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Seitz-Holland J, Nägele FL, Kubicki M, Pasternak O, Cho KIK, Hough M, Mulert C, Shenton ME, Crow TJ, James ACD, Lyall AE. Shared and distinct white matter abnormalities in adolescent-onset schizophrenia and adolescent-onset psychotic bipolar disorder. Psychol Med 2023; 53:4707-4719. [PMID: 35796024 PMCID: PMC11119277 DOI: 10.1017/s003329172200160x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND While adolescent-onset schizophrenia (ADO-SCZ) and adolescent-onset bipolar disorder with psychosis (psychotic ADO-BPD) present a more severe clinical course than their adult forms, their pathophysiology is poorly understood. Here, we study potentially state- and trait-related white matter diffusion-weighted magnetic resonance imaging (dMRI) abnormalities along the adolescent-onset psychosis continuum to address this need. METHODS Forty-eight individuals with ADO-SCZ (20 female/28 male), 15 individuals with psychotic ADO-BPD (7 female/8 male), and 35 healthy controls (HCs, 18 female/17 male) underwent dMRI and clinical assessments. Maps of extracellular free-water (FW) and fractional anisotropy of cellular tissue (FAT) were compared between individuals with psychosis and HCs using tract-based spatial statistics and FSL's Randomise. FAT and FW values were extracted, averaged across all voxels that demonstrated group differences, and then utilized to test for the influence of age, medication, age of onset, duration of illness, symptom severity, and intelligence. RESULTS Individuals with adolescent-onset psychosis exhibited pronounced FW and FAT abnormalities compared to HCs. FAT reductions were spatially more widespread in ADO-SCZ. FW increases, however, were only present in psychotic ADO-BPD. In HCs, but not in individuals with adolescent-onset psychosis, FAT was positively related to age. CONCLUSIONS We observe evidence for cellular (FAT) and extracellular (FW) white matter abnormalities in adolescent-onset psychosis. Although cellular white matter abnormalities were more prominent in ADO-SCZ, such alterations may reflect a shared trait, i.e. neurodevelopmental pathology, present across the psychosis spectrum. Extracellular abnormalities were evident in psychotic ADO-BPD, potentially indicating a more dynamic, state-dependent brain reaction to psychosis.
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Affiliation(s)
- Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Felix L. Nägele
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, 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
| | - Kang Ik K. Cho
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Morgan Hough
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
- Highfield Unit, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University, Giessen, Germany
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Timothy J. Crow
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Anthony C. D. James
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
- Highfield Unit, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Amanda E. Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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2
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Zhang L, Zhang X, Fang X, Zhou C, Wen L, Pan X, Zhang F, Chen J. Eye movement characteristics in male patients with deficit and non-deficit schizophrenia and their relationships with psychiatric symptoms and cognitive function. BMC Neurosci 2021; 22:70. [PMID: 34819034 PMCID: PMC8613938 DOI: 10.1186/s12868-021-00673-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The cognitive impairment pattern of deficit schizophrenia (DS) is centered on an impaired attention function. Previous studies have suggested that the exploratory eye movement (EEM) tests reflect attention deficits in patients with schizophrenia. However, no study has investigated the characteristics of eye movement in DS in the Chinese Han population. This study aimed to investigate the pattern of eye movement characteristics in DS patients and to examine whether eye movement characteristic is associated with serious negative symptoms and cognitive decline in this schizophrenia subtype. METHODS A total of 86 male patients [37 DS and 49 non-deficit schizophrenia (NDS)] and 80 healthy controls (HC) participated in this study. Clinical symptoms were assessed using the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). Cognitive function was assessed using the Mattis Dementia Rating Scale (MDRS-2). Eye movement data of subjects were collected using an eye movement tracking analyzer. RESULTS There were significant differences in the overall eye movement data and cognitive test scores among the three groups (all P < 0.001). Both DS and NDS schizophrenia subgroups showed more severe eye movement and cognitive impairment compared with the control group. The number of eye fixations (NEF), total of eye scanning length (TESL), and cognitive function in DS patients were significantly lower than those in NDS patients. The discriminant analysis (D score) was higher than that of the control group (P < 0.001). In the DS group, the inattention factor of SANS was negatively correlated with the attention factor (r = - 0.545, P = 0.001) and structure factor of cognitive (r = - 0.389, P = 0.023), the affective flattening factor of SANS was negatively correlated with TESL (r = - 0.353, P = 0.041) and initiation/retention factor of cognitive (r = - 0.376,P = 0.028). TESL was found to positively correlate with the MDRS-2 total score (r = 0.427, P = 0.012), attention factor (r = 0.354, P = 0.040), and memory factor (r = 0.349, P = 0.043) in the DS group, whereas the mean of eye scanning length (MESL) positively correlated with cognitive impairments in the NDS group. The negative symptoms showed no significant correlation with cognition in the NDS group. CONCLUSIONS Total of eye scanning length may be a characteristic eye movement symptom in DS patients, which is associated with serious negative symptoms and cognitive impairment in this schizophrenia subtype.
