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Miyazawa A, Kanahara N, Shiko Y, Ozawa Y, Kawasaki Y, Komatsu H, Masumo Y, Nakata Y, Iyo M. The cortical silent period in schizophrenia: A systematic review and meta-analysis focusing on disease stage and antipsychotic medication. J Psychopharmacol 2022; 36:479-488. [PMID: 35475374 DOI: 10.1177/02698811221078751] [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: 01/10/2023]
Abstract
BACKGROUND Although numerous studies reported some changes of cortical silent period (CSP), an indicator of gamma-aminobutyric acid (GABA) function in central nervous system, in schizophrenia patients, it has been unknown how the disease stage and antipsychotic medication affect CSP values. METHODS The present study conducted a systematic review of previous literature comparing CSP between schizophrenia patients and healthy subjects, and then performed meta-analysis on the effects of (1) the disease stage and (2) antipsychotics on CSP. RESULTS (1) In the comparison of the disease stage comprising a total of 17 reports, there was no significant difference in CSP between patients under drug-naïve first-episode psychoses and healthy controls, or between patients with antipsychotic medication and healthy controls. (2) In the comparison of the antipsychotic class, patients treated with clozapine were longer in CSP compared to healthy controls. Patients treated with olanzapine/quetiapine or with other type of antipsychotics were not different from healthy controls. Regarding other type of antipsychotics, the iteration analysis after leaving out one literature showed that patients were shorter in CSP than healthy controls. CONCLUSION The results showed that clozapine seems to surely prolong CSP, indicating the enhancement of GABA transmission via GABAB receptors, suggesting the possible relationship between the CSP prolongation by clozapine and its high efficacy in psychopathology. The finding of shorter CSP in patients with other type of antipsychotics was distinct from clozapine/olanzapine/quetiapine, but was difficult to interpret since this group included a variety of transcranial magnetic stimulation (TMS) methodologies and patients' background.
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Affiliation(s)
- Atsuhiro Miyazawa
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.,Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Komatsu
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yuto Masumo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yusuke Nakata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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2
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Howells FM, Hsieh JH, Temmingh HS, Baldwin DS, Stein DJ. Capacity for cortical excitation is reduced in psychotic disorders: An investigation of the TMS-EMG cortical silent period. Schizophr Res 2022; 240:73-77. [PMID: 34968895 DOI: 10.1016/j.schres.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Fleur M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Jennifer H Hsieh
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Henk S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Valkenberg Hospital, Cape Town, Western Cape Province, South Africa
| | - David S Baldwin
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, South Africa; SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, South Africa
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3
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Abualait T, Alzahrani S, AlOthman A, Alhargan FA, Altwaijri N, Khallaf R, Nasim E, Bashir S. Assessment of Cortical Plasticity in Schizophrenia by Transcranial Magnetic Stimulation. Neural Plast 2021; 2021:5585951. [PMID: 34899900 PMCID: PMC8660255 DOI: 10.1155/2021/5585951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/18/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Neural plasticity refers to the capability of the brain to modify its structure and/or function and organization in response to a changing environment. Evidence shows that disruption of neuronal plasticity and altered functional connectivity between distinct brain networks contribute significantly to the pathophysiological mechanisms of schizophrenia. Transcranial magnetic stimulation has emerged as a noninvasive brain stimulation tool that can be utilized to investigate cortical excitability with the aim of probing neural plasticity mechanisms. In particular, in pathological disorders, such as schizophrenia, cortical dysfunction, such as an aberrant excitatory-inhibitory balance in cortical networks, altered cortical connectivity, and impairment of critical period timing are very important to be studied using different TMS paradigms. Studying such neurophysiological characteristics and plastic changes would help in elucidating different aspects of the pathophysiological mechanisms underlying schizophrenia. This review attempts to summarize the findings of available TMS studies with diagnostic and characterization aims, but not with therapeutic purposes, in schizophrenia. Findings provide further evidence of aberrant excitatory-inhibitory balance in cortical networks, mediated by neurotransmitter pathways such as the glutamate and GABA systems. Future studies with combining techniques, for instance, TMS with brain imaging or molecular genetic typing, would shed light on the characteristics and predictors of schizophrenia.
