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Nelson EA, Kraguljac NV, Maximo JO, Armstrong W, Lahti AC. Hippocampal Hyperconnectivity to the Visual Cortex Predicts Treatment Response. Schizophr Bull 2023; 49:605-613. [PMID: 36752830 PMCID: PMC10154738 DOI: 10.1093/schbul/sbac213] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Converging lines of evidence point to hippocampal dysfunction in psychosis spectrum disorders, including altered functional connectivity. Evidence also suggests that antipsychotic medications can modulate hippocampal dysfunction. The goal of this project was to identify patterns of hippocampal connectivity predictive of response to antipsychotic treatment in 2 cohorts of patients with a psychosis spectrum disorder, one medication-naïve and the other one unmedicated. HYPOTHESIS We hypothesized that we would identify reliable patterns of hippocampal connectivity in the 2 cohorts that were predictive of treatment response and that medications would modulate abnormal hippocampal connectivity after 6 weeks of treatment. STUDY DESIGN We used a prospective design to collect resting-state fMRI scans prior to antipsychotic treatment and after 6 weeks of treatment with risperidone, a commonly used antipsychotic medication, in both cohorts. We enrolled 44 medication-naïve first-episode psychosis patients (FEP) and 39 unmedicated patients with schizophrenia (SZ). STUDY RESULTS In both patient cohorts, we observed a similar pattern where greater hippocampal connectivity to regions of the occipital cortex was predictive of treatment response. Lower hippocampal connectivity of the frontal pole, orbitofrontal cortex, subcallosal area, and medial prefrontal cortex was predictive of treatment response in unmedicated SZ, but not in the medication-naïve cohort. Furthermore, greater reduction in hippocampal connectivity to the visual cortex with treatment was associated with better clinical response. CONCLUSIONS Our results suggest that greater connectivity between the hippocampus and occipital cortex is not only predictive of better treatment response, but that antipsychotic medications have a modulatory effect by reducing hyperconnectivity.
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Affiliation(s)
- Eric A Nelson
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jose O Maximo
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William Armstrong
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Lahti AC. Discovery of early schizophrenia through neuroimaging. Psychiatry Res 2023; 322:114993. [PMID: 36773467 DOI: 10.1016/j.psychres.2022.114993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 11/29/2022]
Abstract
In order to understand the pathophysiology of schizophrenia we carried out a number of brain imaging studies in both medicated and unmedicated patients. In addition, to help unravel the pathophysiological mechanisms without the confound of prior exposure to antipsychotic medication or chronicity, we enrolled a large group of antipsychotic medication-naïve first episode psychosis patients at first treatment contact, and performed longitudinal multimodal neuroimaging studies over several months. In unmedicated patients we found both functional and structural connectivity alterations. Similarly, in medication-naïve patients we replicated many of our prior findings, suggesting that functional and structural connectivity alterations are core pathological features of the illness. We found that a longer duration of untreated psychosis, i.e. the time between first symptom onset and initial treatment contact, was associated with greater structural and functional connectivity abnormalities, which in turn was associated with worse subsequent clinical response to treatment. These results underscore the critical importance of early identification and treatment in patients with psychosis spectrum disorders.
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Affiliation(s)
- Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, United States.
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Kang Y, Zhang Y, Huang K, Wang Z. The genetic influence of the DRD3 rs6280 polymorphism (Ser9Gly) on functional connectivity and gray matter volume of the hippocampus in patients with first-episode, drug-naïve schizophrenia. Behav Brain Res 2023; 437:114124. [PMID: 36154848 DOI: 10.1016/j.bbr.2022.114124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/17/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022]
Abstract
The D3 dopamine receptor (DRD3) plays a major role in cognitive function and is a candidate gene for schizophrenia. DRD3 is widely distributed in the hippocampus, but whether there are potential associations between the rs6280 genotype, the hippocampus, and cognitive function in first-episode, drug-naïve (FES) patients and healthy controls (HCs) is still poorly understood. First, using functional and structural magnetic resonance imaging data, we calculated the gray matter volume (GMV) and functional connectivity (FC) of the hippocampus. Then, we examined the possible interaction effect of the DRD3 genotype and the disease on the FC and GMV of the hippocampus in 52 FES patients and 51 HCs. Finally, the correlation between the FC and GMV in the hippocampus, influenced by rs6280, and the cognitive performance of subjects was analyzed. A significant interaction effect of diagnostic group by genotype of rs6280 on the GMV of the left hippocampus was found, with lower GMV in FES patients that were C carriers compared with TT homozygotes; the opposite pattern was found in the genetic subgroups of HCs. In the FES group, C carriers performed significantly worse on reasoning and problem-solving tests than TT homozygotes. The left hippocampal GMV positively correlated with reasoning and problem-solving performance in TT homozygotes, but this correlation disappeared in FES patients that were C carriers and in genetic subgroups of HCs. Together, these results suggest that FES patients that are C carriers of rs6280 have lower GMV in the hippocampus, resulting in greater cognitive impairment.
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Affiliation(s)
- Yafei Kang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Youming Zhang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Kexin Huang
- West China Biomedical Big Data Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Zhenhong Wang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China.
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Messaritaki E, Foley S, Barawi K, Ettinger U, Jones DK. Increased structural connectivity in high schizotypy. Netw Neurosci 2023; 7:213-233. [PMID: 37334008 PMCID: PMC10270715 DOI: 10.1162/netn_a_00279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/14/2022] [Indexed: 09/23/2023] Open
Abstract
The link between brain structural connectivity and schizotypy was explored in two healthy participant cohorts, collected at two different neuroimaging centres, comprising 140 and 115 participants, respectively. The participants completed the Schizotypal Personality Questionnaire (SPQ), through which their schizotypy scores were calculated. Diffusion-MRI data were used to perform tractography and to generate the structural brain networks of the participants. The edges of the networks were weighted with the inverse radial diffusivity. Graph theoretical metrics of the default mode, sensorimotor, visual, and auditory subnetworks were derived and their correlation coefficients with the schizotypy scores were calculated. To the best of our knowledge, this is the first time that graph theoretical measures of structural brain networks are investigated in relation to schizotypy. A positive correlation was found between the schizotypy score and the mean node degree and mean clustering coefficient of the sensorimotor and the default mode subnetworks. The nodes driving these correlations were the right postcentral gyrus, the left paracentral lobule, the right superior frontal gyrus, the left parahippocampal gyrus, and the bilateral precuneus, that is, nodes that exhibit compromised functional connectivity in schizophrenia. Implications for schizophrenia and schizotypy are discussed.
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Affiliation(s)
- Eirini Messaritaki
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Kali Barawi
- School of Medicine, Cardiff University, Cardiff, UK
| | | | - Derek K. Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
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Zahid U, Onwordi EC, Hedges EP, Wall MB, Modinos G, Murray RM, Egerton A. Neurofunctional correlates of glutamate and GABA imbalance in psychosis: A systematic review. Neurosci Biobehav Rev 2023; 144:105010. [PMID: 36549375 DOI: 10.1016/j.neubiorev.2022.105010] [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] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/01/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Glutamatergic and GABAergic dysfunction are implicated in the pathophysiology of schizophrenia. Previous work has shown relationships between glutamate, GABA, and brain activity in healthy volunteers. We conducted a systematic review to evaluate whether these relationships are disrupted in psychosis. Primary outcomes were the relationship between metabolite levels and fMRI BOLD response in psychosis relative to healthy volunteers. 17 case-control studies met inclusion criteria (594 patients and 538 healthy volunteers). Replicated findings included that in psychosis, positive associations between ACC glutamate levels and brain activity are reduced during resting state conditions and increased during cognitive control tasks, and negative relationships between GABA and local activation in the ACC are reduced. There was evidence that antipsychotic medication may alter the relationship between glutamate levels and brain activity. Emerging literature is providing insights into disrupted relationships between neurometabolites and brain activity in psychosis. Future studies determining a link to clinical variables may develop this approach for biomarker applications, including development or targeting novel therapeutics.
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Affiliation(s)
- Uzma Zahid
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Psychiatry, University of Oxford, UK.
| | - Ellis C Onwordi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital Campus, London, UK; Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK; South London and Maudsley NHS Foundation Trust, Camberwell, London, UK
| | - Emily P Hedges
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthew B Wall
- Invicro London, Hammersmith Hospital, UK; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK; Clinical Psychopharmacology Unit, University College London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Su W, Zhao Z, Li G, Tang X, Xu L, Tang Y, Wei Y, Cui H, Zhang T, Zhang J, Liu X, Guo Q, Wang J. Thalamo-hippocampal dysconnectivity is associated with serum cholesterol level in drug-naïve patients with first-episode schizophrenia. J Psychiatr Res 2022; 151:497-506. [PMID: 35623125 DOI: 10.1016/j.jpsychires.2022.05.013] [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: 12/26/2021] [Revised: 03/25/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
Hippocampal deficits and metabolic dysregulations such as dyslipidemia have been frequently reported in schizophrenia and are suggested to contribute to the pathophysiology of schizophrenia. Hippocampus is particularly susceptible to environmental challenges including metabolism and inflammation. However, evidence linking hippocampal alterations and metabolic dysregulations are quite sparse in drug-naïve schizophrenia. A total of 166 drug-naïve patients with first-episode schizophrenia (FES) and 78 healthy controls (HC) underwent measures for several serum metabolic markers, structural and resting-state functional magnetic resonance imaging (rs-fMRI), as well as diffusion tensor imaging (DTI). Seed-to-voxel functional connectivity (FC) and probabilistic tractography were performed to assess the functional and microstructural connectivity of the bilateral hippocampi. Clinical symptoms were evaluated with Positive and Negative Syndrome Scale (PANSS). Patients with FES showed significantly decreased total cholesterol (Chol) level. Patients showed elevated FC between the left hippocampus and bilateral thalami while showing decreased microstructural connectivity between the left hippocampus and bilateral thalami. Multiple regression analyses showed that FC from the left hippocampus to the right superior frontal gyrus (SFG), bilateral frontal pole (FP), and right thalamus were negatively associated with the Chol level, while no association was observed in the HC group. Our study validated alterations in both functional and microstructural thalamo-hippocampal connectivities, and abnormal cholesterol level in FES. Moreover, decreased cholesterol level is associated with elevated thalamo-hippocampal functional connectivity in patients with FES, suggesting that dyslipidemia may interact with the hippocampal dysfunction in FES.
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Affiliation(s)
- Wenjun Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Zexin Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Guanjun Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xiaochen Tang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Lihua Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yingying Tang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yanyan Wei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Huiru Cui
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Tianhong Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Jie Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - Xiaohua Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| | - Qian Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, 200031, China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, 200240, China.
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Soldevila-Matías P, Albajes-Eizagirre A, Radua J, García-Martí G, Rubio JM, Tordesillas-Gutierrez D, Fuentes-Durá I, Solanes A, Fortea L, Oliver D, Sanjuán J. Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:101-116. [PMID: 35840277 DOI: 10.1016/j.rpsmen.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/09/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.
