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Zhang Z, Robinson L, Campbell I, Irish M, Bobou M, Winterer J, Zhang Y, King S, Vaidya N, Broulidakis MJ, van Noort BM, Stringaris A, Banaschewski T, Bokde ALW, Brühl R, Fröhner JH, Grigis A, Garavan H, Gowland P, Heinz A, Hohmann S, Martinot JL, Martinot MLP, Nees F, Orfanos DP, Paus T, Poustka L, Sinclair J, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U, Desrivières S. Distinct personality profiles associated with disease risk and diagnostic status in eating disorders. J Affect Disord 2024; 360:146-155. [PMID: 38810783 DOI: 10.1016/j.jad.2024.05.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/13/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Personality traits have been associated with eating disorders (EDs) and comorbidities. However, it is unclear which personality profiles are premorbid risk rather than diagnostic markers. METHODS We explored associations between personality and ED-related mental health symptoms using canonical correlation analyses. We investigated personality risk profiles in a longitudinal sample, associating personality at age 14 with onset of mental health symptoms at ages 16 or 19. Diagnostic markers were identified in a sample of young adults with anorexia nervosa (AN, n = 58) or bulimia nervosa (BN, n = 63) and healthy controls (n = 47). RESULTS Two significant premorbid risk profiles were identified, successively explaining 7.93 % and 5.60 % of shared variance (Rc2). The first combined neuroticism (canonical loading, rs = 0.68), openness (rs = 0.32), impulsivity (rs = 0.29), and conscientiousness (rs = 0.27), with future onset of anxiety symptoms (rs = 0.87) and dieting (rs = 0.58). The other, combined lower agreeableness (rs = -0.60) and lower anxiety sensitivity (rs = -0.47), with future deliberate self-harm (rs = 0.76) and purging (rs = 0.55). Personality profiles associated with "core psychopathology" in both AN (Rc2 = 80.56 %) and BN diagnoses (Rc2 = 64.38 %) comprised hopelessness (rs = 0.95, 0.87) and neuroticism (rs = 0.93, 0.94). For BN, this profile also included impulsivity (rs = 0.60). Additionally, extraversion (rs = 0.41) was associated with lower depressive risk in BN. LIMITATIONS The samples were not ethnically diverse. The clinical cohort included only females. There was non-random attrition in the longitudinal sample. CONCLUSIONS The results suggest neuroticism and impulsivity as risk and diagnostic markers for EDs, with neuroticism and hopelessness as shared diagnostic markers. They may inform the design of more personalised prevention and intervention strategies.
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Affiliation(s)
- Zuo Zhang
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Lauren Robinson
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Iain Campbell
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Madeleine Irish
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Marina Bobou
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Jeanne Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Yuning Zhang
- Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, United Kingdom
| | - Sinead King
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom; School of Medicine, Center for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI) Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
| | - M John Broulidakis
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA
| | - Betteke Maria van Noort
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany
| | - Argyris Stringaris
- Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, and AP-HP, Sorbonne University, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | | | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Julia Sinclair
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Ulrike Schmidt
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sylvane Desrivières
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom.
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Kesby JP, Turner KM. The Translational Utility of Circuit-Based Manipulations in Preclinical Models. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:103-104. [PMID: 38298780 PMCID: PMC10829644 DOI: 10.1016/j.bpsgos.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/11/2023] [Indexed: 02/02/2024] Open
Affiliation(s)
- James P. Kesby
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Karly M. Turner
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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Srivastav S, Cui X, Varela RB, Kesby JP, Eyles D. Increasing dopamine synthesis in nigrostriatal circuits increases phasic dopamine release and alters dorsal striatal connectivity: implications for schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:69. [PMID: 37798312 PMCID: PMC10556015 DOI: 10.1038/s41537-023-00397-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
One of the most robust neurochemical abnormalities reported in patients with schizophrenia is an increase in dopamine (DA) synthesis and release, restricted to the dorsal striatum (DS). This hyper functionality is strongly associated with psychotic symptoms and progresses in those who later transition to schizophrenia. To understand the implications of this progressive neurobiology on brain function, we have developed a model in rats which we refer to as EDiPs (Enhanced Dopamine in Prodromal schizophrenia). The EDiPs model features a virally mediated increase in dorsal striatal (DS) DA synthesis capacity across puberty and into adulthood. This protocol leads to progressive changes in behaviour and neurochemistry. Our aim in this study was to explore if increased DA synthesis capacity alters the physiology of DA release and DS connectivity. Using fast scan cyclic voltammetry to assess DA release we show that evoked/phasic DA release is increased in the DS of EDiPs rats, whereas tonic/background levels of DA remain unaffected. Using quantitative immunohistochemistry methods to quantify DS synaptic architecture we show a presynaptic marker for DA release sites (Bassoon) was elevated within TH axons specifically within the DS, consistent with the increased phasic DA release in this region. Alongside changes in DA systems, we also show increased density of vesicular glutamate transporter 1 (VGluT1) synapses in the EDiPs DS suggesting changes in cortical connectivity. Our data may prove relevant in understanding the long-term implications for DS function in response to the robust and prolonged increases in DA synthesis uptake and release reported in schizophrenia.
