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Atagun MI, Drukker M, Hall MH, Altun IK, Tatli SZ, Guloksuz S, van Os J, van Amelsvoort T. Meta-analysis of auditory P50 sensory gating in schizophrenia and bipolar disorder. Psychiatry Res Neuroimaging 2020; 300:111078. [PMID: 32361172 DOI: 10.1016/j.pscychresns.2020.111078] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 11/15/2022]
Abstract
The ability of the brain to reduce the amount of trivial or redundant sensory inputs is called gating function. Dysfunction of sensory gating may lead to cognitive fragmentation and poor real-world functioning. The auditory dual-click paradigm is a pertinent neurophysiological measure of sensory gating function. This meta-analysis aimed to examine the subcomponents of abnormal P50 waveforms in bipolar disorder and schizophrenia to assess P50 sensory gating deficits and examine effects of diagnoses, illness states (first-episode psychosis vs. schizophrenia, remission vs. episodes in bipolar disorder), and treatment status (medication-free vs. medicated). Literature search of PubMed between Jan 1st 1980 and March 31st 2019 identified 2091 records for schizophrenia, 362 for bipolar disorder. 115 studies in schizophrenia (4932 patients), 16 in bipolar disorder (975 patients) and 10 in first-degree relatives (848 subjects) met the inclusion criteria. P50 sensory gating ratio (S2/S1) and S1-S2 difference were significantly altered in schizophrenia, bipolar disorder and their first-degree relatives. First-episode psychosis did not differ from schizophrenia, however episodes altered P50 sensory gating in bipolar disorder. Medications improve P50 sensory gating alterations in schizophrenia significantly and at trend level in bipolar disorder. Future studies should examine longitudinal course of P50 sensory gating in schizophrenia and bipolar disorder.
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Affiliation(s)
- Murat Ilhan Atagun
- Department of Psychiatry, Ankara Yildirim Beyazit University Medical School, Universities Region, Ihsan Dogramaci Boulevard. No: 6, Bilkent, Cankaya, Ankara Turkey.
| | - Marjan Drukker
- Department of Psychiatry and Neuropsychology, Maastricht University School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands
| | - Mei Hua Hall
- Psychosis Neurobiology Laboratory, Harvard Medical School, McLean Hospital, Belmont, Massachusetts, USA
| | - Ilkay Keles Altun
- Department of Psychiatry, Bursa Higher Education Training and Education Hospital, Bursa, Turkey
| | | | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, Maastricht University School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, Maastricht University School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands; King's Health Partners Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, United Kingdom; Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands
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Chan SY, Brady R, Hwang M, Higgins A, Nielsen K, Öngür D, Hall MH. Heterogeneity of Outcomes and Network Connectivity in Early-Stage Psychosis: A Longitudinal Study. Schizophr Bull 2020; 47:138-148. [PMID: 32572485 PMCID: PMC7825010 DOI: 10.1093/schbul/sbaa079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Imaging studies in psychotic disorders typically examine cross-sectional relationships between magnetic resonance imaging (MRI) signals and diagnosis or symptoms. We sought to examine changes in network connectivity identified using resting-state functional MRI (fMRI) corresponding to divergent functional recovery trajectories and relapse in early-stage psychosis (ESP). Prior studies have linked schizophrenia to hyperconnectivity in the default mode network (DMN). Given the correlations between the DMN and behavioral impairments in psychosis, we hypothesized that dynamic changes in DMN connectivity reflect the heterogeneity of outcomes in ESP. Longitudinal data were collected from 66 ESP patients and 20 healthy controls. Longitudinal cluster analysis identified subgroups of patients with similar trajectories in terms of symptom severity and functional outcomes. DMN connectivity was measured in a subset of patients (n = 36) longitudinally over 2 scans separated by a mean of 12 months. We then compared connectivity between patients and controls, and among the different outcome trajectory subgroups. Among ESP participants, 4 subgroups were empirically identified corresponding to: "Poor," "Middle," "Catch-up," and "Good" trajectory outcomes in the complete dataset (n = 36), and an independent replication (n = 30). DMN connectivity changes differed significantly between functional subgroups (F3,32 = 6.06, P-FDR corrected = .01); DMN connectivity increased over time in the "Poor" outcome cluster (β = +0.145) but decreased over time in the "Catch-up" cluster (β = -0.212). DMN connectivity is dynamic and correlates with a change in functional status over time in ESP. This approach identifies a brain-based marker that reflects important neurobiological processes required to sustain functional recovery.
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Affiliation(s)
- Shi Yu Chan
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA,Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA,To whom correspondence should be addressed; Psychosis Neurobiology Lab/Schizophrenia and Bipolar Disorders Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478; tel: 1-617-855-3528, fax: 1-617-855-2895, e-mail:
| | - Roscoe Brady
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA,Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA
| | - Melissa Hwang
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA
| | - Amy Higgins
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA,Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA
| | - Kathryn Nielsen
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA,Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Mei-Hua Hall
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA,Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
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Gault JM, Thompson JA, Maharajh K, Hosokawa P, Stevens KE, Olincy A, Liedtke EI, Ojemann A, Ojemann S, Abosch A. Striatal and Thalamic Auditory Response During Deep Brain Stimulation for Essential Tremor: Implications for Psychosis. Neuromodulation 2020; 23:478-488. [PMID: 32022409 DOI: 10.1111/ner.13101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 12/04/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The P50, a positive auditory-evoked potential occurring 50 msec after an auditory click, has been characterized extensively with electroencephalography (EEG) to detect aberrant auditory electrophysiology in disorders like schizophrenia (SZ) where 61-74% have an auditory gating deficit. The P50 response occurs in primary auditory cortex and several thalamocortical regions. In rodents, the gated P50 response has been identified in the reticular thalamic nucleus (RT)-a deep brain structure traversed during deep brain stimulation (DBS) targeting of the ventral intermediate nucleus (VIM) of the thalamus to treat essential tremor (ET) allowing for interspecies comparison. The goal was to utilize the unique opportunity provided by DBS surgery for ET to map the P50 response in multiple deep brain structures in order to determine the utility of intraoperative P50 detection for facilitating DBS targeting of auditory responsive subterritories. MATERIALS AND METHODS We developed a method to assess P50 response intraoperatively with local field potentials (LFP) using microelectrode recording during routine clinical electrophysiologic mapping for awake DBS surgery in seven ET patients. Recording sites were mapped into a common stereotactic space. RESULTS Forty significant P50 responses of 155 recordings mapped to the ventral thalamus, RT and CN head/body interface at similar rates of 22.7-26.7%. P50 response exhibited anatomic specificity based on distinct positions of centroids of positive and negative responses within brain regions and the fact that P50 response was not identified in the recordings from either the internal capsule or the dorsal thalamus. CONCLUSIONS Detection of P50 response intraoperatively may guide DBS targeting RT and subterritories within CN head/body interface-DBS targets with the potential to treat psychosis and shown to modulate schizophrenia-like aberrancies in mouse models.
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Affiliation(s)
- Judith M Gault
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - John A Thompson
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Keeran Maharajh
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Patrick Hosokawa
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Karen E Stevens
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Erin I Liedtke
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Alex Ojemann
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Steven Ojemann
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
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Zhou TH, Mueller NE, Spencer KM, Mallya SG, Lewandowski KE, Norris LA, Levy DL, Cohen BM, Öngür D, Hall MH. Auditory steady state response deficits are associated with symptom severity and poor functioning in patients with psychotic disorder. Schizophr Res 2018; 201:278-286. [PMID: 29807805 PMCID: PMC7003536 DOI: 10.1016/j.schres.2018.05.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Gamma oscillation is important for cortico-cortical coordination and the integration of information across neural networks. The 40 Hz auditory steady-state response (ASSR), which reflects neural synchrony in the gamma band (30-100 Hz), is abnormal in patients with schizophrenia (SZ). The present study used the ASSR at multiple frequencies to examine (1) gamma dysfunction in patients with SZ, schizoaffective (SA), and bipolar disorder (BD) compared with controls, (2) the relationship between ASSR measures and clinical symptom severity, and (3) the relationship between ASSR measures and real-life community functioning. METHODS EEG was recorded from 75 controls, 52 SZ, 55 SA, and 89 BD patients during 20-30-40-Hz binaural click trains. ANCOVA was used to compare ASSR measures between groups controlling for age, sex, and education. Associations between ASSR measures, symptom severity, and community functioning were examined using linear regression and Pearson partial correlations. RESULTS ASSR deficits at gamma frequency were observed in all patient groups. SA patients showed additional specific deficit in the 20 Hz ASSR. Severity of manic, depressive, and anxiety symptoms mediated ASSR deficits. Severity of hallucinatory symptom and community functioning, particularly independent living/meaningful activity, were significantly and independently associated with the 40 Hz ASSR. CONCLUSIONS SZ, SA and BD patients are likely to share the same abnormalities in neural processes that generate gamma oscillations. 40 Hz ASSR are associated with community functioning across patients and may serve as a biomarker for predicting functional outcome.