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Affiliation(s)
- Pau Soldevila-Matías
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gracián García-Martí
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain
| | - José M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA
| | - Diana Tordesillas-Gutierrez
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Inmaculada Fuentes-Durá
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Julio Sanjuán
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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Nelson EA, Kraguljac NV, Maximo JO, Briend F, Armstrong W, Ver Hoef LW, Johnson V, Lahti AC. Hippocampal Dysconnectivity and Altered Glutamatergic Modulation of the Default Mode Network: A Combined Resting-State Connectivity and Magnetic Resonance Spectroscopy Study in Schizophrenia. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:108-118. [PMID: 32684484 PMCID: PMC7904096 DOI: 10.1016/j.bpsc.2020.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/06/2020] [Accepted: 04/21/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Converging lines of evidence point to hippocampal dysfunction in schizophrenia. It is thought that hippocampal dysfunction spreads across hippocampal subfields and to cortical regions by way of long-range efferent projections. Importantly, abnormalities in the excitation/inhibition balance could impair the long-range modulation of neural networks. The goal of this project was twofold. First, we sought to identify replicable patterns of hippocampal dysconnectivity in patients with a psychosis spectrum disorder. Second, we aimed to investigate a putative link between glutamatergic metabolism and hippocampal connectivity alterations. METHODS We evaluated resting-state hippocampal functional connectivity alterations in two cohorts of patients with a psychosis spectrum disorder. The first cohort consisted of 55 medication-naïve patients with first-episode psychosis and 41 matched healthy control subjects, and the second cohort consisted of 42 unmedicated patients with schizophrenia and 41 matched control subjects. We also acquired measurements of glutamate + glutamine in the left hippocampus using magnetic resonance spectroscopy for 42 patients with first-episode psychosis and 37 healthy control subjects from our first cohort. RESULTS We observed a pattern of hippocampal functional hypoconnectivity to regions of the default mode network and hyperconnectivity to the lateral occipital cortex in both cohorts. We also show that in healthy control subjects, greater hippocampal glutamate + glutamine levels predicted greater hippocampal functional connectivity to the anterior default mode network. Furthermore, this relationship was reversed in medication-naïve subjects with first-episode psychosis. CONCLUSIONS These results suggest that an alteration in the relationship between glutamate and functional connectivity may disrupt the dynamic of major neural networks.
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Affiliation(s)
- Eric A. Nelson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jose O Maximo
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Frederic Briend
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William Armstrong
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lawrence W. Ver Hoef
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victoria Johnson
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.,Correspondence: Adrienne C. Lahti, MD, University of Alabama at Birmingham, Sparks Center, Room 501, 1720 7 Ave. S, Birmingham, Al 35233, Telephone: 205-996-6776, Fax: 205-975-4879,
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Mnemonic Discrimination Deficits in First-Episode Psychosis and a Ketamine Model Suggest Dentate Gyrus Pathology Linked to NMDA Receptor Hypofunction. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1185-1192. [PMID: 34649019 DOI: 10.1016/j.bpsc.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/17/2021] [Accepted: 09/12/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Converging evidence from neuroimaging and postmortem studies suggests that hippocampal subfields are differentially affected in schizophrenia. Recent studies report dentate gyrus dysfunction in chronic schizophrenia, but the underlying mechanisms remain to be elucidated. Here, we sought to examine if this deficit is already present in first-episode psychosis and if NMDA receptor hypofunction, a putative central pathophysiological mechanism in schizophrenia, experimentally induced by ketamine, would result in a similar abnormality. METHODS We applied a mnemonic discrimination task selectively taxing pattern separation in two experiments: 1) a group of 23 patients with first-episode psychosis and 23 matched healthy volunteers and 2) a group of 19 healthy volunteers before and during a ketamine challenge (0.27 mg/kg over 10 min, then 0.25 mg/kg/hour for 50 min, 0.01 mL/s). We calculated response bias-corrected pattern separation and recognition scores. We also examined the relationships between task performance and symptom severity as well as ketamine levels. RESULTS We reported a deficit in pattern separation performance in patients with first-episode psychosis compared with healthy volunteers (p = .04) and in volunteers during the ketamine challenge compared with baseline (p = .003). Pattern recognition was lower in patients with first-episode psychosis than in control subjects (p < .01). Exploratory analyses revealed no correlation between task performance and Repeatable Battery for the Assessment of Neuropsychological Status total scores or positive symptoms in patients with first-episode psychosis or with ketamine serum levels. CONCLUSIONS We observed a mnemonic discrimination deficit in both datasets. Our findings suggest a tentative mechanistic link between dentate gyrus dysfunction in first-episode psychosis and NMDA receptor hypofunction.
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Sonnenschein SF, Grace AA. Peripubertal mGluR2/3 Agonist Treatment Prevents Hippocampal Dysfunction and Dopamine System Hyperactivity in Adulthood in MAM Model of Schizophrenia. Schizophr Bull 2021; 47:1806-1814. [PMID: 33928393 PMCID: PMC8530391 DOI: 10.1093/schbul/sbab047] [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] [Indexed: 12/21/2022]
Abstract
Pomaglumetad methionil (POM), a group 2 metabotropic glutamate receptor (mGluR2/3) agonist, showed promise as a novel antipsychotic in preclinical research but failed to show efficacy in clinical trials, though it has been suggested that it may be effective in certain patient populations, including early in disease patients. We used the methyazoxymethanol acetate (MAM) rat model of schizophrenia to determine whether POM may prevent the development of dopamine (DA) system dysfunction in a model representative of the hyperdopaminergic state thought to underlie psychosis, compared to control (SAL) rats. MAM and SAL rats were administered either POM (3 mg/kg, i.p.), vehicle (1 ml/kg), or no injection during postnatal day (PD) 31-40. In either late adolescence (PD 47-56) or adulthood (PD 83-96), novel object recognition (NOR) was tested, followed by anesthetized in vivo electrophysiological recordings of VTA DA neuron activity or ventral hippocampal (vHPC) pyramidal neuron activity. MAM rats treated with POM demonstrated increased NOR in adulthood compared to no injection MAM rats, but not compared to vehicle-treated MAM rats. POM-treated MAM rats demonstrated normalized DA neuron population activity and vHPC pyramidal neuron activity compared to vehicle and no injection MAM rats in both late adolescence and adulthood. No significant differences were observed across treatment groups in SAL rats. These results suggest that peripubertal mGluR2/3 agonist administration can prevent the emergence of vHPC pyramidal neuron hyperactivity and increased DA neuron population activity in adult MAM rats.
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Affiliation(s)
- Susan F Sonnenschein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,To whom correspondence should be addressed; Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave. Suite 530, Pittsburgh, PA 15213, US; tel: 989-600-9132, fax: 412-624-9198, e-mail:
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA
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12
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Dugré JR, Dumais A, Tikasz A, Mendrek A, Potvin S. Functional connectivity abnormalities of the long-axis hippocampal subregions in schizophrenia during episodic memory. NPJ SCHIZOPHRENIA 2021; 7:19. [PMID: 33658524 PMCID: PMC7930183 DOI: 10.1038/s41537-021-00147-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/19/2021] [Indexed: 01/05/2023]
Abstract
Past evidence suggests that hippocampal subregions, namely the anterior and posterior parts, may be engaged in distinct networks underlying the memory functions which may be altered in patients with schizophrenia. However, of the very few studies that have investigated the hippocampal longitudinal axis subdivisions functional connectivity in patients with schizophrenia, the majority was based on resting-state data, and yet, none aimed to examine these during an episodic memory task. A total of 41 patients with schizophrenia and 45 healthy controls were recruited for a magnetic resonance imaging protocol in which they performed an explicit memory task. Seed-based functional connectivity analysis was employed to assess connectivity abnormalities between hippocampal subregions and voxel-wise connectivity targets in patients with schizophrenia. We observed a significantly reduced connectivity between the posterior hippocampus and regions from the default mode network, but increased connectivity with the primary visual cortex, in patients with schizophrenia compared to healthy subjects. Increased connectivity between the anterior hippocampus and anterior temporal regions also characterized patients with schizophrenia. In the current study, we provided evidence and support for studying hippocampal subdivisions along the longitudinal axis in schizophrenia. Our results suggest that the abnormalities in hippocampal subregions functional connectivity reflect deficits in episodic memory that may be implicated in the pathophysiology of schizophrenia.
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Affiliation(s)
- Jules R Dugré
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Alexandre Dumais
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, QC, Canada
| | - Andras Tikasz
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Adriana Mendrek
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, Bishop's University, Sherbrooke, QC, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
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13
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P K, F S, A D, P A. High schizotypy traits are associated with reduced hippocampal resting state functional connectivity. Psychiatry Res Neuroimaging 2021; 307:111215. [PMID: 33168329 DOI: 10.1016/j.pscychresns.2020.111215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
Altered hippocampal functioning is proposed to play a critical role in the development of schizophrenia-spectrum disorders. Previous resting state functional Magnetic Resonance Imaging (rs-fMRI) studies report disrupted hippocampal connectivity in patients with psychosis and in individuals with clinical high risk, yet hippocampal connectivity has not been investigated in people with high schizotypy traits. Here we used rs-fMRI to examine hippocampal connectivity in healthy people with low (LS, n = 23) and high levels (HS, n = 22) of schizotypal traits assessed using the Schizotypy Personality Questionnaire. Using a bilateral hippocampal seed region, we examined resting state functional connectivity (RSFC) between hippocampus and striatal, thalamic and prefrontal cortex regions of interest. Compared to LS, HS participants showed lower RSFC between hippocampus and striatum and between hippocampus and thalamus. Whilst the group effect of reduced hippocampal RSFC in striatal and thalamic regions was driven by total schizotypy scores, positive schizotypy subfactor scores were significantly positively correlated with hippocampus-caudate/thalamus RSFC. Group differences in RSFC were not observed between hippocampus and prefrontal cortex. These results demonstrate that subclinical schizotypal traits are associated with altered hippocampal connectivity in striatal and thalamic regions and provide further support that hippocampal dysconnectivity confers risk for schizophrenia spectrum disorders.
