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Schmitt JE, DeBevits JJ, Roalf DR, Ruparel K, Gallagher RS, Gur RC, Alexander-Bloch A, Eom TY, Alam S, Steinberg J, Akers W, Khairy K, Crowley TB, Emanuel B, Zakharenko SS, McDonald-McGinn DM, Gur RE. A Comprehensive Analysis of Cerebellar Volumes in the 22q11.2 Deletion Syndrome. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:79-90. [PMID: 34848384 PMCID: PMC9162086 DOI: 10.1016/j.bpsc.2021.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The presence of a 22q11.2 microdeletion (22q11.2 deletion syndrome [22q11DS]) ranks among the greatest known genetic risk factors for the development of psychotic disorders. There is emerging evidence that the cerebellum is important in the pathophysiology of psychosis. However, there is currently limited information on cerebellar neuroanatomy in 22q11DS specifically. METHODS High-resolution 3T magnetic resonance imaging was acquired in 79 individuals with 22q11DS and 70 typically developing control subjects (N = 149). Lobar and lobule-level cerebellar volumes were estimated using validated automated segmentation algorithms, and subsequently group differences were compared. Hierarchical clustering, principal component analysis, and graph theoretical models were used to explore intercerebellar relationships. Cerebrocerebellar structural connectivity with cortical thickness was examined via linear regression models. RESULTS Individuals with 22q11DS had, on average, 17.3% smaller total cerebellar volumes relative to typically developing subjects (p < .0001). The lobules of the superior posterior cerebellum (e.g., VII and VIII) were particularly affected in 22q11DS. However, all cerebellar lobules were significantly smaller, even after adjusting for total brain volumes (all cerebellar lobules p < .0002). The superior posterior lobule was disproportionately associated with cortical thickness in the frontal lobes and cingulate cortex, brain regions known be affected in 22q11DS. Exploratory analyses suggested that the superior posterior lobule, particularly Crus I, may be associated with psychotic symptoms in 22q11DS. CONCLUSIONS The cerebellum is a critical but understudied component of the 22q11DS neuroendophenotype.
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Affiliation(s)
- J Eric Schmitt
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania; Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - John J DeBevits
- Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - David R Roalf
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - R Sean Gallagher
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Aaron Alexander-Bloch
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania
| | - Tae-Yeon Eom
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Shahinur Alam
- Center for Bioimage Informatics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jeffrey Steinberg
- Center for Bioimage Informatics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Walter Akers
- Center for Bioimage Informatics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Khaled Khairy
- Center for In Vivo Imaging and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - T Blaine Crowley
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beverly Emanuel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stanislav S Zakharenko
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Donna M McDonald-McGinn
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Raquel E Gur
- Brain Behavior Laboratory, Neurodevelopment and Psychosis Section, Department of Psychiatry, Philadelphia, Pennsylvania; Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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2
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Bortolin K, Delavari F, Preti MG, Sandini C, Mancini V, Mullier E, Van De Ville D, Eliez S. Neural substrates of psychosis revealed by altered dependencies between brain activity and white-matter architecture in individuals with 22q11 deletion syndrome. NEUROIMAGE: CLINICAL 2022; 35:103075. [PMID: 35717884 PMCID: PMC9218553 DOI: 10.1016/j.nicl.2022.103075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/10/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022] Open
Abstract
Function-structural dependency is altered in patients with 22q11 deletion syndrome. Stronger dependency in subcortical regions correlates with psychotic symptoms. Weaker dependency in cingulate cortex correlates with psychotic symptoms. Multimodal and not unimodal indexes were correlated with psychosis emergence.
Background Dysconnectivity has been consistently proposed as a major key mechanism in psychosis. Indeed, disruptions in large-scale structural and functional brain networks have been associated with psychotic symptoms. However, brain activity is largely constrained by underlying white matter pathways and the study of function-structure dependency, compared to conventional unimodal analysis, allows a biologically relevant assessment of neural mechanisms. The 22q11.2 deletion syndrome (22q11DS) constitutes a remarkable opportunity to study the pathophysiological processes of psychosis. Methods 58 healthy controls and 57 deletion carriers, aged from 16 to 32 years old, underwent resting-state functional and diffusion-weighted magnetic resonance imaging. Deletion carriers were additionally fully assessed for psychotic symptoms. Firstly, we used a graph signal processing method to combine brain activity and structural connectivity measures to obtain regional structural decoupling indexes (SDIs). We use SDI to assess the differences of functional structural dependency (FSD) across the groups. Subsequently we investigated how alterations in FSDs are associated with the severity of positive psychotic symptoms in participants with 22q11DS. Results In line with previous findings, participants in both groups showed a spatial gradient of FSD ranging from sensory-motor regions (stronger FSD) to regions involved in higher-order function (weaker FSD). Compared to controls, in participants with 22q11DS, and further in deletion carriers with more severe positive psychotic symptoms, the functional activity was more strongly dependent on the structure in parahippocampal gyrus and subcortical dopaminergic regions, while it was less dependent within the cingulate cortex. This analysis revealed group differences not otherwise detected when assessing the structural and functional nodal measures separately. Conclusions Our findings point toward a disrupted modulation of functional activity on the underlying structure, which was further associated to psychopathology for candidate critical regions in 22q11DS. This study provides the first evidence for the clinical relevance of function-structure dependency and its contribution to the emergence of psychosis.
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Affiliation(s)
- Karin Bortolin
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland; Medical Image Processing Laboratory, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Farnaz Delavari
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland; Medical Image Processing Laboratory, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Maria Giulia Preti
- Medical Image Processing Laboratory, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Lausanne, Switzerland.
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
| | - Valentina Mancini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
| | - Emeline Mullier
- Autism Brain and Behavior Laboratory, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Medical Image Processing Laboratory, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Lausanne, Switzerland.
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland; Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland.
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3
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Age-Related Improvements in Executive Functions and Focal Attention in 22q11.2 Deletion Syndrome Vary Across Domain and Task. J Int Neuropsychol Soc 2022; 28:337-350. [PMID: 33952381 DOI: 10.1017/s135561772100059x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Executive functions (EF) and focal attention have been identified as a weakness in the profile of 22q11.2 deletion syndrome (22q11DS). However, due to a high variety of tasks used across previous studies, it remains unclear whether impairments may be more pronounced for specific subdomains of EF and focal attention. Furthermore, age-related changes have only been examined in a few studies, so far only yielding a partial view of the overall developmental profile. METHOD In a broad age range (8-35 years) composed of longitudinal data, 183 participants (103 diagnosed with 22q11DS) completed an extensive assessment of EF and attention. To get a more comprehensive overview of specific versus global impairments, several tasks were assessed within multiple domains. RESULTS Results suggest differential impairments and trajectories in specific EF subdomains. Specifically, our findings suggest that individuals with 22q11DS not only showed lower overall inhibition skills, but also that initiation skills developed at a slower pace compared to healthy controls. Results are less clear regarding cognitive flexibility, updating and focal attention, for which performance strongly depended on the tasks that was selected to assess the domain. CONCLUSIONS Findings confirm and extend knowledge on differential developmental patterns of EF and attention domains in 22q11DS. They further stress the necessity to administer extensive, multifaceted evaluations to gain a more reliable overview of patients' cognitive profile.
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Pelgrim TAD, Bossong MG, Cuiza A, Alliende LM, Mena C, Tepper A, Ramirez-Mahaluf JP, Iruretagoyena B, Ornstein C, Fritsch R, Cruz JP, Tejos C, Repetto G, Crossley N. Abnormal nodal and global network organization in resting state functional MRI from subjects with the 22q11 deletion syndrome. Sci Rep 2021; 11:21623. [PMID: 34732759 PMCID: PMC8566599 DOI: 10.1038/s41598-021-00873-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/05/2021] [Indexed: 12/31/2022] Open
Abstract
The 22q11 deletion syndrome is a genetic disorder associated with a high risk of developing psychosis, and is therefore considered a neurodevelopmental model for studying the pathogenesis of schizophrenia. Studies have shown that localized abnormal functional brain connectivity is present in 22q11 deletion syndrome like in schizophrenia. However, it is less clear whether these abnormal cortical interactions lead to global or regional network disorganization as seen in schizophrenia. We analyzed from a graph-theory perspective fMRI data from 40 22q11 deletion syndrome patients and 67 healthy controls, and reconstructed functional networks from 105 brain regions. Between-group differences were examined by evaluating edge-wise strength and graph theoretical metrics of local (weighted degree, nodal efficiency, nodal local efficiency) and global topological properties (modularity, local and global efficiency). Connectivity strength was globally reduced in patients, driven by a large network comprising 147 reduced connections. The 22q11 deletion syndrome network presented with abnormal local topological properties, with decreased local efficiency and reductions in weighted degree particularly in hub nodes. We found evidence for abnormal integration but intact segregation of the 22q11 deletion syndrome network. Results suggest that 22q11 deletion syndrome patients present with similar aberrant local network organization as seen in schizophrenia, and this network configuration might represent a vulnerability factor to psychosis.