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Affiliation(s)
- Lin Zhang
- Department of Geriatric Psychiatry, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China.,Department of Psychiatry, The Second People's Hospital of Jiangning District, No. 50 ChenLing Road, Nanjing, 210003, Jiangsu, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
| | - Xinyu Fang
- Department of Geriatric Psychiatry, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Chao Zhou
- Department of Geriatric Psychiatry, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Lu Wen
- Department of Psychiatry, The Second People's Hospital of Jiangning District, No. 50 ChenLing Road, Nanjing, 210003, Jiangsu, China
| | - Xinming Pan
- Department of Psychiatry, The Second People's Hospital of Jiangning District, No. 50 ChenLing Road, Nanjing, 210003, Jiangsu, China
| | - Fuquan Zhang
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China
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3
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Yang M, Gao S, Xiong W, Zhang XY. Sex-differential associations between cognitive impairments and white matter abnormalities in first episode and drug-naïve schizophrenia. Early Interv Psychiatry 2021; 15:1179-1187. [PMID: 33058544 DOI: 10.1111/eip.13059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/24/2020] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Abstract
AIM Previous evidence has suggested that schizophrenia patients may display sex differences in cognitive impairments and cognitive impairments are related to disrupted white matter (WM) microstructure. The current research aims to address the intriguing possibility for the sex-specific association between cognitive deficits and WM abnormalities in first-episode and drug-naïve schizophrenia. METHODS Cognitive performance on the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) was measured in 39 FEND patients (females:males = 23:16) and 30 healthy controls (females:males = 17:13), together with whole-brain WM fractional anisotropy (FA) values determined using voxel-based diffusion tensor imaging. Correlations between cognitive performance and FA values were assessed. RESULTS Patients performed significantly worse than healthy controls in the total score and most of the subscores of MCCB. Female patients displayed better cognitive performance than male patients on the Trail Making A Test, the Hopkins Verbal Learning Test and the Spatial Span Test in the Wechsler Memory Scale. More importantly, sex-differential association between cognitive performance and FA values was found in patients, but not in healthy controls. In particular, FA values in the cerebellum were negatively correlated with the continuous performance and digital sequence scores in male patients but positively correlated with the performance on the Spatial Span Test in the Wechsler Memory Scale in female patients. CONCLUSIONS These findings suggest sex-specific neurobiological substrates involved in cognitive deficits in early-onset schizophrenia and have important implications for differentially targeted interventions between males and females.
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Affiliation(s)
- Mi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Shan Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Weisen Xiong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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4
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Levitt JJ, Nestor PG, Kubicki M, Lyall AE, Zhang F, Riklin-Raviv T, O′Donnell LJ, McCarley RW, Shenton ME, Rathi Y. Miswiring of Frontostriatal Projections in Schizophrenia. Schizophr Bull 2020; 46:990-998. [PMID: 31990358 PMCID: PMC7342176 DOI: 10.1093/schbul/sbz129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We investigated brain wiring in chronic schizophrenia and healthy controls in frontostriatal circuits using diffusion magnetic resonance imaging tractography in a novel way. We extracted diffusion streamlines in 27 chronic schizophrenia and 26 healthy controls connecting 4 frontal subregions to the striatum. We labeled the projection zone striatal surface voxels into 2 subtypes: dominant-input from a single cortical subregion, and, functionally integrative, with mixed-input from diverse cortical subregions. We showed: 1) a group difference for total striatal surface voxel number (P = .045) driven by fewer mixed-input voxels in the left (P = .007), but not right, hemisphere; 2) a group by hemisphere interaction for the ratio quotient between voxel subtypes (P = .04) with a left (P = .006), but not right, hemisphere increase in schizophrenia, also reflecting fewer mixed-input voxels; and 3) fewer mixed-input voxel counts in schizophrenia (P = .045) driven by differences in left hemisphere limbic (P = .007) and associative (P = .01), but not sensorimotor, striatum. These results demonstrate a less integrative pattern of frontostriatal structural connectivity in chronic schizophrenia. A diminished integrative pattern yields a less complex input pattern to the striatum from the cortex with less circuit integration at the level of the striatum. Further, as brain wiring occurs during early development, aberrant brain wiring could serve as a developmental biomarker for schizophrenia.
