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Parker D, Trotti R, McDowell J, Keedy S, Keshavan M, Pearlson G, Gershon E, Ivleva E, Huang LY, Sauer K, Hill S, Sweeny J, Tamminga C, Clementz B. Differentiating Biomarker Features and Familial Characteristics of B-SNIP Psychosis Biotypes. RESEARCH SQUARE 2024:rs.3.rs-3702638. [PMID: 38260530 PMCID: PMC10802686 DOI: 10.21203/rs.3.rs-3702638/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Idiopathic psychosis shows considerable biological heterogeneity across cases. B-SNIP used psychosis-relevant biomarkers to identity psychosis Biotypes, which will aid etiological and targeted treatment investigations. Psychosis probands from the B-SNIP consortium (n = 1907), their first-degree biological relatives (n = 705), and healthy participants (n = 895) completed a biomarker battery composed of cognition, saccades, and auditory EEG measurements. ERP quantifications were substantially modified from previous iterations of this approach. Multivariate integration reduced multiple biomarker outcomes to 11 "bio-factors". Twenty-four different approaches indicated bio-factor data among probands were best distributed as three subgroups. Numerical taxonomy with k-means constructed psychosis Biotypes, and rand indices evaluated consistency of Biotype assignments. Psychosis subgroups, their non-psychotic first-degree relatives, and healthy individuals were compared across bio-factors. The three psychosis Biotypes differed significantly on all 11 bio-factors, especially prominent for general cognition, antisaccades, ERP magnitude, and intrinsic neural activity. Rand indices showed excellent consistency of clustering membership when samples included at least 1100 subjects. Canonical discriminant analysis described composite bio-factors that simplified group comparisons and captured neural dysregulation, neural vigor, and stimulus salience variates. Neural dysregulation captured Biotype-2, low neural vigor captured Biotype-1, and deviations of stimulus salience captured Biotype-3. First-degree relatives showed similar patterns as their Biotyped proband relatives on general cognition, antisaccades, ERP magnitudes, and intrinsic brain activity. Results extend previous efforts by the B-SNIP consortium to characterize biologically distinct psychosis Biotypes. They also show that at least 1100 observations are necessary to achieve consistent outcomes. First-degree relative data implicate specific bio-factor deviations to the subtype of their proband and may inform studies of genetic risk.
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Clementz BA, Chattopadhyay I, Trotti RL, Parker DA, Gershon ES, Hill SK, Ivleva EI, Keedy SK, Keshavan MS, McDowell JE, Pearlson GD, Tamminga CA, Gibbons RD. Clinical characterization and differentiation of B-SNIP psychosis Biotypes: Algorithmic Diagnostics for Efficient Prescription of Treatments (ADEPT)-1. Schizophr Res 2023; 260:143-151. [PMID: 37657281 PMCID: PMC10712427 DOI: 10.1016/j.schres.2023.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/03/2023]
Abstract
Clinically defined psychosis diagnoses are neurobiologically heterogeneous. The B-SNIP consortium identified and validated more neurobiologically homogeneous psychosis Biotypes using an extensive battery of neurocognitive and psychophysiological laboratory measures. However, typically the first step in any diagnostic evaluation is the clinical interview. In this project, we evaluated if psychosis Biotypes have clinical characteristics that can support their differentiation in addition to obtaining laboratory testing. Clinical interview data from 1907 individuals with a psychosis Biotype were used to create a diagnostic algorithm. The features were 58 ratings from standard clinical scales. Extremely randomized tree algorithms were used to evaluate sensitivity, specificity, and overall classification success. Biotype classification accuracy peaked at 91 % with the use of 57 items on average. A reduced feature set of 28 items, though, also showed 81 % classification accuracy. Using this reduced item set, we found that only 10-11 items achieved a one-vs-all (Biotype-1 or not, Biotype-2 or not, Biotype-3 or not) area under the sensitivity-specificity curve of .78 to .81. The top clinical characteristics for differentiating psychosis Biotypes, in order of importance, were (i) difficulty in abstract thinking, (ii) multiple indicators of social functioning, (iii) conceptual disorganization, (iv) severity of hallucinations, (v) stereotyped thinking, (vi) suspiciousness, (vii) unusual thought content, (viii) lack of spontaneous speech, and (ix) severity of delusions. These features were remarkably different from those that differentiated DSM psychosis diagnoses. This low-burden adaptive algorithm achieved reasonable classification accuracy and will support Biotype-specific etiological and treatment investigations even in under-resourced clinical and research environments.
