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Omlor W, Rabe F, Fuchs S, Cecere G, Homan S, Surbeck W, Kallen N, Georgiadis F, Spiller T, Seifritz E, Weickert T, Bruggemann J, Weickert C, Potkin S, Hashimoto R, Sim K, Rootes-Murdy K, Quide Y, Houenou J, Banaj N, Vecchio D, Piras F, Piras F, Spalletta G, Salvador R, Karuk A, Pomarol-Clotet E, Rodrigue A, Pearlson G, Glahn D, Tomecek D, Spaniel F, Skoch A, Kirschner M, Kaiser S, Kochunov P, Fan FM, Andreassen OA, Westlye LT, Berthet P, Calhoun VD, Howells F, Uhlmann A, Scheffler F, Stein D, Iasevoli F, Cairns MJ, Carr VJ, Catts SV, Di Biase MA, Jablensky A, Green MJ, Henskens FA, Klauser P, Loughland C, Michie PT, Mowry B, Pantelis C, Rasser PE, Schall U, Scott R, Zalesky A, de Bartolomeis A, Barone A, Ciccarelli M, Brunetti A, Cocozza S, Pontillo G, Tranfa M, Di Giorgio A, Thomopoulos SI, Jahanshad N, Thompson PM, van Erp T, Turner J, Homan P. Estimating multimodal brain variability in schizophrenia spectrum disorders: A worldwide ENIGMA study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.22.559032. [PMID: 37961617 PMCID: PMC10634976 DOI: 10.1101/2023.09.22.559032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Objective Schizophrenia is a multifaceted disorder associated with structural brain heterogeneity. Despite its relevance for identifying illness subtypes and informative biomarkers, structural brain heterogeneity in schizophrenia remains incompletely understood. Therefore, the objective of this study was to provide a comprehensive insight into the structural brain heterogeneity associated with schizophrenia. Methods This meta- and mega-analysis investigated the variability of multimodal structural brain measures of white and gray matter in individuals with schizophrenia versus healthy controls. Using the ENIGMA dataset of MRI-based brain measures from 22 international sites with up to 6139 individuals for a given brain measure, we examined variability in cortical thickness, surface area, folding index, subcortical volume and fractional anisotropy. Results We found that individuals with schizophrenia are distinguished by higher heterogeneity in the frontotemporal network with regard to multimodal structural measures. Moreover, individuals with schizophrenia showed higher homogeneity of the folding index, especially in the left parahippocampal region. Conclusions Higher multimodal heterogeneity in frontotemporal regions potentially implies different subtypes of schizophrenia that converge on impaired frontotemporal interaction as a core feature of the disorder. Conversely, more homogeneous folding patterns in the left parahippocampal region might signify a consistent characteristic of schizophrenia shared across subtypes. These findings underscore the importance of structural brain variability in advancing our neurobiological understanding of schizophrenia, and aid in identifying illness subtypes as well as informative biomarkers.
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Takahashi T, Sasabayashi D, Takayanagi Y, Higuchi Y, Mizukami Y, Akasaki Y, Nishiyama S, Furuichi A, Kobayashi H, Yuasa Y, Tsujii N, Noguchi K, Suzuki M. Anatomical variations in the insular cortex in individuals at a clinical high-risk state for psychosis and patients with schizophrenia. Front Psychiatry 2023; 14:1192854. [PMID: 37476540 PMCID: PMC10354273 DOI: 10.3389/fpsyt.2023.1192854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Since the number of insular gyri is higher in schizophrenia patients, it has potential as a marker of early neurodevelopmental deviations. However, it currently remains unknown whether the features of the insular gross anatomy are similar between schizophrenia patients and individuals at risk of psychosis. Furthermore, the relationship between anatomical variations in the insular cortex and cognitive function has not yet been clarified. Methods The gross anatomical features (i.e., the number of gyri and development pattern of each gyrus) of the insular cortex were examined using magnetic resonance imaging, and their relationships with clinical characteristics were investigated in 57 subjects with an at-risk mental state (ARMS) and 63 schizophrenia patients in comparison with 61 healthy controls. Results The number of insular gyri bilaterally in the anterior subdivision was higher in the ARMS and schizophrenia groups than in the control group. The schizophrenia group was also characterized by a higher number of insular gyri in the left posterior subdivision. A well-developed right middle short insular gyrus was associated with symptom severity in first-episode schizophrenia patients, whereas chronic schizophrenia patients with a well-developed left accessory gyrus were characterized by less severe cognitive impairments in motor and executive functions. The features of the insular gross anatomy were not associated with clinical characteristics in the ARMS group. Discussion The features of the insular gross anatomy that were shared in the ARMS and schizophrenia groups may reflect a vulnerability to psychosis that may be attributed to anomalies in the early stages of neurodevelopment. However, the contribution of the insular gross anatomy to the clinical characteristics of schizophrenia may differ according to illness stages.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Arisawabashi Hospital, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yukiko Akasaki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Health Administration Center, Faculty of Education and Research Promotion, Academic Assembly, University of Toyama, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yusuke Yuasa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Noa Tsujii
- Department of Child Mental Health and Development, Toyama University Hospital, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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Basavaraju R, France J, Sigmon HC, Girgis RR, Brucato G, Lieberman JA, Small SA, Provenzano FA. Increased parietal and occipital lobe gyrification predicts conversion to syndromal psychosis in a clinical high-risk cohort. Schizophr Res 2023; 255:246-255. [PMID: 37043842 DOI: 10.1016/j.schres.2023.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/15/2023] [Accepted: 03/12/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Local gyrification index (lGI), indicative of the degree of cortical folding is a proxy marker for early cortical neurodevelopmental abnormalities. We studied the difference in lGI between those who do and do not convert to psychosis (non-converters) in a clinical high-risk (CHR) cohort, and whether lGI predicts conversion to psychosis. METHODS Seventy-two CHR participants with attenuated positive symptom syndrome were followed up for two years. The difference in baseline whole-brain lGI was examined on the T1-weighted MRIs between, i)CHR (N = 72) and healthy controls (N = 19), ii)Converters to psychosis (N = 24) and non-converters (N = 48), adjusting for age and sex, on Freesurfer-6.0. The significant cluster obtained in the converters versus non-converters comparison was registered as a region of interest to individual images of all 72 participants and lGI values were extracted from this region. A cox proportional hazards model was applied with these values to study whether lGI predicts conversion to psychosis. RESULTS lGI was not different between CHR and healthy controls. lGI was increased in converters in the right-sided inferior parietal and lateral occipital areas (corrected cluster-wise-p-value = 0.009, cohen's f = 0.42) compared to non-converters, which significantly increased the risk of onset of psychosis (p = 0.029, hazard ratio = 1.471). CONCLUSIONS Increased gyrification in the right-sided inferior parietal and lateral occipital area differentiates converters to psychosis in CHR, significantly increasing the risk of conversion to psychosis. This measure may reflect underlying traits in parts of the brain that develop earliest in-utero (parietal and occipital), conferring a heightened vulnerability to convert to syndromal psychosis subsequently.
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Affiliation(s)
- Rakshathi Basavaraju
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, USA
| | - Jeanelle France
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, USA
| | - Hannah C Sigmon
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, USA
| | - Ragy R Girgis
- Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University Medical Center, USA
| | - Gary Brucato
- Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University Medical Center, USA
| | - Jeffrey A Lieberman
- Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University Medical Center, USA
| | - Scott A Small
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, USA
| | - Frank A Provenzano
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, USA.
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Maitra R, Horne CM, O’Daly O, Papanastasiou E, Gaser C. Psychotic Like Experiences in Healthy Adolescents are Underpinned by Lower Fronto-Temporal Cortical Gyrification: a Study from the IMAGEN Consortium. Schizophr Bull 2023; 49:309-318. [PMID: 36226895 PMCID: PMC10016412 DOI: 10.1093/schbul/sbac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND HYPOTHESIS Psychotic Like Experiences (PLEs) are widely prevalent in children and adolescents and increase the risk of developing psychosis. Cortical gyrification characterizes brain development from in utero till about the first 2 years of life and can be measured in later years as static gyrification changes demonstrating neurodevelopment and dynamic gyrification changes reflecting brain maturation during adolescence. We hypothesized that PLEs would be associated with static cortical gyrification changes reflecting a neurodevelopmental abnormality. STUDY DESIGN We studied 1252 adolescents recruited in the IMAGEN consortium. We used a longitudinal study design, with Magnetic Resonance Imaging measurements at age 14 years and age 19 years; measurement of PLEs using the Community Assessment of Psychic Experiences (CAPE) questionnaire at age 19 years; and clinical diagnoses at age 23 years. STUDY RESULTS Our results show static gyrification changes in adolescents with elevated PLEs on 3 items of the CAPE-voice hearing, unusual experiences of receiving messages, and persecutory ideas-with lower cortical gyrification in fronto-temporal regions in the left hemisphere. This group also demonstrated dynamic gyrification changes with higher cortical gyrification in right parietal cortex in late adolescence; a finding that we replicated in an independent sample of patients with first-episode psychosis. Adolescents with high PLEs were also 5.6 times more likely to transition to psychosis in adulthood by age 23 years. CONCLUSIONS This is the largest study in adolescents that demonstrates fronto-temporal abnormality of cortical gyrification as a potential biomarker for vulnerability to PLEs and transition to psychosis.
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Affiliation(s)
- Raka Maitra
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s CollegeLondon, UK
| | - Charlotte M Horne
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s CollegeLondon, UK
| | - Owen O’Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s CollegeLondon, UK
| | - Evangelos Papanastasiou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s CollegeLondon, UK
- Therapeutic Area CNS, Boehringer Ingelheim International GmbH, Inghelheim, Germany
| | - Christian Gaser
- Departments of Neurology, Jena University Hospital, Jena, Germany
- Departments of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Howes OD, Cummings C, Chapman GE, Shatalina E. Neuroimaging in schizophrenia: an overview of findings and their implications for synaptic changes. Neuropsychopharmacology 2023; 48:151-167. [PMID: 36056106 PMCID: PMC9700830 DOI: 10.1038/s41386-022-01426-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 11/09/2022]
Abstract
Over the last five decades, a large body of evidence has accrued for structural and metabolic brain alterations in schizophrenia. Here we provide an overview of these findings, focusing on measures that have traditionally been thought to reflect synaptic spine density or synaptic activity and that are relevant for understanding if there is lower synaptic density in the disorder. We conducted literature searches to identify meta-analyses or other relevant studies in patients with chronic or first-episode schizophrenia, or in people at high genetic or clinical risk for psychosis. We identified 18 meta-analyses including over 50,000 subjects in total, covering: structural MRI measures of gyrification index, grey matter volume, grey matter density and cortical thickness, neurite orientation dispersion and density imaging, PET imaging of regional glucose metabolism and magnetic resonance spectroscopy measures of N-acetylaspartate. We also review preclinical evidence on the relationship between ex vivo synaptic measures and structural MRI imaging, and PET imaging of synaptic protein 2A (SV2A). These studies show that schizophrenia is associated with lower grey matter volumes and cortical thickness, accelerated grey matter loss over time, abnormal gyrification patterns, and lower regional SV2A levels and metabolic markers in comparison to controls (effect sizes from ~ -0.11 to -1.0). Key regions affected include frontal, anterior cingulate and temporal cortices and the hippocampi. We identify several limitations for the interpretation of these findings in terms of understanding synaptic alterations. Nevertheless, taken with post-mortem findings, they suggest that schizophrenia is associated with lower synaptic density in some brain regions. However, there are several gaps in evidence, in particular whether SV2A findings generalise to other cohorts.