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Affiliation(s)
- Teuntje A D Pelgrim
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Analía Cuiza
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luz María Alliende
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Mena
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Angeles Tepper
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Claudia Ornstein
- Departamento de Psiquiatria y Salud Mental, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Rosemarie Fritsch
- Departamento de Psiquiatria y Salud Mental, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Juan Pablo Cruz
- Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Tejos
- Department of Electrical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile
- Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriela Repetto
- Genetic and Genomic Center, Universidad del Desarrollo, Santiago, Chile
| | - Nicolas Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile.
- Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Escuela de Medicina, Pontificia Universidad Católica, Diagonal Paraguay 362, Santiago, Chile.
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Zöller D, Sandini C, Schaer M, Eliez S, Bassett DS, Van De Ville D. Structural control energy of resting-state functional brain states reveals less cost-effective brain dynamics in psychosis vulnerability. Hum Brain Mapp 2021; 42:2181-2200. [PMID: 33566395 PMCID: PMC8046160 DOI: 10.1002/hbm.25358] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/01/2020] [Accepted: 01/05/2021] [Indexed: 12/19/2022] Open
Abstract
How the brain's white-matter anatomy constrains brain activity is an open question that might give insights into the mechanisms that underlie mental disorders such as schizophrenia. Chromosome 22q11.2 deletion syndrome (22q11DS) is a neurodevelopmental disorder with an extremely high risk for psychosis providing a test case to study developmental aspects of schizophrenia. In this study, we used principles from network control theory to probe the implications of aberrant structural connectivity for the brain's functional dynamics in 22q11DS. We retrieved brain states from resting-state functional magnetic resonance images of 78 patients with 22q11DS and 85 healthy controls. Then, we compared them in terms of persistence control energy; that is, the control energy that would be required to persist in each of these states based on individual structural connectivity and a dynamic model. Persistence control energy was altered in a broad pattern of brain states including both energetically more demanding and less demanding brain states in 22q11DS. Further, we found a negative relationship between persistence control energy and resting-state activation time, which suggests that the brain reduces energy by spending less time in energetically demanding brain states. In patients with 22q11DS, this behavior was less pronounced, suggesting a deficiency in the ability to reduce energy through brain activation. In summary, our results provide initial insights into the functional implications of altered structural connectivity in 22q11DS, which might improve our understanding of the mechanisms underlying the disease.
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Affiliation(s)
- Daniela Zöller
- Medical Image Processing LaboratoryInstitute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
- Department of Radiology and Medical InformaticsUniversity of GenevaGenevaSwitzerland
- Institute of Neuromodulation and NeurotechnologyUniversity of TübingenTübingenGermany
- Developmental Imaging an Psychopathology Laboratory, Department of PsychiatryUniversity of GenevaGenevaSwitzerland
| | - Corrado Sandini
- Institute of Neuromodulation and NeurotechnologyUniversity of TübingenTübingenGermany
| | - Marie Schaer
- Institute of Neuromodulation and NeurotechnologyUniversity of TübingenTübingenGermany
| | - Stephan Eliez
- Institute of Neuromodulation and NeurotechnologyUniversity of TübingenTübingenGermany
| | - Danielle S. Bassett
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Electrical & Systems EngineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Physics & AstronomyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Dimitri Van De Ville
- Medical Image Processing LaboratoryInstitute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
- Department of Radiology and Medical InformaticsUniversity of GenevaGenevaSwitzerland
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6
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Bagautdinova J, Padula MC, Zöller D, Sandini C, Schneider M, Schaer M, Eliez S. Identifying neurodevelopmental anomalies of white matter microstructure associated with high risk for psychosis in 22q11.2DS. Transl Psychiatry 2020; 10:408. [PMID: 33235187 PMCID: PMC7686319 DOI: 10.1038/s41398-020-01090-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/25/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022] Open
Abstract
Disruptions of white matter microstructure have been widely reported in schizophrenia. However, the emergence of these alterations during preclinical stages remains poorly understood. 22q11.2 Deletion Syndrome (22q11.2DS) represents a unique model to study the interplay of different risk factors that may impact neurodevelopment in premorbid psychosis. To identify the impact of genetic predisposition for psychosis on white matter development, we acquired longitudinal MRI data in 201 individuals (22q11.2DS = 101; controls = 100) aged 5-35 years with 1-3 time points and reconstructed 18 white matter tracts using TRACULA. Mixed model regression was used to characterize developmental trajectories of four diffusion measures-fractional anisotropy (FA), axial (AD), radial (RD), and mean diffusivity (MD) in each tract. To disentangle the impact of additional environmental and developmental risk factors on white matter maturation, we used a multivariate approach (partial least squares (PLS) correlation) in a subset of 39 individuals with 22q11.2DS. Results revealed no divergent white matter developmental trajectories in patients with 22q11.2DS compared to controls. However, 22q11.2DS showed consistently increased FA and reduced AD, RD, and MD in most white matter tracts. PLS correlation further revealed a significant white matter-clinical risk factors relationship. These results indicate that while age-related changes are preserved in 22q11.2DS, white matter microstructure is widely disrupted, suggesting that genetic high risk for psychosis involves early occurring neurodevelopmental insults. In addition, multivariate modeling showed that clinical risk factors further impact white matter development. Together, these findings suggest that genetic, developmental, and environmental risk factors may play a cumulative role in altering normative white matter development during premorbid stages of psychosis.
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Affiliation(s)
- Joëlle Bagautdinova
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
| | - Maria C Padula
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
- Medical Image Processing Laboratory, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Institute of Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, University of Tübingen, Tübingen, Germany
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
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7
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Heller C, Steinmann S, Levitt JJ, Makris N, Antshel KM, Fremont W, Coman IL, Schweinberger SR, Weiß T, Bouix S, Kubicki MR, Kates WR, Kikinis Z. Abnormalities in white matter tracts in the fronto-striatal-thalamic circuit are associated with verbal performance in 22q11.2DS. Schizophr Res 2020; 224:141-150. [PMID: 33268158 PMCID: PMC7727455 DOI: 10.1016/j.schres.2020.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/13/2020] [Accepted: 09/14/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Abnormalities in fronto-striatal-thalamic (FST) sub-circuits are present in schizophrenia and are associated with cognitive impairments. However, it remains unknown whether abnormalities in FST sub-circuits are present before psychosis onset. This may be elucidated by investigating 22q11.2 deletion syndrome (22q11DS), a genetic syndrome associated with a 30% risk for developing schizophrenia in adulthood and a decline in Verbal IQ (VIQ) preceding psychosis onset. Here, we examined white matter (WM) tracts in FST sub-circuits, especially those in the dorsolateral (DLPFC) and ventrolateral prefrontal cortex (VLPFC) sub-circuits, and their associations with VIQ in young adults with 22q11DS. METHODS Diffusion MRI scans were acquired from 21 individuals with 22q11DS with prodromal symptoms of schizophrenia, 30 individuals with 22q11DS without prodromal symptoms, and 30 healthy controls (mean age: 21 ± 2 years). WM tracts were reconstructed between striatum and thalamus with rostral middle frontal gyrus (rMFG) and inferior frontal gyrus (IFG), representing DLPFC and VLPFC respectively. Fractional anisotropy (FA) and radial diffusivity (RD) were used for group comparisons. VIQ was assessed and associations with the diffusion measures were evaluated. RESULTS FA was significantly increased and RD decreased in most tracts of the DLPFC and VLPFC sub-circuits in 22q11DS. Verbal IQ scores correlated negatively with FA and, at trend level, positively with RD in the right thalamus-IFG tract in 22q11DS with prodromal symptoms. CONCLUSIONS While abnormalities in FST sub-circuits are associated with schizophrenia, we observed that these abnormalities are also present in 22q11DS individuals with prodromal symptoms and are associated with verbal performance in the right thalamus-IFG tract.
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Affiliation(s)
- Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; Department of Clinical Psychology, Friedrich-Schiller-University Jena, Germany.
| | - Saskia Steinmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - James J. Levitt
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kevin M. Antshel
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA,Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Wanda Fremont
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ioana L. Coman
- Department of Computer Science, SUNY Oswego, Oswego, NY, USA
| | | | - Thomas Weiß
- Department of Clinical Psychology, Friedrich Schiller University Jena, Germany
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek R. Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Wendy R. Kates
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Zora Kikinis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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8
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Dima DC, Adams R, Linden SC, Baird A, Smith J, Foley S, Perry G, Routley BC, Magazzini L, Drakesmith M, Williams N, Doherty J, van den Bree MBM, Owen MJ, Hall J, Linden DEJ, Singh KD. Electrophysiological network alterations in adults with copy number variants associated with high neurodevelopmental risk. Transl Psychiatry 2020; 10:324. [PMID: 32958742 PMCID: PMC7506525 DOI: 10.1038/s41398-020-00998-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/04/2020] [Indexed: 12/20/2022] Open
Abstract
Rare copy number variants associated with increased risk for neurodevelopmental and psychiatric disorders (referred to as ND-CNVs) are characterized by heterogeneous phenotypes thought to share a considerable degree of overlap. Altered neural integration has often been linked to psychopathology and is a candidate marker for potential convergent mechanisms through which ND-CNVs modify risk; however, the rarity of ND-CNVs means that few studies have assessed their neural correlates. Here, we used magnetoencephalography (MEG) to investigate resting-state oscillatory connectivity in a cohort of 42 adults with ND-CNVs, including deletions or duplications at 22q11.2, 15q11.2, 15q13.3, 16p11.2, 17q12, 1q21.1, 3q29, and 2p16.3, and 42 controls. We observed decreased connectivity between occipital, temporal, and parietal areas in participants with ND-CNVs. This pattern was common across genotypes and not exclusively characteristic of 22q11.2 deletions, which were present in a third of our cohort. Furthermore, a data-driven graph theory framework enabled us to successfully distinguish participants with ND-CNVs from unaffected controls using differences in node centrality and network segregation. Together, our results point to alterations in electrophysiological connectivity as a putative common mechanism through which genetic factors confer increased risk for neurodevelopmental and psychiatric disorders.
