schizophrenia by D-serine is related to auditory and frontally-generated biomarkers: A randomized, double-blind, placebo-controlled study. RESEARCH SQUARE 2023:rs.3.rs-2943290. [PMID: 37293030 PMCID: PMC10246259 DOI: 10.21203/rs.3.rs-2943290/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Auditory cognition is impaired in schizophrenia, and typically engages a complex, distributed, hierarchical network, including both auditory and frontal input. We recently demonstrated proof of principle for the target engagement of an N-methyl-D-aspartate-type glutamate receptor (NMDAR) agonist + auditory targeted remediation (d-serine+AudRem) combination, showing significant improvement in auditory-learning induced plasticity and mismatch negativity. In this secondary analysis, we report on frontal EEG outcomes, assessing for both generalized effects and the mechanism of auditory plasticity. 21 schizophrenia or schizoaffective disorder participants were randomized to three 1x weekly AudRem + double-blind d-serine (100 mg/kg) visits. In AudRem, participants indicated which paired tone was higher in pitch. The focus of this secondary analysis was a frontally (premotor) mediated EEG outcome- event-related desynchronization in the b band (b-ERD), which was shown to be sensitive to AudRem in previous studies. d-Serine+AudRem led to significant improvement in b-ERD power across the retention and motor preparation intervals (F 1,18 =6.0, p=0.025) vs. AudRem alone. b-ERD was significantly related to baseline cognition, but not auditory-learning induced plasticity. The principal finding of this prespecified secondary analysis are that in addition to improving auditory based biomarkers, the d-serine+AudRem combination led to significant improvement in biomarkers thought to represent frontally mediated dysfunction, suggesting potential generalization of effects. Changes in auditory-learning induced plasticity were independent of these frontally mediated biomarkers. Ongoing work will assess whether d-serine+AudRem is sufficient to remediate cognition or whether targeting frontal NMDAR deficits with higher-level remediation may also be required. Trial Registration: NCT03711500.
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Sklar AL, Ren X, Chlpka L, Curtis M, Coffman BA, Salisbury DF. Diminished Auditory Cortex Dynamic Range and its Clinical Correlates in First Episode Psychosis. Schizophr Bull 2023; 49:679-687. [PMID: 36749310 PMCID: PMC10154701 DOI: 10.1093/schbul/sbac208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND HYPOTHESIS There is growing appreciation for the contribution of sensory disruptions to disease morbidity in psychosis. The present study examined auditory cortex (AC) dynamic range: the scaling of neurophysiological responses to stimulus intensity, among individuals with a schizophrenia spectrum illness (FESz) and its relationship to clinical outcomes at disease onset. STUDY DESIGN Magnetoencephalography (MEG) was recorded from 35 FESz and 40 healthy controls (HC) during binaural presentation of tones at three intensities (75 dB, 80 dB, and 85 dB). MRIs were obtained to enhance cortical localization of MEG sensor-level activity. All participants completed the MATRICS cognitive battery (MCCB) and Global Functioning: Role and Social scales (GFR/GFS). Patients were administered the Positive and Negative Syndrome Scale (PANSS). STUDY RESULTS FESz exhibited reduced AC response relative to HC. Enhancement of AC activity to tones of increasing intensity was blunted in FESz relative to HC. Reduced dynamic range (85-75 dB AC response) was associated with lower GFS (r = .58) and GFR (r = .45) scores, worse MCCB performance (r = .45), and increased PANSS Negative symptom subscale scores (r = -.55) among FESz, relationships not observed with AC responses to individual tones. CONCLUSION Beyond an impaired AC response to pure tones, FESz exhibit reduced dynamic range relative to HC. This impairment was correlated with markers of disease morbidity including poorer community functioning as well as cognitive and negative symptoms. The relationship with impaired social functioning may reflect the role of AC dynamic range in decoding the emotional content of language and highlights its importance to future therapeutic sensory remediation protocols.
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Affiliation(s)
- Alfredo L Sklar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Xi Ren
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Lydia Chlpka
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Mark Curtis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Brian A Coffman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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19
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Medalia A, Saperstein A, Javitt DC, Qian M, Meyler S, Styke S. Feasibility and clinical utility of using the tone matching test for assessment of early auditory processing in schizophrenia. Psychiatry Res 2023; 323:115152. [PMID: 36907004 PMCID: PMC10106445 DOI: 10.1016/j.psychres.2023.115152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
Early auditory processing (EAP) deficits are prevalent in schizophrenia and linked to disturbances in higher order cognition and daily functioning. Treatments that target EAP have the potential to drive downstream cognitive and functional improvements, but clinically feasible means to detect EAP impairment are lacking. This report describes the clinical feasibility and utility of using the Tone Matching (TM) Test to assess EAP in adults with schizophrenia. Clinicians were trained to administer the TM Test as part of a baseline cognitive battery to inform choice of cognitive remediation (CR) exercises. Only if the TM Test indicated EAP impairment, were the recommended CR exercises to include EAP training. Results indicated clinicians included the TM Test in all baseline assessments and identified 51.72% as EAP impaired. There were significant positive relationships between TM Test performance and cognitive summary scores, confirming instrumental validity. All clinicians found the TM Test useful for CR treatment planning. CR participants with impaired EAP spent significantly more training time on EAP exercises compared to CR participants with intact EAP (20.11% vs 3.32%). This study found that it is feasible to use the TM Test in community clinics and the test was perceived as clinically useful for personalizing treatment.
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Affiliation(s)
- Alice Medalia
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY, USA.
| | - Alice Saperstein
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY, USA
| | - Daniel C Javitt
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Experimental Therapeutics Division, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Min Qian
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, United States
| | - Shanique Meyler
- The Graduate Center, City University of New York, New York, NY 10016, USA
| | - Sarah Styke
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461, USA
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20
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Dondé C, Kantrowitz JT, Medalia A, Saperstein AM, Balla A, Sehatpour P, Martinez A, O'Connell MN, Javitt DC. Early auditory processing dysfunction in schizophrenia: Mechanisms and implications. Neurosci Biobehav Rev 2023; 148:105098. [PMID: 36796472 PMCID: PMC10106448 DOI: 10.1016/j.neubiorev.2023.105098] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Schizophrenia is a major mental disorder that affects approximately 1% of the population worldwide. Cognitive deficits are a key feature of the disorder and a primary cause of long-term disability. Over the past decades, significant literature has accumulated demonstrating impairments in early auditory perceptual processes in schizophrenia. In this review, we first describe early auditory dysfunction in schizophrenia from both a behavioral and neurophysiological perspective and examine their interrelationship with both higher order cognitive constructs and social cognitive processes. Then, we provide insights into underlying pathological processes, especially in relationship to glutamatergic and N-methyl-D-aspartate receptor (NMDAR) dysfunction models. Finally, we discuss the utility of early auditory measures as both treatment targets for precision intervention and as translational biomarkers for etiological investigation. Altogether, this review points out the crucial role of early auditory deficits in the pathophysiology of schizophrenia, in addition to major implications for early intervention and auditory-targeted approaches.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, F-38000 Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, F-38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France.
| | - Joshua T Kantrowitz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States; Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Alice Medalia
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Alice M Saperstein
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Andrea Balla
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Pejman Sehatpour
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Antigona Martinez
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Monica N O'Connell
- Translational Neuroscience Division, Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Daniel C Javitt
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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21
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Yeh TC, Huang CCY, Chung YA, Park SY, Im JJ, Lin YY, Ma CC, Tzeng NS, Chang HA. Resting-State EEG Connectivity at High-Frequency Bands and Attentional Performance Dysfunction in Stabilized Schizophrenia Patients. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040737. [PMID: 37109695 PMCID: PMC10141517 DOI: 10.3390/medicina59040737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/24/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Attentional dysfunction has long been viewed as one of the fundamental underlying cognitive deficits in schizophrenia. There is an urgent need to understand its neural underpinning and develop effective treatments. In the process of attention, neural oscillation has a central role in filtering information and allocating resources to either stimulus-driven or goal-relevant objects. Here, we asked if resting-state EEG connectivity correlated with attentional performance in schizophrenia patients. Materials and Methods: Resting-state EEG recordings were obtained from 72 stabilized patients with schizophrenia. Lagged phase synchronization (LPS) was used to measure whole-brain source-based functional connectivity between 84 intra-cortical current sources determined by eLORETA (exact low-resolution brain electromagnetic tomography) for five frequencies. The Conners' Continuous Performance Test-II (CPT-II) was administered for evaluating attentional performance. Linear regression with a non-parametric permutation randomization procedure was used to examine the correlations between the whole-brain functional connectivity and the CPT-II measures. Results: Greater beta-band right hemispheric fusiform gyrus (FG)-lingual gyrus (LG) functional connectivity predicted higher CPT-II variability scores (r = 0.44, p < 0.05, corrected), accounting for 19.5% of variance in the CPT-II VAR score. Greater gamma-band right hemispheric functional connectivity between the cuneus (Cu) and transverse temporal gyrus (TTG) and between Cu and the superior temporal gyrus (STG) predicted higher CPT-II hit reaction time (HRT) scores (both r = 0.50, p < 0.05, corrected), accounting for 24.6% and 25.1% of variance in the CPT-II HRT score, respectively. Greater gamma-band right hemispheric Cu-TTG functional connectivity predicted higher CPT-II HRT standard error (HRTSE) scores (r = 0.54, p < 0.05, corrected), accounting for 28.7% of variance in the CPT-II HRTSE score. Conclusions: Our study indicated that increased right hemispheric resting-state EEG functional connectivity at high frequencies was correlated with poorer focused attention in schizophrenia patients. If replicated, novel approaches to modulate these networks may yield selective, potent interventions for improving attention deficits in schizophrenia.
