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Guo X, Yu J, Quan C, Xiao J, Wang J, Zhang B, Hao X, Wu X, Liang J. The effect of N-methyl-D-aspartate receptor antagonists on the mismatch negativity of event-related potentials and its regulatory factors: A systematic review and meta-analysis. J Psychiatr Res 2024; 172:210-220. [PMID: 38402843 DOI: 10.1016/j.jpsychires.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/27/2024]
Abstract
This study investigates the influence of N-methyl-D-aspartate receptor (NMDAR) antagonists on the mismatch negativity (MMN) components of event-related potentials (ERPs) in healthy subjects and explores whether NMDAR antagonists have different effects on MMN components under different types of antagonists, drug dosages, and deviant stimuli. We conducted a comprehensive literature search of PubMed, EMBASE, and the Cochrane Library from inception to August 1, 2023 for studies comparing the MMN components between the NMDAR antagonist intervention group and the control group (or baseline). All statistical analyses were performed using Stata version 12.0 software. Sixteen articles were included in the systematic review: 13 articles were included in the meta-analysis of MMN amplitudes, and seven articles were included in the meta-analysis of MMN latencies. The pooled analysis showed that NMDAR antagonists reduced MMN amplitudes [SMD (95% CI) = 0.32 (0.16, 0.47), P < 0.01, I2 = 47.3%, p < 0.01] and prolonged MMN latencies [SMD (95% CI) = 0.31 (0.13, 0.49), P = 0.16, I2 = 28.3%, p < 0.01]. The type of antagonist drug regulates the effect of NMDAR antagonists on MMN amplitudes. Different antagonists, doses of antagonists, and types of deviant stimuli can also have different effects on MMN. These findings indicate a correlation between NMDAR and MMN, which may provide a foundation for the application of ERP-MMN in the early identification of NMDAR encephalitis.
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Affiliation(s)
- Xin Guo
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Jieyang Yu
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Chunhua Quan
- Central Laboratory, The Affiliated Hospital of Yanbian University, Juzi-St., No.1327, Yanji, 133000, China.
| | - Jinyu Xiao
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Jiangtao Wang
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Bo Zhang
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Xiaosheng Hao
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Xuemei Wu
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
| | - Jianmin Liang
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
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Hamilton HK, Mathalon DH, Ford JM. P300 in schizophrenia: Then and now. Biol Psychol 2024; 187:108757. [PMID: 38316196 DOI: 10.1016/j.biopsycho.2024.108757] [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: 08/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
The 1965 discovery of the P300 component of the electroencephalography (EEG)-based event-related potential (ERP), along with the subsequent identification of its alteration in people with schizophrenia, initiated over 50 years of P300 research in schizophrenia. Here, we review what we now know about P300 in schizophrenia after nearly six decades of research. We describe recent efforts to expand our understanding of P300 beyond its sensitivity to schizophrenia itself to its potential role as a biomarker of risk for psychosis or a heritable endophenotype that bridges genetic risk and psychosis phenomenology. We also highlight efforts to move beyond a syndrome-based approach to understand P300 within the context of the clinical, cognitive, and presumed pathophysiological heterogeneity among people diagnosed with schizophrenia. Finally, we describe several recent approaches that extend beyond measuring the traditional P300 ERP component in people with schizophrenia, including time-frequency analyses and pharmacological challenge studies, that may help to clarify specific cognitive mechanisms that are disrupted in schizophrenia. Moreover, we discuss several promising areas for future research, including studies of animal models that can be used for treatment development.
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Affiliation(s)
- Holly K Hamilton
- University of Minnesota, Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA; Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Daniel H Mathalon
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Judith M Ford
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
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3
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Mismatch negativity as an index of target engagement for excitation/inhibition-based treatment development: a double-blind, placebo-controlled, randomized, single-dose cross-over study of the serotonin type-3 receptor antagonist CVN058. Neuropsychopharmacology 2022; 47:711-718. [PMID: 34667294 PMCID: PMC8782925 DOI: 10.1038/s41386-021-01170-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
Serotonin type-3 receptor (5-HT3R) antagonists show potential as a treatment for cognitive deficits in schizophrenia. CVN058, a brain-penetrant, potent and selective 5-HT3R antagonist, shows efficacy in rodent models of cognition and was well-tolerated in Phase-1 studies. We evaluated the target engagement of CVN058 using mismatch negativity (MMN) in a randomized, double-blind, placebo-controlled, cross-over study. Subjects were stable outpatients with schizophrenia or schizoaffective disorder treated with antipsychotics. Subjects were not permitted to use other 5-HT3R modulators or serotonin reuptake inhibitors. Each subject received a high (150 mg) and low (15 mg or 75 mg) oral dose of CVN058 and placebo in a randomized order across 3 single-day treatment visits separated by at least 1 week. The primary pre-registered outcome was amplitude of duration MMN. Amplitude of other MMN deviants (frequency, intensity, frequency modulation, and location), P50, P300 and auditory steady-state response (ASSR) were exploratory endpoints. 19 of 22 randomized subjects (86.4%) completed the study. Baseline PANSS scores indicated moderate impairment. CVN058 150 mg led to significant improvement vs. placebo on the primary outcome of duration MMN (p = 0.02, Cohen's d = 0.48). A significant treatment effect was also seen in a combined analysis across all MMN deviants (p < 0.001, d = 0.57). Effects on location MMN were independently significant (p < 0.007, d = 0.46). No other significant effects were seen for other deviants, doses or EEG measures. There were no clinically significant treatment related adverse effects. These results show MMN to be a sensitive target engagement biomarker for 5-HT3R, and support the potential utility of CVN058 in correcting the excitatory/inhibitory imbalance in schizophrenia.
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4
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Yi GL, Zhu MZ, Cui HC, Yuan XR, Liu P, Tang J, Li YQ, Zhu XH. A hippocampus dependent neural circuit loop underlying the generation of auditory mismatch negativity. Neuropharmacology 2022; 206:108947. [PMID: 35026286 DOI: 10.1016/j.neuropharm.2022.108947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/11/2021] [Accepted: 01/06/2022] [Indexed: 11/16/2022]
Abstract
Extracting relevant information and transforming it into appropriate behavior, is a fundamental brain function, and requires the coordination between the sensory and cognitive systems, however, the underlying mechanisms of interplay between sensory and cognition systems remain largely unknown. Here, we developed a mouse model for mimicking human auditory mismatch negativity (MMN), a well-characterized translational biomarker for schizophrenia, and an index of early auditory information processing. We found that a subanesthetic dose of ketamine decreased the amplitude of MMN in adult mice. Using pharmacological and chemogenetic approaches, we identified an auditory cortex-entorhinal cortex-hippocampus neural circuit loop that is required for the generation of MMN. In addition, we found that inhibition of dCA1→MEC circuit impaired the auditory related fear discrimination. Moreover, we found that ketamine induced MMN deficiency by inhibition of long-range GABAergic projection from the CA1 region of the dorsal hippocampus to the medial entorhinal cortex. These results provided circuit insights for ketamine effects and early auditory information processing. As the entorhinal cortex is the interface between the neocortex and hippocampus, and the hippocampus is critical for the formation, consolidation, and retrieval of episodic memories and other cognition, our results provide a neural mechanism for the interplay between the sensory and cognition systems.
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Affiliation(s)
- Guo-Liang Yi
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Min-Zhen Zhu
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - He-Chen Cui
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Xin-Rui Yuan
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Peng Liu
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Jie Tang
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Yuan-Qing Li
- Research Center for Brain-Computer Interface, Pazhou Lab, Guangzhou, 510330, China
| | - Xin-Hong Zhu
- Institute of Mental Health, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China; Research Center for Brain Health, Pazhou Lab, Guangzhou, 510330, China; School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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Elsayed NA, Boyer TM, Burd I. Fetal Neuroprotective Strategies: Therapeutic Agents and Their Underlying Synaptic Pathways. Front Synaptic Neurosci 2021; 13:680899. [PMID: 34248595 PMCID: PMC8262796 DOI: 10.3389/fnsyn.2021.680899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/28/2021] [Indexed: 01/31/2023] Open
Abstract
Synaptic signaling is integral for proper brain function. During fetal development, exposure to inflammation or mild hypoxic-ischemic insult may lead to synaptic changes and neurological damage that impairs future brain function. Preterm neonates are most susceptible to these deleterious outcomes. Evaluating clinically used and novel fetal neuroprotective measures is essential for expanding treatment options to mitigate the short and long-term consequences of fetal brain injury. Magnesium sulfate is a clinical fetal neuroprotective agent utilized in cases of imminent preterm birth. By blocking N-methyl-D-aspartate receptors, magnesium sulfate reduces glutamatergic signaling, which alters calcium influx, leading to a decrease in excitotoxicity. Emerging evidence suggests that melatonin and N-acetyl-L-cysteine (NAC) may also serve as novel putative fetal neuroprotective candidates. Melatonin has important anti-inflammatory and antioxidant properties and is a known mediator of synaptic plasticity and neuronal generation. While NAC acts as an antioxidant and a precursor to glutathione, it also modulates the glutamate system. Glutamate excitotoxicity and dysregulation can induce perinatal preterm brain injury through damage to maturing oligodendrocytes and neurons. The improved drug efficacy and delivery of the dendrimer-bound NAC conjugate provides an opportunity for enhanced pharmacological intervention. Here, we review recent literature on the synaptic pathways underlying these therapeutic strategies, discuss the current gaps in knowledge, and propose future directions for the field of fetal neuroprotective agents.
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Affiliation(s)
- Nada A. Elsayed
- Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Theresa M. Boyer
- Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Irina Burd
- Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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6
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Lockhofen DEL, Mulert C. Neurochemistry of Visual Attention. Front Neurosci 2021; 15:643597. [PMID: 34025339 PMCID: PMC8133366 DOI: 10.3389/fnins.2021.643597] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/12/2021] [Indexed: 11/25/2022] Open
Abstract
Visual attention is the cognitive process that mediates the selection of important information from the environment. This selection is usually controlled by bottom-up and top-down attentional biasing. Since for most humans vision is the dominant sense, visual attention is critically important for higher-order cognitive functions and related deficits are a core symptom of many neuropsychiatric and neurological disorders. Here, we summarize the importance and relative contributions of different neuromodulators and neurotransmitters to the neural mechanisms of top-down and bottom-up attentional control. We will not only review the roles of widely accepted neuromodulators, such as acetylcholine, dopamine and noradrenaline, but also the contributions of other modulatory substances. In doing so, we hope to shed some light on the current understanding of the role of neurochemistry in shaping neuron properties contributing to the allocation of attention in the visual field.
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Affiliation(s)
| | - Christoph Mulert
- Center for Psychiatry and Psychotherapy, Justus-Liebig University, Hessen, Germany
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Murphy N, Lijffijt M, Ramakrishnan N, Vo-Le B, Vo-Le B, Iqbal S, Iqbal T, O'Brien B, Smith MA, Swann AC, Mathew SJ. Does mismatch negativity have utility for NMDA receptor drug development in depression? ACTA ACUST UNITED AC 2021; 44:61-73. [PMID: 33825765 PMCID: PMC8827377 DOI: 10.1590/1516-4446-2020-1685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
CLINICAL TRIAL REGISTRATION Rapid antidepressant effects associated with ketamine have shifted the landscape for the development of therapeutics to treat major depressive disorder (MDD) from a monoaminergic to glutamatergic model. Treatment with ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, may be effective, but has many non-glutamatergic targets, and clinical and logistical problems are potential challenges. These factors underscore the importance of manipulations of binding mechanics to produce antidepressant effects without concomitant clinical side effects. This will require identification of efficient biomarkers to monitor target engagement. The mismatch negativity (MMN) is a widely used electrophysiological signature linked to the activity of NMDA receptors (NMDAR) in humans and animals and validated in pre-clinical and clinical studies of ketamine. In this review, we explore the flexibility of the MMN and its capabilities for reliable use in drug development for NMDAR antagonists in MDD. We supplement this with findings from our own research with three distinct NMDAR antagonists. The research described illustrates that there are important distinctions between the mechanisms of NMDAR antagonism, which are further crystallized when considering the paradigm used to study the MMN. We conclude that the lack of standardized methodology currently prevents MMN from being ready for common use in drug discovery. This manuscript describes data collected from the following National Institutes of Health (NIH) and Veterans Affairs (VA) studies: AV-101, NCT03583554; lanicemine, NCT03166501; ketamine, NCT02556606.