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Affiliation(s)
- Kozhuharova P
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, United Kingdom.
| | - Saviola F
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, United Kingdom; Centre for Mind/Brain Sciences, University of Trento, Rovereto (Trento), Italy
| | - Diaconescu A
- Department of Psychiatry, Brain and Therapeutics, Krembil Centre for Neuroinformatics, CAMH
| | - Allen P
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, United Kingdom; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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14
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Kraguljac NV, Lahti AC. Neuroimaging as a Window Into the Pathophysiological Mechanisms of Schizophrenia. Front Psychiatry 2021; 12:613764. [PMID: 33776813 PMCID: PMC7991588 DOI: 10.3389/fpsyt.2021.613764] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia is a complex neuropsychiatric disorder with a diverse clinical phenotype that has a substantial personal and public health burden. To advance the mechanistic understanding of the illness, neuroimaging can be utilized to capture different aspects of brain pathology in vivo, including brain structural integrity deficits, functional dysconnectivity, and altered neurotransmitter systems. In this review, we consider a number of key scientific questions relevant in the context of neuroimaging studies aimed at unraveling the pathophysiology of schizophrenia and take the opportunity to reflect on our progress toward advancing the mechanistic understanding of the illness. Our data is congruent with the idea that the brain is fundamentally affected in the illness, where widespread structural gray and white matter involvement, functionally abnormal cortical and subcortical information processing, and neurometabolic dysregulation are present in patients. Importantly, certain brain circuits appear preferentially affected and subtle abnormalities are already evident in first episode psychosis patients. We also demonstrated that brain circuitry alterations are clinically relevant by showing that these pathological signatures can be leveraged for predicting subsequent response to antipsychotic treatment. Interestingly, dopamine D2 receptor blockers alleviate neural abnormalities to some extent. Taken together, it is highly unlikely that the pathogenesis of schizophrenia is uniform, it is more plausible that there may be multiple different etiologies that converge to the behavioral phenotype of schizophrenia. Our data underscore that mechanistically oriented neuroimaging studies must take non-specific factors such as antipsychotic drug exposure or illness chronicity into consideration when interpreting disease signatures, as a clear characterization of primary pathophysiological processes is an imperative prerequisite for rational drug development and for alleviating disease burden in our patients.
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Affiliation(s)
- Nina Vanessa Kraguljac
- Neuroimaging and Translational Research Laboratory, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adrienne Carol Lahti
- Neuroimaging and Translational Research Laboratory, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
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Sonnenschein SF, Grace AA. Emerging therapeutic targets for schizophrenia: a framework for novel treatment strategies for psychosis. Expert Opin Ther Targets 2021; 25:15-26. [PMID: 33170748 PMCID: PMC7855878 DOI: 10.1080/14728222.2021.1849144] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/05/2020] [Indexed: 01/10/2023]
Abstract
Introduction: Antipsychotic drugs are central to the treatment of schizophrenia, but their limitations necessitate improved treatment strategies. Multiple lines of research have implicated glutamatergic dysfunction in the hippocampus as an early source of pathophysiology in schizophrenia. Novel compounds have been designed to treat glutamatergic dysfunction, but they have produced inconsistent results in clinical trials. Areas covered: This review discusses how the hippocampus is thought to drive psychotic symptoms through its influence on the dopamine system. It offers the reader an evaluation of proposed treatment strategies including direct modulation of GABA or glutamate neurotransmission or reducing the deleterious impact of stress on circuit development. Finally, we offer a perspective on aspects of future research that will advance our knowledge and may create new therapeutic opportunities. PubMed was searched for relevant literature between 2010 and 2020 and related studies. Expert opinion: Targeting aberrant excitatory-inhibitory neurotransmission in the hippocampus and its related circuits has the potential to alleviate symptoms and reduce the risk of transition to psychosis if implemented as an early intervention. Longitudinal multimodal brain imaging combined with mechanistic theories generated from animal models can be used to better understand the progression of hippocampal-dopamine circuit dysfunction and heterogeneity in treatment response.
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Affiliation(s)
| | - Anthony A. Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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16
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Soldevila-Matías P, Albajes-Eizagirre A, Radua J, García-Martí G, Rubio JM, Tordesillas-Gutierrez D, Fuentes-Durá I, Solanes A, Fortea L, Oliver D, Sanjuán J. Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 15:S1888-9891(20)30100-2. [PMID: 32988773 DOI: 10.1016/j.rpsm.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/02/2020] [Accepted: 08/09/2020] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.
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Affiliation(s)
- Pau Soldevila-Matías
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gracián García-Martí
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain
| | - José M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA
| | - Diana Tordesillas-Gutierrez
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Inmaculada Fuentes-Durá
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Julio Sanjuán
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
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Hippocampal glutamate and hippocampus subfield volumes in antipsychotic-naive first episode psychosis subjects and relationships to duration of untreated psychosis. Transl Psychiatry 2020; 10:137. [PMID: 32398671 PMCID: PMC7217844 DOI: 10.1038/s41398-020-0812-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 11/08/2022] Open
Abstract
Evidence points toward a relationship between longer duration of untreated psychosis (DUP) and worse long-term outcomes in patients with first episode psychosis (FEP), but the underlying neurobiology remains poorly understood. Proton magnetic resonance spectroscopy studies have reported altered hippocampus glutamatergic neurotransmission, and structural MRI as reported hippocampal atrophy that may be associated with memory impairment in schizophrenia. Here, we quantify left hippocampus glutamate (Glx) and left hippocampus subfield volumes in 54 antipsychotic-naive FEP and 41 healthy controls (HC), matched on age, sex, and parental occupation. While there were no significant group difference in Glx levels, hippocampal Glx levels were significantly higher in those who underwent a long DUP (>12 months) compared to those with a short DUP, and compared to HC. Compared to HC, FEP had significantly reduced whole hippocampus volume, as well as of CA1, CA4, granule cell layer, subiculum, and presubiculum subfields. Smaller whole hippocampal volume, as well as CA1, molecular layer, subiculum, presubiculum, and hippocampal tail volumes were significantly associated with longer DUP. However, we found no significant association between hippocampal Glx levels and hippocampal volume or subfields, suggesting that these alterations are not related, or their relationship does not follow a linear pattern. However, our results strongly suggest that one or several pathophysiological processes underlie the DUP. Importantly, our data highlight the critical need for reducing the DUP and for early pharmacological intervention with the hope to prevent structural deficits and, hopefully, improve clinical outcomes.
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18
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Common increased hippocampal volume but specific changes in functional connectivity in schizophrenia patients in remission and non-remission following electroconvulsive therapy: A preliminary study. NEUROIMAGE-CLINICAL 2019; 24:102081. [PMID: 31734526 PMCID: PMC6861644 DOI: 10.1016/j.nicl.2019.102081] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/10/2019] [Accepted: 11/06/2019] [Indexed: 01/21/2023]
Abstract
Electroconvulsive therapy (ECT) is considered a treatment option in patients with drug-resistant schizophrenia (SZ). However, approximately one-third of patients do not benefit from ECT in the clinic. Thus, it is critical to investigate differences between ECT responders and non-responders. Accumulated evidence has indicated that one region of ECT action is the hippocampus, which also plays an important role in SZ pathophysiology. To date, no studies have investigated differences in ECT effects in the hippocampus between treatment responders and non-responders. This study recruited twenty-one SZ patients treated for four weeks with ECT (MSZ, n = 21) and twenty-one SZ patients who received pharmaceutical therapy (DSZ, n = 21). The MSZ group was further categorized into responders (MSR, n = 10) or non-responders (MNR, n = 11) based on treatment outcomes by the criterion of a 50% reduction in the Positive and Negative Syndrome Scale total scores. Using structural and resting-state functional MRI, we measured the hippocampal volume and functional connectivity (FC) in all SZ patients (before and after treatment) and 23 healthy controls. In contrast to pharmaceutical therapy, ECT induced bilateral hippocampal volume increases in the MSZ. Both the MSR and MNR exhibited hippocampal expansion after ECT, whereas a lower baseline volume in one of hippocampal subfield (hippocampus-amygdala transition area) was found in the MNR. After ECT, increased FC between the hippocampus and brain networks associated with cognitive function was only observed in the MSR. The mechanism of action of ECT in schizophrenia is complex. A combination of baseline impairment level, ECT-introduced morphological changes and post-ECT FC increases in the hippocampus may jointly contribute to the post-ECT symptom improvements in patients with SZ.
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Kraguljac NV, Morgan CJ, Reid MA, White DM, Jindal RD, Sivaraman S, Martinak BK, Lahti AC. A longitudinal magnetic resonance spectroscopy study investigating effects of risperidone in the anterior cingulate cortex and hippocampus in schizophrenia. Schizophr Res 2019; 210:239-244. [PMID: 30630705 PMCID: PMC7881837 DOI: 10.1016/j.schres.2018.12.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/30/2022]
Abstract
Magnetic Resonance Spectroscopy is a popular approach to probe brain chemistry in schizophrenia (SZ), but no consensus exists as to the extent of alterations. This may be attributable to differential effects of populations studied, brain regions examined, or antipsychotic medication effects. Here, we measured neurometabolites in the anterior cingulate cortex (ACC) and hippocampus, two structurally dissimilar brain regions implicated in the SZ pathophysiology. We enrolled 61 SZ with the goal to scan them before and after six weeks of treatment with risperidone. We also scanned 31 matched healthy controls twice, six weeks apart. Using mixed effect repeated measures linear models to examine the effect of group and time on metabolite levels in each voxel, we report an increase in hippocampal glutamate + glutamine (Glx) in SZ compared to controls (p = 0.043), but no effect of antipsychotic medication (p = 0.330). In the ACC, we did not find metabolite alterations or antipsychotic medication related changes after six weeks of treatment with risperidone. The coefficients for the discriminant function (differentiating SZ from HC) in the ACC were greatest for NAA (-0.83), and in the hippocampus for Glx (0.76), the same metabolites were associated with greater treatment response in patients at trend level. Taken together, our data extends the existing literature by demonstrating regionally distinct metabolite alterations in the same patient group and suggests that antipsychotic medications may have limited effects on metabolite levels in these regions.
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Affiliation(s)
- Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | | | - Meredith A. Reid
- MRI Research Center, Department of Electrical and Computer Engineering, Auburn University
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Ripu D. Jindal
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham,Department of Neurology, Birmingham VA Medical Center
| | - Soumya Sivaraman
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Bridgette K. Martinak
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
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Li S, Hu N, Zhang W, Tao B, Dai J, Gong Y, Tan Y, Cai D, Lui S. Dysconnectivity of Multiple Brain Networks in Schizophrenia: A Meta-Analysis of Resting-State Functional Connectivity. Front Psychiatry 2019; 10:482. [PMID: 31354545 PMCID: PMC6639431 DOI: 10.3389/fpsyt.2019.00482] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/19/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Seed-based studies on resting-state functional connectivity (rsFC) in schizophrenia have shown disrupted connectivity involving a number of brain networks; however, the results have been controversial. Methods: We conducted a meta-analysis based on independent component analysis (ICA) brain templates to evaluate dysconnectivity within resting-state brain networks in patients with schizophrenia. Seventy-six rsFC studies from 70 publications with 2,588 schizophrenia patients and 2,567 healthy controls (HCs) were included in the present meta-analysis. The locations and activation effects of significant intergroup comparisons were extracted and classified based on the ICA templates. Then, multilevel kernel density analysis was used to integrate the results and control bias. Results: Compared with HCs, significant hypoconnectivities were observed between the seed regions and the areas in the auditory network (left insula), core network (right superior temporal cortex), default mode network (right medial prefrontal cortex, and left precuneus and anterior cingulate cortices), self-referential network (right superior temporal cortex), and somatomotor network (right precentral gyrus) in schizophrenia patients. No hyperconnectivity between the seed regions and any other areas within the networks was detected in patients, compared with the connectivity in HCs. Conclusions: Decreased rsFC within the self-referential network and default mode network might play fundamental roles in the malfunction of information processing, while the core network might act as a dysfunctional hub of regulation. Our meta-analysis is consistent with diffuse hypoconnectivities as a dysregulated brain network model of schizophrenia.