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Affiliation(s)
- Sunil Srivastav
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Xiaoying Cui
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | | | - James P Kesby
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Darryl Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia.
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Tunset ME, Haslene-Hox H, Van Den Bossche T, Maleki S, Vaaler A, Kondziella D. Blood-borne extracellular vesicles of bacteria and intestinal cells in patients with psychotic disorders. Nord J Psychiatry 2023; 77:686-695. [PMID: 37354486 DOI: 10.1080/08039488.2023.2223572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Human cells and bacteria secrete extracellular vesicles (EV) which play a role in intercellular communication. EV from the host intestinal epithelium are involved in the regulation of bacterial gene expression and growth. Bacterial EV (bactEV) produced in the intestine can pass to various tissues where they deliver biomolecules to many kinds of cells, including neurons. Emerging data indicate that gut microbiota is altered in patients with psychotic disorders. We hypothesized that the amount and content of blood-borne EV from intestinal cells and bactEV in psychotic patients would differ from healthy controls. METHODS We analyzed for human intestinal proteins by proteomics, for bactEV by metaproteomic analysis, and by measuring the level of lipopolysaccharide (LPS) in blood-borne EV from patients with psychotic disorders (n = 25), tested twice, in the acute phase of psychosis and after improvement, with age- and sex-matched healthy controls (n = 25). RESULTS Patients with psychotic disorders had lower LPS levels in their EV compared to healthy controls (p = .027). Metaproteome analyses confirmed LPS finding and identified Firmicutes and Bacteroidetes as dominating phyla. Total amounts of human intestine proteins in EV isolated from blood was lower in patients compared to controls (p = .02). CONCLUSIONS Our results suggest that bactEV and host intestinal EV are decreased in patients with psychosis and that this topic is worthy of further investigation given potential pathophysiological implications. Possible mechanisms involve dysregulation of the gut microbiota by host EV, altered translocation of bactEV to systemic circulation where bactEV can interact with both the brain and the immune system.
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Affiliation(s)
- Mette Elise Tunset
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Hanne Haslene-Hox
- Department of Biotechnology and Nanomedicine, SINTEF, Trondheim, Norway
| | - Tim Van Den Bossche
- VIB - UGent Center for Medical Biotechnology, VIB, Ghent, Belgium
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Susan Maleki
- Department of Biotechnology and Nanomedicine, SINTEF, Trondheim, Norway
| | - Arne Vaaler
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Acute Psychiatry, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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5
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Baker A, Suetani S, Cosgrove P, Siskind D, Murray GK, Scott JG, Kesby JP. Reversal learning in those with early psychosis features contingency-dependent changes in loss response and learning. Cogn Neuropsychiatry 2023; 28:342-360. [PMID: 37737715 DOI: 10.1080/13546805.2023.2259019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION People with psychotic disorders commonly feature broad decision-making impairments that impact their functional outcomes. Specific associative/reinforcement learning problems have been demonstrated in persistent psychosis. But these phenotypes may differ in early psychosis, suggesting that aspects of cognition decline over time. METHODS The present proof-of-concept study examined goal-directed action and reversal learning in controls and those with early psychosis. RESULTS Equivalent performance was observed between groups during outcome-specific devaluation, and reversal learning at an 80:20 contingency (reward probability for high:low targets). But when the low target reward probability was increased (80:40) those with early psychosis altered their response to loss, whereas controls did not. Computational modelling confirmed that in early psychosis there was a change in punishment learning that increased the chance of staying with the same stimulus after a loss, multiple trials into the future. In early psychosis, the magnitude of this response was greatest in those with higher IQ and lower clinical severity scores. CONCLUSIONS We show preliminary evidence that those with early psychosis present with a phenotype that includes altered responding to loss and hyper-adaptability in response to outcome changes. This may reflect a compensatory response to overcome the milieu of corticostriatal changes associated with psychotic disorders.
