1
|
Buzzanca A, Accinni T, Frascarelli M, Troisi E, Kotzalidis GD, Di Bonaventura C, Fanella M, Putotto C, Marino B, Pasquini M, Biondi M, Di Fabio F. Recognition of facial emotion expressions and perceptual processes in 22q11.2 deletion syndrome. Early Interv Psychiatry 2023; 17:76-84. [PMID: 35347860 PMCID: PMC10078714 DOI: 10.1111/eip.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/25/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Social cognition (SC) deficits and of its facial emotion expression (FEE) component have been described in 22q11.2 Deletion Syndrome (22q11.2DS), a high-risk for schizophrenia (SCZ) systemic genetic syndrome. Correlations between deficits in FEE skills and visual-spatial abilities in people with 22q11.2DS warrant investigation. METHODS The sample consisted of 37 patients with 22q11.2DS (DEL), 19 with 22q11.2DS and psychosis (DEL-SCZ), 23 with idiopathic SCZ, and 48 healthy controls. We assessed FEE through The Ekman 60 Faces test (EK-F60), visual-spatial skills with Raven's Standard Progressive Matrices, and symptom severity with the positive And negative syndrome scale. Statistics were conducted through multivariate analysis of variance and correlation analysis. RESULTS Patients with 22q11.2DS performed worse that the other groups in recognizing Surprise, Disgust, Rage, Fear, and Neutral expressions on the EK-F60. Recognition of Surprise and Disgust correlated positively with visual-spatial abilities in patients with 22q11.2DS; negative and cognitive symptoms correlated negatively with recognition of Sadness, Surprise, and Disgust. CONCLUSIONS Patients with 22q11.2DS show impairments of both peripheral and central steps of the emotional recognition process, leading to SC deficits. The latter are present regardless of the presence of a full-blown psychosis.
Collapse
Affiliation(s)
- Antonino Buzzanca
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Tommaso Accinni
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Marianna Frascarelli
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Eloisa Troisi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Georgios D Kotzalidis
- Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Carlo Di Bonaventura
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Martina Fanella
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Carolina Putotto
- Department of Paediatrics, Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Bruno Marino
- Department of Paediatrics, Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Fabio Di Fabio
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
2
|
Benedetti A, Molent C, Barcik W, Papaleo F. Social behavior in 16p11.2 and 22q11.2 copy number variations: Insights from mice and humans. GENES, BRAIN, AND BEHAVIOR 2021; 21:e12787. [PMID: 34889032 PMCID: PMC9744525 DOI: 10.1111/gbb.12787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
Genetic 16p11.2 and 22q11.2 deletions and duplications in humans may alter behavioral developmental trajectories increasing the risk of autism and schizophrenia spectrum disorders, and of attention-deficit/hyperactivity disorder. In this review, we will concentrate on 16p11.2 and 22q11.2 deletions' effects on social functioning, beyond diagnostic categorization. We highlight diagnostic and social sub-constructs discrepancies. Notably, we contrast evidence from human studies with social profiling performed in several mouse models mimicking 16p11.2 and 22q11.2 deletion syndromes. Given the complexity of social behavior, there is a need to assess distinct social processes. This will be important to better understand the biology underlying such genetic-dependent dysfunctions, as well as to give perspective on how therapeutic strategies can be improved. Bridges and divergent points between human and mouse studies are highlighted. Overall, we give challenges and future perspectives to sort the genetics of social heterogeneity.
Collapse
Affiliation(s)
- Arianna Benedetti
- Genetics of Cognition laboratory, Neuroscience areaIstituto Italiano di TecnologiaGenoaItaly,CNRS, GREDEGUniversité Côte d'AzurNiceFrance
| | - Cinzia Molent
- Genetics of Cognition laboratory, Neuroscience areaIstituto Italiano di TecnologiaGenoaItaly,Dipartimento di Medicina Sperimentale(Di. Mes) Università degli Studi di GenovaGenoaItaly
| | - Weronika Barcik
- Genetics of Cognition laboratory, Neuroscience areaIstituto Italiano di TecnologiaGenoaItaly
| | - Francesco Papaleo
- Genetics of Cognition laboratory, Neuroscience areaIstituto Italiano di TecnologiaGenoaItaly,Department of Neurosciences and Mental HealthFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| |
Collapse
|
3
|
Bush L, Scott MN. Neuropsychological and ASD phenotypes in rare genetic syndromes: A critical review of the literature. Clin Neuropsychol 2021; 36:993-1027. [PMID: 34569897 DOI: 10.1080/13854046.2021.1980111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by core deficits in social communication and restricted and repetitive behaviors and interests. Recent advances in clinical genetics have improved our understanding of genetic syndromes associated with ASD, which has helped clarify distinct etiologies of ASD and document syndrome-specific profiles of neurocognitive strengths and weaknesses. Pediatric neuropsychologists have the potential to be impactful members of the care team for children with genetic syndromes and their families. METHOD We provide a critical review of the current literature related to the neuropsychological profiles of children with four genetic syndromes associated with ASD, including Tuberous Sclerosis Complex (TSC), fragile X syndrome (FXS), 22q11.2 deletion syndrome, and Angelman syndrome. Recommendations for assessment, intervention, and future directions are provided. RESULTS There is vast heterogeneity in terms of the cognitive, language, and developmental abilities of these populations. The within- and across-syndrome variability characteristic of genetic syndromes should be carefully considered during clinical evaluations, including possible measurement limitations, presence of intellectual disability, and important qualitative differences in the ASD-phenotypes across groups. CONCLUSIONS Individuals with genetic disorders pose challenging diagnostic and assessment questions. Pediatric neuropsychologists with expertise in neurodevelopmental processes are well suited to address these questions and identify profiles of neurocognitive strengths and weaknesses, tailor individualized recommendations, and provide diagnostic clarification.
Collapse
Affiliation(s)
- Lauren Bush
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Megan N Scott
- The Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA
| |
Collapse
|
4
|
Jalal R, Nair A, Lin A, Eckfeld A, Kushan L, Zinberg J, Karlsgodt KH, Cannon TD, Bearden CE. Social cognition in 22q11.2 deletion syndrome and idiopathic developmental neuropsychiatric disorders. J Neurodev Disord 2021; 13:15. [PMID: 33863277 PMCID: PMC8052741 DOI: 10.1186/s11689-021-09363-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/03/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is a common recurrent neurogenetic condition associated with elevated risk for developmental neuropsychiatric disorders and intellectual disability. Children and adults with 22q11DS often exhibit marked social impairment as well as neurocognitive deficits, and have elevated rates of both autism spectrum disorder (ASD) and psychosis. However, the relationship between the basic processes of social cognition and cognitive ability has not been well studied in 22q11DS. Here, we examined differences in social cognition in 22q11DS, relative to multiple groups of idiopathic neuropsychiatric disorders, and typically developing healthy controls (HC). Additionally, we examined differences in intellectual functioning and its relationship to social cognitive abilities. Finally, we examined the relationship between social cognitive abilities and real-world social behavior. METHODS We examined social cognition and intellectual functioning in 273 participants (mean age = 17.74 ± 5.18% female = 44.3%): 50 with 22q11DS, 49 youth with first episode psychosis (FEP), 48 at clinical high-risk (CHR) for psychosis, 24 participants with ASD, and 102 HC. Social cognition was assessed using The Awareness of Social Inference Test (TASIT), while reciprocal social behavior was assessed via parent/caregiver ratings on the Social Responsiveness Scale (SRS). Participants were also administered the Wechsler Abbreviated Scale of Intelligence, 2nd edition (WASI-II) to assess intellectual functioning. RESULTS The 22q11DS group exhibited significantly lower social cognitive abilities compared to CHR, FEP, and HC groups after controlling for intellectual functioning, but not in comparison to the ASD group. Significant positive correlations were found between social cognition, as measured by the TASIT and IQ across groups. In contrast, no significant relationships were found between TASIT and real-world social behavior (SRS) for any group. CONCLUSIONS Our findings indicate social cognitive deficits are more prominent in 22q11DS than idiopathic neuropsychiatric conditions across the age range, even after adjusting for global intellectual function. These results contribute to our understanding of the intellectual and social vulnerabilities of 22q11DS in comparison to idiopathic neuropsychiatric disorders. Our findings of robust associations between intellectual ability and social cognition emphasizes the importance of accounting for neurocognitive deficits in social skills interventions and tailoring these existing treatment models for 22q11DS and other populations with intellectual impairment.