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Affiliation(s)
- Ta-Chuan Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
| | - Cathy Chia-Yu Huang
- Department of Life Sciences, National Central University, Taoyuan 320317, Taiwan
| | - Yong-An Chung
- Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Sonya Youngju Park
- Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Jooyeon Jamie Im
- Department of Psychology, Seoul National University, Seoul 08826, Republic of Korea
| | - Yen-Yue Lin
- Department of Life Sciences, National Central University, Taoyuan 320317, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325208, Taiwan
| | - Chin-Chao Ma
- Department of Psychiatry, Tri-Service General Hospital Beitou Branch, National Defense Medical Center, Taipei 112003, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
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22
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Labelle A, Knott V. An α7 nAChR approach for the baseline-dependent modulation of deviance detection in schizophrenia: A pilot study assessing the combined effect of CDP-choline and galantamine. J Psychopharmacol 2023; 37:381-395. [PMID: 36927273 PMCID: PMC10101183 DOI: 10.1177/02698811231158903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Cognitive operations including pre-attentive sensory processing are markedly impaired in patients with schizophrenia (SCZ) but evidence significant interindividual heterogeneity, which moderates treatment response with nicotinic acetylcholine receptor (nAChR) agonists. Previous studies in healthy volunteers have shown baseline-dependency effects of the α7 nAChR agonist cytidine 5'-diphosphocholine (CDP-choline) administered alone and in combination with a nicotinic allosteric modulator (galantamine) on auditory deviance detection measured with the mismatch negativity (MMN) event-related potential (ERP). AIM The objective of this pilot study was to assess the acute effect of this combined α7 nAChR-targeted treatment (CDP-choline/galantamine) on speech MMN in patients with SCZ (N = 24) stratified by baseline MMN responses into low, medium, and high baseline auditory deviance detection subgroups. METHODS Patients with a stable diagnosis of SCZ attended two randomized, double-blind, placebo-controlled and counter-balanced testing sessions where they received a placebo or a CDP-choline (500 mg) and galantamine (16 mg) treatment. MMN ERPs were recorded during the presentation of a fast multi-feature speech MMN paradigm including five speech deviants. Clinical measures were acquired before and after treatment administration. RESULTS While no main treatment effect was observed, CDP-choline/galantamine significantly increased MMN amplitudes to frequency, duration, and vowel speech deviants in low group individuals. Individuals with higher positive and negative symptom scale negative, general, and total scores expressed the greatest MMN amplitude improvement following CDP-choline/galantamine. CONCLUSIONS These baseline-dependent nicotinic effects on early auditory information processing warrant different dosage and repeated administration assessments in patients with low baseline deviance detection levels.
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Affiliation(s)
- Joëlle Choueiry
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Crystal M Blais
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | - Alain Labelle
- The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.,Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada.,School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada.,The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
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23
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Cecchi M, Adachi M, Basile A, Buhl DL, Chadchankar H, Christensen S, Christian E, Doherty J, Fadem KC, Farley B, Forman MS, Honda S, Johannesen J, Kinon BJ, Klamer D, Marino MJ, Missling C, O'Donnell P, Piser T, Puryear CB, Quirk MC, Rotte M, Sanchez C, Smith DG, Uslaner JM, Javitt DC, Keefe RSE, Mathalon D, Potter WZ, Walling DP, Ereshefsky L. Validation of a suite of ERP and QEEG biomarkers in a pre-competitive, industry-led study in subjects with schizophrenia and healthy volunteers. Schizophr Res 2023; 254:178-189. [PMID: 36921403 DOI: 10.1016/j.schres.2023.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/23/2022] [Accepted: 02/10/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Complexity and lack of standardization have mostly limited the use of event-related potentials (ERPs) and quantitative EEG (QEEG) biomarkers in drug development to small early phase trials. We present results from a clinical study on healthy volunteers (HV) and patients with schizophrenia (SZ) that assessed test-retest, group differences, variance, and correlation with functional assessments for ERP and QEEG measures collected at clinical and commercial trial sites with standardized instrumentation and methods, and analyzed through an automated data analysis pipeline. METHODS 81 HV and 80 SZ were tested at one of four study sites. Subjects were administered two ERP/EEG testing sessions on separate visits. Sessions included a mismatch negativity paradigm, a 40 Hz auditory steady-state response paradigm, an eyes-closed resting state EEG, and an active auditory oddball paradigm. SZ subjects were also tested on the Brief Assessment of Cognition (BAC), Positive and Negative Syndrome Scale (PANSS), and Virtual Reality Functional Capacity Assessment Tool (VRFCAT). RESULTS Standardized ERP/EEG instrumentation and methods ensured few test failures. The automated data analysis pipeline allowed for near real-time analysis with no human intervention. Test-retest reliability was fair-to-excellent for most of the outcome measures. SZ subjects showed significant deficits in ERP and QEEG measures consistent with published academic literature. A subset of ERP and QEEG measures correlated with functional assessments administered to the SZ subjects. CONCLUSIONS With standardized instrumentation and methods, complex ERP/EEG testing sessions can be reliably performed at clinical and commercial trial sites to produce high-quality data in near real-time.
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Affiliation(s)
| | | | - A Basile
- Merck & Co., Inc., Kenilworth, NJ, USA
| | | | | | | | | | | | | | | | | | | | | | | | - D Klamer
- Anavex Life Sciences Corp., NY, USA
| | | | | | | | - T Piser
- Onsero Therapeutics, MA, USA
| | | | | | | | | | | | | | | | | | - D Mathalon
- University of California, San Francisco, CA, USA
| | - W Z Potter
- Independent Consultant, Philadelphia, PA, USA
| | | | - L Ereshefsky
- CenExel Research, USA; University of Texas Health Science Center at San Antonio, TX, USA
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24
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Fivel L, Mondino M, Brunelin J, Haesebaert F. Basic auditory processing and its relationship with symptoms in patients with schizophrenia: A systematic review. Psychiatry Res 2023; 323:115144. [PMID: 36940586 DOI: 10.1016/j.psychres.2023.115144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
Processing of basic auditory features, one of the earliest stages of auditory perception, has been the focus of considerable investigations in schizophrenia. Although numerous studies have shown abnormalities in pitch perception in schizophrenia, other basic auditory features such as intensity, duration, and sound localization have been less explored. Additionally, the relationship between basic auditory features and symptom severity shows inconsistent results, preventing concrete conclusions. Our aim was to present a comprehensive overview of basic auditory processing in schizophrenia and its relationship with symptoms. We conducted a systematic review according to the PRISMA guidelines. PubMed, Embase, and PsycINFO databases were searched for studies exploring auditory perception in schizophrenia compared to controls, with at least one behavioral task investigating basic auditory processing using pure tones. Forty-one studies were included. The majority investigated pitch processing while the others investigated intensity, duration and sound localization. The results revealed that patients have a significant deficit in the processing of all basic auditory features. Although the search for a relationship with symptoms was limited, auditory hallucinations experience appears to have an impact on basic auditory processing. Further research may examine correlations with clinical symptoms to explore the performance of patient subgroups and possibly implement remediation strategies.