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Affiliation(s)
- Tian-Hang Zhou
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA,Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | - Nora E. Mueller
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA,Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Kevin M. Spencer
- Veterans Affairs Boston Healthcare System, Harvard Medical School, Jamaica Plain, USA
| | - Sonal G. Mallya
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA
| | - Kathryn Eve Lewandowski
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA
| | - Lesley A. Norris
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA
| | - Deborah L. Levy
- Psychology Research Laboratory, McLean Hospital, Harvard Medical School, Belmont, USA
| | - Bruce M. Cohen
- Program for Neuropsychiatric Research, McLean Hospital, Harvard Medical School, Belmont, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA
| | - Mei-Hua Hall
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, USA; Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, USA.
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Cheng CH, Chan PYS, Liu CY, Hsu SC. Auditory sensory gating in patients with bipolar disorders: A meta-analysis. J Affect Disord 2016; 203:199-203. [PMID: 27295376 DOI: 10.1016/j.jad.2016.06.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 05/29/2016] [Accepted: 06/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sensory gating (SG) refers to the attenuation of neural response to the second identical stimulus and is conceptualized as an automatic process to inhibit redundant information. Although its deficit in schizophrenia has been well-documented, the degree to which SG is modulated by bipolar disorders (BD) remains elusive. Thus, the present meta-analysis study aimed to explore the pooled effect sizes of SG ability in BD patients. METHODS Ten studies consisting of 14 individual investigations were included, consisting of 699 healthy controls and 568 BD patients. The effect sizes, calculated as Cohen's d, were estimated individually for S2/S1 ratio and S1-S2 difference. Additionally, S2/S1 ratio was examined in two conditions: BD with and without a history of psychosis. RESULTS We found that BD patients with (d=0.847, p<0.001) or without (d=0.589, p<0.001) a psychotic history exhibited an impaired SG ability compared to the healthy controls. Furthermore, both S1-S2 difference score and S2/S1 ratio, at a group level, can differentiate BD patients from healthy controls. LIMITATIONS We were not able to divide patients with BD into different subtypes, and thus our data should be interpreted with cautions. CONCLUSION These findings suggest BD itself impairs SG ability, which worsens with a psychotic history. The current understanding invites future research to ascertain the role of SG in subtypes of BD.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Pei-Ying S Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Buoli M, Caldiroli A, Cumerlato Melter C, Serati M, de Nijs J, Altamura AC. Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review. Psychiatry Clin Neurosci 2016; 70:227-44. [PMID: 26969211 DOI: 10.1111/pcn.12386] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). METHODS We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included. RESULTS BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated anti- S accharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. CONCLUSION Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cumerlato Melter
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica de Nijs
- Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Mokhtari M, Narayanan B, Hamm JP, Soh P, Calhoun VD, Ruaño G, Kocherla M, Windemuth A, Clementz BA, Tamminga CA, Sweeney JA, Keshavan MS, Pearlson GD. Multivariate Genetic Correlates of the Auditory Paired Stimuli-Based P2 Event-Related Potential in the Psychosis Dimension From the BSNIP Study. Schizophr Bull 2016; 42:851-62. [PMID: 26462502 PMCID: PMC4838080 DOI: 10.1093/schbul/sbv147] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The complex molecular etiology of psychosis in schizophrenia (SZ) and psychotic bipolar disorder (PBP) is not well defined, presumably due to their multifactorial genetic architecture. Neurobiological correlates of psychosis can be identified through genetic associations of intermediate phenotypes such as event-related potential (ERP) from auditory paired stimulus processing (APSP). Various ERP components of APSP are heritable and aberrant in SZ, PBP and their relatives, but their multivariate genetic factors are less explored. METHODS We investigated the multivariate polygenic association of ERP from 64-sensor auditory paired stimulus data in 149 SZ, 209 PBP probands, and 99 healthy individuals from the multisite Bipolar-Schizophrenia Network on Intermediate Phenotypes study. Multivariate association of 64-channel APSP waveforms with a subset of 16 999 single nucleotide polymorphisms (SNPs) (reduced from 1 million SNP array) was examined using parallel independent component analysis (Para-ICA). Biological pathways associated with the genes were assessed using enrichment-based analysis tools. RESULTS Para-ICA identified 2 ERP components, of which one was significantly correlated with a genetic network comprising multiple linearly coupled gene variants that explained ~4% of the ERP phenotype variance. Enrichment analysis revealed epidermal growth factor, endocannabinoid signaling, glutamatergic synapse and maltohexaose transport associated with P2 component of the N1-P2 ERP waveform. This ERP component also showed deficits in SZ and PBP. CONCLUSIONS Aberrant P2 component in psychosis was associated with gene networks regulating several fundamental biologic functions, either general or specific to nervous system development. The pathways and processes underlying the gene clusters play a crucial role in brain function, plausibly implicated in psychosis.
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Affiliation(s)
- Mohammadreza Mokhtari
- Olin Neuropsychiatry Research Center, Hartford Hospital, Institute of Living, Hartford, CT
| | - Balaji Narayanan
- Olin Neuropsychiatry Research Center, Hartford Hospital, Institute of Living, Hartford, CT;
| | - Jordan P. Hamm
- Department of Psychology, University of Georgia, Athens, GA
| | - Pauline Soh
- Olin Neuropsychiatry Research Center, Hartford Hospital, Institute of Living, Hartford, CT
| | - Vince D. Calhoun
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM;,Image Analysis and MR Research Center, The Mind Research Network, Albuquerque, NM
| | - Gualberto Ruaño
- Genetics Research Center, Hartford Hospital, Hartford, CT;,Genomas Inc, Hartford, CT
| | - Mohan Kocherla
- Genetics Research Center, Hartford Hospital, Hartford, CT;,Genomas Inc, Hartford, CT
| | | | | | - Carol A. Tamminga
- Department of Psychiatry, UT Southwestern Medical School, Dallas, TX
| | - John A. Sweeney
- Department of Psychiatry, UT Southwestern Medical School, Dallas, TX
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Hartford Hospital, Institute of Living, Hartford, CT;,Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT
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Li Z, Deng W, Liu X, Zheng Z, Li M, Li Y, Han Y, Ma X, Wang Q, Liu X, Li T. Contingent negative variation in patients with deficit schizophrenia or bipolar I disorder with psychotic features: measurement and correlation with clinical characteristics. Nord J Psychiatry 2015; 69:196-203. [PMID: 25263850 DOI: 10.3109/08039488.2014.959562] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Schizophrenia is a highly heterogeneous disease. Event-related potentials have been regarded to establish intermediate phenotypes of schizophrenia. Our previous study found that patients with deficit schizophrenia (DS) are relatively homogeneous and show a significantly longer onset latency of contingent negative variation (CNV) expectancy wave. AIMS To further examine CNV in patients with first-episode and drug-naïve DS or bipolar I disorder (BP I) with psychotic features, and also investigate correlations between CNV and clinical characteristics in DS and BP I. METHOD We elicited a CNV using an alarm (S1)-imperative (S2) paradigm in 30 DS patients or 33 BP I with psychotic features as well as 40 healthy controls. RESULTS CNV amplitude was significantly smaller and reaction time significantly longer in the DS and BP I groups than in healthy controls. Post-imperative negative variation (PINV) interval was significantly shorter in the DS group than in healthy controls. The onset latency of CNV expectancy wave was significantly longer and PINV area significantly smaller in the DS group than in the other groups. In the DS group, CNV amplitude and PINV interval correlated negatively with the subscale of negative symptoms on the Positive and Negative Syndrome Scale (PANSS); CNV amplitude also correlated negatively with disease duration. In the BP I group, CNV amplitude and reaction time showed no correlation with clinical features. CONCLUSIONS CNV amplitude is a common trait marker for psychosis. The onset latency of CNV expectancy wave appears to be a specific trait marker and may be used to identify candidate genes for DS.