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Affiliation(s)
- Nicholas Murphy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA.,The Menninger Clinic, Houston, TX, USA
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Nithya Ramakrishnan
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Bylinda Vo-Le
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Brittany Vo-Le
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Sidra Iqbal
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Tabish Iqbal
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Brittany O'Brien
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Mark A Smith
- VistaGen Therapeutics, Inc., South San Francisco, CA, USA.,Medical College of Georgia, Augusta, GA, USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Sanjay J Mathew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA.,The Menninger Clinic, Houston, TX, USA
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Jacob MS, Roach BJ, Hamilton HK, Carrión RE, Belger A, Duncan E, Johannesen J, Keshavan M, Loo S, Niznikiewicz M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Stone W, Tsuang M, Walker EF, Woods SW, Mathalon DH. Visual cortical plasticity and the risk for psychosis: An interim analysis of the North American Prodrome Longitudinal Study. Schizophr Res 2021; 230:26-37. [PMID: 33667856 PMCID: PMC8328744 DOI: 10.1016/j.schres.2021.01.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 11/08/2020] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adolescence/early adulthood coincides with accelerated pruning of cortical synapses and the onset of schizophrenia. Cortical gray matter reduction and dysconnectivity in schizophrenia are hypothesized to result from impaired synaptic plasticity mechanisms, including long-term potentiation (LTP), since deficient LTP may result in too many weak synapses that are then subject to over-pruning. Deficient plasticity has already been observed in schizophrenia. Here, we assessed whether such deficits are present in the psychosis risk syndrome (PRS), particularly those who subsequently convert to full psychosis. METHODS An interim analysis was performed on a sub-sample from the NAPLS-3 study, including 46 healthy controls (HC) and 246 PRS participants. All participants performed an LTP-like visual cortical plasticity paradigm involving assessment of visual evoked potentials (VEPs) elicited by vertical and horizontal line gratings before and after high frequency ("tetanizing") visual stimulation with one of the gratings to induce "input-specific" neuroplasticity (i.e., VEP changes specific to the tetanized stimulus). Non-parametric, cluster-based permutation testing was used to identify electrodes and timepoints that demonstrated input-specific plasticity effects. RESULTS Input-specific pre-post VEP changes (i.e., increased negative voltage) were found in a single spatio-temporal cluster covering multiple occipital electrodes in a 126-223 ms time window. This plasticity effect was deficient in PRS individuals who subsequently converted to psychosis, relative to PRS non-converters and HC. CONCLUSIONS Input-specific LTP-like visual plasticity can be measured from VEPs in adolescents and young adults. Interim analyses suggest that deficient visual cortical plasticity is evident in those PRS individuals at greatest risk for transition to psychosis.
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Affiliation(s)
- Michael S. Jacob
- VA San Francisco Healthcare System, San Francisco, CA, USA,Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brian J. Roach
- VA San Francisco Healthcare System, San Francisco, CA, USA
| | - Holly K. Hamilton
- VA San Francisco Healthcare System, San Francisco, CA, USA,Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ricardo E. Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY, USA,Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erica Duncan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA,Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Jason Johannesen
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Sandra Loo
- Semel Institute for Neuroscience and Human Behavior, Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Margaret Niznikiewicz
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E. Bearden
- Semel Institute for Neuroscience and Human Behavior, Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kristin S. Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Tyrone D. Cannon
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA,Department of Psychology, Yale University, School of Medicine, New Haven, CT, USA
| | - Barbara A. Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY, USA,Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA,Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - Thomas H. McGlashan
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Ming Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | | | - Scott W. Woods
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Daniel H. Mathalon
- VA San Francisco Healthcare System, San Francisco, CA, USA,Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
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9
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Longitudinal relationships between mismatch negativity, cognitive performance, and real-world functioning in early psychosis. Schizophr Res 2021; 228:385-393. [PMID: 33549980 PMCID: PMC7987838 DOI: 10.1016/j.schres.2021.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/13/2021] [Accepted: 01/17/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Reduced mismatch negativity (MMN) is observed in early psychosis (EP) and correlated with cognition and functioning, but few studies have examined their longitudinal relationships and diagnostic specificity. We examined MMN, neuro- and social-cognition, and functional measures in EP patients with schizophrenia-spectrum (SZ) or bipolar disorder (BD) over a 1-year follow-up. METHODS 54 EP patients (SZ: n = 24; BD: n = 30) and 42 healthy controls completed baseline measures: MMN, neuro- and social-cognition, and functional assessments. 30 EP patients completed 12-month follow-up assessments. Patients and controls were compared on MMN at baseline and follow-up, and diagnostic subgroup analyses were performed. Associations amongst MMN, neuro- and social cognition, and clinical measures were examined and predictive models of follow-up outcomes were conducted. RESULTS EP patients showed significantly reduced MMN compared to controls at baseline (p = 0.023). MMN was impaired in SZ patients at baseline (p = 0.017) and follow-up (p = 0.003); BD patients did not differ from controls at either timepoint. MMN was associated with symptom severity and functioning at baseline, and with social cognition and functioning at follow up, but was not predictive of functional outcomes at follow-up. CONCLUSIONS MMN abnormalities were evident in EP SZ-spectrum disorders at both timepoints, but not in BD at either timepoint. MMN was associated with functioning cross-sectionally, but did not predict future functional outcomes. However, deficits in MMN were associated with social cognition, which may have downstream effects on community functioning. Implications for targeted interventions to improve social processing and community outcomes are discussed.
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Rodrigues FS, França AP, Broetto N, Furian AF, Oliveira MS, Santos ARS, Royes LFF, Fighera MR. Sustained glial reactivity induced by glutaric acid may be the trigger to learning delay in early and late phases of development: Involvement of p75 NTR receptor and protection by N-acetylcysteine. Brain Res 2020; 1749:147145. [PMID: 33035499 DOI: 10.1016/j.brainres.2020.147145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 11/17/2022]
Abstract
Degeneration of striatal neurons and cortical atrophy are pathological characteristics of glutaric acidemia type I (GA-I), a disease characterized by accumulation of glutaric acid (GA). The mechanisms that lead to neuronal loss and cognitive impairment are still unclear. The purpose of this study was to verify if acute exposure to GA during the neonatal period is sufficient to trigger apoptotic processes and lead to learning delay in early and late period. Besides, whether N-acetylcysteine (NAC) would protect against impairment induced by GA. Pups mice received a dose of GA (2.5 μmol/ g) or saline, 12 hs after birth, and were treated with NAC (250 mg/kg) or saline, up to 21th day of life. Although GA exhibited deficits in the procedural and working memories in 21 and 40-day-old mice, NAC protected against cognitive impairment. In striatum and cortex, NAC prevented glial cells activation (GFAP and Iba-1), decreased NGF, Bcl-2 and NeuN, the increase of lipid peroxidation and PARP induced by GA in both ages. NAC protected against increased p75NTR induced by GA, but not in cortex of 21-day-old mice. Thus, we showed that the integrity of striatal and cortical pathways has an important role for learning and suggested that sustained glial reactivity in neonatal period can be an initial trigger for delay of cognitive development. Furthermore, NAC protected against cognitive impairment induced by GA. This work shows that early identification of the alterations induced by GA is important to avoid future clinical complications and suggest that NAC could be an adjuvant treatment for this acidemia.
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Affiliation(s)
- Fernanda Silva Rodrigues
- Centro de Ciências da Saúde, Departamento de Neuropsiquiatria, Laboratório de Neuropsiquiatria Experimental e Clínico, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil; Centro de Educação Física e Desportos, Departamento de Métodos e Técnicas Desportivas, Laboratório de Bioquímica do Exercício (BIOEX), Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; Centro de Ciências Biológicas, Laboratório de Neurobiologia da Dor e Inflamação, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil; Centro de Ciências Biológicas, Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Angela Patrícia França
- Centro de Ciências Biológicas, Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Núbia Broetto
- Centro de Ciências da Saúde, Departamento de Neuropsiquiatria, Laboratório de Neuropsiquiatria Experimental e Clínico, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil; Centro de Educação Física e Desportos, Departamento de Métodos e Técnicas Desportivas, Laboratório de Bioquímica do Exercício (BIOEX), Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Ana Flávia Furian
- Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, 97105-900 Santa Maria, RS, Brazil
| | - Mauro Schneider Oliveira
- Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, 97105-900 Santa Maria, RS, Brazil
| | - Adair Roberto Soares Santos
- Centro de Ciências Biológicas, Laboratório de Neurobiologia da Dor e Inflamação, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil; Centro de Ciências Biológicas, Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Luiz Fernando Freire Royes
- Centro de Ciências Naturais e Exatas, Programa de Pós-Graduação em Ciências Biológicas: Bioquímica Toxicológica, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil; Centro de Educação Física e Desportos, Departamento de Métodos e Técnicas Desportivas, Laboratório de Bioquímica do Exercício (BIOEX), Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; Centro de Ciências Biológicas, Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Michele Rechia Fighera
- Centro de Ciências da Saúde, Departamento de Neuropsiquiatria, Laboratório de Neuropsiquiatria Experimental e Clínico, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil; Centro de Ciências Naturais e Exatas, Programa de Pós-Graduação em Ciências Biológicas: Bioquímica Toxicológica, Universidade Federal de Santa Maria, 97105-900 Santa Maria, RS, Brazil; Centro de Ciências Biológicas, Programa de Pós-Graduação em Neurociências, Universidade Federal de Santa Catarina, 88040-900 Florianópolis, SC, Brazil; Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmacologia, Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, 97105-900 Santa Maria, RS, Brazil.
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11
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Egerton A, Grace AA, Stone J, Bossong MG, Sand M, McGuire P. Glutamate in schizophrenia: Neurodevelopmental perspectives and drug development. Schizophr Res 2020; 223:59-70. [PMID: 33071070 DOI: 10.1016/j.schres.2020.09.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 08/12/2020] [Accepted: 09/20/2020] [Indexed: 12/14/2022]
Abstract
Research into the neurobiological processes that may lead to the onset of schizophrenia places growing emphasis on the glutamatergic system and brain development. Preclinical studies have shown that neurodevelopmental, genetic, and environmental factors contribute to glutamatergic dysfunction and schizophrenia-related phenotypes. Clinical research has suggested that altered brain glutamate levels may be present before the onset of psychosis and relate to outcome in those at clinical high risk. After psychosis onset, glutamate dysfunction may also relate to the degree of antipsychotic response and clinical outcome. These findings support ongoing efforts to develop pharmacological interventions that target the glutamate system and could suggest that glutamatergic compounds may be more effective in specific patient subgroups or illness stages. In this review, we consider the updated glutamate hypothesis of schizophrenia, from a neurodevelopmental perspective, by reviewing recent preclinical and clinical evidence, and discuss the potential implications for novel therapeutics.
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Affiliation(s)
- Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - James Stone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthijs G Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael Sand
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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12
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Hirano S, Spencer KM, Onitsuka T, Hirano Y. Language-Related Neurophysiological Deficits in Schizophrenia. Clin EEG Neurosci 2020; 51:222-233. [PMID: 31741393 DOI: 10.1177/1550059419886686] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Schizophrenia is a severe psychiatric disorder that affects all aspects of one's life with several cognitive and social dysfunctions. However, there is still no objective and universal index for diagnosis and treatment of this disease. Many researchers have studied language processing in schizophrenia since most of the patients show symptoms related to language processing, such as thought disorder, auditory verbal hallucinations, or delusions. Electroencephalography (EEG) and magnetoencephalography (MEG) with millisecond order high temporal resolution, have been applied to reveal the abnormalities in language processing in schizophrenia. The aims of this review are (a) to provide an overview of recent findings in language processing in schizophrenia with EEG and MEG using neurophysiological indices, providing insights into underlying language related pathophysiological deficits in this disease and (b) to emphasize the advantage of EEG and MEG in research on language processing in schizophrenia.
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Affiliation(s)
- Shogo Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan.,Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kevin M Spencer
- Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Toshiaki Onitsuka
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan.,Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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13
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Koshiyama D, Kirihara K, Tada M, Nagai T, Fujioka M, Usui K, Araki T, Kasai K. Reduced Auditory Mismatch Negativity Reflects Impaired Deviance Detection in Schizophrenia. Schizophr Bull 2020; 46:937-946. [PMID: 32072183 PMCID: PMC7345817 DOI: 10.1093/schbul/sbaa006] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The auditory mismatch negativity (MMN) is a translatable electroencephalographic biomarker automatically evoked in response to unattended sounds that is robustly associated with cognitive and psychosocial disability in patients with schizophrenia. Although recent animal studies have tried to clarify the neural substrates of the MMN, the nature of schizophrenia-related deficits is unknown. In this study, we applied a novel paradigm developed from translational animal model studies to carefully deconstruct the constituent neurophysiological processes underlying MMN generation. Patients with schizophrenia (N = 25) and healthy comparison subjects (HCS; N = 27) underwent MMN testing using both a conventional auditory oddball paradigm and a "many-standards paradigm" that was specifically developed to deconstruct the subcomponent adaptation and deviance detection processes that are presumed to underlie the MMN. Using a conventional oddball paradigm, patients with schizophrenia exhibited large effect size deficits of both duration and frequency MMN, consistent with many previous studies. Furthermore, patients with schizophrenia showed selective impairments in deviance detection but no impairment in adaptation to repeated tones. These findings support the use of the many-standards paradigm for deconstructing the constituent processes underlying the MMN, with implications for the use of these translational measures to accelerate the development of new treatments that target perceptual and cognitive impairments in schizophrenia and related disorders.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Kawamuro Memorial Hospital, Niigata, Japan
| | - Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; tel: +81-3-5800-8919, fax: +81-3-5800-9162, e-mail:
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14
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Jalewa J, Todd J, Michie PT, Hodgson DM, Harms L. Do rat auditory event related potentials exhibit human mismatch negativity attributes related to predictive coding? Hear Res 2020; 399:107992. [PMID: 32571607 DOI: 10.1016/j.heares.2020.107992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 01/11/2023]
Abstract
Rodent models play a significant role in understanding disease mechanisms and the screening of new treatments. With regard to psychiatric disorders such as schizophrenia, however, it is difficult to replicate the human symptoms in rodents because these symptoms are often either 'uniquely human' or are only conveyed via self-report. There is a growing interest in rodent mismatch responses (MMRs) as a translatable 'biomarker' for disorders such as schizophrenia. In this review, we will summarize the attributes of human MMN, and discuss the scope of exploring the attributes of human MMN in rodents. Here, we examine how reliably MMRs that are measured in rats mimic human attributes, and present original data examining whether manipulations of stimulus conditions known to modulate human MMN, do the same for rat MMRs. Using surgically-implanted epidural electroencephalographic electrodes and wireless telemetry in freely-moving rats, we observed human-like modulations of MMRs, namely that larger MMRs were elicited to unexpected (deviant) stimuli that a) had a larger change in pitch compared to the expected (standard) stimulus, b) were less frequently presented (lower probability), and c) had no jitter (stable stimulus onset asynchrony) compared to high jitter. Overall, these findings contribute to the mounting evidence for rat MMRs as a good analogue of human MMN, bolstering the development of a novel approach in future to validate the preclinical models based on a translatable biomarker, MMN.
