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Mehta UM, Ithal D, Roy N, Shekhar S, Govindaraj R, Ramachandraiah CT, Bolo NR, Bharath RD, Thirthalli J, Venkatasubramanian G, Gangadhar BN, Keshavan MS. Posterior Cerebellar Resting-State Functional Hypoconnectivity: A Neural Marker of Schizophrenia Across Different Stages of Treatment Response. Biol Psychiatry 2024; 96:365-375. [PMID: 38336217 DOI: 10.1016/j.biopsych.2024.01.027] [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: 08/02/2023] [Revised: 01/11/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Identifying stable and consistent resting-state functional connectivity patterns across illness trajectories has the potential to be considered fundamental to the pathophysiology of schizophrenia. We aimed to identify consistent resting-state functional connectivity patterns across heterogeneous schizophrenia groups defined based on treatment response. METHODS In phase 1, we used a cross-sectional case-control design to characterize and compare stable independent component networks from resting-state functional magnetic resonance imaging scans of antipsychotic-naïve participants with first-episode schizophrenia (n = 54) and healthy participants (n = 43); we also examined associations with symptoms, cognition, and disability. In phase 2, we examined the stability (and replicability) of our phase 1 results in 4 groups (N = 105) representing a cross-sequential gradation of schizophrenia based on treatment response: risperidone responders, clozapine responders, clozapine nonresponders, and clozapine nonresponders following electroconvulsive therapy. Hypothesis-free whole-brain within- and between-network connectivity were examined. RESULTS Phase 1 identified posterior and anterior cerebellar hypoconnectivity and limbic hyperconnectivity in schizophrenia at a familywise error rate-corrected cluster significance threshold of p < .01. These network aberrations had unique associations with positive symptoms, cognition, and disability. During phase 2, we replicated the phase 1 results while comparing each of the 4 schizophrenia groups to the healthy participants. The participants in 2 longitudinal subdatasets did not demonstrate a significant change in these network aberrations following risperidone or electroconvulsive therapy. Posterior cerebellar hypoconnectivity (with thalamus and cingulate) emerged as the most consistent finding; it was replicated across different stages of treatment response (Cohen's d range -0.95 to -1.44), reproduced using different preprocessing techniques, and not confounded by educational attainment. CONCLUSIONS Posterior cerebellar-thalamo-cingulate hypoconnectivity is a consistent and stable state-independent neural marker of schizophrenia.
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Affiliation(s)
- Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India.
| | - Dhruva Ithal
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Neelabja Roy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Shreshth Shekhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Ramajayam Govindaraj
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | | | - Nicolas R Bolo
- Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, Massachusetts
| | - Rose Dawn Bharath
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | | | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, Massachusetts
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Avery SN, Rogers BP, McHugo M, Armstrong K, Blackford JU, Vandekar SN, Woodward ND, Heckers S. Hippocampal Network Dysfunction in Early Psychosis: A 2-Year Longitudinal Study. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:979-989. [PMID: 37881573 PMCID: PMC10593896 DOI: 10.1016/j.bpsgos.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/17/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
Background Hippocampal abnormalities are among the most consistent findings in schizophrenia. Numerous studies have reported deficits in hippocampal volume, function, and connectivity in the chronic stage of illness. While hippocampal volume and function deficits are also present in the early stage of illness, there is mixed evidence of both higher and lower functional connectivity. Here, we use graph theory to test the hypothesis that hippocampal network connectivity is broadly lowered in early psychosis and progressively worsens over 2 years. Methods We examined longitudinal resting-state functional connectivity in 140 participants (68 individuals in the early stage of psychosis, 72 demographically similar healthy control individuals). We used an anatomically driven approach to quantify hippocampal network connectivity at 2 levels: 1) a core hippocampal-medial temporal lobe cortex (MTLC) network; and 2) an extended hippocampal-cortical network. Group and time effects were tested in a linear mixed effects model. Results Early psychosis patients showed elevated functional connectivity in the core hippocampal-MTLC network, but contrary to our hypothesis, did not show alterations within the broader hippocampal-cortical network. Hippocampal-MTLC network hyperconnectivity normalized longitudinally and predicted improvement in positive symptoms but was not associated with increasing illness duration. Conclusions These results show abnormally elevated functional connectivity in a core hippocampal-MTLC network in early psychosis, suggesting that selectively increased hippocampal signaling within a localized cortical circuit may be a marker of the early stage of psychosis. Hippocampal-MTLC hyperconnectivity could have prognostic and therapeutic implications.