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Affiliation(s)
- Zhe Li
- Zhe Li, M.D., The Mental Health Center and the Psychiatric Laboratory, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University , Chengdu, Sichuan 610041 , China
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Hall MH, Chen CY, Cohen BM, Spencer KM, Levy DL, Öngür D, Smoller JW. Genomewide association analyses of electrophysiological endophenotypes for schizophrenia and psychotic bipolar disorders: a preliminary report. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:151-61. [PMID: 25740047 PMCID: PMC4458348 DOI: 10.1002/ajmg.b.32298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/26/2015] [Indexed: 01/30/2023]
Abstract
Several event-related potentials (ERP), including P3, sensory gating (P50), and gamma oscillation, are robustly impaired in patients with schizophrenia (SCZ) and bipolar disorder (BIP). Although these ERPs are known to be heritable, little is known about the specific genetic loci involved and the degree to which they overlap with loci influencing mood and psychotic disorders. In the present study, we conducted GWAS to a) identify common variants associated with ERP endophenotypes, and b) construct polygenic risk scores (PRS) to examine overlap between genetic components of ERPs and mood and psychotic disorders. The sample consisted of 271 patients with SCZ or psychotic BIP diagnosis and 128 controls for whom ERP and genomewide data were available. GWAS were conducted using the full sample. PRS, derived from the Psychiatric Genomics Consortium (PGC) analyses of SCZ, BIP, and major depressive disorder were applied to each ERP phenotype. We identified a region on chromosome 14 that was significantly associated with sensory gating (peak SNP rs10132223, P = 1.27 × 10(-9) ). This locus has not been previously associated with psychotic illness in PGC-GWAS. In the PRS analyses, patients with a higher load of SCZ risk alleles had reduced gamma response whereas patients with a higher load of BIP risk alleles had smaller P3 amplitude. We observed a genomewide significant locus on chromosome 14 for P50. This locus may influence P50 but not psychotic illness. Among patients with psychotic illness, PRS results indicated genetic overlap between SCZ loci and gamma oscillation and between BIP loci and P3 amplitude.
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Affiliation(s)
- Mei-Hua Hall
- Department of Psychiatry, Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts
| | - Chia-Yen Chen
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts
- Analytic and Translational Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts
| | - Bruce M. Cohen
- Program for Neuropsychiatric Research, McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kevin M. Spencer
- VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts
| | - Deborah L. Levy
- Department of Psychiatry, Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Psychology Research Laboratory, McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dost Öngür
- Department of Psychiatry, Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts
- Stanley Center for Psychiatric Research, Broad Institute, Boston, Massachusetts
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Shaikh M, Dutt A, Broome MR, Vozmediano AG, Ranlund S, Diez A, Caseiro O, Lappin J, Amankwa S, Carletti F, Fusar-Poli P, Walshe M, Hall MH, Howes O, Ellett L, Murray RM, McGuire P, Valmaggia L, Bramon E. Sensory gating deficits in the attenuated psychosis syndrome. Schizophr Res 2015; 161:277-82. [PMID: 25556079 DOI: 10.1016/j.schres.2014.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 10/31/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Individuals with an "Attenuated Psychosis Syndrome" (APS) have a 20-40% chance of developing a psychotic disorder within two years; however it is difficult to predict which of them will become ill on the basis of their clinical symptoms alone. We examined whether P50 gating deficits could help to discriminate individuals with APS and also those who are particularly likely to make a transition to psychosis. METHOD 36 cases meeting PACE (Personal Assessment and Crisis Evaluation) criteria for the APS, all free of antipsychotics, and 60 controls performed an auditory conditioning-testing experiment while their electroencephalogram was recorded. The P50 ratio and its C-T difference were compared between groups. Subjects received follow-up for up to 2 years to determine their clinical outcome. RESULTS The P50 ratio was significantly higher and C-T difference lower in the APS group compared to controls. Of the individuals with APS who completed the follow-up (n=36), nine (25%) developed psychosis. P50 ratio and the C-T difference did not significantly differ between those individuals who developed psychosis and those who did not within the APS group. CONCLUSION P50 deficits appear to be associated with the pre-clinical phase of psychosis. However, due to the limitations of the study and its sample size, replication in an independent cohort is necessary, to clarify the role of P50 deficits in illness progression and whether this inexpensive and non-invasive EEG marker could be of clinical value in the prediction of psychosis outcomes amongst populations at risk.
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Affiliation(s)
- Madiha Shaikh
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychology, Royal Holloway, University of London, UK.
| | - Anirban Dutt
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Alberto G Vozmediano
- Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Siri Ranlund
- Division of Psychiatry & Institute of Cognitive Neuroscience, University College London, W1W 7EJ, UK
| | - Alvaro Diez
- Division of Psychiatry & Institute of Cognitive Neuroscience, University College London, W1W 7EJ, UK
| | - Olalla Caseiro
- University Hospital Marqués de Valdecilla, IFIMAV, Spain
| | - Julia Lappin
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Susan Amankwa
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Francesco Carletti
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Paolo Fusar-Poli
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Muriel Walshe
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Mei-Hua Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - Oliver Howes
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Lyn Ellett
- Department of Psychology, Royal Holloway, University of London, UK
| | - Robin M Murray
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Philip McGuire
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Lucia Valmaggia
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK
| | - Elvira Bramon
- NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, The South London and Maudsley NHS Foundation Trust, London, UK; Division of Psychiatry & Institute of Cognitive Neuroscience, University College London, W1W 7EJ, UK
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11
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Noto MN, de Souza Noto C, de Jesus DR, Zugman A, Mansur RB, Berberian AA, Leclerc E, McIntyre RS, Correll CU, Brietzke E. Recognition of bipolar disorder type I before the first manic episode: challenges and developments. Expert Rev Neurother 2014; 13:795-806; quiz 807. [DOI: 10.1586/14737175.2013.811132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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12
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Wang Y, Feng Y, Jia Y, Wang W, Xie Y, Guan Y, Zhong S, Zhu D, Huang L. Auditory M50 and M100 sensory gating deficits in bipolar disorder: a MEG study. J Affect Disord 2014; 152-154:131-8. [PMID: 24021957 DOI: 10.1016/j.jad.2013.08.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 08/12/2013] [Accepted: 08/12/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Auditory sensory gating deficits have been reported in subjects with bipolar disorder, but the hemispheric and neuronal origins of this deficit are not well understood. Moreover, gating of the auditory evoked components reflecting early attentive stage of information processing has not been investigated in bipolar disorder. The objectives of this study were to investigate the right and left hemispheric auditory sensory gating of the M50 (preattentive processing) and M100 (early attentive processing) in patients diagnosed with bipolar I disorder by utilizing magnetoencephalography (MEG). METHODS Whole-head MEG data were acquired during the standard paired-click paradigm in 20 bipolar I disorder patients and 20 healthy controls. The M50 and the M100 responses were investigated, and dipole source localizations were also investigated. Sensory gating were determined by measuring the strength of the M50 and the M100 response to the second click divided by that of the first click (S2/S1). RESULTS In every subject, M50 and M100 dipolar sources localized to the left and right posterior portion of superior temporal gyrus (STG). Bipolar I disorder patients showed bilateral gating deficits in M50 and M100. The bilateral M50 S2 source strengths were significantly higher in the bipolar I disorder group compared to the control group. LIMITATIONS The sample size was relatively small. More studies with larger sample sizes are warranted. Bipolar subjects were taking a wide range of medications that could not be readily controlled for. CONCLUSIONS These findings suggest that bipolar I disorder patients have auditory gating deficits at both pre-attentive and early attentive levels, which might be related to STG structural abnormality.
