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Tume CE, Chick SL, Holmans PA, Rees E, O’Donovan MC, Cameron D, Bray NJ. Genetic Implication of Specific Glutamatergic Neurons of the Prefrontal Cortex in the Pathophysiology of Schizophrenia. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100345. [PMID: 39099730 PMCID: PMC11295574 DOI: 10.1016/j.bpsgos.2024.100345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/03/2024] [Accepted: 05/19/2024] [Indexed: 08/06/2024] Open
Abstract
Background The prefrontal cortex (PFC) has been strongly implicated in the pathophysiology of schizophrenia. Here, we combined high-resolution single-nuclei RNA sequencing data from the human PFC with large-scale genomic data for schizophrenia to identify constituent cell populations likely to mediate genetic liability to the disorder. Methods Gene expression specificity values were calculated from a single-nuclei RNA sequencing dataset comprising 84 cell populations from the human PFC, spanning gestation to adulthood. Enrichment of schizophrenia common variant liability and burden of rare protein-truncating coding variants were tested in genes with high expression specificity for each cell type. We also explored schizophrenia common variant associations in relation to gene expression across the developmental trajectory of implicated neurons. Results Common risk variation for schizophrenia was prominently enriched in genes with high expression specificity for a population of mature layer 4 glutamatergic neurons emerging in infancy. Common variant liability to schizophrenia increased along the developmental trajectory of this neuronal population. Fine-mapped genes at schizophrenia genome-wide association study risk loci had significantly higher expression specificity than other genes in these neurons and in a population of layer 5/6 glutamatergic neurons. People with schizophrenia had a higher rate of rare protein-truncating coding variants in genes expressed by cells of the PFC than control individuals, but no cell population was significantly enriched above this background rate. Conclusions We identified a population of layer 4 glutamatergic PFC neurons likely to be particularly affected by common variant genetic risk for schizophrenia, which may contribute to disturbances in thalamocortical connectivity in the condition.
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Affiliation(s)
- Claire E. Tume
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Sophie L. Chick
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Peter A. Holmans
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Elliott Rees
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Michael C. O’Donovan
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Darren Cameron
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Nicholas J. Bray
- Centre for Neuropsychiatric Genetics & Genomics, Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, Wales, United Kingdom
- Neuroscience & Mental Health Innovation Institute, Cardiff University, Cardiff, Wales, United Kingdom
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2
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Akhgari A, Michel TM, Vafaee MS. Dendritic spines and their role in the pathogenesis of neurodevelopmental and neurological disorders. Rev Neurosci 2024; 35:489-502. [PMID: 38440811 DOI: 10.1515/revneuro-2023-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/02/2024] [Indexed: 03/06/2024]
Abstract
Since Cajal introduced dendritic spines in the 19th century, they have attained considerable attention, especially in neuropsychiatric and neurologic disorders. Multiple roles of dendritic spine malfunction and pathology in the progression of various diseases have been reported. Thus, it is inevitable to consider these structures as new therapeutic targets for treating neuropsychiatric and neurologic disorders such as autism spectrum disorders, schizophrenia, dementia, Down syndrome, etc. Therefore, we attempted to prepare a narrative review of the literature regarding the role of dendritic spines in the pathogenesis of aforementioned diseases and to shed new light on their pathophysiology.
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Affiliation(s)
- Aisan Akhgari
- Student Research Committee, Tabriz University of Medical Sciences, Golgasht Street, Tabriz 5166616471, Iran
| | - Tanja Maria Michel
- Research Unit for Psychiatry, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
- Clinical Institute, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
| | - Manouchehr Seyedi Vafaee
- Research Unit for Psychiatry, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
- Clinical Institute, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
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3
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Kalinovic R, Pascariu A, Vlad G, Nitusca D, Sălcudean A, Sirbu IO, Marian C, Enatescu VR. Involvement of the Expression of G Protein-Coupled Receptors in Schizophrenia. Pharmaceuticals (Basel) 2024; 17:85. [PMID: 38256919 PMCID: PMC10818502 DOI: 10.3390/ph17010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/13/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
The expression of GPCRs has been associated with schizophrenia, and their expression may induce morphological changes in brain regions responsible for schizophrenia and disease-specific behavioral changes. The articles included in this review were selected using keywords and databases of scientific research websites. The expressions of GPRs have different involvements in schizophrenia, some increase the risk while others provide protection, and they may also be potential targets for new treatments. Proper evaluation of these factors is essential to have a better therapeutic response with a lower rate of chronicity and thus improve the long-term prognosis.
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Affiliation(s)
- Raluka Kalinovic
- Doctoral School, University of Medicine and Pharmacy Victor Babes Timisoara, 300041 Timisoara, Romania
- Eduard Pamfil Psychiatric Clinic, Timisoara County Emergency Clinical Hospital, 300425 Timisoara, Romania; (A.P.); (G.V.); (V.R.E.)
| | - Andrei Pascariu
- Eduard Pamfil Psychiatric Clinic, Timisoara County Emergency Clinical Hospital, 300425 Timisoara, Romania; (A.P.); (G.V.); (V.R.E.)
| | - Gabriela Vlad
- Eduard Pamfil Psychiatric Clinic, Timisoara County Emergency Clinical Hospital, 300425 Timisoara, Romania; (A.P.); (G.V.); (V.R.E.)
| | - Diana Nitusca
- Department of Biochemistry, University of Medicine and Pharmacy Victor Babes Timisoara, 300041 Timisoara, Romania; (D.N.); (I.O.S.); (C.M.)
- Center for Complex Networks Science, Victor Babes University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timisoara, Romania
| | - Andreea Sălcudean
- Discipline of Sociobiology, Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540136 Targu Mures, Romania;
| | - Ioan Ovidiu Sirbu
- Department of Biochemistry, University of Medicine and Pharmacy Victor Babes Timisoara, 300041 Timisoara, Romania; (D.N.); (I.O.S.); (C.M.)
- Center for Complex Networks Science, Victor Babes University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timisoara, Romania
| | - Catalin Marian
- Department of Biochemistry, University of Medicine and Pharmacy Victor Babes Timisoara, 300041 Timisoara, Romania; (D.N.); (I.O.S.); (C.M.)
- Center for Complex Networks Science, Victor Babes University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timisoara, Romania
| | - Virgil Radu Enatescu
- Eduard Pamfil Psychiatric Clinic, Timisoara County Emergency Clinical Hospital, 300425 Timisoara, Romania; (A.P.); (G.V.); (V.R.E.)
- Discipline of Psychiatry, Department of Neurosciences, University of Medicine and Pharmacy Victor Babes Timisoara, 300041 Timisoara, Romania
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4
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Chopra S, Segal A, Oldham S, Holmes A, Sabaroedin K, Orchard ER, Francey SM, O’Donoghue B, Cropley V, Nelson B, Graham J, Baldwin L, Tiego J, Yuen HP, Allott K, Alvarez-Jimenez M, Harrigan S, Fulcher BD, Aquino K, Pantelis C, Wood SJ, Bellgrove M, McGorry PD, Fornito A. Network-Based Spreading of Gray Matter Changes Across Different Stages of Psychosis. JAMA Psychiatry 2023; 80:1246-1257. [PMID: 37728918 PMCID: PMC10512169 DOI: 10.1001/jamapsychiatry.2023.3293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/21/2023] [Indexed: 09/22/2023]
Abstract
Importance Psychotic illness is associated with anatomically distributed gray matter reductions that can worsen with illness progression, but the mechanisms underlying the specific spatial patterning of these changes is unknown. Objective To test the hypothesis that brain network architecture constrains cross-sectional and longitudinal gray matter alterations across different stages of psychotic illness and to identify whether certain brain regions act as putative epicenters from which volume loss spreads. Design, Settings, and Participants This case-control study included 534 individuals from 4 cohorts, spanning early and late stages of psychotic illness. Early-stage cohorts included patients with antipsychotic-naive first-episode psychosis (n = 59) and a group of patients receiving medications within 3 years of psychosis onset (n = 121). Late-stage cohorts comprised 2 independent samples of people with established schizophrenia (n = 136). Each patient group had a corresponding matched control group (n = 218). A sample of healthy adults (n = 356) was used to derive representative structural and functional brain networks for modeling of network-based spreading processes. Longitudinal illness-related and antipsychotic-related gray matter changes over 3 and 12 months were examined using a triple-blind randomized placebo-control magnetic resonance imaging study of the antipsychotic-naive patients. All data were collected between April 29, 2008, and January 15, 2020, and analyses were performed between March 1, 2021, and January 14, 2023. Main Outcomes and Measures Coordinated deformation models were used to estimate the extent of gray matter volume (GMV) change in each of 332 parcellated areas by the volume changes observed in areas to which they were structurally or functionally coupled. To identify putative epicenters of volume loss, a network diffusion model was used to simulate the spread of pathology from different seed regions. Correlations between estimated and empirical spatial patterns of GMV alterations were used to quantify model performance. Results Of 534 included individuals, 354 (66.3%) were men, and the mean (SD) age was 28.4 (7.4) years. In both early and late stages of illness, spatial patterns of cross-sectional volume differences between patients and controls were more accurately estimated by coordinated deformation models constrained by structural, rather than functional, network architecture (r range, >0.46 to <0.57; P < .01). The same model also robustly estimated longitudinal volume changes related to illness (r ≥ 0.52; P < .001) and antipsychotic exposure (r ≥ 0.50; P < .004). Network diffusion modeling consistently identified, across all 4 data sets, the anterior hippocampus as a putative epicenter of pathological spread in psychosis. Epicenters of longitudinal GMV loss were apparent in posterior cortex early in the illness and shifted to the prefrontal cortex with illness progression. Conclusion and Relevance These findings highlight a central role for white matter fibers as conduits for the spread of pathology across different stages of psychotic illness, mirroring findings reported in neurodegenerative conditions. The structural connectome thus represents a fundamental constraint on brain changes in psychosis, regardless of whether these changes are caused by illness or medication. Moreover, the anterior hippocampus represents a putative epicenter of early brain pathology from which dysfunction may spread to affect connected areas.