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Affiliation(s)
- Andrea Baker
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
- School of Medicine and Dentistry, Griffith University, Brisbane, Australia
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Peter Cosgrove
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Dan Siskind
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Metro South Addiction and Mental Health Services, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - James P Kesby
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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Hanewald B, Lockhofen DEL, Sammer G, Stingl M, Gallhofer B, Mulert C, Iffland JR. Functional connectivity in a monetary and social incentive delay task in medicated patients with schizophrenia. Front Psychiatry 2023; 14:1200860. [PMID: 37711426 PMCID: PMC10498543 DOI: 10.3389/fpsyt.2023.1200860] [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: 04/05/2023] [Accepted: 08/02/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Numerous studies indicate impaired reward-related learning in individuals with schizophrenia, with various factors such as illness duration, medication, disease severity, and level of analysis (behavioral or neurophysiological data) potentially confounding the results. Patients with schizophrenia who are treated with second-generation antipsychotics have been found to have a less affected reward system. However, this finding does not explain the neural dysfunctions observed in previous studies. This study aimed to address the open question of whether the less impaired reward-related behavior is associated with unimpaired task-related functional connectivity or altered task-related functional connectivity. Methods The study included 23 participants diagnosed within the schizophrenia spectrum and 23 control participants matched in terms of age, sex, and education. Participants underwent an MRI while performing a monetary incentive delay task and a social incentive delay task. The collected data were analyzed in terms of behavior and functional connectivity. Results Both groups exhibited a main effect of reward type on behavioral performance, indicating faster reaction times in the social incentive delay task, but no main effect of reward level. Altered functional connectivity was observed in predictable brain regions within the patient group, depending on the chosen paradigm, but not when compared to healthy individuals. Discussion In addition to expected slower response times, patients with schizophrenia demonstrated similar response patterns to control participants at the behavioral level. The similarities in behavioral data may underlie different connectivity patterns. Our findings suggest that perturbations in reward processing do not necessarily imply disturbances in underlying connectivities. Consequently, we were able to demonstrate that patients with schizophrenia are indeed capable of exhibiting goal-directed, reward-responsive behavior, although there are differences depending on the type of reward.
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Affiliation(s)
- Bernd Hanewald
- Center for Psychiatry, Justus Liebig University Giessen, Giessen, Germany
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Demler VF, Sterner EF, Wilson M, Zimmer C, Knolle F. Association between increased anterior cingulate glutamate and psychotic-like experiences, but not autistic traits in healthy volunteers. Sci Rep 2023; 13:12792. [PMID: 37550354 PMCID: PMC10406950 DOI: 10.1038/s41598-023-39881-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023] Open
Abstract
Despite many differences, autism spectrum disorder and schizophrenia spectrum disorder share environmental risk factors, genetic predispositions as well as neuronal abnormalities, and show similar cognitive deficits in working memory, perspective taking, or response inhibition. These shared abnormalities are already present in subclinical traits of these disorders. The literature proposes that changes in the inhibitory GABAergic and the excitatory glutamatergic system could explain underlying neuronal commonalities and differences. Using magnetic resonance spectroscopy (1H-MRS), we investigated the associations between glutamate concentrations in the anterior cingulate cortex (ACC), the left/right putamen, and left/right dorsolateral prefrontal cortex and psychotic-like experiences (Schizotypal Personality Questionnaire) and autistic traits (Autism Spectrum Quotient) in 53 healthy individuals (26 women). To investigate the contributions of glutamate concentrations in different cortical regions to symptom expression and their interactions, we used linear regression analyses. We found that only glutamate concentration in the ACC predicted psychotic-like experiences, but not autistic traits. Supporting this finding, a binomial logistic regression predicting median-split high and low risk groups for psychotic-like experiences revealed ACC glutamate levels as a significant predictor for group membership. Taken together, this study provides evidence that glutamate levels in the ACC are specifically linked to the expression of psychotic-like experiences, and may be a potential candidate in identifying early risk individuals prone to developing psychotic-like experiences.