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Affiliation(s)
- Jaishree Jalewa
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Juanita Todd
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Patricia T Michie
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Deborah M Hodgson
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Lauren Harms
- Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia.
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15
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de la Garrigue N, Glasser J, Sehatpour P, Iosifescu DV, Dias E, Carlson M, Shope C, Sobeih T, Choo TH, Wall MM, Kegeles LS, Gangwisch J, Mayer M, Brazis S, De Baun HM, Wolfer S, Bermudez D, Arnold M, Rette D, Meftah AM, Conant M, Lieberman JA, Kantrowitz JT. Grant Report on d-Serine Augmentation of Neuroplasticity-Based Auditory Learning in Schizophrenia †. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2020; 5:e200018. [PMID: 32856005 PMCID: PMC7448686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We report on the rationale and design of an ongoing NIMH sponsored R61-R33 project in schizophrenia/schizoaffective disorder. This project studies augmenting the efficacy of auditory neuroplasticity cognitive remediation (AudRem) with d-serine, an N-methyl-d-aspartate-type glutamate receptor (NMDAR) glycine-site agonist. We operationalize improved (smaller) thresholds in pitch (frequency) between successive auditory stimuli after AudRem as improved plasticity, and mismatch negativity (MMN) and auditory θ as measures of functional target engagement of both NMDAR agonism and plasticity. Previous studies showed that AudRem alone produces significant, but small cognitive improvements, while d-serine alone improves symptoms and MMN. However, the strongest results for plasticity outcomes (improved pitch thresholds, auditory MMN and θ) were found when combining d-serine and AudRem. AudRem improvements correlated with reading and other auditory cognitive tasks, suggesting plasticity improvements are predictive of functionally relevant outcomes. While d-serine appears to be efficacious for acute AudRem enhancement, the optimal dose remains an open question, as does the ability of combined d-serine + AudRem to produce sustained improvement. In the ongoing R61, 45 schizophrenia patients will be randomized to receive three placebo-controlled, double-blind d-serine + AudRem sessions across three separate 15 subject dose cohorts (80/100/120 mg/kg). Successful completion of the R61 is defined by ≥moderate effect size changes in target engagement and correlation with function, without safety issues. During the three-year R33, we will assess the sustained effects of d-serine + AudRem. In addition to testing a potentially viable treatment, this project will develop a methodology to assess the efficacy of novel NMDAR modulators, using d-serine as a "gold-standard".
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Affiliation(s)
| | - Juliana Glasser
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Pejman Sehatpour
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA,Nathan Kline Institute, Orangeburg, NY 10962, USA
| | - Dan V. Iosifescu
- Nathan Kline Institute, Orangeburg, NY 10962, USA,NYU Langone Medical Center, New York, NY 10016, USA
| | - Elisa Dias
- Nathan Kline Institute, Orangeburg, NY 10962, USA,NYU Langone Medical Center, New York, NY 10016, USA
| | - Marlene Carlson
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | | | - Tarek Sobeih
- Nathan Kline Institute, Orangeburg, NY 10962, USA
| | - Tse-Hwei Choo
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Melanie M. Wall
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Lawrence S. Kegeles
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - James Gangwisch
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Megan Mayer
- New York State Psychiatric Institute, New York, NY 10032, USA
| | | | | | | | - Dalton Bermudez
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Molly Arnold
- Nathan Kline Institute, Orangeburg, NY 10962, USA
| | | | - Amir M. Meftah
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melissa Conant
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Jeffrey A. Lieberman
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Joshua T. Kantrowitz
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA,Nathan Kline Institute, Orangeburg, NY 10962, USA,Correspondence: Joshua T. Kantrowitz, ; Tel.: +1-646-774-6738
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16
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Schwertner A, Zortea M, Torres FV, Ramalho L, Alves CFDS, Lannig G, Torres ILS, Fregni F, Gauer G, Caumo W. S-Ketamine's Effect Changes the Cortical Electrophysiological Activity Related to Semantic Affective Dimension of Pain: A Placebo- Controlled Study in Healthy Male Individuals. Front Neurosci 2019; 13:959. [PMID: 31611759 PMCID: PMC6753200 DOI: 10.3389/fnins.2019.00959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 08/26/2019] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies using the electroencephalogram (EEG) technique pointed out that ketamine decreases the amplitude of cortical electrophysiological signal during cognitive tasks, although its effects on the perception and emotional-valence judgment of stimuli are still unknown. Objective We evaluated the effect of S-ketamine on affective dimension of pain using EEG and behavioral measures. The hypothesis was that S-ketamine would be more effective than placebo, both within and between groups, to attenuate the EEG signal elicited by target and non-target words. Methods This double-blind parallel placebo-controlled study enrolled 24 healthy male volunteers between 19 and 40 years old. They were randomized to receive intravenous S-ketamine (n = 12) at a plasmatic concentration of 60 ng/ml or placebo (n = 12). Participants completed a computerized oddball paradigm containing written words semantically related to pain (targets), and non-pain related words (standard). The volunteers had to classify the words either as “positive,” “negative” or “neutral” (emotional valence judgment). The paradigm consisted in 6 blocks of 50 words each with a fixed 4:1 target/non-target rate presented in a single run. Infusion started during the interval between the 3rd and 4th blocks, for both groups. EEG signal was registered using four channels (Fz, Pz, Pz, and Oz, according to the 10–20 EEG system) with a linked-earlobe reference. The area under the curve (AUC) of the N200 (interval of 100–200 ms) and P300 (300–500 ms) components of event-related potentials (ERPs) was measured for each channel. Results S-ketamine produced substantial difference (delta) in the AUC of grand average ERP components N200 (P = 0.05) and P300 (P = 0.02) at Pz during infusion period when compared to placebo infusion for both targets and non-targets. S-ketamine was also associated with a decrease in the amount of pain-related words judged as negative from before to after infusion [mean = 0.83 (SD = 0.09) vs. mean = 0.73 (SD = 0.11), respectively; P = 0.04]. Conclusion Our findings suggest that S-ketamine actively changed the semantic processing of written words. There was an increase in electrophysiological response for pain-related stimuli and a decrease for standard stimuli, as evidenced by the increased delta of AUCs. Behaviorally, S-ketamine seems to have produced an emotional and discrimination blunting effect for pain-related words. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT03915938.
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Affiliation(s)
- André Schwertner
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Maxciel Zortea
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Felipe Vasconcelos Torres
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Leticia Ramalho
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Camila Fernanda da Silveira Alves
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Guilherme Lannig
- Clinical Research Center, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Iraci L S Torres
- Post-graduation Program in Biological Sciences: Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Pharmacology of Pain and Neuromodulation: Pre-clinical Investigations, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Fregni
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Gustavo Gauer
- Post-graduation Program in Psychology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Wolnei Caumo
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
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17
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Roach BJ, D'Souza DC, Ford JM, Mathalon DH. Test-retest reliability of time-frequency measures of auditory steady-state responses in patients with schizophrenia and healthy controls. NEUROIMAGE-CLINICAL 2019; 23:101878. [PMID: 31228795 PMCID: PMC6587022 DOI: 10.1016/j.nicl.2019.101878] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/18/2019] [Accepted: 05/25/2019] [Indexed: 11/29/2022]
Abstract
Background Auditory steady-state response (ASSR) paradigms have consistently demonstrated gamma band abnormalities in schizophrenia at a 40-Hz driving frequency with both electroencephalography (EEG) and magnetoencephalography (MEG). Various time-frequency measures have been used to assess the 40-Hz ASSR, including evoked power, single trial total power, phase-locking factor (PLF), and phase-locking angle (PLA). While both EEG and MEG studies have shown power and PLF ASSR measures to exhibit excellent test-retest reliability in healthy adults, the reliability of these measures in patients with schizophrenia has not been determined. Methods ASSRs were obtained by recording EEG data during presentation of repeated 20-Hz, 30-Hz and 40-Hz auditory click trains from nine schizophrenia patients (SZ) and nine healthy controls (HC) tested on two occasions. Similar ASSR data were collected from a separate group of 30 HC on two to three test occasions. A subset of these HC subjects had EEG recordings during two tasks, passively listening and actively attending to click train stimuli. Evoked power, total power, PLF, and PLA were calculated following Morlet wavelet time-frequency decomposition of EEG data and test-retest generalizability (G) coefficients were calculated for each ASSR condition, time-frequency measure, and subject group. Results G-coefficients ranged from good to excellent (> 0.6) for most 40-Hz time-frequency measures and participant groups, whereas 20-Hz G-coefficients were much more variable. Importantly, test-retest reliability was excellent for the various 40-Hz ASSR measures in SZ, similar to reliabilities in HC. Active attention to click train stimuli modestly reduced G-coefficients in HC relative to the passive listening condition. Discussion The excellent test-retest reliability of 40-Hz ASSR measures replicates previous EEG and MEG studies. PLA, a relatively new time-frequency measure, was shown for the first time to have excellent reliability, comparable to power and PLF measures. Excellent reliability of 40 Hz ASSR measures in SZ supports their use in clinical trials and longitudinal observational studies.
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Affiliation(s)
- Brian J Roach
- Psychiatry Service, San Francisco VA, San Francisco, CA, USA
| | - Deepak Cyril D'Souza
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Judith M Ford
- Psychiatry Service, San Francisco VA, San Francisco, CA, USA; Department of Psychiatry, UCSF, San Francisco, CA, USA
| | - Daniel H Mathalon
- Psychiatry Service, San Francisco VA, San Francisco, CA, USA; Department of Psychiatry, UCSF, San Francisco, CA, USA.
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18
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Hochberger WC, Joshi YB, Thomas ML, Zhang W, Bismark AW, Treichler EBH, Tarasenko M, Nungaray J, Sprock J, Cardoso L, Swerdlow N, Light GA. Neurophysiologic measures of target engagement predict response to auditory-based cognitive training in treatment refractory schizophrenia. Neuropsychopharmacology 2019; 44:606-612. [PMID: 30377381 PMCID: PMC6333927 DOI: 10.1038/s41386-018-0256-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/01/2018] [Indexed: 01/20/2023]
Abstract
Cognitive impairment is a core feature of schizophrenia and a strong predictor of psychosocial disability. Auditory-based targeted cognitive training (TCT) aims to enhance verbal learning and other domains of cognitive functioning through "bottom-up" tuning of the neural systems underlying early auditory information processing (EAIP). Although TCT has demonstrated efficacy at the group level, individual response to TCT varies considerably, with nearly half of patients showing little-to-no benefit. EEG measures of EAIP, mismatch negativity (MMN) and P3a, are sensitive to the neural systems engaged by TCT exercises and might therefore predict clinical outcomes after a full course of treatment. This study aimed to determine whether initial malleability of MMN and P3a to 1-h of auditory-based TCT predicts improvements in verbal learning and clinical symptom reduction following a full (30-h) course of TCT. Treatment refractory patients diagnosed with schizophrenia were randomly assigned to receive treatment-as-usual (TAU; n = 22) or TAU augmented with TCT (n = 23). Results indicated that malleability (i.e., change from baseline after the initial 1-h dose of TCT) of MMN and P3a predicted improvements in verbal learning as well as decreases in the severity of positive symptoms. Examination of MMN and P3a malleability in patients after their first dose of TCT can be used to predict clinical response to a full course of treatment and shows promise for future biomarker-informed treatment assignment.