Collapse
Affiliation(s)
- Rhideeta Jalal
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Aarti Nair
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA.
| | - Amy Lin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Ariel Eckfeld
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Leila Kushan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jamie Zinberg
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Katherine H Karlsgodt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| |
Collapse
|
5
|
Milic B, Feller C, Schneider M, Debbané M, Loeffler-Stastka H. Social cognition in individuals with 22q11.2 deletion syndrome and its link with psychopathology and social outcomes: a review. BMC Psychiatry 2021; 21:130. [PMID: 33676445 PMCID: PMC7936464 DOI: 10.1186/s12888-020-02975-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 11/18/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The 22q11.2 deletion syndrome (22q11DS) is a genetic syndrome that results in a highly variable profile of affected individuals of which impairments in the social domain and increased psychopathology are the most prominent. Notably, 25-30% of affected individuals eventually develop schizophrenia/psychosis, predisposing persons with the syndrome to increased risk for this disorder. Because social cognition is considered to underlie social behavior and to be related to psychopathology, this systematic review investigated social cognition in individuals with 22q11DS and examined reported links across its domains with psychopathology and social outcomes. This can provide the basis for a closer understanding of the path from risk to disorder and will inform on the specific domains that can be targeted with preventive intervention strategies. METHOD Systematic literature review of studies that reported the links between social cognitive domains and psychopathology and/or social outcomes in individuals with 22q11DS. Electronic databases searched were PubMed and PsycINFO. RESULTS Defined eligibility criteria identified a total of ten studies to be included in the present review. Selected studies investigated links between two domains of social cognition (emotion processing and theory of mind (ToM)) and psychopathology and/or social outcomes. With respect to the links to psychopathology, two aspects of social cognition were related primarily to negative symptoms. Results regarding the associations to positive and emotional symptoms (anxiety/depression) are limited and require further investigation. Even though both aspects of social cognition were associated with social outcomes, several studies also found no links between these two domains. Both reports invite for an additional examination of reported results and specific considerations regarding chosen constructs. CONCLUSION Although equivocal, results of the present review provide sufficient evidence that social cognition is a useful domain for the closer elucidation of clinical outcomes and social difficulties in this population. At the same time, longitudinal studies and consideration of other variables are also necessary for a timely understanding of affected persons in this respect.
Collapse
Affiliation(s)
- Branka Milic
- Clinic for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
| | - Clémence Feller
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Martin Debbané
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | |
Collapse
|
6
|
Peyroux E, Babinet MN, Cannarsa C, Madelaine C, Favre E, Demily C, Michael GA. What do error patterns in processing facial expressions, social interaction scenes and vocal prosody tell us about the way social cognition works in children with 22q11.2DS? Eur Child Adolesc Psychiatry 2020; 29:299-313. [PMID: 31123832 DOI: 10.1007/s00787-019-01345-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 05/03/2019] [Indexed: 11/30/2022]
Abstract
Impairments in social cognition have been frequently described in 22q11.2 deletion syndrome (22q11.2DS) and are thought to be a hallmark of difficulties in social interactions. The present study addresses aspects that are critical for everyday social cognitive functioning but have received little attention so far. Sixteen children with 22q11.2DS and 22 controls completed 1 task of facial expression recognition, 1 task of attribution of facial expressions to faceless characters involved in visually presented social interactions, and 1 task of attribution of facial expressions to characters involved in aurally presented dialogues. All three tasks have in common to involve processing of emotions. All participants also completed two tasks of attention and two tasks of visual spatial perception, and their parents completed some scales regarding behavioural problems of their children. Patients performed worse than controls in all three tasks of emotion processing, and even worse in the second and third tasks. However, they performed above chance level in all three tasks, and the results were independent of IQ, age and gender. The analysis of error patterns suggests that patients tend to coarsely categorize situations as either attractive or repulsive and also that they have difficulties in differentiating emotions that are associated with threats. An isolated association between the tasks of emotion and behaviour was found, showing that the more frequently patients with 22q11.2DS perceive happiness where there is not, the less they exhibit aggressive behaviour.
Collapse
Affiliation(s)
- Elodie Peyroux
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, 95 Bd Pinel, Bron, France.,EDRPsy, UMR 5229, CNRS, 67 Bd Pinel, Bron, France
| | - Marie-Noëlle Babinet
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, 95 Bd Pinel, Bron, France.,EDRPsy, UMR 5229, CNRS, 67 Bd Pinel, Bron, France
| | - Costanza Cannarsa
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, 95 Bd Pinel, Bron, France.,EDRPsy, UMR 5229, CNRS, 67 Bd Pinel, Bron, France.,Université de Lyon, Lyon, France.,Laboratoire D'Étude Des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Lyon, France
| | - Charline Madelaine
- Université de Lyon, Lyon, France.,Laboratoire D'Étude Des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Lyon, France.,Laboratoire de Psychologie de Caen Normandie PALM (EA 7452), Université Caen-Normandie, Caen, France
| | - Emilie Favre
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, 95 Bd Pinel, Bron, France.,EDRPsy, UMR 5229, CNRS, 67 Bd Pinel, Bron, France
| | - Caroline Demily
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, 95 Bd Pinel, Bron, France.,EDRPsy, UMR 5229, CNRS, 67 Bd Pinel, Bron, France
| | - George A Michael
- Université de Lyon, Lyon, France. .,Laboratoire D'Étude Des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Lyon, France.
| |
Collapse
|
7
|
Dubourg L, Vrticka P, Pouillard V, Eliez S, Schneider M. Divergent default mode network connectivity during social perception in 22q11.2 deletion syndrome. Psychiatry Res Neuroimaging 2019; 291:9-17. [PMID: 31344628 DOI: 10.1016/j.pscychresns.2019.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/09/2019] [Accepted: 07/12/2019] [Indexed: 02/05/2023]
Abstract
AIM The 22q11.2 deletion (22q11DS) syndrome is a neurogenetic condition marked by social dysfunction. A major network involved in social cognition is the default mode network (DMN). To date, no study has investigated DMN functional connectivity during socio-cognitive paradigms in 22q11DS. METHOD We used the psychophysiological analysis (PPI) to investigate functional connectivity of the DMN during social perception in 22 participants with 22q11DS and 22 healthy controls. Association between DMN connectivity and prodromal symptoms was also examined. RESULTS 22q11DS patients exhibited stronger connectivity between the inferior parietal lobule (IPL) and the posterior cingulate cortex (PCC)/precuneus as well as lower connectivity between the precuneus and middle/superior frontal regions compared to controls. Association between IPL-PCC/precuneus connectivity and negative symptoms was also found in individuals with 22q11DS. CONCLUSION Our results point to (1) divergent DMN connectivity in patients with 22q11DS compared to controls; (2) association between DMN connectivity and negative symptom severity in patients. Results support the role of the DMN in social deficits of the 22q11DS population.
Collapse
Affiliation(s)
- Lydia Dubourg
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland.
| | - Pascal Vrticka
- Department of Social Neuroscience, Max Planck Institute for Human Cognitive and brain Sciences, Leipzig, Germany
| | - Virginie Pouillard
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland; Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
8
|
Peyroux E, Rigard C, Saucourt G, Poisson A, Plasse J, Franck N, Demily C. Subthreshold social cognitive deficits may be a key to distinguish 22q11.2DS from schizophrenia. Early Interv Psychiatry 2019; 13:304-307. [PMID: 29575660 DOI: 10.1111/eip.12557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 12/30/2017] [Accepted: 02/04/2018] [Indexed: 11/27/2022]
Abstract
AIM Social cognitive impairments are core features in 22q11.2 deletion syndrome (22q11.2DS) and schizophrenia (SCZ). Indeed, adults with 22q.11.2 DS often have poorer social competence as well as poorer performance on measures of social cognitive skills (emotion recognition and theory of mind, ToM) compared with typically developing people. However, studies comparing specific social cognitive components in 22q11.2DS and SCZ have not yet been widely conducted. METHODS In this study we compared performances of 22q11.2DS and SCZ on both facial emotion recognition and ToM. Patients with 22q11.2DS (n = 18) and matched SCZ patients were recruited. After neuropsychological testing, the facial emotion recognition test assessed the patients' ability to recognize six basic, universal emotions (joy, anger, sadness, fear, disgust, and contempt). The Versailles-situational intentional reading evaluated ToM with six scenes from movies showing characters in complex interactions (involving hints, lies, and indirect speech). RESULTS We show that 22q11.2DS exhibited significantly lower performance in emotion recognition than SCZ patients did, especially for disgust, contempt, and fear. This impairment seems to be a core cognitive phenotype in 22q11.2DS, regardless of the presence of SCZ symptoms. Concerning ToM, our results may highlight the same impairment level in 22q11.2DS and SCZ but require to be replicated in a larger cohort. CONCLUSION Our results document the existence of threshold social cognitive deficits distinguishing 22q11.2DS from SCZ.