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Affiliation(s)
- Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sultan Alzahrani
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Ahmed AlOthman
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Fahad Abdulah Alhargan
- Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nouf Altwaijri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rooa Khallaf
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Eman Nasim
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
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4
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Mehta UM, Ektare A, Jakhar J, Basavaraju R, Sanjay TN, Naik SS, Syed FA, Bhargav PH, Reddy PV, Kelkar RS, Arumugham SS, Kesavan M, Thirthalli J, Gangadhar BN. A transdiagnostic evaluation of cortical inhibition in severe mental disorders using Transcranial Magnetic Stimulation. J Psychiatr Res 2021; 143:364-369. [PMID: 34571321 DOI: 10.1016/j.jpsychires.2021.09.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
Multiple lines of investigations suggest the presence of cortical inhibition aberrations as central to the phenotypic manifestations of severe mental disorders. Transcranial Magnetic Stimulation (TMS) combined with electromyography can characterize these inhibitory processes in the motor cortex with satisfactory temporal precision. We examined TMS-evoked short- (SICI) and long-interval intracortical inhibition (LICI) and cortical silent period (CSP) as markers of GABAA- (SICI) and GABAB-mediated (LICI and CSP) cortical neurotransmission in symptomatic individuals with mania (n = 40), schizophrenia (n = 76), unipolar depression (n = 86), and OCD (n = 43), and compared them against similar recordings in healthy subjects (n = 125). We hypothesized transdiagnostic GABAA deficits across all the clinical groups and diagnosis-specific GABAB alterations in mania (increased) and OCD (decreased). After controlling for potential confounder variables (gender, education, benzodiazepine prescription, and motor threshold) using the ANCOVA, we observed no significant group difference in SICI (F = 1.04, P = 0.38), but a significant group effect in LICI (F = 16.29, P < 0.001) and CSP (F = 3.02, P = 0.018). Post-hoc analyses revealed that LICI was significantly reduced in OCD but increased in mania and schizophrenia with reference to the healthy group. Similarly, CSP was significantly reduced in OCD and depression groups as compared to the reference group. We observed that LICI and CSP, both followed similar descending gradients from mania through schizophrenia and depression to OCD; with significant elevation in mania, and reduction in depression and OCD, as compared to the healthy group. This pattern of GABAB-mediated cortical inhibition aberrations needs independent validation as potential state-markers of distinct clinical categories.
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Affiliation(s)
- Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India.
| | - Aboli Ektare
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Jitender Jakhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Rakshathi Basavaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Tarasingh N Sanjay
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Shalini S Naik
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Farooq Ali Syed
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Praerna Hemant Bhargav
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Preethi V Reddy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Radhika Suneel Kelkar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Shyam Sundar Arumugham
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Muralidharan Kesavan
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, 560029, India
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5
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Carment L, Dupin L, Guedj L, Térémetz M, Cuenca M, Krebs MO, Amado I, Maier MA, Lindberg PG. Neural noise and cortical inhibition in schizophrenia. Brain Stimul 2020; 13:1298-1304. [PMID: 32585356 DOI: 10.1016/j.brs.2020.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/25/2020] [Accepted: 06/14/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Neural information processing is subject to noise and this leads to variability in neural firing and behavior. Schizophrenia has been associated with both more variable motor control and impaired cortical inhibition, which is crucial for excitatory/inhibitory balance in neural commands. HYPOTHESIS In this study, we hypothesized that impaired intracortical inhibition in motor cortex would contribute to task-related motor noise in schizophrenia. METHODS We measured variability of force and of electromyographic (EMG) activity in upper limb and hand muscles during a visuomotor grip force-tracking paradigm in patients with schizophrenia (N = 25), in unaffected siblings (N = 17) and in healthy control participants (N = 25). Task-dependent primary motor cortex (M1) excitability and inhibition were assessed using transcranial magnetic stimulation (TMS). RESULTS During force maintenance patients with schizophrenia showed increased variability in force and EMG, despite similar mean force and EMG magnitudes. Compared to healthy controls, patients with schizophrenia also showed increased M1 excitability and reduced cortical inhibition during grip-force tracking. EMG variability and force variability correlated negatively to cortical inhibition in patients with schizophrenia. EMG variability also correlated positively to negative symptoms. Siblings had similar variability and cortical inhibition compared to controls. Increased EMG and force variability indicate enhanced motor noise in schizophrenia, which relates to reduced motor cortex inhibition. CONCLUSION The findings suggest that excessive motor noise in schizophrenia may arise from an imbalance of M1 excitation/inhibition of GABAergic origin. Thus, higher motor noise may provide a useful marker of impaired cortical inhibition in schizophrenia.