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Affiliation(s)
- James J Levitt
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, Harvard Medical School, Boston, MA,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,To whom correspondence should be addressed; Department of Psychiatry-116A, VA Boston Healthcare System, Harvard Medical School, 940 Belmont Street, Brockton, MA 02301; tel: (508) 583-4500 x61798, fax: 617-525-6150, e-mail:
| | - Paul G Nestor
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, Harvard Medical School, Boston, MA,Department of Psychology, University of Massachusetts, Boston, MA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Amanda E Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Fan Zhang
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Tammy Riklin-Raviv
- Department of Electrical and Computer Engineering, Ben Gurion University, Beer-Sheva, Israel
| | - Lauren J O′Donnell
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Robert W McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, Harvard Medical School, Boston, MA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA,VA Boston Healthcare System, Brockton Division, Brockton, MA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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5
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Rivas-Grajales AM, Savadjiev P, Kubicki M, Nestor PG, Niznikiewicz M, McCarley RW, Westin CF, Shenton ME, Levitt JJ. Striato-nigro-striatal tract dispersion abnormalities in patients with chronic schizophrenia. Brain Imaging Behav 2020; 13:1236-1245. [PMID: 30109597 DOI: 10.1007/s11682-018-9934-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The white matter connections between the midbrain dopamine neurons and the striatum are part of a neural system involved in reward-based learning, a process that is impaired in patients with schizophrenia. The striato-nigro-striatal (SNS) tract, which participates in this process, has not as yet been explored. The present study aimed to use diffusion MRI (dMRI) to delineate the SNS tract, and to compare the application of two dMRI measures, Tract Dispersion (TD), an index of white matter morphology, and Fractional Anisotropy (FA), an index of white matter integrity, to detect group differences between patients with chronic schizophrenia (CSZ) and healthy controls (HC). dMRI scans were acquired in 22 male patients with CSZ and 23 age-matched HC. Two-tensor tractography was used in addition to manually-delineated regions of interest to extract the SNS tract. A mixed-model analysis of variance was used to investigate differences in TD and FA between CSZ patients and HC. The associations between TD and behavioral measures were also explored. Patients and controls differed significantly in TD (P = 0.04), but not in FA (P = 0.69). The group differences in TD were driven by a higher TD in the right hemisphere in the CSZ group. Higher TD correlated significantly with poorer performance in the Iowa Gambling Task (IGT) when combining the scores of both groups. The findings suggest that dysconnectiviy of the SNS tract which is associated with schizophrenia, could arise from abnormalities in white matter morphology. These abnormalities may potentially reflect irregularities in brain development.
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Affiliation(s)
- Ana María Rivas-Grajales
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Peter Savadjiev
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul G Nestor
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Margaret Niznikiewicz
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Robert W McCarley
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Carl-Fredrik Westin
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - James J Levitt
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA.
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6
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Lyall AE, Savadjiev P, del Re EC, Seitz J, O’Donnell LJ, Westin CF, Mesholam-Gately RI, Petryshen T, Wojcik JD, Nestor P, Niznikiewicz M, Goldstein J, Seidman LJ, McCarley RW, Shenton ME, Kubicki M. Utilizing Mutual Information Analysis to Explore the Relationship Between Gray and White Matter Structural Pathologies in Schizophrenia. Schizophr Bull 2019; 45:386-395. [PMID: 29618096 PMCID: PMC6403063 DOI: 10.1093/schbul/sby028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Schizophrenia has been characterized as a neurodevelopmental disorder, with structural brain abnormalities reported at all stages. However, at present, it remains unclear whether gray and white matter abnormalities represent related or independent pathologies in schizophrenia. In this study, we present findings from an integrative analysis exploring the morphological relationship between gray and white matter in 45 schizophrenia participants and 49 healthy controls. We utilized mutual information (MI), a measure of how much information two variables share, to assess the morphological dependence between gray and white matter in three segments of the corpus callsoum, and the gray matter regions these segments connect: (1) the genu and the left and right rostral middle frontal gyrus (rMFG), (2) the isthmus and the left and right superior temporal gyrus (STG), (3) the splenium and the left and right lateral occipital gyrus (LOG). We report significantly reduced MI between white matter tract dispersion of the right hemispheric callosal connections to the STG and both cortical thickness and area in the right STG in schizophrenia patients, despite a lack of group differences in cortical thickness, surface area, or dispersion. We believe that this reduction in morphological dependence between gray and white matter may reflect a possible decoupling of the developmental processes that shape morphological features of white and gray matter early in life. The present study also demonstrates the importance of studying the relationship between gray and white matter measures, as opposed to restricting analyses to gray and white matter measures independently.