Collapse
Affiliation(s)
- Elodie Peyroux
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, Bron, France.,University Department of Rehabilitation (SUR-CL3R, CRR), Le Vinatier Hospital, Lyon, France.,Center of Cognitive Neurosciences, UMR 5229, CNRS, Bron, France
| | - Caroline Rigard
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, Bron, France.,Center of Cognitive Neurosciences, UMR 5229, CNRS, Bron, France
| | - Guillaume Saucourt
- Unité polaire de psychoéducation (UPP), Le Vinatier Hospital, Bron, France
| | - Alice Poisson
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, Bron, France.,Center of Cognitive Neurosciences, UMR 5229, CNRS, Bron, France
| | - Julien Plasse
- University Department of Rehabilitation (SUR-CL3R, CRR), Le Vinatier Hospital, Lyon, France
| | - Nicolas Franck
- University Department of Rehabilitation (SUR-CL3R, CRR), Le Vinatier Hospital, Lyon, France.,Center of Cognitive Neurosciences, UMR 5229, CNRS, Bron, France.,Claude Bernard - Lyon 1, University of Lyon, Villeurbanne, France
| | - Caroline Demily
- GénoPsy, Reference Center for Rare Diseases, Le Vinatier Hospital, Bron, France.,Center of Cognitive Neurosciences, UMR 5229, CNRS, Bron, France.,Claude Bernard - Lyon 1, University of Lyon, Villeurbanne, France
| |
Collapse
|
9
|
Abstract
OBJECTIVE While individuals with 22q11.2 deletion syndrome (22q11DS) are at increased risk for a variety of functional impairments and psychiatric disorders, including psychosis, not all individuals with 22q11DS experience negative outcomes. Efforts to further understand which childhood variables best predict adult functional outcomes are needed, especially those that investigate childhood executive functioning abilities. METHODS This longitudinal study followed 63 individuals with 22q11DS and 43 control participants over 9 years. Childhood executive functioning ability was assessed using both rater-based and performance-based measures and tested as predictors of young adult outcomes. RESULTS Childhood global executive functioning abilities and parent report of child executive functioning abilities were the most consistent predictors of young adult outcomes. The study group moderated the relationship between child executive functioning and young adult outcomes for several outcomes such that the relationships were stronger in the 22q11DS sample. CONCLUSION Rater-based and performance-based measures of childhood executive functioning abilities predicted young adult outcomes in individuals with and without 22q11DS. Executive functioning could be a valuable target for treatment in children with 22q11DS for improving not only childhood functioning but also adult outcomes. (JINS, 2018, 24, 905-916).
Collapse
|
10
|
Lattanzi GM, Buzzanca A, Frascarelli M, Di Fabio F. Genetic and clinical features of social cognition in 22q11.2 deletion syndrome. J Neurosci Res 2018; 96:1631-1640. [DOI: 10.1002/jnr.24265] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 05/12/2018] [Accepted: 05/15/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Guido Maria Lattanzi
- Department of Human Neurosciences; Sapienza University; Rome 00185 Italy
- Department of Psychosis Studies; Institute of Psychiatry, Psychology and Neuroscience, King's College; London SE5 8AF United Kingdom
| | - Antonino Buzzanca
- Department of Human Neurosciences; Sapienza University; Rome 00185 Italy
| | | | - Fabio Di Fabio
- Department of Human Neurosciences; Sapienza University; Rome 00185 Italy
| |
Collapse
|
11
|
Vo OK, McNeill A, Vogt KS. The psychosocial impact of 22q11 deletion syndrome on patients and families: A systematic review. Am J Med Genet A 2018; 176:2215-2225. [PMID: 29575505 PMCID: PMC6221171 DOI: 10.1002/ajmg.a.38673] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/07/2018] [Accepted: 02/25/2018] [Indexed: 12/16/2022]
Abstract
The 22q11 deletion syndrome (22q11DS) is one of the most common genomic disorders in humans, affecting around 1:2,000 to 1: 4,000 people. 22q11DS affects multiple body systems and is associated with multiple physical problems. Given the high rate of physical morbidity associated with the 22q11DS, it was hypothesized that it would exert a high psychosocial impact on patients and their relatives. To investigate this, a systematic review of the literature and narrative synthesis was performed. Three major themes emerged. First, the complex and conflicting emotions experienced by family members resulting from the diagnosis. Second, the pervasive educational and health‐care challenges associated with the diagnosis and third that people affect by 22q11DS strived for individualism. The results of this review help to inform clinical management of families with 22q11DS.
Collapse
Affiliation(s)
- Oanh Kieu Vo
- Sheffield Institute of Translational Neuroscience, The University of Sheffield, Sheffield, United Kingdom
| | - Alisdair McNeill
- Sheffield Institute of Translational Neuroscience, The University of Sheffield, Sheffield, United Kingdom.,Sheffield Clinical Genetics Service, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, United Kingdom
| | - Katharina Sophie Vogt
- Sheffield Institute of Translational Neuroscience, The University of Sheffield, Sheffield, United Kingdom
| |
Collapse
|
12
|
Morel A, Peyroux E, Leleu A, Favre E, Franck N, Demily C. Overview of Social Cognitive Dysfunctions in Rare Developmental Syndromes With Psychiatric Phenotype. Front Pediatr 2018; 6:102. [PMID: 29774207 PMCID: PMC5943552 DOI: 10.3389/fped.2018.00102] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 03/27/2018] [Indexed: 12/26/2022] Open
Abstract
Rare neurodevelopmental syndromes often present social cognitive deficits that may underlie difficulties in social interactions and increase the risk of psychosis or autism spectrum disorders. However, little is known regarding the specificities of social cognitive impairment across syndromes while it remains a major challenge for the care. Our review provides an overview of social cognitive dysfunctions in rare diseases associated with psychiatric symptoms (with a prevalence estimated between 1 in 1,200 and 1 in 25,000 live births: 22q11.2 deletion syndrome, Angelman syndrome, Fragile X syndrome, Klinefelter syndrome, Prader-Willi syndrome, Rett syndrome, Smith-Magenis syndrome, Turner syndrome, and Williams syndrome) and shed some light on the specific mechanisms that may underlie these skills in each clinical presentation. We first detail the different processes included in the generic expression "social cognition" before summarizing the genotype, psychiatric phenotype, and non-social cognitive profile in each syndrome. Then, we offer a systematic review of the social cognitive abilities and the disturbed mechanisms they are likely associated with. We followed the PRISMA process, including the definition of the relevant search terms, the selection of studies based on clear inclusion, and exclusion criteria and the quality appraisal of papers. We finally provide insights that may have considerable influence on the development of adapted therapeutic interventions such as social cognitive training (SCT) therapies specifically designed to target the psychiatric phenotype. The results of this review suggest that social cognition impairments share some similarities across syndromes. We propose that social cognitive impairments are strongly involved in behavioral symptoms regardless of the overall cognitive level measured by intelligence quotient. Better understanding the mechanisms underlying impaired social cognition may lead to adapt therapeutic interventions. The studies targeting social cognition processes offer new thoughts about the development of specific cognitive training programs, as they highlight the importance of connecting neurocognitive and SCT techniques.
Collapse
Affiliation(s)
- Aurore Morel
- Scientific Brain Training, Reference Center for Rare Diseases GénoPsy, CH Le Vinatier, UMR 5229, Université Lyon 1, CNRS, Lyon, France
| | - Elodie Peyroux
- Reference Center for Rare Diseases GénoPsy, SUR/CL3R: Service Universitaire de Réhabilitation, CH Le Vinatier, UMR 5229, Université Lyon 1, CNRS, Lyon, France
| | - Arnaud Leleu
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, INRA, Université Bourgogne Franche-Comté, CNRS, Dijon, France
| | - Emilie Favre
- Reference Center for Rare Diseases GénoPsy, CH Le Vinatier, UMR 5229, Université Lyon 1, CNRS, Lyon, France
| | - Nicolas Franck
- Centre ressource de réhabilitation psychosociale et de remédiation cognitive, CH Le Vinatier, Lyon et UMR 5229 (CNRS and Université Lyon), Lyon, France
| | - Caroline Demily
- Reference Center for Rare Diseases GénoPsy, CH Le Vinatier, UMR 5229, Université Lyon 1, CNRS, Lyon, France
| |
Collapse
|
13
|
Badoud D, Schneider M, Menghetti S, Glaser B, Debbané M, Eliez S. Understanding others: a pilot investigation of cognitive and affective facets of social cognition in patients with 22q11.2 deletion syndrome (22q11DS). J Neurodev Disord 2017; 9:35. [PMID: 28946869 PMCID: PMC5613394 DOI: 10.1186/s11689-017-9216-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although significant impairments in the affective and cognitive facets of social cognition have been highlighted in patients with 22q11.2 deletion syndrome (22q11DS) in previous studies, these domains have never been investigated simultaneously within the same group of participants. Furthermore, despite theoretical evidence, associations between these two processes and schizotypal symptoms or social difficulties in this population have been scarcely examined. METHODS Twenty-nine participants with 22q11DS and 27 typically developing controls (N = 5 siblings; N = 22 unrelated controls) aged between 11 and 21 years participated in the study. Both groups were matched for age and gender distribution. Two computerized social cognition tasks evaluating perspective and emotion recognition abilities were administered to all participants. The levels of schizotypal trait expression and social functioning were further investigated in both groups, based on a validated self-report questionnaire (Schizotypal Personality Questionnaire) and parental interview (Vineland Adaptive Behavior Scales). RESULTS Participants with 22q11DS exhibited lower perspective-taking and emotion recognition capacities than typically developing controls. The two socio-cognitive dimensions investigated here were further correlated in healthy controls. The efficiency of perspective-taking processes (response time) was marginally related to the degree of schizotypal trait expression in patients with 22q11DS. CONCLUSIONS This study first provides support for significant deficits in two core facets of social cognition in 22q11DS. The associations observed between the experimental tasks and measures of social functioning or schizotypal symptoms in 22q11DS open promising research avenue, which should be more deeply investigated in future studies.