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Affiliation(s)
- Loïc Carment
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France.
| | - Lucile Dupin
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France
| | - Laura Guedj
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, C3RP, Université de Paris, GHU Psychiatrie et Neurosciences Sainte-Anne, Paris, France
| | - Maxime Térémetz
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France
| | - Macarena Cuenca
- Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Centre de Recherche Clinique, Hôpital Sainte-Anne, Paris, France
| | - Marie-Odile Krebs
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, C3RP, Université de Paris, GHU Psychiatrie et Neurosciences Sainte-Anne, Paris, France
| | - Isabelle Amado
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, C3RP, Université de Paris, GHU Psychiatrie et Neurosciences Sainte-Anne, Paris, France
| | - Marc A Maier
- Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Université de Paris, CNRS UMR, 8002, Paris, France
| | - Påvel G Lindberg
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France
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6
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Kim HK, Blumberger DM, Daskalakis ZJ. Neurophysiological Biomarkers in Schizophrenia-P50, Mismatch Negativity, and TMS-EMG and TMS-EEG. Front Psychiatry 2020; 11:795. [PMID: 32848953 PMCID: PMC7426515 DOI: 10.3389/fpsyt.2020.00795] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
Impaired early auditory processing is a well characterized finding in schizophrenia that is theorized to contribute to clinical symptoms, cognitive impairment, and social dysfunction in patients. Two neurophysiological measures of early auditory processing, P50 gating ("P50") and mismatch negativity (MMN), which measure sensory gating and detection of change in auditory stimuli, respectively, are consistently shown to be impaired in patients with schizophrenia. Transcranial magnetic stimulation (TMS) may also be a potential method by which sensory processing can be assessed, since TMS paradigms can be used to measure GABAB-mediated cortical inhibition that is linked with sensory gating. In this review, we examine the potential of P50, MMN and two TMS paradigms, cortical silent period (CSP) and long-interval intracortical inhibition (LICI), as endophenotypes as well as their ability to be used as predictive markers for interventions targeted at cognitive and psychosocial functioning. Studies consistently support a link between MMN, P50, and cognitive dysfunction, with robust evidence for a link between MMN and psychosocial functioning in schizophrenia as well. Importantly, studies have demonstrated that MMN can be used to predict performance in social and cognitive training tasks. A growing body of studies also supports the potential of MMN to be used as an endophenotype, and future studies are needed to determine if MMN can be used as an endophenotype specifically in schizophrenia. P50, however, has weaker evidence supporting its use as an endophenotype. While CSP and LICI are not as extensively investigated, growing evidence is supporting their potential to be used as an endophenotype in schizophrenia. Future studies that assess the ability of P50, MMN, and TMS neurophysiological measures to predict performance in cognitive and social training programs may identify markers that inform clinical decisions in the treatment of neurocognitive impairments in schizophrenia.
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Affiliation(s)
- Helena K Kim
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Daniel M Blumberger
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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7
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Newton R, Rouleau A, Nylander AG, Loze JY, Resemann HK, Steeves S, Crespo-Facorro B. Diverse definitions of the early course of schizophrenia-a targeted literature review. NPJ SCHIZOPHRENIA 2018; 4:21. [PMID: 30323274 PMCID: PMC6189105 DOI: 10.1038/s41537-018-0063-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder and patients experience significant comorbidity, especially cognitive and psychosocial deficits, already at the onset of disease. Previous research suggests that treatment during the earlier stages of disease reduces disease burden, and that a longer time of untreated psychosis has a negative impact on treatment outcomes. A targeted literature review was conducted to gain insight into the definitions currently used to describe patients with a recent diagnosis of schizophrenia in the early course of disease ('early' schizophrenia). A total of 483 relevant English-language publications of clinical guidelines and studies were identified for inclusion after searches of MEDLINE, MEDLINE In-Process, relevant clinical trial databases and Google for records published between January 2005 and October 2015. The extracted data revealed a wide variety of terminology and definitions used to describe patients with 'early' or 'recent-onset' schizophrenia, with no apparent consensus. The most commonly used criteria to define patients with early schizophrenia included experience of their first episode of schizophrenia or disease duration of less than 1, 2 or 5 years. These varied definitions likely result in substantial disparities of patient populations between studies and variable population heterogeneity. Better agreement on the definition of early schizophrenia could aid interpretation and comparison of studies in this patient population and consensus on definitions should allow for better identification and management of schizophrenia patients in the early course of their disease.