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Affiliation(s)
- Sidhant Chopra
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Ashlea Segal
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Stuart Oldham
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Alexander Holmes
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Kristina Sabaroedin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
- Department of Radiology, Hotchkiss Brain Institute and Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Paediatrics, Hotchkiss Brain Institute and Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Edwina R. Orchard
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
- Child Study Centre, Yale University, New Haven, Connecticut
| | - Shona M. Francey
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Brian O’Donoghue
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Vanessa Cropley
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne, Carlton, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica Graham
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Baldwin
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susy Harrigan
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Mental Health, Melbourne School of Global and Population Health, The University of Melbourne, Parkville, Victoria, Australian
| | - Ben D. Fulcher
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
| | - Kevin Aquino
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
- Centre for Complex Systems, University of Sydney, Sydney, New South Wales, Australia
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne, Carlton, Victoria, Australia
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Western Health Sunshine Hospital, St Albans, Victoria, Australia
| | - Stephen J. Wood
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- School of Psychology, University of Birmingham, Edgbaston, United Kingdom
| | - Mark Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Patrick D. McGorry
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
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5
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Chatterjee I, Chatterjee S. Investigating the symptomatic and morphological changes in the brain based on pre and post-treatment: A critical review from clinical to neuroimaging studies on schizophrenia. IBRO Neurosci Rep 2023. [DOI: 10.1016/j.ibneur.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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6
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Nath M, Bhardwaj SK, Srivastava LK, Wong TP. Altered excitatory and decreased inhibitory transmission in the prefrontal cortex of male mice with early developmental disruption to the ventral hippocampus. Cereb Cortex 2023; 33:865-880. [PMID: 35297476 PMCID: PMC9890473 DOI: 10.1093/cercor/bhac107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Ventral hippocampal (vHPC)-prefrontal cortical (PFC) pathway dysfunction is a core neuroimaging feature of schizophrenia. However, mechanisms underlying impaired connectivity within this pathway remain poorly understood. The vHPC has direct projections to the PFC that help shape its maturation. Here, we wanted to investigate the effects of early developmental vHPC perturbations on long-term functional PFC organization. Using whole-cell recordings to assess PFC cellular activity in transgenic male mouse lines, we show early developmental disconnection of vHPC inputs, by excitotoxic lesion or cell-specific ablations, impairs pyramidal cell firing output and produces a persistent increase in excitatory and decrease in inhibitory synaptic inputs onto pyramidal cells. We show this effect is specific to excitatory vHPC projection cell ablation. We further identify PV-interneurons as a source of deficit in inhibitory transmission. We find PV-interneurons are reduced in density, show a reduced ability to sustain high-frequency firing, and show deficits in excitatory inputs that emerge over time. We additionally show differences in vulnerabilities to early developmental vHPC disconnection, wherein PFC PV-interneurons but not pyramidal cells show deficits in NMDA receptor-mediated current. Our results highlight mechanisms by which the PFC adapts to early developmental vHPC perturbations, providing insights into schizophrenia circuit pathology.
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Affiliation(s)
- Moushumi Nath
- Integrated Program in Neuroscience, McGill University, Montreal, QC H3A 0G4, Canada.,Basic Neuroscience Division, Douglas Hospital Research Centre, Montreal, QC H4H 1R3, Canada
| | - Sanjeev K Bhardwaj
- Basic Neuroscience Division, Douglas Hospital Research Centre, Montreal, QC H4H 1R3, Canada
| | - Lalit K Srivastava
- Basic Neuroscience Division, Douglas Hospital Research Centre, Montreal, QC H4H 1R3, Canada.,Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
| | - Tak Pan Wong
- Basic Neuroscience Division, Douglas Hospital Research Centre, Montreal, QC H4H 1R3, Canada.,Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
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7
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Cheng W, van der Meer D, Parker N, Hindley G, O'Connell KS, Wang Y, Shadrin AA, Alnæs D, Bahrami S, Lin A, Karadag N, Holen B, Fernandez-Cabello S, Fan CC, Dale AM, Djurovic S, Westlye LT, Frei O, Smeland OB, Andreassen OA. Shared genetic architecture between schizophrenia and subcortical brain volumes implicates early neurodevelopmental processes and brain development in childhood. Mol Psychiatry 2022; 27:5167-5176. [PMID: 36100668 DOI: 10.1038/s41380-022-01751-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 01/14/2023]
Abstract
Patients with schizophrenia have consistently shown brain volumetric abnormalities, implicating both etiological and pathological processes. However, the genetic relationship between schizophrenia and brain volumetric abnormalities remains poorly understood. Here, we applied novel statistical genetic approaches (MiXeR and conjunctional false discovery rate analysis) to investigate genetic overlap with mixed effect directions using independent genome-wide association studies of schizophrenia (n = 130,644) and brain volumetric phenotypes, including subcortical brain and intracranial volumes (n = 33,735). We found brain volumetric phenotypes share substantial genetic variants (74-96%) with schizophrenia, and observed 107 distinct shared loci with sign consistency in independent samples. Genes mapped by shared loci revealed (1) significant enrichment in neurodevelopmental biological processes, (2) three co-expression clusters with peak expression at the prenatal stage, and (3) genetically imputed thalamic expression of CRHR1 and ARL17A was associated with the thalamic volume as early as in childhood. Together, our findings provide evidence of shared genetic architecture between schizophrenia and brain volumetric phenotypes and suggest that altered early neurodevelopmental processes and brain development in childhood may be involved in schizophrenia development.
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Affiliation(s)
- Weiqiu Cheng
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Dennis van der Meer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Nadine Parker
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guy Hindley
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Kevin S O'Connell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Yunpeng Wang
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Centre for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, Oslo, Norway
| | - Alexey A Shadrin
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Shahram Bahrami
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Aihua Lin
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Naz Karadag
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Børge Holen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sara Fernandez-Cabello
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Chun-Chieh Fan
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, 92093, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Anders M Dale
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, 92093, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, USA.,Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Oleksandr Frei
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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8
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Vanes LD, Murray RM, Nosarti C. Adult outcome of preterm birth: Implications for neurodevelopmental theories of psychosis. Schizophr Res 2022; 247:41-54. [PMID: 34006427 DOI: 10.1016/j.schres.2021.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/22/2022]
Abstract
Preterm birth is associated with an elevated risk of developmental and adult psychiatric disorders, including psychosis. In this review, we evaluate the implications of neurodevelopmental, cognitive, motor, and social sequelae of preterm birth for developing psychosis, with an emphasis on outcomes observed in adulthood. Abnormal brain development precipitated by early exposure to the extra-uterine environment, and exacerbated by neuroinflammation, neonatal brain injury, and genetic vulnerability, can result in alterations of brain structure and function persisting into adulthood. These alterations, including abnormal regional brain volumes and white matter macro- and micro-structure, can critically impair functional (e.g. frontoparietal and thalamocortical) network connectivity in a manner characteristic of psychotic illness. The resulting executive, social, and motor dysfunctions may constitute the basis for behavioural vulnerability ultimately giving rise to psychotic symptomatology. There are many pathways to psychosis, but elucidating more precisely the mechanisms whereby preterm birth increases risk may shed light on that route consequent upon early neurodevelopmental insult.
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Affiliation(s)
- Lucy D Vanes
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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9
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Fountoulakis KN, Stahl SM. The effect of first- and second-generation antipsychotics on brain morphology in schizophrenia: A systematic review of longitudinal magnetic resonance studies with a randomized allocation to treatment arms. J Psychopharmacol 2022; 36:428-438. [PMID: 35395911 DOI: 10.1177/02698811221087645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Schizophrenia manifests as loss of brain volume in specific areas in a progressive nature and an important question concerns whether long-term treatment with medications contributes to this. The aim of the current PRISMA systematic review was to search for prospective studies involving randomization to treatment. PROSPERO ID: CRD42020197874. The MEDLINE/PUBMED was searched and it returned 2638 articles; 3 were fulfilling the inclusion criteria. A fourth was published later; they included 359 subjects, of whom 86 were healthy controls, while the rest were first-episode patients, with 91 under olanzapine, 93 under haloperidol, 48 under risperidone, 5 under paliperidone, 6 under ziprasidone, and 30 under placebo. Probably one-third of patients were suffering from a psychotic disorder other than schizophrenia. The consideration of their results suggested that there is no significant difference between these medications concerning their effects on brain structure and also in comparison to healthy subjects. There does not seem to be any strong support to the opinion that medications that treat psychosis cause loss of brain volume in patients with schizophrenia. On the contrary, the data might imply the possible presence of a protective effect for D2, 5-HT2, and NE alpha-2 antagonists (previously called SGAs). However, the literature is limited and focused research in large study samples is essential to clarify the issue, since important numerical differences do exist. The possibility of the results and their heterogeneity to be artifacts secondary to a modification of magnetic resonance imaging (MRI) signal by antipsychotics should not be easily rejected until relevant data are available.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stephen M Stahl
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Department of Psychiatry, Cambridge University, Cambridge, UK
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10
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Analysis of mRNA and Protein Levels of CAP2, DLG1 and ADAM10 Genes in Post-Mortem Brain of Schizophrenia, Parkinson's and Alzheimer's Disease Patients. Int J Mol Sci 2022; 23:ijms23031539. [PMID: 35163460 PMCID: PMC8835961 DOI: 10.3390/ijms23031539] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/22/2022] Open
Abstract
Schizophrenia (SCZ) is a mental illness characterized by aberrant synaptic plasticity and connectivity. A large bulk of evidence suggests genetic and functional links between postsynaptic abnormalities and SCZ. Here, we performed quantitative PCR and Western blotting analysis in the dorsolateral prefrontal cortex (DLPFC) and hippocampus of SCZ patients to investigate the mRNA and protein expression of three key spine shapers: the actin-binding protein cyclase-associated protein 2 (CAP2), the sheddase a disintegrin and metalloproteinase 10 (ADAM10), and the synapse-associated protein 97 (SAP97). Our analysis of the SCZ post-mortem brain indicated increased DLG1 mRNA in DLPFC and decreased CAP2 mRNA in the hippocampus of SCZ patients, compared to non-psychiatric control subjects, while the ADAM10 transcript was unaffected. Conversely, no differences in CAP2, SAP97, and ADAM10 protein levels were detected between SCZ and control individuals in both brain regions. To assess whether DLG1 and CAP2 transcript alterations were selective for SCZ, we also measured their expression in the superior frontal gyrus of patients affected by neurodegenerative disorders, like Parkinson’s and Alzheimer’s disease. Interestingly, also in Parkinson’s disease patients, we found a selective reduction of CAP2 mRNA levels relative to controls but unaltered protein levels. Taken together, we reported for the first time altered CAP2 expression in the brain of patients with psychiatric and neurological disorders, thus suggesting that aberrant expression of this gene may contribute to synaptic dysfunction in these neuropathologies.