Collapse
Affiliation(s)
- D. Badoud
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, Geneva, Switzerland
- Lab of Action and Body, Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - M. Schneider
- Office Medico-Pédagogique Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Contextual Psychiatry, Research group psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - S. Menghetti
- Office Medico-Pédagogique Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - B. Glaser
- Office Medico-Pédagogique Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - M. Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, Geneva, Switzerland
- Office Medico-Pédagogique Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - S. Eliez
- Office Medico-Pédagogique Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
14
|
Morel A, Demily C. Cognition sociale dans les troubles neuro-génétiques de l’enfant : revue de la littérature. Arch Pediatr 2017; 24:757-765. [DOI: 10.1016/j.arcped.2017.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 01/15/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
|
15
|
Norkett EM, Lincoln SH, Gonzalez-Heydrich J, D'Angelo EJ. Social cognitive impairment in 22q11 deletion syndrome: A review. Psychiatry Res 2017; 253:99-106. [PMID: 28364592 DOI: 10.1016/j.psychres.2017.01.103] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 11/14/2016] [Accepted: 01/23/2017] [Indexed: 11/29/2022]
Abstract
Individuals with 22q11.2 deletion syndrome (22q11DS) exhibit a broad array of physical and psychiatric features, of which impaired social cognition and poor social functioning are common. This review seeks to (1) characterize the current understanding of impairment across social cognitive domains in the context of 22q11DS, and (2) synthesize the relevant literature on social cognition and psychosis, given that the prevalence of psychosis in 22q11DS is especially high compared to the general population. A total of 16 papers examining social cognition in 22q11DS were identified through a comprehensive literature search conducted using electronic databases such as PubMed and PSYCInfo. Results suggest that individuals with 22q11DS exhibit impaired emotion processing and complex theory of mind relative to their typically developing peers, though some findings were accounted for by neurocognitive and intellectual abilities. Further, no studies have examined the domains of attribution bias or social perception in 22q11DS, highlighting a critical gap in the extant literature. More research is needed to better elucidate the trajectory of how and why social cognitive impairment develops in 22q11DS, and to explore possible relationships to psychiatric comorbidities like psychosis. Treatment implications and future steps are considered.
Collapse
Affiliation(s)
- Emily M Norkett
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States
| | - Sarah Hope Lincoln
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States.
| | - Joseph Gonzalez-Heydrich
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States
| | - Eugene J D'Angelo
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States
| |
Collapse
|
16
|
Schreiner M, Forsyth JK, Karlsgodt KH, Anderson AE, Hirsh N, Kushan L, Uddin LQ, Mattiacio L, Coman IL, Kates WR, Bearden CE. Intrinsic Connectivity Network-Based Classification and Detection of Psychotic Symptoms in Youth With 22q11.2 Deletions. Cereb Cortex 2017; 27:3294-3306. [PMID: 28383675 PMCID: PMC6059149 DOI: 10.1093/cercor/bhx076] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 02/01/2017] [Indexed: 01/10/2023] Open
Abstract
22q11.2 Deletion syndrome (22q11DS) is a genetic disorder associated with numerous phenotypic consequences and is one of the greatest known risk factors for psychosis. We investigated intrinsic-connectivity-networks (ICNs) as potential biomarkers for patient and psychosis-risk status in 2 independent cohorts, UCLA (33 22q11DS-participants, 33 demographically matched controls), and Syracuse (28 22q11DS, 28 controls). After assessing group connectivity differences, ICNs from the UCLA cohort were used to train classifiers to distinguish cases from controls, and to predict psychosis risk status within 22q11DS; classifiers were subsequently tested on the Syracuse cohort. In both cohorts we observed significant hypoconnectivity in 22q11DS relative to controls within anterior cingulate (ACC)/precuneus, executive, default mode (DMN), posterior DMN, and salience networks. Of 12 ICN-derived classifiers tested in the Syracuse replication-cohort, the ACC/precuneus, DMN, and posterior DMN classifiers accurately distinguished between 22q11DS and controls. Within 22q11DS subjects, connectivity alterations within 4 networks predicted psychosis risk status for a given individual in both cohorts: the ACC/precuneus, DMN, left executive, and salience networks. Widespread within-network-hypoconnectivity in large-scale networks implicated in higher-order cognition may be a defining characteristic of 22q11DS during adolescence and early adulthood; furthermore, loss of coherence within these networks may be a valuable biomarker for individual prediction of psychosis-risk in 22q11DS.
Collapse
Affiliation(s)
- Matthew Schreiner
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
- Interdepartmental Neuroscience Program, University of California, Los Angeles, CA 90095, USA
| | - Jennifer K. Forsyth
- Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | | | - Ariana E. Anderson
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Nurit Hirsh
- Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Leila Kushan
- Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Lucina Q. Uddin
- Department of Psychology, University of Miami, Coral Gables, FL 33124, USA
- Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Leah Mattiacio
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, New York, NY 13210, USA
| | - Ioana L. Coman
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, New York, NY 13210, USA
| | - Wendy R. Kates
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, New York, NY 13210, USA
| | - Carrie E. Bearden
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
- Department of Psychology, University of California, Los Angeles, CA 90095, USA
| |
Collapse
|
17
|
Olszewski AK, Kikinis Z, Gonzalez CS, Coman IL, Makris N, Gong X, Rathi Y, Zhu A, Antshel KM, Fremont W, Kubicki MR, Bouix S, Shenton ME, Kates WR. The social brain network in 22q11.2 deletion syndrome: a diffusion tensor imaging study. Behav Brain Funct 2017; 13:4. [PMID: 28209179 PMCID: PMC5314621 DOI: 10.1186/s12993-017-0122-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 02/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a neurogenetic disorder that is associated with a 25-fold increase in schizophrenia. Both individuals with 22q11.2DS and those with schizophrenia present with social cognitive deficits, which are putatively subserved by a network of brain regions that are involved in the processing of social cognitive information. This study used two-tensor tractography to examine the white matter tracts believed to underlie the social brain network in a group of 57 young adults with 22q11.2DS compared to 30 unaffected controls. RESULTS Results indicated that relative to controls, participants with 22q11.2DS showed significant differences in several DTI metrics within the inferior fronto-occipital fasciculus, cingulum bundle, thalamo-frontal tract, and inferior longitudinal fasciculus. In addition, participants with 22q11.2DS showed significant differences in scores on measures of social cognition, including the Social Responsiveness Scale and Trait Emotional Intelligence Questionnaire. Further analyses among individuals with 22q11.2DS demonstrated an association between DTI metrics and positive and negative symptoms of psychosis, as well as differentiation between individuals with 22q11.2DS and overt psychosis, relative to those with positive prodromal symptoms or no psychosis. CONCLUSIONS Findings suggest that white matter disruption, specifically disrupted axonal coherence in the right inferior fronto-occipital fasciculus, may be a biomarker for social cognitive difficulties and psychosis in individuals with 22q11.2DS.