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Affiliation(s)
- Laure Fivel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France.
| | - Jerome Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
| | - Frédéric Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
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25
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Efficacy and auditory biomarker analysis of fronto-temporal transcranial direct current stimulation (tDCS) in targeting cognitive impairment associated with recent-onset schizophrenia: study protocol for a multicenter randomized double-blind sham-controlled trial. Trials 2023; 24:141. [PMID: 36829240 PMCID: PMC9951427 DOI: 10.1186/s13063-023-07160-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/13/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND In parallel to the traditional symptomatology, deficits in cognition (memory, attention, reasoning, social functioning) contribute significantly to disability and suffering in individuals with schizophrenia. Cognitive deficits have been closely linked to alterations in early auditory processes (EAP) that occur in auditory cortical areas. Preliminary evidence indicates that cognitive deficits in schizophrenia can be improved with a reliable and safe non-invasive brain stimulation technique called tDCS (transcranial direct current stimulation). However, a significant proportion of patients derive no cognitive benefits after tDCS treatment. Furthermore, the neurobiological mechanisms of cognitive changes after tDCS have been poorly explored in trials and are thus still unclear. METHOD The study is designed as a randomized, double-blind, 2-arm parallel-group, sham-controlled, multicenter trial. Sixty participants with recent-onset schizophrenia and cognitive impairment will be randomly allocated to receive either active (n=30) or sham (n=30) tDCS (20-min, 2-mA, 10 sessions during 5 consecutive weekdays). The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left auditory cortex. Cognition, tolerance, symptoms, general outcome and EAP (measured with EEG and multimodal MRI) will be assessed prior to tDCS (baseline), after the 10 sessions, and at 1- and 3-month follow-up. The primary outcome will be the number of responders, defined as participants demonstrating a cognitive improvement ≥Z=0.5 from baseline on the MATRICS Consensus Cognitive Battery total score at 1-month follow-up. Additionally, we will measure how differences in EAP modulate individual cognitive benefits from active tDCS and whether there are changes in EAP measures in responders after active tDCS. DISCUSSION Besides proposing a new fronto-temporal tDCS protocol by targeting the auditory cortical areas, we aim to conduct a randomized controlled trial (RCT) with follow-up assessments up to 3 months. In addition, this study will allow identifying and assessing the value of a wide range of neurobiological EAP measures for predicting and explaining cognitive deficit improvement after tDCS. The results of this trial will constitute a step toward the use of tDCS as a therapeutic tool for the treatment of cognitive impairment in recent-onset schizophrenia. TRIAL REGISTRATION ClinicalTrials.gov NCT05440955. Prospectively registered on July 1st, 2022.
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Javitt DC. Cognitive Impairment Associated with Schizophrenia: From Pathophysiology to Treatment. Annu Rev Pharmacol Toxicol 2023; 63:119-141. [PMID: 36151052 DOI: 10.1146/annurev-pharmtox-051921-093250] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cognitive impairment is a core feature of schizophrenia and a major contributor to poor functional outcomes. Methods for assessment of cognitive dysfunction in schizophrenia are now well established. In addition, there has been increasing appreciation in recent years of the additional role of social cognitive impairment in driving functional outcomes and of the contributions of sensory-level dysfunction to higher-order impairments. At the neurochemical level, acute administration of N-methyl-d-aspartate receptor (NMDAR) antagonists reproduces the pattern of neurocognitive dysfunction associated with schizophrenia, encouraging the development of treatments targeted at both NMDAR and its interactome. At the local-circuit level, an auditory neurophysiological measure, mismatch negativity, has emerged both as a veridical index of NMDAR dysfunction and excitatory/inhibitory imbalance in schizophrenia and as a critical biomarker for early-stage translational drug development. Although no compounds have yet been approved for treatment of cognitive impairment associated with schizophrenia, several candidates are showing promise in early-phase testing.
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Affiliation(s)
- Daniel C Javitt
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; .,Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
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27
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Vinogradov S, Chafee MV, Lee E, Morishita H. Psychosis spectrum illnesses as disorders of prefrontal critical period plasticity. Neuropsychopharmacology 2023; 48:168-185. [PMID: 36180784 PMCID: PMC9700720 DOI: 10.1038/s41386-022-01451-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 01/05/2023]
Abstract
Emerging research on neuroplasticity processes in psychosis spectrum illnesses-from the synaptic to the macrocircuit levels-fill key gaps in our models of pathophysiology and open up important treatment considerations. In this selective narrative review, we focus on three themes, emphasizing alterations in spike-timing dependent and Hebbian plasticity that occur during adolescence, the critical period for prefrontal system development: (1) Experience-dependent dysplasticity in psychosis emerges from activity decorrelation within neuronal ensembles. (2) Plasticity processes operate bidirectionally: deleterious environmental and experiential inputs shape microcircuits. (3) Dysregulated plasticity processes interact across levels of scale and time and include compensatory mechanisms that have pathogenic importance. We present evidence that-given the centrality of progressive dysplastic changes, especially in prefrontal cortex-pharmacologic or neuromodulatory interventions will need to be supplemented by corrective learning experiences for the brain if we are to help people living with these illnesses to fully thrive.
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Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry & Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Matthew V Chafee
- Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Erik Lee
- Masonic Institute for the Developing Brain, University of Minnesota Medical School, Minneapolis, MN, USA
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, MN, USA
| | - Hirofumi Morishita
- Department of Psychiatry, Neuroscience, & Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Associations between polygenic risk, negative symptoms, and functional connectome topology during a working memory task in early-onset schizophrenia. SCHIZOPHRENIA 2022; 8:54. [PMID: 35853905 PMCID: PMC9261080 DOI: 10.1038/s41537-022-00260-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022]
Abstract
Working memory (WM) deficit in schizophrenia is thought to arise from a widespread neural inefficiency. However, we do not know if this deficit results from the illness-related genetic risk and influence the symptom burden in various domains, especially in patients who have an early onset illness. We used graph theory to examine the topology of the functional connectome in 99 subjects (27 early-onset schizophrenia (EOS), 24 asymptomatic siblings, and 48 healthy subjects) during an n-back task, and calculated their polygenic risk score (PRS) for susceptibility to schizophrenia. Linear regression analysis was used to test associations of the PRS, clinical symptoms, altered connectomic properties, and WM accuracy in EOS. Indices of small-worldness and segregation were elevated in EOS during the WM task compared with the other two groups; these connectomic aberrations correlated with increased PRS and negative symptoms. In patients with higher polygenic risk, WM performance was lower only when both the connectomic aberrations and the burden of negative symptoms were higher. Negative symptoms had a stronger moderating role in this relationship. Our findings suggest that the aberrant connectomic topology is a feature of WM task performance in schizophrenia; this relates to higher polygenic risk score as well as higher burden of negative symptoms. The deleterious effects of polygenic risk on cognition are played out via its effects on the functional connectome, as well as negative symptoms.
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Atypical prediction error learning is associated with prodromal symptoms in individuals at clinical high risk for psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:105. [PMID: 36433979 PMCID: PMC9700713 DOI: 10.1038/s41537-022-00302-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022]
Abstract
Reductions in the auditory mismatch negativity (MMN) have been well-demonstrated in schizophrenia rendering it a promising biomarker for understanding the emergence of psychosis. According to the predictive coding theory of psychosis, MMN impairments may reflect disturbances in hierarchical information processing driven by maladaptive precision-weighted prediction errors (pwPEs) and enhanced belief updating. We applied a hierarchical Bayesian model of learning to single-trial EEG data from an auditory oddball paradigm in 31 help-seeking antipsychotic-naive high-risk individuals and 23 healthy controls to understand the computational mechanisms underlying the auditory MMN. We found that low-level sensory and high-level volatility pwPE expression correlated with EEG amplitudes, coinciding with the timing of the MMN. Furthermore, we found that prodromal positive symptom severity was associated with increased expression of sensory pwPEs and higher-level belief uncertainty. Our findings provide support for the role of pwPEs in auditory MMN generation, and suggest that increased sensory pwPEs driven by changes in belief uncertainty may render the environment seemingly unpredictable. This may predispose high-risk individuals to delusion-like ideation to explain this experience. These results highlight the value of computational models for understanding the pathophysiological mechanisms of psychosis.
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de la Salle S, Shah U, Hyde M, Baysarowich R, Aidelbaum R, Choueiry J, Knott V. Synchronized Auditory Gamma Response to Frontal Transcranial Direct Current Stimulation (tDCS) and its Inter-Individual Variation in Healthy Humans. Clin EEG Neurosci 2022; 53:472-483. [PMID: 35491558 DOI: 10.1177/15500594221098285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In schizophrenia, a disorder associated with N-methyl-D-aspartate receptor (NMDAR) hypofunction, auditory cortical plasticity deficits have been indexed by the synchronized electroencephalographic (EEG) auditory steady-state gamma-band (40-Hz) response (ASSR) and the early auditory evoked gamma-band response (aeGBR), both considered to be target engagement biomarkers for NMDAR function, and potentially amenable to treatment by NMDAR modulators. As transcranial direct current stimulation (tDCS) is likely dependent on NMDAR neurotransmission, this preliminary study, conducted in 30 healthy volunteers, assessed the off-line effects of prefrontal anodal tDCS and sham (placebo) treatment on 40-Hz ASSR and aeGBR. Anodal tDCS failed to alter aeGBR but increased both 40-Hz ASSR power, as measured by event-related spectral perturbations (ERSP), and phase locking, as measured by inter-trial phase consistency (ITPC). Inter-individual differences in tDCS-induced increases in ERSP were negatively related to baseline ERSPs. These findings provide tentative support for further study of tDCS as a potential NMDAR neuromodulatory intervention for synchronized auditory gamma response deficits.