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Affiliation(s)
- Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Clinical Experimental Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
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13
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Thermenos HW, Keshavan MS, Juelich RJ, Molokotos E, Whitfield-Gabrieli S, Brent BK, Makris N, Seidman LJ. A review of neuroimaging studies of young relatives of individuals with schizophrenia: a developmental perspective from schizotaxia to schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:604-35. [PMID: 24132894 DOI: 10.1002/ajmg.b.32170] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 04/24/2013] [Indexed: 11/08/2022]
Abstract
In an effort to identify the developing abnormalities preceding psychosis, Dr. Ming T. Tsuang and colleagues at Harvard expanded Meehl's concept of "schizotaxia," and examined brain structure and function in families affected by schizophrenia (SZ). Here, we systematically review genetic (familial) high-risk (HR) studies of SZ using magnetic resonance imaging (MRI), examine how findings inform models of SZ etiology, and suggest directions for future research. Neuroimaging studies of youth at HR for SZ through the age of 30 were identified through a MEDLINE (PubMed) search. There is substantial evidence of gray matter volume abnormalities in youth at HR compared to controls, with an accelerated volume reduction over time in association with symptoms and cognitive deficits. In structural neuroimaging studies, prefrontal cortex (PFC) alterations were the most consistently reported finding in HR. There was also consistent evidence of smaller hippocampal volume. In functional studies, hyperactivity of the right PFC during performance of diverse tasks with common executive demands was consistently reported. The only longitudinal fMRI study to date revealed increasing left middle temporal activity in association with the emergence of psychotic symptoms. There was preliminary evidence of cerebellar and default mode network alterations in association with symptoms. Brain abnormalities in structure, function and neurochemistry are observed in the premorbid period in youth at HR for SZ. Future research should focus on the genetic and environmental contributions to these alterations, determine how early they emerge, and determine whether they can be partially or fully remediated by innovative treatments.
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Affiliation(s)
- H W Thermenos
- Harvard Medical School, Boston, Massachusetts; Massachusetts Mental Health Center, Division of Public Psychiatry, Boston, Massachusetts; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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14
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Is aberrant functional connectivity a psychosis endophenotype? A resting state functional magnetic resonance imaging study. Biol Psychiatry 2013; 74:458-66. [PMID: 23746539 PMCID: PMC3752322 DOI: 10.1016/j.biopsych.2013.04.024] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 04/19/2013] [Accepted: 04/21/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Schizophrenia and bipolar disorder share overlapping symptoms and risk genes. Shared aberrant functional connectivity is hypothesized in both disorders and in relatives. METHODS We investigated resting state functional magnetic resonance imaging in 70 schizophrenia and 64 psychotic bipolar probands, their respective first-degree relatives (n = 70 and 52), and 118 healthy subjects. We used independent component analysis to identify components representing various resting state networks and assessed spatial aspects of functional connectivity within all networks. We first investigated group differences using five-level, one-way analysis of covariance (ANCOVA), followed by post hoc t tests within regions displaying ANCOVA group differences and correlation of such functional connectivity measures with symptom ratings to examine clinical relationships. RESULTS Seven networks revealed abnormalities (five-level one-way ANCOVA, family-wise error correction p < .05): A) fronto-occipital, B) midbrain/cerebellum, C) frontal/thalamic/basal ganglia, D) meso/paralimbic, E) posterior default mode network, F) fronto-temporal/paralimbic and G) sensorimotor networks. Abnormalities in networks B and F were unique to schizophrenia probands. Furthermore, abnormalities in networks D and E were common to both patient groups. Finally, networks A, C, and G showed abnormalities shared by probands and their relative groups. Negative correlation with Positive and Negative Syndrome Scale negative and positive scores were found in regions within network C and F respectively, and positive correlation with Positive and Negative Syndrome Scale negative scores was found in regions in network D among schizophrenia probands only. CONCLUSIONS Schizophrenia, psychotic bipolar probands, and their relatives share both unique and overlapping within-network brain connectivity abnormalities, revealing potential psychosis endophenotypes.
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15
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Cabranes JA, Ancín I, Santos JL, Sánchez-Morla E, García-Jiménez MA, Rodríguez-Moya L, Fernández C, Barabash A. P50 sensory gating is a trait marker of the bipolar spectrum. Eur Neuropsychopharmacol 2013; 23:721-7. [PMID: 22770636 DOI: 10.1016/j.euroneuro.2012.06.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 06/12/2012] [Accepted: 06/12/2012] [Indexed: 02/03/2023]
Abstract
UNLABELLED Sensory gating deficit, assessed by a paired auditory stimulus paradigm (P50), has been reported as a stable marker of schizophrenia. The aim of this study was to explore if this neurophysiological disturbance also fulfilled stability criteria in the bipolar disorder (BD) spectrum bipolar, as state independence is one of the main points to be considered as a potential endophenotype of the illness. The P50 evoked potential was studied in 95 healthy controls and 126 bipolar euthymic patients. Euthymia was established according to Van Gorp's criteria. Bipolar I and II subtypes were analyzed separately. The influence of a lifetime history of psychoses was also evaluated in the clinical sample. P50 gating was deficitary in all the subsamples of patients relative to healthy comparison subjects. Bipolar I patients with and without a history of psychosis showed higher P50 ratios than the other subgroups of patients, although these differences were not significant. P50 alterations were mainly due to a deficit in the inhibition of the second wave (test wave or S2) amplitude. CONCLUSIONS The findings suggest that this inhibitory deficit can be considered characteristic of the illness and that the intensity of the gating abnormality varies according to the severity of BD.
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Affiliation(s)
- José A Cabranes
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos, Madrid, Spain
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16
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Patterson JV, Sandman CA, Jin Y, Kemp AS, Potkin SG, Bunney WE. Gating of a novel brain potential is associated with perceptual anomalies in bipolar disorder. Bipolar Disord 2013; 15:314-25. [PMID: 23531082 DOI: 10.1111/bdi.12048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Our laboratory recently identified the P85 gating ratio as a candidate biomarker for bipolar disorder. In order to evaluate the phenomenological significance of P85 gating, the current study examined reports of perceptual anomalies and their relationship to the P50 and P85 physiological measures of sensory gating. METHODS Reports of perceptual anomalies on the Structured Clinical Interview to Assess Perceptual Anomalies were compared in patients meeting DSM-IV criteria for paranoid schizophrenia (n = 66), schizoaffective disorder (n = 45), or bipolar I disorder (n = 42), and controls (n = 56), as well as their relationship with P85 and P50 gating. RESULTS The bipolar disorder group reported significantly more auditory, visual, and total anomalies than both the schizophrenia and control groups. The schizophrenia group also had more anomalies than the control group. Comparison of psychiatric subgroups revealed that the bipolar depressed, bipolar disorder with psychosis, and schizoaffective bipolar type groups reported the most anomalies compared to the other patient groups (bipolar disorder without psychosis, schizoaffective, bipolar manic). The total perceptual anomalies score and the P85 ratio significantly differentiated the bipolar disorder, schizoaffective, and paranoid schizophrenia groups from each other. CONCLUSIONS These findings provide evidence of the phenomenological significance of P85. The results also yield further support not only for the P85 ratio, but also for increased reports of perceptual anomalies as possible markers for bipolar disorder.
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Affiliation(s)
- Julie V Patterson
- Department of Psychiatry and Human Behavior, University of California at Irvine, Irvine, CA, USA.