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Affiliation(s)
- Siyi Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Na Hu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Tao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Dai
- Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China
| | - Yao Gong
- Department of Geriatric Psychiatry, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, China
| | - Duanfang Cai
- Department of Psychiatry, Zigong Mental Health Center, Zigong, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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21
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Cadena EJ, White DM, Kraguljac NV, Reid MA, Jindal R, Pixley RM, Lahti AC. Cognitive control network dysconnectivity and response to antipsychotic treatment in schizophrenia. Schizophr Res 2019; 204:262-270. [PMID: 30098853 PMCID: PMC7909720 DOI: 10.1016/j.schres.2018.07.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/26/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Abstract
To better understand cognitive control impairment in schizophrenia, it is vital to determine the extent of dysfunctional connectivity in the associated fronto-striatal brain network, with a focus on the connections with the anterior cingulate cortex (ACC), prior to the potential confounding effect of medication. It is also essential to determine the effects following antipsychotic medication and the relationship of those effects on psychosis improvement. Twenty-two patients with schizophrenia, initially unmedicated and after a 6-week course of risperidone, and 20 matched healthy controls (HC) performed a fMRI task twice, six weeks apart. We investigated group and longitudinal differences in ACC-related functional connectivity during performance of a Stroop color task as well as connectivity patterns associated with improvement in psychosis symptoms. Unmedicated patients with schizophrenia showed greater functional connectivity between ACC and bilateral caudate and midbrain and lower connectivity with left putamen compared to healthy controls. At baseline, greater functional connectivity between ACC and bilateral putamen predicted subsequent better treatment response. Change in functional connectivity between ACC and left putamen positively correlated with better treatment response. These results suggest that patterns of functional connectivity in fronto-striatal networks can be utilized to predict potential response to antipsychotic medication. Prior to treatment, brain function may be structured with a predisposition that favors or not treatment response.
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22
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Sivaraman S, Kraguljac NV, White DM, Morgan CJ, Gonzales SS, Lahti AC. Neurometabolic abnormalities in the associative striatum in antipsychotic-naïve first episode psychosis patients. Psychiatry Res Neuroimaging 2018; 281:101-106. [PMID: 30286325 PMCID: PMC7874514 DOI: 10.1016/j.pscychresns.2018.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 12/23/2022]
Abstract
Schizophrenia is a chronic, often progressive, disorder. Understanding the underlying neurobiology present in the early stages of the illness is as a pivotal step in designing targeted interventions aimed at arresting disease progression. The aim of our study was to examine neurometabolic changes in the dopamine rich associative striatum in medication-naïve first episode psychosis (FEP). We quantified neurometabolites in 14 FEP and 18 healthy controls (HC) matched on key demographic characteristics. Spectra from the voxel in the left associative striatum were acquired using a PRESS sequence (TR/TE = 2000/80 ms; 512 averages). MRS data were quantified in the time domain with AMARES in jMRUI. Choline was significantly elevated in FEP compared to HC. No significant alterations in other metabolites were observed. We did not observe correlations between metabolite levels and clinical characteristics in FEP. Here, we demonstrated elevated choline and a disruption of the relationship between N-acetyl-aspartate and Glx (glutamate + glutamine) in medication-naïve FEP patients in the left striatum indicating possible mitochondrial, membrane and glial dysfunction as an underlying pathological phenomenon. In addition, striatal choline shows promise as a biomarker for FEP that may have utility in clinical trials investigating target engagement in experimental regimens.
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Affiliation(s)
- Soumya Sivaraman
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David M White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Charity J Morgan
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sara S Gonzales
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Cadena EJ, White DM, Kraguljac NV, Reid MA, Maximo JO, Nelson EA, Gawronski BA, Lahti AC. A Longitudinal Multimodal Neuroimaging Study to Examine Relationships Between Resting State Glutamate and Task Related BOLD Response in Schizophrenia. Front Psychiatry 2018; 9:632. [PMID: 30555359 PMCID: PMC6281980 DOI: 10.3389/fpsyt.2018.00632] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/07/2018] [Indexed: 01/10/2023] Open
Abstract
Previous studies have observed impairments in both brain function and neurometabolite levels in schizophrenia. In this study, we investigated the relationship between brain activity and neurochemistry in off-medication patients with schizophrenia and if this relationship is altered following antipsychotic medication by combining proton magnetic resonance spectroscopy (1H-MRS) with functional magnetic resonance imaging (fMRI). We used single voxel MRS acquired in the bilateral dorsal anterior cingulate cortex (ACC) and fMRI during performance of a Stroop color-naming task in 22 patients with schizophrenia (SZ), initially off-medication and after a 6-week course of risperidone, and 20 matched healthy controls (HC) twice, 6 weeks apart. We observed a significant decrease in ACC glutamate + glutamine (Glx)/Creatine (Cr) levels in medicated SZ patients compared to HC but not compared to their off-medication baseline. In off-medication SZ, the relationship between ACC Glx/Cr levels and the blood oxygen level-dependent (BOLD) response in regions of the salience network (SN) and posterior default mode network (DMN) was opposite than of HC. After 6 weeks, the relationship between Glx and the BOLD response was still opposite between the groups; however for both groups the direction of the relationship changed from baseline to week 6. These results suggest a mechanism whereby alterations in the relationship between cortical glutamate and BOLD response is disrupting the modulation of major neural networks subserving cognitive processes, potentially affecting cognition. While these relationships appear to normalize with treatment in patients, the interpretations of the results are confounded by significant group differences in Glx levels, as well as the variability of the relationship between Glx and BOLD response in HC over time, which may be driven by factors including habituation to task or scanner environment.
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Affiliation(s)
- Elyse J. Cadena
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Meredith A. Reid
- Magnetic Resonance Imaging Research Center, Auburn University at Birmingham, Birmingham, AL, United States
| | - Jose O. Maximo
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Eric A. Nelson
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Brian A. Gawronski
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
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Overbeek G, Gawne TJ, Reid MA, Salibi N, Kraguljac NV, White DM, Lahti AC. Relationship Between Cortical Excitation and Inhibition and Task-Induced Activation and Deactivation: A Combined Magnetic Resonance Spectroscopy and Functional Magnetic Resonance Imaging Study at 7T in First-Episode Psychosis. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:121-130. [PMID: 30470582 DOI: 10.1016/j.bpsc.2018.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/18/2018] [Accepted: 10/07/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Schizophrenia is thought to be a disorder of brain dysconnectivity. An imbalance between cortical excitation/inhibition is also implicated, but the link between these abnormalities remains unclear. The present study used magnetic resonance spectroscopy and functional magnetic resonance imaging at 7T to investigate how measurements of glutamate and gamma-aminobutyric acid (GABA) relate to the blood oxygen level-dependent (BOLD) response during a cognitive task, and how these relationships are altered in schizophrenia. METHODS Usable functional magnetic resonance imaging data from 17 first-episode psychosis (FEP) patients (4 women, 13 men) and 21 matched healthy control subjects (HCs) (5 women, 16 men) were acquired during a Stroop task. Within- and between-group comparisons of the BOLD response were performed. Neurometabolite levels were measured in the dorsal anterior cingulate cortex. Two multiple regressions investigated how glutamate, glutamine, and GABA related to the BOLD response in HCs and FEP patients separately. A third investigated between-group differences in the relationships between the BOLD response and each of these neurometabolites. RESULTS Compared with HCs, FEP patients showed an increased BOLD response within regions of the executive and default mode networks. In FEP patients, the relationship between anterior cingulate cortex glutamate levels and the BOLD response in regions of the posterior default mode network was opposite to that of HCs. In FEP patients but not HCs, anterior cingulate cortex GABA levels correlated with the local BOLD response and with the Stroop reaction time. CONCLUSION These results suggest a mechanism whereby alterations in the relationship between cortical glutamate/GABA and BOLD response is disrupting the dynamic of major neural networks, possibly affecting cognition.
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Affiliation(s)
- Gregory Overbeek
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Timothy J Gawne
- Department of Vision Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Meredith A Reid
- Magnetic Resonance Imaging Research Center, Auburn University, Auburn, Alabama
| | - Nouha Salibi
- Siemens Healthineers MR R&D, Malvern, Pennsylvania
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - David M White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama.
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Sedlak TW, Nucifora LG, Koga M, Shaffer LS, Higgs C, Tanaka T, Wang AM, Coughlin JM, Barker PB, Fahey JW, Sawa A. Sulforaphane Augments Glutathione and Influences Brain Metabolites in Human Subjects: A Clinical Pilot Study. MOLECULAR NEUROPSYCHIATRY 2018; 3:214-222. [PMID: 29888232 PMCID: PMC5981770 DOI: 10.1159/000487639] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/12/2018] [Indexed: 12/17/2022]
Abstract
Schizophrenia and other neuropsychiatric disorders await mechanism-associated interventions. Excess oxidative stress is increasingly appreciated to participate in the pathophysiology of brain disorders, and decreases in the major antioxidant, glutathione (GSH), have been reported in multiple studies. Technical cautions regarding the estimation of oxidative stress-related changes in the brain via imaging techniques have led investigators to explore peripheral GSH as a possible pathological signature of oxidative stress-associated brain changes. In a preclinical model of GSH deficiency, we found a correlation between whole brain and peripheral GSH levels. We found that the naturally occurring isothiocyanate sulforaphane increased blood GSH levels in healthy human subjects following 7 days of daily oral administration. In parallel, we explored the potential influence of sulforaphane on brain GSH levels in the anterior cingulate cortex, hippocampus, and thalamus via 7-T magnetic resonance spectroscopy. A significant positive correlation between blood and thalamic GSH post- and pre-sulforaphane treatment ratios was observed, in addition to a consistent increase in brain GSH levels in response to treatment. This clinical pilot study suggests the value of exploring relationships between peripheral GSH and clinical/neuropsychological measures, as well as the influences sulforaphane has on functional measures that are altered in neuropsychiatric disorders.