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Affiliation(s)
- Richard Newton
- Austin Health, University of Melbourne, Melbourne, VIC, Australia.,Peninsula Health, Frankston, VIC, Australia
| | | | | | | | | | | | - Benedicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
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8
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Kaskie RE, Ferrarelli F. Investigating the neurobiology of schizophrenia and other major psychiatric disorders with Transcranial Magnetic Stimulation. Schizophr Res 2018; 192:30-38. [PMID: 28478887 DOI: 10.1016/j.schres.2017.04.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/24/2017] [Accepted: 04/26/2017] [Indexed: 11/16/2022]
Abstract
Characterizing the neurobiology of schizophrenia and other major psychiatric disorders is one of the main challenges of the current research in psychiatry. The availability of Transcranial Magnetic Stimulation (TMS) allows to directly probe virtually any cortical areas, thus providing a unique way to assess the neurophysiological properties of cortical neurons. This article presents a review of studies employing TMS in combination with Motor Evoked Potentials (TMS/MEPs) and high density Electroencephalogram (TMS/hd-EEG) in schizophrenia and other major psychiatric disorders. Studies were identified by conducting a PubMed search using the following search item: "transcranial magnetic stimulation and (Schizophrenia or OCD or MDD or ADHD)". Studies that utilized TMS/MEP and/or TMS/hd-EEG measures to characterize cortical excitability, inhibition, oscillatory activity, and/or connectivity in psychiatric patients were selected. Across disorders, patients displayed a pattern of reduced cortical inhibition, and to a lesser extent increased excitability, in the motor cortex, which was most consistently established in Schizophrenia. Furthermore, psychiatric patients showed abnormalities in a number of TMS-evoked EEG oscillations, which was most prominent in the prefrontal cortex of Schizophrenia relative to healthy comparison subjects. Overall, results from this review point to significant impairments in cortical excitability, inhibition, and oscillatory activity, especially in frontal areas, in several major psychiatric disorders. Building on these findings, future studies employing TMS-based experimental paradigms may help elucidating the neurobiology of these psychiatric disorders, and may assess the contribution of TMS-related measures in monitoring and possibly maximizing the effectiveness of treatment interventions in psychiatric populations.
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9
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Noda Y, Barr MS, Zomorrodi R, Cash RFH, Farzan F, Rajji TK, Chen R, Daskalakis ZJ, Blumberger DM. Evaluation of short interval cortical inhibition and intracortical facilitation from the dorsolateral prefrontal cortex in patients with schizophrenia. Sci Rep 2017; 7:17106. [PMID: 29213090 PMCID: PMC5719013 DOI: 10.1038/s41598-017-17052-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/21/2017] [Indexed: 02/05/2023] Open
Abstract
GABAergic and glutamatergic dysfunction in the dorsolateral prefrontal cortex (DLPFC) are thought to be the core pathophysiological mechanisms of schizophrenia. Recently, we have established a method to index these functions from the DLPFC using the paired transcranial magnetic stimulation (TMS) paradigms of short interval intracortical inhibition (SICI) and facilitation (ICF) combined with electroencephalography (EEG). In this study, we aimed to evaluate neurophysiological indicators related to GABAA and glutamate receptor-mediated functions respectively from the DLPFC in patients with schizophrenia using these paradigms, compared to healthy controls. Given that these activities contribute to cognitive functions, the relationship between the TMS-evoked potential (TEP) modulations by SICI/ICF and cognitive/clinical measures were explored. Compared to controls, patients showed reduced inhibition in P60 (t22 = −4.961, p < 0.0001) by SICI and reduced facilitation in P60 (t22 = 5.174, p < 0.0001) and N100 (t22 = 3.273, p = 0.003) by ICF. In patients, the modulation of P60 by SICI was correlated with the longest span of the Letter-Number Span Test (r = −0.775, p = 0.003), while the modulation of N100 by ICF was correlated with the total score of the Positive and Negative. Syndrome Scale (r = 0.817, p = 0.002). These findings may represent the pathophysiology, which may be associated with prefrontal GABAA and glutamatergic dysfunctions, in the expression of symptoms of schizophrenia.
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Affiliation(s)
- Yoshihiro Noda
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada
| | - Mera S Barr
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Reza Zomorrodi
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada
| | - Robin F H Cash
- Division of Neurology, Department of Medicine, University of Toronto, Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, M5T 2S8, Ontario, Canada
| | - Faranak Farzan
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, M5T 2S8, Ontario, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada. .,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada. .,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada.
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10
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Bolden LB, Griffis JC, Pati S, Szaflarski JP. Cortical excitability and neuropsychological functioning in healthy adults. Neuropsychologia 2017. [PMID: 28648572 DOI: 10.1016/j.neuropsychologia.2017.06.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Evidence from clinical populations, such as epilepsy and attention deficit/hyperactivity disorder, suggests a relationship between hyperexcitability and cognitive impairment, but this relationship has not been demonstrated in healthy individuals. Here, we investigate the relationship between cortical excitability and cognitive functioning in healthy adults. Single- and paired-pulse TMS was applied to 20 healthy adults to measure cortical excitability and long-interval intracortical inhibition (LICI). A neuropsychological battery was administered to assess aspects of attention, executive function, and mood. Participants with primarily excitatory responses to the LICI paradigm performed worse on a composite measure of attention and reported more negative mood states than participants with primarily inhibitory responses. Thus, differences in attention and mood among healthy adults are related to differences in cortical excitability as measured by LICI. This is consistent with a role for GABAB inhibitory circuits in regulating attention and mood, and suggests that individual variability in these domains may reflect variability in cortical excitability. This study demonstrates preliminary evidence that increased cortical excitability is associated with poorer cognition and mood in healthy adults. These findings provide new insight into the presence of cognitive dysfunction in several patient populations with hyperexcitability and support the development of neurostimulation interventions for clinical use.