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Affiliation(s)
- Oliver D Howes
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
| | - Connor Cummings
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Clare Hall (College), University of Cambridge, Cambridge, UK
| | - George E Chapman
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ekaterina Shatalina
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
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Kitajima K, Tamura S, Sasabayashi D, Nakajima S, Iwata Y, Ueno F, Takai Y, Takahashi J, Caravaggio F, Mar W, Torres-Carmona E, Noda Y, Gerretsen P, Luca VD, Mimura M, Hirano S, Nakao T, Onitsuka T, Remington G, Graff-Guerrero A, Hirano Y. Decreased cortical gyrification and surface area in the left medial parietal cortex in patients with treatment-resistant and ultratreatment-resistant schizophrenia. Psychiatry Clin Neurosci 2023; 77:2-11. [PMID: 36165228 PMCID: PMC10092309 DOI: 10.1111/pcn.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 01/06/2023]
Abstract
AIM Validating the vulnerabilities and pathologies underlying treatment-resistant schizophrenia (TRS) is an important challenge in optimizing treatment. Gyrification and surface area (SA), reflecting neurodevelopmental features, have been linked to genetic vulnerability to schizophrenia. The aim of this study was to identify gyrification and SA abnormalities specific to TRS. METHODS We analyzed 3T magnetic resonance imaging findings of 24 healthy controls (HCs), 20 responders to first-line antipsychotics (FL-Resp), and 41 patients with TRS, including 19 clozapine responders (CLZ-Resp) and 22 FL- and clozapine-resistant patients (patients with ultratreatment-resistant schizophrenia [URS]). The local gyrification index (LGI) and associated SA were analyzed across groups. Diagnostic accuracy was verified by receiver operating characteristic curve analysis. RESULTS Both CLZ-Resp and URS had lower LGI values than HCs (P = 0.041, Hedges g [gH ] = 0.75; P = 0.013, gH = 0.96) and FL-Resp (P = 0.007, gH = 1.00; P = 0.002, gH = 1.31) in the left medial parietal cortex (Lt-MPC). In addition, both CLZ-Resp and URS had lower SA in the Lt-MPC than FL-Resp (P < 0.001, gH = 1.22; P < 0.001, gH = 1.75). LGI and SA were positively correlated in non-TRS (FL-Resp) (ρ = 0.64, P = 0.008) and TRS (CLZ-Resp + URS) (ρ = 0.60, P < 0.001). The areas under the receiver operating characteristic curve for non-TRS versus TRS with LGI and SA in the Lt-MPC were 0.79 and 0.85, respectively. SA in the Lt-MPC was inversely correlated with negative symptoms (ρ = -0.40, P = 0.018) and clozapine plasma levels (ρ = -0.35, P = 0.042) in TRS. CONCLUSION LGI and SA in the Lt-MPC, a functional hub in the default-mode network, were abnormally reduced in TRS compared with non-TRS. Thus, altered LGI and SA in the Lt-MPC might be structural features associated with genetic vulnerability to TRS.
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Affiliation(s)
- Kazutoshi Kitajima
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Tamura
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan.,Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Yusuke Iwata
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Fumihiko Ueno
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Yoshifumi Takai
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junichi Takahashi
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Fernando Caravaggio
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Wanna Mar
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Edgardo Torres-Carmona
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yoshihiro Noda
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Philip Gerretsen
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Vincenzo de Luca
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Masaru Mimura
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Shogo Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiaki Onitsuka
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Gary Remington
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Graff-Guerrero
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
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Korda AI, Andreou C, Avram M, Handels H, Martinetz T, Borgwardt S. Chaos analysis of the brain topology in first-episode psychosis and clinical high risk patients. Front Psychiatry 2022; 13:965128. [PMID: 36311536 PMCID: PMC9606602 DOI: 10.3389/fpsyt.2022.965128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Structural MRI studies in first-episode psychosis (FEP) and in clinical high risk (CHR) patients have consistently shown volumetric abnormalities in frontal, temporal, and cingulate cortex areas. The aim of the present study was to employ chaos analysis for the identification of brain topology differences in people with psychosis. Structural MRI were acquired from 77 FEP, 73 CHR and 44 healthy controls (HC). Chaos analysis of the gray matter distribution was performed: First, the distances of each voxel from the center of mass in the gray matter image was calculated. Next, the distances multiplied by the voxel intensity were represented as a spatial-series, which then was analyzed by extracting the Largest-Lyapunov-Exponent (lambda). The lambda brain map depicts thus how the gray matter topology changes. Between-group differences were identified by (a) comparing the lambda brain maps, which resulted in statistically significant differences in FEP and CHR compared to HC; and (b) matching the lambda series with the Morlet wavelet, which resulted in statistically significant differences in the scalograms of FEP against CHR and HC. The proposed framework using spatial-series extraction enhances the between-group differences of FEP, CHR and HC subjects, verifies diagnosis-relevant features and may potentially contribute to the identification of structural biomarkers for psychosis.
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Affiliation(s)
- Alexandra I. Korda
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
| | - Christina Andreou
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
| | - Heinz Handels
- Institute of Medical Informatics, University of Lübeck, Lübeck, Germany
| | - Thomas Martinetz
- Institute for Neuro- and Bioinformatics, University of Lübeck, Lübeck, Germany
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psycotherapy, University of Lübeck, Lübeck, Germany
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8
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Brain gyrification in bipolar disorder: a systematic review of neuroimaging studies. Brain Imaging Behav 2022; 16:2768-2784. [PMID: 36042153 DOI: 10.1007/s11682-022-00713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
Bipolar disorder (BD) is a severe mental illness with a strong genetic component. Genetic variations have been involved in the risk of this disorder, including those mediating brain function and neurodevelopment. Early neurodevelopment and neuroprogression processes could be reflected in brain gyrification patterns and help optimize the prediction and diagnosis of such disorders that is often delayed. Previous neuroimaging studies using this measure in patients with bipolar disorder revealed controversial results. This systematic review aimed to summarize available neuroimaging investigations on gyrification in BD compared to healthy controls (HC) and/or other psychiatric groups. Fourteen studies including 733 patients with BD, 585 patients with schizophrenia (SCZ), 90 with schizoaffective disorder (SZA), and 1380 healthy subjects were identified. Overall, a heterogeneous pattern of gyrification emerged between patients with BD and HC. Interestingly, increased gyrification or no differences were also observed in patients with BD compared to those with the schizophrenia-spectrum disorders. Furthermore, relatives of patients with BD showed lower or no differences in gyrification compared to healthy subjects without a family history of affective illness. Differences in the design and in methodological approaches could have contributed to the heterogeneity of the findings. The current review supports an altered brain gyrification pattern that underlies the pathophysiology of BD spanning large anatomical and functional neural networks, associated with altered cognitive functioning, difficulties in processing and affective regulation, and clinical symptoms. Longitudinal studies are needed to test different bipolar phenotypes and pharmacological effects on gyrification.
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Associations of gestational age with gyrification and neurocognition in healthy adults. Eur Arch Psychiatry Clin Neurosci 2022; 273:467-479. [PMID: 35904633 PMCID: PMC10070217 DOI: 10.1007/s00406-022-01454-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
Epidemiological studies have shown that gestational age and birth weight are linked to cognitive performance in adults. On a neurobiological level, this effect is hypothesized to be related to cortical gyrification, which is determined primarily during fetal development. The relationships between gestational age, gyrification and specific cognitive abilities in adults are still poorly understood. In 542 healthy participants, gyrification indices were calculated from structural magnetic resonance imaging T1 data at 3 T using CAT12. After applying a battery of neuropsychological tests, neuropsychological factors were extracted with a factor analysis. We conducted regressions to test associations between gyrification and gestational age as well as birth weight. Moderation analyses explored the relationships between gestational age, gyrification and neuropsychological factors. Gestational age is significantly positively associated with cortical folding in the left supramarginal, bilaterally in the superior frontal and the lingual cortex. We extracted two neuropsychological factors that describe language abilities and working memory/attention. The association between gyrification in the left superior frontal gyrus and working memory/attention was moderated by gestational age. Further, the association between gyrification in the left supramarginal cortex and both, working memory/attention as well as language, were moderated by gestational age. Gyrification is associated with gestational age and related to specific neuropsychological outcomes in healthy adulthood. Implications from these findings for the cortical neurodevelopment of cognitive domains and mental health are discussed.
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10
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Onitsuka T, Hirano Y, Nakazawa T, Ichihashi K, Miura K, Inada K, Mitoma R, Yasui-Furukori N, Hashimoto R. Toward recovery in schizophrenia: Current concepts, findings, and future research directions. Psychiatry Clin Neurosci 2022; 76:282-291. [PMID: 35235256 DOI: 10.1111/pcn.13342] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 11/30/2022]
Abstract
Schizophrenia was initially defined as "dementia praecox" by E. Kraepelin, which implies progressive deterioration. However, recent studies have revealed that early effective intervention may lead to social and functional recovery in schizophrenia. In this review, we provide an overview of current concepts in schizophrenia and pathophysiological hypotheses. In addition, we present recent findings from clinical and basic research on schizophrenia. Recent neuroimaging and neurophysiological studies have consistently revealed specific biological differences in the structure and function of the brain in those with schizophrenia. From a basic research perspective, to determine the essential pathophysiology underlying schizophrenia, it is crucial that findings from all lines of inquiry-induced pluripotent stem cell (iPSC)-derived neural cells from patients, murine models expressing genetic mutations identified in patients, and patient clinical data-be integrated to contextualize the analysis results. However, the findings remain insufficient to serve as a diagnostic tool or a biomarker for predicting schizophrenia-related outcomes. Collaborations to conduct clinical research based on the patients' and their families' values are just beginning, and further development is expected.