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Affiliation(s)
- Suzanne N. Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, Tennessee
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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Dominicus LS, van Rijn L, van der A J, van der Spek R, Podzimek D, Begemann M, de Haan L, van der Pluijm M, Otte WM, Cahn W, Röder CH, Schnack HG, van Dellen E. fMRI connectivity as a biomarker of antipsychotic treatment response: A systematic review. Neuroimage Clin 2023; 40:103515. [PMID: 37797435 PMCID: PMC10568423 DOI: 10.1016/j.nicl.2023.103515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Antipsychotic drugs are the first-choice therapy for psychotic episodes, but antipsychotic treatment response (AP-R) is unpredictable and only becomes clear after weeks of therapy. A biomarker for AP-R is currently unavailable. We reviewed the evidence for the hypothesis that functional magnetic resonance imaging functional connectivity (fMRI-FC) is a predictor of AP-R or could serve as a biomarker for AP-R in psychosis. METHOD A systematic review of longitudinal fMRI studies examining the predictive performance and relationship between FC and AP-R was performed following PRISMA guidelines. Technical and clinical aspects were critically assessed for the retrieved studies. We addressed three questions: Q1) is baseline fMRI-FC related to subsequent AP-R; Q2) is AP-R related to a change in fMRI-FC; and Q3) can baseline fMRI-FC predict subsequent AP-R? RESULTS In total, 28 articles were included. Most studies were of good quality. fMRI-FC analysis pipelines included seed-based-, independent component- / canonical correlation analysis, network-based statistics, and graph-theoretical approaches. We found high heterogeneity in methodological approaches and results. For Q1 (N = 17) and Q2 (N = 18), the most consistent evidence was found for FC between the striatum and ventral attention network as a potential biomarker of AP-R. For Q3 (N = 9) accuracy's varied form 50 till 93%, and prediction models were based on FC between various brain regions. CONCLUSION The current fMRI-FC literature on AP-R is hampered by heterogeneity of methodological approaches. Methodological uniformity and further improvement of the reliability and validity of fMRI connectivity analysis is needed before fMRI-FC analysis can have a place in clinical applications of antipsychotic treatment.
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Affiliation(s)
- L S Dominicus
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - L van Rijn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J van der A
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R van der Spek
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D Podzimek
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Begemann
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L de Haan
- Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amsterdam, Amsterdam, The Netherlands
| | - M van der Pluijm
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - W M Otte
- Department of Child Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands
| | - W Cahn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C H Röder
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H G Schnack
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E van Dellen
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Sreeraj VS, Shivakumar V, Bhalerao GV, Kalmady SV, Narayanaswamy JC, Venkatasubramanian G. Resting-state functional connectivity correlates of antipsychotic treatment in unmedicated schizophrenia. Asian J Psychiatr 2023; 82:103459. [PMID: 36682158 DOI: 10.1016/j.ajp.2023.103459] [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: 10/16/2022] [Revised: 01/03/2023] [Accepted: 01/07/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Antipsychotics may modulate the resting state functional connectivity(rsFC) to improve clinical symptoms in schizophrenia(Sz). Existing literature has potential confounders like past medication effects and evaluating preselected regions/networks. We aimed to evaluate connectivity pattern changes with antipsychotics in unmedicated Sz using Multivariate pattern analysis(MVPA), a data-driven technique for whole-brain connectome analysis. METHODS Forty-seven unmedicated patients with Sz(DSM-IV-TR) underwent clinical evaluation and neuroimaging at baseline and after 3-months of antipsychotic treatment. Resting-state functional MRI was analysed using group-MVPA to derive 5-components. The brain region with significant connectivity pattern changes with antipsychotics was identified, and post-hoc seed-to-voxel analysis was performed to identify connectivity changes and their association with symptom changes. RESULTS Connectome-MVPA analysis revealed the connectivity pattern of a cluster localised to left anterior cingulate and paracingulate gyri (ACC/PCG) (peak coordinates:x = -04,y = +30,z = +26;k = 12;cluster-pFWE=0.002) to differ significantly after antipsychotics. Specifically, its connections with clusters of precuneus/posterior cingulate cortex(PCC) and left inferior temporal gyrus(ITG) correlated with improvement in positive and negative symptoms scores, respectively. CONCLUSION ACC/PCG, a hub of the default mode network, seems to mediate the antipsychotic effects in unmedicated Sz. Evaluating causality models with data from randomised controlled design using the MVPA approach would further enhance our understanding of therapeutic connectomics in Sz.