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Affiliation(s)
- Lauren B Bolden
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Joseph C Griffis
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandipan Pati
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Goodman MS, Bridgman AC, Rabin RA, Blumberger DM, Rajji TK, Daskalakis ZJ, George TP, Barr MS. Differential effects of cannabis dependence on cortical inhibition in patients with schizophrenia and non-psychiatric controls. Brain Stimul 2016; 10:275-282. [PMID: 27964871 DOI: 10.1016/j.brs.2016.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/04/2016] [Accepted: 11/10/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cannabis is the most commonly used illicit substance among patients with schizophrenia. Cannabis exacerbates psychotic symptoms and leads to poor functional outcomes. Dysfunctional cortical inhibition has been implicated in the pathophysiology of schizophrenia; however, the effects of cannabis on this mechanism have been relatively unexamined. The goal of this study was to index cortical inhibition from the motor cortex among 4 groups: schizophrenia patients and non-psychiatric controls dependent on cannabis as well as cannabis-free schizophrenia patients and non-psychiatric controls. METHODS In this cross-sectional study, GABA-mediated cortical inhibition was index with single- and paired-pulse transcranial magnetic stimulation (TMS) paradigms to the left motor cortex in 12 cannabis dependent and 11 cannabis-free schizophrenia patients, and in 10 cannabis dependent and 13 cannabis-free controls. RESULTS Cannabis-dependent patients with schizophrenia displayed greater short-interval cortical inhibition (SICI) compared to cannabis-free schizophrenia patients (p = 0.029), while cannabis-dependent controls displayed reduced SICI compared to cannabis-free controls (p = 0.004). SICI did not differ between cannabis dependent patients and cannabis-free controls, or between dependent schizophrenia patients compared to dependent controls. No significant differences were found for long-interval cortical inhibition (LICI) or intra-cortical facilitation (ICF) receptor function, suggesting a selective effect on SICI. CONCLUSION These findings suggest that cannabis dependence may have selective and differing effects on SICI in schizophrenia patients compared to controls, which may provide insight into the pathophysiology of co-morbid cannabis dependence in schizophrenia.
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Affiliation(s)
- Michelle S Goodman
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Alanna C Bridgman
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Rachel A Rabin
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Daniel M Blumberger
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada; Division of Geriatric Psychiatry, CAMH and Department of Psychiatry, University of Toronto, 80 Workman Way, Toronto M6J 1H4, ON, Canada
| | - Tarek K Rajji
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada; Division of Geriatric Psychiatry, CAMH and Department of Psychiatry, University of Toronto, 80 Workman Way, Toronto M6J 1H4, ON, Canada
| | - Zafiris J Daskalakis
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Tony P George
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Mera S Barr
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada.
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12
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Iscan Z, Nazarova M, Fedele T, Blagovechtchenski E, Nikulin VV. Pre-stimulus Alpha Oscillations and Inter-subject Variability of Motor Evoked Potentials in Single- and Paired-Pulse TMS Paradigms. Front Hum Neurosci 2016; 10:504. [PMID: 27774060 PMCID: PMC5054042 DOI: 10.3389/fnhum.2016.00504] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/26/2016] [Indexed: 12/17/2022] Open
Abstract
Inter- and intra-subject variability of the motor evoked potentials (MEPs) to TMS is a well-known phenomenon. Although a possible link between this variability and ongoing brain oscillations was demonstrated, the results of the studies are not consistent with each other. Exploring this topic further is important since the modulation of MEPs provides unique possibility to relate oscillatory cortical phenomena to the state of the motor cortex probed with TMS. Given that alpha oscillations were shown to reflect cortical excitability, we hypothesized that their power and variability might explain the modulation of subject-specific MEPs to single- and paired-pulse TMS (spTMS, ppTMS, respectively). Neuronal activity was recorded with multichannel electroencephalogram. We used spTMS and two ppTMS conditions: intracortical facilitation (ICF) and short-interval intracortical inhibition (SICI). Spearman correlations were calculated within and across subjects between MEPs and the pre-stimulus power of alpha oscillations in low (8-10 Hz) and high (10-12 Hz) frequency bands. Coefficient of quartile variation was used to measure variability. Across-subject analysis revealed no difference in the pre-stimulus alpha power among the TMS conditions. However, the variability of high-alpha power in spTMS condition was larger than in the SICI condition. In ICF condition pre-stimulus high-alpha power variability correlated positively with MEP amplitude variability. No correlation has been observed between the pre-stimulus alpha power and MEP responses in any of the conditions. Our results show that the variability of the alpha oscillations can be more predictive of TMS effects than the commonly used power of oscillations and we provide further support for the dissociation of high and low-alpha bands in predicting responses produced by the stimulation of the motor cortex.