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Affiliation(s)
- Toshiaki Onitsuka
- Department of Neuroimaging Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Takanobu Nakazawa
- Department of Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Kayo Ichihashi
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ken Inada
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.,Department of Psychiatry, Kitasato University School of Medicine, Kanagawa, Japan
| | - Ryo Mitoma
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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11
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Uekusa S, Onozato M, Umino M, Sakamoto T, Ichiba H, Tsujino N, Funatogawa T, Tagata H, Nemoto T, Mizuno M, Fukushima T. Increased inosine levels in drug-free individuals with at-risk mental state: A serum metabolomics study. Early Interv Psychiatry 2022; 16:247-255. [PMID: 33779047 DOI: 10.1111/eip.13148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 03/12/2021] [Indexed: 12/19/2022]
Abstract
AIM At-risk mental state (ARMS) has been recently attracting attention with respect to the improvement of the management and outcome of psychiatric diseases, such as schizophrenia. Since only a few studies have reported on biological alterations in ARMS, serum metabolomics was carried out in ARMS subjects and healthy controls using liquid chromatography with high-resolution mass spectrometry. METHODS Serum samples were collected from ARMS subjects (n = 24; male: 12; female 12) and age- and sex-matched healthy controls (n = 23 male: 11, female: 12). After serum pre-treatment, liquid chromatography with high-resolution mass spectrometry was performed. Multivariate analyses, such as orthogonal partial least-squares discriminant and volcano plot analyses, were performed. RESULTS Serum inosine, lactate, taurine, 2,3-dihydroxypropanoate and glutamate levels differed between the two groups. A significant increase in inosine levels was detected in the positive- and negative-ion modes; however, significant differences were not observed in the levels of other purine-related metabolites (hypoxanthine, xanthine and urate) between the two groups. CONCLUSION Increased inosine levels may serve as biological markers for ARMS, in addition to alterations in the levels of lactate and certain amino acids.
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Affiliation(s)
- Shusuke Uekusa
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan.,Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Mayu Onozato
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Maho Umino
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Tatsuya Sakamoto
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Hideaki Ichiba
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Naohisa Tsujino
- Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.,Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Tomoyuki Funatogawa
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Hiromi Tagata
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Takeshi Fukushima
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
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12
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Pham TV, Sasabayashi D, Takahashi T, Takayanagi Y, Kubota M, Furuichi A, Kido M, Noguchi K, Suzuki M. Longitudinal Changes in Brain Gyrification in Schizophrenia Spectrum Disorders. Front Aging Neurosci 2022; 13:752575. [PMID: 35002674 PMCID: PMC8739892 DOI: 10.3389/fnagi.2021.752575] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/25/2021] [Indexed: 12/20/2022] Open
Abstract
Previous magnetic resonance imaging (MRI) studies reported increased brain gyrification in schizophrenia and schizotypal disorder, a prototypic disorder within the schizophrenia spectrum. This may reflect deviations in early neurodevelopment; however, it currently remains unclear whether the gyrification pattern longitudinally changes over the course of the schizophrenia spectrum. The present MRI study using FreeSurfer compared longitudinal changes (mean inter-scan interval of 2.7 years) in the local gyrification index (LGI) in the entire cortex among 23 patients with first-episode schizophrenia, 14 with schizotypal disorder, and 39 healthy controls. Significant differences were observed in longitudinal LGI changes between these groups; the schizophrenia group exhibited a progressive decline in LGI, predominantly in the fronto-temporal regions, whereas LGI increased over time in several brain regions in the schizotypal and control groups. In the schizophrenia group, a greater reduction in LGI over time in the right precentral and post central regions correlated with smaller improvements in negative symptoms during the follow-up period. The cumulative medication dosage during follow-up negatively correlated with a longitudinal LGI increase in the right superior parietal area in the schizotypal group, but did not affect longitudinal LGI changes in the schizophrenia group. Collectively, these results suggest that gyrification patterns in the schizophrenia spectrum reflect both early neurodevelopmental abnormalities as a vulnerability factor and active brain pathology in the early stages of schizophrenia.
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Affiliation(s)
- Tien Viet Pham
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Manabu Kubota
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan.,Toyama City Hospital, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama School of Medicine, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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13
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Sasabayashi D, Takayanagi Y, Takahashi T, Furuichi A, Kobayashi H, Noguchi K, Suzuki M. Increased brain gyrification and subsequent relapse in patients with first-episode schizophrenia. Front Psychiatry 2022; 13:937605. [PMID: 36032231 PMCID: PMC9406142 DOI: 10.3389/fpsyt.2022.937605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Most schizophrenia patients experience psychotic relapses, which may compromise long-term outcome. However, it is difficult to objectively assess the actual risk of relapse for each patient as the biological changes underlying relapse remain unknown. The present study used magnetic resonance imaging (MRI) to investigate the relationship between brain gyrification pattern and subsequent relapse in patients with first-episode schizophrenia. The subjects consisted of 19 patients with and 33 patients without relapse during a 3-year clinical follow-up after baseline MRI scanning. Using FreeSurfer software, we compared the local gyrification index (LGI) between the relapsed and non-relapsed groups. In the relapsed group, we also explored the relationship among LGI and the number of relapses and time to first relapse after MRI scanning. Relapsed patients exhibited a significantly higher LGI in the bilateral parietal and left occipital areas than non-relapsed patients. In addition, the time to first relapse was negatively correlated with LGI in the right inferior temporal cortex. These findings suggest that increased LGI in the temporo-parieto-occipital regions in first-episode schizophrenia patients may be a potential prognostic biomarker that reflects relapse susceptibility in the early course of the illness.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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14
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Sasabayashi D, Koike S, Nakajima S, Hirano Y. Editorial: Prognostic imaging biomarkers in psychotic disorders. Front Psychiatry 2022; 13:1053836. [PMID: 36325530 PMCID: PMC9619100 DOI: 10.3389/fpsyt.2022.1053836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Shinsuke Koike
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Yoji Hirano
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.,Neural Dynamics Laboratory, Research Service, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, MA, United States
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15
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Takahashi T, Sasabayashi D, Takayanagi Y, Furuichi A, Kobayashi H, Yuasa Y, Noguchi K, Suzuki M. Gross anatomical features of the insular cortex in schizophrenia and schizotypal personality disorder: Potential relationships with vulnerability, illness stages, and clinical subtypes. Front Psychiatry 2022; 13:1050712. [PMID: 36465304 PMCID: PMC9715601 DOI: 10.3389/fpsyt.2022.1050712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Patients with schizophrenia have a higher number of insular gyri; however, it currently remains unclear whether the brain characteristics of patients with schizotypal personality disorder (SPD), a mild form of schizophrenia, are similar. It is also unknown whether insular gross anatomical features are associated with the illness stages and clinical subtypes of schizophrenia. MATERIALS AND METHODS This magnetic resonance imaging study examined gross anatomical variations in the insular cortex of 133 patients with schizophrenia, 47 with SPD, and 88 healthy controls. The relationships between the insular gross anatomy and schizophrenia subgroups (71 first-episode and 58 chronic groups, 38 deficit and 37 non-deficit subtype groups) were also investigated. RESULTS The number of insular gyri was higher in the schizophrenia and SPD patients than in the controls, where the patients were characterized by well-developed accessory, middle short, and posterior long insular gyri. The insular gross anatomy did not significantly differ between the first-episode and chronic schizophrenia subgroups; however, the relationship between the developed accessory gyrus and more severe positive symptoms was specific to the first-episode group. The prevalence of a right middle short gyrus was higher in the deficit schizophrenia group than in the non-deficit group. DISCUSSION These findings suggest that schizophrenia and SPD patients may share an altered insular gross morphology as a vulnerability factor associated with early neurodevelopmental anomalies, which may also contribute to positive symptomatology in the early illness stages and clinical subtypes of schizophrenia.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yusuke Yuasa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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16
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Surface area in the insula was associated with 28-month functional outcome in first-episode psychosis. NPJ SCHIZOPHRENIA 2021; 7:56. [PMID: 34845247 PMCID: PMC8630202 DOI: 10.1038/s41537-021-00186-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022]
Abstract
Many studies have tested the relationship between demographic, clinical, and psychobiological measurements and clinical outcomes in ultra-high risk for psychosis (UHR) and first-episode psychosis (FEP). However, no study has investigated the relationship between multi-modal measurements and long-term outcomes for >2 years. Thirty-eight individuals with UHR and 29 patients with FEP were measured using one or more modalities (cognitive battery, electrophysiological response, structural magnetic resonance imaging, and functional near-infrared spectroscopy). We explored the characteristics associated with 13- and 28-month clinical outcomes. In UHR, the cortical surface area in the left orbital part of the inferior frontal gyrus was negatively associated with 13-month disorganized symptoms. In FEP, the cortical surface area in the left insula was positively associated with 28-month global social function. The left inferior frontal gyrus and insula are well-known structural brain characteristics in schizophrenia, and future studies on the pathological mechanism of structural alteration would provide a clearer understanding of the disease.
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17
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Takahashi T, Sasabayashi D, Takayanagi Y, Furuichi A, Kido M, Nakamura M, Pham TV, Kobayashi H, Noguchi K, Suzuki M. Altered Heschl's gyrus duplication pattern in first-episode schizophrenia. Schizophr Res 2021; 237:174-181. [PMID: 34536751 DOI: 10.1016/j.schres.2021.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 07/21/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Reduced gray matter volumes in the superior temporal gyrus and its subregions, such as Heschl's gyrus (HG) and the planum temporale (PT), have been reported in schizophrenia (Sz). However, it remains unclear whether patients exhibit an altered sulcogyral pattern on the superior temporal plane. METHODS This magnetic resonance imaging study examined the distribution of HG duplication patterns [i.e., single HG, common stem duplication (CSD), or complete posterior duplication (CPD)] and their relationships with clinical variables and gray matter volumes in the HG and PT of 64 first-episode (FE) patients with Sz and 64 healthy controls. RESULTS The prevalence of duplicated HG patterns was significantly higher and gray matter volumes in the HG and PT of both hemispheres were smaller in FESz patients than in healthy controls. The right CPD pattern in the FESz group was associated with less severe positive symptoms. In the FESz and control groups, CSD and CPD patterns correlated with larger volumes in the HG and PT, respectively. CONCLUSION The present results revealed an altered HG duplication pattern at the earliest phase of Sz, which may reflect early neurodevelopmental anomalies. However, reduced HG and PT volumes in the FESz were not explained by this sulcogyral pattern only, supporting the complex superior temporal pathology of Sz.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan.
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Arisawabashi Hospital, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tien Viet Pham
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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18
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Cortical surface abnormalities are different depending on the stage of schizophrenia: A cross-sectional vertexwise mega-analysis of thickness, area and gyrification. Schizophr Res 2021; 236:104-114. [PMID: 34481405 DOI: 10.1016/j.schres.2021.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/28/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Brain magnetic resonance imaging studies have not investigated the cortical surface comprehensively in schizophrenia subjects by assessing thickness, surface area and gyrification separately during the first-episode of psychosis (FEP) or chronic schizophrenia (ChSch). METHODS We investigated cortical surface abnormalities in 137 FEP patients and 240 ChSch subjects compared to 297 Healthy Controls (HC) contributed by five cohorts. Maps showing results of vertexwise between-group comparisons of cortical thickness, area, and gyrification were produced using T1-weighted datasets processed using FreeSurfer 5.3, followed by validated quality control protocols. RESULTS FEP subjects showed large clusters of increased area and gyrification relative to HC in prefrontal and insuli cortices (Cohen's d: 0.049 to 0.28). These between-group differences occurred partially beyond the effect of sample. ChSch subjects displayed reduced cortical thickness relative to HC in smaller fronto-temporal foci (d: -0.73 to -0.35), but not beyond the effect of sample. Differences between FEP and HC subjects were associated with male gender, younger age, and earlier illness onset, while differences between ChSch and HC were associated with treatment-resistance and first-generation antipsychotic (FGA) intake independently of sample effect. CONCLUSIONS Separate assessments of FEP and ChSch revealed abnormalities that differed in regional distribution, phenotypes affected and effect size. In FEP, associations of greater cortical area and gyrification abnormalities with earlier age of onset suggest an origin on anomalous neurodevelopment, while thickness reductions in ChSch are at least partially explained by treatment-resistance and FGA intake. Associations of between-group differences with clinical variables retained statistical significance beyond the effect of sample.