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Affiliation(s)
- Thomas W. Sedlak
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Leslie G. Nucifora
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Minori Koga
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lindsay S. Shaffer
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cecilia Higgs
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Teppei Tanaka
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anna M. Wang
- Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer M. Coughlin
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter B. Barker
- Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jed W. Fahey
- Department of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Kraguljac NV, Carle M, Frölich MA, Tran S, Yassa MA, White DM, Reddy A, Lahti AC. RETRACTED: Mnemonic Discrimination Deficits in First-Episode Psychosis and a Ketamine Model Suggests Dentate Gyrus Pathology Linked to N-Methyl-D-Aspartate Receptor Hypofunction. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:231-238. [PMID: 29486864 PMCID: PMC5836317 DOI: 10.1016/j.bpsc.2017.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 02/19/2017] [Indexed: 01/21/2023]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). Retraction notice to: “Mnemonic Discrimination Deficits in First-Episode Psychosis and a Ketamine Model Suggests Dentate Gyrus Pathology Linked to N-Methyl-D-Aspartate Receptor Hypofunction” by Nina Vanessa Kraguljac, Matthew Carle, Michael A. Frölich, Steve Tran, Michael A. Yassa, David Matthew White, Abhishek Reddy, and Adrienne Carol Lahti (Biol Psychiatry Cogn Neurosci Neuroimaging 2018; 3:231-238); https://doi.org/10.1016/j.bpsc.2017.02.005. This article has been retracted at the request of Cameron S. Carter, M.D., Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, with agreement from all authors. The authors discovered an error in the calculation of the response bias–corrected pattern recognition score in this article, which has significantly changed the results for experiment 1. Specifically, the authors discovered that the response bias corrected pattern recognition score was erroneously computed as P(‘old’|target) minus P(‘old’|lure) rather than P(‘old’|target) minus P(‘old’|foil). After re-running statistical analyses with the correct values, the authors found a significant difference in the response bias–corrected pattern recognition score in healthy volunteers (HV) compared with first-episode psychosis (FEP) patients (HV: 84.13 ± 10.96; FEP: 63.70 ± 21.83; t = 4.01; p < .01) in experiment 1. This finding is not consistent with the original report, where the authors reported no group differences in bias-corrected pattern recognition scores (originally reported values: t = 0.93, p = .36). The authors again found no significant correlations between pattern completion scores and BPRS total, positive, or negative symptom scores or RBANS scores, consistent with the original report. In experiment 2, bias-corrected pattern recognition scores did not differ between the saline and ketamine conditions (saline: 78.29 ± 28.04; ketamine: 73.59 ± 18.94; t = 0.81; p = 0.43), which is consistent with the original report (originally reported values: t = −0.69, p = .50). Contrary to the original report, task performance during the saline and ketamine infusions was no longer correlated at trend level for pattern recognition. Repeat analyses showed no correlations between pattern recognition scores during the ketamine challenge and BPRS total, positive, and negative symptom scores, or ketamine plasma levels at either time point, consistent with the original report. The authors have verified that bias-corrected pattern separation scores were calculated correctly for both experiments in the initial report. This error affects the abstract, the results, Figure 1, and discussion of the manuscript. The authors voluntarily informed the Journal of this honest error upon its discovery. Because of the extent and nature of the changes to the paper, the editors and authors concluded that, to ensure maximum clarity and transparency, the only course of action was to retract this version of the paper. The authors are revising the paper, which the Journal will re-review and consider further for publication.
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Affiliation(s)
- Nina Vanessa Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Matthew Carle
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael A Frölich
- Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steve Tran
- Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael A Yassa
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, California
| | - David Matthew White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Abhishek Reddy
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama.
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Antoniades M, Schoeler T, Radua J, Valli I, Allen P, Kempton MJ, McGuire P. Verbal learning and hippocampal dysfunction in schizophrenia: A meta-analysis. Neurosci Biobehav Rev 2018; 86:166-175. [PMID: 29223768 PMCID: PMC5818020 DOI: 10.1016/j.neubiorev.2017.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 10/24/2017] [Accepted: 12/01/2017] [Indexed: 12/19/2022]
Abstract
This meta-analysis summarizes research examining whether deficits in verbal learning are related to bilateral hippocampal volume reductions in patients with or at risk for schizophrenia and in healthy controls. 17 studies with 755 patients with schizophrenia (SCZ), 232 Genetic High Risk (GHR) subjects and 914 healthy controls (HC) were included. Pooled correlation coefficients were calculated between hemisphere (left, right or total) and type of recall (immediate or delayed) for each diagnostic group individually (SCZ, GHR and HC). In SCZ, left and right hippocampal volume positively correlated with immediate (r=0.256, 0.230) and delayed (r=0.132, 0.231) verbal recall. There was also a correlation between total hippocampal volume and delayed recall (r=0.233). None of these correlations were significant in healthy controls. There was however, a positive correlation between left hippocampal volume and immediate recall in the GHR group (r=0.356). The results suggest that hippocampal volume affects immediate and delayed verbal learning capacity in schizophrenia and provides further evidence of hippocampal dysfunction in the pathophysiology of schizophrenia.
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Affiliation(s)
- Mathilde Antoniades
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Tabea Schoeler
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Joaquim Radua
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; FIDMAG Germanes Hospitalàries - CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Isabel Valli
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Paul Allen
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Department of Psychology, University of Roehampton, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Dong D, Wang Y, Chang X, Luo C, Yao D. Dysfunction of Large-Scale Brain Networks in Schizophrenia: A Meta-analysis of Resting-State Functional Connectivity. Schizophr Bull 2018; 44:168-181. [PMID: 28338943 PMCID: PMC5767956 DOI: 10.1093/schbul/sbx034] [Citation(s) in RCA: 289] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Schizophrenia is a complex mental disorder with disorganized communication among large-scale brain networks, as demonstrated by impaired resting-state functional connectivity (rsFC). Individual rsFC studies, however, vary greatly in their methods and findings. We searched for consistent patterns of network dysfunction in schizophrenia by using a coordinate-based meta-analysis. Fifty-six seed-based voxel-wise rsFC datasets from 52 publications (2115 patients and 2297 healthy controls) were included in this meta-analysis. Then, coordinates of seed regions of interest (ROI) and between-group effects were extracted and coded. Seed ROIs were categorized into seed networks by their location within an a priori template. Multilevel kernel density analysis was used to identify brain networks in which schizophrenia was linked to hyper-connectivity or hypo-connectivity with each a priori network. Our results showed that schizophrenia was characterized by hypo-connectivity within the default network (DN, self-related thought), affective network (AN, emotion processing), ventral attention network (VAN, processing of salience), thalamus network (TN, gating information) and somatosensory network (SS, involved in sensory and auditory perception). Additionally, hypo-connectivity between the VAN and TN, VAN and DN, VAN and frontoparietal network (FN, external goal-directed regulation), FN and TN, and FN and DN were found in schizophrenia. Finally, the only instance of hyper-connectivity in schizophrenia was observed between the AN and VAN. Our meta-analysis motivates an empirical foundation for a disconnected large-scale brain networks model of schizophrenia in which the salience processing network (VAN) plays the core role, and its imbalanced communication with other functional networks may underlie the core difficulty of patients to differentiate self-representation (inner world) and environmental salience processing (outside world).
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Affiliation(s)
- Debo Dong
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yulin Wang
- Faculty of Psychological and Educational Sciences, Department of Experimental and Applied Psychology, Research Group of Biological Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Psychology and Educational Sciences, Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Xuebin Chang
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
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Hasan A, Wobrock T, Guse B, Langguth B, Landgrebe M, Eichhammer P, Frank E, Cordes J, Wölwer W, Musso F, Winterer G, Gaebel W, Hajak G, Ohmann C, Verde PE, Rietschel M, Ahmed R, Honer WG, Dechent P, Malchow B, Castro MFU, Dwyer D, Cabral C, Kreuzer PM, Poeppl TB, Schneider-Axmann T, Falkai P, Koutsouleris N. Structural brain changes are associated with response of negative symptoms to prefrontal repetitive transcranial magnetic stimulation in patients with schizophrenia. Mol Psychiatry 2017; 22:857-864. [PMID: 27725655 DOI: 10.1038/mp.2016.161] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/06/2016] [Accepted: 08/04/2016] [Indexed: 12/13/2022]
Abstract
Impaired neural plasticity may be a core pathophysiological process underlying the symptomatology of schizophrenia. Plasticity-enhancing interventions, including repetitive transcranial magnetic stimulation (rTMS), may improve difficult-to-treat symptoms; however, efficacy in large clinical trials appears limited. The high variability of rTMS-related treatment response may be related to a comparably large variation in the ability to generate plastic neural changes. The aim of the present study was to determine whether negative symptom improvement in schizophrenia patients receiving rTMS to the left dorsolateral prefrontal cortex (DLPFC) was related to rTMS-related brain volume changes. A total of 73 schizophrenia patients with predominant negative symptoms were randomized to an active (n=34) or sham (n=39) 10-Hz rTMS intervention applied 5 days per week for 3 weeks to the left DLPFC. Local brain volume changes measured by deformation-based morphometry were correlated with changes in negative symptom severity using a repeated-measures analysis of covariance design. Volume gains in the left hippocampal, parahippocampal and precuneal cortices predicted negative symptom improvement in the active rTMS group (all r⩽-0.441, all P⩽0.009), but not the sham rTMS group (all r⩽0.211, all P⩾0.198). Further analyses comparing negative symptom responders (⩾20% improvement) and non-responders supported the primary analysis, again only in the active rTMS group (F(9, 207)=2.72, P=0.005, partial η 2=0.106). Heterogeneity in clinical response of negative symptoms in schizophrenia to prefrontal high-frequency rTMS may be related to variability in capacity for structural plasticity, particularly in the left hippocampal region and the precuneus.
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Affiliation(s)
- A Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - T Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany.,Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - B Guse
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - M Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied, Agatharied, Germany
| | - P Eichhammer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - E Frank
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - W Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - F Musso
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - G Winterer
- Experimental and Clinical Research Centre, The Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - G Hajak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Sozialstiftung Bamberg, Bamberg, Germany
| | - C Ohmann
- European Clinical Research Network, Düsseldorf, Germany
| | - P E Verde
- Coordination Centre for Clinical Trials, Heinrich-Heine University, Düsseldorf, Germany
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Institute of Central Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - R Ahmed
- Institut für anwendungsorientierte Forschung und klinische Studien GmbH, Göttingen, Germany
| | - W G Honer
- Department of Genetic Epidemiology in Psychiatry, Institute of Mental Health, The University of British Columbia, Vancouver, BC, Canada
| | - P Dechent
- Department of Cognitive Neurology, Georg-August-University Goettingen, Goettingen, Germany
| | - B Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - M F U Castro
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - D Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - C Cabral
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - P M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - T B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - T Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - N Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
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Foss-Feig JH, Adkinson BD, Ji JL, Yang G, Srihari VH, McPartland JC, Krystal JH, Murray JD, Anticevic A. Searching for Cross-Diagnostic Convergence: Neural Mechanisms Governing Excitation and Inhibition Balance in Schizophrenia and Autism Spectrum Disorders. Biol Psychiatry 2017; 81:848-861. [PMID: 28434615 PMCID: PMC5436134 DOI: 10.1016/j.biopsych.2017.03.005] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 02/06/2017] [Accepted: 03/05/2017] [Indexed: 01/08/2023]
Abstract
Recent theoretical accounts have proposed excitation and inhibition (E/I) imbalance as a possible mechanistic, network-level hypothesis underlying neural and behavioral dysfunction across neurodevelopmental disorders, particularly autism spectrum disorder (ASD) and schizophrenia (SCZ). These two disorders share some overlap in their clinical presentation as well as convergence in their underlying genes and neurobiology. However, there are also clear points of dissociation in terms of phenotypes and putatively affected neural circuitry. We highlight emerging work from the clinical neuroscience literature examining neural correlates of E/I imbalance across children and adults with ASD and adults with both chronic and early-course SCZ. We discuss findings from diverse neuroimaging studies across distinct modalities, conducted with electroencephalography, magnetoencephalography, proton magnetic resonance spectroscopy, and functional magnetic resonance imaging, including effects observed both during task and at rest. Throughout this review, we discuss points of convergence and divergence in the ASD and SCZ literature, with a focus on disruptions in neural E/I balance. We also consider these findings in relation to predictions generated by theoretical neuroscience, particularly computational models predicting E/I imbalance across disorders. Finally, we discuss how human noninvasive neuroimaging can benefit from pharmacological challenge studies to reveal mechanisms in ASD and SCZ. Collectively, we attempt to shed light on shared and divergent neuroimaging effects across disorders with the goal of informing future research examining the mechanisms underlying the E/I imbalance hypothesis across neurodevelopmental disorders. We posit that such translational efforts are vital to facilitate development of neurobiologically informed treatment strategies across neuropsychiatric conditions.