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Affiliation(s)
- Sara de la Salle
- 580059The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
| | - Urusa Shah
- Neuroscience, 6339Carleton University, Ottawa, ON, Canada
| | - Molly Hyde
- Department of Cellular and Molecular Medicine, 6363University of Ottawa, Ottawa, ON, Canada
| | - Renee Baysarowich
- Department of Cellular and Molecular Medicine, 6363University of Ottawa, Ottawa, ON, Canada
| | - Robert Aidelbaum
- School of Psychology, 6339Carleton University, Ottawa, ON, Canada
| | - Joëlle Choueiry
- 580059The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, 6363University of Ottawa, Ottawa, ON, Canada
| | - Verner Knott
- 580059The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.,Neuroscience, 6339Carleton University, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, 6363University of Ottawa, Ottawa, ON, Canada.,School of Psychology, 6339Carleton University, Ottawa, ON, Canada
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31
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Perez-Rando M, Elvira UKA, García-Martí G, Gadea M, Aguilar EJ, Escarti MJ, Ahulló-Fuster MA, Grasa E, Corripio I, Sanjuan J, Nacher J. Alterations in the volume of thalamic nuclei in patients with schizophrenia and persistent auditory hallucinations. Neuroimage Clin 2022; 35:103070. [PMID: 35667173 PMCID: PMC9168692 DOI: 10.1016/j.nicl.2022.103070] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/02/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022]
Abstract
Analysis of structural MRI images using a probabilistic atlas for segmentation of several nuclei of the thalamus. Comparison of chronic patients with schizophrenia, with and without auditory hallucinations and matched healthy controls. Volumetric reductions in patients with AH vs controls: Medial geniculate nucleus, anterior pulvinar nucleus and lateral and medial mediodorsal nuclei. In patients without AH we found reductions in the volume of the pulvinar and mediodorsal nuclei, but not in the medial geniculate nucleus. Found also some significant correlations between the volume of these nuclei and the total score of the PSYRATS scale.
The thalamus is a subcortical structure formed by different nuclei that relay information to the neocortex. Several reports have already described alterations of this structure in patients of schizophrenia that experience auditory hallucinations. However, to date no study has addressed whether the volumes of specific thalamic nuclei are altered in chronic patients experiencing persistent auditory hallucinations. We have processed structural MRI images using Freesurfer, and have segmented them into 25 nuclei using the probabilistic atlas developed by Iglesias and collaborators (Iglesias et al., 2018). To homogenize the sample, we have matched patients of schizophrenia, with and without persistent auditory hallucinations, with control subjects, considering sex, age and their estimated intracranial volume. This rendered a group number of 41 patients experiencing persistent auditory hallucinations, 35 patients without auditory hallucinations, and 55 healthy controls. In addition, we have also correlated the volume of the altered thalamic nuclei with the total score of the PSYRATS, a clinical scale used to evaluate the positive symptoms of this disorder. We have found alterations in the volume of 8 thalamic nuclei in both cohorts of patients with schizophrenia: The medial and lateral geniculate nuclei, the anterior, inferior, and lateral pulvinar nuclei, the lateral complex and the lateral and medial mediodorsal nuclei. We have also found some significant correlations between the volume of these nuclei in patients experiencing auditory hallucinations, and the total score of the PSYRATS scale. Altogether our results indicate that volumetric alterations of thalamic nuclei involved in audition may be related to persistent auditory hallucinations in chronic schizophrenia patients, whereas alterations in nuclei related to association cortices are evident in all patients. Future studies should explore whether the structural alterations are cause or consequence of these positive symptoms and whether they are already present in first episodes of psychosis.
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Affiliation(s)
- Marta Perez-Rando
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Institute of Research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain.
| | - Uriel K A Elvira
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; Institutes of Biomedical Technologies and Neuroscience, University of La Laguna, San Cristóbal de La Laguna, Spain
| | - Gracian García-Martí
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Quironsalud Hospital, Valencia, Spain
| | - Marien Gadea
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Institute of Research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain; Department of Psychobiology, Faculty of Psychology, Universitat de València, Valencia, Spain
| | - Eduardo J Aguilar
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Psychiatry Unit, Faculty of Medicine, Universitat de València, Valencia, Spain
| | - Maria J Escarti
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain
| | - Mónica Alba Ahulló-Fuster
- Department of Radiology, Rehabilitation and Physiotherapy. Faculty of Nursing, Physiotherapy and Podiatry. Universidad Complutense de Madrid, Spain
| | - Eva Grasa
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Servicio de Psiquiatría. Instituto de Investigación Biomédica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Iluminada Corripio
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Servicio de Psiquiatría. Instituto de Investigación Biomédica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Julio Sanjuan
- Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Quironsalud Hospital, Valencia, Spain
| | - Juan Nacher
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; Spanish National Network for Research in Mental Health, (CIBERSAM), Madrid, Spain; Institute of Research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain.
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32
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Clayson PE, Joshi YB, Thomas ML, Sprock J, Nungaray J, Swerdlow NR, Light GA. Click-evoked auditory brainstem responses (ABRs) are intact in schizophrenia and not sensitive to cognitive training. Biomark Neuropsychiatry 2022. [DOI: 10.1016/j.bionps.2022.100046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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33
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Clayson PE, Joshi YB, Thomas ML, Tarasenko M, Bismark A, Sprock J, Nungaray J, Cardoso L, Wynn JK, Swerdlow NR, Light GA. The viability of the frequency following response characteristics for use as biomarkers of cognitive therapeutics in schizophrenia. Schizophr Res 2022; 243:372-382. [PMID: 34187732 DOI: 10.1016/j.schres.2021.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 06/03/2021] [Accepted: 06/21/2021] [Indexed: 02/07/2023]
Abstract
Deficits in early auditory information processing contribute to cognitive and psychosocial disability; this has prompted development of interventions that target low-level auditory processing, which may alleviate these disabilities. The frequency following response (FFR) is a constellation of event-related potential and frequency characteristics that reflect the processing of acoustic stimuli at the level of the brainstem and ascending portions of the auditory pathway. While FFR is a promising candidate biomarker of response to auditory-based cognitive training interventions, the psychometric properties of FFR in schizophrenia patients have not been studied. Here we assessed the psychometric reliability and magnitude of group differences across 18 different FFR parameters to determine which of these parameters demonstrate adequate internal consistency. Electroencephalography from 40 schizophrenia patients and 40 nonpsychiatric comparison subjects was recorded during rapid presentation of an auditory speech stimulus (6000 trials). Patients showed normal response amplitudes but longer latencies for most FFR peaks and lower signal-to-noise ratios (SNRs) than healthy subjects. Analysis of amplitude and latency estimates of peaks, however, indicated a need for a substantial increase in task length to obtain internal consistency estimates above 0.80. In contrast, excellent internal consistency (>0.95) was shown for FFR sustained responses. Only SNR scores reflecting the FFR sustained response yielded significant group differences and excellent internal consistency, suggesting that this measure is a viable candidate for use in clinical treatment studies. The present study highlights the use of internal consistency estimates to select FFR characteristics for use in future intervention studies interested in individual differences among patients.