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11
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Tognin S, Richter A, Kempton MJ, Modinos G, Antoniades M, Azis M, Allen P, Bossong MG, Perez J, Pantelis C, Nelson B, Amminger P, Riecher-Rössler A, Barrantes-Vidal N, Krebs MO, Glenthøj B, Ruhrmann S, Sachs G, Rutten BPF, de Haan L, van der Gaag M, Valmaggia LR, McGuire P. The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac040. [PMID: 35903803 PMCID: PMC9309497 DOI: 10.1093/schizbullopen/sgac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis. Methods 265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes. Results Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis. Conclusions In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- Department of Psychology, University of Roehampton, London, UK
| | - Matthijs G Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
| | - Jesus Perez
- CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul Amminger
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C’JAAD, Hospitalo-Universitaire department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Services Capital Region of Denmark, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), UK
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12
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Grubisha MJ, Sun T, Eisenman L, Erickson SL, Chou S, Helmer CD, Trudgen MT, Ding Y, Homanics GE, Penzes P, Wills ZP, Sweet RA. A Kalirin missense mutation enhances dendritic RhoA signaling and leads to regression of cortical dendritic arbors across development. Proc Natl Acad Sci U S A 2021; 118:e2022546118. [PMID: 34848542 PMCID: PMC8694055 DOI: 10.1073/pnas.2022546118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 09/15/2021] [Indexed: 11/26/2022] Open
Abstract
Normally, dendritic size is established prior to adolescence and then remains relatively constant into adulthood due to a homeostatic balance between growth and retraction pathways. However, schizophrenia is characterized by accelerated reductions of cerebral cortex gray matter volume and onset of clinical symptoms during adolescence, with reductions in layer 3 pyramidal neuron dendritic length, complexity, and spine density identified in multiple cortical regions postmortem. Nogo receptor 1 (NGR1) activation of the GTPase RhoA is a major pathway restricting dendritic growth in the cerebral cortex. We show that the NGR1 pathway is stimulated by OMGp and requires the Rho guanine nucleotide exchange factor Kalirin-9 (KAL9). Using a genetically encoded RhoA sensor, we demonstrate that a naturally occurring missense mutation in Kalrn, KAL-PT, that was identified in a schizophrenia cohort, confers enhanced RhoA activitation in neuronal dendrites compared to wild-type KAL. In mice containing this missense mutation at the endogenous locus, there is an adolescent-onset reduction in dendritic length and complexity of layer 3 pyramidal neurons in the primary auditory cortex. Spine density per unit length of dendrite is unaffected. Early adult mice with these structural deficits exhibited impaired detection of short gap durations. These findings provide a neuropsychiatric model of disease capturing how a mild genetic vulnerability may interact with normal developmental processes such that pathology only emerges around adolescence. This interplay between genetic susceptibility and normal adolescent development, both of which possess inherent individual variability, may contribute to heterogeneity seen in phenotypes in human neuropsychiatric disease.
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Affiliation(s)
- Melanie J Grubisha
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Tao Sun
- Department of Biostatistics, University of Pittsburgh, PA 15261
| | - Leanna Eisenman
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261
| | - Susan L Erickson
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Shinnyi Chou
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Cassandra D Helmer
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Melody T Trudgen
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, PA 15261
| | - Gregg E Homanics
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Peter Penzes
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611
| | - Zachary P Wills
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261
| | - Robert A Sweet
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213;
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
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Early magnetic resonance imaging biomarkers of schizophrenia spectrum disorders: Toward a fetal imaging perspective. Dev Psychopathol 2021; 33:899-913. [PMID: 32489161 DOI: 10.1017/s0954579420000218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is mounting evidence to implicate the intrauterine environment as the initial pathogenic stage for neuropsychiatric disease. Recent developments in magnetic resonance imaging technology are making a multimodal analysis of the fetal central nervous system a reality, allowing analysis of structural and functional parameters. Exposures to a range of pertinent risk factors whether preconception or in utero can now be indexed using imaging techniques within the fetus' physiological environment. This approach may determine the first "hit" required for diseases that do not become clinically manifest until adulthood, and which only have subtle clinical markers during childhood and adolescence. A robust characterization of a "multi-hit" hypothesis may necessitate a longitudinal birth cohort; within this investigative paradigm, the full range of genetic and environmental risk factors can be assessed for their impact on the early developing brain. This will lay the foundation for the identification of novel biomarkers and the ability to devise methods for early risk stratification and disease prevention. However, these early markers must be followed over time: first, to account for neural plasticity, and second, to assess the effects of postnatal exposures that continue to drive the individual toward disease. We explore these issues using the schizophrenia spectrum disorders as an illustrative paradigm. However, given the potential richness of fetal magnetic resonance imaging, and the likely overlap of biomarkers, these concepts may extend to a range of neuropsychiatric conditions.
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Abstract
Niemann-Pick disease type C (NP-C) is a severe neurovisceral lipid storage disease that results in the accumulation of unesterified cholesterol in lysosomes or endosomes. The clinical presentations of NP-C are variable which include visceral symptoms, neurologic symptoms and psychiatric symptoms. Psychosis is the most common psychiatric manifestation of NP-C and is indistinguishable from a typical psychosis presentation of schizophrenia. The common psychotic presentations in NP-C include visual hallucinations, delusions, auditory hallucinations and thought disorders. Psychosis symptoms are more common in adult or adolescent-onset forms compared with pediatric-onset forms. The underlying pathophysiology of psychosis in NP-C is most probably due to dysconnectivity particularly between frontotemporal connectivity and subcortical structures. NP-C sometimes is mistaken for schizophrenia which causes delay in treatment due to lack of awareness and literature review. This review aims to summarize the relevant case reports on psychosis symptoms in NP-C and discuss the genetics and pathophysiology underlying the condition.
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Affiliation(s)
- Leong Tung Ong
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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15
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Nath M, Wong TP, Srivastava LK. Neurodevelopmental insights into circuit dysconnectivity in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110047. [PMID: 32721441 DOI: 10.1016/j.pnpbp.2020.110047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/01/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022]
Abstract
Schizophrenia is increasingly being recognized as a disorder of brain circuits of developmental origin. Animal models, however, have been technically limited in exploring the effects of early developmental circuit abnormalities on the maturation of the brain and associated behavioural outputs. This review discusses evidence of the developmental emergence of circuit abnormalities in schizophrenia, followed by a critical assessment on how animal models need to be adapted through optimized tools in order to spatially and temporally manipulate early developmental events, thereby providing insight into the causal contribution of developmental perturbations to schizophrenia.
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Affiliation(s)
- Moushumi Nath
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada.
| | - Tak Pan Wong
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
| | - Lalit K Srivastava
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
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16
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Merritt K, Luque Laguna P, Irfan A, David AS. Longitudinal Structural MRI Findings in Individuals at Genetic and Clinical High Risk for Psychosis: A Systematic Review. Front Psychiatry 2021; 12:620401. [PMID: 33603688 PMCID: PMC7884337 DOI: 10.3389/fpsyt.2021.620401] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/08/2021] [Indexed: 01/18/2023] Open
Abstract
Background: Several cross-sectional studies report brain structure differences between healthy volunteers and subjects at genetic or clinical high risk of developing schizophrenia. However, longitudinal studies are important to determine whether altered trajectories of brain development precede psychosis onset. Methods: We conducted a systematic review to determine if brain trajectories differ between (i) those with psychotic experiences (PE), genetic (GHR) or clinical high risk (CHR), compared to healthy volunteers, and (ii) those who transition to psychosis compared to those who do not. Results: Thirty-eight studies measured gray matter and 18 studies measured white matter in 2,473 high risk subjects and 990 healthy volunteers. GHR, CHR, and PE subjects show an accelerated decline in gray matter primarily in temporal, and also frontal, cingulate and parietal cortex. In those who remain symptomatic or transition to psychosis, gray matter loss is more pronounced in these brain regions. White matter volume and fractional anisotropy, which typically increase until early adulthood, did not change or reduced in high risk subjects in the cingulum, thalamic radiation, cerebellum, retrolenticular part of internal capsule, and hippocampal-thalamic tracts. In those who transitioned, white matter volume and fractional anisotropy reduced over time in the inferior and superior fronto-occipital fasciculus, corpus callosum, anterior limb of the internal capsule, superior corona radiate, and calcarine cortex. Conclusion: High risk subjects show deficits in white matter maturation and an accelerated decline in gray matter. Gray matter loss is more pronounced in those who transition to psychosis, but may normalize by early adulthood in remitters.
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Affiliation(s)
- Kate Merritt
- Division of Psychiatry, Institute of Mental Health, University College London, London, United Kingdom
| | - Pedro Luque Laguna
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | - Ayela Irfan
- Division of Psychiatry, Institute of Mental Health, University College London, London, United Kingdom
| | - Anthony S David
- Division of Psychiatry, Institute of Mental Health, University College London, London, United Kingdom
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17
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Bagautdinova J, Zöller D, Schaer M, Padula MC, Mancini V, Schneider M, Eliez S. Altered cortical thickness development in 22q11.2 deletion syndrome and association with psychotic symptoms. Mol Psychiatry 2021; 26:7671-7678. [PMID: 34253864 PMCID: PMC8873018 DOI: 10.1038/s41380-021-01209-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023]
Abstract
Schizophrenia has been extensively associated with reduced cortical thickness (CT), and its neurodevelopmental origin is increasingly acknowledged. However, the exact timing and extent of alterations occurring in preclinical phases remain unclear. With a high prevalence of psychosis, 22q11.2 deletion syndrome (22q11DS) is a neurogenetic disorder that represents a unique opportunity to examine brain maturation in high-risk individuals. In this study, we quantified trajectories of CT maturation in 22q11DS and examined the association of CT development with the emergence of psychotic symptoms. Longitudinal structural MRI data with 1-6 time points were collected from 324 participants aged 5-35 years (N = 148 22q11DS, N = 176 controls), resulting in a total of 636 scans (N = 334 22q11DS, N = 302 controls). Mixed model regression analyses were used to compare CT trajectories between participants with 22q11DS and controls. Further, CT trajectories were compared between participants with 22q11DS who developed (N = 61, 146 scans), or remained exempt of (N = 47; 98 scans) positive psychotic symptoms during development. Compared to controls, participants with 22q11DS showed widespread increased CT, focal reductions in the posterior cingulate gyrus and superior temporal gyrus (STG), and accelerated cortical thinning during adolescence, mainly in frontotemporal regions. Within 22q11DS, individuals who developed psychotic symptoms showed exacerbated cortical thinning in the right STG. Together, these findings suggest that genetic predisposition for psychosis is associated with increased CT starting from childhood and altered maturational trajectories of CT during adolescence, affecting predominantly frontotemporal regions. In addition, accelerated thinning in the STG may represent an early biomarker associated with the emergence of psychotic symptoms.
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Affiliation(s)
- Joëlle Bagautdinova
- Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Daniela Zöller
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland ,grid.5333.60000000121839049Medical Image Processing Laboratory, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland ,grid.8591.50000 0001 2322 4988Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Marie Schaer
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria Carmela Padula
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Valentina Mancini
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Laboratory, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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18
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Does cortical brain morphology act as a mediator between childhood trauma and transition to psychosis in young individuals at ultra-high risk? Schizophr Res 2020; 224:116-125. [PMID: 33071072 DOI: 10.1016/j.schres.2020.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 06/30/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Childhood trauma, particularly sexual abuse, has been associated with transition to psychosis in individuals at "ultra-high risk" (UHR). This study investigated whether the effects of various forms of childhood trauma on transition to psychosis are mediated by cortical thickness and surface area abnormalities. METHODS This prospective study used data from 62 UHR individuals from a previous (PACE 400) cohort study. At follow-up, 24 individuals had transitioned to psychosis (UHR-T) and 38 individuals had not transitioned (UHR-NT). Student-t/Mann-Whitney-U tests were performed to assess morphological differences in childhood trauma (low/high) and transition. Mediation analyses were conducted using regression and bootstrapping techniques. RESULTS UHR individuals with high sexual trauma histories presented with decreased cortical thickness in bilateral middle temporal gyri and the left superior frontal gyrus compared to those with low sexual trauma. Participants with high physical abuse had increased cortical thickness in the right middle frontal gyrus compared to those with low physical abuse. No differences were found for emotional abuse or physical/emotional neglect. Reduced cortical thickness in the right middle temporal gyrus and increased surface area in the right cingulate were found in UHR-T compared to UHR-NT individuals. Sexual abuse had an indirect effect on transition to psychosis, where decreased cortical thickness in the right middle temporal gyrus was a mediator. CONCLUSIONS Results suggest that childhood sexual abuse negatively impacted on cortical development of the right temporal gyrus, and this heightened the risk of transition to psychosis in our sample. Further longitudinal studies are needed to precisely understand this link.