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Affiliation(s)
- Jennifer H Foss-Feig
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; Seaver Autism Center, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; Child Study Center, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Brendan D Adkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Genevieve Yang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - James C McPartland
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Division of Neurocognition, Neurocomputation, & Neurogenetics (N3), Yale University School of Medicine, New Haven, Connecticut; Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Division of Neurocognition, Neurocomputation, & Neurogenetics (N3), Yale University School of Medicine, New Haven, Connecticut; Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Division of Neurocognition, Neurocomputation, & Neurogenetics (N3), Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
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Birur B, Kraguljac NV, Shelton RC, Lahti AC. Brain structure, function, and neurochemistry in schizophrenia and bipolar disorder-a systematic review of the magnetic resonance neuroimaging literature. NPJ SCHIZOPHRENIA 2017; 3:15. [PMID: 28560261 PMCID: PMC5441538 DOI: 10.1038/s41537-017-0013-9] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/17/2017] [Accepted: 01/24/2017] [Indexed: 12/18/2022]
Abstract
Since Emil Kraepelin's conceptualization of endogenous psychoses as dementia praecox and manic depression, the separation between primary psychotic disorders and primary affective disorders has been much debated. We conducted a systematic review of case-control studies contrasting magnetic resonance imaging studies in schizophrenia and bipolar disorder. A literature search in PubMed of studies published between January 2005 and December 2016 was conducted, and 50 structural, 29 functional, 7 magnetic resonance spectroscopy, and 8 combined imaging and genetic studies were deemed eligible for systematic review. Structural neuroimaging studies suggest white matter integrity deficits that are consistent across the illnesses, while gray matter reductions appear more widespread in schizophrenia compared to bipolar disorder. Spectroscopy studies in cortical gray matter report evidence of decreased neuronal integrity in both disorders. Functional neuroimaging studies typically report similar functional architecture of brain networks in healthy controls and patients across the psychosis spectrum, but find differential extent of alterations in task related activation and resting state connectivity between illnesses. The very limited imaging-genetic literature suggests a relationship between psychosis risk genes and brain structure, and possible gene by diagnosis interaction effects on functional imaging markers. While the existing literature suggests some shared and some distinct neural markers in schizophrenia and bipolar disorder, it will be imperative to conduct large, well designed, multi-modal neuroimaging studies in medication-naïve first episode patients that will be followed longitudinally over the course of their illness in an effort to advance our understanding of disease mechanisms.
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Affiliation(s)
- Badari Birur
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL USA
| | - Nina Vanessa Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL USA
| | - Richard C. Shelton
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL USA
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL USA
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Ketamine modulates hippocampal neurochemistry and functional connectivity: a combined magnetic resonance spectroscopy and resting-state fMRI study in healthy volunteers. Mol Psychiatry 2017; 22:562-569. [PMID: 27480494 PMCID: PMC5562151 DOI: 10.1038/mp.2016.122] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 11/21/2022]
Abstract
A growing body of evidence suggests glutamate excess in schizophrenia and that N-methyl-d-aspartate receptor (NMDAR) hypofunction on γ-aminobutyric acid (GABA) interneurons disinhibiting pyramidal cells may be relevant to this hyperglutamatergic state. To better understand how NMDAR hypofunction affects the brain, we used magnetic resonance spectroscopy and resting-state functional magnetic resonance imaging (MRI) to study the effects of ketamine on hippocampal neurometabolite levels and functional connectivity in 15 healthy human subjects. We observed a ketamine-induced increase in hippocampal Glx (glutamate+glutamine; F=3.76; P=0.04), a decrease in fronto-temporal (t=4.92, PFDR<0.05, kE=2198, x=-30, y=52, z=14) and temporo-parietal functional connectivity (t=5.07, PFDR<0.05, kE=6094, x=-28, y=-36, z=-2), and a possible link between connectivity changes and elevated Glx. Our data empirically support that hippocampal glutamatergic elevation and resting-state network alterations may arise from NMDAR hypofunction and establish a proof of principle whereby experimental modelling of a disorder can help mechanistically integrate distinct neuroimaging abnormalities in schizophrenia.
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3T hippocampal glutamate-glutamine complex reflects verbal memory decline in aging. Neurobiol Aging 2017; 54:103-111. [PMID: 28363111 DOI: 10.1016/j.neurobiolaging.2017.01.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/05/2016] [Accepted: 01/06/2017] [Indexed: 12/19/2022]
Abstract
The hippocampus is a critical site for alterations that are responsible for age-related changes in memory. Here, we present a relatively novel approach of examining the relationship between memory performance and glutamate-glutamine levels using short echo time magnetic resonance spectroscopy. Specifically, we investigated the relationship between Glx (a composite of glutamate and glutamine) levels in the hippocampus, performance on a word-recall task, and resting-state functional connectivity. While there was no overall difference in Glx intensity between young and aging adults, we identified a positive correlation between delayed word-list recall and Glx, bilaterally in older adults, but not in young adults. Collapsed across age, we also discovered a negative relationship between Glx intensity and resting-state functional connectivity between the anterior hippocampus and regions in the subcallosal gyrus. These findings demonstrate the possible utility of Glx in identifying age-related changes in the brain and behavior and provide encouragement that magnetic resonance spectroscopy can be useful in predicting age-related decline before any physical abnormalities are present.
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Zhu Y, Tang Y, Zhang T, Li H, Tang Y, Li C, Luo X, He Y, Lu Z, Wang J. Reduced functional connectivity between bilateral precuneus and contralateral parahippocampus in schizotypal personality disorder. BMC Psychiatry 2017; 17:48. [PMID: 28152990 PMCID: PMC5288938 DOI: 10.1186/s12888-016-1146-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 11/29/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Schizotypal personality disorder (SPD) is linked to schizophrenia in terms of shared genetics, biological markers and phenomenological characteristics. In the current study, we aimed to determine whether the previously reported altered functional connectivity (FC) with precuneus in patients with schizophrenia could be extended to individuals with SPD. METHODS Twenty subjects with SPD and 19 healthy controls were recruited from 4461 freshmen at a university in Shanghai and received a resting-state scan of MRI. All participants were evaluated by the Chinese version of Schizotypal Personality Questionnaire (SPQ) and the Chinese version of Symptom Checklist (SCL-90). The imaging data were analysed using the seed-based functional connectivity method. RESULTS Compared with the controls, SPD subjects exhibited reduced FC between bilateral precuneus and contralateral parahippocampus. In SPD group, SPQ total score was negatively correlated with FC between right precuneus and left parahippocampus (r = -0.603, p = 0.006); there was a negative trend between SPQ subscale score of suspiciousness and FC between left precuneus and right parahippocampus (r = -0.553, p = 0.014); and a positive trend was found between SPQ subscale score of odd or eccentric behaviour and FC between left precuneus and right superior temporal gyrus (r = 0.543, p = 0.016). As for the SCL-90 score, a similar negative trend was found between SCL-90 subscale score of suspiciousness and FC between right precuneus and left parahippocampus (r = -0.535, p = 0.018) in SPD group. CONCLUSIONS Our findings suggest that the decreased functional connectivity between precuneus and contralateral parahippocampus might play a key role in the pathophysiology of schizophrenia spectrum disorder.
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Affiliation(s)
- Yikang Zhu
- 0000 0004 0368 8293grid.16821.3cShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030 People’s Republic of China ,Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Yunxiang Tang
- 0000 0004 0369 1660grid.73113.37Department of Medical Psychology, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, People’s Republic of China
| | - Tianhong Zhang
- 0000 0004 0368 8293grid.16821.3cShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030 People’s Republic of China
| | - Hui Li
- 0000 0004 0368 8293grid.16821.3cShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030 People’s Republic of China
| | - Yingying Tang
- 0000 0004 0368 8293grid.16821.3cShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030 People’s Republic of China
| | - Chunbo Li
- 0000 0004 0368 8293grid.16821.3cShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030 People’s Republic of China ,0000 0004 0368 8293grid.16821.3cBio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Xingguang Luo
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06516 USA
| | - Yongguang He
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030, People's Republic of China.
| | - Zheng Lu
- Department of Psychiatry, Shanghai Tongji Hospital, Tongji University School of Medicine, 389 Xin Cun Road, Shanghai, 200065, People's Republic of China.
| | - Jijun Wang
- 0000 0004 0368 8293grid.16821.3cShanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South Wan Ping Road 600, Shanghai, 200030 People’s Republic of China ,0000 0004 0368 8293grid.16821.3cBio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
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Lottman KK, Kraguljac NV, White DM, Morgan CJ, Calhoun VD, Butt A, Lahti AC. Risperidone Effects on Brain Dynamic Connectivity-A Prospective Resting-State fMRI Study in Schizophrenia. Front Psychiatry 2017; 8:14. [PMID: 28220083 PMCID: PMC5292583 DOI: 10.3389/fpsyt.2017.00014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/17/2017] [Indexed: 12/31/2022] Open
Abstract
Resting-state functional connectivity studies in schizophrenia evaluating average connectivity over the entire experiment have reported aberrant network integration, but findings are variable. Examining time-varying (dynamic) functional connectivity may help explain some inconsistencies. We assessed dynamic network connectivity using resting-state functional MRI in patients with schizophrenia, while unmedicated (n = 34), after 1 week (n = 29) and 6 weeks of treatment with risperidone (n = 24), as well as matched controls at baseline (n = 35) and after 6 weeks (n = 19). After identifying 41 independent components (ICs) comprising resting-state networks, sliding window analysis was performed on IC timecourses using an optimal window size validated with linear support vector machines. Windowed correlation matrices were then clustered into three discrete connectivity states (a relatively sparsely connected state, a relatively abundantly connected state, and an intermediately connected state). In unmedicated patients, static connectivity was increased between five pairs of ICs and decreased between two pairs of ICs when compared to controls, dynamic connectivity showed increased connectivity between the thalamus and somatomotor network in one of the three states. State statistics indicated that, in comparison to controls, unmedicated patients had shorter mean dwell times and fraction of time spent in the sparsely connected state, and longer dwell times and fraction of time spent in the intermediately connected state. Risperidone appeared to normalize mean dwell times after 6 weeks, but not fraction of time. Results suggest that static connectivity abnormalities in schizophrenia may partly be related to altered brain network temporal dynamics rather than consistent dysconnectivity within and between functional networks and demonstrate the importance of implementing complementary data analysis techniques.