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Affiliation(s)
- Peter E Clayson
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Yash B Joshi
- VISN 22 Mental Illness Research, Education, & Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Melissa Tarasenko
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; VA San Diego Healthcare System, USA
| | - Andrew Bismark
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; VA San Diego Healthcare System, USA
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - John Nungaray
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Lauren Cardoso
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Jonathan K Wynn
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Gregory A Light
- VISN 22 Mental Illness Research, Education, & Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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34
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The glutamate/N-methyl-d-aspartate receptor (NMDAR) model of schizophrenia at 35: On the path from syndrome to disease. Schizophr Res 2022; 242:56-61. [PMID: 35125283 DOI: 10.1016/j.schres.2022.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 02/07/2023]
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35
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Meiron O, David J, Yaniv A. Early Auditory Processing Predicts Efficient Working Memory Functioning in Schizophrenia. Brain Sci 2022; 12:brainsci12020212. [PMID: 35203975 PMCID: PMC8870168 DOI: 10.3390/brainsci12020212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/25/2022] [Accepted: 01/30/2022] [Indexed: 02/04/2023] Open
Abstract
Early auditory processing (EAP) deficits have been consistently documented in individuals diagnosed with schizophrenia (SZ). However, a relationship between EAP and executive attention has not been confirmed in SZ versus healthy controls (HC). The current study aimed to demonstrate that unlike HC, in SZ patients, auditory change-detection event-related potentials (ERPs) are significantly associated with executive working memory (WM) functioning. Additionally, correlational analyses investigated the relationships between patients’ auditory ERPs, WM performance, and schizophrenia symptom severity scores. We examined verbal WM accuracy associated with “executive-control” prefrontal cortex mechanisms and EAP ERPs under midline prefrontal electrodes in 12 SZ patients versus 12 demographically matched HC. Mismatch negativity (MMN) amplitudes and latencies in SZ patients were not significantly different from HC, however, their verbal WM performance was significantly impaired versus HC. Importantly, prolonged MMN latencies in the SZ group were correlated with better WM accuracy. In the HC group, WM accuracy was unrelated to MMN latencies. Patients’ MMN parameters were unrelated to schizophrenia symptom-domain severity. However, patients’ WM RTs and accuracy were significantly related to illness severity and negative symptom severity, respectively. Therefore, inefficient sensory excitation related to EAP timing may underlie poor executive verbal WM functioning and might indirectly exacerbate the severity of negative symptoms in SZ. Treatments targeting prefrontal cortex dysfunction in schizophrenia are discussed.
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Affiliation(s)
- Oded Meiron
- Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem 91035, Israel; (J.D.); (A.Y.)
- Faculty of Education, Bar-Ilan University, Ramat Gan 5290002, Israel
- Correspondence:
| | - Jonathan David
- Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem 91035, Israel; (J.D.); (A.Y.)
| | - Asaf Yaniv
- Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem 91035, Israel; (J.D.); (A.Y.)
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36
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Mismatch negativity as an index of target engagement for excitation/inhibition-based treatment development: a double-blind, placebo-controlled, randomized, single-dose cross-over study of the serotonin type-3 receptor antagonist CVN058. Neuropsychopharmacology 2022; 47:711-718. [PMID: 34667294 PMCID: PMC8782925 DOI: 10.1038/s41386-021-01170-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
Serotonin type-3 receptor (5-HT3R) antagonists show potential as a treatment for cognitive deficits in schizophrenia. CVN058, a brain-penetrant, potent and selective 5-HT3R antagonist, shows efficacy in rodent models of cognition and was well-tolerated in Phase-1 studies. We evaluated the target engagement of CVN058 using mismatch negativity (MMN) in a randomized, double-blind, placebo-controlled, cross-over study. Subjects were stable outpatients with schizophrenia or schizoaffective disorder treated with antipsychotics. Subjects were not permitted to use other 5-HT3R modulators or serotonin reuptake inhibitors. Each subject received a high (150 mg) and low (15 mg or 75 mg) oral dose of CVN058 and placebo in a randomized order across 3 single-day treatment visits separated by at least 1 week. The primary pre-registered outcome was amplitude of duration MMN. Amplitude of other MMN deviants (frequency, intensity, frequency modulation, and location), P50, P300 and auditory steady-state response (ASSR) were exploratory endpoints. 19 of 22 randomized subjects (86.4%) completed the study. Baseline PANSS scores indicated moderate impairment. CVN058 150 mg led to significant improvement vs. placebo on the primary outcome of duration MMN (p = 0.02, Cohen's d = 0.48). A significant treatment effect was also seen in a combined analysis across all MMN deviants (p < 0.001, d = 0.57). Effects on location MMN were independently significant (p < 0.007, d = 0.46). No other significant effects were seen for other deviants, doses or EEG measures. There were no clinically significant treatment related adverse effects. These results show MMN to be a sensitive target engagement biomarker for 5-HT3R, and support the potential utility of CVN058 in correcting the excitatory/inhibitory imbalance in schizophrenia.
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37
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Clementz BA, Parker DA, Trotti RL, McDowell JE, Keedy SK, Keshavan MS, Pearlson GD, Gershon ES, Ivleva EI, Huang LY, Hill SK, Sweeney JA, Thomas O, Hudgens-Haney M, Gibbons RD, Tamminga CA. Psychosis Biotypes: Replication and Validation from the B-SNIP Consortium. Schizophr Bull 2022; 48:56-68. [PMID: 34409449 PMCID: PMC8781330 DOI: 10.1093/schbul/sbab090] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Current clinical phenomenological diagnosis in psychiatry neither captures biologically homologous disease entities nor allows for individualized treatment prescriptions based on neurobiology. In this report, we studied two large samples of cases with schizophrenia, schizoaffective, and bipolar I disorder with psychosis, presentations with clinical features of hallucinations, delusions, thought disorder, affective, or negative symptoms. A biomarker approach to subtyping psychosis cases (called psychosis Biotypes) captured neurobiological homology that was missed by conventional clinical diagnoses. Two samples (called "B-SNIP1" with 711 psychosis and 274 healthy persons, and the "replication sample" with 717 psychosis and 198 healthy persons) showed that 44 individual biomarkers, drawn from general cognition (BACS), motor inhibitory (stop signal), saccadic system (pro- and anti-saccades), and auditory EEG/ERP (paired-stimuli and oddball) tasks of psychosis-relevant brain functions were replicable (r's from .96-.99) and temporally stable (r's from .76-.95). Using numerical taxonomy (k-means clustering) with nine groups of integrated biomarker characteristics (called bio-factors) yielded three Biotypes that were virtually identical between the two samples and showed highly similar case assignments to subgroups based on cross-validations (88.5%-89%). Biotypes-1 and -2 shared poor cognition. Biotype-1 was further characterized by low neural response magnitudes, while Biotype-2 was further characterized by overactive neural responses and poor sensory motor inhibition. Biotype-3 was nearly normal on all bio-factors. Construct validation of Biotype EEG/ERP neurophysiology using measures of intrinsic neural activity and auditory steady state stimulation highlighted the robustness of these outcomes. Psychosis Biotypes may yield meaningful neurobiological targets for treatments and etiological investigations.
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Affiliation(s)
- Brett A Clementz
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - David A Parker
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Rebekah L Trotti
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
- Institute of Living, Hartford Healthcare Corp, Hartford, CT, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ling-Yu Huang
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Olivia Thomas
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | | | - Robert D Gibbons
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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Lado-Codesido M, Rey Varela RM, Larios Quiñones M, Martínez Agulleiro L, Ossa Basanes J, Martínez Querol M, Mateos R, Spuch C, García-Caballero A. Voices 2: Improving Prosodic Recognition in Schizophrenia With an Online Rehabilitation Program. Front Psychol 2022; 12:739252. [PMID: 35002838 PMCID: PMC8739759 DOI: 10.3389/fpsyg.2021.739252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Emotion recognition of voices may play an important role in interpersonal communication and patients with schizophrenia present alterations in this regard. Several on-line rehabilitation tools have been developed for treatment in this area. Voices is an on-line prosodic recognition program consisting of identifying different emotional tones in neutral phrases, in different sessions of gradually increasing difficulty. This training tool has previously reported benefits, and a new version has been created called Voices 2. The main aim of this study is to test the capacity of the Voices 2 program to improve emotion recognition through prosody for adults with schizophrenia. Secondly, it seeks to observe durability effects 1 month after intervention. Method: A randomized, single-blind, multicenter clinical trial was conducted with 44 outpatients diagnosed with schizophrenia or schizoaffective disorder. The intervention group (also called Voices) was treated with Voices 2, whereas the control group was treated with auditory training that was not related to emotions. Sociodemographic and clinical data, clinical state (PANSS), Intelligence Quotient and prosodic recognition (RMV-SV) were measured at baseline. After intervention, RMV-SV and PANSS were assessed. One month later, the RMV-SV measure was repeated. Results: The control group (n = 19) and the Voices group (n = 22) did not differ on χ2, t or U tests in sociodemographic, clinical and psychometric variables at baseline or post-intervention (all p-values > 0.05). In the Voices group, statistically significant differences were observed in the RMV-SV scale applied post-intervention vs. that applied pre-intervention (Z = 2.47, p = 0.013). Similar results were observed in the 1-month follow-up RMV-SV vs. the pre-intervention RMV-SV (Z = 1.97, p = 0.049). PANSS scale was also assessed with no significant differences between pre vs. post measures in both groups. Lastly, Voices 2 was rated relatively higher, based on its ease of understanding, entertainment value, usefulness and the appropriateness of use of its emotional glossary. Discussion: Improvements were observed in prosodic recognition following intervention with Voices 2 in the Voices group. Although these results are similar to other clinical trial rehabilitation programs, specific research on the matter remains scarce. Certain aspects, such as the durability of effects or adherence should be thoroughly studied and clarified. Clinical Trial Registration: [https://doi.org/10.17605/OSF.IO/G95C4].