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19
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Sanfelici R, Ruef A, Antonucci LA, Penzel N, Sotiras A, Dong MS, Urquijo-Castro M, Wenzel J, Kambeitz-Ilankovic L, Hettwer MD, Ruhrmann S, Chisholm K, Riecher-Rössler A, Falkai P, Pantelis C, Salokangas RKR, Lencer R, Bertolino A, Kambeitz J, Meisenzahl E, Borgwardt S, Brambilla P, Wood SJ, Upthegrove R, Schultze-Lutter F, Koutsouleris N, Dwyer DB. Novel Gyrification Networks Reveal Links with Psychiatric Risk Factors in Early Illness. Cereb Cortex 2021; 32:1625-1636. [PMID: 34519351 DOI: 10.1093/cercor/bhab288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/13/2022] Open
Abstract
Adult gyrification provides a window into coordinated early neurodevelopment when disruptions predispose individuals to psychiatric illness. We hypothesized that the echoes of such disruptions should be observed within structural gyrification networks in early psychiatric illness that would demonstrate associations with developmentally relevant variables rather than specific psychiatric symptoms. We employed a new data-driven method (Orthogonal Projective Non-Negative Matrix Factorization) to delineate novel gyrification-based networks of structural covariance in 308 healthy controls. Gyrification within the networks was then compared to 713 patients with recent onset psychosis or depression, and at clinical high-risk. Associations with diagnosis, symptoms, cognition, and functioning were investigated using linear models. Results demonstrated 18 novel gyrification networks in controls as verified by internal and external validation. Gyrification was reduced in patients in temporal-insular, lateral occipital, and lateral fronto-parietal networks (pFDR < 0.01) and was not moderated by illness group. Higher gyrification was associated with better cognitive performance and lifetime role functioning, but not with symptoms. The findings demonstrated that gyrification can be parsed into novel brain networks that highlight generalized illness effects linked to developmental vulnerability. When combined, our study widens the window into the etiology of psychiatric risk and its expression in adulthood.
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Affiliation(s)
- Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany.,Max Planck School of Cognition, Leipzig, 04103, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany.,Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, 70124, Italy
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, 50937, Germany
| | - Aristeidis Sotiras
- Department of Radiology and Institute of Informatics, Washington University in St. Luis, st. Luis, MO63110, USA
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany
| | - Maria Urquijo-Castro
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, 50937, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, 50937, Germany
| | | | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, 50937, Germany
| | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, UK.,Department of Psychology, Aston University, Birmingham, B4 7ET, UK
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany.,Max-Planck Institute of Psychiatry, Munich, 80804, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centrem University of Melbourne & Melbourne Health, Melbourne, 3053, Australia
| | | | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, 48149, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, 70124, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, 50937, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, 40629, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany.,Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, 4002, Switzerland
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milano, 20122, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, 20122, Italy
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, 3052, Australia.,Orygen, Melbourne, 3052, Australia.,School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, UK.,Early Intervention Service, Birmingham Women's and Children's NHS foundation Trust, Birmingham, B4 6NH, UK
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, 40629, Germany.,Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surubaya, 60286, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, 3000, Switzerland
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany.,Max-Planck Institute of Psychiatry, Munich, 80804, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, 80336, Germany
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20
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Associations between long-term psychosis risk, probabilistic category learning, and attenuated psychotic symptoms with cortical surface morphometry. Brain Imaging Behav 2021; 16:91-106. [PMID: 34218406 DOI: 10.1007/s11682-021-00479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 10/20/2022]
Abstract
Neuroimaging studies have consistently found structural cortical abnormalities in individuals with schizophrenia, especially in structural hubs. However, it is unclear what abnormalities predate psychosis onset and whether abnormalities are related to behavioral performance and symptoms associated with psychosis risk. Using surface-based morphometry, we examined cortical volume, gyrification, and thickness in a psychosis risk group at long-term risk for developing a psychotic disorder (n = 18; i.e., extreme positive schizotypy plus interview-rated attenuated psychotic symptoms [APS]) and control group (n = 19). Overall, the psychosis risk group exhibited cortical abnormalities in multiple structural hub regions, with abnormalities associated with poorer probabilistic category learning, a behavioral measure strongly associated with psychosis risk. For instance, the psychosis risk group had hypogyria in a right posterior midcingulate cortical hub and left superior parietal cortical hub, as well as decreased volume in a right pericalcarine hub. Morphometric measures in all of these regions were also associated with poorer probabilistic category learning. In addition to decreased right pericalcarine volume, the psychosis risk group exhibited a number of other structural abnormalities in visual network structural hub regions, consistent with previous evidence of visual perception deficits in psychosis risk. Further, severity of APS hallucinations, delusional ideation, and suspiciousness/persecutory ideas were associated with gyrification abnormalities, with all domains associated with hypogyria of the right lateral orbitofrontal cortex. Thus, current results suggest that structural abnormalities, especially in structural hubs, are present in psychosis risk and are associated both with poor learning on a psychosis risk-related task and with APS severity.
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21
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Takahashi T, Sasabayashi D, Takayanagi Y, Higuchi Y, Mizukami Y, Nishiyama S, Furuichi A, Kido M, Pham TV, Kobayashi H, Noguchi K, Suzuki M. Heschl's Gyrus Duplication Pattern in Individuals at Risk of Developing Psychosis and Patients With Schizophrenia. Front Behav Neurosci 2021; 15:647069. [PMID: 33958991 PMCID: PMC8093503 DOI: 10.3389/fnbeh.2021.647069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
An increased prevalence of duplicated Heschl’s gyrus (HG), which may reflect an early neurodevelopmental pathology, has been reported in schizophrenia (Sz). However, it currently remains unclear whether individuals at risk of psychosis exhibit similar brain morphological characteristics. This magnetic resonance imaging study investigated the distribution of HG gyrification patterns [i.e., single HG, common stem duplication (CSD), and complete posterior duplication (CPD)] and their relationship with clinical characteristics in 57 individuals with an at-risk mental state (ARMS) [of whom 5 (8.8%) later developed Sz], 63 patients with Sz, and 61 healthy comparisons. The prevalence of duplicated HG patterns (i.e., CSD or CPD) bilaterally was significantly higher in the ARMS and Sz groups than in the controls, whereas no significant differences were observed in HG patterns between these groups. The left CSD pattern, particularly in the Sz group, was associated with a verbal fluency deficit. In the ARMS group, left CSD pattern was related to a more severe general psychopathology. The present results suggest that an altered gyrification pattern on the superior temporal plane reflects vulnerability factors associated with Sz, which may also contribute to the clinical features of high-risk individuals, even without the onset of psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Health Administration Center, Faculty of Education and Research Promotion, Academic Assembly, University of Toyama, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tien Viet Pham
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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22
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Sasabayashi D, Takahashi T, Takayanagi Y, Suzuki M. Anomalous brain gyrification patterns in major psychiatric disorders: a systematic review and transdiagnostic integration. Transl Psychiatry 2021; 11:176. [PMID: 33731700 PMCID: PMC7969935 DOI: 10.1038/s41398-021-01297-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 02/14/2021] [Accepted: 02/24/2021] [Indexed: 01/31/2023] Open
Abstract
Anomalous patterns of brain gyrification have been reported in major psychiatric disorders, presumably reflecting their neurodevelopmental pathology. However, previous reports presented conflicting results of patients having hyper-, hypo-, or normal gyrification patterns and lacking in transdiagnostic consideration. In this article, we systematically review previous magnetic resonance imaging studies of brain gyrification in schizophrenia, bipolar disorder, major depressive disorder, and autism spectrum disorder at varying illness stages, highlighting the gyral pattern trajectory for each disorder. Patients with each psychiatric disorder may exhibit deviated primary gyri formation under neurodevelopmental genetic control in their fetal life and infancy, and then exhibit higher-order gyral changes due to mechanical stress from active brain changes (e.g., progressive reduction of gray matter volume and white matter integrity) thereafter, representing diversely altered pattern trajectories from those of healthy controls. Based on the patterns of local connectivity and changes in neurodevelopmental gene expression in major psychiatric disorders, we propose an overarching model that spans the diagnoses to explain how deviated gyral pattern trajectories map onto clinical manifestations (e.g., psychosis, mood dysregulation, and cognitive impairments), focusing on the common and distinct gyral pattern changes across the disorders in addition to their correlations with specific clinical features. This comprehensive understanding of the role of brain gyrification pattern on the pathophysiology may help to optimize the prediction and diagnosis of psychiatric disorders using objective biomarkers, as well as provide a novel nosology informed by neural circuits beyond the current descriptive diagnostics.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan. .,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan.