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DeLisi LE. What a Clinician Should Know About the Neurobiology of Schizophrenia: A Historical Perspective to Current Understanding. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:368-374. [PMID: 33343248 PMCID: PMC7725146 DOI: 10.1176/appi.focus.20200022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The brain is no doubt the "organ" of psychiatry; yet, over the years, few evidence-based classifications of psychiatric disorders have been based on brain mechanisms. The National Institute of Mental Health notably proposed one such system, known as Research Domain Criteria, although it has not yet influenced any changes in the DSM. Of all the major psychiatric disorders, the brain has been studied most extensively in schizophrenia, with its speculative pathology first documented by Emil Kraepelin as early as the beginning of the 20th century. Subsequently, the revolution in technology over the past 50 years has changed how investigators are able to view the brain before death without performing biopsies. Schizophrenia is thus found to have both structural and functional widespread brain anomalies that likely lead to its clinical deterioration. At the onset of illness, acquiring an MRI scan could be part of the routine evaluation to determine how progressive the disease has so far been. However, this practice is not yet recognized by the American Psychiatric Association in any of its guidelines on the treatment of schizophrenia.
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Affiliation(s)
- Lynn E DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, and Cambridge Health Alliance, Cambridge Hospital, Cambridge, Massachusetts
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20
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Fountoulakis KN, Moeller HJ, Kasper S, Tamminga C, Yamawaki S, Kahn R, Tandon R, Correll CU, Javed A. The report of the joint WPA/CINP workgroup on the use and usefulness of antipsychotic medication in the treatment of schizophrenia. CNS Spectr 2020; 26:1-25. [PMID: 32594935 DOI: 10.1017/s1092852920001546] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This is a report of a joint World Psychiatric Association/International College of Neuropsychopharmacology (WPA/CINP) workgroup concerning the risk/benefit ratio of antipsychotics in the treatment of schizophrenia. It utilized a selective but, within topic, comprehensive review of the literature, taking into consideration all the recently discussed arguments on the matter and avoiding taking sides when the results in the literature were equivocal. The workgroup's conclusions suggested that antipsychotics are efficacious both during the acute and the maintenance phase, and that the current data do not support the existence of a supersensitivity rebound psychosis. Long-term treated patients have better overall outcome and lower mortality than those not taking antipsychotics. Longer duration of untreated psychosis and relapses are modestly related to worse outcome. Loss of brain volume is evident already at first episode and concerns loss of neuropil volume rather than cell loss. Progression of volume loss probably happens in a subgroup of patients with worse prognosis. In humans, antipsychotic treatment neither causes nor worsens volume loss, while there are some data in favor for a protective effect. Schizophrenia manifests 2 to 3 times higher mortality vs the general population, and treatment with antipsychotics includes a number of dangers, including tardive dyskinesia and metabolic syndrome; however, antipsychotic treatment is related to lower mortality, including cardiovascular mortality. In conclusion, the literature strongly supports the use of antipsychotics both during the acute and the maintenance phase without suggesting that it is wise to discontinue antipsychotics after a certain period of time. Antipsychotic treatment improves long-term outcomes and lowers overall and specific-cause mortality.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hans-Jurgen Moeller
- Department of Psychiatry, Ludwig Maximilian University of Munich, Munich, Germany
| | - Siegfried Kasper
- Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Vienna, Austria
| | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Shigeto Yamawaki
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Rene Kahn
- Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rajiv Tandon
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Christoph U Correll
- Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Afzal Javed
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
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21
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Abstract
Psychotic disorders are severe, debilitating, and even fatal. The development of targeted and effective interventions for psychosis depends upon on clear understanding of the timing and nature of disease progression to target processes amenable to intervention. Strong evidence suggests early and ongoing neuroprogressive changes, but timing and inflection points remain unclear and likely differ across cognitive, clinical, and brain measures. Additionally, granular evidence across modalities is particularly sparse in the "bridging years" between first episode and established illness-years that may be especially critical for improving outcomes and during which interventions may be maximally effective. Our objective is the systematic, multimodal characterization of neuroprogression through the early course of illness in a cross-diagnostic sample of patients with psychosis. We aim to (1) interrogate neurocognition, structural brain measures, and network connectivity at multiple assessments over the first eight years of illness to map neuroprogressive trajectories, and (2) examine trajectories as predictors of clinical and functional outcomes. We will recruit 192 patients with psychosis and 36 healthy controls. Assessments will occur at baseline and 8- and 16-month follow ups using clinical, cognitive, and imaging measures. We will employ an accelerated longitudinal design (ALD), which permits ascertainment of data across a longer timeframe and at more frequent intervals than would be possible in a single cohort longitudinal study. Results from this study are expected to hasten identification of actionable treatment targets that are closely associated with clinical outcomes, and identify subgroups who share common neuroprogressive trajectories toward the development of individualized treatments.
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22
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Worthington MA, Cao H, Cannon TD. Discovery and Validation of Prediction Algorithms for Psychosis in Youths at Clinical High Risk. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:738-747. [PMID: 31902580 DOI: 10.1016/j.bpsc.2019.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/07/2019] [Accepted: 10/26/2019] [Indexed: 12/19/2022]
Abstract
In the past 2 to 3 decades, clinicians have used the clinical high risk for psychosis (CHR-P) paradigm to better understand factors that contribute to the onset of psychotic disorders. While this paradigm is useful to identify individuals at risk, the CHR-P criteria are not sufficient to predict outcomes from the CHR-P population. Because approximately 25% of the CHR-P population will ultimately convert to psychosis, more precise methods of prediction are needed to account for heterogeneity in both risk factors and outcomes in the CHR-P population. To this end, several groups in recent years have used data-driven approaches to refine predictive algorithms to predict both conversion to psychosis and functional outcomes. These models have generally used either clinical and behavioral data, including demographics and measures of symptom severity, neurocognitive functioning, and social functioning, or neuroimaging data, including structural and functional measures, to predict conversion to psychosis in CHR-P samples. This review focuses on the empirical models that have been derived within each of these lines of research and evaluates the performance and methodology of these models. This review also serves to inform best practices for data-driven approaches and directions moving forward to improve our prediction of psychotic disorders and associated outcomes. Because sample size is still the most critical consideration in the current models, we urge that algorithms to predict conversion be conducted using multisite data in order to obtain the power necessary to conclusively determine predictive accuracy without overfitting.
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Affiliation(s)
| | - Hengyi Cao
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, Connecticut.
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23
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Prospective memory in schizophrenia: A meta-analysis of comparative studies. Schizophr Res 2019; 212:62-71. [PMID: 31447355 DOI: 10.1016/j.schres.2019.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 06/17/2019] [Accepted: 08/05/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Impairment of prospective memory (PM) in schizophrenia has gained increasing attention. This meta-analysis systematically examined PM impairment in schizophrenia. METHODS Both English (PubMed, PsycINFO, EMBASE, and Cochrane Library) and Chinese (WanFang, Chinese Biomedical and China Journal Net databases) databases were systematically searched from their inception until August 14, 2017. Case-control studies of PM in schizophrenia were included. Standardized mean differences (SMDs) and their 95% confidence interval (CI) were calculated using the random-effects model. RESULTS Twenty-nine case-control studies (n = 2492) were included in the analyses. The overall and three subtypes of PM were compared between patients with schizophrenia (n = 1284) and healthy controls (n = 1208). Compared to healthy controls, patients performed significantly poorer in overall (SMD = -1.125), time-based (SMD = -1.155), event-based (SMD = -1.068), and activity-based PM (SMD = -0.563). Subgroup analyses revealed significant differences between older and younger patients (SMD = -1.398 vs. -0.763), higher male predominance and no sex predominance (SMD = -1.679 vs. -0.800), lower and higher education level (SMD = -1.373 vs.-0.637), chronic and first-episode patients (SMD = -1.237 vs. -0.641) and between eco-valid and dual-task laboratory measurements (SMD = -1.542 vs. -0.725) regarding overall PM. Meta-regression analysis showed that higher negative symptom score was significantly associated with more severe overall PM impairment in patients (P = 0.022). CONCLUSIONS In this meta-analysis the overall PM and all its subtypes, particularly the time-based PM, were significantly impaired in schizophrenia.
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Cho KIK, Kim M, Yoon YB, Lee J, Lee TY, Kwon JS. Disturbed thalamocortical connectivity in unaffected relatives of schizophrenia patients with a high genetic loading. Aust N Z J Psychiatry 2019; 53:889-895. [PMID: 30722672 DOI: 10.1177/0004867418824020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Alterations in thalamocortical anatomical connectivity, specifically the connection between the orbitofrontal cortex and thalamus, have been frequently reported in schizophrenia and are suggested to contribute to the pathophysiology of schizophrenia. The connectivity of the thalamocortical white matter in unaffected relatives of schizophrenia patients was compared to that of healthy controls. METHODS The unaffected relative group was defined as asymptomatic family members who had at least one first-degree relative with schizophrenia and one or more other affected first- to third-degree relatives. A total of 35 unaffected relatives and 34 healthy controls underwent diffusion-weighted and T1-weighted magnetic resonance imaging to examine the white matter connectivity between the thalamus and orbitofrontal cortex using probabilistic tractography. RESULTS After controlling for age and sex, the unaffected relatives exhibited significantly reduced fractional anisotropy values for the left thalamo-orbitofrontal tract compared to that of healthy controls, F(1, 65) = 6.93, p = 0.011, effect size partial η2 = 0.10. However, there was no association between the Genetic Liability Score and fractional anisotropy in the left thalamo-orbitofrontal tracts. CONCLUSION Our findings in the unaffected relatives of schizophrenia patients, which are in line with the alterations reported in schizophrenia, first-episode psychosis and clinical high risk for psychosis, highlight a possible genetic contribution to the proposed biomarker of altered thalamocortical connectivity.
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Affiliation(s)
- Kang Ik K Cho
- 1 Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- 2 Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Minah Kim
- 3 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Youngwoo Bryan Yoon
- 2 Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Junhee Lee
- 3 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Tae Young Lee
- 1 Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- 3 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jun Soo Kwon
- 1 Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- 2 Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
- 3 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
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25
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Niznikiewicz MA. Neurobiological approaches to the study of clinical and genetic high risk for developing psychosis. Psychiatry Res 2019; 277:17-22. [PMID: 30926150 DOI: 10.1016/j.psychres.2019.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/12/2023]
Abstract
Research on neurobiological impairments in clinical and genetic high risk for developing psychosis individuals (CHR) has identified several brain abnormalities that impact both brain structure and function. The current review will discuss research examining brain abnormalities in clinical and genetic high risk for psychosis using magnetic resonance imaging (MRI) focusing on structural brain abnormalities, diffusion tensor imaging (DTI) focusing on the integrity of white matter tracks, functional MRI focusing on functional brain abnormalities, and EEG and event related potential (ERP) methodologies focusing on indices of cognitive dysfunction in CHR. Studies conducted across these different methodologies sought to identify brain regions and brain processes that would distinguish between those high risk individuals who converted to psychosis versus those who did not. In addition, in some of the studies, the distinction was made between individuals who converted to psychosis, those who did not, and those individuals who remained clinically symptomatic while not converting to psychosis. The brain regions most often identified as abnormal in this subject group were the brain areas often found abnormal in schizophrenia, including frontal and temporal regions. Similarly, several cognitive processes often found to be abnormal in schizophrenia have been also found impaired in CHR.