Collapse
Affiliation(s)
- Amy K Olszewski
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Zora Kikinis
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Ioana L Coman
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Nikolaos Makris
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Xue Gong
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anni Zhu
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Wanda Fremont
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Marek R Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,VA Boston Healthcare System, Harvard Medical School, Brockton, MA, USA
| | - Wendy R Kates
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA.
| |
Collapse
|
18
|
Jalbrzikowski M, Ahmed KH, Patel A, Jonas R, Kushan L, Chow C, Bearden CE. Categorical versus dimensional approaches to autism-associated intermediate phenotypes in 22q11.2 microdeletion syndrome. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:53-65. [PMID: 28367513 PMCID: PMC5373800 DOI: 10.1016/j.bpsc.2016.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND 22q11.2 Microdeletion syndrome (22q11DS) is associated with elevated rates of autism spectrum disorders (ASDs), although the diagnosis is controversial. In order to determine whether there is a biological substrate of ASD in 22q11DS, we examined neurocognitive and structural neuroanatomic differences between those with 22q11DS and an ASD diagnosis (22q11DS-ASD+) and those with 22q11DS without ASD (22q11DS-ASD-); we then determined whether these differences were better characterized within a categorical or dimensional framework. METHODS We collected multiple neurocognitive measures and high-resolution T1-weighted scans on 116 individuals (29 22q11DS-ASD+, 32 22q11DS-ASD-, 55 typically developing controls) between 6 and 26 years of age. Measures of subcortical volume, cortical thickness (CT), and surface area were extracted using the FreeSurfer image analysis suite. Group differences in neurocognitive and neuroanatomic measures were assessed; regression analyses were then performed to determine whether a categorical or dimensional measure of ASD was a better predictor of neurocognitive impairment and/or neuroanatomic abnormalities observed in 22q11DS-ASD+. RESULTS In comparison to 22q11DS-ASD-, 22q11DS-ASD+ participants exhibited decreased bilateral hippocampal CT and decreased right amygdala volumes. Those with 22q11DS-ASD+ also showed slowed processing speed and impairments in visuospatial and facial memory. Neurocognitive impairments fit a dimensional model of ASD, whereas reductions in parahippocampal CT were best explained by a categorical measure of ASD. CONCLUSIONS A combination of categorical and dimensional measures of ASD may provide the most comprehensive understanding of ASDs in 22q11DS.
Collapse
Affiliation(s)
| | - Khwaja Hamzah Ahmed
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Arati Patel
- University of Southern California, Keck School of Medicine
| | - Rachel Jonas
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
- University of California, Los Angeles, Interdepartmental Neuroscience Program
| | - Leila Kushan
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Carolyn Chow
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Carrie E. Bearden
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
- University of California, Los Angeles, Department of Psychology
| |
Collapse
|
19
|
Vangkilde A, Jepsen JRM, Schmock H, Olesen C, Arnarsdóttir S, Baaré WFC, Plessen KJ, Didriksen M, Siebner HR, Werge T, Olsen L. Associations between social cognition, skills, and function and subclinical negative and positive symptoms in 22q11.2 deletion syndrome. J Neurodev Disord 2016; 8:42. [PMID: 27891188 PMCID: PMC5112709 DOI: 10.1186/s11689-016-9175-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 11/01/2016] [Indexed: 12/31/2022] Open
Abstract
Background Identification of the early signs of schizophrenia would be a major achievement for the early intervention and prevention strategies in psychiatry. Social impairments are defining features of schizophrenia. Impairments of individual layers of social competencies are frequently described in individuals with 22q11.2 deletion syndrome (22q11.2DS), who have high risk of schizophrenia. It is unclear whether and to what extent social impairments associate with subclinical negative and positive symptoms in 22q11.2DS, and which layer of social impairments are more correlated with schizophrenia-related symptoms. The aims of this study were to conduct a comprehensive investigation of social impairments at three different levels (function, skill, and cognition) and their interrelationship and to determine to what degree the social impairments correlate to subclinical levels of negative and positive symptoms, respectively, in a young cohort of 22q11.2DS not diagnosed with schizophrenia. Methods The level of social impairment was addressed using questionnaires and objective measures of social functioning (The Adaptive Behavior Assessment System), skills (Social Responsiveness Scale), and cognition (The Awareness of Social Inference Test and CANTAB Emotional Recognition Task), and the presence of subclinical symptoms of schizophrenia were evaluated using the Structured Interview for Prodromal Syndromes in a cross-sectional case-control study of 29 cases and 29 controls, aged 12 to 25 years. Association between social impairment and negative and positive symptoms levels was examined in cases only. Results Subjects with 22q11.2DS were highly impaired in social function, social skills, and social cognition (p ≤ 6.2 × 10−9) relative to control peers and presented with more negative (p = 5.8 × 10−11) and positive (p = 7.5 × 10−4) symptoms. In particular, social functional and skill levels were highly associated with notably subclinical negative symptoms levels. Conclusions This study shows strong correlations between levels of social impairments and subclinical negative and positive symptoms. However, longitudinal studies are required to show if social impairments represent early disease manifestations. If parental or self-reporting suggests severe social impairment, it should advocate for clinical awareness not only to social deficits per se but also of potential subclinical psychosis symptoms.
Collapse
Affiliation(s)
- A Vangkilde
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Boserupvej 2, 4000 Roskilde, Denmark ; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Copenhagen Denmark
| | - J R M Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Bispebjerg Bakke 30, 2400 Copenhagen NV, Denmark ; Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Ndr. Ringvej 29-67, 2600 Glostrup, Denmark
| | - H Schmock
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Boserupvej 2, 4000 Roskilde, Denmark ; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Copenhagen Denmark
| | - C Olesen
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark
| | - S Arnarsdóttir
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Boserupvej 2, 4000 Roskilde, Denmark ; deCODE genetics, Amgen, Sturlugata 8, 101 Reykjavik, Iceland
| | - W F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark
| | - K J Plessen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Bispebjerg Bakke 30, 2400 Copenhagen NV, Denmark ; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N, Denmark
| | - M Didriksen
- H. Lundbeck A/S, Ottiliavej 9, 2500 Valby, Denmark
| | - H R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark ; Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
| | - T Werge
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Boserupvej 2, 4000 Roskilde, Denmark ; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Copenhagen Denmark ; Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark
| | - L Olsen
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Boserupvej 2, 4000 Roskilde, Denmark ; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Copenhagen Denmark
| |
Collapse
|
20
|
Mother-Child Interaction as a Window to a Unique Social Phenotype in 22q11.2 Deletion Syndrome and in Williams Syndrome. J Autism Dev Disord 2016; 45:2567-77. [PMID: 25791124 DOI: 10.1007/s10803-015-2425-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Mother-child interactions in 22q11.2 Deletion syndrome (22q11.2DS) and Williams syndrome (WS) were coded for maternal sensitivity/intrusiveness, child's expression of affect, levels of engagement, and dyadic reciprocity. WS children were found to express more positive emotions towards their mothers compared to 22q11.2DS children and those with developmental delay in a conflict interaction. During the same interaction, dyads of 22q11.2DS children were characterized by higher levels of maternal intrusiveness, lower levels of child's engagement and reduced reciprocity compared to dyads of typically developing children. Finally, 22q11.2DS children with the COMT Met allele showed less adaptive behaviors than children with the Val allele. Dyadic behaviors partially coincided with the distinct social phenotypes in these syndromes and are potential behavioral markers of psychopathological trajectory.
Collapse
|
21
|
Jonas RK, Jalbrzikowski M, Montojo CA, Patel A, Kushan L, Chow CC, Vesagas T, Bearden CE. Altered Brain Structure-Function Relationships Underlie Executive Dysfunction in 22q11.2 Deletion Syndrome. MOLECULAR NEUROPSYCHIATRY 2015; 1:235-46. [PMID: 27606315 DOI: 10.1159/000441979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
22q11.2 deletion syndrome (22q11DS) is a neurogenetic disorder associated with elevated rates of developmental neuropsychiatric disorders and impaired executive function (EF). Disrupted brain structure-function relationships may underlie EF deficits in 22q11DS. We administered the Behavior Rating Inventory of Executive Function (BRIEF) to assess real-world EF in patients with 22q11DS and matched controls (n = 86; age 6-17 years), along with cognitive measures that tap behavioral regulation and metacognition aspects of EF. Using FreeSurfer's whole-brain vertex cortical thickness pipeline, we investigated brain structure-EF relationships in patients with 22q11DS and controls. Behaviorally, patients with 22q11DS were impaired on multiple EF measures. Right orbitofrontal cortical thickness showed a differential relationship between real-world EF in patients with 22q11DS and controls. We also observed a group difference in the relationship between behavioral regulation and metacognition measures with thickness of ventral and dorsolateral prefrontal regions, respectively. Our findings suggest that executive dysfunction characteristic of 22q11DS is underscored by altered prefrontal cortical structure.