| | - Tsutomu Takahashi
- grid.267346.20000 0001 2171 836XDepartment of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan ,grid.267346.20000 0001 2171 836XResearch Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- grid.267346.20000 0001 2171 836XDepartment of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan ,Arisawabashi Hospital, Toyama, Japan
| | - Michio Suzuki
- grid.267346.20000 0001 2171 836XDepartment of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan ,grid.267346.20000 0001 2171 836XResearch Center for Idling Brain Science, University of Toyama, Toyama, Japan
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23
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Koutsouleris N, Dwyer DB, Degenhardt F, Maj C, Urquijo-Castro MF, Sanfelici R, Popovic D, Oeztuerk O, Haas SS, Weiske J, Ruef A, Kambeitz-Ilankovic L, Antonucci LA, Neufang S, Schmidt-Kraepelin C, Ruhrmann S, Penzel N, Kambeitz J, Haidl TK, Rosen M, Chisholm K, Riecher-Rössler A, Egloff L, Schmidt A, Andreou C, Hietala J, Schirmer T, Romer G, Walger P, Franscini M, Traber-Walker N, Schimmelmann BG, Flückiger R, Michel C, Rössler W, Borisov O, Krawitz PM, Heekeren K, Buechler R, Pantelis C, Falkai P, Salokangas RKR, Lencer R, Bertolino A, Borgwardt S, Noethen M, Brambilla P, Wood SJ, Upthegrove R, Schultze-Lutter F, Theodoridou A, Meisenzahl E. Multimodal Machine Learning Workflows for Prediction of Psychosis in Patients With Clinical High-Risk Syndromes and Recent-Onset Depression. JAMA Psychiatry 2021; 78:195-209. [PMID: 33263726 PMCID: PMC7711566 DOI: 10.1001/jamapsychiatry.2020.3604] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
IMPORTANCE Diverse models have been developed to predict psychosis in patients with clinical high-risk (CHR) states. Whether prediction can be improved by efficiently combining clinical and biological models and by broadening the risk spectrum to young patients with depressive syndromes remains unclear. OBJECTIVES To evaluate whether psychosis transition can be predicted in patients with CHR or recent-onset depression (ROD) using multimodal machine learning that optimally integrates clinical and neurocognitive data, structural magnetic resonance imaging (sMRI), and polygenic risk scores (PRS) for schizophrenia; to assess models' geographic generalizability; to test and integrate clinicians' predictions; and to maximize clinical utility by building a sequential prognostic system. DESIGN, SETTING, AND PARTICIPANTS This multisite, longitudinal prognostic study performed in 7 academic early recognition services in 5 European countries followed up patients with CHR syndromes or ROD and healthy volunteers. The referred sample of 167 patients with CHR syndromes and 167 with ROD was recruited from February 1, 2014, to May 31, 2017, of whom 26 (23 with CHR syndromes and 3 with ROD) developed psychosis. Patients with 18-month follow-up (n = 246) were used for model training and leave-one-site-out cross-validation. The remaining 88 patients with nontransition served as the validation of model specificity. Three hundred thirty-four healthy volunteers provided a normative sample for prognostic signature evaluation. Three independent Swiss projects contributed a further 45 cases with psychosis transition and 600 with nontransition for the external validation of clinical-neurocognitive, sMRI-based, and combined models. Data were analyzed from January 1, 2019, to March 31, 2020. MAIN OUTCOMES AND MEASURES Accuracy and generalizability of prognostic systems. RESULTS A total of 668 individuals (334 patients and 334 controls) were included in the analysis (mean [SD] age, 25.1 [5.8] years; 354 [53.0%] female and 314 [47.0%] male). Clinicians attained a balanced accuracy of 73.2% by effectively ruling out (specificity, 84.9%) but ineffectively ruling in (sensitivity, 61.5%) psychosis transition. In contrast, algorithms showed high sensitivity (76.0%-88.0%) but low specificity (53.5%-66.8%). A cybernetic risk calculator combining all algorithmic and human components predicted psychosis with a balanced accuracy of 85.5% (sensitivity, 84.6%; specificity, 86.4%). In comparison, an optimal prognostic workflow produced a balanced accuracy of 85.9% (sensitivity, 84.6%; specificity, 87.3%) at a much lower diagnostic burden by sequentially integrating clinical-neurocognitive, expert-based, PRS-based, and sMRI-based risk estimates as needed for the given patient. Findings were supported by good external validation results. CONCLUSIONS AND RELEVANCE These findings suggest that psychosis transition can be predicted in a broader risk spectrum by sequentially integrating algorithms' and clinicians' risk estimates. For clinical translation, the proposed workflow should undergo large-scale international validation.
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Affiliation(s)
- Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany,Max-Planck Institute of Psychiatry, Munich, Germany,Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dominic B. Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carlo Maj
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | | | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany,Max-Planck School of Cognition, Leipzig, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Oemer Oeztuerk
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Shalaila S. Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Weiske
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Linda A. Antonucci
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa K. Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Anita Riecher-Rössler
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Switzerland
| | - Laura Egloff
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Switzerland
| | - André Schmidt
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Switzerland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Timo Schirmer
- GE Healthcare GmbH (previously GE Global Research GmbH), Munich, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University of Münster, Münster, Germany
| | - Petra Walger
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Clinic Düsseldorf, Düsseldorf, Germany
| | - Maurizia Franscini
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zürich, Zürich, Switzerland
| | - Nina Traber-Walker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zürich, Zürich, Switzerland
| | - Benno G. Schimmelmann
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Oleg Borisov
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Peter M. Krawitz
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Karsten Heekeren
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Psychiatry and Psychotherapy I, LVR Hospital Cologne, Cologne, Germany
| | - Roman Buechler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany,Max-Planck Institute of Psychiatry, Munich, Germany
| | | | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stefan Borgwardt
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Switzerland,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Markus Noethen
- Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stephen J. Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia,Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Australia
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany,Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
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24
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Takahashi T, Sasabayashi D, Takayanagi Y, Furuichi A, Kido M, Pham TV, Kobayashi H, Noguchi K, Suzuki M. Increased Heschl's Gyrus Duplication in Schizophrenia Spectrum Disorders: A Cross-Sectional MRI Study. J Pers Med 2021; 11:40. [PMID: 33445715 PMCID: PMC7828168 DOI: 10.3390/jpm11010040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/17/2022] Open
Abstract
Duplicated Heschl's gyrus (HG) is prevalent in patients with schizophrenia and may reflect early neurodevelopmental anomalies. However, it currently remains unclear whether patients with schizotypal disorder, a prototypic disorder within the schizophrenia spectrum, exhibit a similar HG gyrification pattern. In this magnetic resonance imaging study, HG gyrification patterns were examined in 47 patients with schizotypal disorder, 111 with schizophrenia, and 88 age- and sex-matched healthy subjects. HG gyrification patterns were classified as single, common stem duplication (CSD), or complete posterior duplication (CPD). The prevalence of the duplicated HG patterns (CSD or CPD) bilaterally was higher in the schizophrenia and schizotypal groups than in healthy controls, whereas no significant difference was observed between the schizophrenia and schizotypal groups. Schizophrenia patients with the right CPD pattern had less severe positive symptoms, whereas the right single HG pattern was associated with higher doses of antipsychotic medication in schizotypal patients. The present study demonstrated shared HG gyrification patterns in schizophrenia spectrum disorders, which may reflect a common biological vulnerability factor. HG patterns may also be associated with susceptibility to psychopathology.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Arisawabashi Hospital, Toyama 939-2704, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
| | - Tien Viet Pham
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
| | - Kyo Noguchi
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan;
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; (D.S.); (Y.T.); (A.F.); (M.K.); (T.V.P.); (H.K.); (M.S.)
- Research Center for Idling Brain Science, University of Toyama, Toyama 930-0194, Japan
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25
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Sasabayashi D, Takayanagi Y, Takahashi T, Katagiri N, Sakuma A, Obara C, Katsura M, Okada N, Koike S, Yamasue H, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State. Schizophr Bull 2020; 46:834-845. [PMID: 32162659 PMCID: PMC7342178 DOI: 10.1093/schbul/sbaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan; tel: +81-76-434-7323, fax: +81-76-434-5030, e-mail:
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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Nelson EA, Kraguljac NV, White DM, Jindal RD, Shin AL, Lahti AC. A Prospective Longitudinal Investigation of Cortical Thickness and Gyrification in Schizophrenia. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:381-391. [PMID: 32022594 PMCID: PMC7265602 DOI: 10.1177/0706743720904598] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cortical thickness (CT) and gyrification are complementary indices that assess different aspects of gray matter structural integrity. Both neurodevelopment insults and acute tissue response to antipsychotic medication could underlie the known heterogeneity of treatment response and are well-suited for interrogation into the relationship between gray matter morphometry and clinical outcomes in schizophrenia (SZ). METHODS Using a prospective design, we enrolled 34 unmedicated patients with SZ and 23 healthy controls. Patients were scanned at baseline and after a 6-week trial with risperidone. CT and local gyrification index (LGI) values were quantified from structural MRI scans using FreeSurfer 5.3. RESULTS We found reduced CT and LGI in patients compared to controls. Vertex-wise analyses demonstrated that hypogyrification was most prominent in the inferior frontal cortex, temporal cortex, insula, pre/postcentral gyri, temporoparietal junction, and the supramarginal gyrus. Baseline CT was predictive of subsequent response to antipsychotic treatment, and increase in CT after 6 weeks was correlated with greater symptom reductions. CONCLUSIONS In summary, we report evidence of reduced CT and LGI in unmedicated patients compared to controls, suggesting involvement of different aspects of gray matter morphometry in the pathophysiology of SZ. Importantly, we found that lower CT at baseline and greater increase of CT following 6 weeks of treatment with risperidone were associated with better clinical response. Our results suggest that cortical thinning may normalize as a result of a good response to antipsychotic medication, possibly by alleviating potential neurotoxic processes underlying gray matter deterioration.
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Affiliation(s)
- Eric A Nelson
- Department of Psychology, University of Alabama at Birmingham, AL, USA
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - David M White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Ripu D Jindal
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA.,Birmingham Veteran Affairs Medical Center, AL, USA
| | - Ah L Shin
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
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Chaudhary S, Kumaran SS, Goyal V, Kaloiya GS, Kalaivani M, Jagannathan NR, Sagar R, Mehta N, Srivastava AK. Cortical thickness and gyrification index measuring cognition in Parkinson's disease. Int J Neurosci 2020; 131:984-993. [PMID: 32423354 DOI: 10.1080/00207454.2020.1766459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Cortical dynamics is driven by cortico-cortical connectivity and it characterizes cortical morphological features. These brain surface features complement volumetric changes and may offer improved understanding of disease pathophysiology. Hence, present study aims to investigate surface features; cortical thickness (CT) and gyrification index (GI) in Parkinson's disease (PD) patients of normal cognition (PD-CN), cognitively impaired patients with PD (PD-CI) in comparison with cognitively normal healthy controls (HC) to better elucidate cognition linked features in PD. METHOD Anatomical MRI (3DT1) was carried out in 30 HC (56.53 ± 8.42 years), 30 PD-CN (58.8 ± 6.07 years), and 30 PD-CI (60.3 ± 6.43 years) subjects. Whole brain ROI based parcellation using Desikan-Killiany (DK-40) atlas followed by regional CT and GI differentiation [with 'age' and 'total intracranial volume' (TIV) correction], multiple linear regression (with 'age', 'TIV', and 'education' correction) with clinical variables, ROC analysis, and CT-GI correlation across the groups was used for data analysis. RESULTS Widespread cortical thinning with regional GI reduction was evident in PD-CI with respect to other two groups (HC and PD-CN), and with absence of such alterations in PD-CN compared to HC. Frontal, parietal, and temporal CT/GI significantly correlated with cognition and presented classification abilities for cognitive state in PD. Mean regional CT and GI were found negatively correlated across groups with heterogeneous regions. CONCLUSION Fronto-parietal and temporal regions suffer cognition associated cortical thinning and GI reduction. CT may serve better discriminator properties and may be more consistent than GI in studying cognition in PD. Heterogeneous surface dynamics across the groups may signify neuro-developmental alterations in PD.