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Affiliation(s)
- Margaret A Niznikiewicz
- Harvard Medical School and Veterans Administration Boston, Healthcare System, United States.
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26
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Polygenic Scores for Neuropsychiatric Traits and White Matter Microstructure in the Pediatric Population. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:243-250. [DOI: 10.1016/j.bpsc.2018.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/08/2018] [Accepted: 07/09/2018] [Indexed: 12/31/2022]
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27
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Lawrie SM. Are structural brain changes in schizophrenia related to antipsychotic medication? A narrative review of the evidence from a clinical perspective. Ther Adv Psychopharmacol 2018; 8:319-326. [PMID: 30344998 PMCID: PMC6180375 DOI: 10.1177/2045125318782306] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/20/2018] [Indexed: 01/28/2023] Open
Abstract
Some observational studies and literature reviews suggest that antipsychotic drug use is associated with loss of grey or white matter in patients with schizophrenia, whereas others have contradicted this finding. Here, I summarize and critique the available evidence and put it in the context of clinical practice. This narrative review pools evidence from observational and experimental studies in humans and animals on the relationship between antipsychotic medication use and brain structure and function in patients with schizophrenia. To summarize, the observational evidence in patients with schizophrenia and the experimental evidence in animals suggest that antipsychotic drugs can cause reductions in brain volume, but differ as to where those effects are manifest. The experimental evidence in patients is inconclusive. There is stronger and more consistent evidence that other factors, such as alcohol and cannabis use, are likely causes of progressive brain changes in schizophrenia. Overall, I argue the case against antipsychotics is not proven and the jury is out on any significance of putative antipsychotic-induced brain changes. Taken in the context of strong evidence from clinical trials that antipsychotic drugs have beneficial effects on symptoms, function, relapse and cognition, and observational evidence that treatment normalizes other imaging indices and reduces mortality, the balance of probabilities is that antipsychotic drugs do not cause adverse structural brain changes in schizophrenia.
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Affiliation(s)
- Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK
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28
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Neilson E, Bois C, Clarke TK, Hall L, Johnstone EC, Owens DGC, Whalley HC, McIntosh AM, Lawrie SM. Polygenic risk for schizophrenia, transition and cortical gyrification: a high-risk study. Psychol Med 2018; 48:1532-1539. [PMID: 29065934 DOI: 10.1017/s0033291717003087] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Schizophrenia is a highly heritable disorder, linked to several structural abnormalities of the brain. More specifically, previous findings have suggested that increased gyrification in frontal and temporal regions are implicated in the pathogenesis of schizophrenia. METHODS The current study included participants at high familial risk of schizophrenia who remained well (n = 31), who developed sub-diagnostic symptoms (n = 28) and who developed schizophrenia (n = 9) as well as healthy controls (HC) (n = 16). We first tested whether individuals at high familial risk of schizophrenia carried an increased burden of trait-associated alleles using polygenic risk score analysis. We then assessed the extent to which polygenic risk was associated with gyral folding in the frontal and temporal lobes. RESULTS We found that individuals at high familial risk of schizophrenia who developed schizophrenia carried a significantly greater burden of risk-conferring variants for the disorder compared to those at high risk (HR) who developed sub-diagnostic symptoms or remained well and HC. Furthermore, within the HR cohort, there was a significant and positive association between schizophrenia polygenic risk score and bilateral frontal gyrification. CONCLUSIONS These results suggest that polygenic risk for schizophrenia impacts upon early neurodevelopment to confer greater gyral folding in adulthood and an increased risk of developing the disorder.
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Affiliation(s)
- E Neilson
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - C Bois
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - T-K Clarke
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - L Hall
- International Centre for Life,Institute of Genetic Medicine,Newcastle University,Central Parkway,Newcastle upon Tyne,UK
| | - E C Johnstone
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - D G C Owens
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - H C Whalley
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - A M McIntosh
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - S M Lawrie
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
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29
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Correll CU, Rubio JM, Kane JM. What is the risk-benefit ratio of long-term antipsychotic treatment in people with schizophrenia? World Psychiatry 2018; 17:149-160. [PMID: 29856543 PMCID: PMC5980517 DOI: 10.1002/wps.20516] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The long-term benefit-to-risk ratio of sustained antipsychotic treatment for schizophrenia has recently been questioned. In this paper, we critically examine the literature on the long-term efficacy and effectiveness of this treatment. We also review the evidence on the undesired effects, the impact on physical morbidity and mortality, as well as the neurobiological correlates of chronic exposure to antipsychotics. Finally, we summarize factors that affect the risk-benefit ratio. There is consistent evidence supporting the efficacy of antipsychotics in the short term and mid term following stabilization of acute psychotic symptoms. There is insufficient evidence supporting the notion that this effect changes in the long term. Most, but not all, of the long-term cohort studies find a decrease in efficacy during chronic treatment with antipsychotics. However, these results are inconclusive, given the extensive risk of bias, including increasing non-adherence. On the other hand, long-term studies based on national registries, which have lower risk of bias, find an advantage in terms of effectiveness during sustained antipsychotic treatment. Sustained antipsychotic treatment has been also consistently associated with lower mortality in people with schizophrenia compared to no antipsychotic treatment. Nevertheless, chronic antipsychotic use is associated with metabolic disturbance and tardive dyskinesia. The latter is the clearest undesired clinical consequence of brain functioning as a potential result of chronic antipsychotic exposure, likely from dopaminergic hypersensitivity, without otherwise clear evidence of other irreversible neurobiological changes. Adjunctive psychosocial interventions seem critical for achieving recovery. However, overall, the current literature does not support the safe reduction of antipsychotic dosages by 50% or more in stabilized individuals receiving adjunctive psychosocial interventions. In conclusion, the critical appraisal of the literature indicates that, although chronic antipsychotic use can be associated with undesirable neurologic and metabolic side effects, the evidence supporting its long-term efficacy and effectiveness, including impact on life expectancy, outweighs the evidence against this practice, overall indicating a favorable benefit-to-risk ratio. However, the finding that a minority of individuals diagnosed initially with schizophrenia appear to be relapse free for long periods, despite absence of sustained antipsychotic treatment, calls for further research on patient-level predictors of positive outcomes in people with an initial psychotic presentation.
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Affiliation(s)
- Christoph U Correll
- Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Jose M Rubio
- Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - John M Kane
- Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
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30
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Ganella EP, Seguin C, Bartholomeusz CF, Whittle S, Bousman C, Wannan CMJ, Di Biase MA, Phassouliotis C, Everall I, Pantelis C, Zalesky A. Risk and resilience brain networks in treatment-resistant schizophrenia. Schizophr Res 2018; 193:284-292. [PMID: 28735641 DOI: 10.1016/j.schres.2017.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Genes, molecules and neural circuits that are associated with, or confer risk to developing schizophrenia have been studied and mapped. It is hypothesized that certain neural systems may counterbalance familial risk of schizophrenia, and thus confer resilience to developing the disorder. This study sought to identify resting-state functional brain connectivity (rs-FC) representing putative risk or resilience endophenotypes in schizophrenia. METHODS Resting-state functional magnetic resonance imaging (rs-fMRI) was performed in 42 individuals with treatment resistant schizophrenia (TRS), 16 unaffected first-degree family members (UFM) and 42 healthy controls. Whole-brain rs-FC networks were mapped for each individual and analysed graph theoretically to identify network markers associated with schizophrenia risk or resilience. RESULTS The ~900 functional connections showing between-group differences were operationalized as conferring: i) resilience, ii) risk, or iii) precipitating risk and/or illness effects. Approximately 95% of connections belonged to the latter two categories, with substantially fewer connections associated with resilience. Schizophrenia risk primarily involved reduced frontal and occipital rs-FC, with patients showing additional reduced frontal and temporal rs-FC. Functional brain networks were characterized by greater local efficiency in UFM, compared to TRS and controls. CONCLUSIONS TRS and UFM share frontal and occipital rs-FC deficits, representing a 'risk' endophenotype. Additional reductions in frontal and temporal rs-FC appear to be associated with risk that precipitates psychosis in vulnerable individuals, or may be due to other illness-related effects, such as medication. Functional brain networks are more topologically resilient in UFM compared to TRS, which may protect UFM from psychosis onset despite familial liability.
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Affiliation(s)
- Eleni P Ganella
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia; The Cooperative Research Centre (CRC) for Mental Health, Australia.
| | - Caio Seguin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Cali F Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; The Cooperative Research Centre (CRC) for Mental Health, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, VIC, Australia; Swinburne University of Technology, Centre for Human Psychopharmacology, Hawthorne, VIC, Australia; The University of Melbourne, Department of General Practice, Parkville, VIC, Australia
| | - Cassandra M J Wannan
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia; The Cooperative Research Centre (CRC) for Mental Health, Australia
| | - Maria A Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Christina Phassouliotis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Ian Everall
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; The Cooperative Research Centre (CRC) for Mental Health, Australia; North Western Mental Health, Melbourne Health, Parkville, VIC, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, VIC, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; The Cooperative Research Centre (CRC) for Mental Health, Australia; North Western Mental Health, Melbourne Health, Parkville, VIC, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, VIC, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, VIC, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, VIC, Australia; Melbourne School of Engineering, The University of Melbourne, Parkville, VIC, Australia
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31
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Sugranyes G, de la Serna E, Borras R, Sanchez-Gistau V, Pariente JC, Romero S, Baeza I, Díaz-Caneja CM, Rodriguez-Toscano E, Moreno C, Bernardo M, Moreno D, Vieta E, Castro-Fornieles J. Clinical, Cognitive, and Neuroimaging Evidence of a Neurodevelopmental Continuum in Offspring of Probands With Schizophrenia and Bipolar Disorder. Schizophr Bull 2017; 43:1208-1219. [PMID: 28180904 PMCID: PMC5737486 DOI: 10.1093/schbul/sbx002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies in child and adolescent offspring of patients with schizophrenia or bipolar disorders may help understand the influence of neurodevelopmental factors on the premorbid phenotype of these disorders. AIMS To assess whether a combination of neurodevelopmental factors discriminates between young offspring of patients with schizophrenia (SzO) or bipolar disorder (BpO) and community controls (CcO). To assess the association between these factors and rates of psychiatric diagnoses in high risk (HR) youth. METHODS One hundred thirty-three HR offspring (47 SzO and 86 BpO) and 84 CcO, aged 6-17, underwent cross-sectional clinical, neurocognitive, and structural neuroimaging assessment. Information on perinatal events and early childhood development was also obtained. General linear mixed models were performed to assess group discrimination and association with lifetime axis I psychiatric disorders. RESULTS Multivariate analyses revealed that greater neurological soft signs (NSS), less total grey matter volume (GMV) and a higher frequency of obstetric complications discriminated HR offspring from CcO. When comparing each group individually, greater NSS and a higher frequency of obstetric complications discriminated SzO from CcO, and BpO from CcO, while lower intelligence also discriminated SzO from CcO and from BpO. Within HR offspring, lower intelligence and less total GMV were associated with lifetime incidence of psychiatric disorders. CONCLUSIONS Both SzO and BpO showed evidence of neurodevelopmental insult, although this may have a greater impact in SzO. Lower intelligence and less total GMV hold potential as biomarkers of risk for psychiatric disorders in HR youth.