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Affiliation(s)
- William C Hochberger
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Yash B Joshi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Wendy Zhang
- San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program (JDP) in Clinical Psychology, San Diego, CA, USA
| | - Andrew W Bismark
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Emily B H Treichler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Melissa Tarasenko
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - John Nungaray
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Lauren Cardoso
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Alpine Special Treatment Center Inc., Alpine, CA, USA
| | - Neal Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA.
- San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program (JDP) in Clinical Psychology, San Diego, CA, USA.
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19
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Rosburg T, Schmidt A. Potential Mechanisms for the Ketamine-Induced Reduction of P3b Amplitudes. Front Behav Neurosci 2018; 12:308. [PMID: 30618662 PMCID: PMC6297878 DOI: 10.3389/fnbeh.2018.00308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/27/2018] [Indexed: 12/12/2022] Open
Abstract
In specific dosages, the N-methyl-D-aspartate receptor (NMDA) antagonist ketamine can be used to model transient psychotic symptoms in healthy individuals that resemble those of schizophrenia. Ketamine administration also temporarily impairs cognitive functions, which can be studied by event-related potentials (ERPs). ERPs also allow dissecting what stages of information processing are affected by ketamine and what stages remain functional. For tasks requiring the differentiation of targets and non-targets, it has repeatedly been shown that ketamine administration in healthy individuals leads to decreased amplitudes of the ERP component P3b in response to target stimuli. However, it could be argued that this ketamine-induced P3b reduction is the consequence of an increased difficulty to differentiate targets from non-targets, primarily mediated by ketamine's psychotomimetic rather than pharmacological effects. The current review of ERP studies seeks to clarify the issue whether P3b effects of ketamine may indeed be explained as the consequence of an experienced increase in task difficulty or whether alternative mechanisms are perhaps more plausible. The review first summarizes the effects of task difficulty on ERP components related to intentional stimulus categorization (P3b), involuntary attention switches to distractors (P3a), as well as sensory processing (P1, N1). Secondly, the ERP effects of task difficulty are contrasted with those observed in ketamine studies in healthy individuals. Findings show that P3b amplitudes are consistently diminished by an increased task difficulty, as well as after ketamine administration. In contrast and as most important difference, increased task difficulty leads to increased P3a amplitudes to distractors presented in same modality as targets, whereas ketamine leads to reduced P3a amplitudes for such distractors. This dissociation indicates that the decreased P3b amplitudes after ketamine cannot be explained by a drug-induced increase in task difficulty. The conjoint reductions of P3a and P3b amplitudes instead suggest that working memory operations, in particular working memory updating are impaired after ketamine, which is in line with previous behavioral findings.
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Affiliation(s)
- Timm Rosburg
- Forensic Department, University Psychiatric Clinics Basel, Basel, Switzerland
| | - André Schmidt
- Department of Psychiatry, University Psychiatric Clinics Basel, Basel, Switzerland
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20
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Haaf M, Leicht G, Curic S, Mulert C. Glutamatergic Deficits in Schizophrenia - Biomarkers and Pharmacological Interventions within the Ketamine Model. Curr Pharm Biotechnol 2018; 19:293-307. [PMID: 29929462 PMCID: PMC6142413 DOI: 10.2174/1389201019666180620112528] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/12/2018] [Accepted: 05/26/2018] [Indexed: 11/30/2022]
Abstract
Background: The observation that N-methyl-D-aspartate glutamate receptor (NMDAR) antagonists such as ketamine transiently induce schizophrenia-like positive, negative and cognitive symptoms has led to a paradigm shift from dopaminergic to glutamatergic dysfunction in pharmacological models of schizophrenia. NMDAR hypofunction can explain many schizophrenia symptoms directly due to excitatory-to-inhibitory (E/I) imbalance, but also dopaminergic dysfunction itself. However, so far no new drug targeting the NMDAR has been successfully approved. In the search for possible biomarkers it is interesting that ketamine-induced psychopathological changes in healthy participants were accompanied by altered electro-(EEG), magnetoencephalographic (MEG) and functional magnetic resonance imaging (fMRI) signals. Methods: We systematically searched PubMed/Medline and Web of Knowledge databases (January 2006 to July 2017) to identify EEG/MEG and fMRI studies of the ketamine model of schizophrenia with human subjects. The search strategy identified 209 citations of which 46 articles met specified eligibility criteria. Results: In EEG/MEG studies, ketamine induced changes of event-related potentials, such as the P300 potential and the mismatch negativity, similar to alterations observed in schizophrenia patients. In fMRI studies, alterations of activation were observed in different brain regions, most prominently within the anterior cingulate cortex and limbic structures as well as task-relevant brain regions. These alterations were accompanied by changes in functional connectivity, indicating a balance shift of the underlying brain networks. Pharmacological treatments did alter ketamine-induced changes in EEG/MEG and fMRI studies to different extents. Conclusion: This review highlights the potential applicability of the ketamine model for schizophrenia drug development by offering the possibility to assess the effect of pharmacological agents on schizophrenia-like symptoms and to find relevant neurophysiological and neuroimaging biomarkers.
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Affiliation(s)
- Moritz Haaf
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stjepan Curic
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry and Psychotherapy, UKGM, Justus-Liebig University Giessen, Giessen, Germany
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21
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McQueen G, Lally J, Collier T, Zelaya F, Lythgoe DJ, Barker GJ, Stone JM, McGuire P, MacCabe JH, Egerton A. Effects of N-acetylcysteine on brain glutamate levels and resting perfusion in schizophrenia. Psychopharmacology (Berl) 2018; 235:3045-3054. [PMID: 30141055 PMCID: PMC6182588 DOI: 10.1007/s00213-018-4997-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/06/2018] [Indexed: 01/16/2023]
Abstract
RATIONALE N-Acetylcysteine (NAC) is currently under investigation as an adjunctive treatment for schizophrenia. The therapeutic potential of NAC may involve modulation of brain glutamate function, but its effects on brain glutamate levels in schizophrenia have not been evaluated. OBJECTIVES The aim of this study was to examine whether a single dose of NAC can alter brain glutamate levels. A secondary aim was to characterise its effects on regional brain perfusion. METHODS In a double-blind placebo-controlled crossover study, 19 patients with a diagnosis of schizophrenia underwent two MRI scans, following oral administration of 2400 mg NAC or matching placebo. Proton magnetic resonance spectroscopy was used to investigate the effect of NAC on glutamate and Glx (glutamate plus glutamine) levels scaled to creatine (Cr) in the anterior cingulate cortex (ACC) and in the right caudate nucleus. Pulsed continuous arterial spin labelling was used to assess the effects of NAC on resting cerebral blood flow (rCBF) in the same regions. RESULTS Relative to the placebo condition, the NAC condition was associated with lower levels of Glx/Cr, in the ACC (P < 0.05), but not in the caudate nucleus. There were no significant differences in CBF in the NAC compared to placebo condition. CONCLUSIONS These data provide preliminary evidence that NAC can modulate ACC glutamate in patients with schizophrenia. In contrast, physiological effects of NAC on the brain were not detectable as between session changes in rCBF. Future studies assessing the effects of a course of treatment with NAC on glutamate metabolites in schizophrenia are indicated.
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Affiliation(s)
- Grant McQueen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK.
| | - John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tracy Collier
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - David J Lythgoe
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroimaging, King's College London, De Crespigny Park, London, UK
| | - James M Stone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- Experimental Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
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22
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Abdallah CG, De Feyter HM, Averill LA, Jiang L, Averill CL, Chowdhury GMI, Purohit P, de Graaf RA, Esterlis I, Juchem C, Pittman BP, Krystal JH, Rothman DL, Sanacora G, Mason GF. The effects of ketamine on prefrontal glutamate neurotransmission in healthy and depressed subjects. Neuropsychopharmacology 2018; 43:2154-2160. [PMID: 29977074 PMCID: PMC6098048 DOI: 10.1038/s41386-018-0136-3] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/18/2022]
Abstract
The ability of ketamine administration to activate prefrontal glutamate neurotransmission is thought to be a key mechanism contributing to its transient psychotomimetic effects and its delayed and sustained antidepressant effects. Rodent studies employing carbon-13 magnetic resonance spectroscopy (13C MRS) methods have shown ketamine and other N-methyl-D-aspartate (NMDA) receptor antagonists to transiently increase measures reflecting glutamate-glutamine cycling and glutamate neurotransmission in the frontal cortex. However, there are not yet direct measures of glutamate neurotransmission in vivo in humans to support these hypotheses. The current first-level pilot study employed a novel prefrontal 13C MRS approach similar to that used in the rodent studies for direct measurement of ketamine effects on glutamate-glutamine cycling. Twenty-one participants (14 healthy and 7 depressed) completed two 13C MRS scans during infusion of normal saline or subanesthetic doses of ketamine. Compared to placebo, ketamine increased prefrontal glutamate-glutamine cycling, as indicated by a 13% increase in 13C glutamine enrichment (t = 2.4, p = 0.02). We found no evidence of ketamine effects on oxidative energy production, as reflected by 13C glutamate enrichment. During ketamine infusion, the ratio of 13C glutamate/glutamine enrichments, a putative measure of neurotransmission strength, was correlated with the Clinician-Administered Dissociative States Scale (r = -0.54, p = 0.048). These findings provide the most direct evidence in humans to date that ketamine increases glutamate release in the prefrontal cortex, a mechanism previously linked to schizophrenia pathophysiology and implicated in the induction of rapid antidepressant effects.
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Affiliation(s)
- Chadi G Abdallah
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA.
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Henk M De Feyter
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Lynnette A Averill
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lihong Jiang
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher L Averill
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Golam M I Chowdhury
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Prerana Purohit
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Robin A de Graaf
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Christoph Juchem
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
- Department of Radiology, Columbia University, New York, NY, USA
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Brian P Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - John H Krystal
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Douglas L Rothman
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Gerard Sanacora
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Graeme F Mason
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Radiology and Biomedical Imaging, Yale Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
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23
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Ke X, Ding Y, Xu K, He H, Wang D, Deng X, Zhang X, Zhou Y, Zhou C, Liu Y, Ning Y, Fan N. The profile of cognitive impairments in chronic ketamine users. Psychiatry Res 2018; 266:124-131. [PMID: 29864611 DOI: 10.1016/j.psychres.2018.05.050] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 04/20/2018] [Accepted: 05/22/2018] [Indexed: 01/25/2023]
Abstract
The aim of this study was to examine the cognitive function in chronic ketamine users. Factors correlated to cognition impairments were analyzed. Sixty-three chronic ketamine users and 65 healthy subjects were recruited. Cognitive function was assessed by using immediate/delayed visual reproduction (IVR/DVR) tasks, immediate/delayed logical memory (ILM/DLM) tasks, Stroop test, Wisconsin card sorting test (WCST), and continuous performance test (CPT). Psychopathological symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Ketamine users performed worse than controls on the IVR, ILM, DLM, Stroop and auditory CPT tests. IVR and DVR, color-naming and color-interference-reading scores were positively correlated with education level. In ketamine users ILM scores were negatively correlated with the negative subscale of PANSS. DLM score was positively correlated with average dose of ketamine use. Word-reading score was positively correlated with education level, and negatively correlated with duration of ketamine use. False hits in auditory CPT was positively correlated with duration of ketamine use. Number of trials to complete the first category and perseverative errors on WCST were positively correlated with the duration between the test and last ketamine use. Chronic ketamine users had cognitive impairments across multiple domains.
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Affiliation(s)
- Xiaoyin Ke
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China; Shenzhen Kangning Hospital (Mental Health College of Shenzhen University), 1080 Cuizhu Rd., Luohu District, Shenzhen, Guangdong 518020, China
| | - Yi Ding
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China
| | - Ke Xu
- Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06510, USA
| | - Hongbo He
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China
| | - Daping Wang
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China
| | - Xuefeng Deng
- Guangzhou Baiyun voluntary drug rehabilitation hospital, 586 North of Baiyun Road, Baiyun District, Guangzhou, Guangdong 510440, China
| | - Xifan Zhang
- Guangzhou Baiyun voluntary drug rehabilitation hospital, 586 North of Baiyun Road, Baiyun District, Guangzhou, Guangdong 510440, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China
| | - Chao Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China
| | - Yuping Liu
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China.
| | - Ni Fan
- The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, Guangdong 510370, China.
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24
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Kantrowitz JT, Swerdlow NR, Dunn W, Vinogradov S. Auditory System Target Engagement During Plasticity-Based Interventions in Schizophrenia: A Focus on Modulation of N-Methyl-D-Aspartate-Type Glutamate Receptor Function. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:581-590. [PMID: 29656951 PMCID: PMC6062454 DOI: 10.1016/j.bpsc.2018.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/24/2018] [Accepted: 02/12/2018] [Indexed: 12/31/2022]
Abstract
Cognitive deficits are predictive of long-term social and occupational functional deficits in schizophrenia but are currently without gold-standard treatments. In particular, augmentation of auditory cortical neuroplasticity may represent a rate-limiting first step before addressing higher-order cognitive deficits. We review the rationale for N-methyl-d-aspartate-type glutamate receptor (NMDAR) modulators as treatments for auditory plasticity deficits in schizophrenia, along with potential serum and electroencephalographic target engagement biomarkers for NMDAR function. Several recently published NMDAR-modulating treatment studies are covered, involving D-serine, memantine, and transcranial direct current stimulation. While all three interventions appear to modulate auditory plasticity, direct agonists (D-serine) appear to have the largest and most consistent effects on plasticity, at least acutely. We hypothesize that there may be synergistic effects of combining procognitive NMDAR-modulating approaches with auditory cortical neuroplasticity cognitive training interventions. Future studies should assess biomarkers for target engagement and patient stratification, along with head-to-head studies comparing putative interventions and potential long-term versus acute effects.