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Affiliation(s)
- Diana C Dima
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK.
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK.
| | - Rachael Adams
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Stefanie C Linden
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Alister Baird
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Jacqueline Smith
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Gavin Perry
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Bethany C Routley
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Lorenzo Magazzini
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Mark Drakesmith
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Nigel Williams
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Joanne Doherty
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Marianne B M van den Bree
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Michael J Owen
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - David E J Linden
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Neuroscience and Mental Health Research Institute (NMHRI), Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Krish D Singh
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
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9
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Sun D, Ching CRK, Lin A, Forsyth JK, Kushan L, Vajdi A, Jalbrzikowski M, Hansen L, Villalon-Reina JE, Qu X, Jonas RK, van Amelsvoort T, Bakker G, Kates WR, Antshel KM, Fremont W, Campbell LE, McCabe KL, Daly E, Gudbrandsen M, Murphy CM, Murphy D, Craig M, Vorstman J, Fiksinski A, Koops S, Ruparel K, Roalf DR, Gur RE, Schmitt JE, Simon TJ, Goodrich-Hunsaker NJ, Durdle CA, Bassett AS, Chow EWC, Butcher NJ, Vila-Rodriguez F, Doherty J, Cunningham A, van den Bree MB, Linden DEJ, Moss H, Owen MJ, Murphy KC, McDonald-McGinn DM, Emanuel B, van Erp TGM, Turner JA, Thompson PM, Bearden CE. Large-scale mapping of cortical alterations in 22q11.2 deletion syndrome: Convergence with idiopathic psychosis and effects of deletion size. Mol Psychiatry 2020; 25:1822-1834. [PMID: 29895892 PMCID: PMC6292748 DOI: 10.1038/s41380-018-0078-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 04/15/2018] [Accepted: 04/23/2018] [Indexed: 11/11/2022]
Abstract
The 22q11.2 deletion (22q11DS) is a common chromosomal microdeletion and a potent risk factor for psychotic illness. Prior studies reported widespread cortical changes in 22q11DS, but were generally underpowered to characterize neuroanatomic abnormalities associated with psychosis in 22q11DS, and/or neuroanatomic effects of variability in deletion size. To address these issues, we developed the ENIGMA (Enhancing Neuro Imaging Genetics Through Meta-Analysis) 22q11.2 Working Group, representing the largest analysis of brain structural alterations in 22q11DS to date. The imaging data were collected from 10 centers worldwide, including 474 subjects with 22q11DS (age = 18.2 ± 8.6; 46.9% female) and 315 typically developing, matched controls (age = 18.0 ± 9.2; 45.9% female). Compared to controls, 22q11DS individuals showed thicker cortical gray matter overall (left/right hemispheres: Cohen's d = 0.61/0.65), but focal thickness reduction in temporal and cingulate cortex. Cortical surface area (SA), however, showed pervasive reductions in 22q11DS (left/right hemispheres: d = -1.01/-1.02). 22q11DS cases vs. controls were classified with 93.8% accuracy based on these neuroanatomic patterns. Comparison of 22q11DS-psychosis to idiopathic schizophrenia (ENIGMA-Schizophrenia Working Group) revealed significant convergence of affected brain regions, particularly in fronto-temporal cortex. Finally, cortical SA was significantly greater in 22q11DS cases with smaller 1.5 Mb deletions, relative to those with typical 3 Mb deletions. We found a robust neuroanatomic signature of 22q11DS, and the first evidence that deletion size impacts brain structure. Psychotic illness in this highly penetrant deletion was associated with similar neuroanatomic abnormalities to idiopathic schizophrenia. These consistent cross-site findings highlight the homogeneity of this single genetic etiology, and support the suitability of 22q11DS as a biological model of schizophrenia.
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Affiliation(s)
- Daqiang Sun
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA ,0000 0001 0384 5381grid.417119.bDepartment of Mental Health, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA USA
| | - Christopher R. K. Ching
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA ,0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA USA ,0000 0000 9632 6718grid.19006.3eInterdepartmental Neuroscience Program, University of California, Los Angeles, Los Angeles, CA USA
| | - Amy Lin
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA ,0000 0000 9632 6718grid.19006.3eInterdepartmental Neuroscience Program, University of California, Los Angeles, Los Angeles, CA USA
| | - Jennifer K. Forsyth
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA ,0000 0000 9632 6718grid.19006.3eDepartment of Psychology, University of California, Los Angeles, Los Angeles, CA USA
| | - Leila Kushan
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA
| | - Ariana Vajdi
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA
| | - Maria Jalbrzikowski
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - Laura Hansen
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA
| | - Julio E. Villalon-Reina
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA USA
| | - Xiaoping Qu
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA USA
| | - Rachel K. Jonas
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA ,0000 0000 9632 6718grid.19006.3eInterdepartmental Neuroscience Program, University of California, Los Angeles, Los Angeles, CA USA
| | - Therese van Amelsvoort
- 0000 0001 0481 6099grid.5012.6Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Geor Bakker
- 0000 0001 0481 6099grid.5012.6Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Wendy R. Kates
- 0000 0000 9159 4457grid.411023.5Department of Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY USA
| | - Kevin M. Antshel
- 0000 0001 2189 1568grid.264484.8Department of Psychology, Syracuse University, Syracuse, NY USA
| | - Wanda Fremont
- 0000 0000 9159 4457grid.411023.5Department of Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY USA
| | - Linda E. Campbell
- 0000 0000 8831 109Xgrid.266842.cPRC GrowUpWell, University of Newcastle, Newcastle, Australia ,0000 0000 8831 109Xgrid.266842.cSchool of Psychology, University of Newcastle, Newcastle, Australia
| | - Kathryn L. McCabe
- 0000 0000 8831 109Xgrid.266842.cSchool of Psychology, University of Newcastle, Newcastle, Australia ,0000 0004 1936 9684grid.27860.3bUC Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, Davis, CA USA
| | - Eileen Daly
- 0000 0001 2322 6764grid.13097.3cSackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Maria Gudbrandsen
- 0000 0001 2322 6764grid.13097.3cSackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Clodagh M. Murphy
- 0000 0001 2322 6764grid.13097.3cSackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK ,0000 0004 0581 2008grid.451052.7Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust, London, UK
| | - Declan Murphy
- 0000 0001 2322 6764grid.13097.3cSackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK ,0000 0004 0581 2008grid.451052.7Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust, London, UK
| | - Michael Craig
- 0000 0001 2322 6764grid.13097.3cSackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK ,0000 0004 0581 2008grid.451052.7National Autism Unit, Bethlem Royal Hospital, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust, London, UK
| | - Jacob Vorstman
- 0000 0004 0473 9646grid.42327.30Hospital for Sick Children, Toronto, ON Canada ,0000000090126352grid.7692.aDepartment of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Ania Fiksinski
- 0000 0004 0473 9646grid.42327.30Hospital for Sick Children, Toronto, ON Canada ,0000 0000 8793 5925grid.155956.bClinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, University of Toronto, Toronto, ON Canada ,0000 0004 0474 0428grid.231844.8The Dalglish Family 22q Clinic, Department of Psychiatry, and Toronto General Research Institute, University Health Network, Toronto, ON Canada ,0000 0000 8793 5925grid.155956.bCampbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Sanne Koops
- 0000000090126352grid.7692.aDepartment of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kosha Ruparel
- 0000 0001 0680 8770grid.239552.aDepartment of Psychiatry, University of Pennsylvania, and the Lifespan Brain Institute, Penn Medicine and the Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - David R. Roalf
- 0000 0001 0680 8770grid.239552.aDepartment of Psychiatry, University of Pennsylvania, and the Lifespan Brain Institute, Penn Medicine and the Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Raquel E. Gur
- 0000 0004 1936 8972grid.25879.31Department of Radiology, Division of Neuroradiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA ,0000 0001 0680 8770grid.239552.aDepartment of Psychiatry, University of Pennsylvania, and the Lifespan Brain Institute, Penn Medicine and the Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - J. Eric Schmitt
- 0000 0004 1936 8972grid.25879.31Department of Radiology, Division of Neuroradiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA ,0000 0001 0680 8770grid.239552.aDepartment of Psychiatry, University of Pennsylvania, and the Lifespan Brain Institute, Penn Medicine and the Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Tony J. Simon
- 0000 0004 1936 9684grid.27860.3bUC Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, Davis, CA USA
| | - Naomi J. Goodrich-Hunsaker
- 0000 0004 1936 9684grid.27860.3bUC Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, Davis, CA USA ,0000 0004 1936 9115grid.253294.bDepartment of Psychology, Brigham Young University, Provo, UT USA
| | - Courtney A. Durdle
- 0000 0004 1936 9684grid.27860.3bUC Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, Davis, CA USA
| | - Anne S. Bassett
- 0000 0000 8793 5925grid.155956.bClinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, University of Toronto, Toronto, ON Canada ,0000 0004 0474 0428grid.231844.8The Dalglish Family 22q Clinic, Department of Psychiatry, and Toronto General Research Institute, University Health Network, Toronto, ON Canada ,0000 0000 8793 5925grid.155956.bCampbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Eva W. C. Chow
- 0000 0000 8793 5925grid.155956.bClinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Nancy J. Butcher
- 0000 0004 0473 9646grid.42327.30Hospital for Sick Children, Toronto, ON Canada ,0000 0000 8793 5925grid.155956.bClinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Fidel Vila-Rodriguez
- 0000 0001 2288 9830grid.17091.3eDepartment of Psychiatry, University of British Columbia, Vancouver, British Columbia Canada