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Affiliation(s)
| | | | - Vinay Goyal
- Department of Neurology, AIIMS, New Delhi, India
| | - G S Kaloiya
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - M Kalaivani
- Department of Biostatistics, AIIMS, New Delhi, India
| | | | - Rajesh Sagar
- Department of Psychiatry, AIIMS, New Delhi, India
| | - Nalin Mehta
- Department of Physiology, AIIMS, New Delhi, India
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Chen MH, Chang WC, Bai YM, Huang KL, Tu PC, Su TP, Li CT, Lin WC, Tsai SJ, Hsu JW. Cortico-thalamic dysconnection in early-stage schizophrenia: a functional connectivity magnetic resonance imaging study. Eur Arch Psychiatry Clin Neurosci 2020; 270:351-358. [PMID: 30953128 DOI: 10.1007/s00406-019-01003-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 03/21/2019] [Indexed: 10/27/2022]
Abstract
Studies have indicated thalamus-related network dysfunction in schizophrenia and psychotic disorders. However, whether thalamus-related functional connectivity (FC) contributes to the psychopathology and cognitive deficits of early-stage schizophrenia requires further investigation. A total of 34 patients with early-stage schizophrenia (illness duration = 1.62 ± 1.16 years; age = 26.00 ± 6.34 years) and 34 age- and sex-matched healthy controls were enrolled in our study and underwent comprehensive assessments of the clinical symptoms of schizophrenia, working memory tasks, and resting-state FC magnetic resonance imaging. The patients with early-stage schizophrenia had increased FC of the thalamus with the bilateral postcentral and temporal gyri, inferior occipital cortex, and temporal pole and decreased FC of the thalamus with the vestibulocerebellum and frontal pole compared with the controls. Furthermore, increased FC between the thalamus and temporal pole was positively correlated with positive scores of the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and negatively correlated with performance on working memory tasks in early-stage schizophrenia. Increased FC of the thalamus with the inferior occipital cortex was positively associated with negative PANSS scores and negatively correlated with Personal and Social Performance Scale scores in early-stage schizophrenia. Our results supported the vital role of thalamus-related network dysfunction in the psychopathology and cognitive deficits of early-stage schizophrenia.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, 11217, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, 11217, Taipei, Taiwan. .,Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan. .,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan. .,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan. .,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Drobinin V, Van Gestel H, Zwicker A, MacKenzie L, Cumby J, Patterson VC, Vallis EH, Campbell N, Hajek T, Helmick CA, Schmidt MH, Alda M, Bowen CV, Uher R. Psychotic symptoms are associated with lower cortical folding in youth at risk for mental illness. J Psychiatry Neurosci 2020; 45:125-133. [PMID: 31674733 PMCID: PMC7828904 DOI: 10.1503/jpn.180144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cortical folding is essential for healthy brain development. Previous studies have found regional reductions in cortical folding in adult patients with psychotic illness. It is unknown whether these neuroanatomical markers are present in youth with subclinical psychotic symptoms. METHODS We collected MRIs and examined the local gyrification index in a sample of 110 youth (mean age ± standard deviation 14.0 ± 3.7 yr; range 9–25 yr) with a family history of severe mental illness: 48 with psychotic symptoms and 62 without. Images were processed using the Human Connectome Pipeline and FreeSurfer. We tested for group differences in local gyrification index using mixed-effects generalized linear models controlling for age, sex and familial clustering. Sensitivity analysis further controlled for intracranial volume, IQ, and stimulant and cannabis use. RESULTS Youth with psychotic symptoms displayed an overall trend toward lower cortical folding across all brain regions. After adjusting for multiple comparisons and confounders, regional reductions were localized to the frontal and occipital lobes. Specifically, the medial (B = –0.42, pFDR = 0.04) and lateral (B = –0.39, pFDR = 0.04) orbitofrontal cortices as well as the cuneus (B = –0.47, pFDR = 0.03) and the pericalcarine (B = –0.45, pFDR = 0.03) and lingual (B = –0.38, pFDR = 0.04) gyri. LIMITATIONS Inference about developmental trajectories was limited by the cross-sectional data. CONCLUSION Psychotic symptoms in youth are associated with cortical folding deficits, even in the absence of psychotic illness. The current study helps clarify the neurodevelopmental basis of psychosis at an early stage, before medication, drug use and other confounds have had a persistent effect on the brain.
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Affiliation(s)
- Vladislav Drobinin
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Holly Van Gestel
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Alyson Zwicker
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Lynn MacKenzie
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Jill Cumby
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Victoria C. Patterson
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Emily Howes Vallis
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Niamh Campbell
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Tomas Hajek
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Carl A. Helmick
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Matthias H. Schmidt
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Martin Alda
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Chris V. Bowen
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
| | - Rudolf Uher
- From the Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada (Drobinin, Schmidt, Uher); the Nova Scotia Health Authority, Halifax, NS (Drobinin, van Gestel, Zwicker, MacKenzie, Cumby, Patterson, Vallis, Campbell, Helmick, Alda, Bowen, Uher); the Department of Pathology, Dalhousie University, Halifax, NS (Zwicker, Uher); the Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS (MacKenzie, Patterson, Uher); the Department of Psychiatry, Dalhousie University, Halifax, NS (Vallis, Helmick, Alda, Uher); the Department of Medicine, Dalhousie University, Halifax, NS (Campbell); and the Department of Diagnostic Radiology, Dalhousie University, Halifax, NS (Bowen)
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Sasabayashi D, Takayanagi Y, Takahashi T, Nemoto K, Furuichi A, Kido M, Nishikawa Y, Nakamura M, Noguchi K, Suzuki M. Increased brain gyrification in the schizophrenia spectrum. Psychiatry Clin Neurosci 2020; 74:70-76. [PMID: 31596011 DOI: 10.1111/pcn.12939] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/22/2022]
Abstract
AIM Increased brain gyrification in diverse cortical regions has been reported in patients with schizophrenia, possibly reflecting deviations in early neurodevelopment. However, it remains unknown whether patients with schizotypal disorder exhibit similar changes. METHODS This magnetic resonance imaging study investigated brain gyrification in 46 patients with schizotypal disorder (29 male, 17 female), 101 patients with schizophrenia (55 male, 46 female), and 77 healthy controls (44 male, 33 female). T1-weighted magnetic resonance images were obtained for each participant. Using FreeSurfer software, the local gyrification index (LGI) of the entire cortex was compared across the groups. RESULTS Both schizophrenia and schizotypal disorder patients showed a significantly higher LGI in diverse cortical regions, including the bilateral prefrontal and left parietal cortices, as compared with controls, but its extent was broader in schizophrenia especially for the right prefrontal and left occipital regions. No significant correlations were found between the LGI and clinical variables (e.g., symptom severity, medication) for either of the patient groups. CONCLUSION Increased LGI in the frontoparietal regions was common to both patient groups and might represent vulnerability to schizophrenia, while more diverse changes in schizophrenia patients might be associated with the manifestation of florid psychosis.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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Storvestre GB, Valnes LM, Jensen A, Nerland S, Tesli N, Hymer KE, Rosaeg C, Server A, Ringen PA, Jacobsen M, Andreassen OA, Agartz I, Melle I, Haukvik UK. A preliminary study of cortical morphology in schizophrenia patients with a history of violence. Psychiatry Res Neuroimaging 2019; 288:29-36. [PMID: 31071542 DOI: 10.1016/j.pscychresns.2019.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/24/2019] [Accepted: 04/30/2019] [Indexed: 01/13/2023]
Abstract
Clinical studies of patients with schizophrenia and a history of violence are challenging both from an ethical and practical perspective, and the neurobiological underpinnings remain largely unknown. We here present a comprehensive account of the brain cortical characteristics associated with violence in schizophrenia. We obtained 3T MRI scans and thorough clinical characterization of schizophrenia patients with a history of violence (murder, attempted murder, criminal assault, SCZ-V, n = 11), schizophrenia patients with no history of violence (SCZ-NV, n = 17), and healthy controls (HC, n = 19). Cortical thickness, area, and folding were analyzed vertex-wise across the cortical mantle (FreeSurfer). SCZ-V had significantly increased cortical folding in the visual and orbitofrontal cortex, and reduced cortical thickness within the precentral-, parietal-, temporal-, and fusiform cortex compared to SCZ-NV, as well as widespread regional thinning and increased folding compared to HC. There were no group differences in cortical area. A major limitation is the small subject sample. If replicated, the results from this pilot study suggest cortical abnormalities in areas involved in sensory processing, emotion recognition, and reward to be of importance to the neurobiology of violence in schizophrenia.
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Affiliation(s)
| | | | | | - Stener Nerland
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute for Clinical Medicine, University of Oslo, Norway
| | - Natalia Tesli
- Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, P.O.Box 4956 Nydalen, 0424 Oslo, Norway
| | | | | | - Andres Server
- Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Petter Andreas Ringen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | | | - Ole Andreas Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute for Clinical Medicine, University of Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute for Clinical Medicine, University of Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute for Clinical Medicine, University of Oslo, Norway
| | - Unn Kristin Haukvik
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, P.O.Box 4956 Nydalen, 0424 Oslo, Norway.
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32
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Marotta G, Delvecchio G, Pigoni A, Mandolini G, Ciappolino V, Oldani L, Madonna D, Grottaroli M, Altamura AC, Brambilla P. The metabolic basis of psychosis in bipolar disorder: A positron emission tomography study. Bipolar Disord 2019; 21:151-158. [PMID: 30506616 DOI: 10.1111/bdi.12710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Psychotic symptoms are a common feature in bipolar disorder (BD), especially during manic phases, and are associated with a more severe course of illness. However, not all bipolar subjects experience psychosis during the course of their illness, and this difference often guides assessment and pharmacological treatment. The aim of the present study is to elucidate, for the first time, the FDG uptake dysfunctions associated with psychosis in BD patients with and without a history of past psychotic symptoms, through a positron emission tomography (PET) approach. METHODS Fifty BD patients with lifetime psychotic symptoms, 40 BD patients without lifetime psychotic symptoms and 27 healthy controls (HC) were recruited and underwent an 18F-FDG-PET session. RESULTS Compared to HC, BD subjects shared common FDG uptake deficits in several brain areas, including insula, inferior temporal gyrus and middle occipital gyrus. Moreover, we found that BD patients with a history of past psychotic symptoms had a unique FDG uptake alteration in the right fusiform gyrus compared to both BD patients without lifetime psychotic symptoms and HC (all P < 0.01, cFWE corrected). CONCLUSIONS Overall, our results suggest that FDG uptake alterations in brain regions involved in emotion regulation are a key feature of BD, regardless the presence of past psychosis. Finally, we demonstrated that the FDG uptake reduction in fusiform gyrus is associated with the presence of past psychotic symptoms in BD, ultimately leading towards the idea that the fusiform gyrus might be considered a putative biomarker of psychosis.