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Affiliation(s)
- Vanteemar S Sreeraj
- InSTAR Clinic and Translational Psychiatry Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.
| | - Venkataram Shivakumar
- InSTAR Clinic and Translational Psychiatry Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India; Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Sunil V Kalmady
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
| | | | - Ganesan Venkatasubramanian
- InSTAR Clinic and Translational Psychiatry Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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McHugo M, Avery S, Armstrong K, Rogers BP, Vandekar SN, Woodward ND, Blackford JU, Heckers S. Anterior hippocampal dysfunction in early psychosis: a 2-year follow-up study. Psychol Med 2023; 53:160-169. [PMID: 33875028 PMCID: PMC8919704 DOI: 10.1017/s0033291721001318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cross-sectional studies indicate that hippocampal function is abnormal across stages of psychosis. Neural theories of psychosis pathophysiology suggest that dysfunction worsens with illness stage. Here, we test the hypothesis that hippocampal function is impaired in the early stage of psychosis and declines further over the next 2 years. METHODS We measured hippocampal function over 2 years using a scene processing task in 147 participants (76 individuals in the early stage of a non-affective psychotic disorder and 71 demographically similar healthy control individuals). Two-year follow-up was completed in 97 individuals (50 early psychosis, 47 healthy control). Voxelwise longitudinal analysis of activation in response to scenes was carried out within a hippocampal region of interest to test for group differences at baseline and a group by time interaction. RESULTS At baseline, we observed lower anterior hippocampal activation in the early psychosis group relative to the healthy control group. Contrary to our hypothesis, hippocampal activation remained consistent and did not show the predicted decline over 2 years in the early psychosis group. Healthy controls showed a modest reduction in hippocampal activation after 2 years. CONCLUSIONS The results of this study suggest that hippocampal dysfunction in early psychosis does not worsen over 2 years and highlight the need for longer-term longitudinal studies.
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Affiliation(s)
- Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, TN, USA
| | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Research and Development, Tennessee Valley Healthcare System, United States Department of Veteran Affairs
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Soldevila-Matías P, García-Martí G, Fuentes-Durá I, Ruiz JC, González-Navarro L, González-Vivas C, Radua J, Sanjuán J. Brain activity changes with emotional words in different stages of psychosis. Eur Psychiatry 2022; 66:e25. [PMID: 36193735 PMCID: PMC10044295 DOI: 10.1192/j.eurpsy.2022.2321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To date, a large number of functional magnetic resonance imaging (fMRI) studies have been conducted on psychosis. However, little is known about changes in brain functioning in psychotic patients using an emotional auditory paradigm at different stages of the disease. Such knowledge is important for advancing our understanding of the disorder and thus creating more targeted interventions. This study aimed to investigate whether individuals with first-episode psychosis (FEP) and chronic schizophrenia show abnormal brain responses to emotional auditory processing and to compare the responses between FEP and chronic schizophrenia. METHODS Patients with FEP (n = 31) or chronic schizophrenia (n = 23) and healthy controls (HCs, n = 31) underwent an fMRI scan while presented with both emotional and nonemotional words. RESULTS Using HC as a reference, patients with FEP showed decreased right temporal activation, while patients with chronic schizophrenia showed increased bilateral temporal activation. When comparing the patient groups, individuals with FEP showed lower frontal lobe activation. CONCLUSION To the best of our knowledge, this is the first study with an emotional auditory paradigm used in psychotic patients at different stages of the disease. Our results suggested that the temporal lobe might be a key issue in the physiopathology of psychosis, although abnormal activation could also be derived from a connectivity problem. There is lower activation in the early stage and evolution to greater activation when patients become chronic. This study highlights the relevance of using emotional paradigms to better understand brain activation at different stages of psychosis.