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Affiliation(s)
- Brett A Clementz
- Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA 30602, United States of America.
| | - Ishanu Chattopadhyay
- Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago, IL, United States of America
| | - Rebekah L Trotti
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - David A Parker
- Department of Human Genetics, Emory University School of Medicine, Atlanta VA Medical Center, Atlanta, GA, United States of America
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States of America
| | - Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Jennifer E McDowell
- Department of Psychology, Owens Institute for Behavioral Research, University of Georgia, Athens, GA 30602, United States of America
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University, School of Medicine, New Haven, CT, United States of America; Olin NeuroPsychiatry Research Center, Institute of Living, Hartford, CT, United States of America
| | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Robert D Gibbons
- Center for Health Statistics, Departments of Medicine and Public Health Sciences, University of Chicago, Chicago, IL, United States of America
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Parker DA, Cubells JF, Imes SL, Ruban GA, Henshey BT, Massa NM, Walker EF, Duncan EJ, Ousley OY. Deep psychophysiological phenotyping of adolescents and adults with 22q11.2 deletion syndrome: a multilevel approach to defining core disease processes. BMC Psychiatry 2023; 23:425. [PMID: 37312091 PMCID: PMC10262114 DOI: 10.1186/s12888-023-04888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/18/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11.2DS) is the most common chromosomal interstitial-deletion disorder, occurring in approximately 1 in 2000 to 6000 live births. Affected individuals exhibit variable clinical phenotypes that can include velopharyngeal anomalies, heart defects, T-cell-related immune deficits, dysmorphic facial features, neurodevelopmental disorders, including autism, early cognitive decline, schizophrenia, and other psychiatric disorders. Developing comprehensive treatments for 22q11.2DS requires an understanding of both the psychophysiological and neural mechanisms driving clinical outcomes. Our project probes the core psychophysiological abnormalities of 22q11.2DS in parallel with molecular studies of stem cell-derived neurons to unravel the basic mechanisms and pathophysiology of 22q11.2-related psychiatric disorders, with a primary focus on psychotic disorders. Our study is guided by the central hypothesis that abnormal neural processing associates with psychophysiological processing and underlies clinical diagnosis and symptomatology. Here, we present the scientific background and justification for our study, sharing details of our study design and human data collection protocol. METHODS Our study is recruiting individuals with 22q11.2DS and healthy comparison subjects between the ages of 16 and 60 years. We are employing an extensive psychophysiological assessment battery (e.g., EEG, evoked potential measures, and acoustic startle) to assess fundamental sensory detection, attention, and reactivity. To complement these unbiased measures of cognitive processing, we will develop stem-cell derived neurons and examine neuronal phenotypes relevant to neurotransmission. Clinical characterization of our 22q11.2DS and control participants relies on diagnostic and research domain criteria assessments, including standard Axis-I diagnostic and neurocognitive measures, following from the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) and the North American Prodrome Longitudinal Study (NAPLS) batteries. We are also collecting measures of autism spectrum (ASD) and attention deficit/hyperactivity disorder (ADHD)-related symptoms. DISCUSSION Studying 22q11.2DS in adolescence and adulthood via deep phenotyping across multiple clinical and biological domains may significantly increase our knowledge of its core disease processes. Our manuscript describes our ongoing study's protocol in detail. These paradigms could be adapted by clinical researchers studying 22q11.2DS, other CNV/single gene disorders, or idiopathic psychiatric syndromes, as well as by basic researchers who plan to incorporate biobehavioral outcome measures into their studies of 22q11.2DS.
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Affiliation(s)
- David A Parker
- Department of Human Genetics, Emory University School of Medicine, Whitehead Biomedical Research Building 615 Michael Street Suite 301, Atlanta, GA, 30322, USA.