Collapse
Affiliation(s)
- Rachel K Jonas
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Maria Jalbrzikowski
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Caroline A Montojo
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Arati Patel
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Leila Kushan
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Carolyn C Chow
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Therese Vesagas
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, Calif., USA
| |
Collapse
|
22
|
Abstract
22q11.2 Deletion syndrome (22q11.2DS) is a chromosomal microdeletion that affects approximately 40 to 50 genes and affects various organs and systems throughout the body. Detection is typically achieved by fluorescence in situ hybridization after diagnosis of one of the major features of the deletion or via chromosomal microarray or noninvasive prenatal testing. The physical phenotype can include congenital heart defects, palatal and pharyngeal anomalies, hypocalcemia/hypoparathyroidism, skeletal abnormalities, and cranial/brain anomalies, although prevalence rates of all these features are variable. Cognitive function is impaired to some degree in most individuals, with prevalence rates of greater than 90% for motor/speech delays and learning disabilities. Attention, executive function, working memory, visual-spatial abilities, motor skills, and social cognition/social skills are affected. The deletion is also associated with an increased risk for behavioral disorders and psychiatric illness. The early onset of psychiatric symptoms common to 22q11.2DS disrupts the development and quality of life of individuals with the syndrome and is also a potential risk factor for later development of a psychotic disorder. This review discusses prevalence, phenotypic features, and management of psychiatric disorders commonly diagnosed in children and adolescents with 22q11.2DS, including autism spectrum disorders, attention deficit/hyperactivity disorder, anxiety disorders, mood disorders, and schizophrenia/psychotic disorders. Guidelines for the clinical assessment and management of psychiatric disorders in youth with this syndrome are provided, as are treatment guidelines for the use of psychiatric medications.
Collapse
|
23
|
Campbell LE, McCabe KL, Melville JL, Strutt PA, Schall U. Social cognition dysfunction in adolescents with 22q11.2 deletion syndrome (velo-cardio-facial syndrome): relationship with executive functioning and social competence/functioning. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:845-859. [PMID: 25726953 DOI: 10.1111/jir.12183] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Social difficulties are often noted among people with intellectual disabilities. Children and adults with 22q.11.2 deletion syndrome (22q11DS) often have poorer social competence as well as poorer performance on measures of executive and social-cognitive skills compared with typically developing young people. However, the relationship between social functioning and more basic processes of social cognition and executive functioning are not well understood in 22q11DS. The present study examined the relationship between social-cognitive measures of emotion attribution and theory of mind with executive functioning and their contribution to social competence in 22q11DS. METHOD The present cross-sectional study measured social cognition and executive performance of 24 adolescents with 22q11DS compared with 27 age-matched typically developing controls. Social cognition was tested using the emotion attribution task (EAT) and a picture sequencing task (PST), which tested mentalising (false-belief), sequencing, cause and effect, and inhibition. Executive functioning was assessed using computerised versions of the Tower of London task and working memory measures of spatial and non-spatial ability. Social competence was also assessed using the parent-reported Strengths and Difficulties Questionnaire. RESULTS Adolescents with 22q11DS showed impaired false-belief, emotion attribution and executive functioning compared with typically developing control participants. Poorer performance was reported on all story types in the PST, although, patterns of errors and response times across story types were similar in both groups. General sequencing ability was the strongest predictor of false-belief, and performance on the false-belief task predicted emotion attribution accuracy. Intellectual functioning, rather than theory of mind or executive functioning, predicted social competence in 22q11DS. CONCLUSIONS Performance on social-cognitive tasks of theory of mind indicate evidence of a general underlying dysfunction in 22q11DS that includes executive ability to understand cause and effect, to logically reason about social scenarios and also to inhibit responses to salient, but misleading cues. However, general intellectual ability is closely related to actual social competence suggesting that a generalised intellectual deficit coupled with more specific executive impairments may best explain poor social cognition in 22q11DS.
Collapse
Affiliation(s)
- L E Campbell
- Centre for Translational Neuroscience and Mental Health Research, University of Newcastle, McAuley Centre, Waratah, NSW, 2298, Australia
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mail Centre, NSW, 2310, Australia
- School of Psychology, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - K L McCabe
- Centre for Translational Neuroscience and Mental Health Research, University of Newcastle, McAuley Centre, Waratah, NSW, 2298, Australia
- Brain & Mind Research Institute, University of Sydney, Camperdown, NSW, 2050, Australia
- Schizophrenia Research Institute, 405 Liverpool St Darlinghurst, NSW, 2010, Australia
| | - J L Melville
- School of Psychology, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - P A Strutt
- Centre for Translational Neuroscience and Mental Health Research, University of Newcastle, McAuley Centre, Waratah, NSW, 2298, Australia
- School of Psychology, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - U Schall
- Centre for Translational Neuroscience and Mental Health Research, University of Newcastle, McAuley Centre, Waratah, NSW, 2298, Australia
- Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mail Centre, NSW, 2310, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Schizophrenia Research Institute, 405 Liverpool St Darlinghurst, NSW, 2010, Australia
| |
Collapse
|
24
|
Cummings L. Theory of mind in utterance interpretation: the case from clinical pragmatics. Front Psychol 2015; 6:1286. [PMID: 26379602 PMCID: PMC4549655 DOI: 10.3389/fpsyg.2015.01286] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 08/11/2015] [Indexed: 11/18/2022] Open
Abstract
The cognitive basis of utterance interpretation is an area that continues to provoke intense theoretical debate among pragmatists. That utterance interpretation involves some type of mind-reading or theory of mind (ToM) is indisputable. However, theorists are divided on the exact nature of this ToM-based mechanism. In this paper, it is argued that the only type of ToM-based mechanism that can adequately represent the cognitive basis of utterance interpretation is one which reflects the rational, intentional, holistic character of interpretation. Such a ToM-based mechanism is supported on conceptual and empirical grounds. Empirical support for this view derives from the study of children and adults with pragmatic disorders. Specifically, three types of clinical case are considered. In the first case, evidence is advanced which indicates that individuals with pragmatic disorders exhibit deficits in reasoning and the use of inferences. These deficits compromise the ability of children and adults with pragmatic disorders to comply with the rational dimension of utterance interpretation. In the second case, evidence is presented which suggests that subjects with pragmatic disorders struggle with the intentional dimension of utterance interpretation. This dimension extends beyond the recognition of communicative intentions to include the attribution of a range of cognitive and affective mental states that play a role in utterance interpretation. In the third case, evidence is presented that children and adults with pragmatic disorders struggle with the holistic character of utterance interpretation. This serves to distort the contexts in which utterances are processed for their implicated meanings. The paper concludes with some thoughts about the role of theorizing in relation to utterance interpretation.
Collapse
Affiliation(s)
- Louise Cummings
- English, Culture and Media Studies, School of Arts and Humanities, Nottingham Trent University Nottingham, UK
| |
Collapse
|
25
|
Jalbrzikowski M, Lazaro MT, Gao F, Huang A, Chow C, Geschwind DH, Coppola G, Bearden CE. Transcriptome Profiling of Peripheral Blood in 22q11.2 Deletion Syndrome Reveals Functional Pathways Related to Psychosis and Autism Spectrum Disorder. PLoS One 2015. [PMID: 26201030 PMCID: PMC4511766 DOI: 10.1371/journal.pone.0132542] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background 22q11.2 Deletion Syndrome (22q11DS) represents one of the greatest known genetic risk factors for the development of psychotic illness, and is also associated with high rates of autistic spectrum disorders (ASD) in childhood. We performed integrated genomic analyses of 22q11DS to identify genes and pathways related to specific phenotypes. Methods We used a high-resolution aCGH array to precisely characterize deletion breakpoints. Using peripheral blood, we examined differential expression (DE) and networks of co-expressed genes related to phenotypic variation within 22q11DS patients. Whole-genome transcriptional profiling was performed using Illumina Human HT-12 microarrays. Data mining techniques were used to validate our results against independent samples of both peripheral blood and brain tissue from idiopathic psychosis and ASD cases. Results Eighty-five percent of 22q11DS individuals (N = 39) carried the typical 3 Mb deletion, with significant variability in deletion characteristics in the remainder of the sample (N = 7). DE analysis and weighted gene co-expression network analysis (WGCNA) identified expression changes related to psychotic symptoms in patients, including a module of co-expressed genes which was associated with psychosis in 22q11DS and involved in pathways associated with transcriptional regulation. This module was enriched for brain-expressed genes, was not related to antipsychotic medication use, and significantly overlapped with transcriptional changes in idiopathic schizophrenia. In 22q11DS-ASD, both DE and WGCNA analyses implicated dysregulation of immune response pathways. The ASD-associated module showed significant overlap with genes previously associated with idiopathic ASD. Conclusion These findings further support the use of peripheral tissue in the study of major mutational models of diseases affecting the brain, and point towards specific pathways dysregulated in 22q11DS carriers with psychosis and ASD.