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Affiliation(s)
- Pau Soldevila-Matías
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain.,Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain.,Department of Psychology, Faculty of Health Sciences, European University of Valencia, Spain
| | - Gracián García-Martí
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain.,Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Valencia, Spain
| | - Inmaculada Fuentes-Durá
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain.,CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Juan Carlos Ruiz
- Department of Behavioural Sciences Methodology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | - Carlos González-Vivas
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Julio Sanjuán
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain.,Department of Psychology, Faculty of Health Sciences, European University of Valencia, Spain.,Department of Psychiatry, University of Valencia School of Medicine, Valencia, Spain
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7
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González-Vivas C, Valdés-Florido MJ, García-Martí G, Soldevila-Matías P, Martí-Bonmatí L, Nacher J, Sanjuan J. How voices change the brain. Two fMRI follow-up case reports. Schizophr Res 2022; 248:329-330. [PMID: 36155306 DOI: 10.1016/j.schres.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/15/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022]
Affiliation(s)
| | | | | | - Pau Soldevila-Matías
- Hospital Clínico Universitario Valencia, INCLIVA, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain; State Reference Center for Psychosocial Rehabilitation (Creap), Valencia, Spain
| | | | - Juan Nacher
- Hospital Clínico Universitario Valencia, INCLIVA, Spain; CIBERSAM, Spain; Universitat de Valencia, Spain
| | - Julio Sanjuan
- Hospital Clínico Universitario Valencia, INCLIVA, Spain; CIBERSAM, Spain; Universitat de Valencia, Spain.
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8
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Soldevila-Matías P, Albajes-Eizagirre A, Radua J, García-Martí G, Rubio JM, Tordesillas-Gutierrez D, Fuentes-Durá I, Solanes A, Fortea L, Oliver D, Sanjuán J. Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:101-116. [PMID: 35840277 DOI: 10.1016/j.rpsmen.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/09/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.
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Affiliation(s)
- Pau Soldevila-Matías
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gracián García-Martí
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain
| | - José M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA
| | - Diana Tordesillas-Gutierrez
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Inmaculada Fuentes-Durá
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Julio Sanjuán
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
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9
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Increased cingulo-orbital connectivity is associated with violent behaviours in schizophrenia. J Psychiatr Res 2022; 147:183-189. [PMID: 35051717 DOI: 10.1016/j.jpsychires.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Although schizophrenia patients are at a heightened risk of exhibiting violent behaviours compared to the general population, few functional neuroimaging studies have explored the aberrant neurocircuitry underpinning such behaviours. This study aimed to identify disrupted resting-state activity and functional connectivity in schizophrenia patients with a history of violence. METHODS Resting state functional magnetic resonance imaging data was collected from 62 schizophrenia patients and 25 healthy controls. Voxel-wise analyses of fractional amplitude of low frequency fluctuations (fALFF) were implemented to investigate disrupted regional patterns of spontaneous brain activity. Brain regions which yielded significant differences between groups were subsequently used as data-driven seeds for functional connectivity analyses. Finally, significant alterations (activity and connectivity) were correlated with lifetime violent behaviours. RESULTS When compared to healthy controls, schizophrenia patients exhibited reduced fALFF in multiple brain regions including the (subgenual) anterior cingulate cortex (ACC), posterior cingulate cortex, precuneus cortex and left lateral orbitofrontal cortex (OFC). Seed-to-voxel analyses yielded significantly enhanced connectivity between the ACC and left OFC. The heightened functional connectivity between the latter two regions predicted the number of violent behaviours reported by schizophrenia patients. CONCLUSION The current study demonstrated that the functional connectivity of brain regions associated with emotion regulation is impaired in schizophrenia and associated with violent antecedents among patients. This result is consistent with predominant theoretical models proposing that the OFC plays a critical role in the neurobiology of violence.