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Affiliation(s)
- María Lado-Codesido
- University of Santiago de Compostela, Santiago de Compostela, Spain.,Department of Psychiatry, Donostia University Hospital, San Sebastián, Spain
| | | | - Marina Larios Quiñones
- Centro de Rehabilitación Laboral "Nueva Vida," Red Pública de Atención Social a Personas con Enfermedad Mental Grave y Duradera, Consejería de Políticas Sociales, Familias, Igualdad y Natalidad, Asociación Psiquiatría y Vida, Madrid, Spain
| | | | | | | | - Raimundo Mateos
- Department of Psychiatry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Spuch
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Alejandro García-Caballero
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain.,Department of Psychiatry, University Hospital Complex of Ourense, Ourense, Spain
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Yi GL, Zhu MZ, Cui HC, Yuan XR, Liu P, Tang J, Li YQ, Zhu XH. A hippocampus dependent neural circuit loop underlying the generation of auditory mismatch negativity. Neuropharmacology 2022; 206:108947. [PMID: 35026286 DOI: 10.1016/j.neuropharm.2022.108947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/11/2021] [Accepted: 01/06/2022] [Indexed: 11/16/2022]
Abstract
Extracting relevant information and transforming it into appropriate behavior, is a fundamental brain function, and requires the coordination between the sensory and cognitive systems, however, the underlying mechanisms of interplay between sensory and cognition systems remain largely unknown. Here, we developed a mouse model for mimicking human auditory mismatch negativity (MMN), a well-characterized translational biomarker for schizophrenia, and an index of early auditory information processing. We found that a subanesthetic dose of ketamine decreased the amplitude of MMN in adult mice. Using pharmacological and chemogenetic approaches, we identified an auditory cortex-entorhinal cortex-hippocampus neural circuit loop that is required for the generation of MMN. In addition, we found that inhibition of dCA1→MEC circuit impaired the auditory related fear discrimination. Moreover, we found that ketamine induced MMN deficiency by inhibition of long-range GABAergic projection from the CA1 region of the dorsal hippocampus to the medial entorhinal cortex. These results provided circuit insights for ketamine effects and early auditory information processing. As the entorhinal cortex is the interface between the neocortex and hippocampus, and the hippocampus is critical for the formation, consolidation, and retrieval of episodic memories and other cognition, our results provide a neural mechanism for the interplay between the sensory and cognition systems.
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Affiliation(s)
- Guo-Liang Yi
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Min-Zhen Zhu
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - He-Chen Cui
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Xin-Rui Yuan
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Peng Liu
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Jie Tang
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Yuan-Qing Li
- Research Center for Brain-Computer Interface, Pazhou Lab, Guangzhou, 510330, China
| | - Xin-Hong Zhu
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China; Research Center for Brain Health, Pazhou Lab, Guangzhou, 510330, China; School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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40
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Green MF, Wynn JK, Gabrielian S, Hellemann G, Horan WP, Kern RS, Lee J, Marder SR, Sugar CA. Motivational and cognitive factors linked to community integration in homeless veterans: study 1 - individuals with psychotic disorders. Psychol Med 2022; 52:169-177. [PMID: 32517838 DOI: 10.1017/s0033291720001889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the determinants of community integration (i.e. recovery) for individuals with a history of homelessness, yet such information is essential to develop targeted interventions. METHODS We recruited homeless Veterans with a history of psychotic disorders and evaluated four domains of correlates of community integration: perception, non-social cognition, social cognition, and motivation. Baseline assessments occurred after participants were engaged in supported housing services but before they received housing, and again after 12 months. Ninety-five homeless Veterans with a history of psychosis were assessed at baseline and 53 returned after 12 months. We examined both cross-sectional and longitudinal relationships with 12-month community integration. RESULTS The strongest longitudinal association was between a baseline motivational measure and social integration at 12 months. We also observed cross-sectional associations at baseline between motivational measures and community integration, including social, work, and independent living. Cross-lagged panel analyses did not suggest causal associations for the motivational measures. Correlations with perception and non-social cognition were weak. One social cognition measure showed a significant longitudinal correlation with independent living at 12 months that was significant for cross-lagged analysis, consistent with a causal relationship and potential treatment target. CONCLUSIONS The relatively selective associations for motivational measures differ from what is typically seen in psychosis, in which all domains are associated with community integration. These findings are presented along with a partner paper (Study 2) to compare findings from this study to an independent sample without a history of psychotic disorders to evaluate the consistency in findings regarding community integration across projects.
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Affiliation(s)
- Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Sonya Gabrielian
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
- VeriSci, Durham, North Carolina, USA
| | - Robert S Kern
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Stephen R Marder
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
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Giordano GM, Giuliani L, Perrottelli A, Bucci P, Di Lorenzo G, Siracusano A, Brando F, Pezzella P, Fabrazzo M, Altamura M, Bellomo A, Cascino G, Comparelli A, Monteleone P, Pompili M, Galderisi S, Maj M. Mismatch Negativity and P3a Impairment through Different Phases of Schizophrenia and Their Association with Real-Life Functioning. J Clin Med 2021; 10:5838. [PMID: 34945138 PMCID: PMC8707866 DOI: 10.3390/jcm10245838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Impairment in functioning since the onset of psychosis and further deterioration over time is a key aspect of subjects with schizophrenia (SCZ). Mismatch negativity (MMN) and P3a, indices of early attention processing that are often impaired in schizophrenia, might represent optimal electrophysiological candidate biomarkers of illness progression and poor outcome. However, contrasting findings are reported about the relationships between MMN-P3a and functioning. The study aimed to investigate in SCZ the influence of illness duration on MMN-P3a and the relationship of MMN-P3a with functioning. Pitch (p) and duration (d) MMN-P3a were investigated in 117 SCZ and 61 healthy controls (HCs). SCZ were divided into four illness duration groups: ≤ 5, 6 to 13, 14 to 18, and 19 to 32 years. p-MMN and d-MMN amplitude was reduced in SCZ compared to HCs, independently from illness duration, psychopathology, and neurocognitive deficits. p-MMN reduction was associated with lower "Work skills". The p-P3a amplitude was reduced in the SCZ group with longest illness duration compared to HCs. No relationship between P3a and functioning was found. Our results suggested that MMN amplitude reduction might represent a biomarker of poor functioning in SCZ.
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Affiliation(s)
- Giulia M. Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Paola Bucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.D.L.); (A.S.)
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.D.L.); (A.S.)
| | - Francesco Brando
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Michele Fabrazzo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Mario Altamura
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Antonello Bellomo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of Neurosciences, University of Salerno, 84133 Salerno, Italy; (G.C.); (P.M.)
| | - Anna Comparelli
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (A.C.); (M.P.)
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of Neurosciences, University of Salerno, 84133 Salerno, Italy; (G.C.); (P.M.)
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (A.C.); (M.P.)
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
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Grubisha MJ, Sun T, Eisenman L, Erickson SL, Chou S, Helmer CD, Trudgen MT, Ding Y, Homanics GE, Penzes P, Wills ZP, Sweet RA. A Kalirin missense mutation enhances dendritic RhoA signaling and leads to regression of cortical dendritic arbors across development. Proc Natl Acad Sci U S A 2021; 118:e2022546118. [PMID: 34848542 PMCID: PMC8694055 DOI: 10.1073/pnas.2022546118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 09/15/2021] [Indexed: 11/26/2022] Open
Abstract
Normally, dendritic size is established prior to adolescence and then remains relatively constant into adulthood due to a homeostatic balance between growth and retraction pathways. However, schizophrenia is characterized by accelerated reductions of cerebral cortex gray matter volume and onset of clinical symptoms during adolescence, with reductions in layer 3 pyramidal neuron dendritic length, complexity, and spine density identified in multiple cortical regions postmortem. Nogo receptor 1 (NGR1) activation of the GTPase RhoA is a major pathway restricting dendritic growth in the cerebral cortex. We show that the NGR1 pathway is stimulated by OMGp and requires the Rho guanine nucleotide exchange factor Kalirin-9 (KAL9). Using a genetically encoded RhoA sensor, we demonstrate that a naturally occurring missense mutation in Kalrn, KAL-PT, that was identified in a schizophrenia cohort, confers enhanced RhoA activitation in neuronal dendrites compared to wild-type KAL. In mice containing this missense mutation at the endogenous locus, there is an adolescent-onset reduction in dendritic length and complexity of layer 3 pyramidal neurons in the primary auditory cortex. Spine density per unit length of dendrite is unaffected. Early adult mice with these structural deficits exhibited impaired detection of short gap durations. These findings provide a neuropsychiatric model of disease capturing how a mild genetic vulnerability may interact with normal developmental processes such that pathology only emerges around adolescence. This interplay between genetic susceptibility and normal adolescent development, both of which possess inherent individual variability, may contribute to heterogeneity seen in phenotypes in human neuropsychiatric disease.