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Affiliation(s)
- Kristin K Lottman
- Department of Biomedical Engineering, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham , Birmingham, AL , USA
| | - David M White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Charity J Morgan
- Department of Biostatistics, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Allison Butt
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham , Birmingham, AL , USA
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Wagner G, Gussew A, Köhler S, de la Cruz F, Smesny S, Reichenbach JR, Bär KJ. Resting state functional connectivity of the hippocampus along the anterior–posterior axis and its association with glutamatergic metabolism. Cortex 2016; 81:104-17. [DOI: 10.1016/j.cortex.2016.03.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 02/29/2016] [Accepted: 03/30/2016] [Indexed: 12/17/2022]
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Kraguljac NV, White DM, Hadley N, Hadley JA, ver Hoef L, Davis E, Lahti AC. Aberrant Hippocampal Connectivity in Unmedicated Patients With Schizophrenia and Effects of Antipsychotic Medication: A Longitudinal Resting State Functional MRI Study. Schizophr Bull 2016; 42:1046-55. [PMID: 26873890 PMCID: PMC4903060 DOI: 10.1093/schbul/sbv228] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
To better characterize hippocampal pathophysiology in schizophrenia, we conducted a longitudinal study evaluating hippocampal functional connectivity during resting state, using seeds prescribed in its anterior and posterior regions. We enrolled 34 unmedicated patients with schizophrenia or schizoaffective disorder (SZ) and 34 matched healthy controls. SZ were scanned while off medication, then were treated with risperidone for 6 weeks and re-scanned (n = 22). Group differences in connectivity, as well as changes in connectivity over time, were assessed on the group's participant level functional connectivity maps. We found significant dysconnectivity with anterior and posterior hippocampal seeds in unmedicated SZ. Baseline connectivity between the hippocampus and anterior cingulate cortex, caudate nucleus, auditory cortex and calcarine sulcus in SZ predicted subsequent response to antipsychotic medications. These same regions demonstrated changes over the 6-week treatment trial that were correlated with symptomatic improvement. Our findings implicate several neural networks relevant to clinical improvement with antipsychotic medications.
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Affiliation(s)
- Nina Vanessa Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - David Matthew White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - Nathan Hadley
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - Jennifer Ann Hadley
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL;,Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL
| | - Lawrence ver Hoef
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - Ebony Davis
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL;
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Change in brain network topology as a function of treatment response in schizophrenia: a longitudinal resting-state fMRI study using graph theory. NPJ SCHIZOPHRENIA 2016; 2:16014. [PMID: 27336056 PMCID: PMC4898893 DOI: 10.1038/npjschz.2016.14] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 01/17/2023]
Abstract
A number of neuroimaging studies have provided evidence in support of the hypothesis that faulty interactions between spatially disparate brain regions underlie the pathophysiology of schizophrenia, but it remains unclear to what degree antipsychotic medications affect these. We hypothesized that the balance between functional integration and segregation of brain networks is impaired in unmedicated patients with schizophrenia, but that it can be partially restored by antipsychotic medications. We included 32 unmedicated patients with schizophrenia (SZ) and 32 matched healthy controls (HC) in this study. We obtained resting-state scans while unmedicated, and again after 6 weeks of treatment with risperidone to assess functional integration and functional segregation of brain networks using graph theoretical measures. Compared with HC, unmedicated SZ showed reduced global efficiency and increased clustering coefficients. This pattern of aberrant functional network integration and segregation was modulated with antipsychotic medications, but only in those who responded to treatment. Our work lends support to the concept of schizophrenia as a dysconnectivity syndrome, and suggests that faulty brain network topology in schizophrenia is modulated by antipsychotic medication as a function of treatment response.
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Interneuron Transcriptional Dysregulation Causes Frequency-Dependent Alterations in the Balance of Inhibition and Excitation in Hippocampus. J Neurosci 2016; 35:15276-90. [PMID: 26586816 DOI: 10.1523/jneurosci.1834-15.2015] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Circuit dysfunction in complex brain disorders such as schizophrenia and autism is caused by imbalances between inhibitory and excitatory synaptic transmission (I/E). Short-term plasticity differentially alters responses from excitatory and inhibitory synapses, causing the I/E ratio to change as a function of frequency. However, little is known about I/E ratio dynamics in complex brain disorders. Transcriptional dysregulation in interneurons, particularly parvalbumin interneurons, is a consistent pathophysiological feature of schizophrenia. Peroxisome proliferator activated receptor γ coactivator 1α (PGC-1α) is a transcriptional coactivator that in hippocampus is highly concentrated in inhibitory interneurons and regulates parvalbumin transcription. Here, we used PGC-1α(-/-) mice to investigate effects of interneuron transcriptional dysregulation on the dynamics of the I/E ratio at the synaptic and circuit level in hippocampus. We find that loss of PGC-1α increases the I/E ratio onto CA1 pyramidal cells in response to Schaffer collateral stimulation in slices from young adult mice. The underlying mechanism is enhanced basal inhibition, including increased inhibition from parvalbumin interneurons. This decreases the spread of activation in CA1 and dramatically limits pyramidal cell spiking, reducing hippocampal output. The I/E ratio and CA1 output are partially restored by paired-pulse stimulation at short intervals, indicating frequency-dependent effects. However, circuit dysfunction persists, indicated by alterations in kainate-induced gamma oscillations and impaired nest building. Together, these results show that transcriptional dysregulation in hippocampal interneurons causes frequency-dependent alterations in I/E ratio and circuit function, suggesting that PGC-1α deficiency in psychiatric and neurological disorders contributes to disease by causing functionally relevant alterations in I/E balance. SIGNIFICANCE STATEMENT Alteration in the inhibitory and excitatory synaptic transmission (I/E) balance is a fundamental principle underlying the circuit dysfunction observed in many neuropsychiatric and neurodevelopmental disorders. The I/E ratio is dynamic, continuously changing because of synaptic short-term plasticity. We show here that transcriptional dysregulation in interneurons, particularly parvalbumin interneurons, causes frequency-dependent alterations in the I/E ratio and in circuit function in hippocampus. Peroxisome proliferator activated receptor γ coactivator 1α (PGC-1α-deficient) mice have enhanced inhibition in CA1, the opposite of what is seen in cortex. This study fills an important gap in current understanding of how changes in inhibition in complex brain disorders affect I/E dynamics, leading to region-specific circuit dysfunction and behavioral impairment. This study also provides a conceptual framework for analyzing the effects of short-term plasticity on the I/E balance in disease models.
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Peters H, Shao J, Scherr M, Schwerthöffer D, Zimmer C, Förstl H, Bäuml J, Wohlschläger A, Riedl V, Koch K, Sorg C. More Consistently Altered Connectivity Patterns for Cerebellum and Medial Temporal Lobes than for Amygdala and Striatum in Schizophrenia. Front Hum Neurosci 2016; 10:55. [PMID: 26924973 PMCID: PMC4756145 DOI: 10.3389/fnhum.2016.00055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/05/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Brain architecture can be divided into a cortico-thalamic system and modulatory "subcortical-cerebellar" systems containing key structures such as striatum, medial temporal lobes (MTLs), amygdala, and cerebellum. Subcortical-cerebellar systems are known to be altered in schizophrenia. In particular, intrinsic functional brain connectivity (iFC) between these systems has been consistently demonstrated in patients. While altered connectivity is known for each subcortical-cerebellar system separately, it is unknown whether subcortical-cerebellar systems' connectivity patterns with the cortico-thalamic system are comparably altered across systems, i.e., if separate subcortical-cerebellar systems' connectivity patterns are consistent across patients. METHODS To investigate this question, 18 patients with schizophrenia (3 unmedicated, 15 medicated with atypical antipsychotics) and 18 healthy controls were assessed by resting-state functional magnetic resonance imaging (fMRI). Independent component analysis of fMRI data revealed cortical intrinsic brain networks (NWs) with time courses representing proxies for cortico-thalamic system activity. Subcortical-cerebellar systems' activity was represented by fMRI-based time courses of selected regions-of-interest (ROIs; i.e., striatum, MTL, amygdala, cerebellum). Correlation analysis among ROI- and NWs-time courses yielded individual connectivity matrices [i.e., connectivity between NW and ROIs (allROIs-NW, separateROI-NW), only NWs (NWs-NWs), and only ROIs (allROIs-allROIs)] as main outcome measures, which were classified by support-vector-machine-based (SVM) leave-one-out cross-validation. Differences in classification accuracy were statistically evaluated for consistency across subjects and systems. RESULTS Correlation matrices based on allROIs-NWs yielded 91% classification accuracy, which was significantly superior to allROIs-allROIs and NWs-NWs (56 and 74%, respectively). Considering separate subcortical-cerebellar systems, cerebellum-NWs and MTL-NWs reached highest accuracy values with 91 and 85%, respectively, while those of striatum-NW and amygdala-NW were significantly lower with about 65% classification accuracy. CONCLUSION RESULTS provide initial evidence for differential consistency of altered intrinsic connectivity patterns between subcortical-cerebellar systems and the cortico-thalamic system. Data suggest that differential dysconnectivity patterns between subcortical-cerebellar and cortical systems might reflect different disease states or patient subgroups.