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Affiliation(s)
- Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,To whom correspondence should be addressed; Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, c. Villarroel 170, 08036 Barcelona, Spain; tel: +34-93-227-9974/9970, fax: +34-93-227-9974, e-mail:
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Roger Borras
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Vanessa Sanchez-Gistau
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Early Intervention Team, Pere Mata Institute of Reus, Health Research Institute Pere Virgili (IISPV), Reus, Spain
| | - Jose C Pariente
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Soledad Romero
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Elisa Rodriguez-Toscano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Miguel Bernardo
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Dolores Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Eduard Vieta
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
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Progressive cortical reorganisation: A framework for investigating structural changes in schizophrenia. Neurosci Biobehav Rev 2017; 79:1-13. [DOI: 10.1016/j.neubiorev.2017.04.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
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Effects of environmental risks and polygenic loading for schizophrenia on cortical thickness. Schizophr Res 2017; 184:128-136. [PMID: 27989645 DOI: 10.1016/j.schres.2016.12.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/09/2016] [Accepted: 12/11/2016] [Indexed: 01/21/2023]
Abstract
There are established differences in cortical thickness (CT) in schizophrenia (SCZ) and bipolar (BD) patients when compared to healthy controls (HC). However, it is unknown to what extent environmental or genetic risk factors impact on CT in these populations. We have investigated the effect of Environmental Risk Scores (ERS) and Polygenic Risk Scores for SCZ (PGRS-SCZ) on CT. Structural MRI scans were acquired at 3T for patients with SCZ or BD (n=57) and controls (n=41). Cortical reconstructions were generated in FreeSurfer (v5.3). The ERS was created by determining exposure to cannabis use, childhood adverse events, migration, urbanicity and obstetric complications. The PGRS-SCZ were generated, for a subset of the sample (Patients=43, HC=32), based on the latest PGC GWAS findings. ANCOVAs were used to test the hypotheses that ERS and PGRS-SCZ relate to CT globally, and in frontal and temporal lobes. An increase in ERS was negatively associated with CT within temporal lobe for patients. A higher PGRS-SCZ was also related to global cortical thinning for patients. ERS effects remained significant when including PGRS-SCZ as a fixed effect. No relationship which survived FDR correction was found for ERS and PGRS-SCZ in controls. Environmental risk for SCZ was related to localised cortical thinning in patients with SCZ and BD, while increased PGRS-SCZ was associated with global cortical thinning. Genetic and environmental risk factors for SCZ appear therefore to have differential effects. This provides a mechanistic means by which different risk factors may contribute to the development of SCZ and BD.
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Bartholomeusz CF, Cropley VL, Wannan C, Di Biase M, McGorry PD, Pantelis C. Structural neuroimaging across early-stage psychosis: Aberrations in neurobiological trajectories and implications for the staging model. Aust N Z J Psychiatry 2017; 51:455-476. [PMID: 27733710 DOI: 10.1177/0004867416670522] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model. RESULTS In general, grey matter (and, to a lesser extent, white matter) declines across multiple frontal, temporal (especially superior regions), insular and parietal regions during the first episode of psychosis, which has a steeper trajectory than that of age-matched healthy counterparts. Although the ultra-high-risk of psychosis literature is considerably mixed, evidence indicates that certain volumetric structural aberrations predate psychotic illness onset (e.g. prefrontal cortex thinning), while other abnormalities present in ultra-high-risk of psychosis populations are potentially non-psychosis-specific (e.g. hippocampal volume reductions). CONCLUSION We highlight the advantages of longitudinal designs, discuss the implications such studies have on clinical staging and provide directions for future research.
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Affiliation(s)
- Cali F Bartholomeusz
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Vanessa L Cropley
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Cassandra Wannan
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Maria Di Biase
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Patrick D McGorry
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christos Pantelis
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- 4 Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia
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Zhou FC, Wang CY, Ungvari GS, Ng CH, Zhou Y, Zhang L, Zhou J, Shum DHK, Man D, Liu DT, Li J, Xiang YT. Longitudinal changes in prospective memory and their clinical correlates at 1-year follow-up in first-episode schizophrenia. PLoS One 2017; 12:e0172114. [PMID: 28245266 PMCID: PMC5330457 DOI: 10.1371/journal.pone.0172114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 01/31/2017] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate prospective memory (PM) and the association with clinical factors at 1-year follow-up in first-episode schizophrenia (FES). Thirty-two FES patients recruited from a university-affiliated psychiatric hospital in Beijing and 17 healthy community controls (HCs) were included. Time- and event-based PM (TBPM and EBPM) performances were measured with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT) at baseline and at one-year follow-up. A number of other neurocognitive tests were also administered. Remission was determined at the endpoint according to the PANSS score ≤ 3 for selected items. Repeated measures analysis of variance revealed a significant interaction between time (baseline vs. endpoint) and group (FES vs. HCs) for EBPM (F(1, 44) = 8.8, p = 0.005) and for all neurocognitive components. Paired samples t-tests showed significant improvement in EBPM in FES (13.1±3.7 vs. 10.3±4.8; t = 3.065, p = 0.004), compared to HCs (15.7±3.6 vs. 16.5±2.3; t = -1.248, p = 0.230). A remission rate of 59.4% was found in the FES group. Analysis of covariance revealed that remitters performed significantly better on EBPM (14.9±2.6 vs. 10.4±3.6; F(1, 25) = 12.2, p = 0.002) than non-remitters at study endpoint. The association between EBPM and 12-month clinical improvement in FES suggests that EBPM may be a potential neurocognitive marker for the effectiveness of standard pharmacotherapy. Furthermore, the findings also imply that PM may not be strictly a trait-related endophenotype as indicated in previous studies.
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Affiliation(s)
- Fu-Chun Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gabor S. Ungvari
- The University of Notre Dame Australia / Marian Centre, Perth, Australia
- School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Yan Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Liang Zhang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jingjing Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - David H. K. Shum
- Menzies Health Institute Queensland and School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
| | - David Man
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Deng-Tang Liu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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36
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Lee PH, Baker JT, Holmes AJ, Jahanshad N, Ge T, Jung JY, Cruz Y, Manoach DS, Hibar DP, Faskowitz J, McMahon KL, de Zubicaray GI, Martin NG, Wright MJ, Öngür D, Buckner R, Roffman J, Thompson PM, Smoller JW. Partitioning heritability analysis reveals a shared genetic basis of brain anatomy and schizophrenia. Mol Psychiatry 2016; 21:1680-1689. [PMID: 27725656 PMCID: PMC5144575 DOI: 10.1038/mp.2016.164] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 07/14/2016] [Accepted: 08/11/2016] [Indexed: 01/18/2023]
Abstract
Schizophrenia is a devastating neurodevelopmental disorder with a complex genetic etiology. Widespread cortical gray matter loss has been observed in patients and prodromal samples. However, it remains unresolved whether schizophrenia-associated cortical structure variations arise due to disease etiology or secondary to the illness. Here we address this question using a partitioning-based heritability analysis of genome-wide single-nucleotide polymorphism (SNP) and neuroimaging data from 1750 healthy individuals. We find that schizophrenia-associated genetic variants explain a significantly enriched proportion of trait heritability in eight brain phenotypes (false discovery rate=10%). In particular, intracranial volume and left superior frontal gyrus thickness exhibit significant and robust associations with schizophrenia genetic risk under varying SNP selection conditions. Cross-disorder comparison suggests that the neurogenetic architecture of schizophrenia-associated brain regions is, at least in part, shared with other psychiatric disorders. Our study highlights key neuroanatomical correlates of schizophrenia genetic risk in the general population. These may provide fundamental insights into the complex pathophysiology of the illness, and a potential link to neurocognitive deficits shaping the disorder.
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Affiliation(s)
- P H Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - J T Baker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - A J Holmes
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - N Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - T Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - J-Y Jung
- Department of Pediatrics, Division of Systems Medicine, Stanford University, Stanford, CA, USA
| | - Y Cruz
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - D S Manoach
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - D P Hibar
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - J Faskowitz
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - K L McMahon
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - G I de Zubicaray
- Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - N G Martin
- Queensland Institute of Medical Research (QIMR) Berghofer, Brisbane, QLD, Australia
| | - M J Wright
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia
| | - D Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - R Buckner
- Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
- Department of Psychology and Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - J Roffman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Schizophrenia Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - P M Thompson
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - J W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Uehara T, Sumiyoshi T, Kurachi M. New Pharmacotherapy Targeting Cognitive Dysfunction of Schizophrenia via Modulation of GABA Neuronal Function. Curr Neuropharmacol 2016; 13:793-801. [PMID: 26630957 PMCID: PMC4759318 DOI: 10.2174/1570159x13666151009120153] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 11/22/2022] Open
Abstract
Schizophrenia is considered a neurodevelopmental and neurodegenerative disorder. Cognitive impairment is a core symptom in patients with the illness, and has been suggested a major predictor of functional outcomes. Reduction of parvalbumin (PV)-positive γ-aminobutyric acid (GABA) interneurons has been associated with the pathophysiology of schizophrenia, in view of the link between the abnormality of GABA neurons and cognitive impairments of the disease. It is assumed that an imbalance of excitatory and inhibitory (E-I) activity induced by low activity of glutamatergic projections and PV-positive GABA interneurons in the prefrontal cortex resulted in sustained neural firing and gamma oscillation, leading to impaired cognitive function. Therefore, it is important to develop novel pharmacotherapy targeting GABA neurons and their activities. Clinical evidence suggests serotonin (5-HT) 1A receptor agonist improves cognitive disturbances of schizophrenia, consistent with results from preclinical studies, through mechanism that corrects E-I imbalance via the suppression of GABA neural function. On the other hand, T-817MA, a novel neurotrophic agent, ameliorated loss of PV-positive GABA neurons in the medial prefrontal cortex and reduction of gamma-band activity, as well as cognitive dysfunction in animal model of schizophrenia. In conclusion, a pharmacotherapy to alleviate abnormalities in GABA neurons through 5-HT1A agonists and T-817MA is expected to prevent the onset and/or progression of schizophrenia.
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Affiliation(s)
- Takashi Uehara
- Department of Neuropsychiatry, Kanazawa Medical University, 1-1 Daigaku, Uchinada-cho, Ishikawa 920-0293, Japan.