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Affiliation(s)
- Giorgio Marotta
- Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Scientific Institute, IRCCS E. Medea, Pordenone, Italy
| | - Alessandro Pigoni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianmario Mandolini
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Domenico Madonna
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marika Grottaroli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alfredo Carlo Altamura
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
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Yan J, Cui Y, Li Q, Tian L, Liu B, Jiang T, Zhang D, Yan H. Cortical thinning and flattening in schizophrenia and their unaffected parents. Neuropsychiatr Dis Treat 2019; 15:935-946. [PMID: 31114205 PMCID: PMC6489638 DOI: 10.2147/ndt.s195134] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/01/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Schizophrenia is a neurodevelopmental disorder with high heritability. Widespread cortical thinning has been identified in schizophrenia, suggesting that it is a result of cortical development deficit. However, the findings of other cortical morphological indexes of patients are inconsistent, and the research on their relationship with genetic risk factors for schizophrenia is rare. Methods: In order to investigate cortical morphology deficits and their disease-related genetic liability in schizophrenia, we analyzed a sample of 33 patients with schizophrenia, 60 biological parents of the patients, as well as 30 young controls for patients and 28 elderly controls for parents with age, sex and education level being well-matched. We calculated vertex-wise measurements of cortical thickness, surface area, local gyrification index, sulcal depth, and their correlation with the clinical and cognitive characteristics. Results: Widespread cortical thinning of the fronto-temporo-parietal region, sulcal flattening of the insula and gyrification reduction of the frontal cortex were observed in schizophrenia patients. Conjunction analysis revealed that patients with schizophrenia and their parents shared significant cortical thinning of bilateral prefrontal and insula, left lateral occipital and fusiform regions (Monte Carlo correction, P<0.05), as well as a trend-level sulcal depth reduction mainly in bilateral insula and occipital cortex. We observed comprehensive cognitive deficits in patients and similar impairment in the speed of processing of their unaffected parents. Significant associations between lower processing speed and thinning of the frontal cortex and flattening of the parahippocampal gyrus were found in patients and their parents, respectively. However, no significant correlation between abnormal measurements of cortical morphology and clinical characteristics was found. Conclusion: The results suggest that cortical morphology may be susceptible to a genetic risk of schizophrenia and could underlie the cognitive dysfunction in patients and their unaffected relatives. The abnormalities shared with unaffected parents allow us to better understand the disease-specific genetic effect on cortical development.
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Affiliation(s)
- Jing Yan
- Peking University Sixth Hospital/Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, People's Republic of China
| | - Yue Cui
- Brainnetome Center/National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, People's Republic of China.,University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Qianqian Li
- Peking University Sixth Hospital/Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, People's Republic of China
| | - Lin Tian
- Department of Psychiatry, Wuxi Mental Health Center, Nanjing Medical University, Wuxi 214151, People's Republic of China.,Wuxi Mental Health Center, Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Wuxi, 214151, People's Republic of China
| | - Bing Liu
- Brainnetome Center/National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, People's Republic of China.,University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Tianzi Jiang
- Brainnetome Center/National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, People's Republic of China.,University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Dai Zhang
- Peking University Sixth Hospital/Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, People's Republic of China.,Peking-Tsinghua Joint Center for Life Sciences & PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, People's Republic of China
| | - Hao Yan
- Peking University Sixth Hospital/Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, People's Republic of China
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Spalthoff R, Gaser C, Nenadić I. Altered gyrification in schizophrenia and its relation to other morphometric markers. Schizophr Res 2018; 202:195-202. [PMID: 30049600 DOI: 10.1016/j.schres.2018.07.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 06/10/2018] [Accepted: 07/03/2018] [Indexed: 01/04/2023]
Abstract
Schizophrenia is modelled as a neurodevelopmental disease with high heritability. However, established markers like cortical thickness and grey matter volume are heavily influenced by post-onset changes and thus provide limited possibility of accessing early pathologies. Gyrification on the other side is assumed to be more specifically determined by genetic and early developmental factors. Here, we compare T1 weighted 3 Tesla MRI scans of 51 schizophrenia patients and 102 healthy controls (matched for age and gender) using a unified processing pipeline with the CAT12 toolbox. Our study provides a direct comparison between 3D gyrification, cortical thickness, and grey matter volume. We demonstrate that significant (p < 0.05, FWE corrected) results only partially overlap between modalities. Gyrification is altered in bilateral insula, temporal pole and left orbitofrontal cortex, while cortical thickness is additionally reduced in the prefrontal cortex, precuneus, and occipital cortex. Grey matter volume (VBM) was reduced in bilateral medial temporal lobes including the amygdala as well as medial and dorsolateral prefrontal cortices and cerebellum. Our results lend further support for altered gyrification as a marker of early neurodevelopmental disturbance in schizophrenia and show its relation to other morphological markers.
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Affiliation(s)
- Robert Spalthoff
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Psychiatry and Psychotherapy, Phillips University Marburg/Marburg University Hospital UKGM, Marburg, Germany.
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35
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Bernardoni F, King JA, Geisler D, Birkenstock J, Tam FI, Weidner K, Roessner V, White T, Ehrlich S. Nutritional Status Affects Cortical Folding: Lessons Learned From Anorexia Nervosa. Biol Psychiatry 2018; 84:692-701. [PMID: 29910027 DOI: 10.1016/j.biopsych.2018.05.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/11/2018] [Accepted: 05/01/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cortical folding is thought to remain relatively invariant after birth. Therefore, differences seen in psychiatric disorders have been proposed as early biomarkers or used as intermediate phenotypes in imaging genetics studies. Anorexia nervosa (AN) is associated with drastic and rapid structural brain alterations and thus may be an ideal model disorder to study environmental influences on cortical folding. METHODS To date, the only two studies in AN applied different methods (local gyrification index and mean curvature) and found seemingly discordant results. We computed both vertexwise measures in a sizable sample of acutely underweight female AN patients (n = 87, mean age 16.5 years), long-term recovered patients (n = 58, mean age 22 years), and healthy control participants (n = 141, mean age 19.5 years). The majority of acutely ill patients were scanned longitudinally (n = 57) again after partial weight normalization (>14% body mass index increase). RESULTS While gyrification was broadly reduced in acutely ill patients, normal values were restored in most brain regions after partial weight restoration (≈3 months), and after full recovery no significant differences were evident relative to control participants. Increased gyrification was largely predicted by weight restoration alone. Results for absolute mean curvature analyses complemented those obtained using the local gyrification index. CONCLUSIONS Together, these findings indicate that nutritional status affects cortical folding and suggest that gyrification studies may need to better control for environmental factors. Moreover, they provide novel support for the likelihood that macroscopic changes in the cortical organization in AN are more reflective of nutritional state than premorbid trait markers or permanent scars.
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Affiliation(s)
- Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julian Birkenstock
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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36
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Sakuma A, Obara C, Katsura M, Ito F, Ohmuro N, Iizuka K, Kikuchi T, Miyakoshi T, Matsuoka H, Matsumoto K. No regional gray matter volume reduction observed in young Japanese people at ultra-high risk for psychosis: A voxel-based morphometry study. Asian J Psychiatr 2018; 37:167-171. [PMID: 30293050 DOI: 10.1016/j.ajp.2018.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/28/2018] [Accepted: 09/26/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Structural brain magnetic resonance imaging studies of individuals at ultra-high risk (UHR) for psychosis have shown subtle but widespread reductions in baseline gray matter volume (GMV) in the frontal, temporal, and limbic regions compared with healthy controls (HC). These regions coincide with regions of reduced GMV in patients with established psychosis and have led to the consideration of structural changes in UHR as a potential biomarker for future transition to psychosis. However, most studies have been from Europe, North America, and Australia, with few reports from other regions, and two recent studies from Asian countries have failed to detect regional GMV reduction in UHR, suggesting the need for further analysis of an Asian sample. In this study, we investigated GMV reduction in Japanese UHR subjects. RESULTS The study used voxel-based morphometry to compare magnetic resonance imaging brain scans between 45 UHR individuals recruited by a specialist and 33 HCs. This showed no significant GMV reduction in the UHR group compared with the healthy control group. This negative result may be attributable to characteristics of Asian samples, such as a low prevalence of illicit drug use, or to the heterogeneous nature of UHR subjects.
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Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Psychiatry, Sendai City Hospital, 1-1 Asuto-nagamachi, Taihaku-ku, Sendai, Miyagi, 982-8502, Japan.
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Kunio Iizuka
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Tatsuo Kikuchi
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Tetsuo Miyakoshi
- Sapporo Prison, 2-1-5-1 Higashi-naebo, Higashi-ku, Sapporo, 007-8601, Japan.
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan; Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
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Takahashi T, Suzuki M. Brain morphologic changes in early stages of psychosis: Implications for clinical application and early intervention. Psychiatry Clin Neurosci 2018; 72:556-571. [PMID: 29717522 DOI: 10.1111/pcn.12670] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 12/20/2022]
Abstract
To date, a large number of magnetic resonance imaging (MRI) studies have been conducted in schizophrenia, which generally demonstrate gray matter reduction, predominantly in the frontal and temporo-limbic regions, as well as gross brain abnormalities (e.g., a deviated sulcogyral pattern). Although the causes as well as timing and course of these findings remain elusive, these morphologic changes (especially gross brain abnormalities and medial temporal lobe atrophy) are likely present at illness onset, possibly reflecting early neurodevelopmental abnormalities. In addition, longitudinal MRI studies suggest that patients with schizophrenia and related psychoses also have progressive gray matter reduction during the transition period from prodrome to overt psychosis, as well as initial periods after psychosis onset, while such changes may become almost stable in the chronic stage. These active brain changes during the early phases seem to be relevant to the development of clinical symptoms in a region-specific manner (e.g., superior temporal gyrus atrophy and positive psychotic symptoms), but may be at least partly ameliorated by antipsychotic medication. Recently, increasing evidence from MRI findings in individuals at risk for developing psychosis has suggested that those who subsequently develop psychosis have baseline brain changes, which could be at least partly predictive of later transition into psychosis. In this article, we selectively review previous MRI findings during the course of psychosis and also refer to the possible clinical applicability of these neuroimaging research findings, especially in the diagnosis of schizophrenia and early intervention for psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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38
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Neilson E, Bois C, Clarke TK, Hall L, Johnstone EC, Owens DGC, Whalley HC, McIntosh AM, Lawrie SM. Polygenic risk for schizophrenia, transition and cortical gyrification: a high-risk study. Psychol Med 2018; 48:1532-1539. [PMID: 29065934 DOI: 10.1017/s0033291717003087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Schizophrenia is a highly heritable disorder, linked to several structural abnormalities of the brain. More specifically, previous findings have suggested that increased gyrification in frontal and temporal regions are implicated in the pathogenesis of schizophrenia. METHODS The current study included participants at high familial risk of schizophrenia who remained well (n = 31), who developed sub-diagnostic symptoms (n = 28) and who developed schizophrenia (n = 9) as well as healthy controls (HC) (n = 16). We first tested whether individuals at high familial risk of schizophrenia carried an increased burden of trait-associated alleles using polygenic risk score analysis. We then assessed the extent to which polygenic risk was associated with gyral folding in the frontal and temporal lobes. RESULTS We found that individuals at high familial risk of schizophrenia who developed schizophrenia carried a significantly greater burden of risk-conferring variants for the disorder compared to those at high risk (HR) who developed sub-diagnostic symptoms or remained well and HC. Furthermore, within the HR cohort, there was a significant and positive association between schizophrenia polygenic risk score and bilateral frontal gyrification. CONCLUSIONS These results suggest that polygenic risk for schizophrenia impacts upon early neurodevelopment to confer greater gyral folding in adulthood and an increased risk of developing the disorder.