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10
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Stripeikyte G, Potheegadoo J, Progin P, Rognini G, Blondiaux E, Salomon R, Griffa A, Hagmann P, Faivre N, Do KQ, Conus P, Blanke O. Fronto-Temporal Disconnection Within the Presence Hallucination Network in Psychotic Patients With Passivity Experiences. Schizophr Bull 2021; 47:1718-1728. [PMID: 33823042 PMCID: PMC8530400 DOI: 10.1093/schbul/sbab031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Psychosis, characterized by hallucinations and delusions, is a common feature of psychiatric disease, especially schizophrenia. One prominent theory posits that psychosis is driven by abnormal sensorimotor predictions leading to the misattribution of self-related events. This misattribution has been linked to passivity experiences (PE), such as loss of agency and, more recently, to presence hallucinations (PH), defined as the conscious experience of the presence of an alien agent while no person is actually present. PH has been observed in schizophrenia, Parkinson's disease, and neurological patients with brain lesions and, recently, the brain mechanisms of PH (PH-network) have been determined comprising bilateral posterior middle temporal gyrus (pMTG), inferior frontal gyrus (IFG), and ventral premotor cortex (vPMC). Given that the experience of an alien agent is a common feature of PE, we here analyzed the functional connectivity within the PH-network in psychotic patients with (N = 39) vs without PE (N = 26). We observed reduced fronto-temporal functional connectivity in patients with PE compared to patients without PE between the right pMTG and the right and left IFG of the PH-network. Moreover, when seeding from these altered regions, we observed specific alterations with brain regions commonly linked to auditory-verbal hallucinations (such as Heschl's gyrus). The present connectivity findings within the PH-network extend the disconnection hypothesis for hallucinations to the specific case of PH and associates the PH-network with key brain regions for frequent psychotic symptoms such as auditory-verbal hallucinations, showing that PH are relevant to the study of the brain mechanisms of psychosis and PE.
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Affiliation(s)
- Giedre Stripeikyte
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Jevita Potheegadoo
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Pierre Progin
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
- Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Giulio Rognini
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Eva Blondiaux
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Roy Salomon
- Gonda Brain Research Center, Bar Ilan University (BIU), Ramat-Gan, Israel
| | - Alessandra Griffa
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Patric Hagmann
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Nathan Faivre
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Kim Q Do
- Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
- Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Olaf Blanke
- Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
- Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
- Department of Neurology, University Hospital, Geneva, Switzerland
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11
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Chopra S, Francey SM, O’Donoghue B, Sabaroedin K, Arnatkeviciute A, Cropley V, Nelson B, Graham J, Baldwin L, Tahtalian S, Yuen HP, Allott K, Alvarez-Jimenez M, Harrigan S, Pantelis C, Wood SJ, McGorry P, Fornito A. Functional Connectivity in Antipsychotic-Treated and Antipsychotic-Naive Patients With First-Episode Psychosis and Low Risk of Self-harm or Aggression: A Secondary Analysis of a Randomized Clinical Trial. JAMA Psychiatry 2021; 78:994-1004. [PMID: 34160595 PMCID: PMC8223142 DOI: 10.1001/jamapsychiatry.2021.1422] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Altered functional connectivity (FC) is a common finding in resting-state functional magnetic resonance imaging (rs-fMRI) studies of people with psychosis, yet how FC disturbances evolve in the early stages of illness, and how antipsychotic treatment influences these disturbances, remains unknown. OBJECTIVE To investigate longitudinal FC changes in antipsychotic-naive and antipsychotic-treated patients with first-episode psychosis (FEP). DESIGN, SETTING, AND PARTICIPANTS This secondary analysis of a triple-blind, randomized clinical trial was conducted over a 5-year recruitment period between April 2008 and December 2016 with 59 antipsychotic-naive patients with FEP receiving either a second-generation antipsychotic or a placebo pill over a treatment period of 6 months. Participants were required to have low suicidality and aggression, to have a duration of untreated psychosis