| | - Joseph F Cubells
- Department of Human Genetics; Emory Autism Center; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Sid L Imes
- Department of Human Genetics, Emory University School of Medicine, Whitehead Biomedical Research Building 615 Michael Street Suite 301, Atlanta, GA, 30322, USA
| | - Gabrielle A Ruban
- Department of Human Genetics, Emory University School of Medicine, Whitehead Biomedical Research Building 615 Michael Street Suite 301, Atlanta, GA, 30322, USA
| | - Brett T Henshey
- Emory University, Whitehead Biomedical Research Building 615 Michael Street Suite 301, Atlanta, GA, 30322, USA
| | - Nicholas M Massa
- Atlanta Veterans Administration Health Care System, 1670 Clairmont Road, Decatur, GA, 30033, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Psychology and Interdisciplinary Sciences Building Suite 487, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - Erica J Duncan
- Atlanta Veterans Administration Health Care System, 1670 Clairmont Road, Decatur, GA, 30033, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Brain Health Center, 12 Executive Park Dr, Atlanta, GA, 30329, USA
| | - Opal Y Ousley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, USA
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Trotti RL, Parker DA, Sabatinelli D, Keshavan MS, Keedy SK, Gershon ES, Pearlson GD, Hill SK, Tamminga CA, McDowell JE, Clementz BA. Emotional scene processing in biotypes of psychosis. Psychiatry Res 2023; 324:115227. [PMID: 37121219 PMCID: PMC10175237 DOI: 10.1016/j.psychres.2023.115227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/14/2023] [Accepted: 04/23/2023] [Indexed: 05/02/2023]
Abstract
Social-emotional deficits in psychosis may be indexed by deviations in emotional scene processing, but event-related potential (ERP) studies indicate such deviations may not map cleanly to diagnostic categories. Neurobiologically defined psychosis subgroups offer an alternative that may better capture neurophysiological correlates of social-emotional deficits. The current study investigates emotional scene-elicited ERPs in Biotypes of psychosis in a large (N = 622), well-characterized sample. Electroencephalography was recorded in healthy persons (N = 129), Biotype-1 (N = 195), Biotype-2 (N = 131), and Biotype-3 (N = 167) psychosis cases. ERPs were measured from posterior and centroparietal scalp locations. Neural responses to emotional scenes were compared between healthy and psychosis groups. Multivariate group discrimination analyses resulted in two composite variates that differentiated groups. The first variate displayed large differences between low-cognition (Biotype-1, Biotype-2) and intact-cognition groups (Biotype-3, healthy persons). The second indicated a small-to-moderate distinction of Biotypes-2 and -3 from Biotype-1 and healthy persons. Two multivariate correlations were identified indicating associations between 1) self-reported emotional experience and generalized cognition and 2) socio-occupational functioning and late-stage emotional processing. Psychosis Biotypes displayed emotional processing deficits not apparent in DSM psychosis subgroups. Future translational research may benefit from exploring emotional scene processing in such neurobiologically-defined psychosis groups.
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Affiliation(s)
- R L Trotti
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - D A Parker
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - D Sabatinelli
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - M S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - S K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - E S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - G D Pearlson
- Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - S K Hill
- Department of Psychology, Rosalind Franklin University, North Chicago, IL, USA
| | - C A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J E McDowell
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - B A Clementz
- Department of Psychology, University of Georgia, Athens, GA, USA
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Raymond N, Lizano P, Kelly S, Hegde R, Keedy S, Pearlson GD, Gershon ES, Clementz BA, Tamminga CA, Keshavan M. What can clozapine’s effect on neural oscillations tell us about its therapeutic effects? A scoping review and synthesis. Biomark Neuropsychiatry 2022. [DOI: 10.1016/j.bionps.2022.100048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Clementz BA, Parker DA, Trotti RL, McDowell JE, Keedy SK, Keshavan MS, Pearlson GD, Gershon ES, Ivleva EI, Huang LY, Hill SK, Sweeney JA, Thomas O, Hudgens-Haney M, Gibbons RD, Tamminga CA. Psychosis Biotypes: Replication and Validation from the B-SNIP Consortium. Schizophr Bull 2022; 48:56-68. [PMID: 34409449 PMCID: PMC8781330 DOI: 10.1093/schbul/sbab090] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Current clinical phenomenological diagnosis in psychiatry neither captures biologically homologous disease entities nor allows for individualized treatment prescriptions based on neurobiology. In this report, we studied two large samples of cases with schizophrenia, schizoaffective, and bipolar I disorder with psychosis, presentations with clinical features of hallucinations, delusions, thought disorder, affective, or negative symptoms. A biomarker approach to subtyping psychosis cases (called psychosis Biotypes) captured neurobiological homology that was missed by conventional clinical diagnoses. Two samples (called "B-SNIP1" with 711 psychosis and 274 healthy persons, and the "replication sample" with 717 psychosis and 198 healthy persons) showed that 44 individual biomarkers, drawn from general cognition (BACS), motor inhibitory (stop signal), saccadic system (pro- and anti-saccades), and auditory EEG/ERP (paired-stimuli and oddball) tasks of psychosis-relevant brain functions were replicable (r's from .96-.99) and temporally stable (r's from .76-.95). Using numerical taxonomy (k-means clustering) with nine groups of integrated biomarker characteristics (called bio-factors) yielded three Biotypes that were virtually identical between the two samples and showed highly similar case assignments to subgroups based on cross-validations (88.5%-89%). Biotypes-1 and -2 shared poor cognition. Biotype-1 was further characterized by low neural response magnitudes, while Biotype-2 was further characterized by overactive neural responses and poor sensory motor inhibition. Biotype-3 was nearly normal on all bio-factors. Construct validation of Biotype EEG/ERP neurophysiology using measures of intrinsic neural activity and auditory steady state stimulation highlighted the robustness of these outcomes. Psychosis Biotypes may yield meaningful neurobiological targets for treatments and etiological investigations.