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17
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Holstein DH, Vollenweider FX, Geyer MA, Csomor PA, Belser N, Eich D. Sensory and sensorimotor gating in adult attention-deficit/hyperactivity disorder (ADHD). Psychiatry Res 2013; 205:117-26. [PMID: 23017654 DOI: 10.1016/j.psychres.2012.08.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 07/30/2012] [Accepted: 08/10/2012] [Indexed: 12/15/2022]
Abstract
Even though there is an impaired perceptual capacity in attention-deficit/hyperactivity disorder (ADHD) patients, psychophysiological alterations, such as impaired gating as indexed by prepulse inhibition (PPI) or suppression of P50 auditory event-related potentials, have not been found in patients with ADHD. Hence, potential relationships of psychophysiological measures of gating to psychopathology and cognitive performance remain unclear. The present study investigates two distinct operational measures of gating as well as cognitive performance within adult ADHD patients in order to assess the relationship of these measures to psychopathology. PPI, P50 suppression, cognitive performance, and psychopathologic symptoms were assessed in 26 ADHD patients and 26 healthy control subjects. ADHD patients compared to healthy control subjects exhibited impaired P50 suppression, performed worse in cognitive tasks, and reported more psychopathological symptoms, but were normal in the test of PPI. Thus, P50 gating deficits are not specific to schizophrenia-spectrum disorders. These findings highlight the differences between P50 gating and PPI as measures of the gating construct. In keeping with the lack of correlations between these two putative operational measures of gating seen in both humans and animals, adult ADHD patients exhibit deficient P50 suppression and poor cognitive performance, despite exhibiting normal levels of PPI.
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Affiliation(s)
- Dominique H Holstein
- Psychiatric University Hospital of Psychiatry Zurich, PO Box 1932, CH-8032 Zurich, Switzerland.
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18
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Hall MH, Smoller JW, Cook NR, Schulze K, Lee PH, Taylor G, Bramon E, Coleman MJ, Murray RM, Salisbury DF, Levy DL. Patterns of deficits in brain function in bipolar disorder and schizophrenia: a cluster analytic study. Psychiatry Res 2012; 200:272-80. [PMID: 22925372 PMCID: PMC3535009 DOI: 10.1016/j.psychres.2012.07.052] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 06/29/2012] [Accepted: 07/30/2012] [Indexed: 11/27/2022]
Abstract
Historically, bipolar disorder and schizophrenia have been considered distinct disorders with different etiologies. Growing evidence suggests that overlapping genetic influences contribute to risk for these disorders and that each disease is genetically heterogeneous. Using cluster analytic methods, we empirically identified homogeneous subgroups of patients, their relatives, and controls based on distinct neurophysiologic profiles. Seven phenotypes were collected from two independent cohorts at two institutions. K-means clustering was used to identify neurophysiologic profiles. In the analysis of all participants, three distinct profiles emerged: "globally impaired", "sensory processing", and "high cognitive". In a secondary analysis, restricted to patients only, we observed a similar clustering into three profiles. The neurophysiological profiles of the Schizophrenia (SZ) and Bipolar Disorder (BPD) patients did not support the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic distinction between these two disorders. Smokers in the globally impaired group smoked significantly more cigarettes than those in the sensory processing or high cognitive groups. Our results suggest that empirical analyses of neurophysiological phenotypes can identify potentially biologically relevant homogenous subgroups independent of diagnostic boundaries. We hypothesize that each neurophysiology subgroup may share similar genotypic profiles, which may increase statistical power to detect genetic risk factors.
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Affiliation(s)
- Mei-Hua Hall
- Psychology Research Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
| | - Jordan W Smoller
- Psychiatric Genetics Program in Mood and Anxiety Disorders, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nancy R. Cook
- Division of Preventive Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Katja Schulze
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Phil Hyoun Lee
- Psychiatric Genetics Program in Mood and Anxiety Disorders, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Grantley Taylor
- Cognitive Neuroscience Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Elvira Bramon
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Michael J. Coleman
- Psychology Research Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Robin M. Murray
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Dean F Salisbury
- Cognitive Neuroscience Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Deborah L. Levy
- Psychology Research Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
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Association between the 2-bp deletion polymorphism in the duplicated version of the alpha7 nicotinic receptor gene and P50 sensory gating. Eur J Hum Genet 2012; 21:76-81. [PMID: 22588665 DOI: 10.1038/ejhg.2012.81] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
There is considerable evidence implicating the 15q13.3 region in neuropsychiatric disorders, with the α7 nicotinic receptor gene CHRNA7 the most plausible candidate. This region has multiple duplications and many copy number variants (CNVs). A common CNV involves a partial duplication of CHRNA7 (CHRFAM7A), which occurs in either orientation. We examined the distribution of these alternative genomic arrangements in a large cohort of psychiatric patients, their relatives and controls using the 2-bp deletion polymorphism as a marker for the orientation of CHRFAM7A. We investigated three common alleles for association with psychosis and with the P50 sensory gating deficit, which is strongly associated with psychosis and strongly linked to 15q13.3. We found significant within-family association with P50 (empirical P=0.004), which is robust to population stratification. Most of the effect came from the 2-bp deletion allele, which tags the variant of CHRFAM7A in the same orientation as CHRNA7. This allele is associated with the presence of the P50 sensory gating deficit (empirical P=0.0006). Tests comparing within-family and between-family components of association suggest considerable population stratification in the sample. We found no evidence for association with psychosis, but this may reflect lower power using this phenotype. Four out of six previous association studies found association of different psychiatric phenotypes with the same 2-bp deletion allele.
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Hunter SK, Kisley MA, McCarthy L, Freedman R, Ross RG. Diminished cerebral inhibition in neonates associated with risk factors for schizophrenia: parental psychosis, maternal depression, and nicotine use. Schizophr Bull 2011; 37:1200-8. [PMID: 20403924 PMCID: PMC3196957 DOI: 10.1093/schbul/sbq036] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Diminished inhibitory gating of cerebral auditory evoked responses is transmitted in families with psychoses as an endophenotype related to the genetic risk for these illnesses. To assess whether the endophenotype is already expressed in infants of parents with psychotic illness and to assess effects of other known risk factors for schizophrenia, ie, maternal cigarette smoking and depression, inhibitory gating of cerebral auditory evoked responses was evaluated by comparing the P1 evoked responses to the first and second of paired auditory stimuli. Cerebral evoked responses were recorded during active sleep from 22 infants with a parent diagnosed with a psychotic illness and 129 infants with parents with no such history. Of these infants, 25 were prenatally exposed to nicotine (16 from the comparison group and 9 from the group with parental psychosis). Mothers of 35 infants had diagnoses of major depressive disorder. Parental psychosis (P = .032) and exposure to maternal smoking (P = .012) both resulted in diminished inhibitory gating in infant offspring. Compared to infants of mothers who did not smoke and who had neither parental psychosis nor maternal depression, diminished inhibitory gating was observed in infants with parental psychosis (P = .027) and in infants with maternal depression (P = .049). Diminished inhibitory gating of auditory evoked response in infants who have risk factors for schizophrenia mirrors reports of its familial transmission in adults. The results further indicate that the phenotypic expression of familial genetic and environmental risks for psychosis is already manifest very early in development.