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Affiliation(s)
- Joshua T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York; Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, New York.
| | - Neal R Swerdlow
- Department of Psychiatry, University of California, San Diego, La Jolla
| | - Walter Dunn
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, California
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
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25
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Schwertner A, Zortea M, Torres FV, Caumo W. Effects of Subanesthetic Ketamine Administration on Visual and Auditory Event-Related Potentials (ERP) in Humans: A Systematic Review. Front Behav Neurosci 2018; 12:70. [PMID: 29713269 PMCID: PMC5911464 DOI: 10.3389/fnbeh.2018.00070] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/29/2018] [Indexed: 01/02/2023] Open
Abstract
Ketamine is a non-competitive N-Methyl-D-Aspartate (NMDA) receptor antagonist whose effect in subanesthetic doses has been studied for chronic pain and mood disorders treatment. It has been proposed that ketamine could change the perception of nociceptive stimuli by modulating the cortical connectivity and altering the top-down mechanisms that control conscious pain perception. As this is a strictly central effect, it would be relevant to provide fresh insight into ketamine's effect on cortical response to external stimuli. Event-related potentials (ERPs) reflect the combined synchronic activity of postsynaptic potentials of many cortical pyramidal neurons similarly oriented, being a well-established technique to study cortical responses to sensory input. Therefore, the aim of this study was to examine the current evidence of subanesthetic ketamine doses on patterns of cortical activity based on ERPs in healthy subjects. To answer the question whether ERPs could be potential markers of the cortical effects of ketamine, we conducted a systematic review of ketamine's effect on ERPs after single and repeated doses. We have searched PubMed, EMBASE and Cochrane Databases and pre-selected 141 articles, 18 of which met the inclusion criteria. Our findings suggest that after ketamine administration some ERP parameters are reduced (reduced N2, P2, and P3 amplitudes, PN and MMN) while others remain stable or are even increased (P50 reduction, PPI, P1, and N1 amplitudes). The current understanding of these effects is that ketamine alters the perceived contrast between distinct visual and auditory stimuli. The analgesic effect of ketamine might also be influenced by a decreased affective discrimination of sensorial information, a finding from studies using ketamine as a model for schizophrenia, but that can give an important hint not only for the treatment of mood disorders, but also to treat pain and ketamine abuse.
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Affiliation(s)
- André Schwertner
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain & Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Maxciel Zortea
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain & Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Felipe V Torres
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain & Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Wolnei Caumo
- Post-graduation Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain & Neuromodulation, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
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26
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Hamilton HK, Perez VB, Ford JM, Roach BJ, Jaeger J, Mathalon DH. Mismatch Negativity But Not P300 Is Associated With Functional Disability in Schizophrenia. Schizophr Bull 2018; 44:492-504. [PMID: 29036701 PMCID: PMC5890465 DOI: 10.1093/schbul/sbx104] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mismatch negativity (MMN) and P300 event-related potential (ERP) reductions in schizophrenia (SZ) reflect preattentive and attention-mediated auditory processing deficits, respectively. Although both have been linked to cognitive deficits in SZ, their relative contributions to real-world functioning are unclear. We sought to determine the functional significance of disrupted auditory processing in SZ by examining MMN and P300 in typically disabled low-functioning patients and in patients with high levels of independent role functioning. MMN to auditory deviants and P300 to infrequent auditory target and nontarget novel stimuli were assessed in 20 high-functioning SZ patients (HF-SZ), 17 low-functioning patients (LF-SZ), and 35 healthy comparison (HC) subjects. There was a group effect on MMN and P300 amplitudes across stimulus types. MMN was significantly diminished in LF-SZ compared to HF-SZ and HC, and HF-SZ demonstrated comparable MMN to HC. In contrast, P300 was significantly reduced in both LF-SZ and HF-SZ compared to HC. Logistic regression suggested independent sensitivity of MMN to functioning in SZ over and above P300 measures. Neither MMN nor P300 were associated with positive or negative symptom severity. Results replicate MMN and P300 abnormalities in SZ, and also suggest that the neural mechanisms associated with the preattentive detection of auditory deviance are most compromised in patients with functional disability. MMN may index pathophysiological processes that are critical for optimal functioning in SZ.
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Affiliation(s)
- Holly K Hamilton
- San Francisco VA Health Care System, San Francisco, CA,University of California, San Francisco, San Francisco, CA
| | - Veronica B Perez
- California School of Professional Psychology, San Diego, CA,University of California, San Diego, San Diego, CA
| | - Judith M Ford
- San Francisco VA Health Care System, San Francisco, CA,University of California, San Francisco, San Francisco, CA
| | - Brian J Roach
- Northern California Institute for Research and Education, San Francisco, CA
| | - Judith Jaeger
- Albert Einstein College of Medicine, New York, NY,CognitionMetrics, LLC, Wilmington, DE
| | - Daniel H Mathalon
- San Francisco VA Health Care System, San Francisco, CA,University of California, San Francisco, San Francisco, CA,To whom correspondence should be addressed; San Francisco VA Health Care System, 4150 Clement Street, 116D, San Francisco, CA 94121; tel: 415-221-4810-x23860; e-mail:
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27
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Bravermanová A, Viktorinová M, Tylš F, Novák T, Androvičová R, Korčák J, Horáček J, Balíková M, Griškova-Bulanova I, Danielová D, Vlček P, Mohr P, Brunovský M, Koudelka V, Páleníček T. Psilocybin disrupts sensory and higher order cognitive processing but not pre-attentive cognitive processing-study on P300 and mismatch negativity in healthy volunteers. Psychopharmacology (Berl) 2018; 235:491-503. [PMID: 29302713 DOI: 10.1007/s00213-017-4807-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023]
Abstract
RATIONALE Disruption of auditory event-related evoked potentials (ERPs) P300 and mismatch negativity (MMN), electrophysiological markers of attentive and pre-attentive cognitive processing, is repeatedly described in psychosis and schizophrenia. Similar findings were observed in a glutamatergic model of psychosis, but the role of serotonergic 5-HT2A receptors in information processing is less clear. OBJECTIVES We studied ERPs in a serotonergic model of psychosis, induced by psilocybin, a psychedelic with 5-HT2A/C agonistic properties, in healthy volunteers. METHODS Twenty subjects (10M/10F) were given 0.26 mg/kg of psilocybin orally in a placebo-controlled, double-blind, cross-over design. ERPs (P300, MMN) were registered during the peak of intoxication. Correlations between measured electrophysiological variables and psilocin serum levels and neuropsychological effects were also analyzed. RESULTS Psilocybin induced robust psychedelic effects and psychotic-like symptoms, decreased P300 amplitude (p = 0.009) but did not affect the MMN. Psilocybin's disruptive effect on P300 correlated with the intensity of the psychedelic state, which was dependent on the psilocin serum levels. We also observed a decrease in N100 amplitude (p = 0.039) in the P300 paradigm and a negative correlation between P300 and MMN amplitude (p = 0.014). CONCLUSIONS Even though pre-attentive cognition (MMN) was not affected, processing at the early perceptual level (N100) and in higher-order cognition (P300) was significantly disrupted by psilocybin. Our results have implications for the role of 5-HT2A receptors in altered information processing in psychosis and schizophrenia.
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Affiliation(s)
- Anna Bravermanová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,First Faculty of Medicine, Charles University Prague, Kateřinská 32, 121 08, Prague 2, Czech Republic
| | - Michaela Viktorinová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Filip Tylš
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Tomáš Novák
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Renáta Androvičová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Jakub Korčák
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Jiří Horáček
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Marie Balíková
- First Faculty of Medicine, Charles University Prague, Kateřinská 32, 121 08, Prague 2, Czech Republic
| | - Inga Griškova-Bulanova
- Institute of Biosciences, Vilnius University, Sauletekio ave 7, 102 57, Vilnius, Lithuania
| | - Dominika Danielová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Přemysl Vlček
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Pavel Mohr
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Martin Brunovský
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic
| | - Vlastimil Koudelka
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Tomáš Páleníček
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic. .,Third Faculty of Medicine, Charles University Prague, Ruská 87, 100 00, Praha 10, Czech Republic.
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Kantrowitz JT, Epstein ML, Lee M, Lehrfeld N, Nolan KA, Shope C, Petkova E, Silipo G, Javitt DC. Improvement in mismatch negativity generation during d-serine treatment in schizophrenia: Correlation with symptoms. Schizophr Res 2018; 191:70-79. [PMID: 28318835 DOI: 10.1016/j.schres.2017.02.027] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Deficits in N-methyl-d-aspartate-type (NMDAR) function contribute to symptoms and cognitive dysfunction in schizophrenia. The efficacy of NMDAR agonists in the treatment of persistent symptoms of schizophrenia has been variable, potentially reflecting limitations in functional target engagement. We recently demonstrated significant improvement in auditory mismatch negativity (MMN) with once-weekly treatment with d-serine, a naturally occurring NMDAR glycine-site agonist. This study investigates effects of continuous (daily) NMDAR agonists in schizophrenia/schizoaffective disorder. METHODS Primary analysis was on MMN after double-blind crossover (60mg/kg/d, n=16, 6weeks) treatment with d-serine/placebo. Secondary measures included clinical symptoms, neurocognition, and the effects of open-label (30-120mg/kg/d, n=21) d-serine and bitopertin/placebo (10mg, n=29), a glycine transport inhibitor. RESULTS Double-blind d-serine treatment led to significant improvement in MMN frequency (p=0.001, d=2.3) generation and clinical symptoms (p=0.023, d=0.80). MMN frequency correlated significantly with change in symptoms (r=-0.63, p=0.002) following co-variation for treatment type. d-Serine treatment led to a significant, large effect size increase vs. placebo in evoked α-power in response to standards (p=0.036, d=0.81), appearing to normalize evoked α power relative to previous findings with controls. While similar results were seen with open-label d-serine, no significant effects of bitopertin were observed for symptoms or MMN. CONCLUSIONS These findings represent the first randomized double-blind placebo-controlled study with 60mg/kg d-serine in schizophrenia, and are consistent with meta-analyses showing significant effects of d-serine in schizophrenia. Results overall support suggest that MMN may have negative, as well as positive, predictive value in predicting efficacy of novel compounds. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov: NCT00322023/NCT00817336 (d-serine); NCT01116830 (bitopertin).
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Affiliation(s)
- Joshua T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States; Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States.
| | - Michael L Epstein
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States; Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States; Graduate Center, City University of New York, 365 5th Ave, New York, NY, United States
| | - Migyung Lee
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States; Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
| | - Nayla Lehrfeld
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Karen A Nolan
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States; Department of Psychiatry, New York University School of Medicine, 1 Park Ave, New York, NY, United States
| | - Constance Shope
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Eva Petkova
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States; Department of Child and Adolescent Psychiatry, New York University School of Medicine, 1 Park Ave, New York, NY, United States
| | - Gail Silipo
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Daniel C Javitt
- Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States; Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
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29
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Harms L, Fulham WR, Todd J, Meehan C, Schall U, Hodgson DM, Michie PT. Late deviance detection in rats is reduced, while early deviance detection is augmented by the NMDA receptor antagonist MK-801. Schizophr Res 2018; 191:43-50. [PMID: 28385587 DOI: 10.1016/j.schres.2017.03.042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/20/2017] [Accepted: 03/23/2017] [Indexed: 01/08/2023]
Abstract
One of the most robust electrophysiological features of schizophrenia is reduced mismatch negativity, a component of the event related potential (ERP) induced by rare and unexpected stimuli in an otherwise regular pattern. Emerging evidence suggests that mismatch negativity (MMN) is not the only ERP index of deviance detection in the mammalian brain and that sensitivity to deviant sounds in a regular background can be observed at earlier latencies in both the human and rodent brain. Pharmacological studies in humans and rodents have previously found that MMN reductions similar to those seen in schizophrenia can be elicited by N-methyl-d-aspartate (NMDA) receptor antagonism, an observation in agreement with the hypothesised role of NMDA receptor hypofunction in schizophrenia pathogenesis. However, it is not known how NMDA receptor antagonism affects early deviance detection responses. Here, we show that NMDA antagonism impacts both early and late deviance detection responses. By recording EEG in awake, freely-moving rats in a drug-free condition and after varying doses of NMDA receptor antagonist MK-801, we found the hypothesised reduction of deviance detection for a late, negative potential (N55). However, the amplitude of an early component, P13, as well as deviance detection evident in the same component, were increased by NMDA receptor antagonism. These findings indicate that late deviance detection in rats is similar to human MMN, but the surprising effect of MK-801 in increasing ERP amplitudes as well as deviance detection at earlier latencies suggests that future studies in humans should examine ERPs over early latencies in schizophrenia and after NMDA antagonism.