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Affiliation(s)
- Verena F Demler
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Elisabeth F Sterner
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Martin Wilson
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, UK
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Franziska Knolle
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
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Knolle F, Arumugham SS, Barker RA, Chee MWL, Justicia A, Kamble N, Lee J, Liu S, Lenka A, Lewis SJG, Murray GK, Pal PK, Saini J, Szeto J, Yadav R, Zhou JH, Koch K. A multicentre study on grey matter morphometric biomarkers for classifying early schizophrenia and parkinson's disease psychosis. NPJ Parkinsons Dis 2023; 9:87. [PMID: 37291143 PMCID: PMC10250419 DOI: 10.1038/s41531-023-00522-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 05/15/2023] [Indexed: 06/10/2023] Open
Abstract
Psychotic symptoms occur in a majority of schizophrenia patients and in ~50% of all Parkinson's disease (PD) patients. Altered grey matter (GM) structure within several brain areas and networks may contribute to their pathogenesis. Little is known, however, about transdiagnostic similarities when psychotic symptoms occur in different disorders, such as in schizophrenia and PD. The present study investigated a large, multicenter sample containing 722 participants: 146 patients with first episode psychosis, FEP; 106 individuals in at-risk mental state for developing psychosis, ARMS; 145 healthy controls matching FEP and ARMS, Con-Psy; 92 PD patients with psychotic symptoms, PDP; 145 PD patients without psychotic symptoms, PDN; 88 healthy controls matching PDN and PDP, Con-PD. We applied source-based morphometry in association with receiver operating curves (ROC) analyses to identify common GM structural covariance networks (SCN) and investigated their accuracy in identifying the different patient groups. We assessed group-specific homogeneity and variability across the different networks and potential associations with clinical symptoms. SCN-extracted GM values differed significantly between FEP and Con-Psy, PDP and Con-PD, PDN and Con-PD, as well as PDN and PDP, indicating significant overall grey matter reductions in PD and early schizophrenia. ROC analyses showed that SCN-based classification algorithms allow good classification (AUC ~0.80) of FEP and Con-Psy, and fair performance (AUC ~0.72) when differentiating PDP from Con-PD. Importantly, the best performance was found in partly the same networks, including the thalamus. Alterations within selected SCNs may be related to the presence of psychotic symptoms in both early schizophrenia and PD psychosis, indicating some commonality of underlying mechanisms. Furthermore, results provide evidence that GM volume within specific SCNs may serve as a biomarker for identifying FEP and PDP.
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Affiliation(s)
- Franziska Knolle
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | - Shyam S Arumugham
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Roger A Barker
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Azucena Justicia
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Siwei Liu
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
- Department of Neurology, Medstar Georgetown University School of Medicine, Washington, DC, USA
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Jitender Saini
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Jennifer Szeto
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Ravi Yadav
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | - Juan H Zhou
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kathrin Koch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.