Collapse
Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, United States of America
| | - Maria T. Lazaro
- Interdepartmental Neuroscience Program, University of California Los Angeles, Los Angeles, United States of America
| | - Fuying Gao
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, United States of America
| | - Alden Huang
- Interdepartmental Neuroscience Program, University of California Los Angeles, Los Angeles, United States of America
| | - Carolyn Chow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, United States of America
| | - Daniel H. Geschwind
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, United States of America
- Department of Neurology, University of California Los Angeles, Los Angeles, United States of America
| | - Giovanni Coppola
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, United States of America
- Department of Neurology, University of California Los Angeles, Los Angeles, United States of America
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, United States of America
- Department of Psychology, University of California Los Angeles, Los Angeles, United States of America
- * E-mail:
| |
Collapse
|
26
|
Chan C, Costain G, Ogura L, Silversides CK, Chow EWC, Bassett AS. Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome. J Genet Couns 2015; 24:810-21. [PMID: 25579115 DOI: 10.1007/s10897-014-9811-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 12/12/2014] [Indexed: 12/25/2022]
Abstract
22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome in humans. Survival to reproductive age and beyond is now the norm. Several manifestations of this syndrome, such as congenital cardiac disease and neuropsychiatric disorders, may increase risk for adverse pregnancy outcomes in the general population. However, there are limited data on reproductive health in 22q11.2DS. We performed a retrospective chart review for 158 adults with 22q11.2DS (75 male, 83 female; mean age 34.3 years) and extracted key variables relevant to pregnancy and reproductive health. We present four illustrative cases as brief vignettes. There were 25 adults (21 > age 35 years; 21 female) with a history of one or more pregnancies. Outcomes for women with 22q11.2DS, compared with expectations for the general population, showed a significantly elevated prevalence of small for gestational age liveborn offspring (p < 0.001), associated mainly with infants with 22q11.2DS. Stillbirths also showed elevated prevalence (p < 0.05). Not all observed adverse events appeared to be attributable to transmission of the 22q11.2 deletion. Recurring issues relevant to reproductive health in 22q11.2DS included the potential impact of maternal morbidities, inadequate social support, unsafe sexual practices, and delayed diagnosis of 22q11.2DS and/or lack of genetic counseling. These preliminary results emphasize the importance of early diagnosis and long term follow-up that could help facilitate genetic counseling for men and women with 22q11.2DS. We propose initial recommendations for pre-conception management, educational strategies, prenatal planning, and preparation for possible high-risk pregnancy and/or delivery.
Collapse
Affiliation(s)
- Chrystal Chan
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Undergraduate Medical Education, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gregory Costain
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Undergraduate Medical Education, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lucas Ogura
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Candice K Silversides
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, ON, Canada.,Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, Toronto, ON, Canada.,Obstetric Medicine Program, Mount Sinai Hospital, Toronto, ON, Canada
| | - Eva W C Chow
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anne S Bassett
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Division of Cardiology, Department of Medicine, University Health Network, Toronto, ON, Canada. .,Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Department of Psychiatry, and Toronto General Research Institute, University Health Network, Toronto, ON, Canada. .,The Dalglish Family Hearts and Minds Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
| |
Collapse
|
27
|
Angkustsiri K, Goodlin-Jones B, Deprey L, Brahmbhatt K, Harris S, Simon TJ. Social impairments in chromosome 22q11.2 deletion syndrome (22q11.2DS): autism spectrum disorder or a different endophenotype? J Autism Dev Disord 2014; 44:739-46. [PMID: 24045981 DOI: 10.1007/s10803-013-1920-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
High prevalence of autism spectrum disorders (ASD) has been reported in 22q11.2DS, although this has been based solely on parent report measures. This study describes the presence of ASD using a procedure more similar to that used in clinical practice by incorporating history (Social Communication Questionnaire) AND a standardized observation measure (Autism Diagnostic Observation Schedule) and suggests that ASD is not as common as previously reported in 22q11.2DS. Differences in methodology, along with comorbid conditions such as anxiety, likely contribute to false elevations in ASD prevalence and information from multiple sources should be included in the evaluation of ASD.
Collapse
Affiliation(s)
- Kathleen Angkustsiri
- Department of Pediatrics, University of California at Davis Medical Center, Sacramento, CA, USA,
| | | | | | | | | | | |
Collapse
|
28
|
Gothelf D, Law AJ, Frisch A, Chen J, Zarchi O, Michaelovsky E, Ren-Patterson R, Lipska BK, Carmel M, Kolachana B, Weizman A, Weinberger DR. Biological effects of COMT haplotypes and psychosis risk in 22q11.2 deletion syndrome. Biol Psychiatry 2014; 75:406-13. [PMID: 23992923 PMCID: PMC3872263 DOI: 10.1016/j.biopsych.2013.07.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/22/2013] [Accepted: 07/22/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11.2DS) is the most common genetic syndrome associated with schizophrenia. The catechol-O-methyltransferase (COMT) gene is located in the obligatory deletion region, and possible associations between COMT variants and neuropsychiatric manifestations in 22q11.2DS have been reported. The purpose of the current study was to evaluate the effect of COMT hemizygosity and molecular haplotypes on gene expression and enzyme activity and its association with psychotic symptoms in 22q11.2DS. METHODS Lymphoblast samples were drawn from 53 individuals with 22q11.2DS and 16 typically developing control subjects. We measured COMT messenger (m)RNA and protein expression and enzyme activity using standard procedures. The presence of a psychotic disorder and cognitive deficits were also evaluated using structured testing. RESULTS There was an approximately 50% reduction in COMT mRNA, protein, and enzyme activity levels in 22q11.2DS samples. Haplotype analysis revealed clear phenotypic differences between various Val-containing haplotypes on COMT-3' untranslated region extended mRNA, soluble COMT and membrane-bound proteins, and enzyme activity. The G variant of rs165599, a 3' untranslated region single nucleotide polymorphism, was associated with low levels of COMT expression and with the presence of psychosis and lower performance IQ scores in our 22q11.2DS sample. Finally, we demonstrate that the COMT rs74745580 "T" mutation is associated with absent soluble COMT expression and very low COMT activity in two 22q11.2DS individuals. CONCLUSIONS Our findings confirm a robust effect of COMT hemizygosity on COMT activity and show complex interactions of variants within the COMT gene that influence COMT biology and confound conclusions based on associations with the Val158Met genotype alone.
Collapse
Affiliation(s)
- Doron Gothelf
- Behavioral Neurogenetics Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amanda J Law
- Departments of Psychiatry and Cell and Developmental Biology, School of Medicine, University of Colorado, Aurora, Colorado; Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Amos Frisch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Felsenstein Medical Research Center, Petah Tiqwa, Israel
| | - Jingshan Chen
- Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Omer Zarchi
- Behavioral Neurogenetics Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Renee Ren-Patterson
- Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Barbara K Lipska
- Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Miri Carmel
- The Felsenstein Medical Research Center, Petah Tiqwa, Israel
| | - Bhaskar Kolachana
- Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Felsenstein Medical Research Center, Petah Tiqwa, Israel
| | - Daniel R Weinberger
- Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland; Lieber Institute for Brain Development, Johns Hopkins University Medical Campus; Departments of Psychiatry, Neurology, and Neuroscience and the McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
29
|
Risk factors and the evolution of psychosis in 22q11.2 deletion syndrome: a longitudinal 2-site study. J Am Acad Child Adolesc Psychiatry 2013; 52:1192-1203.e3. [PMID: 24157393 DOI: 10.1016/j.jaac.2013.08.008] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 07/23/2013] [Accepted: 08/26/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE 22q11.2 Deletion syndrome (22q11.2DS) is associated with high rates of schizophrenia, other neuropsychiatric disorders, and cognitive deficits. The objectives of this 2-center study were to longitudinally assess the trajectories of psychiatric disorders in 22q11.2DS from childhood to adulthood, and to identify risk factors for their emergence. METHOD A total of 125 children and adults with 22q11.2DS were evaluated at 2 time points, baseline and follow-up (4 years apart), using standardized psychiatric and cognitive measures. RESULTS The rate of mood disorders tended to decrease during childhood and increase during late adolescence. Statistically significant predictors for the presence of a psychotic disorder as well as the severity of positive symptoms at follow-up were identical, and consisted of an anxiety disorder at baseline, lower baseline Full Scale IQ, and a greater decrease in verbal IQ scores between time points. Nine of 10 individuals with an emerging psychotic disorder had an anxiety disorder at baseline. The age of onset for a psychotic disorder was between 14 and 22 years in 82.6% of cases. CONCLUSIONS It is important to evaluate the presence of anxiety disorders in children and adolescents with 22q11.2DS, as they are major risk factors for the emergence of psychotic disorders, which usually occur during late adolescence in this at-risk population.