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Affiliation(s)
- L Harms
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Schizophrenia Research Institute, Randwick, NSW, Australia.
| | - W R Fulham
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - J Todd
- Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - C Meehan
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia
| | - U Schall
- Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Schizophrenia Research Institute, Randwick, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - D M Hodgson
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Schizophrenia Research Institute, Randwick, NSW, Australia
| | - P T Michie
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Centre for Brain and Mental Health Research, Callaghan, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Schizophrenia Research Institute, Randwick, NSW, Australia
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30
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Mismatch negativity in preclinical models of schizophrenia. Schizophr Res 2018; 191:35-42. [PMID: 28768598 DOI: 10.1016/j.schres.2017.07.039] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 07/14/2017] [Accepted: 07/18/2017] [Indexed: 11/23/2022]
Abstract
Schizophrenia is a mental disorder associated with profoundly disruptive positive and negative symptomology that result in difficulties building close relationships with others, performing daily tasks and sustaining independent living, resulting in poor social, vocational and occupational attainment (functional outcome). Mismatch Negativity (MMN) is a change in the sensory event-related potential that occurs in response to deviation from an established pattern of stimulation. Patients with schizophrenia show a reduction in MMN that is positively associated with impaired cognition and poor functional outcome. This has led to interest in MMN as a potential clinical and pre-clinical biomarker of fundamental neural processes responsible for reduced functional outcome. To date, relatively few studies have sought to assess MMN in non-human primates or rodents. The validity of these studies will be reviewed using criteria used to identify true deviance detection based MMN responses in human subjects. Although MMN has been difficult to establish in pre-clinical models the weight of evidence suggests that non-human animals show true deviance based MMN.
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31
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Hamilton HK, D’Souza DC, Ford JM, Roach BJ, Kort NS, Ahn KH, Bhakta S, Ranganathan M, Mathalon DH. Interactive effects of an N-methyl-d-aspartate receptor antagonist and a nicotinic acetylcholine receptor agonist on mismatch negativity: Implications for schizophrenia. Schizophr Res 2018; 191:87-94. [PMID: 28711472 PMCID: PMC5745273 DOI: 10.1016/j.schres.2017.06.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/18/2017] [Accepted: 06/21/2017] [Indexed: 11/29/2022]
Abstract
N-methyl-d-aspartate glutamate receptor (NMDAR) hypofunction has been implicated in the pathophysiology of schizophrenia, including auditory processing abnormalities reflected by the mismatch negativity (MMN) event-related potential component. Evidence suggesting cognitive benefits from nicotine administration, together with the high rate of cigarette use in patients with schizophrenia, has stimulated interest in whether nicotine modulates NMDAR hypofunction. We examined the interactive effects of ketamine, an NMDAR antagonist that produces transient schizophrenia-like neurophysiological effects, and nicotine, a nicotinic acetylcholine receptor (nAChR) agonist, in 30 healthy volunteers to determine whether nicotine prevents or attenuates MMN abnormalities. Secondary analyses compared the profile of ketamine and schizophrenia effects on MMN using previously reported data from 24 schizophrenia patients (Hay et al. 2015). Healthy volunteers completed four test days, during which they received ketamine/placebo and nicotine/placebo in a double-blind, counterbalanced design. MMN to intensity, frequency, duration, and frequency+duration double deviant sounds was assessed each day. Ketamine decreased intensity, frequency, and double deviant MMN amplitudes, whereas nicotine increased intensity and double deviant MMN amplitudes. A ketamine×nicotine interaction indicated, however, that nicotine failed to attenuate the decrease in MMN associated with ketamine. Although the present dose of ketamine produced smaller decrements in MMN than those associated with schizophrenia, the profile of effects across deviant types did not differ between ketamine and schizophrenia. Results suggest that while ketamine and schizophrenia produce similar profiles of MMN effects across deviant types, nicotinic agonists may have limited potential to improve these putative NMDAR hypofunction-mediated impairments in schizophrenia.
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Affiliation(s)
- Holly K. Hamilton
- San Francisco VA Health Care System, 4150 Clement St 116D, San Francisco, CA 94121 USA,University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
| | - Deepak C. D’Souza
- Veterans Affairs Connecticut Health Care System, 950 Campbell Ave, 116A, West Haven, CT 06516 USA,Yale University, 300 George St, Suite 901, New Haven, CT 06511 USA
| | - Judith M. Ford
- San Francisco VA Health Care System, 4150 Clement St 116D, San Francisco, CA 94121 USA,University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
| | - Brian J. Roach
- Northern California Institute for Research and Education, 4150 Clement St, San Francisco, CA 94121 USA
| | - Naomi S. Kort
- University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
| | - Kyung-Heup Ahn
- Veterans Affairs Connecticut Health Care System, 950 Campbell Ave, 116A, West Haven, CT 06516 USA,Yale University, 300 George St, Suite 901, New Haven, CT 06511 USA
| | - Savita Bhakta
- Yale University, 300 George St, Suite 901, New Haven, CT 06511 USA
| | | | - Daniel H. Mathalon
- San Francisco VA Health Care System, 4150 Clement St 116D, San Francisco, CA 94121 USA,University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
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32
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Neural mechanisms of mismatch negativity dysfunction in schizophrenia. Mol Psychiatry 2017; 22:1585-1593. [PMID: 28167837 PMCID: PMC5547016 DOI: 10.1038/mp.2017.3] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/26/2016] [Accepted: 12/06/2016] [Indexed: 02/08/2023]
Abstract
Schizophrenia is associated with cognitive deficits that reflect impaired cortical information processing. Mismatch negativity (MMN) indexes pre-attentive information processing dysfunction at the level of primary auditory cortex. This study investigates mechanisms underlying MMN impairments in schizophrenia using event-related potential, event-related spectral decomposition (ERSP) and resting state functional connectivity (rsfcMRI) approaches. For this study, MMN data to frequency, intensity and duration-deviants were analyzed from 69 schizophrenia patients and 38 healthy controls. rsfcMRI was obtained from a subsample of 38 patients and 23 controls. As expected, schizophrenia patients showed highly significant, large effect size (P=0.0004, d=1.0) deficits in MMN generation across deviant types. In ERSP analyses, responses to deviants occurred primarily the theta (4-7 Hz) frequency range consistent with distributed corticocortical processing, whereas responses to standards occurred primarily in alpha (8-12 Hz) range consistent with known frequencies of thalamocortical activation. Independent deficits in schizophrenia were observed in both the theta response to deviants (P=0.021) and the alpha-response to standards (P=0.003). At the single-trial level, differential patterns of response were observed for frequency vs duration/intensity deviants, along with At the network level, MMN deficits engaged canonical somatomotor, ventral attention and default networks, with a differential pattern of engagement across deviant types (P<0.0001). Findings indicate that deficits in thalamocortical, as well as corticocortical, connectivity contribute to auditory dysfunction in schizophrenia. In addition, differences in ERSP and rsfcMRI profiles across deviant types suggest potential differential engagement of underlying generator mechanisms.
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Oranje B, Aggernaes B, Rasmussen H, Ebdrup BH, Glenthøj BY. Selective attention and mismatch negativity in antipsychotic-naïve, first-episode schizophrenia patients before and after 6 months of antipsychotic monotherapy. Psychol Med 2017; 47:2155-2165. [PMID: 28443529 DOI: 10.1017/s0033291717000599] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Attention deficits have been frequently reported in schizophrenia. It has been suggested that treatment with second-generation antipsychotics can ameliorate these deficits. In this study, the influence of 6 months treatment with quetiapine, a compound with less affinity for dopamine D2 receptors than for serotonergic 5-HT2A receptors, on electrophysiological parameters of attention was investigated in a group of antipsychotic-naïve, first-episode schizophrenia patients compared with a group of age- and gender-matched healthy controls. METHOD A total of 34 first-episode, antipsychotic-naïve patients with schizophrenia and an equal number of healthy controls were tested in a selective attention and a typical mismatch negativity (MMN) paradigm at baseline and after 6 months. The patients were treated with quetiapine according to their clinical needs during the period between baseline and follow-up, whereas controls received no treatment. RESULTS Patients showed lower MMN and P200 amplitude than healthy controls in the selective attention paradigm at baseline, while this was not the case for MMN of the typical MMN paradigm. Interestingly, after 6 months treatment, this MMN deficit was only ameliorated in patients treated with above median dosages of quetiapine. Patients had lower P3B amplitude, yet showed similar levels of processing negativity and N100 amplitude compared with healthy controls, both at baseline and follow-up. CONCLUSIONS The results indicate that deficits in MMN, P200 and P3B amplitude are present at early stages of schizophrenia, although depending on the paradigm used. Furthermore, the results indicate that 6 months quetiapine treatment ameliorates MMN but not P3B deficits, and only in those subjects on higher dosages.
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Affiliation(s)
- B Oranje
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - B Aggernaes
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - H Rasmussen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - B H Ebdrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
| | - B Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Services Glostrup,Capital Region Denmark, Glostrup,Denmark
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Abstract
PURPOSE/BACKGROUND Deficits in N-methyl-D-aspartate receptor (NMDAR) function contribute to symptoms and cognitive dysfunction in schizophrenia and are associated with impaired generation of event-related potential measures including auditory mismatch negativity. Parallel studies of the NMDAR agonist D-serine have suggested that sensitivity of these measures to glutamate-based interventions is related to symptomatic and cognitive response. Bitopertin is a selective inhibitor of glycine transport. This study investigates effects of bitopertin on NMDAR-related event-related potential deficits in schizophrenia. METHODS/PROCEDURES Patients with schizophrenia/schizoaffective disorder were treated with bitopertin (10 mg, n = 29), in a double-blind, parallel group investigation. Auditory mismatch negativity served as primary outcome measures. Secondary measures included clinical symptoms and neurocognitive performance. FINDINGS/RESULTS No significant changes were seen with bitopertin for neurophysiological, clinical, or neurocognitive assessments. IMPLICATIONS/CONCLUSIONS These findings represent the first assessment of the effect of bitopertin on neurophysiological biomarkers. Bitopertin did not significantly affect either symptoms or NMDAR-related biomarkers at the dose tested (10 mg). Mismatch negativity showed high test-retest reliability, supporting its use as a target engagement measure.
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35
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Kantrowitz JT, Epstein ML, Beggel O, Rohrig S, Lehrfeld JM, Revheim N, Lehrfeld NP, Reep J, Parker E, Silipo G, Ahissar M, Javitt DC. Neurophysiological mechanisms of cortical plasticity impairments in schizophrenia and modulation by the NMDA receptor agonist D-serine. Brain 2017; 139:3281-3295. [PMID: 27913408 DOI: 10.1093/brain/aww262] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/20/2016] [Accepted: 08/29/2016] [Indexed: 11/12/2022] Open
Abstract
Schizophrenia is associated with deficits in cortical plasticity that affect sensory brain regions and lead to impaired cognitive performance. Here we examined underlying neural mechanisms of auditory plasticity deficits using combined behavioural and neurophysiological assessment, along with neuropharmacological manipulation targeted at the N-methyl-D-aspartate type glutamate receptor (NMDAR). Cortical plasticity was assessed in a cohort of 40 schizophrenia/schizoaffective patients relative to 42 healthy control subjects using a fixed reference tone auditory plasticity task. In a second cohort (n = 21 schizophrenia/schizoaffective patients, n = 13 healthy controls), event-related potential and event-related time-frequency measures of auditory dysfunction were assessed during administration of the NMDAR agonist d-serine. Mismatch negativity was used as a functional read-out of auditory-level function. Clinical trials registration numbers were NCT01474395/NCT02156908 Schizophrenia/schizoaffective patients showed significantly reduced auditory plasticity versus healthy controls (P = 0.001) that correlated with measures of cognitive, occupational and social dysfunction. In event-related potential/time-frequency analyses, patients showed highly significant reductions in sensory N1 that reflected underlying impairments in θ responses (P < 0.001), along with reduced θ and β-power modulation during retention and motor-preparation intervals. Repeated administration of d-serine led to intercorrelated improvements in (i) auditory plasticity (P < 0.001); (ii) θ-frequency response (P < 0.05); and (iii) mismatch negativity generation to trained versus untrained tones (P = 0.02). Schizophrenia/schizoaffective patients show highly significant deficits in auditory plasticity that contribute to cognitive, occupational and social dysfunction. d-serine studies suggest first that NMDAR dysfunction may contribute to underlying cortical plasticity deficits and, second, that repeated NMDAR agonist administration may enhance cortical plasticity in schizophrenia.