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Affiliation(s)
- E Neilson
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - C Bois
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - T-K Clarke
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - L Hall
- International Centre for Life,Institute of Genetic Medicine,Newcastle University,Central Parkway,Newcastle upon Tyne,UK
| | - E C Johnstone
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - D G C Owens
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - H C Whalley
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - A M McIntosh
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
| | - S M Lawrie
- Division of Psychiatry,University of Edinburgh,Royal Edinburgh Hospital,Kennedy Tower,Edinburgh,UK
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Das T, Borgwardt S, Hauke DJ, Harrisberger F, Lang UE, Riecher-Rössler A, Palaniyappan L, Schmidt A. Disorganized Gyrification Network Properties During the Transition to Psychosis. JAMA Psychiatry 2018; 75:613-622. [PMID: 29710118 PMCID: PMC6137528 DOI: 10.1001/jamapsychiatry.2018.0391] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE There is urgent need to improve the limited prognostic accuracy of clinical instruments to predict psychosis onset in individuals at clinical high risk (CHR) for psychosis. As yet, no reliable biological marker has been established to delineate CHR individuals who will develop psychosis from those who will not. OBJECTIVES To investigate abnormalities in a graph-based gyrification connectome in the early stages of psychosis and to test the accuracy of this systems-based approach to predict a transition to psychosis among CHR individuals. DESIGN, SETTING, AND PARTICIPANTS This investigation was a cross-sectional magnetic resonance imaging (MRI) study with follow-up assessment to determine the transition status of CHR individuals. Participants were recruited from a specialized clinic for the early detection of psychosis at the Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland. Participants included individuals in the following 4 study groups: 44 healthy controls (HC group), 63 at-risk mental state (ARMS) individuals without later transition to psychosis (ARMS-NT group), 16 ARMS individuals with later transition to psychosis (ARMS-T group), and 38 antipsychotic-free patients with first-episode psychosis (FEP group). The study dates were November 2008 to November 2014. The dates of analysis were March to November 2017. MAIN OUTCOMES AND MEASURES Gyrification-based structural covariance networks (connectomes) were constructed to quantify global integration, segregation, and small-worldness. Group differences in network measures were assessed using functional data analysis across a range of network densities. The extremely randomized trees algorithm with repeated 5-fold cross-validation was used to delineate ARMS-T individuals from ARMS-NT individuals. Permutation tests were conducted to assess the significance of classification performance measures. RESULTS The 4 study groups comprised 161 participants with mean (SD) ages ranging from 24.0 (4.7) to 25.9 (5.7) years. Small-worldness was reduced in the ARMS-T and FEP groups and was associated with decreased integration and increased segregation in both groups (Hedges g range, 0.666-1.050). Using the connectome properties as features, a good classification performance was obtained (accuracy, 90.49%; balanced accuracy, 81.34%; positive predictive value, 84.47%; negative predictive value, 92.18%; sensitivity, 66.11%; specificity, 96.58%; and area under the curve, 88.30%). CONCLUSIONS AND RELEVANCE These findings suggest that there is poor integration in the coordinated development of cortical folding in patients who develop psychosis. These results further suggest that gyrification-based connectomes might be a promising means to generate systems-based measures from anatomical data to improve individual prediction of a transition to psychosis in CHR individuals.
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Affiliation(s)
- Tushar Das
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada,Department of Psychiatry, University of Western Ontario, London, Ontario, Canada,Lawson Health Research Institute, London, Ontario, Canada
| | - Stefan Borgwardt
- Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland
| | - Daniel J. Hauke
- Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland
| | - Fabienne Harrisberger
- Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland
| | - Anita Riecher-Rössler
- Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland
| | - Lena Palaniyappan
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada,Department of Psychiatry, University of Western Ontario, London, Ontario, Canada,Lawson Health Research Institute, London, Ontario, Canada,Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - André Schmidt
- Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland
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Li RR, Lyu HL, Liu F, Lian N, Wu RR, Zhao JP, Guo WB. Altered functional connectivity strength and its correlations with cognitive function in subjects with ultra-high risk for psychosis at rest. CNS Neurosci Ther 2018; 24:1140-1148. [PMID: 29691990 DOI: 10.1111/cns.12865] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 12/21/2022] Open
Abstract
AIMS Evidence of altered structural and functional connectivity in the frontal-occipital network is associated with cognitive deficits in patients with schizophrenia. However, the altered patterns of functional connectivity strength (FCS) in individuals with ultra-high risk (UHR) for psychosis remain unknown. In this study, whole-brain FCS was assessed to examine the altered patterns of FCS in UHR subjects. METHODS A total of 34 UHR subjects and 37 age- and sex-matched healthy controls were enrolled to undergo resting-state functional magnetic resonance imaging. The imaging data were analyzed using the graph theory method. RESULTS Compared with healthy controls, UHR subjects showed significantly decreased FCS in the left middle frontal gyrus and significantly increased FCS in the left calcarine cortex. The FCS values in the left middle frontal gyrus were positively correlated to the scores of the Brief Assessments of Cognitionin Schizophrenia Symbol Coding Test (r = 0.366, P = 0.033) in the UHR subjects. A negative correlation was found between the FCS values in the left calcarine cortex and the scores of the Stroop color-naming test (r = -0.475, P = 0.016) in the UHR subjects. A combination of the FCS values in the 2 brain areas showed an accuracy of 87.32%, a sensitivity of 73.53%, and a specificity of 100% for distinguishing UHR subjects from healthy controls. CONCLUSIONS Significantly altered FCS in the frontal-occipital network is observed in the UHR subjects. Furthermore, decreased FCS in the left middle frontal gyrus and increased FCS in the left calcarine have significant correlations with the cognitive measures of the UHR subjects and thus improve our understanding of the underlying pathophysiological mechanisms of schizophrenia. Moreover, a combination of the FCS values in the 2 brain areas can serve as a potential image marker to distinguish UHR subjects from healthy controls.
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Affiliation(s)
- Ran-Ran Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hai-Long Lyu
- Department of Psychiatry, The First Affiliated Hospital, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Lian
- The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Ren-Rong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jing-Ping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wen-Bin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Cortical Morphometry in the Psychosis Risk Period: A Comprehensive Perspective of Surface Features. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:434-443. [PMID: 31054647 DOI: 10.1016/j.bpsc.2018.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Gyrification features reflect brain development in the early prenatal environment. Clarifying the nature of these features in psychosis can help shed light on the role of early developmental insult. However, the literature is currently widely discrepant, which may reflect confounds related to formally psychotic patient populations or overreliance on a single feature of cortical surface morphometry (CSM). METHODS This study compares CSM features of gyrification in clinical high-risk (n = 43) youths during the prodromal risk period to typically developing control subjects over two time points across three metrics: local gyrification index, mean curvature index, and sulcal depth (improving resolution and examination of change over 1 year). RESULTS Gyrification was stable over time, supporting the idea that gyrification reflects early insult rather than abnormal development or reorganization associated with the disease state. Each of the indices highlighted unique, aberrant features in the clinical high-risk group with respect to control subjects. Specifically, the local gyrification index reflected hypogyrification in the lateral orbitofrontal cortex, superior bank of the superior temporal sulcus, anterior isthmus of the cingulate gyrus, and temporal poles; the mean curvature index indicated sharper gyral and flatter or wider sulcal peaks in the cingulate, postcentral, and lingual gyrus; sulcal depth identified shallow features in the parietal, superior temporal sulcus, and cingulate regions. Further, both the mean curvature index and sulcal depth converged on abnormal features in the parietal cortex. CONCLUSIONS Gyrification metrics suggest early developmental insult and provide support for neurodevelopmental hypotheses. Observations of stable CSM features across time provide context for interpreting extant studies and speak to CSM as a promising stable marker and/or endophenotype. Collectively, findings support the importance of considering multiple CSM features.
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Nelson EA, White DM, Kraguljac NV, Lahti AC. Gyrification Connectomes in Unmedicated Patients With Schizophrenia and Following a Short Course of Antipsychotic Drug Treatment. Front Psychiatry 2018; 9:699. [PMID: 30618873 PMCID: PMC6306495 DOI: 10.3389/fpsyt.2018.00699] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/03/2018] [Indexed: 12/18/2022] Open
Abstract
Schizophrenia (SZ) is a d isease characterized by brain dysconnectivity and abnormal brain development. The study of cortical gyrification in schizophrenia may capture underlying alterations reflective of neurodevelopmental abnormalities more accurately than other imaging modalities. Graph-based connectomic approaches have been previously used in schizophrenia to study structural and functional brain covariance using a diversity of techniques. The goal of the present study was to evaluate morphological covariance using a measure of local gyrification index in patients with schizophrenia. The aims of this study were two-fold: (1) Evaluate the structural covariance of local gyrification index using graph theory measures of integration and segregation in unmedicated patients with schizophrenia compared to healthy controls and (2) investigate changes in these measures following a short antipsychotic drug (APD) treatment. Using a longitudinal prospective design, structural scans were obtained prior to treatment in 34 unmedicated patients with SZ and after 6 weeks of treatment with risperidone. To control for the effect of time, 23 matched healthy controls (HC) were also scanned twice, 6 weeks apart. The cortical surface of each structural image was reconstructed and local gyrification index values were computed using FreeSurfer. Local gyrification index values where then parcellated into atlas based regions and entered into a 68 × 68 correlation matrix to construct local gyrification index connectomes for each group at each time point. Longitudinal comparisons showed significant group by time interactions for measures of segregation (clustering, local efficiency) and modularity, but not for measures of integration (path length, global efficiency). Post-hoc tests showed increased clustering, local efficiency, and modularity connectomes in unmedicated patients with SZ at baseline compared to HC. Post-hoc tests did not show significant within group differences for HCs or patients with SZ. After 6 weeks of treatment, there were no significant differences between the groups on these measures. Abnormal cortical topography is detected in schizophrenia and is modified by short term APD treatment reflective of decreases in hyper-specialization in network connectivity. We speculate that changes in the structural organization of the brain is achieved through the neuroplastic effects that APDs have on brain tissue, thus promoting more efficient brain connections and, possibly, a therapeutic effect.
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Affiliation(s)
- Eric A Nelson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - David M White
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Nina V Kraguljac
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adrienne C Lahti
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, United States
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Abstract
The cerebral cortex of the human brain has a complex morphological structure consisting of folded or smooth cortical surfaces. These morphological features are referred to as cortical gyrification and are characterized by the gyrification index (GI). A number of cortical gyrification studies have been published using the manual tracing GI, automated GI, and local GI in patients with schizophrenia. In this review, we highlighted abnormal cortical gyrification in patients with schizophrenia, first-episode schizophrenia, siblings of patients, and high-risk and at-risk individuals. Previous researches also indicated that abnormalities in cortical gyrification may underlie the severity of clinical symptoms, neurological soft signs, and executive functions. A substantial body of research has been conducted; however, some researches showed an increased GI, which is called as "hypergyria," and others showed a decreased GI, which is called as "hypogyria." We discussed that different GI methods and a wide variety of characteristics, such as age, sex, stage, and severity of illness, might be important reasons for the conflicting findings. These issues still need to be considered, and future studies should address them.
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Affiliation(s)
- Yukihisa Matsuda
- Faculty of Pharmacy and Pharmaceutical Sciences, Fukuyama University, Hiroshima, Japan
| | - Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan, .,Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan,
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