| | - Joanne Doherty
- 0000 0001 0807 5670grid.5600.3MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Adam Cunningham
- 0000 0001 0807 5670grid.5600.3MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Marianne B.M. van den Bree
- 0000 0001 0807 5670grid.5600.3MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - David E. J. Linden
- 0000 0001 0807 5670grid.5600.3MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Hayley Moss
- 0000 0001 0807 5670grid.5600.3MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael J. Owen
- 0000 0001 0807 5670grid.5600.3MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Kieran C. Murphy
- 0000 0004 0488 7120grid.4912.eDepartment of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Donna M. McDonald-McGinn
- 0000 0001 0680 8770grid.239552.aDivision of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania USA ,0000 0004 1936 8972grid.25879.31Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA ,0000 0001 0680 8770grid.239552.aDivision of Clinical Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania USA
| | - Beverly Emanuel
- 0000 0004 1936 8972grid.25879.31Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA ,0000 0001 0680 8770grid.239552.aDivision of Clinical Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania USA
| | - Theo G. M. van Erp
- 0000 0001 0668 7243grid.266093.8Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA USA
| | - Jessica A. Turner
- 0000 0004 1936 7400grid.256304.6Imaging Genetics and Neuroinformatics Lab, Department of Psychology, Georgia State University, Atlanta, GA USA ,0000 0004 0409 4614grid.280503.cMind Research Network, Albuquerque, NM USA
| | - Paul M. Thompson
- 0000 0001 2156 6853grid.42505.36Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA USA ,0000 0001 2156 6853grid.42505.36Departments of Neurology, Psychiatry, Radiology, Engineering, Pediatrics and Ophthalmology, University of Southern California, California, CA USA
| | - Carrie E. Bearden
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA USA ,0000 0000 9632 6718grid.19006.3eDepartment of Psychology, University of California, Los Angeles, Los Angeles, CA USA
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10
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Maeder J, Sandini C, Zöller D, Schneider M, Bostelmann M, Pouillard V, Caroni P, Kliegel M, Eliez S. [Formula: see text] Long-term verbal memory deficit and associated hippocampal alterations in 22q11.2 deletion syndrome. Child Neuropsychol 2019; 26:289-311. [PMID: 31460828 DOI: 10.1080/09297049.2019.1657392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a genetic disease associated with an increased risk for schizophrenia and a specific cognitive profile. In this paper, we challenge the current view of spared verbal memory in 22q11.2DS by investigating verbal memory consolidation processes over an extended time span to further qualify the neuropsychological profile. Our hypotheses are based on brain anomalies of the medial temporal lobes consistently reported in this syndrome.Eighty-four participants (45 with 22q11.2DS), aged 8-24 years old, completed a verbal episodic memory task to investigate long-term memory on four different time delays. We compared trajectories of forgetting between groups (22q11.2DS vs. controls) and analyzed performance inside the 22q11.2DS sample through cluster analyses. Potential links between memory performance and volume of the hippocampal subfields were examined.We showed accelerated long-term forgetting (ALF) in the 22q11.2DS group, visible after a delay of one day. Using mixed models, we showed significant differences in the shape of memory trajectories between subgroups of participants with 22q11.2DS. These sub-groups differed in terms of memory recognition, intellectual functioning, positive psychotic symptoms and grey matter volume of hippocampal subfields but not in terms of age.In conclusion, by investigating memory processes on longer delays than standardized memory tasks, we identified deficits in long-term memory consolidation leading to ALF in 22q11.2DS. Nevertheless, we showed that a subgroup of patients had larger memory consolidation deficit associated with lower intellectual functioning, higher rates of positive psychotic symptoms and hippocampal alterations.
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Affiliation(s)
- Johanna Maeder
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.,Medical Image Processing Lab, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Neurosciences, KU Leuven, Center for Contextual Psychiatry, Leuven, Belgium
| | - Mathilde Bostelmann
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.,Laboratory of Brain and Cognitive Development, Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Virginie Pouillard
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Pico Caroni
- Friedrich Miescher Institute, Basel, Switzerland
| | - Matthias Kliegel
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
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11
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Larsen KM, Dzafic I, Siebner HR, Garrido MI. Alteration of functional brain architecture in 22q11.2 deletion syndrome – Insights into susceptibility for psychosis. Neuroimage 2019; 190:154-171. [DOI: 10.1016/j.neuroimage.2018.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 12/23/2022] Open
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12
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Fiksinski AM, Schneider M, Murphy CM, Armando M, Vicari S, Canyelles JM, Gothelf D, Eliez S, Breetvelt EJ, Arango C, Vorstman JAS. Understanding the pediatric psychiatric phenotype of 22q11.2 deletion syndrome. Am J Med Genet A 2018; 176:2182-2191. [PMID: 30194907 PMCID: PMC6209526 DOI: 10.1002/ajmg.a.40387] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/22/2018] [Accepted: 06/10/2018] [Indexed: 01/29/2023]
Abstract
The purpose of this article is to provide an overview of current insights into the neurodevelopmental and psychiatric manifestations of 22q11.2 deletion syndrome (22q11DS) in children and adolescents. The pediatric neuropsychiatric expression of 22q11DS is characterized by high variability, both interindividual and intraindividual (different expressions over the lifespan). Besides varying levels of intellectual disability, the prevalence of autism spectrum disorders, attention deficit disorders, anxiety disorders, and psychotic disorders in young individuals with 22q11DS is significantly higher than in the general population, or in individuals with idiopathic intellectual disability. Possible explanations for this observed phenotypic variability will be discussed, including genetic pleiotropy, gene-environment interactions, the age-dependency of phenotypes, but also the impact of assessment and ascertainment bias as well as the limitations of our current diagnostic classification system. The implications inferred by these observations aforementioned bear direct relevance to both scientists and clinicians. Observations regarding the neuropsychiatric manifestations in individuals with 22q11DS exemplify the need for a dimensional approach to neuropsychiatric assessment, in addition to our current categorical diagnostic classification system. The potential usefulness of 22q11DS as a genetic model to study the early phases of schizophrenia as well as the phenomenon of neuropsychiatric pleiotropy observed in many CNV's will be delineated. From a clinical perspective, the importance of regular neuropsychiatric evaluations with attention to symptoms not always captured in diagnostic categories and of maintaining equilibrium between individual difficulties and competencies and environmental demands will be discussed.
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Affiliation(s)
- Ania M Fiksinski
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
- Dalglish Family 22q Clinic for Adults with 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, and Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Clodagh M Murphy
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, Adult Autism and ADHD Service, South London and Maudsley Foundation NHS Trust, London, UK
| | - Marco Armando
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | | | - Doron Gothelf
- Child and Adolescent Psychiatry Unit Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Sagol School of Neuroscience and Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, Geneva, Switzerland
| | - Elemi J Breetvelt
- Dalglish Family 22q Clinic for Adults with 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, and Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Jacob A S Vorstman
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
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13
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Herbet G, Zemmoura I, Duffau H. Functional Anatomy of the Inferior Longitudinal Fasciculus: From Historical Reports to Current Hypotheses. Front Neuroanat 2018; 12:77. [PMID: 30283306 PMCID: PMC6156142 DOI: 10.3389/fnana.2018.00077] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
The inferior longitudinal fasciculus (ILF) is a long-range, associative white matter pathway that connects the occipital and temporal-occipital areas of the brain to the anterior temporal areas. In view of the ILF's anatomic connections, it has been suggested that this pathway has a major role in a relatively large array of brain functions. Until recently, however, the literature data on these potential functions were scarce. Here, we review the key findings of recent anatomic, neuromodulation, and neuropsychological studies. We also summarize reports on how this tract is disrupted in a wide range of brain disorders, including psychopathologic, neurodevelopmental, and neurologic diseases. Our review reveals that the ILF is a multilayered, bidirectional tract involved in processing and modulating visual cues and thus in visually guided decisions and behaviors. Accordingly, sudden disruption of the ILF by neurologic insult is mainly associated with neuropsychological impairments of visual cognition (e.g., visual agnosia, prosopagnosia, and alexia). Furthermore, disruption of the ILF may constitute the pathophysiologic basis for visual hallucinations and socio-emotional impairments in schizophrenia, as well as emotional difficulties in autism spectrum disorder. Degeneration of the ILF in neurodegenerative diseases affecting the temporal lobe may explain (at least in part) the gradual onset of semantic and lexical access difficulties. Although some of the functions mediated by the ILF appear to be relatively lateralized, observations from neurosurgery suggest that disruption of the tract's anterior portion can be dynamically compensated for by the contralateral portion. This might explain why bilateral disruption of the ILF in either acute or progressive disease is highly detrimental in neuropsychological terms.