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Affiliation(s)
- Sharon K. Hunter
- Department of Psychiatry, University of Colorado Denver, Aurora, CO,To whom correspondence should be addressed; Department of Psychiatry, School of Medicine, University of Colorado Denver, Campus Box F546, 13001 E. 17th Place, Aurora, CO 80045, US; tel: +1-303-724-6201, fax: +1-303-724-6207, e-mail:
| | - Michael A. Kisley
- Department of Psychology, University of Colorado, Colorado Springs, CO
| | - Lizbeth McCarthy
- Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver, Aurora, CO
| | - Randal G. Ross
- Department of Psychiatry, University of Colorado Denver, Aurora, CO
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Ancín I, Cabranes JA, Vázquez-Álvarez B, Santos JL, Sánchez-Morla E, García-Jiménez MÁ, Fernández C, Barabash A. Sensory gating deficit is associated with catechol-O-methyltransferase polymorphisms in bipolar disorder. World J Biol Psychiatry 2011; 12:376-84. [PMID: 21595525 DOI: 10.3109/15622975.2011.552192] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES. Recent studies have evidenced that bipolar patients show a sensory gating deficit (P50). Among the neural systems that could be influencing this electrophysiological phenotype, dopamine seems to play an important role. We hypothesize that catechol-O-methyltransferase (COMT), the main metabolizer of dopamine in prefrontal cortex, is related to this deficit. METHODS. We selected three polymorphisms in COMT gene: rs2075507 (Promoter 2 region), Val158Met (rs4680) and rs165599 (3' region). A case-control study was performed in 784 controls and 238 bipolar patients. Besides, 122 euthymic bipolar subjects and 95 healthy subjects carried out a sensory gating task (P50). RESULTS. Polymorphism rs165599 in the COMT gene was associated with susceptibility to bipolar disorder (BD), mainly in women (AG: OR = 1.46; GG: OR = 1.84; P = 0.03). In the female group, haplotype AAG was associated with an OR = 7.6. Subjects who carried Val158 allele evidenced a deficit in suppression (P = 0.046) and rs165599 allele G carriers (mainly in homozygosis) had a bigger S2 amplitude and a higher S2/S1 ratio (1.6(e-5) < P < 0.01). Not a single association was proven in the control group. CONCLUSIONS. Our results support the association of the COMT gene with BD and with one of its potential endophenotypes, auditory sensory gating deficit, measured by the P50 paradigm.
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Affiliation(s)
- Inés Ancín
- Laboratory of Psychoneuroendocrinology and Molecular Genetics. Biomedical Research Foundation, Clínico San Carlos Hospital, Madrid, Spain
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22
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Hall MH, Taylor G, Sham P, Schulze K, Rijsdijk F, Picchioni M, Toulopoulou T, Ettinger U, Bramon E, Murray RM, Salisbury DF. The early auditory gamma-band response is heritable and a putative endophenotype of schizophrenia. Schizophr Bull 2011; 37:778-87. [PMID: 19946013 PMCID: PMC3122286 DOI: 10.1093/schbul/sbp134] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Reduced power and phase locking of the early auditory gamma-band response (EAGBR) have been reported in schizophrenia, but findings are equivocal. Further, little is known about genetic (heritability) and environmental influences on the EAGBR or its potential as an endophenotype of schizophrenia. The present study used a twin design to examine whether EAGBR power and phase locking are heritable and reduced in schizophrenic patients and their unaffected co-twins and thus putative endophenotypes of schizophrenia. METHODS The study sample included a total of 194 individuals, consisting of 15 monozygotic [MZ] twin pairs concordant for schizophrenia, 9 MZ twin pairs discordant for schizophrenia, and 42 MZ and 31 dizygotic (DZ) control pairs. Evoked power and phase-locking factor of the EAGBR were computed on Morlet wavelet-transformed electroencephalogram responses to standard tones during an auditory oddball target detection task. Structural equation modeling was applied to estimate heritability and genetic and environmental correlations with schizophrenia for the EAGBR measures. RESULTS Both evoked power and phase-locking phenotypes were heritable traits (power: h(2) = 0.65; phase locking: h(2) = 0.63). Impaired EAGBR measures were significantly associated with schizophrenia. Patients with schizophrenia and their unaffected identical co-twins exhibited significantly reduced EAGBR power compared with control subjects. In each phenotype, shared genetic factors were likely the source of the observed associations with schizophrenia. CONCLUSIONS Our results support EAGBR measures as putative endophenotypes of schizophrenia, likely reflecting an ubiquitous local cortical circuit deficit.
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Affiliation(s)
- Mei-Hua Hall
- Cognitive Neuroscience Laboratory, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
| | - Grantley Taylor
- Cognitive Neuroscience Laboratory, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478
| | - Pak Sham
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | | | - Fruhling Rijsdijk
- Social Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, London, UK
| | | | | | | | | | | | - Dean F. Salisbury
- Cognitive Neuroscience Laboratory, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478
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Evidence for association of the non-duplicated region of CHRNA7 gene with bipolar disorder but not with Schizophrenia. Psychiatr Genet 2011; 20:289-97. [PMID: 20463630 DOI: 10.1097/ypg.0b013e32833a9b7a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Biological evidence in both human and animal studies suggests α7 neuronal nicotinic acetylcholine receptor subunit gene (CHRNA7) as a suitable functional candidate for genetic studies in psychiatric populations. This gene maps to chromosome 15q13-14, a major linkage hotspot for schizophrenia (SCH) and bipolar disorder (BD). In this study we examine the role of CHRNA7 in influencing the risk of SCH and BD. METHODS In the present investigation four SNPs of the non-duplicated region of CHRNA7 were genotyped: -86C/T variant, located in the 5'-upstream regulatory region; and three intronic polymorphisms (rs883473, rs6494223 and rs904952). Genetic analysis was performed on 510 patients diagnosed with SCH, 245 with BD and on 793 unrelated healthy controls. RESULTS SNP analysis suggested a significant difference in -86C/T allele (P=0.025) and genotype (P=0.03) frequencies between BD and control groups, although significance was lost after correction for multiple testing. Besides, the nucleotide change (T) in rs6494223 had a protective effect against BD [odds ratio (OR)=0.70 (0.57-0.87); P=0.001]. Genotype frequencies also showed significant association (P=0.001) [CT genotype OR=0.71 (0.5-0.96); TT genotype OR=0.47 (0.29-0.77)]. Haplotypic analysis revealed a positive association of the gene with BD (global-stat=24.18, P value=0.007) with a maximum effect in the region that covered introns 3 and 4. In contrast, no evidence of risk variants was found in the analysis of the SCH sample. CONCLUSION Our data support the non-duplicated region of CHRNA7 gene as a susceptibility region for BD but not for SCH. Further genotyping of this region may help to delimit the causal polymorphism.
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Hall MH, Spencer KM, Schulze K, McDonald C, Kalidindi S, Kravariti E, Kane F, Murray RM, Bramon E, Sham P, Rijsdijk F. The genetic and environmental influences of event-related gamma oscillations on bipolar disorder. Bipolar Disord 2011; 13:260-71. [PMID: 21676129 PMCID: PMC3119203 DOI: 10.1111/j.1399-5618.2011.00925.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Gamma oscillations have been proposed to play an important role in neural information coding. There have been a limited number of electrophysiology studies in evoked gamma band responses (GBRs) in bipolar disorder (BPD). It is also unclear whether GBR deficits, if present, are potential endophenotypes for BPD as little is known about the heritability of GBRs. The present study aimed to examine whether GBRs derived from two auditory tasks, the oddball task and the dual-click paradigm, are potential BPD endophenotypes. METHODS A total of 308 subjects were included in this study: 198 healthy controls, 59 BPD patients (22 monozygotic BPD twins and 37 BPD patients from 31 families), and 51 unaffected relatives. The evoked gamma responses were calculated using a Morlet wavelet transformation. Structural equation modelling was applied to obtain the genetic (heritability) and environment estimates in each GBR variable and their (genetic) overlap with BPD. RESULTS The heritability estimates of GBR to standard stimuli were 0.51 and 0.35 to target stimuli in the oddball task. However, neither response type was impaired in BPD patients or their unaffected relatives. The heritability estimates of GBR to S1 stimuli were 0.54 and 0.50 to S2 stimuli in the dual-click paradigm. BPD patients had reduced gamma power and suppression to S1 stimuli but their unaffected relatives did not. CONCLUSIONS Evoked GBRs are heritable traits. However, GBR deficits are not observed in clinically unaffected relatives nor associated with BPD. Gamma responses do not appear to satisfy criteria for being BPD endophenotypes.