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Affiliation(s)
- Henning Peters
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität MünchenMünchen, Germany
| | - Junming Shao
- School of Computer Science and Engineering, University of Electronic Science and Technology of ChinaChengdu, China
- Big Data Research Center, University of Electronic Science and Technology of ChinaChengdu, China
- Center for Information in BioMedicine, University of Electronic Science and Technology of ChinaChengdu, China
| | - Martin Scherr
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Dirk Schwerthöffer
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
| | - Hans Förstl
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Josef Bäuml
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
| | - Afra Wohlschläger
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
| | - Valentin Riedl
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
- Department of Nuclear Medicine, Technische Universität MünchenMünchen, Germany
| | - Kathrin Koch
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
| | - Christian Sorg
- Department of Psychiatry, Technische Universität MünchenMünchen, Germany
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technische Universität MünchenMünchen, Germany
- Department of Neuroradiology, Technische Universität MünchenMünchen, Germany
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Kraguljac NV, White DM, Hadley JA, Visscher K, Knight D, ver Hoef L, Falola B, Lahti AC. Abnormalities in large scale functional networks in unmedicated patients with schizophrenia and effects of risperidone. NEUROIMAGE-CLINICAL 2015; 10:146-58. [PMID: 26793436 PMCID: PMC4683457 DOI: 10.1016/j.nicl.2015.11.015] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/30/2015] [Accepted: 11/20/2015] [Indexed: 12/25/2022]
Abstract
Objective To describe abnormalities in large scale functional networks in unmedicated patients with schizophrenia and to examine effects of risperidone on networks. Material and methods 34 unmedicated patients with schizophrenia and 34 matched healthy controls were enrolled in this longitudinal study. We collected resting state functional MRI data with a 3T scanner at baseline and six weeks after they were started on risperidone. In addition, a group of 19 healthy controls were scanned twice six weeks apart. Four large scale networks, the dorsal attention network, executive control network, salience network, and default mode network were identified with seed based functional connectivity analyses. Group differences in connectivity, as well as changes in connectivity over time, were assessed on the group's participant level functional connectivity maps. Results In unmedicated patients with schizophrenia we found resting state connectivity to be increased in the dorsal attention network, executive control network, and salience network relative to control participants, but not the default mode network. Dysconnectivity was attenuated after six weeks of treatment only in the dorsal attention network. Baseline connectivity in this network was also related to clinical response at six weeks of treatment with risperidone. Conclusions Our results demonstrate abnormalities in large scale functional networks in patients with schizophrenia that are modulated by risperidone only to a certain extent, underscoring the dire need for development of novel antipsychotic medications that have the ability to alleviate symptoms through attenuation of dysconnectivity. We found widespread functional dysconnectivity in unmedicated patients with schizophrenia. Large scale functional networks appear differentially affected in the disorder. Attenuation of dysconnectivity with risperidone is seen only to a limited extent.
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Key Words
- ALFF, amplitude of low frequency fluctuations
- Antipsychotic medication
- BOLD, blood oxygen level dependent signal
- BPRS, Brief Psychiatric Rating Scale
- DAN, dorsal attention network
- DARTEL, diffeomorphic anatomical registration using exponentiated lie algebra algorithm
- DMN, default mode network
- Default mode network
- Dorsal attention network
- ECN, executive control network
- Executive control network
- FD, framewise displacement
- FDR, false discovery rate
- HC, healthy control
- KE, cluster extent
- MNI, Montreal Neurological Institute
- RBANS, Repeatable Battery for the Assessment of Neuropsychological Status
- SZ, patient with schizophrenia
- Salience network
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Affiliation(s)
- Nina Vanessa Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - David Matthew White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Jennifer Ann Hadley
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Kristina Visscher
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - David Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Lawrence ver Hoef
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Blessing Falola
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Nomura T, Oyamada Y, Fernandes HB, Remmers CL, Xu J, Meltzer HY, Contractor A. Subchronic phencyclidine treatment in adult mice increases GABAergic transmission and LTP threshold in the hippocampus. Neuropharmacology 2015; 100:90-7. [PMID: 25937215 DOI: 10.1016/j.neuropharm.2015.04.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/16/2015] [Accepted: 04/17/2015] [Indexed: 01/24/2023]
Abstract
Repeated administration of non-competitive N-methyl-d-aspartate (NMDA) receptor antagonists such as phencyclidine (PCP) to rodents causes long-lasting deficits in cognition and memory, and has effects on behaviors that have been suggested to be models of the cognitive impairment associated with schizophrenia (CIAS). Despite this being a widely studied animal model, little is known about the long lasting changes in synapses and circuits that underlie the altered behaviors. Here we examined synaptic transmission ex-vivo in the hippocampus of mice after a subchronic PCP (scPCP) administration regime. We found that after at least one week of drug free washout period when mice have impaired cognitive function, the threshold for long-term potentiation (LTP) of CA1 excitatory synapses was elevated. This elevated LTP threshold was directly related to increased inhibitory input to CA1 pyramidal cells through increased activity of GABAergic neurons. These results suggest repeated PCP administration causes a long-lasting metaplastic change in the inhibitory circuits in the hippocampus that results in impaired LTP, and could contribute to the deficits in hippocampal-dependent memory in PCP-treated mice. Changes in GABA signaling have been described in patients with schizophrenia, therefore our results support using scPCP as a model of CIAS. This article is part of the Special Issue entitled 'Synaptopathy--from Biology to Therapy'.
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Affiliation(s)
- Toshihiro Nomura
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Yoshihiro Oyamada
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Sumitomo Dainippon Pharma Co., Ltd., 33-94 Enoki-cho, Suita, Osaka 564-0053, Japan
| | - Herman B Fernandes
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Christine L Remmers
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jian Xu
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Herbert Y Meltzer
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Anis Contractor
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL 60611, USA.
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Duan HF, Gan JL, Yang JM, Cheng ZX, Gao CY, Shi ZJ, Zhu XQ, Liang XJ, Zhao LM. A longitudinal study on intrinsic connectivity of hippocampus associated with positive symptom in first-episode schizophrenia. Behav Brain Res 2015; 283:78-86. [PMID: 25619684 DOI: 10.1016/j.bbr.2015.01.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/10/2015] [Accepted: 01/14/2015] [Indexed: 11/16/2022]
Abstract
Hippocampal pathology has been considered to underlie clinical, functional and cognitive impairments in schizophrenia. While longitudinal magnetic resonance imaging (MRI) studies have demonstrated progressive gray matter reduction of the hippocampus during the early phases of schizophrenia (SCZ), very little is known about whether functional connectivity (FC) between the hippocampus and other brain regions also exhibit progressive changes. In this study, resting state functional MRI (fMRI) was used to examine changes in hippocampal connectivity at baseline and follow-up scans comparing 68 patients with first episode SCZ and 62 matched controls. At baseline and follow-up, in the bilateral hippocampal network, SCZ mainly showed decreased FC with bilateral cerebellum posterior lobe, frontal gyrus temporal gyrus, precuneus, and cingulate cortex compared to controls. Furthermore, in the bilateral hippocampus, there was a significant interaction effect of group and time for FC with cerebellum posterior lobe, temporal gyrus, frontal gyrus, and posterior cingulate cortex. Interestingly, longitudinal changes of bilateral hippocampal connectivity with right middle frontal gyrus negatively correlated with positive symptom scores in SCZ. These results provide novel evidence for the progressive changes of FC between hippocampus and other brain regions in SCZ. It further suggests that longitudinal changes of bilateral hippocampal connectivity with right middle frontal gyrus can contribute to the formation and emergence of positive symptom of SCZ.
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Affiliation(s)
- Hui-Feng Duan
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Jing-Li Gan
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China.
| | - Jia-Ming Yang
- Center for Medical Imaging, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Zheng-Xiang Cheng
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Cun-You Gao
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Zhen-Juan Shi
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Xi-Quan Zhu
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Xue-Jun Liang
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
| | - Lan-Min Zhao
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo 454003, Henan Province, PR China
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McHugo M, Rogers BP, Talati P, Woodward ND, Heckers S. Increased Amplitude of Low Frequency Fluctuations but Normal Hippocampal-Default Mode Network Connectivity in Schizophrenia. Front Psychiatry 2015; 6:92. [PMID: 26157396 PMCID: PMC4478381 DOI: 10.3389/fpsyt.2015.00092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/10/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Clinical and preclinical studies have established that the hippocampus is hyperactive in schizophrenia, making it a possible biomarker for drug development. Increased hippocampal connectivity, which can be studied conveniently with resting state imaging, has been proposed as a readily accessible corollary of hippocampal hyperactivity. Here, we tested the hypothesis that hippocampal activity and connectivity are increased in patients with schizophrenia. METHODS Sixty-three schizophrenia patients and 71 healthy control subjects completed a resting state functional magnetic resonance imaging scan. We assessed hippocampal activity with the amplitude of low frequency fluctuations. We analyzed hippocampal functional connectivity with the default mode network using three common methods: group and single subject level independent component analysis, and seed-based functional connectivity. RESULTS In patients with schizophrenia, we observed increased amplitude of low frequency fluctuations but normal hippocampal connectivity using independent component and seed-based analyses. CONCLUSION Our results indicate that although intrinsic hippocampal activity may be increased in schizophrenia, this finding does not extend to functional connectivity. Neuroimaging methods that directly assess hippocampal activity may be more promising for the identification of a biomarker for schizophrenia.
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Affiliation(s)
- Maureen McHugo
- Department of Psychiatry, Vanderbilt University , Nashville, TN , USA
| | - Baxter P Rogers
- Institute of Imaging Sciences, Vanderbilt University , Nashville, TN , USA
| | - Pratik Talati
- Department of Psychiatry, Vanderbilt University , Nashville, TN , USA ; Vanderbilt Brain Institute, Vanderbilt University , Nashville, TN , USA
| | - Neil D Woodward
- Department of Psychiatry, Vanderbilt University , Nashville, TN , USA
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University , Nashville, TN , USA
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Zhuo C, Zhu J, Qin W, Qu H, Ma X, Tian H, Xu Q, Yu C. Functional connectivity density alterations in schizophrenia. Front Behav Neurosci 2014; 8:404. [PMID: 25477799 PMCID: PMC4237131 DOI: 10.3389/fnbeh.2014.00404] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/05/2014] [Indexed: 11/30/2022] Open
Abstract
Background: Schizophrenia is characterized by altered resting-state functional connectivity. Most previous studies have focused on changes in connectivity strengths; however, the alterations in connectivity density in schizophrenia remain largely unknown. Here, we aimed to investigate changes in resting-state functional connectivity density (rsFCD) in schizophrenia. Methods: A total of 95 schizophrenia patients and 93 sex- and age-matched healthy controls (HCs) underwent resting-state functional MRI examinations. The rsFCD, which reflects the total number of functional connections between a given brain voxel and all other voxels in the entire brain, was calculated for each voxel of each subject. Voxel-based comparisons were performed to identify brain regions with significant rsFCD differences between patients and controls (P < 0.05, corrected). Results: Compared with HCs, patients with schizophrenia showed significantly increased rsFCD in the bilateral striatum and hippocampus and significantly decreased rsFCD in the bilateral sensorimotor cortices and right occipital cortex. However, the rsFCD values of these brain regions were not correlated with antipsychotic dosage, illness duration, or clinical symptom severity. Conclusions: The striatal and hippocampal regions and parietal-occipital regions exhibited completely different changes in rsFCD in schizophrenia, which roughly correspond to dopamine activity in these regions in schizophrenia. These findings support the connectivity disorder hypothesis of schizophrenia and increase our understanding of the neural mechanisms of schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital Tianjin, China ; Functional Neuroimaging Laboratory, Department of Psychiatry, Tianjin Mental Health Center, Tianjin Anding Hospital Tianjin, China ; Tianjin Anning Hospital Tianjin, China
| | - Jiajia Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital Tianjin, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital Tianjin, China
| | - Hongru Qu
- Tianjin Anning Hospital Tianjin, China
| | | | - Hongjun Tian
- Functional Neuroimaging Laboratory, Department of Psychiatry, Tianjin Mental Health Center, Tianjin Anding Hospital Tianjin, China
| | | | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital Tianjin, China
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