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Affiliation(s)
- Melanie J Grubisha
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Tao Sun
- Department of Biostatistics, University of Pittsburgh, PA 15261
| | - Leanna Eisenman
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261
| | - Susan L Erickson
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Shinnyi Chou
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Cassandra D Helmer
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Melody T Trudgen
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, PA 15261
| | - Gregg E Homanics
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Peter Penzes
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611
| | - Zachary P Wills
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261
| | - Robert A Sweet
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213;
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
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Raucher-Chéné D, Thibaudeau E, Sauvé G, Lavigne KM, Lepage M. Understanding others as a mediator between verbal memory and negative symptoms in schizophrenia-spectrum disorder. J Psychiatr Res 2021; 143:429-435. [PMID: 34656875 DOI: 10.1016/j.jpsychires.2021.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/05/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022]
Abstract
From the onset of schizophrenia, verbal memory (VM) deficits and negative symptoms are strongly associated, and both additively predict functional outcomes. Emotion recognition (ER) and theory of mind (ToM; the ability to infer others' mental states), two components of social cognition, are also particularly affected in schizophrenia. Explanatory models of negative symptoms have integrated these cognitive impairments as potential precursors and previous studies revealed relationships between ER and/or ToM and VM, as well as with negative symptoms, but the organization of these associations remains unclear. We aimed to determine whether impairments in VM and social cognition sequentially pave the way for negative symptoms in schizophrenia. To this end, we used mediation analyses. One hundred and forty participants with a diagnosis of schizophrenia or schizoaffective disorder were recruited. First, correlational analyses were conducted between our variables of interest. The mediating effect of social cognition between VM and negative symptoms was then examined using the PROCESS macro. Variables of interest were significantly correlated (r = |0.166| to |0.391|), except for ER and negative symptoms. Only the serial multiple mediation model with 2 mediators (ER followed by ToM) revealed a significant indirect effect of VM on negative symptoms (β = - 0.160, 95% CI = -.370 to -.004). This relationship was selective for expressive negative symptoms (e.g., blunted affect and alogia). This study illustrates the richness of the relationship between cognitive deficits and negative symptoms and provides additional information for the involvement of social cognition in negative symptoms' etiology.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | - Elisabeth Thibaudeau
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Geneviève Sauvé
- Douglas Mental Health University Institute, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Katie M Lavigne
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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44
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Ahmed S, Lepock JR, Mizrahi R, Bagby RM, Gerritsen CJ, Korostil M, Light GA, Kiang M. Decreased Gamma Auditory Steady-State Response Is Associated With Impaired Real-World Functioning in Unmedicated Patients at Clinical High Risk for Psychosis. Clin EEG Neurosci 2021; 52:400-405. [PMID: 33356513 DOI: 10.1177/1550059420982706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM Deficits in synchronous, gamma-frequency neural oscillations may contribute to schizophrenia patients' real-world functional impairment and can be measured electroencephalographically using the auditory steady-state response (ASSR). Gamma ASSR deficits have been reported in schizophrenia patients and individuals at clinical high risk (CHR) for developing psychosis. We hypothesized that, in CHR patients, gamma ASSR would correlate with real-world functioning, consistent with a role for gamma synchrony deficits in functional impairment. METHODS A total of 35 CHR patients rated on Global Functioning: Social and Role scales had EEG recorded while listening to 1-ms, 93-dB clicks presented at 40 Hz in 500-ms trains, in response to which 40-Hz evoked power and intertrial phase-locking factor (PLF) were measured. RESULTS In CHR patients, lower 40-Hz PLF correlated with lower social functioning. CONCLUSIONS Gamma synchrony deficits may be a biomarker of real-world impairment at early stages of the schizophrenia disease trajectory.
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Affiliation(s)
- Sarah Ahmed
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jennifer R Lepock
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Romina Mizrahi
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - R Michael Bagby
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | - Cory J Gerritsen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | - Michele Korostil
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Michael Kiang
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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45
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Clayson PE, Molina JL, Joshi YB, Thomas ML, Sprock J, Nungaray J, Swerdlow NR, Light GA. Evaluation of the frequency following response as a predictive biomarker of response to cognitive training in schizophrenia. Psychiatry Res 2021; 305:114239. [PMID: 34673326 DOI: 10.1016/j.psychres.2021.114239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/01/2021] [Accepted: 10/09/2021] [Indexed: 11/28/2022]
Abstract
Neurophysiological biomarkers of auditory processing show promise predicting outcomes following auditory-based targeted cognitive training (TCT) in schizophrenia, but the viability of the frequency following response (FFR) as a biomarker has yet to be examined, despite its ecological and face validity for auditory-based interventions. FFR is an event-related potential (ERP) that reflects early auditory processing. We predicted that schizophrenia patients would show acute- and longer-term FFR malleability in the context of TCT. Patients were randomized to either TCT (n = 30) or treatment as usual (TAU; n = 22), and electroencephalography was recorded during rapid presentation of an auditory speech stimulus before treatment, after one hour of training, and after 30 h of training. Whereas patients in the TCT group did not show changes in FFR after training, amplitude reductions were observed in the TAU. FFR was positively associated with performance on a measure of single word-in-noise perception in the TCT group, and with a measure of sentence-in-noise perception in both groups. Psychometric reliability analyses of FFR scores indicated high internal consistency but low one-hour and 12-week test-rest reliability. These findings support the dissociation between measures of speech discriminability along the hierarchy of cortical and subcortical early auditory information processing in schizophrenia.
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Affiliation(s)
- Peter E Clayson
- Department of Psychology, University of South Florida, University of California San Diego, 9500 Gilman Drive #0804 La Jolla, Tampa, CA 92093, USA
| | - Juan L Molina
- VISN 22 Mental Illness Research, Education and Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA
| | - Yash B Joshi
- VISN 22 Mental Illness Research, Education and Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - John Nungaray
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Gregory A Light
- VISN 22 Mental Illness Research, Education and Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
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N-methyl-d-aspartate receptor antagonism modulates P300 event-related potentials and associated activity in salience and central executive networks. Pharmacol Biochem Behav 2021; 211:173287. [PMID: 34653398 DOI: 10.1016/j.pbb.2021.173287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/21/2022]
Abstract
Impairments in auditory information processing in schizophrenia as indexed electrophysiologically by P300 deficits during novelty (P3a) and target (P3b) processing are linked to N -methyl- D -aspartate receptor (NMDAR) dysfunction. This study in 14 healthy volunteers examined the effects of a subanesthetic dose of the NMDAR antagonist ketamine on P300 and their relationship to psychomimetic symptoms and cortical source activity (with eLORETA). Ketamine reduced early (e- P3a) and late (l-P3a) novelty P300 at sensor (scalp)-level and at source-level in the salience network. Increases in dissociation symptoms were negatively correlated with ketamine-induced P3b changes, at sensor-level and source-level, in both salience and central executive networks. These P3a alterations during novelty processing, and the symptom-related P3b changes during target processing support a model of NMDAR hypofunction underlying disrupted auditory attention in schizophrenia.
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47
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Central auditory processing deficits in schizophrenia: Effects of auditory-based cognitive training. Schizophr Res 2021; 236:135-141. [PMID: 34500174 PMCID: PMC9259506 DOI: 10.1016/j.schres.2021.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/23/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sensory processing abnormalities are common in schizophrenia (SZ) and impact everyday functions, such as speech perception in noisy environments. Auditory-based targeted cognitive training (TCT) is a "bottom up" cognitive remediation intervention designed to enhance the speed and accuracy of low-level auditory information processing. However, the effects of TCT on behavioral measures of central auditory processing (CAP) and the role of CAP function on verbal learning outcomes in SZ are unknown. METHODS SZ (n = 42) and healthy subjects (CTL; n = 18) underwent comprehensive clinical, neurocognitive, and auditory assessments, including tests of hearing sensitivity and speech recognition (Words-in-Noise (WIN), Quick Speech-in-Noise (SIN)). SZ patients were randomized to receive either treatment-as-usual (TAU); or 30-h of TCT + TAU using a stratified, parallel design. SZ patients repeated assessments ~10-12 weeks later. RESULTS Patients exhibited deficits in both WIN (p < 0.05, d = 0.50) and SIN (p < 0.01, d = 0.63). A treatment × time interaction on WIN (p < 0.05, d = 0.74), but not SIN discriminability, was seen in the TCT group relative to TAU. Specific enhancements in the 4-dB over background range drove gains in WIN performance. Moreover, SZ patients with greater CAP deficits experienced robust gains in verbal learning after 30-h of TCT relative to SZ patients without CAP impairment (p < 0.01, d = 1.28). CONCLUSION Findings demonstrate that intensive auditory training enhances the fidelity of auditory processing and perception, such that specific CAP deficits were 'normalized' and were predictive of gains in verbal learning after TCT. It is conceivable that patients with deficiencies in CAP measures may benefit most from TCT and other interventions targeting auditory dysfunction in SZ.