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Affiliation(s)
- Mei-Hua Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital Research Service, Boston, MA, USA.
| | - Kevin M Spencer
- Research Service, VA Boston Healthcare System and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Katja Schulze
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Colm McDonald
- Department of Psychiatry, Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Sridevi Kalidindi
- Social, Genetic Developmental Psychiatry Research Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Eugenia Kravariti
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Fergus Kane
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Robin M Murray
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Elvira Bramon
- Division of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Pak Sham
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Frühling Rijsdijk
- Social, Genetic Developmental Psychiatry Research Centre, Institute of Psychiatry, King’s College London, London, UK
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25
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Shaikh M, Hall MH, Schulze K, Dutt A, Walshe M, Williams I, Constante M, Picchioni M, Toulopoulou T, Collier D, Rijsdijk F, Powell J, Arranz M, Murray RM, Bramon E. Do COMT, BDNF and NRG1 polymorphisms influence P50 sensory gating in psychosis? Psychol Med 2011; 41:263-276. [PMID: 20102668 DOI: 10.1017/s003329170999239x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Auditory P50 sensory gating deficits correlate with genetic risk for schizophrenia and constitute a plausible endophenotype for the disease. The well-supported role of catechol-O-methyltransferase (COMT), brain-derived neurotrophic factor (BDNF) and neuregulin 1 (NRG1) genes in neurodevelopment and cognition make a strong theoretical case for their influence on the P50 endophenotype. METHOD The possible role of NRG1, COMT Val158Met and BDNF Val66Met gene polymorphisms on the P50 endophenotype was examined in a large sample consisting of psychotic patients, their unaffected relatives and unrelated healthy controls using linear regression analyses. RESULTS Although P50 deficits were present in patients and their unaffected relatives, there was no evidence for an association between NRG1, COMT Val158Met or BDNF Val66Met genotypes and the P50 endophenotype. CONCLUSIONS The evidence from our large study suggests that any such association between P50 indices and NRG1, COMT Val158Met or BDNF Val66Met genotypes, if present, must be very subtle.
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Affiliation(s)
- M Shaikh
- NIHR Biomedical Research Centre, Institute of Psychiatry, King's College London/South London and Maudsley NHS Foundation Trust, London, UK.
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26
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De Pradier M, Gorwood P, Beaufils B, Adès J, Dubertret C. Influence of the serotonin transporter gene polymorphism, cannabis and childhood sexual abuse on phenotype of bipolar disorder: a preliminary study. Eur Psychiatry 2011; 25:323-7. [PMID: 20434316 DOI: 10.1016/j.eurpsy.2009.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 10/09/2009] [Accepted: 10/15/2009] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The gene coding for the 5-HT transporter (5-HTT) is considered as a candidate gene for bipolar disorder, either as a "vulnerability" or as a "modifying the phenotype" gene. Psychotic symptoms occur at least once in one bipolar patient out of two, the relevant risk factors being insufficiently understood. The gene × environment interaction approach offers the opportunity to disentangle the latter, including childhood sexual abuse and cannabis abuse. METHODS We investigated the 5-HTTLPR of the 5-HTT gene (G) and the presence of childhood sexual abuse and cannabis comorbidity (E) in 137 bipolar patients with (versus without) lifetime psychotic symptoms. RESULTS The short allele and cannabis abuse were significantly more frequent among patients with psychotic symptoms than in those without (p=0.01 and p=0.004, respectively), while childhood sexual abuse was not. Complex interactions were found between presence of the short allele, cannabis abuse or dependence and childhood sexual abuse. CONCLUSIONS The short allele of the 5-HTTLPR polymorphism of the 5-HTT gene was a risk factor for psychotic symptoms in bipolar disorder in the present sample, directly but also indirectly, through the presence of cannabis abuse or dependence, as an exacerbating factor heightening psychotic symptoms.
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Affiliation(s)
- M De Pradier
- Inserm U675-U894, Center of Psychiatry and Neurosciences, Paris, France
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27
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Ivleva EI, Morris DW, Moates AF, Suppes T, Thaker GK, Tamminga CA. Genetics and intermediate phenotypes of the schizophrenia--bipolar disorder boundary. Neurosci Biobehav Rev 2010; 34:897-921. [PMID: 19954751 DOI: 10.1016/j.neubiorev.2009.11.022] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 11/20/2009] [Accepted: 11/23/2009] [Indexed: 12/20/2022]
Abstract
Categorization of psychotic illnesses into schizophrenic and affective psychoses remains an ongoing controversy. Although Kraepelinian subtyping of psychosis was historically beneficial, modern genetic and neurophysiological studies do not support dichotomous conceptualization of psychosis. Evidence suggests that schizophrenia and bipolar disorder rather present a clinical continuum with partially overlapping symptom dimensions, neurophysiology, genetics and treatment responses. Recent large scale genetic studies have produced inconsistent findings and exposed an urgent need for re-thinking phenomenology-based approach in psychiatric research. Epidemiological, linkage and molecular genetic studies, as well as studies in intermediate phenotypes (neurocognitive, neurophysiological and anatomical imaging) in schizophrenia and bipolar disorders are reviewed in order to support a dimensional conceptualization of psychosis. Overlapping and unique genetic and intermediate phenotypic signatures of the two psychoses are comprehensively recapitulated. Alternative strategies which may be implicated into genetic research are discussed.
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Affiliation(s)
- Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA.
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28
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Angiotensin-converting enzyme polymorphism in schizophrenia, bipolar disorders, and their first-degree relatives. Psychiatr Genet 2010; 20:14-9. [DOI: 10.1097/ypg.0b013e3283351194] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Hall MH, Smoller JW. A new role for endophenotypes in the GWAS era: functional characterization of risk variants. Harv Rev Psychiatry 2010; 18:67-74. [PMID: 20047462 PMCID: PMC3586547 DOI: 10.3109/10673220903523532] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mei-Hua Hall
- Harvard Medical School, Psychology Research Laboratory, McLean Hospital, Belmont, MA, USA.
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30
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Carpenter WT, Bustillo JR, Thaker GK, van Os J, Krueger RF, Green MJ. The psychoses: cluster 3 of the proposed meta-structure for DSM-V and ICD-11. Psychol Med 2009; 39:2025-2042. [PMID: 19796428 DOI: 10.1017/s0033291709990286] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In an effort to group mental disorders on the basis of etiology, five clusters have been proposed. Here we consider the validity of the cluster comprising selected psychotic and related disorders. METHOD A group of diagnostic entities classified under schizophrenia and other psychotic disorders in DSM-IV-TR were assigned to this cluster and the bordering disorders, bipolar (BD) and schizotypal personality disorders (SPD), were included. We then reviewed the literature in relation to 11 validating criteria proposed by the DSM-V Task Force Study Group. RESULTS Relevant comparisons on the 11 spectrum criteria are rare for the included disorders except for schizophrenia and the two border conditions, BD and SPD. The core psychosis group is congruent at the level of shared psychotic psychopathology and response to antipsychotic medication. BD and SPD are exceptions in that psychosis is not typical in BD-II disorder and frank psychosis is excluded in SPD. There is modest similarity between schizophrenia and BD relating to risk factors, neural substrates, cognition and endophenotypes, but key differences are noted. There is greater support for a spectrum relationship of SPD and schizophrenia. Antecedent temperament, an important validator for other groupings, has received little empirical study in the various psychotic disorders. CONCLUSIONS The DSM-IV-TR grouping of psychotic disorders is supported by tradition and shared psychopathology, but few data exist across these diagnoses relating to the 11 spectrum criteria. The case for including BD is modest, and the relationship of BD to other mood disorders is addressed elsewhere. Evidence is stronger for inclusion of SPD, but the relationship with other personality disorders along the 11 criteria is not addressed and the absence of psychosis presents a conceptual problem. There are no data along the 11 spectrum criteria that are decisive for a cluster based on etiology, and inclusion of BD and SPD is questionable.