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Affiliation(s)
- Zafer Iscan
- Centre for Cognition and Decision Making, National Research University Higher School of Economics Moscow, Russia
| | - Maria Nazarova
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Research Center of NeurologyMoscow, Russia
| | - Tommaso Fedele
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Department of Neurosurgery, University Hospital of Zurich, University of ZurichZurich, Switzerland
| | - Evgeny Blagovechtchenski
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Laboratory of Neuroscience and Molecular Pharmacology, Institute of Translational Biomedicine, Saint Petersburg State UniversitySaint Petersburg, Russia
| | - Vadim V Nikulin
- Centre for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia; Neurophysics Group, Department of Neurology, Charité - University Medicine BerlinBerlin, Germany
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13
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Mellerio C, Lapointe MN, Roca P, Charron S, Legrand L, Meder JF, Oppenheim C, Cachia A. Identification of Reliable Sulcal Patterns of the Human Rolandic Region. Front Hum Neurosci 2016; 10:410. [PMID: 27582700 PMCID: PMC4987365 DOI: 10.3389/fnhum.2016.00410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/02/2016] [Indexed: 11/13/2022] Open
Abstract
A major feature of the human cortex is its huge morphological variability. Although a comprehensive literature about the sulco-gyral pattern of the central region is available from post-mortem data, a reliable and reproducible characterization from in vivo data is still lacking. The aim of this study is to test the reliability of morphological criteria of the central region sulci used in post-mortem data, when applied to in vivo magnetic resonance imaging (MRI) data. Thirty right-handed healthy individuals were included in the study. Automated segmentation and three dimensional (3D) surface-based rendering were obtained from clinical 3D T1-weighted MRI. Two senior radiologists labeled the three sulci composing the central region (precentral [PreCS], central [CS] and postcentral [PostCS]) and analyzed their morphological variations using 47 standard criteria derived from Ono's atlas based on post-mortem data. For each criterion, inter-rater concordance and comparison with the occurrence frequency provided in Ono's atlas were estimated. Overall, the sulcal pattern criteria derived from MRI data were highly reproducible between the raters with a high mean inter-rater concordance in the three sulci (CS: κ = 0.92 in left hemisphere/κ = 0.91 in right hemisphere; PreCS: κ = 0.91/κ = 0.93; PostCS: κ = 0.84/0.79). Only a very limited number of sulcal criteria significantly differed between the in vivo and the post-mortem data (CS: 2 criteria in the left hemisphere/3 criteria in the right hemisphere; PreCS: 3 in the left and right hemispheres; PostCS: 3 in the left hemisphere and 5 in the right hemisphere). Our study provides a comprehensive description of qualitative sulcal patterns in the central region from in vivo clinical MRI with high agreement with previous post-mortem data. Such identification of reliable sulcal patterns of the central region visible with standard clinical MRI data paves the way for the detection of subtle variations of the central sulcation associated with variations of normal or pathological functioning.