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Purcell JR, Brown JW, Tullar RL, Bloomer BF, Kim DJ, Moussa-Tooks AB, Dolan-Bennett K, Bangert BM, Wisner KM, Lundin NB, O'Donnell BF, Hetrick WP. Insular and Striatal Correlates of Uncertain Risky Reward Pursuit in Schizophrenia. Schizophr Bull 2023; 49:726-737. [PMID: 36869757 PMCID: PMC10154703 DOI: 10.1093/schbul/sbac206] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
BACKGROUND AND HYPOTHESIS Risk-taking in specific contexts can be beneficial, leading to rewarding outcomes. Schizophrenia is associated with disadvantageous decision-making, as subjects pursue uncertain risky rewards less than controls. However, it is unclear whether this behavior is associated with more risk sensitivity or less reward incentivization. Matching on demographics and intelligence quotient (IQ), we determined whether risk-taking was more associated with brain activation in regions affiliated with risk evaluation or reward processing. STUDY DESIGN Subjects (30 schizophrenia/schizoaffective disorder, 30 controls) completed a modified, fMRI Balloon Analogue Risk Task. Brain activation was modeled during decisions to pursue risky rewards and parametrically modeled according to risk level. STUDY RESULTS The schizophrenia group exhibited less risky-reward pursuit despite previous adverse outcomes (Average Explosions; F(1,59) = 4.06, P = .048) but the comparable point at which risk-taking was volitionally discontinued (Adjusted Pumps; F(1,59) = 2.65, P = .11). Less activation was found in schizophrenia via whole brain and region of interest (ROI) analyses in the right (F(1,59) = 14.91, P < 0.001) and left (F(1,59) = 16.34, P < 0.001) nucleus accumbens (NAcc) during decisions to pursue rewards relative to riskiness. Risk-taking correlated with IQ in schizophrenia, but not controls. Path analyses of average ROI activation revealed less statistically determined influence of anterior insula upon dorsal anterior cingulate bilaterally (left: χ2 = 12.73, P < .001; right: χ2 = 9.54, P = .002) during risky reward pursuit in schizophrenia. CONCLUSIONS NAcc activation in schizophrenia varied less according to the relative riskiness of uncertain rewards compared to controls, suggesting aberrations in reward processing. The lack of activation differences in other regions suggests similar risk evaluation. Less insular influence on the anterior cingulate may relate to attenuated salience attribution or inability for risk-related brain region collaboration to sufficiently perceive situational risk.
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Affiliation(s)
- John R Purcell
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry, Brain Health Institute, Rutgers University, Piscataway, NJ, USA
| | - Joshua W Brown
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Rachel L Tullar
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Bess F Bloomer
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Dae-Jin Kim
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Alexandra B Moussa-Tooks
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Katherine Dolan-Bennett
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Department of Psychological and Brain Science, Washington University, St. Louise, MO, USA
| | - Brianna M Bangert
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Krista M Wisner
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - Nancy B Lundin
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Brian F O'Donnell
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
| | - William P Hetrick
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
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Knolle F, Sterner E, Moutoussis M, Adams RA, Griffin JD, Haarsma J, Taverne H, Goodyer IM, Fletcher PC, Murray GK. Action selection in early stages of psychosis: an active inference approach. J Psychiatry Neurosci 2023; 48:E78-E89. [PMID: 36810306 PMCID: PMC9949875 DOI: 10.1503/jpn.220141] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/11/2022] [Accepted: 11/28/2022] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND To interact successfully with their environment, humans need to build a model to make sense of noisy and ambiguous inputs. An inaccurate model, as suggested to be the case for people with psychosis, disturbs optimal action selection. Recent computational models, such as active inference, have emphasized the importance of action selection, treating it as a key part of the inferential process. Based on an active inference framework, we sought to evaluate previous knowledge and belief precision in an action-based task, given that alterations in these parameters have been linked to the development of psychotic symptoms. We further sought to determine whether task performance and modelling parameters would be suitable for classification of patients and controls. METHODS Twenty-three individuals with an at-risk mental state, 26 patients with first-episode psychosis and 31 controls completed a probabilistic task in which action choice (go/no-go) was dissociated from outcome valence (gain or loss). We evaluated group differences in performance and active inference model parameters and performed receiver operating characteristic (ROC) analyses to assess group classification. RESULTS We found reduced overall performance in patients with psychosis. Active inference modelling revealed that patients showed increased forgetting, reduced confidence in policy selection and less optimal general choice behaviour, with poorer action-state associations. Importantly, ROC analysis showed fair-to-good classification performance for all groups, when combining modelling parameters and performance measures. LIMITATIONS The sample size is moderate. CONCLUSION Active inference modelling of this task provides further explanation for dysfunctional mechanisms underlying decision-making in psychosis and may be relevant for future research on the development of biomarkers for early identification of psychosis.