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Affiliation(s)
- Brett A Clementz
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - David A Parker
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Rebekah L Trotti
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
- Institute of Living, Hartford Healthcare Corp, Hartford, CT, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ling-Yu Huang
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Olivia Thomas
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | | | - Robert D Gibbons
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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Trotti RL, Abdelmageed S, Parker DA, Sabatinelli D, Tamminga CA, Gershon ES, Keedy SK, Keshavan MS, Pearlson GD, Sweeney JA, McDowell JE, Clementz BA. Neural Processing of Repeated Emotional Scenes in Schizophrenia, Schizoaffective Disorder, and Bipolar Disorder. Schizophr Bull 2021; 47:1473-1481. [PMID: 33693875 PMCID: PMC8379546 DOI: 10.1093/schbul/sbab018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Impaired emotional processing and cognitive functioning are common in schizophrenia, schizoaffective disorder, and bipolar disorders, causing significant socioemotional disability. While a large body of research demonstrates abnormal cognition/emotion interactions in these disorders, previous studies investigating abnormalities in the emotional scene response using event-related potentials (ERPs) have yielded mixed findings, and few studies compare findings across psychiatric diagnoses. The current study investigates the effects of emotion and repetition on ERPs in a large, well-characterized sample of participants with schizophrenia-bipolar syndromes. Two ERP components that are modulated by emotional content and scene repetition, the early posterior negativity (EPN) and late positive potential (LPP), were recorded in healthy controls and participants with schizophrenia, schizoaffective disorder, bipolar disorder with psychosis, and bipolar disorder without psychosis. Effects of emotion and repetition were compared across groups. Results displayed significant but small effects in schizophrenia and schizoaffective disorder, with diminished EPN amplitudes to neutral and novel scenes, reduced LPP amplitudes to emotional scenes, and attenuated effects of scene repetition. Despite significant findings, small effect sizes indicate that emotional scene processing is predominantly intact in these disorders. Multivariate analyses indicate that these mild ERP abnormalities are related to cognition, psychosocial functioning, and psychosis severity. This relationship suggests that impaired cognition, rather than diagnosis or mood disturbance, may underlie disrupted neural scene processing in schizophrenia-bipolar syndromes.
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Affiliation(s)
- Rebekah L Trotti
- Department of Psychology, University of Georgia, 613 Psychology Building, 125 Baldwin St., Athens, GA 30602, USA
| | - Sunny Abdelmageed
- Department of Psychology, University of Georgia, 613 Psychology Building, 125 Baldwin St., Athens, GA 30602, USA
| | - David A Parker
- Department of Psychology, University of Georgia, 613 Psychology Building, 125 Baldwin St., Athens, GA 30602, USA
| | - Dean Sabatinelli
- Department of Psychology, University of Georgia, 613 Psychology Building, 125 Baldwin St., Athens, GA 30602, USA
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | | | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer E McDowell
- Department of Psychology, University of Georgia, 613 Psychology Building, 125 Baldwin St., Athens, GA 30602, USA
| | - Brett A Clementz
- Department of Psychology, University of Georgia, 613 Psychology Building, 125 Baldwin St., Athens, GA 30602, USA
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Grover S, Keshavan MS, Lizano PL, Reinhart RMG. Proximate markers of cognitive dysfunction in schizophrenia. Schizophr Res 2021; 233:114-115. [PMID: 34325964 PMCID: PMC8380687 DOI: 10.1016/j.schres.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Shrey Grover
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, United States
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Paulo L Lizano
- Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Robert M G Reinhart
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, United States; Center for Systems Neuroscience, Cognitive Neuroimaging Center, Center for Research in Sensory Communications and Neural Technology, Boston University, Boston, MA, United States.