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Affiliation(s)
- Joshua T Kantrowitz
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA .,2 Division of Experimental Therapeutics, Departments of Psychiatry and Neuroscience, Columbia University, New York, NY, USA
| | - Michael L Epstein
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA.,3 Graduate Center, City University of New York, New York, NY, USA
| | - Odeta Beggel
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Stephanie Rohrig
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Jonathan M Lehrfeld
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Nadine Revheim
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Nayla P Lehrfeld
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Jacob Reep
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Emily Parker
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Gail Silipo
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Merav Ahissar
- 4 Edmond and Lily Safra Center for Brain Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel C Javitt
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA.,2 Division of Experimental Therapeutics, Departments of Psychiatry and Neuroscience, Columbia University, New York, NY, USA
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36
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Skvarc DR, Dean OM, Byrne LK, Gray L, Lane S, Lewis M, Fernandes BS, Berk M, Marriott A. The effect of N-acetylcysteine (NAC) on human cognition - A systematic review. Neurosci Biobehav Rev 2017; 78:44-56. [PMID: 28438466 DOI: 10.1016/j.neubiorev.2017.04.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 04/13/2017] [Accepted: 04/15/2017] [Indexed: 12/15/2022]
Abstract
Oxidative stress, neuroinflammation and neurogenesis are commonly implicated as cognitive modulators across a range of disorders. N-acetylcysteine (NAC) is a glutathione precursor with potent antioxidant, pro-neurogenesis and anti-inflammatory properties and a favourable safety profile. A systematic review of the literature specifically examining the effect of NAC administration on human cognition revealed twelve suitable articles for inclusion: four examining Alzheimer's disease; three examining healthy participants; two examining physical trauma; one examining bipolar disorder, one examining schizophrenia, and one examining ketamine-induced psychosis. Heterogeneity of studies, insufficiently powered studies, infrequency of cognition as a primary outcome, heterogeneous methodologies, formulations, co-administered treatments, administration regimes, and assessment confounded the drawing of firm conclusions. The available data suggested statistically significant cognitive improvements following NAC treatment, though the paucity of NAC-specific research makes it difficult to determine if this effect is meaningful. While NAC may have a positive cognitive effect in a variety of contexts; larger, targeted studies are warranted, specifically evaluating its role in other clinical disorders with cognitive sequelae resulting from oxidative stress and neuroinflammation.
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Affiliation(s)
- David R Skvarc
- School of Psychology, Deakin University, Melbourne, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia
| | - Olivia M Dean
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, Australia
| | - Linda K Byrne
- School of Psychology, Deakin University, Melbourne, Australia
| | - Laura Gray
- Deakin University, School of Medicine, Geelong, Australia
| | - Stephen Lane
- Deakin University, School of Medicine, Geelong, Australia; Biostatistics Unit, Barwon Health, Geelong, Australia
| | - Matthew Lewis
- School of Psychology, Deakin University, Melbourne, Australia; Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Caulfield, Australia
| | - Brisa S Fernandes
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, Australia
| | - Andrew Marriott
- Department of Anaesthesia, Perioperative Medicine & Pain Management, Barwon Health, Geelong, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia.
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Rapado-Castro M, Dodd S, Bush AI, Malhi GS, Skvarc DR, On ZX, Berk M, Dean OM. Cognitive effects of adjunctive N-acetyl cysteine in psychosis. Psychol Med 2017; 47:866-876. [PMID: 27894373 DOI: 10.1017/s0033291716002932] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cognitive deficits are predictors of functional outcome in patients with psychosis. While conventional antipsychotics are relatively effective on positive symptoms, their impact on negative and cognitive symptoms is limited. Recent studies have established a link between oxidative stress and neurocognitive deficits in psychosis. N-acetylcysteine (NAC), a glutathione precursor with glutamatergic properties, has shown efficacy on negative symptoms and functioning in patients with schizophrenia and bipolar disorder, respectively. However, there are few evidence-based approaches for managing cognitive impairment in psychosis. The present study aims to examine the cognitive effects of adjunctive NAC treatment in a pooled subgroup of participants with psychosis who completed neuropsychological assessment in two trials of both schizophrenia and bipolar disorder. METHOD A sample of 58 participants were randomized in a double fashion to receive 2 g/day of NAC (n = 27) or placebo (n = 31) for 24 weeks. Attention, working memory and executive function domains were assessed. Differences between cognitive performance at baseline and end point were examined using Wilcoxon's test. The Mann-Whitney test was used to examine the differences between the NAC and placebo groups at the end point. RESULTS Participants treated with NAC had significantly higher working memory performance at week 24 compared with placebo (U = 98.5, p = 0.027). CONCLUSIONS NAC may have an impact on cognitive performance in psychosis, as a significant improvement in working memory was observed in the NAC-treated group compared with placebo; however, these preliminary data require replication. Glutamatergic compounds such as NAC may constitute a step towards the development of useful therapies for cognitive impairment in psychosis.
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Affiliation(s)
- M Rapado-Castro
- Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón,School of Medicine,Universidad Complutense,IiSGM,CIBERSAM,Madrid,Spain
| | - S Dodd
- Deakin University, IMPACT Strategic Research Centre, School of Medicine,Barwon Health,PO Box 291,Geelong,Victoria,Australia
| | - A I Bush
- Department of Psychiatry,University of Melbourne,Level 1 North,Main Block,Royal Melbourne Hospital,Parkville,Victoria,Australia
| | - G S Malhi
- Academic Department of Psychiatry,Kolling Institute,Northern Sydney Local Health District,St Leonards,NSW,Australia
| | - D R Skvarc
- Deakin University, IMPACT Strategic Research Centre, School of Medicine,Barwon Health,PO Box 291,Geelong,Victoria,Australia
| | - Z X On
- Melbourne School of Psychological Sciences,University of Melbourne,Level 12,Redmond Barry Building 115,Parkville,Victoria,Australia
| | - M Berk
- Orygen, The National Centre of Excellence in Youth Mental Health,Victoria,Australia
| | - O M Dean
- Deakin University, IMPACT Strategic Research Centre, School of Medicine,Barwon Health,PO Box 291,Geelong,Victoria,Australia
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Role of N-Methyl-D-Aspartate Receptors in Action-Based Predictive Coding Deficits in Schizophrenia. Biol Psychiatry 2017; 81:514-524. [PMID: 27647218 PMCID: PMC5203970 DOI: 10.1016/j.biopsych.2016.06.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 06/24/2016] [Accepted: 06/27/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND Recent theoretical models of schizophrenia posit that dysfunction of the neural mechanisms subserving predictive coding contributes to symptoms and cognitive deficits, and this dysfunction is further posited to result from N-methyl-D-aspartate glutamate receptor (NMDAR) hypofunction. Previously, by examining auditory cortical responses to self-generated speech sounds, we demonstrated that predictive coding during vocalization is disrupted in schizophrenia. To test the hypothesized contribution of NMDAR hypofunction to this disruption, we examined the effects of the NMDAR antagonist, ketamine, on predictive coding during vocalization in healthy volunteers and compared them with the effects of schizophrenia. METHODS In two separate studies, the N1 component of the event-related potential elicited by speech sounds during vocalization (talk) and passive playback (listen) were compared to assess the degree of N1 suppression during vocalization, a putative measure of auditory predictive coding. In the crossover study, 31 healthy volunteers completed two randomly ordered test days, a saline day and a ketamine day. Event-related potentials during the talk/listen task were obtained before infusion and during infusion on both days, and N1 amplitudes were compared across days. In the case-control study, N1 amplitudes from 34 schizophrenia patients and 33 healthy control volunteers were compared. RESULTS N1 suppression to self-produced vocalizations was significantly and similarly diminished by ketamine (Cohen's d = 1.14) and schizophrenia (Cohen's d = .85). CONCLUSIONS Disruption of NMDARs causes dysfunction in predictive coding during vocalization in a manner similar to the dysfunction observed in schizophrenia patients, consistent with the theorized contribution of NMDAR hypofunction to predictive coding deficits in schizophrenia.
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Chau SA, Herrmann N, Sherman C, Chung J, Eizenman M, Kiss A, Lanctôt KL. Visual Selective Attention Toward Novel Stimuli Predicts Cognitive Decline in Alzheimer’s Disease Patients. J Alzheimers Dis 2016; 55:1339-1349. [DOI: 10.3233/jad-160641] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sarah A. Chau
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Chelsea Sherman
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Jonathan Chung
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
- Department of Electrical and Computer Engineering, University of Toronto, Toronto, Canada
| | - Moshe Eizenman
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
- Department of Electrical and Computer Engineering, University of Toronto, Toronto, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - Alex Kiss
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Koychev I, William Deakin JF, El-Deredy W, Haenschel C. Effects of Acute Ketamine Infusion on Visual Working Memory: Event-Related Potentials. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016. [PMID: 29528296 DOI: 10.1016/j.bpsc.2016.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Working memory (WM) deficits are a core feature of schizophrenia. Electrophysiological studies suggest that impaired early visual processing may contribute to impaired WM in the visual domain. Abnormal N-methyl-D-aspartate (NMDA) receptor function has been implicated both in WM and in early visual processing deficits in schizophrenia. We investigated whether ketamine, a noncompetitive NMDA antagonist, would replicate in healthy volunteers the WM performance and early visual processing abnormalities we and others have reported in patients with schizophrenia. METHODS Forty-four healthy volunteers were randomly assigned to receive intravenous ketamine or placebo. During infusion, the effects of ketamine were recorded using standardized psychiatric scales. Visual evoked potentials (P100 and P300 components) were recorded during performance of a delayed matching to sample task. RESULTS Ketamine induced mild psychosis-like symptoms and impaired WM performance. It also significantly increased the P100 amplitude, while P300 amplitude decreased in a load-dependent manner. Amplitudes of P100 during retrieval correlated with cognitive performance only in the placebo group. CONCLUSIONS We confirmed previous studies showing that ketamine reproduces the impairment of WM performance and smaller P300 amplitudes observed in schizophrenia. However, ketamine increased visual P100 amplitude in contrast to our observation of reduced P100 amplitudes in established schizophrenia. The effects of ketamine on WM and P300 are likely to involve impaired NMDA function, as these receptors are implicated in changes of synaptic strength underlying associative learning and memory. Increased P100 amplitude may reflect the secondary disinhibition of cortical glutamate release that occurs after NMDA blockade.
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Affiliation(s)
- Ivan Koychev
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, United Kingdom; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom.
| | - John Francis William Deakin
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, United Kingdom; Manchester Mental Health and Social Care Trust, Manchester, United Kingdom
| | - Wael El-Deredy
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom; School of Biomedical Engineering, University of Valparaiso, Valparaiso, Chile
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Abstract
Despite a lack of recent progress in the treatment of schizophrenia, our understanding of its genetic and environmental causes has considerably improved, and their relationship to aberrant patterns of neurodevelopment has become clearer. This raises the possibility that 'disease-modifying' strategies could alter the course to - and of - this debilitating disorder, rather than simply alleviating symptoms. A promising window for course-altering intervention is around the time of the first episode of psychosis, especially in young people at risk of transition to schizophrenia. Indeed, studies performed in both individuals at risk of developing schizophrenia and rodent models for schizophrenia suggest that pre-diagnostic pharmacotherapy and psychosocial or cognitive-behavioural interventions can delay or moderate the emergence of psychosis. Of particular interest are 'hybrid' strategies that both relieve presenting symptoms and reduce the risk of transition to schizophrenia or another psychiatric disorder. This Review aims to provide a broad-based consideration of the challenges and opportunities inherent in efforts to alter the course of schizophrenia.
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Abstract
UNLABELLED Deficits in auditory emotion recognition (AER) are a core feature of schizophrenia and a key component of social cognitive impairment. AER deficits are tied behaviorally to impaired ability to interpret tonal ("prosodic") features of speech that normally convey emotion, such as modulations in base pitch (F0M) and pitch variability (F0SD). These modulations can be recreated using synthetic frequency modulated (FM) tones that mimic the prosodic contours of specific emotional stimuli. The present study investigates neural mechanisms underlying impaired AER using a combined event-related potential/resting-state functional connectivity (rsfMRI) approach in 84 schizophrenia/schizoaffective disorder patients and 66 healthy comparison subjects. Mismatch negativity (MMN) to FM tones was assessed in 43 patients/36 controls. rsfMRI between auditory cortex and medial temporal (insula) regions was assessed in 55 patients/51 controls. The relationship between AER, MMN to FM tones, and rsfMRI was assessed in the subset who performed all assessments (14 patients, 21 controls). As predicted, patients showed robust reductions in MMN across FM stimulus type (p = 0.005), particularly to modulations in F0M, along with impairments in AER and FM tone discrimination. MMN source analysis indicated dipoles in both auditory cortex and anterior insula, whereas rsfMRI analyses showed reduced auditory-insula connectivity. MMN to FM tones and functional connectivity together accounted for ∼50% of the variance in AER performance across individuals. These findings demonstrate that impaired preattentive processing of tonal information and reduced auditory-insula connectivity are critical determinants of social cognitive dysfunction in schizophrenia, and thus represent key targets for future research and clinical intervention. SIGNIFICANCE STATEMENT Schizophrenia patients show deficits in the ability to infer emotion based upon tone of voice [auditory emotion recognition (AER)] that drive impairments in social cognition and global functional outcome. This study evaluated neural substrates of impaired AER in schizophrenia using a combined event-related potential/resting-state fMRI approach. Patients showed impaired mismatch negativity response to emotionally relevant frequency modulated tones along with impaired functional connectivity between auditory and medial temporal (anterior insula) cortex. These deficits contributed in parallel to impaired AER and accounted for ∼50% of variance in AER performance. Overall, these findings demonstrate the importance of both auditory-level dysfunction and impaired auditory/insula connectivity in the pathophysiology of social cognitive dysfunction in schizophrenia.