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Affiliation(s)
- Franziska Knolle
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Elisabeth Sterner
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Michael Moutoussis
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Rick A Adams
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Juliet D Griffin
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Joost Haarsma
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Hilde Taverne
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Ian M Goodyer
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Paul C Fletcher
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
| | - Graham K Murray
- From the Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany (Knolle, Sterner); the Department of Psychiatry, University of Cambridge, Cambridge, UK (Knolle, Griffin, Taverne, Goodyer, Fletcher, Murray); the Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London, UK (Moutoussis, Adams); the Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (Adams); the Wellcome Centre for Human Neuroimaging, University College London, London, UK (Haarsma); the University of Amsterdam, Amsterdam, NL (Taverne); Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK (Goodyer, Fletcher); Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK (Murray)
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Menon V, Palaniyappan L, Supekar K. Integrative Brain Network and Salience Models of Psychopathology and Cognitive Dysfunction in Schizophrenia. Biol Psychiatry 2022:S0006-3223(22)01637-7. [PMID: 36702660 DOI: 10.1016/j.biopsych.2022.09.029] [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: 03/25/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 01/28/2023]
Abstract
Brain network models of cognitive control are central to advancing our understanding of psychopathology and cognitive dysfunction in schizophrenia. This review examines the role of large-scale brain organization in schizophrenia, with a particular focus on a triple-network model of cognitive control and its role in aberrant salience processing. First, we provide an overview of the triple network involving the salience, frontoparietal, and default mode networks and highlight the central role of the insula-anchored salience network in the aberrant mapping of salient external and internal events in schizophrenia. We summarize the extensive evidence that has emerged from structural, neurochemical, and functional brain imaging studies for aberrancies in these networks and their dynamic temporal interactions in schizophrenia. Next, we consider the hypothesis that atypical striatal dopamine release results in misattribution of salience to irrelevant external stimuli and self-referential mental events. We propose an integrated triple-network salience-based model incorporating striatal dysfunction and sensitivity to perceptual and cognitive prediction errors in the insula node of the salience network and postulate that dysregulated dopamine modulation of salience network-centered processes contributes to the core clinical phenotype of schizophrenia. Thus, a powerful paradigm to characterize the neurobiology of schizophrenia emerges when we combine conceptual models of salience with large-scale cognitive control networks in a unified manner. We conclude by discussing potential therapeutic leads on restoring brain network dysfunction in schizophrenia.
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Affiliation(s)
- Vinod Menon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University School of Medicine, Stanford, California.
| | - Lena Palaniyappan
- Department of Psychiatry and Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Kaustubh Supekar
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University School of Medicine, Stanford, California
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Palaniyappan L. Subcortical Origin of Salience Processing Deficits in Schizophrenia. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 3:6-7. [PMID: 36712574 PMCID: PMC9874130 DOI: 10.1016/j.bpsgos.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 02/01/2023] Open
Affiliation(s)
- Lena Palaniyappan
- Address correspondence to Lena Palaniyappan, M.D., Ph.D., F.R.C.P.C.
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Impairments in goal-directed action and reversal learning in a proportion of individuals with psychosis. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:1390-1403. [PMID: 35915336 PMCID: PMC9622547 DOI: 10.3758/s13415-022-01026-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 01/27/2023]
Abstract
Cognitive impairment in psychosis is one of the strongest predictors of functional decline. Problems with decision-making processes, such as goal-directed action and reversal learning, can reflect cortico-striatal dysfunction. The heterogenous symptoms and neurobiology observed in those with psychosis suggests that specific cognitive phenotypes may reflect differing causative mechanisms. As such, decision-making performance could identify subgroups of individuals with more severe cortico-striatal dysfunction and help to predict their functional decline. The present work evaluated the relationship between goal-directed action, reversal learning, and symptom profiles in those with psychosis. We assessed decision-making processes in healthy controls (N = 34) and those with persistent psychosis (N = 45), subclassifying subjects based on intact/impaired goal-directed action. Compared with healthy controls (<20%), a large proportion (58%) of those with persistent psychosis displayed impaired goal-directed action, predicting poor serial reversal learning performance. Computational approaches indicated that those with impaired goal-directed action had a decreased capacity to rapidly update their prior beliefs in the face of changing contingencies. Impaired decision-making also was associated with reduced levels of grandiosity and increased problems with abstract thinking. These findings suggest that prominent decision-making deficits, indicative of cortico-striatal dysfunction, are present in a large proportion of people with persistent psychosis. Moreover, these impairments would have significant functional implications in terms of planning and abstract thinking.
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