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Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Ilyess Zemmoura
- Department of Neurosurgery, Tours University Medical Center, Tours, France
- UMR 1253, iBrain, INSERM, University of Tours, Tours, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
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14
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Nuninga JO, Bohlken MM, Koops S, Fiksinski AM, Mandl RCW, Breetvelt EJ, Duijff SN, Kahn RS, Sommer IEC, Vorstman JAS. White matter abnormalities in 22q11.2 deletion syndrome patients showing cognitive decline. Psychol Med 2018; 48:1655-1663. [PMID: 29143717 DOI: 10.1017/s0033291717003142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Decline in cognitive functioning precedes the first psychotic episode in the course of schizophrenia and is considered a hallmark symptom of the disorder. Given the low incidence of schizophrenia, it remains a challenge to investigate whether cognitive decline coincides with disease-related changes in brain structure, such as white matter abnormalities. The 22q11.2 deletion syndrome (22q11DS) is an appealing model in this context, as 25% of patients develop psychosis. Furthermore, we recently showed that cognitive decline also precedes the onset of psychosis in individuals with 22q11DS. Here, we investigate whether the early cognitive decline in patients with 22q11DS is associated with alterations in white matter microstructure. METHODS We compared the fractional anisotropy (FA) of white matter in 22q11DS patients with cognitive decline [n = 16; -18.34 (15.8) VIQ percentile points over 6.80 (2.39) years] to 22q11DS patients without cognitive decline [n = 18; 17.71 (20.17) VIQ percentile points over 5.27 (2.03) years] by applying an atlas-based approach to diffusion-weighted imaging data. RESULTS FA was significantly increased (p < 0.05, FDR) in 22q11DS patients with a cognitive decline in the bilateral superior longitudinal fasciculus, the bilateral cingulum bundle, all subcomponents of the left internal capsule and the left superior frontal-occipital fasciculus as compared with 22q11DS patients without cognitive decline. CONCLUSIONS Within 22q11DS, the early cognitive decline is associated with microstructural differences in white matter. At the mean age of 17.8 years, these changes are reflected in increased FA in several tracts. We hypothesize that similar brain alterations associated with cognitive decline take place early in the trajectory of schizophrenia.
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Affiliation(s)
- Jasper Olivier Nuninga
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - Marc Marijn Bohlken
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - Sanne Koops
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - Ania M Fiksinski
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - René C W Mandl
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - Elemi J Breetvelt
- Dalglish Family Hearts and Minds Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network,Toronto, Ontario,Canada
| | - Sasja N Duijff
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - René S Kahn
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - Iris E C Sommer
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
| | - Jacob A S Vorstman
- Department of Psychiatry,Rudolf Magnus Institute of Neuroscience, University Medical Center,Utrecht,The Netherlands
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15
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Zick JL, Blackman RK, Crowe DA, Amirikian B, DeNicola AL, Netoff TI, Chafee MV. Blocking NMDAR Disrupts Spike Timing and Decouples Monkey Prefrontal Circuits: Implications for Activity-Dependent Disconnection in Schizophrenia. Neuron 2018; 98:1243-1255.e5. [PMID: 29861281 DOI: 10.1016/j.neuron.2018.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 03/06/2018] [Accepted: 05/04/2018] [Indexed: 01/09/2023]
Abstract
We employed multi-electrode array recording to evaluate the influence of NMDA receptors (NMDAR) on spike-timing dynamics in prefrontal networks of monkeys as they performed a cognitive control task measuring specific deficits in schizophrenia. Systemic, periodic administration of an NMDAR antagonist (phencyclidine) reduced the prevalence and strength of synchronous (0-lag) spike correlation in simultaneously recorded neuron pairs. We employed transfer entropy analysis to measure effective connectivity between prefrontal neurons at lags consistent with monosynaptic interactions and found that effective connectivity was persistently reduced following exposure to the NMDAR antagonist. These results suggest that a disruption of spike timing and effective connectivity might be interrelated factors in pathogenesis, supporting an activity-dependent disconnection theory of schizophrenia. In this theory, disruption of NMDAR synaptic function leads to dysregulated timing of action potentials in prefrontal networks, accelerating synaptic disconnection through a spike-timing-dependent mechanism.
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Affiliation(s)
- Jennifer L Zick
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA; Medical Scientist Training Program (MD/PhD), University of Minnesota, Minneapolis, MN 55455, USA
| | - Rachael K Blackman
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA; Medical Scientist Training Program (MD/PhD), University of Minnesota, Minneapolis, MN 55455, USA
| | - David A Crowe
- Department of Biology, Augsburg University, Minneapolis, MN 55454, USA
| | - Bagrat Amirikian
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA; Center for Cognitive Sciences, University of Minnesota, Minneapolis, MN 55455, USA; Brain Sciences Center, VA Medical Center, Minneapolis, MN 55417, USA
| | - Adele L DeNicola
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA; Brain Sciences Center, VA Medical Center, Minneapolis, MN 55417, USA
| | - Theoden I Netoff
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, 55455 USA
| | - Matthew V Chafee
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA; Center for Cognitive Sciences, University of Minnesota, Minneapolis, MN 55455, USA; Brain Sciences Center, VA Medical Center, Minneapolis, MN 55417, USA.
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16
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Sandini C, Zöller D, Scariati E, Padula MC, Schneider M, Schaer M, Van De Ville D, Eliez S. Development of Structural Covariance From Childhood to Adolescence: A Longitudinal Study in 22q11.2DS. Front Neurosci 2018; 12:327. [PMID: 29867336 PMCID: PMC5968113 DOI: 10.3389/fnins.2018.00327] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Schizophrenia is currently considered a neurodevelopmental disorder of connectivity. Still few studies have investigated how brain networks develop in children and adolescents who are at risk for developing psychosis. 22q11.2 Deletion Syndrome (22q11DS) offers a unique opportunity to investigate the pathogenesis of schizophrenia from a neurodevelopmental perspective. Structural covariance (SC) is a powerful approach to explore morphometric relations between brain regions that can furthermore detect biomarkers of psychosis, both in 22q11DS and in the general population. Methods: Here we implement a state-of-the-art sliding-window approach to characterize maturation of SC network architecture in a large longitudinal cohort of patients with 22q11DS (110 with 221 visits) and healthy controls (117 with 211 visits). We furthermore propose a new clustering-based approach to group regions according to trajectories of structural connectivity maturation. We correlate measures of SC with development of working memory, a core executive function that is highly affected in both idiopathic psychosis and 22q11DS. Finally, in 22q11DS we explore correlations between SC dysconnectivity and severity of internalizing psychopathology. Results: In HCs network architecture underwent a quadratic developmental trajectory maturing up to mid-adolescence. Late-childhood maturation was particularly evident for fronto-parietal cortices, while Default-Mode-Network-related regions showed a more protracted linear development. Working memory performance was positively correlated with network segregation and fronto-parietal connectivity. In 22q11DS, we demonstrate aberrant maturation of SC with disturbed architecture selectively emerging during adolescence and correlating more severe internalizing psychopathology. Patients also presented a lack of typical network development during late-childhood, that was particularly prominent for frontal connectivity. Conclusions: Our results suggest that SC maturation may underlie critical cognitive development occurring during late-childhood in healthy controls. Aberrant trajectories of SC maturation may reflect core developmental features of 22q11DS, including disturbed cognitive maturation during childhood and predisposition to internalizing psychopathology and psychosis during adolescence.