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Affiliation(s)
- Amanda E Lyall
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA,To whom correspondence should be addressed; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, US; tel: (617)-525-6129, fax: (617)-525-6150, e-mail:
| | - Peter Savadjiev
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Elisabetta C del Re
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,VA Boston Healthcare System, Brockton, MA
| | - Johanna Seitz
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Lauren J O’Donnell
- Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, MA
| | - Carl-Fredrik Westin
- Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, MA
| | - Raquelle I Mesholam-Gately
- Massachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tracey Petryshen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA,Stanley Center of Psychiatry Research, Broad Institute MIT and Harvard, Boston, MA,Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA
| | - Joanne D Wojcik
- Massachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Paul Nestor
- Research and Development, VA Boston Healthcare System, Boston, MA,Department of Psychology, University of Massachussetts, Boston, MA
| | - Margaret Niznikiewicz
- Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton, MA
| | - Jill Goldstein
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Larry J Seidman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA,Massachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Robert W McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton, MA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,VA Boston Healthcare System, Brockton, MA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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7
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Sex difference in association of symptoms and white matter deficits in first-episode and drug-naive schizophrenia. Transl Psychiatry 2018; 8:281. [PMID: 30563964 PMCID: PMC6298972 DOI: 10.1038/s41398-018-0346-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/10/2018] [Accepted: 11/25/2018] [Indexed: 11/10/2022] Open
Abstract
Accumulating evidence shows that disruption of white matter (WM) may be involved in the pathophysiology of schizophrenia, even at the onset of psychosis. However, very few studies have explored sex difference in its association with psychopathology in schizophrenia. This study aims to compare sex differences in clinical features and WM abnormalities in first-episode and drug-naive (FEDN) schizophrenia among Han Chinese inpatients. The WM fractional anisotropy (FA) values of the whole-brain were determined using voxel-based diffusion tensor imaging (DTI) in 39 (16 males and 23 females) FEDN patients with schizophrenia and 30 healthy controls (13 males and 17 females) matched for gender, age, and education. Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).Our results showed that compared with the controls, the patients showed widespread areas of lower FA, including corpus callosum, brainstem, internal capsule, cingulate, and cerebellum (all adjusted p < 0.01). Further, male patients showed lower FA values in left cingulate (F = 4.92, p = 0.033), but higher scores on the PANSS total, positive, and general psychopathology subscale scores (all p < 0.01) than female patients. Multivariate regression analysis showed that for male patients, FA values in right corpus callosum were positively associated with the PANSS total (beta = 0.785, t = 3.76, p = 0.002) and the negative symptom scores (beta = 0.494, t = 2.20, p = 0.044), while for female patients, FA values in left cingulate were negatively associated with the PANSS positive symptom score (beta = -0.717, t = -2.25, p = 0.041). Our findings indicate sex difference in white matter disconnectivity and its association with psychopathological symptoms in an early course of schizophrenia onset.
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8
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Egloff L, Lenz C, Studerus E, Harrisberger F, Smieskova R, Schmidt A, Huber C, Simon A, Lang UE, Riecher-Rössler A, Borgwardt S. Sexually dimorphic subcortical brain volumes in emerging psychosis. Schizophr Res 2018; 199:257-265. [PMID: 29605160 DOI: 10.1016/j.schres.2018.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/27/2018] [Accepted: 03/18/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND In schizophrenic psychoses, the normal sexual dimorphism of the brain has been shown to be disrupted or even reversed. Little is known, however, at what time point in emerging psychosis this occurs. We have therefore examined, if these alterations are already present in the at-risk mental state (ARMS) for psychosis and in first episode psychosis (FEP) patients. METHODS Data from 65 ARMS (48 (73.8%) male; age=25.1±6.32) and 50 FEP (37 (74%) male; age=27±6.56) patients were compared to those of 70 healthy controls (HC; 27 (38.6%) male; age=26±4.97). Structural T1-weighted images were acquired using a 3 Tesla magnetic resonance imaging (MRI) scanner. Linear mixed effects models were used to investigate whether subcortical brain volumes are dependent on sex. RESULTS We found men to have larger total brain volumes (p<0.001), and smaller bilateral caudate (p=0.008) and hippocampus volume (p<0.001) than women across all three groups. Older subjects had more GM and WM volume than younger subjects. No significant sex×group interaction was found. CONCLUSIONS In emerging psychosis there still seem to exist patterns of normal sexual dimorphism in total brain and caudate volume. The only structure affected by reversed sexual dimorphism was the hippocampus, with women showing larger volumes than men even in HC. Thus, we conclude that subcortical volumes may not be primarily affected by disrupted sexual dimorphism in emerging psychosis.
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Affiliation(s)
- Laura Egloff
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland; University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland
| | - Claudia Lenz
- University of Basel, Institute of Forensic Medicine, Basel, Switzerland
| | - Erich Studerus
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Fabienne Harrisberger
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Renata Smieskova
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - André Schmidt
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Christian Huber
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Andor Simon
- University Hospital of Bern, University Hospital of Psychiatry, Bern, Switzerland; Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, Bruderholz, Switzerland
| | - Undine E Lang
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Stefan Borgwardt
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland.
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