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Affiliation(s)
- W T Carpenter
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
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31
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Patterson JV, Sandman CA, Ring A, Jin Y, Bunney WE. An initial report of a new biological marker for bipolar disorder: P85 evoked brain potential. Bipolar Disord 2009; 11:596-609. [PMID: 19689502 DOI: 10.1111/j.1399-5618.2009.00734.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Progress toward understanding the neurobiological and genetic underpinnings of bipolar disorder has been limited by the scarcity of potential biological markers that predict its occurrence. A measure of the integrity of brain inhibitory function, sensory gating, measured using the amplitude of the evoked potential at 50 ms to the first of two paired clicks divided by the response to the second, has been characterized as a biological marker for schizophrenia. Currently, no such biological marker exists for bipolar disorder. The goal of this research was to determine how gating of an auditory brain potential at 85 ms (P85), not previously examined in sensory gating studies, differentiated control and patient groups. METHODS P50 and P85 auditory evoked potentials were collected from individuals diagnosed with schizoaffective disorder (n = 45), paranoid schizophrenia (n = 66), and bipolar I disorder (n = 42) using DSM-IV criteria and the Structured Clinical Interview for DSM-IV; and from 56 healthy controls. RESULTS The P85 gating ratio was significantly larger in the bipolar disorder group compared to each of the other groups (F(3,204) = 5.47, p = 0.001, and post-hoc tests). The P50 gating ratio was significantly larger for the schizoaffective group than for the control group (F(3,204) = 2.81, p = 0.040), but did not differ from the ratio for the schizophrenia, paranoid type (p = 0.08) and bipolar groups. CONCLUSIONS The previously unstudied P85 gating ratio may provide a new marker specific to bipolar disorder. The findings will promote further studies to investigate the unique contribution of this measure as an endophenotype.
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Affiliation(s)
- Julie V Patterson
- Department of Psychiatry and Human Behavior, University of California at Irvine, Irvine, California 92868, USA.
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Dome P, Lazary J, Kalapos MP, Rihmer Z. Smoking, nicotine and neuropsychiatric disorders. Neurosci Biobehav Rev 2009; 34:295-342. [PMID: 19665479 DOI: 10.1016/j.neubiorev.2009.07.013] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 07/23/2009] [Accepted: 07/30/2009] [Indexed: 12/20/2022]
Abstract
Tobacco smoking is an extremely addictive and harmful form of nicotine (NIC) consumption, but unfortunately also the most prevalent. Although disproportionately high frequencies of smoking and its health consequences among psychiatric patients are widely known, the neurobiological background of this epidemiological association is still obscure. The diverse neuroactive effects of NIC and some other major tobacco smoke constituents in the central nervous system may underlie this association. This present paper summarizes the pharmacology of NIC and its receptors (nAChR) based on a systematic review of the literature. The role of the brain's reward system(s) in NIC addiction and the results of functional and structural neuroimaging studies on smoking-related states and behaviors (i.e. dependence, craving, withdrawal) are also discussed. In addition, the epidemiological, neurobiological, and genetic aspects of smoking in several specific neuropsychiatric disorders are reviewed and the clinical relevance of smoking in these disease states addressed.
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Affiliation(s)
- Peter Dome
- Department of Clinical and Theoretical Mental Health, Kutvolgyi Clinical Center, Semmelweis University, Faculty of Medicine, Kutvolgyi ut 4, 1125 Budapest, Hungary.
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Hall MH, Schulze K, Rijsdijk F, Kalidindi S, McDonald C, Bramon E, Murray RM, Sham P. Are auditory P300 and duration MMN heritable and putative endophenotypes of psychotic bipolar disorder? A Maudsley Bipolar Twin and Family Study. Psychol Med 2009; 39:1277-1287. [PMID: 19250581 DOI: 10.1017/s0033291709005261] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Impaired P300 auditory response has been reported in patients with psychotic bipolar disorder (BPD) and unaffected relatives of psychotic bipolar patients. Deficits in mismatch negativity (MMN), however, have not been observed in bipolar patients. To our knowledge, no family study of MMN in BPD has been reported. The current study combined the Maudsley twin and bipolar family samples using genetic model fitting analyses to: (1) assess the relationship between BPD and MMN, (2) substantiate the association between psychotic BPD and P300 variables, (3) verify the genetic overlap of BPD with P300 amplitude previously reported in the twin sample, and (4) examine the shared genetic influences between BPD and bilateral temporal scalp locations of P300 components. METHOD A total of 301 subjects were included in this study, including 94 twin pairs, 31 bipolar families, and 39 unrelated healthy controls. Statistical analyses were based on structural equation modelling. RESULTS Both P300 and MMN are heritable, with heritability estimates of 0.58 for MMN, 0.68-0.80 for P300 amplitude, and 0.21-0.56 for P300 latency. The bipolar patients and their relatives showed normal MMN. No significant association, either genetic or environmental, was found with BPD. BPD was significantly associated with reduced P300 amplitude and prolonged latency on midline and bilateral temporal-posterior scalp areas. Shared genetic factors were the main source of these associations. CONCLUSIONS The results confirm that MMN is not an endophenotype for psychotic BPD whereas P300 amplitude and latency components are valid endophenotypes for psychotic BPD.
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MESH Headings
- Acoustic Stimulation
- Adult
- Bipolar Disorder/diagnosis
- Bipolar Disorder/genetics
- Bipolar Disorder/physiopathology
- Bipolar Disorder/psychology
- Cerebral Cortex/physiopathology
- Cohort Studies
- Contingent Negative Variation/genetics
- Diseases in Twins/diagnosis
- Diseases in Twins/genetics
- Diseases in Twins/physiopathology
- Diseases in Twins/psychology
- Dominance, Cerebral/genetics
- Dominance, Cerebral/physiology
- Electrocardiography
- England
- Event-Related Potentials, P300/genetics
- Event-Related Potentials, P300/physiology
- Evoked Potentials, Auditory/genetics
- Evoked Potentials, Auditory/physiology
- Female
- Humans
- Male
- Middle Aged
- Models, Genetic
- Phenotype
- Psychiatric Status Rating Scales
- Reaction Time/genetics
- Reaction Time/physiology
- Signal Processing, Computer-Assisted
- Social Environment
- Statistics as Topic
- Twins, Dizygotic/genetics
- Twins, Dizygotic/psychology
- Twins, Monozygotic/genetics
- Twins, Monozygotic/psychology
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Affiliation(s)
- M-H Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
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34
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Abstract
The search for liability genes of the world's 2 major psychotic disorders, schizophrenia and bipolar disorder I (BP-I), has been extremely difficult even though evidence suggests that both are highly heritable. This difficulty is due to the complex and multifactorial nature of these disorders. They encompass several intermediate phenotypes, some overlapping across the 2 psychotic disorders that jointly and/or interactively produce the clinical manifestations. Research of the past few decades has identified several neurophysiological deficits in schizophrenia that frequently occur before the onset of psychosis. These include abnormalities in smooth pursuit eye movements, P50 sensory gating, prepulse inhibition, P300, mismatch negativity, and neural synchrony. Evidence suggests that many of these physiological deficits are distinct from each other. They are stable, mostly independent of symptom state and medications (with some exceptions) and are also observed in non-ill relatives. This suggests a familial and perhaps genetic nature. Some deficits are also observed in the BP-I probands and to a lesser extent their relatives. These deficits in physiological measures may represent the intermediate phenotypes that index small effects of genes (and/or environmental factors). The use of these measures in genetic studies may help the hunt for psychosis liability genes and clarify the extent to which the 2 major psychotic disorders share etio-pathophysiology. In spite of the rich body of work describing these neurophysiological measures in psychotic disorders, challenges remain: Many of the neurophysiological phenotypes are still relatively complex and are associated with low heritability estimates. Further refinement of these physiological phenotypes is needed that could identify specific underlying physiological deficits and thereby improve their heritability estimates. The extent to which these neurophysiological deficits are unique or overlap across BP-I and schizophrenia is unclear. And finally, the clinical and functional consequences of the neurophysiological deficits both in the probands and their relatives are not well described.
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Affiliation(s)
- Gunvant K. Thaker
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228,To whom correspondence should be addressed; tel: 410-402-6821; fax: 410-402-6021; e-mail:
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