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Affiliation(s)
- Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maria C Padula
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Neuroscience, Center for Contextual Psychiatry, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Dimitri Van De Ville
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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17
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Sandini C, Scariati E, Padula MC, Schneider M, Schaer M, Van De Ville D, Eliez S. Cortical Dysconnectivity Measured by Structural Covariance Is Associated With the Presence of Psychotic Symptoms in 22q11.2 Deletion Syndrome. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:433-442. [PMID: 29735153 DOI: 10.1016/j.bpsc.2017.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 04/24/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is the third-largest known genetic risk factor for the development of psychosis. Dysconnectivity has consistently been implicated in the physiopathology of psychosis. Structural covariance of cortical morphology is a method of exploring connectivity among brain regions that to date has not been employed in 22q11DS. METHODS In the present study we employed structural covariance of cortical thickness to explore connectivity alterations in a group of 108 patients with 22q11DS compared with 96 control subjects. We subsequently divided patients into two subgroups of 31 subjects each according to the presence of attenuated psychotic symptoms. FreeSurfer software was used to obtain the mean cortical thickness in 148 brain regions from T1-weighted 3T images. For each population we reconstructed a brain graph using Pearson correlation between the average thickness of each couple of brain regions, which we characterized in terms of mean correlation strength and in terms of network architecture using graph theory. RESULTS Patients with 22q11DS presented increased mean correlation strength, but there was no difference in global architecture compared with control subjects. However, symptomatic patients presented increased mean correlation strength coupled with increased segregation and decreased integration compared with both control subjects and nonsymptomatic patients. They also presented increased centrality for a cluster of anterior cingulate and dorsomedial prefrontal regions. CONCLUSIONS These results confirm the importance of cortical dysconnectivity in the physiopathology of psychosis. Moreover they support the significance of aberrant anterior cingulate connectivity.
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Affiliation(s)
- Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland.
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland
| | - Maria Carmela Padula
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland; Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland; Stanford Cognitive and Systems Neuroscience Laboratory, Stanford University School of Medicine, Stanford, California
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University of Geneva, Switzerland; Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland; Department of Genetic Medicine and Development, University of Geneva School of Medicine, Switzerland
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18
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Psychotic symptoms influence the development of anterior cingulate BOLD variability in 22q11.2 deletion syndrome. Schizophr Res 2018; 193:319-328. [PMID: 28803847 DOI: 10.1016/j.schres.2017.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 11/23/2022]
Abstract
Chromosome 22q11.2 deletion syndrome (22q11DS) is a neurodevelopmental disorder associated with a broad phenotype of clinical, cognitive and psychiatric features. Due to the very high prevalence of schizophrenia (30-40%), the investigation of psychotic symptoms in the syndrome is promising to reveal biomarkers for the development of psychosis, also in the general population. Since schizophrenia is seen as a disorder of the dynamic interactions between brain networks, we here investigated brain dynamics, assessed by the variability of blood oxygenation level dependent (BOLD) signals, in patients with psychotic symptoms. We included 28 patients with 22q11DS presenting higher positive psychotic symptoms, 29 patients with lower positive psychotic symptoms and 69 healthy controls between 10 and 30years old. To overcome limitations of mass-univariate approaches, we employed multivariate analysis, namely partial least squares correlation, combined with proper statistical testing, to analyze resting-state BOLD signal variability and its age-relationship in patients with positive psychotic symptoms. Our results revealed a missing positive age-relationship in the dorsal anterior cingulate cortex (dACC) in patients with higher positive psychotic symptoms, leading to globally lower variability in the dACC in those patients. Patients without positive psychotic symptoms and healthy controls had the same developmental trajectory in this region. Alterations of brain structure and function in the ACC have been previously reported in 22q11DS and linked to psychotic symptoms. The present results support the implication of this region in the development of psychotic symptoms and suggest aberrant BOLD signal variability development as a potential biomarker for psychosis.
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19
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Mattiaccio LM, Coman IL, Thompson CA, Fremont WP, Antshel KM, Kates WR. Frontal dysconnectivity in 22q11.2 deletion syndrome: an atlas-based functional connectivity analysis. Behav Brain Funct 2018; 14:2. [PMID: 29352808 PMCID: PMC5775582 DOI: 10.1186/s12993-018-0134-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/04/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is a neurodevelopmental syndrome associated with deficits in cognitive and emotional processing. This syndrome represents one of the highest risk factors for the development of schizophrenia. Previous studies of functional connectivity (FC) in 22q11DS report aberrant connectivity patterns in large-scale networks that are associated with the development of psychotic symptoms. METHODS In this study, we performed a functional connectivity analysis using the CONN toolbox to test for differential connectivity patterns between 54 individuals with 22q11DS and 30 healthy controls, between the ages of 17-25 years old. We mapped resting-state fMRI data onto 68 atlas-based regions of interest (ROIs) generated by the Desikan-Killany atlas in FreeSurfer, resulting in 2278 ROI-to-ROI connections for which we determined total linear temporal associations between each. Within the group with 22q11DS only, we further tested the association between prodromal symptoms of psychosis and FC. RESULTS We observed that relative to controls, individuals with 22q11DS displayed increased FC in lobar networks involving the frontal-frontal, frontal-parietal, and frontal-occipital ROIs. In contrast, FC between ROIs in the parietal-temporal and occipital lobes was reduced in the 22q11DS group relative to healthy controls. Moreover, positive psychotic symptoms were positively associated with increased functional connections between the left precuneus and right superior frontal gyrus, as well as reduced functional connectivity between the bilateral pericalcarine. Positive symptoms were negatively associated with increased functional connectivity between the right pericalcarine and right postcentral gyrus. CONCLUSIONS Our results suggest that functional organization may be altered in 22q11DS, leading to disruption in connectivity between frontal and other lobar substructures, and potentially increasing risk for prodromal psychosis.
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Affiliation(s)
- Leah M Mattiaccio
- Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, USA
| | - Ioana L Coman
- Department of Computer Science, State University of New York at Oswego, Oswego, NY, USA
| | - Carlie A Thompson
- Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, USA
| | - Wanda P Fremont
- Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, USA
| | - Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, NY, 13210, USA
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY, USA.
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20
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Padula MC, Scariati E, Schaer M, Eliez S. A Mini Review on the Contribution of the Anterior Cingulate Cortex in the Risk of Psychosis in 22q11.2 Deletion Syndrome. Front Psychiatry 2018; 9:372. [PMID: 30174623 PMCID: PMC6107828 DOI: 10.3389/fpsyt.2018.00372] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/25/2018] [Indexed: 12/31/2022] Open
Abstract
22q11.2 deletion syndrome (22q11DS) is a neurogenetic disorder that causes a high risk of developing schizophrenia, thus representing a unique model for the investigation of biomarkers of psychosis. Cognitive and clinical risk factors have been identified as reliable predictors of schizophrenia in patients with 22q11DS and are currently used in the clinical practice. However, biomarkers based on neuroimaging are still lacking, mainly because of the analytic approaches adopted so far, which are almost uniquely based on the comparison of 22q11DS patients with healthy controls. Such comparisons do not take into account the heterogeneity within patients with 22q11DS, who indeed show various clinical manifestations. More recently, a number of studies compared measures of brain morphology and connectivity between patients with 22q11DS with different symptomatic profiles. The aim of this short review is to highlight the brain alterations found in patients with 22q11DS fulfilling ultra-high risk (UHR) criteria. Findings point to alterations in brain morphology and connectivity in frontal brain regions, and in particular in the anterior cingulate cortex, in patients with 22q11DS presenting UHR symptoms. These alterations may represent valuable biomarkers of psychosis in 22q11DS.
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Affiliation(s)
- Maria C Padula
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland.,Developmental Imaging and Psychopathology Laboratory, Office Médico-Pédagogique, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, Office Médico-Pédagogique, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, Office Médico-Pédagogique, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, Office Médico-Pédagogique, Department of Psychiatry, University of Geneva, Geneva, Switzerland
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21
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Padula MC, Schaer M, Scariati E, Mutlu AK, Zöller D, Schneider M, Eliez S. Quantifying indices of short- and long-range white matter connectivity at each cortical vertex. PLoS One 2017; 12:e0187493. [PMID: 29141024 PMCID: PMC5687731 DOI: 10.1371/journal.pone.0187493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 10/20/2017] [Indexed: 01/27/2023] Open
Abstract
Several neurodevelopmental diseases are characterized by impairments in cortical morphology along with altered white matter connectivity. However, the relationship between these two measures is not yet clear. In this study, we propose a novel methodology to compute and display metrics of white matter connectivity at each cortical point. After co-registering the extremities of the tractography streamlines with the cortical surface, we computed two measures of connectivity at each cortical vertex: the mean tracts’ length, and the proportion of short- and long-range connections. The proposed measures were tested in a clinical sample of 62 patients with 22q11.2 deletion syndrome (22q11DS) and 57 typically developing individuals. Using these novel measures, we achieved a fine-grained visualization of the white matter connectivity patterns at each vertex of the cortical surface. We observed an intriguing pattern of both increased and decreased short- and long-range connectivity in 22q11DS, that provides novel information about the nature and topology of white matter alterations in the syndrome. We argue that the method presented in this study opens avenues for additional analyses of the relationship between cortical properties and patterns of underlying structural connectivity, which will help clarifying the intrinsic mechanisms that lead to altered brain structure in neurodevelopmental disorders.