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The effects of ketamine on the mismatch negativity (MMN) in humans – A meta-analysis. Clin Neurophysiol 2016; 127:1387-1394. [DOI: 10.1016/j.clinph.2015.10.062] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/12/2015] [Accepted: 10/28/2015] [Indexed: 12/17/2022]
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Abstract
BACKGROUND Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. Furthermore, cognitive dysfunction is a frequent residual manifestation in depression and may persist during the remitted phase. Cognitive deficits may also impede functional recovery, including workforce performance, in patients with MDD. The overarching aims of this opinion article are to critically evaluate the effects of available antidepressants as well as novel therapeutic targets on neurocognitive dysfunction in MDD. DISCUSSION Conventional antidepressant drugs mitigate cognitive dysfunction in some people with MDD. However, a significant proportion of MDD patients continue to experience significant cognitive impairment. Two multicenter randomized controlled trials (RCTs) reported that vortioxetine, a multimodal antidepressant, has significant precognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction in an RCT of adults after full or partial remission of MDD. Preliminary evidence also indicates that erythropoietin may alleviate cognitive dysfunction in MDD. Several other novel agents may be repurposed as cognitive enhancers for MDD treatment, including minocycline, insulin, antidiabetic agents, angiotensin-converting enzyme inhibitors, S-adenosyl methionine, acetyl-L-carnitine, alpha lipoic acid, omega-3 fatty acids, melatonin, modafinil, galantamine, scopolamine, N-acetylcysteine, curcumin, statins, and coenzyme Q10. The management of cognitive dysfunction remains an unmet need in the treatment of MDD. However, it is hoped that the development of novel therapeutic targets will contribute to 'cognitive remission', which may aid functional recovery in MDD.
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Abstract
Our brains are highly responsive to novelty. However, how novelty is processed in the brain, and what neurotransmitter systems play a role therein, remains elusive. Here, we systematically review studies on human participants that have looked at the neuromodulatory basis of novelty detection and processing. While theoretical models and studies on nonhuman animals have pointed to a role of the dopaminergic, cholinergic, noradrenergic and serotonergic systems, the human literature has focused almost exclusively on the first two. Dopamine was found to affect electrophysiological responses to novelty early in time after stimulus presentation, but evidence on its effects on later processing was found to be contradictory: While neuropharmacological studies mostly yielded null effects, gene studies did point to an important role for dopamine. Acetylcholine seems to dampen novelty signals in the medial temporal lobe, but boost them in frontal cortex. Findings on 5-HT (serotonin) were found to be mostly contradictory. Two large gaps were identified in the literature. First, few studies have looked at neuromodulatory influences on behavioral effects of novelty. Second, no study has looked at the involvement of the noradrenergic system in novelty processing.
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Affiliation(s)
- Mauricio Rangel-Gomez
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA Department of Cognitive Psychology, VU University Amsterdam, the Netherlands
| | - Martijn Meeter
- Department of Cognitive Psychology, VU University Amsterdam, the Netherlands
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Durieux AMS, Fernandes C, Murphy D, Labouesse MA, Giovanoli S, Meyer U, Li Q, So PW, McAlonan G. Targeting Glia with N-Acetylcysteine Modulates Brain Glutamate and Behaviors Relevant to Neurodevelopmental Disorders in C57BL/6J Mice. Front Behav Neurosci 2015; 9:343. [PMID: 26696857 PMCID: PMC4677305 DOI: 10.3389/fnbeh.2015.00343] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/23/2015] [Indexed: 01/25/2023] Open
Abstract
An imbalance between excitatory (E) glutamate and inhibitory (I) GABA transmission may underlie neurodevelopmental conditions such as autism spectrum disorder (ASD) and schizophrenia. This may be direct, through alterations in synaptic genes, but there is increasing evidence for the importance of indirect modulation of E/I balance through glial mechanisms. Here, we used C57BL/6J mice to test the hypothesis that striatal glutamate levels can be shifted by N-acetylcysteine (NAC), which acts at the cystine-glutamate antiporter of glial cells. Striatal glutamate was quantified in vivo using proton magnetic resonance spectroscopy. The effect of NAC on behaviors relevant to ASD was examined in a separate cohort. NAC induced a time-dependent decrease in striatal glutamate, which recapitulated findings of lower striatal glutamate reported in ASD. NAC-treated animals were significantly less active and more anxious in the open field test; and NAC-treated females had significantly impaired prepulse inhibition of startle response. This at least partly mimics greater anxiety and impaired sensorimotor gating reported in neurodevelopmental disorders. Thus glial mechanisms regulate glutamate acutely and have functional consequences even in adulthood. Glial cells may be a potential drug target for the development of new therapies for neurodevelopmental disorders across the life-span.
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Affiliation(s)
- Alice M S Durieux
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Cathy Fernandes
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Marie Anais Labouesse
- Physiology and Behaviour Laboratory, Swiss Federal Institute of Technology Schwerzenbach, Switzerland
| | - Sandra Giovanoli
- Physiology and Behaviour Laboratory, Swiss Federal Institute of Technology Schwerzenbach, Switzerland ; Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse Zurich, Switzerland
| | - Urs Meyer
- Physiology and Behaviour Laboratory, Swiss Federal Institute of Technology Schwerzenbach, Switzerland ; Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse Zurich, Switzerland
| | - Qi Li
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong Hong Kong, China
| | - Po-Wah So
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
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Dodman K, Featherstone RE, Bang J, Liang Y, Siegel SJ. Ceftriaxone reverses ketamine-induced lasting EEG and astrocyte alterations in juvenile mice. Drug Alcohol Depend 2015; 156:14-20. [PMID: 26442907 PMCID: PMC4633341 DOI: 10.1016/j.drugalcdep.2015.07.1198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ketamine, an N-methyl-d-aspartate receptor antagonist, is used as a pediatric anesthetic because of its favorable safety profile. It is also being investigated as an antidepressant. Unfortunately, ketamine causes adverse reactions including hallucinations and is associated with a high prevalence of abuse among adolescents. Although chronic ketamine use has been shown to produce cognitive impairments even years following cessation, little is known about its long-term consequences on adolescents. The beta-lactam ceftriaxone has been shown to attenuate alcohol withdrawal, and alleviate early brain injury and memory impairments following subarachnoid hemorrhage. However, its ability to reverse the effects of adolescent ketamine exposure is not known. Previous data indicate that ketamine causes a reduction in the number of Excitatory Amino Acid Transporter Type 2 (EAAT2)-containing astrocytes. Additionally, the beta lactam antibiotic ceftriaxone increased expression of EAAT2. As EAAT2 is a principal mechanism of glutamate clearance from the synapse, the current study tests the hypothesis that ceftriaxone may reverse functional consequences of ketamine exposure. METHODS We examined the effects of chronic ketamine in juvenile mice as well as reversal by ceftriaxone using electroencephalography (EEG). Subsequently, we assessed the effects of these treatments on markers of astrocyte proliferation, using Glial Fibrillary Acidic Protein (GFAP), and function, as evidenced by EAAT2. RESULTS Juvenile mice exposed to chronic ketamine showed lasting alterations in EEG measurements as well as markers of astrocyte number and function. These alterations were reversed by ceftriaxone. CONCLUSIONS Data suggest that ceftriaxone may be able to ameliorate ketamine-induced long-term disturbances in adolescent brains.
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Affiliation(s)
- K Dodman
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - R E Featherstone
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - J Bang
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Y Liang
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - S J Siegel
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States.
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Javitt DC, Sweet RA. Auditory dysfunction in schizophrenia: integrating clinical and basic features. Nat Rev Neurosci 2015; 16:535-50. [PMID: 26289573 PMCID: PMC4692466 DOI: 10.1038/nrn4002] [Citation(s) in RCA: 252] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Schizophrenia is a complex neuropsychiatric disorder that is associated with persistent psychosocial disability in affected individuals. Although studies of schizophrenia have traditionally focused on deficits in higher-order processes such as working memory and executive function, there is an increasing realization that, in this disorder, deficits can be found throughout the cortex and are manifest even at the level of early sensory processing. These deficits are highly amenable to translational investigation and represent potential novel targets for clinical intervention. Deficits, moreover, have been linked to specific structural abnormalities in post-mortem auditory cortex tissue from individuals with schizophrenia, providing unique insights into underlying pathophysiological mechanisms.
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Affiliation(s)
- Daniel C Javitt
- Division of Experimental Therapeutics, Departments of Psychiatry and Neuroscience, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, Unit 21, New York, New York 10032, USA
- Program in Cognitive Neuroscience and Schizophrenia, Nathan S. Kline Institute, 140 Old Orangeburg Rd, Orangeburg, New York 10962, USA
| | - Robert A Sweet
- Departments of Psychiatry and Neurology, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA
- VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Research Office Building (151R), University Drive C, Pittsburgh, Pennsylvania 15240, USA
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Featherstone RE, Siegel SJ. The Role of Nicotine in Schizophrenia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 124:23-78. [PMID: 26472525 DOI: 10.1016/bs.irn.2015.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Schizophrenia is associated with by severe disruptions in thought, cognition, emotion, and behavior. Patients show a marked increase in rates of smoking and nicotine dependence relative to nonaffected individuals, a finding commonly ascribed to the potential ameliorative effects of nicotine on symptom severity and cognitive impairment. Indeed, many studies have demonstrated improvement in patients following the administration of nicotine. Such findings have led to an increased emphasis on the development of therapeutic agents to target the nicotinic system as well as increasing the impetus to understand the genetic basis for nicotinic dysfunction in schizophrenia. The goal of this review article is to provide a critical summary of evidence for the role of the nicotinic system in schizophrenia. The first part will review the role of nicotine in normalization of primary dysfunctions and endophenotypical changes found in schizophrenia. The second part will provide a summary of genetic evidence linking polymorphisms in nicotinic receptor genes to smoking and schizophrenia. The third part will summarize attempts to treat schizophrenia using agents specifically targeting nicotinic and nicotinic receptor subtypes. Although currently available antipsychotic treatments are generally able to manage some aspects of schizophrenia (e.g., positive symptoms) they fail to address several other critically effected aspects of the disease. As such, the search for novel mechanisms to treat this disease is necessary.
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Affiliation(s)
- Robert E Featherstone
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Steven J Siegel
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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MacDonald ML, Ding Y, Newman J, Hemby S, Penzes P, Lewis DA, Yates N, Sweet RA. Altered glutamate protein co-expression network topology linked to spine loss in the auditory cortex of schizophrenia. Biol Psychiatry 2015; 77:959-68. [PMID: 25433904 PMCID: PMC4428927 DOI: 10.1016/j.biopsych.2014.09.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/11/2014] [Accepted: 09/02/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Impaired glutamatergic signaling is believed to underlie auditory cortex pyramidal neuron dendritic spine loss and auditory symptoms in schizophrenia. Many schizophrenia risk loci converge on the synaptic glutamate signaling network. We therefore hypothesized that alterations in glutamate signaling protein expression and co-expression network features are present in schizophrenia. METHODS Gray matter homogenates were prepared from auditory cortex gray matter of 22 schizophrenia and 23 matched control subjects, a subset of whom had been previously assessed for dendritic spine density. One hundred fifty-five selected synaptic proteins were quantified by targeted mass spectrometry. Protein co-expression networks were constructed using weighted gene co-expression network analysis. RESULTS Proteins with evidence for altered expression in schizophrenia were significantly enriched for glutamate signaling pathway proteins (GRIA4, GRIA3, ATP1A3, and GNAQ). Synaptic protein co-expression was significantly decreased in schizophrenia with the exception of a small group of postsynaptic density proteins, whose co-expression increased and inversely correlated with spine density in schizophrenia subjects. CONCLUSIONS We observed alterations in the expression of glutamate signaling pathway proteins. Among these, the novel observation of reduced ATP1A3 expression is supported by strong genetic evidence indicating it may contribute to psychosis and cognitive impairment phenotypes. The observations of altered protein network topology further highlight the complexity of glutamate signaling network pathology in schizophrenia and provide a framework for evaluating future experiments to model the contribution of genetic risk to disease pathology.
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Affiliation(s)
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA
| | - Jason Newman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Scott Hemby
- Neuroscience Program, Wake Forest University School of Medicine, Winston-Salem, NC,Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Peter Penzes
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, Il,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Il
| | - David A. Lewis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - Robert A. Sweet
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA,Department of Neurology, University of Pittsburgh, Pittsburgh, PA
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