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Joshi YB, Thomas ML, Braff DL, Green MF, Gur RC, Gur RE, Nuechterlein KH, Stone WS, Greenwood TA, Lazzeroni LC, MacDonald LR, Molina JL, Nungaray JA, Radant AD, Silverman JM, Sprock J, Sugar CA, Tsuang DW, Tsuang MT, Turetsky BI, Swerdlow NR, Light GA. Anticholinergic Medication Burden-Associated Cognitive Impairment in Schizophrenia. Am J Psychiatry 2021; 178:838-847. [PMID: 33985348 PMCID: PMC8440496 DOI: 10.1176/appi.ajp.2020.20081212] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Many psychotropic medications used to treat schizophrenia have significant anticholinergic properties, which are linked to cognitive impairment and dementia risk in healthy subjects. Clarifying the impact of cognitive impairment attributable to anticholinergic medication burden may help optimize cognitive outcomes in schizophrenia. The aim of this study was to comprehensively characterize how this burden affects functioning across multiple cognitive domains in schizophrenia outpatients. METHODS Cross-sectional data were analyzed using inferential statistics and exploratory structural equation modeling to determine the relationship between anticholinergic medication burden and cognition. Patients with a diagnosis of schizophrenia or schizoaffective disorder (N=1,120) were recruited from the community at five U.S. universities as part of the Consortium on the Genetics of Schizophrenia-2. For each participant, prescribed medications were rated and summed according to a modified Anticholinergic Cognitive Burden (ACB) scale. Cognitive functioning was assessed by performance on domains of the Penn Computerized Neurocognitive Battery (PCNB). RESULTS ACB score was significantly associated with cognitive performance, with higher ACB groups scoring worse than lower ACB groups on all domains tested on the PCNB. Similar effects were seen on other cognitive tests. Effects remained significant after controlling for demographic characteristics and potential proxies of illness severity, including clinical symptoms and chlorpromazine-equivalent antipsychotic dosage. CONCLUSIONS Anticholinergic medication burden in schizophrenia is substantial, common, conferred by multiple medication classes, and associated with cognitive impairments across all cognitive domains. Anticholinergic medication burden from all medication classes-including psychotropics used in usual care-should be considered in treatment decisions and accounted for in studies of cognitive functioning in schizophrenia.
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Affiliation(s)
- Yash B. Joshi
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego,Department of Psychiatry, University of California, San Diego, La Jolla
| | | | - David L. Braff
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego,Department of Psychiatry, University of California, San Diego, La Jolla
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles,Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | | | - William S. Stone
- Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston
| | | | - Laura C. Lazzeroni
- Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif,Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif
| | - Laura R. MacDonald
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego,Department of Psychiatry, University of California, San Diego, La Jolla
| | - Juan L. Molina
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego,Department of Psychiatry, University of California, San Diego, La Jolla
| | - John A. Nungaray
- Department of Psychiatry, University of California, San Diego, La Jolla
| | - Allen D. Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle,Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle
| | - Jeremy M. Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York,Research and Development, James J. Peters VA Medical Center, New York
| | - Joyce Sprock
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego,Department of Psychiatry, University of California, San Diego, La Jolla
| | - Catherine A. Sugar
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles,Department of Biostatistics, UCLA School of Public Health, Los Angeles
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle,Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle
| | - Ming T. Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla
| | | | - Neal R. Swerdlow
- Department of Psychiatry, University of California, San Diego, La Jolla
| | - Gregory A. Light
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego,Department of Psychiatry, University of California, San Diego, La Jolla
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Foti D, Perlman G, Bromet EJ, Harvey PD, Hajcak G, Mathalon DH, Kotov R. Pathways from performance monitoring to negative symptoms and functional outcomes in psychotic disorders. Psychol Med 2021; 51:2012-2022. [PMID: 32317045 PMCID: PMC10769507 DOI: 10.1017/s0033291720000768] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Performance monitoring entails rapid error detection to maintain task performance. Impaired performance monitoring is a candidate pathophysiological process in psychotic disorders, which may explain the broader deficit in executive function and its known associations with negative symptoms and poor functioning. The current study models cross-sectional pathways bridging neurophysiological measures of performance monitoring with executive function, symptoms, and functioning. METHODS Data were from the 20-year assessment of the Suffolk County Mental Health Project. Individuals with psychotic disorders (N = 181) were originally recruited from inpatient psychiatric facilities. Data were also collected from a geographically and demographically matched group with no psychosis history (N = 242). Neural measures were the error-related negativity (ERN) and error positivity (Pe). Structural equation modeling tested mediation pathways. RESULTS Blunted ERN and Pe in the clinical cohort related to impaired executive function (r = 0.26-0.35), negative symptom severity (r = 0.17-0.25), and poor real-world functioning (r = 0.17-0.19). Associations with executive function were consistent across groups. Multiple potential pathways were identified in the clinical cohort: reduced ERN to inexpressivity was mediated by executive function (β = 0.10); reduced Pe to global functioning was mediated by executive function and avolition (β = 0.10). CONCLUSIONS This supports a transdiagnostic model of psychotic disorders by which poor performance monitoring contributes to impaired executive function, which contributes to negative symptoms and poor real-world functioning. If supported by future longitudinal research, these pathways could inform the development of targeted interventions to address cognitive and functional deficits that are central to psychotic disorders.
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Affiliation(s)
- Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, IN
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University, Stony Brook, NY
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University, Stony Brook, NY
| | | | - Greg Hajcak
- Department of Psychology and Biomedical Science, Florida State University, Tallahassee, FL
| | - Daniel H. Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY
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50
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Osborne KJ, Damme KS, Gupta T, Dean DJ, Bernard JA, Mittal VA. Timing dysfunction and cerebellar resting state functional connectivity abnormalities in youth at clinical high-risk for psychosis. Psychol Med 2021; 51:1289-1298. [PMID: 32008594 PMCID: PMC9754787 DOI: 10.1017/s0033291719004161] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Consistent with pathophysiological models of psychosis, temporal disturbances in schizophrenia spectrum populations may reflect abnormal cortical (e.g. prefrontal cortex) and subcortical (e.g. striatum) cerebellar connectivity. However, few studies have examined associations between cerebellar connectivity and timing dysfunction in psychosis populations, and none have been conducted in youth at clinical high-risk (CHR) for psychosis. Thus, it is currently unknown if impairments in temporal processes are present in CHR youth or how they may be associated with cerebellar connectivity and worsening of symptoms. METHODS A total of 108 (56 CHR/52 controls) youth were administered an auditory temporal bisection task along with a resting state imaging scan to examine cerebellar resting state connectivity. Positive and negative symptoms at baseline and 12 months later were also quantified. RESULTS Controlling for alcohol and cannabis use, CHR youth exhibited poorer temporal accuracy compared to controls, and temporal accuracy deficits were associated with abnormal connectivity between the bilateral anterior cerebellum and a right caudate/nucleus accumbens striatal cluster. Poor temporal accuracy accounted for 11% of the variance in worsening of negative symptoms over 12 months. CONCLUSIONS Behavioral findings suggest CHR youth perceive durations of auditory tones as shortened compared to objective time, which may indicate a slower internal clock. Poorer temporal accuracy in CHR youth was associated with abnormalities in brain regions involved in an important cerebellar network implicated in prominent pathophysiological models of psychosis. Lastly, temporal accuracy was associated with worsening of negative symptoms across 12 months, suggesting temporal dysfunction may be sensitive to illness progression.
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Affiliation(s)
- K. Juston Osborne
- Northwestern University, Department of Psychology, Evanston, IL, USA
| | | | - Tina Gupta
- Northwestern University, Department of Psychology, Evanston, IL, USA
| | - Derek J. Dean
- University of Colorado Boulder, Department of Psychology, Boulder, CO, USA
| | - Jessica A. Bernard
- Texas A & M University, Department of Psychology, College Station, TX, USA
| | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Evanston, Chicago, IL, USA
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