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Affiliation(s)
- Maria Carmela Padula
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
- * E-mail:
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
| | - A. Kadir Mutlu
- Neuro-Electronics Research Flanders, Leuven, The Netherlands
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale Lausanne (EPFL), Lausanne, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
- Department of Genetic Medicine and Development, University of Geneva School of medicine, Geneva, Switzerland
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22
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Roalf DR, Eric Schmitt J, Vandekar SN, Satterthwaite TD, Shinohara RT, Ruparel K, Elliott MA, Prabhakaran K, McDonald-McGinn DM, Zackai EH, Gur RC, Emanuel BS, Gur RE. White matter microstructural deficits in 22q11.2 deletion syndrome. Psychiatry Res 2017; 268:35-44. [PMID: 28865345 PMCID: PMC5814141 DOI: 10.1016/j.pscychresns.2017.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/02/2017] [Accepted: 08/06/2017] [Indexed: 02/06/2023]
Abstract
Diffusion tensor imaging (DTI) studies in 22q11.2 deletion syndrome (22q11DS), a neurogenetic condition associated with psychosis, report brain white matter (WM) microstructure aberrations. Several studies report that WM disruptions in 22q11DS are similar to deficits in idiopathic schizophrenia. Yet, DTI results in 22q11DS are inconsistent. We used DTI to compare WM structure in 22q11DS individuals to healthy controls (HC) and explored WM differences in 22q11DS with (+) and without (-) psychosis spectrum symptoms. We examined 39 22q11DS individuals and 39 age, sex and race equivalent HC. DTI was performed at 3T using a 64-direction protocol. Fractional anisotropy (FA) was lower, while radial diffusivity was higher in 22q11DS within the cingulum bundle. Mean diffusivity was lower in the inferior longitudinal fasciculus, while axial diffusivity (AD) was lower in the cingulum bundle, forceps major, and several posterior to anterior fasciculi. 22q11DS+ had lower FA in the cingulum bundle and lower AD in the uncinate fasciculus compared to 22q11DS-. Overall, we found aberrant WM microstructure in individuals with 22q11DS compared to age and sex matched HC and exploratory analysis indicated subtle WM deficits associated with psychosis. The findings highlight the dysfunction of WM microstructure in 22q11DS and its potential importance in elucidating WM abnormalities in psychosis.
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Affiliation(s)
- David R Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - J Eric Schmitt
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Simon N Vandekar
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Theodore D Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T Shinohara
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mark A Elliott
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Karthik Prabhakaran
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donna M McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Beverly S Emanuel
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
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23
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Padula MC, Scariati E, Schaer M, Sandini C, Ottet MC, Schneider M, Van De Ville D, Eliez S. Altered structural network architecture is predictive of the presence of psychotic symptoms in patients with 22q11.2 deletion syndrome. NEUROIMAGE-CLINICAL 2017; 16:142-150. [PMID: 28794975 PMCID: PMC5540832 DOI: 10.1016/j.nicl.2017.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/13/2017] [Accepted: 07/24/2017] [Indexed: 11/10/2022]
Abstract
22q11.2 deletion syndrome (22q11DS) represents a homogeneous model of schizophrenia particularly suitable for the search of neural biomarkers of psychosis. Impairments in structural connectivity related to the presence of psychotic symptoms have been reported in patients with 22q11DS. However, the relationships between connectivity changes in patients with different symptomatic profiles are still largely unknown and warrant further investigations. In this study, we used structural connectivity to discriminate patients with 22q11DS with (N = 31) and without (N = 31) attenuated positive psychotic symptoms. Different structural connectivity measures were used, including the number of streamlines connecting pairs of brain regions, graph theoretical measures, and diffusion measures. We used univariate group comparisons as well as predictive multivariate approaches. The univariate comparison of connectivity measures between patients with or without attenuated positive psychotic symptoms did not give significant results. However, the multivariate prediction revealed that altered structural network architecture discriminates patient subtypes (accuracy = 67.7%). Among the regions contributing to the classification we found the anterior cingulate cortex, which is known to be associated to the presence of psychotic symptoms in patients with 22q11DS. Furthermore, a significant discrimination (accuracy = 64%) was obtained with fractional anisotropy and radial diffusivity in the left inferior longitudinal fasciculus and the right cingulate gyrus. Our results point to alterations in structural network architecture and white matter microstructure in patients with 22q11DS with attenuated positive symptoms, mainly involving connections of the limbic system. These alterations may therefore represent a potential biomarker for an increased risk of psychosis that should be further tested in longitudinal studies. Altered network architecture discriminates psychotic patients with 22q11DS; Altered diffusivity measures are evident in psychotic patients with 22q11DS; White matter alterations associated to psychosis are located in limbic regions.
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Affiliation(s)
- Maria C Padula
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Marie Christine Ottet
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Dimitri Van De Ville
- Medical Image Processing Lab, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of medicine, Geneva, Switzerland
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24
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Altered Cortical Ensembles in Mouse Models of Schizophrenia. Neuron 2017; 94:153-167.e8. [PMID: 28384469 DOI: 10.1016/j.neuron.2017.03.019] [Citation(s) in RCA: 128] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 10/07/2016] [Accepted: 03/10/2017] [Indexed: 01/26/2023]
Abstract
In schizophrenia, brain-wide alterations have been identified at the molecular and cellular levels, yet how these phenomena affect cortical circuit activity remains unclear. We studied two mouse models of schizophrenia-relevant disease processes: chronic ketamine (KET) administration and Df(16)A+/-, modeling 22q11.2 microdeletions, a genetic variant highly penetrant for schizophrenia. Local field potential recordings in visual cortex confirmed gamma-band abnormalities similar to patient studies. Two-photon calcium imaging of local cortical populations revealed in both models a deficit in the reliability of neuronal coactivity patterns (ensembles), which was not a simple consequence of altered single-neuron activity. This effect was present in ongoing and sensory-evoked activity and was not replicated by acute ketamine administration or pharmacogenetic parvalbumin-interneuron suppression. These results are consistent with the hypothesis that schizophrenia is an "attractor" disease and demonstrate that degraded neuronal ensembles are a common consequence of diverse genetic, cellular, and synaptic alterations seen in chronic schizophrenia.
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25
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Dubourg L, Schneider M, Padula MC, Chambaz L, Schaer M, Eliez S. Implication of reward alterations in the expression of negative symptoms in 22q11.2 deletion syndrome: a behavioural and DTI study. Psychol Med 2017; 47:1442-1453. [PMID: 28112057 DOI: 10.1017/s0033291716003482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Alterations of the reward system have been proposed as one of the core mechanisms underlying the expression of negative symptoms in schizophrenia. Specifically, deficits in specific reward components and white matter (WM) integrity of the reward system have been highlighted. The putative link between negative symptoms and the hedonic experience, or structural connectivity of the reward system has never been examined in the 22q11.2 deletion syndrome (22q11DS), a condition with increased risk for psychosis. METHOD Anticipatory and consummatory dimensions of pleasure were assessed in participants with 22q11DS (N = 54) and healthy controls (N = 55). In patients with 22q11DS, the association between pleasure scores and positive or negative symptoms was investigated. Furthermore, WM integrity of the accumbofrontal tract was quantified using diffusion tensor imaging (DTI). Associations between DTI measures, pleasure dimensions and negative symptoms were examined. RESULTS Patients with 22q11DS showed reduced anticipatory and consummatory pleasure compared to controls. Furthermore, anticipatory pleasure scores were negatively correlated to negative and positive symptoms in 22q11DS. WM microstructural changes of the accumbofrontal tract in terms of increased fractional anisotropy and reduced radial anisotropy were also identified in patients. However, no significant correlation between the DTI measures and pleasure dimensions or psychotic symptoms was observed. CONCLUSIONS This study revealed that participants with 22q11DS differed in their experience of pleasure compared to controls. The anticipatory pleasure component appears to be related to negative and positive symptom severity in patients. Alterations of WM integrity of the accumbofrontal tract seem to be related to myelination abnormalities in 22q11DS patients.
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Affiliation(s)
- L Dubourg
- Department of Psychiatry,Office Médico-Pédagogique Research Unit, School of Medicine, University of Geneva,Geneva,Switzerland
| | - M Schneider
- Department of Psychiatry,Office Médico-Pédagogique Research Unit, School of Medicine, University of Geneva,Geneva,Switzerland
| | - M C Padula
- Department of Psychiatry,Office Médico-Pédagogique Research Unit, School of Medicine, University of Geneva,Geneva,Switzerland
| | - L Chambaz
- Department of Psychiatry,Office Médico-Pédagogique Research Unit, School of Medicine, University of Geneva,Geneva,Switzerland
| | - M Schaer
- Department of Psychiatry,Office Médico-Pédagogique Research Unit, School of Medicine, University of Geneva,Geneva,Switzerland
| | - S Eliez
- Department of Psychiatry,Office Médico-Pédagogique Research Unit, School of Medicine, University of Geneva,Geneva,Switzerland
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26
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Tylee DS, Kikinis Z, Quinn TP, Antshel KM, Fremont W, Tahir MA, Zhu A, Gong X, Glatt SJ, Coman IL, Shenton ME, Kates WR, Makris N. Machine-learning classification of 22q11.2 deletion syndrome: A diffusion tensor imaging study. NEUROIMAGE-CLINICAL 2017; 15:832-842. [PMID: 28761808 PMCID: PMC5522376 DOI: 10.1016/j.nicl.2017.04.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 03/27/2017] [Accepted: 04/04/2017] [Indexed: 11/27/2022]
Abstract
Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a genetic neurodevelopmental syndrome that has been studied intensively in order to understand relationships between the genetic microdeletion, brain development, cognitive function, and the emergence of psychiatric symptoms. White matter microstructural abnormalities identified using diffusion tensor imaging methods have been reported to affect a variety of neuroanatomical tracts in 22q11.2DS. In the present study, we sought to combine two discovery-based approaches: (1) white matter query language was used to parcellate the brain's white matter into tracts connecting pairs of 34, bilateral cortical regions and (2) the diffusion imaging characteristics of the resulting tracts were analyzed using a machine-learning method called support vector machine in order to optimize the selection of a set of imaging features that maximally discriminated 22q11.2DS and comparison subjects. With this unique approach, we both confirmed previously-recognized 22q11.2DS-related abnormalities in the inferior longitudinal fasciculus (ILF), and identified, for the first time, 22q11.2DS-related anomalies in the middle longitudinal fascicle and the extreme capsule, which may have been overlooked in previous, hypothesis-guided studies. We further observed that, in participants with 22q11.2DS, ILF metrics were significantly associated with positive prodromal symptoms of psychosis.