Collapse
|
30
|
Jalbrzikowski M, Jonas R, Senturk D, Patel A, Chow C, Green MF, Bearden CE. Structural abnormalities in cortical volume, thickness, and surface area in 22q11.2 microdeletion syndrome: Relationship with psychotic symptoms. Neuroimage Clin 2013; 3:405-15. [PMID: 24273724 PMCID: PMC3814944 DOI: 10.1016/j.nicl.2013.09.013] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION 22q11.2 deletion syndrome (22q11DS) represents one of the largest known genetic risk factors for psychosis, yet the neurobiological mechanisms underlying symptom development are not well understood. Here we conducted a cross-sectional study of 22q11DS to decompose cortical volume into its constituent parts, cortical thickness (CT) and surface area (SA), which are believed to have distinct neurodevelopmental origins. METHODS High-resolution T1-weighted scans were collected on 65 participants (31 22q11DS, 34 demographically comparable typically developing controls, 10-25 years old). Measures of cortical volume, CT, and SA were extracted from regions of interest using the FreeSurfer image analysis suite. Group differences and age-related trajectories in these structures, as well as their association with psychotic symptomatology, were assessed. RESULTS Relative to controls, 22q11DS participants showed bilateral volumetric reductions in the inferior temporal cortex, fusiform gyrus, anterior cingulate, superior parietal cortex, and cuneus, which were driven by decreased SA in these regions. 22q11DS participants also had increased volumes, driven by increased CT, in bilateral insula regions. 22q11DS youth had increased CT in frontal regions, particularly middle frontal and medial orbitofrontal cortices. A pattern of age-associated cortical thinning was observed in typically developing controls in brain regions associated with visual and sensory information-processing (i.e., left pericalcarine cortex and fusiform gyrus, right lingual and postcentral cortices). However, this relationship was disrupted in 22q11DS participants. Finally, correlational analyses revealed that increased CT in right medial orbitofrontal cortex was associated with increased positive symptom severity in 22q11DS. CONCLUSION Differential disruptions of CT and SA in distinct cortical regions in 22q11DS may indicate abnormalities in distinct developmental neural processes. Further, neuroanatomic abnormalities in medial frontal brain structures disproportionately affected in idiopathic schizophrenia were associated with psychotic symptom severity in 22q11DS youth, suggesting that disrupted biological processes in these cortical regions may underlie development of psychotic symptoms, both in 22q11DS and in the broader population.
Collapse
Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Rachel Jonas
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Damla Senturk
- Department of Biostatistics, School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Arati Patel
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Carolyn Chow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90095, USA
- VA Greater Los Angeles Healthcare System, VISN22 Mental Illness Research, Education and Clinical Center, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA
| | - Carrie E. Bearden
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| |
Collapse
|
31
|
Martin AK, Robinson G, Dzafic I, Reutens D, Mowry B. Theory of mind and the social brain: implications for understanding the genetic basis of schizophrenia. GENES BRAIN AND BEHAVIOR 2013; 13:104-17. [DOI: 10.1111/gbb.12066] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/22/2013] [Accepted: 07/28/2013] [Indexed: 02/03/2023]
Affiliation(s)
- A. K. Martin
- Queensland Brain Institute; University of Queensland; Brisbane QLD Australia
| | - G. Robinson
- School of Psychology; University of Queensland; Brisbane QLD Australia
| | - I. Dzafic
- Queensland Brain Institute; University of Queensland; Brisbane QLD Australia
| | - D. Reutens
- Centre for Advanced Imaging; University of Queensland; Brisbane QLD Australia
| | - B. Mowry
- Queensland Brain Institute; University of Queensland; Brisbane QLD Australia
| |
Collapse
|
32
|
Schreiner MJ, Karlsgodt KH, Uddin LQ, Chow C, Congdon E, Jalbrzikowski M, Bearden CE. Default mode network connectivity and reciprocal social behavior in 22q11.2 deletion syndrome. Soc Cogn Affect Neurosci 2013; 9:1261-7. [PMID: 23912681 DOI: 10.1093/scan/nst114] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
22q11.2 deletion syndrome (22q11DS) is a genetic mutation associated with disorders of cortical connectivity and social dysfunction. However, little is known about the functional connectivity (FC) of the resting brain in 22q11DS and its relationship with social behavior. A seed-based analysis of resting-state functional magnetic resonance imaging data was used to investigate FC associated with the posterior cingulate cortex (PCC), in (26) youth with 22qDS and (51) demographically matched controls. Subsequently, the relationship between PCC connectivity and Social Responsiveness Scale (SRS) scores was examined in 22q11DS participants. Relative to 22q11DS participants, controls showed significantly stronger FC between the PCC and other default mode network (DMN) nodes, including the precuneus, precentral gyrus and left frontal pole. 22q11DS patients did not show age-associated FC changes observed in typically developing controls. Increased connectivity between PCC, medial prefrontal regions and the anterior cingulate cortex, was associated with lower SRS scores (i.e. improved social competence) in 22q11DS. DMN integrity may play a key role in social information processing. We observed disrupted DMN connectivity in 22q11DS, paralleling reports from idiopathic autism and schizophrenia. Increased strength of long-range DMN connectivity was associated with improved social functioning in 22q11DS. These findings support a 'developmental-disconnection' hypothesis of symptom development in this disorder.
Collapse
Affiliation(s)
- Matthew J Schreiner
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Katherine H Karlsgodt
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Lucina Q Uddin
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Carolyn Chow
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Eliza Congdon
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Maria Jalbrzikowski
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Carrie E Bearden
- Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA Interdepartmental Neuroscience Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, Department of Psychiatry, Feinstein Institute for Medical Research, Manhasset, NY 11030, Zucker Hillside Hospital, Glen Oaks, NY 11004, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305 and Department of Psychology, University of California, Los Angeles, CA 90095, USA
| |
Collapse
|
33
|
Dahoun T, Eliez S, Chen F, Badoud D, Schneider M, Larøi F, Debbane M. Action simulation in hallucination-prone adolescents. Front Hum Neurosci 2013; 7:329. [PMID: 23847502 PMCID: PMC3701149 DOI: 10.3389/fnhum.2013.00329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/12/2013] [Indexed: 12/15/2022] Open
Abstract
Theoretical and empirical accounts suggest that impairments in self-other discrimination processes are likely to promote the expression of hallucinations. Studies using a variety of paradigms involving self-performed actions argue in favor of perspective taking confusion in hallucination-prone subjects. However, our understanding of such processes during adolescence is still at an early stage. The present study thus aims (1) to delineate the neural correlates sustaining mental simulation of actions involving self-performed actions (first-person perspective; 1PP) and other-performed actions (third-person perspective; 3PP) during adolescence (2) to identify atypical activation patterns during 1PP/3PP mental simulation of actions in hallucination-prone adolescents (3) to examine whether differential risk for schizophrenia (clinical vs. genetic) is also associated with differential impairments in the 1PP/3PP mental simulation of actions during adolescence. Twenty-two typically developing controls (Control group; 6 females), 12 hallucination-prone adolescents [auditory hallucination (AH) group; 7 females] and 13 adolescents with 22q11.2 Deletion Syndrome (22q11.2DS group; 4 females) were included in the study. During the fMRI task, subjects were presented with a cue (self-other priming cues) indicating to perform the task using either a first person perspective (“you”-1PP) or a third person perspective (“best friend”-3PP) and then they were asked to mentally simulate actions based on the type of cue. Hallucination-proneness was assessed using a self-report questionnaire [Cardiff Anomalous Perception Scale (CAPS)]. Our results indicated that atypical patterns of cerebral activation, particularly in the key areas of self-other distinction, were found in both groups at risk for auditory hallucinations (AHs and 22q11.2DS). More precisely, adolescents in the AH group presented decreased activations in the right middle occipital gyrus BA19, left cingulate gyrus BA31, and right precuneus BA31 for the 3PP > 1PP contrast. Adolescents in the 22q11.2DS group presented decreased activations in the right superior occipital gyrus BA19, left caudate tail and left precuneus BA7 for the 3PP > 1PP contrast. In comparison to the Control group, only the 22q11.2DS adolescents showed a decreased activation for other-related cues (prime other > prime self contrast) in areas of visual imagery, episodic memory and social cognition. This study characterizes the neural correlates of mental imagery for actions during adolescence, and suggests that a differential risk for hallucination-proneness (clinical vs. genetic) is associated to similar patterns of atypical activations in key areas sustaining self-other discrimination processes. These observations may provide relevant information for future research and prevention strategies with regards to hallucination-proneness during adolescence.
Collapse
Affiliation(s)
- Tarik Dahoun
- Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine Geneva, Switzerland
| | | | | | | | | | | | | |
Collapse
|