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Affiliation(s)
- Charles Mellerio
- Department of Neuroradiology, Centre Hospitalier Sainte-AnneParis, France; University Paris DescartesParis, France; Imaging Biomarkers of Brain Development and Disorders, INSERM, UMR 894Paris, France
| | - Marie-Noël Lapointe
- Department of Radiology, Hôpital de l'Enfant-Jésus, CHU de Québec Ville de Québec, QC, Canada
| | - Pauline Roca
- Department of Neuroradiology, Centre Hospitalier Sainte-AnneParis, France; Imaging Biomarkers of Brain Development and Disorders, INSERM, UMR 894Paris, France
| | - Sylvain Charron
- Department of Neuroradiology, Centre Hospitalier Sainte-AnneParis, France; University Paris DescartesParis, France
| | - Laurence Legrand
- Department of Neuroradiology, Centre Hospitalier Sainte-AnneParis, France; University Paris DescartesParis, France
| | - Jean-François Meder
- Department of Neuroradiology, Centre Hospitalier Sainte-AnneParis, France; University Paris DescartesParis, France; Imaging Biomarkers of Brain Development and Disorders, INSERM, UMR 894Paris, France
| | - Catherine Oppenheim
- Department of Neuroradiology, Centre Hospitalier Sainte-AnneParis, France; University Paris DescartesParis, France; Imaging Biomarkers of Brain Development and Disorders, INSERM, UMR 894Paris, France
| | - Arnaud Cachia
- University Paris DescartesParis, France; Imaging Biomarkers of Brain Development and Disorders, INSERM, UMR 894Paris, France; Laboratory for the Psychology of Child Development and Education, CNRS, UMR 8240Paris, France; Institut Universitaire de FranceParis, France
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14
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GABA abnormalities in schizophrenia: a methodological review of in vivo studies. Schizophr Res 2015; 167:84-90. [PMID: 25458856 PMCID: PMC4409914 DOI: 10.1016/j.schres.2014.10.011] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 10/04/2014] [Accepted: 10/07/2014] [Indexed: 12/31/2022]
Abstract
Abnormalities of GABAergic interneurons are some of the most consistent findings from post-mortem studies of schizophrenia. However, linking these molecular deficits with in vivo observations in patients - a critical goal in order to evaluate interventions that would target GABAergic deficits - presents a challenge. Explanatory models have been developed based on animal work and the emerging experimental literature in schizophrenia patients. This literature includes: neuroimaging ligands to GABA receptors, magnetic resonance spectroscopy (MRS) of GABA concentration, transcranial magnetic stimulation of cortical inhibitory circuits and pharmacologic probes of GABA receptors to dynamically challenge the GABA system, usually in combination with neuroimaging studies. Pharmacologic challenges have elicited behavioral changes, and preliminary studies of therapeutic GABAergic interventions have been conducted. This article critically reviews the evidence for GABAergic dysfunction from each of these areas. These methods remain indirect measures of GABAergic function, and a broad array of dysfunction is linked with the putative GABAergic measures, including positive symptoms, cognition, emotion, motor processing and sensory processing, covering diverse brain areas. Measures of receptor binding have not shown replicable group differences in binding, and MRS assays of GABA concentration have yielded equivocal evidence of large-scale alteration in GABA concentration. Overall, the experimental base remains sparse, and much remains to be learned about the role of GABAergic interneurons in healthy brains. Challenges with pharmacologic and functional probes show promise, and may yet enable a better characterization of GABAergic deficits in schizophrenia.
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15
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Nordmann G, Azorina V, Langguth B, Schecklmann M. A systematic review of non-motor rTMS induced motor cortex plasticity. Front Hum Neurosci 2015; 9:416. [PMID: 26257632 PMCID: PMC4508515 DOI: 10.3389/fnhum.2015.00416] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 07/06/2015] [Indexed: 11/29/2022] Open
Abstract
Motor cortex excitability can be measured by single- and paired-pulse transcranial magnetic stimulation (TMS). Repetitive transcranial magnetic stimulation (rTMS) can induce neuroplastic effects in stimulated and in functionally connected cortical regions. Due to its ability to non-invasively modulate cortical activity, rTMS has been investigated for the treatment of various neurological and psychiatric disorders. However, such studies revealed a high variability of both clinical and neuronal effects induced by rTMS. In order to better elucidate this meta-plasticity, rTMS-induced changes in motor cortex excitability have been monitored in various studies in a pre-post stimulation design. Here, we give a literature review of studies investigating motor cortex excitability changes as a neuronal marker for rTMS effects over non-motor cortical areas. A systematic literature review in April 2014 resulted in 29 articles in which motor cortex excitability was assessed before and after rTMS over non-motor areas. The majority of the studies focused on the stimulation of one of three separate cortical areas: the prefrontal area (17 studies), the cerebellum (8 studies), or the temporal cortex (3 studies). One study assessed the effects of multi-site rTMS. Most studies investigated healthy controls but some also stimulated patients with neuropsychiatric conditions (e.g., affective disorders, tinnitus). Methods and findings of the identified studies were highly variable showing no clear systematic pattern of interaction of non-motor rTMS with measures of motor cortex excitability. Based on the available literature, the measurement of motor cortex excitability changes before and after non-motor rTMS has only limited value in the investigation of rTMS related meta-plasticity as a neuronal state or as a trait marker for neuropsychiatric diseases. Our results do not suggest that there are systematic alterations of cortical excitability changes during rTMS treatment, which calls into question the practice of re-adjusting the stimulation intensity according to the motor threshold over the course of the treatment.