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Oliver W, Parker D, Hetrick W, Clementz BA. Is a paired-stimuli configuration necessary to obtain typical evoked response differences in studies of psychosis? An MEG study. Biomark Neuropsychiatry 2021; 4. [DOI: 10.1016/j.bionps.2021.100033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Donati FL, D’Agostino A, Ferrarelli F. Neurocognitive and neurophysiological endophenotypes in schizophrenia: An overview. Biomark Neuropsychiatry 2020. [DOI: 10.1016/j.bionps.2020.100017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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11
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Hudgens-Haney ME, Clementz BA, Ivleva EI, Keshavan MS, Pearlson GD, Gershon ES, Keedy SK, Sweeney JA, Gaudoux F, Bunouf P, Canolle B, Tonner F, Gatti-McArthur S, Tamminga CA. Cognitive Impairment and Diminished Neural Responses Constitute a Biomarker Signature of Negative Symptoms in Psychosis. Schizophr Bull 2020; 46:1269-1281. [PMID: 32043133 PMCID: PMC7505197 DOI: 10.1093/schbul/sbaa001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The treatment of negative symptoms (NS) in psychosis represents an urgent unmet medical need given the significant functional impairment it contributes to psychosis syndromes. The lack of progress in treating NS is impacted by the lack of known pathophysiology or associated quantitative biomarkers, which could provide tools for research. This current analysis investigated potential associations between NS and an extensive battery of behavioral and brain-based biomarkers in 932 psychosis probands from the B-SNIP database. The current analyses examined associations between PANSS-defined NS and (1) cognition, (2) pro-/anti-saccades, (3) evoked and resting-state electroencephalography (EEG), (4) resting-state fMRI, and (5) tractography. Canonical correlation analyses yielded symptom-biomarker constructs separately for each biomarker modality. Biomarker modalities were integrated using canonical discriminant analysis to summarize the symptom-biomarker relationships into a "biomarker signature" for NS. Finally, distinct biomarker profiles for 2 NS domains ("diminished expression" vs "avolition/apathy") were computed using step-wise linear regression. NS were associated with cognitive impairment, diminished EEG response amplitudes, deviant resting-state activity, and oculomotor abnormalities. While a connection between NS and poor cognition has been established, association to neurophysiology is novel, suggesting directions for future mechanistic studies. Each biomarker modality was related to NS in distinct and complex ways, giving NS a rich, interconnected fingerprint and suggesting that any one biomarker modality may not adequately capture the full spectrum of symptomology.
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Affiliation(s)
| | - Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT
- Institute of Living, Hartford Hospital, Hartford, CT
| | | | - Sarah K Keedy
- Department of Psychiatry, University of Chicago, Chicago, IL
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | | | | | | | | | | | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
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Clementz BA, Trotti RL, Pearlson GD, Keshavan MS, Gershon ES, Keedy SK, Ivleva EI, McDowell JE, Tamminga CA. Testing Psychosis Phenotypes From Bipolar-Schizophrenia Network for Intermediate Phenotypes for Clinical Application: Biotype Characteristics and Targets. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:808-818. [PMID: 32600898 DOI: 10.1016/j.bpsc.2020.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Psychiatry aspires to the molecular understanding of its disorders and, with that knowledge, to precision medicine. Research supporting such goals in the dimension of psychosis has been compromised, in part, by using phenomenology alone to estimate disease entities. To this end, we are proponents of a deep phenotyping approach in psychosis, using computational strategies to discover the most informative phenotypic fingerprint as a promising strategy to uncover mechanisms in psychosis. METHODS Doing this, the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) has used biomarkers to identify distinct subtypes of psychosis with replicable biomarker characteristics. While we have presented these entities as relevant, their potential utility in clinical practice has not yet been demonstrated. RESULTS Here we carried out an analysis of clinical features that characterize biotypes. We found that biotypes have unique and defining clinical characteristics that could be used as initial screens in the clinical and research settings. Differences in these clinical features appear to be consistent with biotype biomarker profiles, indicating a link between biological features and clinical presentation. Clinical features associated with biotypes differ from those associated with DSM diagnoses, indicating that biotypes and DSM syndromes are not redundant and are likely to yield different treatment predictions. We highlight 3 predictions based on biotype that are derived from individual biomarker features and cannot be obtained from DSM psychosis syndromes. CONCLUSIONS In the future, biotypes may prove to be useful for targeting distinct molecular, circuit, cognitive, and psychosocial therapies for improved functional outcomes.
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Affiliation(s)
- Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Rebekah L Trotti
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts
| | - Elliot S Gershon
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - Sarah K Keedy
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.
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