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Xi YB, Li C, Cui LB, Liu J, Guo F, Li L, Liu TT, Liu K, Chen G, Xi M, Wang HN, Yin H. Anterior Cingulate Cortico-Hippocampal Dysconnectivity in Unaffected Relatives of Schizophrenia Patients: A Stochastic Dynamic Causal Modeling Study. Front Hum Neurosci 2016; 10:383. [PMID: 27512370 PMCID: PMC4961710 DOI: 10.3389/fnhum.2016.00383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/14/2016] [Indexed: 11/13/2022] Open
Abstract
Familial risk plays a significant role in the etiology of schizophrenia (SZ). Many studies using neuroimaging have demonstrated structural and functional alterations in relatives of SZ patients, with significant results found in diverse brain regions involving the anterior cingulate cortex (ACC), caudate, dorsolateral prefrontal cortex (DLPFC), and hippocampus. This study investigated whether unaffected relatives of first episode SZ differ from healthy controls (HCs) in effective connectivity measures among these regions. Forty-six unaffected first-degree relatives of first episode SZ patients-according to the DSM-IV-were studied. Fifty HCs were included for comparison. All subjects underwent resting state functional magnetic resonance imaging (fMRI). We used stochastic dynamic causal modeling (sDCM) to estimate the directed connections between the left ACC, right ACC, left caudate, right caudate, left DLPFC, left hippocampus, and right hippocampus. We used Bayesian parameter averaging (BPA) to characterize the differences. The BPA results showed hyperconnectivity from the left ACC to right hippocampus and hypoconnectivity from the right ACC to right hippocampus in SZ relatives compared to HCs. The pattern of anterior cingulate cortico-hippocampal connectivity in SZ relatives may be a familial feature of SZ risk, appearing to reflect familial susceptibility for SZ.
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Affiliation(s)
- Yi-Bin Xi
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Chen Li
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Long-Biao Cui
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Jian Liu
- Network Center, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Fan Guo
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Liang Li
- School of Biomedical Engineering, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Ting-Ting Liu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Kang Liu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Gang Chen
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Min Xi
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
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Abstract
Identifying predictors and elucidating the fundamental mechanisms underlying onset of psychosis are critical for the development of targeted preemptive interventions. This article presents a selective review of findings on risk prediction algorithms and potential mechanisms of onset in youth at clinical high-risk for psychosis, focusing principally on recent findings of the North American Prodrome Longitudinal Study (NAPLS). Multivariate models incorporating risk factors from clinical, demographic, neurocognitive, and psychosocial assessments achieve high levels of predictive accuracy when applied to individuals who meet criteria for a prodromal risk syndrome. An individualized risk calculator is available to scale the risk for newly ascertained cases, which could aid in clinical decision making. At risk individuals who convert to psychosis show elevated levels of proinflammatory cytokines, as well as disrupted resting state thalamo-cortical functional connectivity at baseline, compared with those who do not. Further, converters show a steeper rate of gray matter reduction, most prominent in prefrontal cortex, that in turn is predicted by higher levels of inflammatory markers at baseline. Microglia, resident immune cells in the brain, have recently been discovered to influence synaptic plasticity in health and impair plasticity in disease. Processes that modulate microglial activation may represent convergent mechanisms that influence brain dysconnectivity and risk for onset of psychosis and thus may be targetable in developing and testing preventive interventions.
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Affiliation(s)
- Tyrone D. Cannon
- *To whom correspondence should be addressed; Department of Psychology, Yale University, PO Box 208205, 2 Hillhouse Avenue, New Haven, CT 06520, US; tel: 203-436-1545, fax: 203-432-5281, e-mail:
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40
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Bois C, Levita L, Ripp I, Owens DCG, Johnstone EC, Whalley HC, Lawrie SM. Longitudinal changes in hippocampal volume in the Edinburgh High Risk Study of Schizophrenia. Schizophr Res 2016; 173:146-151. [PMID: 25534070 DOI: 10.1016/j.schres.2014.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/28/2014] [Accepted: 12/03/2014] [Indexed: 10/24/2022]
Abstract
Schizophrenia is associated with structural brain abnormalities that are likely to be present before disease onset. It remains unclear to what extent these represent general vulnerability indicators or are associated with the developing clinical state itself. It also remains unclear whether such state or trait alterations may be evident at any given time-point, or whether they progress over time. To investigate this, structural brain scans were acquired at two time-points (mean scan-interval 1.87years) in a cohort of young unaffected individuals at high familial risk of schizophrenia (baseline, n=142; follow-up, n=64) and healthy controls (baseline, n=36; follow-up, n=18). Sub-cortical reconstructions of the hippocampus and amygdala were generated using the longitudinal pipeline available with Freesurfer. The high risk cohort was subdivided into individuals that remained well during the study (HR[well], baseline, n=68; follow-up, n=30), transient and/or partial symptoms that were insufficient to support a formal diagnosis (HR[symp], baseline, n=57; follow-up, n=26) and individuals that subsequently developed schizophrenia according to ICD-10 criteria (HR[ill], baseline, n=17; follow-up, n=8). Longitudinal change in the hippocampus and amygdala was compared, focusing first on overall differences between high-risk individuals and controls and then on sub-group differences within the high-risk cohort. We found a significantly altered developmental trajectory for all high risk individuals compared to controls, with controls showing a significant increase in hippocampal volume over time compared to those at high risk. We did not find evidence of altered longitudinal trajectories based on clinical outcome within the high risk cohort. These results suggest that an altered developmental trajectory of hippocampal volume is associated with a general familial predisposition to develop schizophrenia, as this alteration was not related to subsequent clinical outcome.
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Affiliation(s)
- C Bois
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK.
| | - L Levita
- Department of Psychology, University of Sheffield, UK
| | - I Ripp
- Department of Neuroscience, University of Cologne, Germany
| | - D C G Owens
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - E C Johnstone
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - S M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
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Cropley VL, Lin A, Nelson B, Reniers RLEP, Yung AR, Bartholomeusz CF, Klauser P, Velakoulis D, McGorry P, Wood SJ, Pantelis C. Baseline grey matter volume of non-transitioned "ultra high risk" for psychosis individuals with and without attenuated psychotic symptoms at long-term follow-up. Schizophr Res 2016; 173:152-158. [PMID: 26032566 DOI: 10.1016/j.schres.2015.05.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Two thirds of individuals identified as ultra-high risk (UHR) for psychosis do not transition to psychosis over the medium to long-term (non-transition; UHR-NT). Nevertheless, many of these individuals have persistent attenuated psychotic symptoms (APS). The current study examined whether there were differences in baseline grey matter volume (i.e. at initial identification as UHR) in UHR-NT individuals whom had APS compared to those without APS (No-APS) at medium to long-term follow-up. METHODS Participants were help-seeking individuals who were identified as being at UHR for psychosis between 2 and 12years previously (mean=7.5). The sample consisted of 109 participants who underwent a Magnetic Resonance Imaging scan at baseline and who had not been observed to develop a psychotic disorder over the follow-up period (UHR-NT). Using voxel-based morphometry, baseline grey matter volume (GMV) was compared between participants with (N=30) and without (N=79) APS at follow-up. RESULTS At baseline, the APS and No-APS groups were clinically indistinguishable. At follow-up, the APS group had significantly worse symptoms and impaired functioning. Individuals with APS had reduced baseline GMV in frontal, temporal, posterior and cingulate regions compared to those without APS at follow-up. Reduced GMV was associated with more severe positive, negative and depressive symptoms and lower global functioning in the combined UHR-NT cohort. These associations were independent of later APS outcome. DISCUSSION This study found that differences in regional GMV are discernible at an early stage of UHR and may be specific to individuals who have APS and psychopathology at follow-up. Our findings suggest that lower GMV at baseline may confer neurobiological risk for later APS and/or increased psychopathology while the absence of these structural abnormalities might be protective.
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Affiliation(s)
- Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Victoria 3052, Australia.
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia 6008, Australia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne and Melbourne Health, Parkville, Victoria 3052, Australia
| | - Renate L E P Reniers
- School of Psychology,-University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Alison R Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Cali F Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Victoria 3052, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne and Melbourne Health, Parkville, Victoria 3052, Australia
| | - Paul Klauser
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Monash Clinical and Imaging Neuroscience, Monash University, Clayton, Victoria, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne and Melbourne Health, Parkville, Victoria 3052, Australia
| | - Stephen J Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; School of Psychology,-University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Victoria 3052, Australia
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McClatchy DB, Savas JN, Martínez-Bartolomé S, Park SK, Maher P, Powell SB, Yates JR. Global quantitative analysis of phosphorylation underlying phencyclidine signaling and sensorimotor gating in the prefrontal cortex. Mol Psychiatry 2016; 21:205-15. [PMID: 25869802 PMCID: PMC4605830 DOI: 10.1038/mp.2015.41] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/27/2015] [Accepted: 03/02/2015] [Indexed: 01/09/2023]
Abstract
Prepulse inhibition (PPI) is an example of sensorimotor gating and deficits in PPI have been demonstrated in schizophrenia patients. Phencyclidine (PCP) suppression of PPI in animals has been studied to elucidate the pathological elements of schizophrenia. However, the molecular mechanisms underlying PCP treatment or PPI in the brain are still poorly understood. In this study, quantitative phosphoproteomic analysis was performed on the prefrontal cortex from rats that were subjected to PPI after being systemically injected with PCP or saline. PCP downregulated phosphorylation events were significantly enriched in proteins associated with long-term potentiation (LTP). Importantly, this data set identifies functionally novel phosphorylation sites on known LTP-associated signaling molecules. In addition, mutagenesis of a significantly altered phosphorylation site on xCT (SLC7A11), the light chain of system xc-, the cystine/glutamate antiporter, suggests that PCP also regulates the activity of this protein. Finally, new insights were also derived on PPI signaling independent of PCP treatment. This is the first quantitative phosphorylation proteomic analysis providing new molecular insights into sensorimotor gating.
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Affiliation(s)
| | - Jeffrey N. Savas
- Department of Chemical Physiology, The Scripps Research Institute
| | | | - Sung Kyu Park
- Department of Chemical Physiology, The Scripps Research Institute
| | - Pamela Maher
- Cellular Neurobiology Laboratory, Salk Institute
| | | | - John R. Yates
- Department of Chemical Physiology, The Scripps Research Institute
- Corresponding Author:
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Lewis DA, Glausier JR. Alterations in Prefrontal Cortical Circuitry and Cognitive Dysfunction in Schizophrenia. NEBRASKA SYMPOSIUM ON MOTIVATION. NEBRASKA SYMPOSIUM ON MOTIVATION 2016; 63:31-75. [PMID: 27627824 DOI: 10.1007/978-3-319-30596-7_3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Grey matter networks in people at increased familial risk for schizophrenia. Schizophr Res 2015; 168:1-8. [PMID: 26330380 DOI: 10.1016/j.schres.2015.08.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/12/2015] [Accepted: 08/20/2015] [Indexed: 02/06/2023]
Abstract
Grey matter brain networks are disrupted in schizophrenia, but it is still unclear at which point during the development of the illness these disruptions arise and whether these can be associated with behavioural predictors of schizophrenia. We investigated if single-subject grey matter networks were disrupted in a sample of people at familial risk of schizophrenia. Single-subject grey matter networks were extracted from structural MRI scans of 144 high risk subjects, 32 recent-onset patients and 36 healthy controls. The following network properties were calculated: size, connectivity density, degree, path length, clustering coefficient, betweenness centrality and small world properties. People at risk of schizophrenia showed decreased path length and clustering in mostly prefrontal and temporal areas. Within the high risk sample, the path length of the posterior cingulate cortex and the betweenness centrality of the left inferior frontal operculum explained 81% of the variance in schizotypal cognitions, which was previously shown to be the strongest behavioural predictor of schizophrenia in the study. In contrast, local grey matter volume measurements explained 48% of variance in schizotypy. The present results suggest that single-subject grey matter networks can quantify behaviourally relevant biological alterations in people at increased risk for schizophrenia before disease onset.