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Key Words
- (-fp), fronto-parietal aspect
- (-to), temporo-occipital aspect
- (-tp), temporo-parietal aspect
- (22q11.2DS), 22q11.2 deletion syndrome
- (AD), axial diffusivity
- (DTI), diffusion tensor imaging
- (DWI), diffusion weighted image
- (EmC), extreme capsule
- (FA), fractional anisotropy
- (FOV), field of view
- (GDS), Gordon Diagnostic Systems
- (ILF), inferior longitudinal fasciculus
- (MdLF), middle longitudinal fascicle
- (RD), radial diffusivity
- (ROI), region of interest
- (SIPS), Structured Interview for Prodromal Syndromes
- (SRS), Social Responsiveness Scale
- (STG), superior temporal gyrus
- (SVM), support vector machine
- (UKF), Unscented Kalman Filter
- (WAIS-III), Wechsler Adult Intelligence Scale – 3rd edition
- (WMQL), white matter query language
- (dTP), dorsal temporal pole
- 22q11.2 deletion syndrome
- Callosal asymmetry
- Diffusion tensor imaging
- Extreme capsule
- Inferior longitudinal fasciculus
- Machine-learning
- Middle longitudinal fascicle
- Support vector machine
- Velocardiofacial syndrome
- White matter query language
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Affiliation(s)
- Daniel S Tylee
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Psychiatry and Behavioral Sciences; SUNY Upstate Medical University, Syracuse, NY, USA
| | - Zora Kikinis
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Thomas P Quinn
- Bioinformatics Core Research Group, Deakin University, Geelong, Victoria, Australia
| | | | - Wanda Fremont
- Department of Psychiatry and Behavioral Sciences; SUNY Upstate Medical University, Syracuse, NY, USA.
| | - Muhammad A Tahir
- Department of Psychiatry and Behavioral Sciences; SUNY Upstate Medical University, Syracuse, NY, USA
| | - Anni Zhu
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Xue Gong
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephen J Glatt
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Psychiatry and Behavioral Sciences; SUNY Upstate Medical University, Syracuse, NY, USA.
| | - Ioana L Coman
- Department of Psychiatry and Behavioral Sciences; SUNY Upstate Medical University, Syracuse, NY, USA.
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Harvard Medical School, Brockton, MA, USA.
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences; SUNY Upstate Medical University, Syracuse, NY, USA.
| | - Nikos Makris
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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27
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Olszewski AK, Kikinis Z, Gonzalez CS, Coman IL, Makris N, Gong X, Rathi Y, Zhu A, Antshel KM, Fremont W, Kubicki MR, Bouix S, Shenton ME, Kates WR. The social brain network in 22q11.2 deletion syndrome: a diffusion tensor imaging study. Behav Brain Funct 2017; 13:4. [PMID: 28209179 PMCID: PMC5314621 DOI: 10.1186/s12993-017-0122-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 02/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a neurogenetic disorder that is associated with a 25-fold increase in schizophrenia. Both individuals with 22q11.2DS and those with schizophrenia present with social cognitive deficits, which are putatively subserved by a network of brain regions that are involved in the processing of social cognitive information. This study used two-tensor tractography to examine the white matter tracts believed to underlie the social brain network in a group of 57 young adults with 22q11.2DS compared to 30 unaffected controls. RESULTS Results indicated that relative to controls, participants with 22q11.2DS showed significant differences in several DTI metrics within the inferior fronto-occipital fasciculus, cingulum bundle, thalamo-frontal tract, and inferior longitudinal fasciculus. In addition, participants with 22q11.2DS showed significant differences in scores on measures of social cognition, including the Social Responsiveness Scale and Trait Emotional Intelligence Questionnaire. Further analyses among individuals with 22q11.2DS demonstrated an association between DTI metrics and positive and negative symptoms of psychosis, as well as differentiation between individuals with 22q11.2DS and overt psychosis, relative to those with positive prodromal symptoms or no psychosis. CONCLUSIONS Findings suggest that white matter disruption, specifically disrupted axonal coherence in the right inferior fronto-occipital fasciculus, may be a biomarker for social cognitive difficulties and psychosis in individuals with 22q11.2DS.
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Affiliation(s)
- Amy K Olszewski
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Zora Kikinis
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Ioana L Coman
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Nikolaos Makris
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Xue Gong
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anni Zhu
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Wanda Fremont
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Marek R Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,VA Boston Healthcare System, Harvard Medical School, Brockton, MA, USA
| | - Wendy R Kates
- Department of Psychiatry, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA.
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28
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Padula MC, Schaer M, Scariati E, Maeder J, Schneider M, Eliez S. Multimodal investigation of triple network connectivity in patients with 22q11DS and association with executive functions. Hum Brain Mapp 2017; 38:2177-2189. [PMID: 28117515 DOI: 10.1002/hbm.23512] [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: 07/19/2016] [Revised: 12/15/2016] [Accepted: 12/29/2016] [Indexed: 12/12/2022] Open
Abstract
Large-scale brain networks play a prominent role in cognitive abilities and their activity is impaired in psychiatric disorders, such as schizophrenia. Patients with 22q11.2 deletion syndrome (22q11DS) are at high risk of developing schizophrenia and present similar cognitive impairments, including executive functions deficits. Thus, 22q11DS represents a model for the study of neural biomarkers associated with schizophrenia. In this study, we investigated structural and functional connectivity within and between the Default Mode (DMN), the Central Executive (CEN), and the Saliency network (SN) in 22q11DS using resting-state fMRI and DTI. Furthermore, we investigated if triple network impairments were related to executive dysfunctions or the presence of psychotic symptoms. Sixty-three patients with 22q11DS and sixty-eighty controls (age 6-33 years) were included in the study. Structural connectivity between main nodes of DMN, CEN, and SN was computed using probabilistic tractography. Functional connectivity was computed as the partial correlation between the time courses extracted from each node. Structural and functional connectivity measures were then correlated to executive functions and psychotic symptom scores. Our results showed mainly reduced structural connectivity within the CEN, DMN, and SN, in patients with 22q11DS compared with controls as well as reduced between-network connectivity. Functional connectivity appeared to be more preserved, with impairments being evident only within the DMN. Structural connectivity impairments were also related to executive dysfunctions. These findings show an association between triple network structural alterations and executive deficits in patients with the microdeletion, suggesting that 22q11DS and schizophrenia share common psychopathological mechanisms. Hum Brain Mapp 38:2177-2189, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Maria C Padula
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland.,Stanford Cognitive and Systems Neuroscience Laboratory, Stanford University School of Medicine, Stanford, California
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Johanna Maeder
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland.,Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, Belgium
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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29
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Schmitt JE, Yi J, Calkins ME, Ruparel K, Roalf DR, Cassidy A, Souders MC, Satterthwaite TD, McDonald-McGinn DM, Zackai EH, Gur RC, Emanuel BS, Gur RE. Disrupted anatomic networks in the 22q11.2 deletion syndrome. Neuroimage Clin 2016; 12:420-8. [PMID: 27622139 PMCID: PMC5008050 DOI: 10.1016/j.nicl.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 07/06/2016] [Accepted: 08/23/2016] [Indexed: 11/16/2022]
Abstract
The 22q11.2 deletion syndrome (22q11DS) is an uncommon genetic disorder with an increased risk of psychosis. Although the neural substrates of psychosis and schizophrenia are not well understood, aberrations in cortical networks represent intriguing potential mechanisms. Investigations of anatomic networks within 22q11DS are sparse. We investigated group differences in anatomic network structure in 48 individuals with 22q11DS and 370 typically developing controls by analyzing covariance patterns in cortical thickness among 68 regions of interest using graph theoretical models. Subjects with 22q11DS had less robust geographic organization relative to the control group, particularly in the occipital and parietal lobes. Multiple global graph theoretical statistics were decreased in 22q11DS. These results are consistent with prior studies demonstrating decreased connectivity in 22q11DS using other neuroimaging methodologies.
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Affiliation(s)
- J. Eric Schmitt
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - James Yi
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David R. Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Amy Cassidy
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margaret C. Souders
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donna M. McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elaine H. Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Beverly S. Emanuel
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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