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Affiliation(s)
- Grégory Nordmann
- Experimental and Clinical Neuroscience, University of Regensburg Regensburg, Germany ; Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
| | - Valeriya Azorina
- Experimental and Clinical Neuroscience, University of Regensburg Regensburg, Germany ; Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
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16
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Hasan A, Brinkmann C, Strube W, Palm U, Malchow B, Rothwell JC, Falkai P, Wobrock T. Investigations of motor-cortex cortical plasticity following facilitatory and inhibitory transcranial theta-burst stimulation in schizophrenia: a proof-of-concept study. J Psychiatr Res 2015; 61:196-204. [PMID: 25555304 DOI: 10.1016/j.jpsychires.2014.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 12/08/2014] [Accepted: 12/12/2014] [Indexed: 12/12/2022]
Abstract
Impaired neural plasticity has been proposed as an important pathophysiological feature underlying the neurobiology and symptomatology of schizophrenia. In this proof-of-concept study, we aimed to explore cortical plasticity in schizophrenia patients with two different transcranial theta-burst (TBS) paradigms. TBS induces Ca(2+)-dependent long-term-potentiation (LTP)-like and long-term-depression (LTP)-like plasticity in the human motor cortex. A total of 10 schizophrenia patients and 10 healthy controls were included in this study. Cortical excitability was investigated using transcranial magnetic stimulation in each study participant before and after TBS applied to the left primary motor-cortex on two different days. cTBS600 was used to induce LTD-like and cTBS300 was used to induce LTP-like plasticity in the absence of any prior motor-cortex activation. Repeated measures ANOVAs showed a significant interaction between the timecourse, the study group and the stimulation paradigm (cTBS600 vs. cTBS300) for the left, but not for the right hemisphere. Healthy controls showed an MEP amplitude decrease at a trend level following cTBS600 and a numeric, but not significant, increase in MEP amplitudes following cTBS300. Schizophrenia patients did not show an MEP amplitude decrease following cTBS600, but surprisingly a significant MEP decrease following cTBS300. The proportion of subjects showing the expected changes in motor-cortex excitability following both cTBS paradigms was higher in healthy controls. These preliminary results indicate differences in cortical plasticity following two different cTBS protocols in schizophrenia patients compared to healthy controls. However, the incomplete plasticity response in the healthy controls and the proof-of-concept nature of this study need to be considered as important limitations.
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Affiliation(s)
- Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany.
| | - Caroline Brinkmann
- Department of Psychiatry and Psychotherapy, University of Goettingen, Goettingen, Germany
| | - Wolfgang Strube
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, UK
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, University of Goettingen, Goettingen, Germany; Centre of Mental Health, Darmstadt-Dieburg Clinics, Darmstadt, Germany
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17
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Sabouni A, Pouliot P, Shmuel A, Lesage F. BRAIN initiative: fast and parallel solver for real-time monitoring of the eddy current in the brain for TMS applications. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:6250-3. [PMID: 25571425 DOI: 10.1109/embc.2014.6945057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper introduce a fast and efficient solver for simulating the induced (eddy) current distribution in the brain during transcranial magnetic stimulation procedure. This solver has been integrated with MRI and neuronavigation software to accurately model the electromagnetic field and show eddy current in the head almost in real-time. To examine the performance of the proposed technique, we used a 3D anatomically accurate MRI model of the 25 year old female subject.
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18
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Mehta UM, Thirthalli J, Basavaraju R, Gangadhar BN. Association of intracortical inhibition with social cognition deficits in schizophrenia: Findings from a transcranial magnetic stimulation study. Schizophr Res 2014; 158:146-50. [PMID: 25048423 DOI: 10.1016/j.schres.2014.06.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 05/13/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
Abstract
Abnormal cortical-inhibition has been hypothesized to underlie social-cognition deficits in schizophrenia. Studies using transcranial magnetic stimulation (TMS) as a neurophysiological probe have demonstrated cortical-inhibition deficits in this group. We compared TMS-measured short- and long-interval intracortical-inhibition (SICI & LICI) in antipsychotic-naïve (n=33) and medicated (n=21) schizophrenia patients and in healthy comparison subjects (n=45). We also studied the association between cortical-inhibition and social-cognition deficits in the patients. Antipsychotic-naïve patients had significant deficits in SICI (i.e., less inhibitory response). In this group, SICI had significant inverse correlations with emotion processing and a global social-cognition score. Impaired intracortical-inhibition may thus contribute to social-cognition deficits in schizophrenia.
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Affiliation(s)
- Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
| | - Rakshathi Basavaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
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