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Bois C, Ronan L, Levita L, Whalley HC, Giles S, McIntosh AM, Fletcher PC, Owens DC, Johnstone EC, Lawrie SM. Cortical Surface Area Differentiates Familial High Risk Individuals Who Go on to Develop Schizophrenia. Biol Psychiatry 2015; 78:413-20. [PMID: 25758056 DOI: 10.1016/j.biopsych.2014.12.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 11/06/2014] [Accepted: 12/12/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Schizophrenia is associated with structural brain abnormalities that may be present before disease onset. It remains unclear whether these represent general vulnerability indicators or are associated with the clinical state itself. METHODS To investigate this, structural brain scans were acquired at two time points (mean scan interval 1.87 years) in a cohort of individuals at high familial risk of schizophrenia (n = 142) and control subjects (n = 36). Cortical reconstructions were generated using FreeSurfer. The high-risk cohort was subdivided into individuals that remained well during the study, individuals that had transient psychotic symptoms, and individuals that subsequently became ill. Baseline measures and longitudinal change in global estimates of thickness and surface area and lobar values were compared, focusing on overall differences between high-risk individuals and control subjects and then on group differences within the high-risk cohort. RESULTS Longitudinally, control subjects showed a significantly greater reduction in cortical surface area compared with the high-risk group. Within the high-risk group, differences in surface area at baseline predicted clinical course, with individuals that subsequently became ill having significantly larger surface area than individuals that remained well during the study. For thickness, longitudinal reductions were most prominent in the frontal, cingulate, and occipital lobes in all high-risk individuals compared with control subjects. CONCLUSIONS Our results suggest that larger surface areas at baseline may be associated with mechanisms that go above and beyond a general familial disposition. A relative preservation over time of surface area, coupled with a thinning of the cortex compared with control subjects, may serve as vulnerability markers of schizophrenia.
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Affiliation(s)
- Catherine Bois
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom.
| | - Lisa Ronan
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Stephen Giles
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Paul C Fletcher
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridge and Peterborough Foundation National Health Service Trust, Cambridge, United Kingdom
| | - David C Owens
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Eve C Johnstone
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
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Nucifora PGP. Overdiagnosis in the era of neuropsychiatric imaging. Acad Radiol 2015; 22:995-9. [PMID: 25784322 DOI: 10.1016/j.acra.2015.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/28/2015] [Accepted: 02/05/2015] [Indexed: 12/17/2022]
Abstract
New guidelines proposed by the National Institute of Mental Health are intended to transform the management of patients with psychiatric disorders. It is anticipated that neuroimaging and other biomarkers will play a more prominent role in diagnosis and prognosis, especially in the prodromal phase of illness. Earlier treatment of psychiatric disorders has the potential to improve outcomes significantly. However, diagnosis in the absence of symptoms can lead to overdiagnosis. Overdiagnosis is a problem in many fields of medicine but could pose additional problems in psychiatry because of the stigmatization that often accompanies a diagnosis of mental illness. This review discusses the magnetic resonance imaging methods that hold the most promise for evaluating neuropsychiatric disorders, the likelihood that they could lead to overdiagnosis, and opportunities to minimize the impact of overdiagnosis in psychiatric disorders.
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Affiliation(s)
- Paolo G P Nucifora
- Department of Radiology, Philadelphia VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104; Department of Radiology, University of Pennsylvania, 3400 Spruce St, Philadelphia, Pennsylvania.
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Sugranyes G, de la Serna E, Romero S, Sanchez-Gistau V, Calvo A, Moreno D, Baeza I, Diaz-Caneja CM, Sanchez-Gutierrez T, Janssen J, Bargallo N, Castro-Fornieles J. Gray Matter Volume Decrease Distinguishes Schizophrenia From Bipolar Offspring During Childhood and Adolescence. J Am Acad Child Adolesc Psychiatry 2015. [PMID: 26210337 DOI: 10.1016/j.jaac.2015.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE There is increasing support toward the notion that schizophrenia and bipolar disorder share neurodevelopmental underpinnings, although areas of divergence remain. We set out to examine gray matter volume characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder comparatively. METHOD In this 2-center study, magnetic resonance structural neuroimaging data were acquired in 198 children and adolescents (aged 6-17 years): 38 offspring of patients with schizophrenia, 77 offspring of patients with bipolar disorder, and 83 offspring of community controls. Analyses of global brain volumes and voxel-based morphometry (using familywise error correction) were conducted. RESULTS There was an effect of group on total cerebral gray matter volume (F = 3.26, p = .041), driven by a decrease in offspring of patients with schizophrenia relative to offspring of controls (p = .035). At a voxel-based level, we observed an effect of group in the left inferior frontal cortex/anterior insula (F = 14.7, p < .001), which was driven by gray matter volume reduction in offspring of patients with schizophrenia relative to both offspring of controls (p = .044) and of patients with bipolar disorder (p < .001). No differences were observed between offspring of patients with bipolar disorder and offspring of controls in either global or voxel-based gray matter volumes. CONCLUSION This first comparative study between offspring of patients with schizophrenia and bipolar disorder suggests that gray matter volume reduction in childhood and adolescence may be specific to offspring of patients with schizophrenia; this may index a greater neurodevelopmental impact of risk for schizophrenia relative to bipolar disorder during youth.
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Affiliation(s)
- Gisela Sugranyes
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain, and Institute of Neuroscience, Hospital Clínic of Barcelona.
| | - Elena de la Serna
- Institute of Neuroscience, Hospital Clínic of Barcelona, and Biomedical Research Network Centre in Mental Health (CIBERSAM), Madrid
| | - Soledad Romero
- Institute of Neuroscience, Hospital Clínic of Barcelona, and Biomedical Research Network Centre in Mental Health (CIBERSAM), Madrid
| | | | - Anna Calvo
- IDIBAPS and Biomedical Research Network Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Grupo de Imagen Biomédica de la Universidad de Barcelona (GIB-UB)
| | - Dolores Moreno
- CIBERSAM and Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Complutense University, Madrid
| | - Inmaculada Baeza
- IDIBAPS, Institute of Neuroscience, Hospital Clínic of Barcelona, and CIBERSAM
| | - Covadonga M Diaz-Caneja
- Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Complutense University, Madrid
| | - Teresa Sanchez-Gutierrez
- Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Complutense University, Madrid
| | - Joost Janssen
- CIBERSAM and Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Complutense University, Madrid
| | - Nuria Bargallo
- IDIBAPS, CIBERSAM, and Image Diagnosis Center, Hospital Clinic of Barcelona
| | - Josefina Castro-Fornieles
- IDIBAPS, Institute of Neuroscience, Hospital Clínic of Barcelona, and CIBERSAM; University of Barcelona
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Spine pruning drives antipsychotic-sensitive locomotion via circuit control of striatal dopamine. Nat Neurosci 2015; 18:883-91. [PMID: 25938885 PMCID: PMC4459733 DOI: 10.1038/nn.4015] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 04/08/2015] [Indexed: 02/06/2023]
Abstract
Psychiatric and neurodevelopmental disorders may arise from anomalies in long-range neuronal connectivity downstream of pathologies in dendritic spines. However, the mechanisms that may link spine pathology to circuit abnormalities relevant to atypical behavior remain unknown. Using a mouse model to conditionally disrupt a critical regulator of the dendritic spine cytoskeleton, Arp2/3, we report here a molecular mechanism that unexpectedly reveals the interrelationship of progressive spine pruning, elevated frontal cortical excitation of pyramidal neurons, and striatal hyperdopaminergia within a cortical-to-midbrain circuit abnormality. The main symptomatic manifestations of this circuit abnormality are psychomotor agitation and stereotypical behaviors, which are relieved by antipsychotics. Moreover, antipsychotic-responsive locomotion can be directly mimicked in wildtype mice by optogenetic activation of this circuit. Collectively these results reveal molecular and neural-circuit mechanisms, illustrating how diverse pathologies may converge to drive behaviors relevant to psychiatric disorders.
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Abstract
Neuroimaging studies have identified patterns of brain abnormalities in various stages of schizophrenia, but whether these abnormalities reflect primary factors associated with the causes of illness or secondary phenomena such as medications has been unclear. Recent work conducted within the prodromal risk paradigm suggests that progressive change in brain structure and function occurs around the time when clinically high-risk individuals transition into full-blown psychosis, effects that cannot be explained by exposure to medications or illness chronicity. This article reviews recent work bearing on the question of the timing of onset and course of brain changes, focusing on structural MRI, diffusion tensor imaging, and resting state connectivity MRI, in association with the onset and course of psychosis. We conclude with a consideration of potential mechanisms underlying progressive tissue changes during the prodromal phase of schizophrenia and implications for prevention.
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Affiliation(s)
- Yoonho Chung
- Deparment of Psychology, Yale University, New Haven CT
| | - Tyrone D. Cannon
- Deparment of Psychology, Yale University, New Haven CT
- Department of Psychiatry, Yale University, New Haven CT
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Firth J, Cotter J, Elliott R, French P, Yung AR. A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med 2015; 45:1343-1361. [PMID: 25650668 DOI: 10.1017/s0033291714003110] [Citation(s) in RCA: 350] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The typically poor outcomes of schizophrenia could be improved through interventions that reduce cardiometabolic risk, negative symptoms and cognitive deficits; aspects of the illness which often go untreated. The present review and meta-analysis aimed to establish the effectiveness of exercise for improving both physical and mental health outcomes in schizophrenia patients. METHOD We conducted a systematic literature search to identify all studies that examined the physical or mental effects of exercise interventions in non-affective psychotic disorders. Of 1581 references, 20 eligible studies were identified. Data on study design, sample characteristics, outcomes and feasibility were extracted from all studies and systematically reviewed. Meta-analyses were also conducted on the physical and mental health outcomes of randomized controlled trials. RESULTS Exercise interventions had no significant effect on body mass index, but can improve physical fitness and other cardiometabolic risk factors. Psychiatric symptoms were significantly reduced by interventions using around 90 min of moderate-to-vigorous exercise per week (standardized mean difference: 0.72, 95% confidence interval -1.14 to -0.29). This amount of exercise was also reported to significantly improve functioning, co-morbid disorders and neurocognition. CONCLUSIONS Interventions that implement a sufficient dose of exercise, in supervised or group settings, can be feasible and effective interventions for schizophrenia.
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Affiliation(s)
- J Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - J Cotter
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - R Elliott
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - P French
- Psychosis Research Unit, Greater Manchester West NHS Mental Health Trust,UK
| | - A R Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
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