of less than 6 months, and to be living in stable accommodations with social support. Both FEP groups received intensive psychosocial therapy. A healthy control group was also recruited. Participants completed rs-fMRI scans at baseline, 3 months, and 12 months. Data were analyzed from May 2019 to August 2020. INTERVENTIONS Resting-state functional MRI was used to probe brain FC. Patients received either a second-generation antipsychotic or a matched placebo tablet. Both patient groups received a manualized psychosocial intervention. MAIN OUTCOMES AND MEASURES The primary outcomes of this analysis were to investigate (1) FC differences between patients and controls at baseline; (2) FC changes in medicated and unmedicated patients between baseline and 3 months; and (3) associations between longitudinal FC changes and clinical outcomes. An additional aim was to investigate long-term FC changes at 12 months after baseline. These outcomes were not preregistered. RESULTS Data were analyzed for 59 patients (antipsychotic medication plus psychosocial treatment: 28 [47.5%]; mean [SD] age, 19.5 [3.0] years; 15 men [53.6%]; placebo plus psychosocial treatment: 31 [52.5%]; mean [SD] age, 18.8 [2.7]; 16 men [51.6%]) and 27 control individuals (mean [SD] age, 21.9 [1.9] years). At baseline, patients showed widespread functional dysconnectivity compared with controls, with reductions predominantly affecting interactions between the default mode network, limbic systems, and the rest of the brain. From baseline to 3 months, patients receiving placebo showed increased FC principally within the same systems; some of these changes correlated with improved clinical outcomes (canonical correlation analysis R = 0.901; familywise error-corrected P = .005). Antipsychotic exposure was associated with increased FC primarily between the thalamus and the rest of the brain. CONCLUSIONS AND RELEVANCE In this secondary analysis of a clinical trial, antipsychotic-naive patients with FEP showed widespread functional dysconnectivity at baseline, followed by an early normalization of default mode network and cortical limbic dysfunction in patients receiving placebo and psychosocial intervention. Antipsychotic exposure was associated with FC changes concentrated on thalamocortical networks. TRIAL REGISTRATION ACTRN12607000608460.
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Affiliation(s)
- Sidhant Chopra
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia,Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Shona M. Francey
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Brian O’Donoghue
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kristina Sabaroedin
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia,Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica Graham
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Baldwin
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Steven Tahtalian
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susy Harrigan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia,Department of Social Work, Monash University, Caulfield, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Stephen J. Wood
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia,University of Birmingham School of Psychology, Edgbaston, United Kingdom
| | - Patrick McGorry
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Clayton, Victoria, Australia,Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
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12
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Kraguljac NV, Lahti AC. Neuroimaging as a Window Into the Pathophysiological Mechanisms of Schizophrenia. Front Psychiatry 2021; 12:613764. [PMID: 33776813 PMCID: PMC7991588 DOI: 10.3389/fpsyt.2021.613764] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia is a complex neuropsychiatric disorder with a diverse clinical phenotype that has a substantial personal and public health burden. To advance the mechanistic understanding of the illness, neuroimaging can be utilized to capture different aspects of brain pathology in vivo, including brain structural integrity deficits, functional dysconnectivity, and altered neurotransmitter systems. In this review, we consider a number of key scientific questions relevant in the context of neuroimaging studies aimed at unraveling the pathophysiology of schizophrenia and take the opportunity to reflect on our progress toward advancing the mechanistic understanding of the illness. Our data is congruent with the idea that the brain is fundamentally affected in the illness, where widespread structural gray and white matter involvement, functionally abnormal cortical and subcortical information processing, and neurometabolic dysregulation are present in patients. Importantly, certain brain circuits appear preferentially affected and subtle abnormalities are already evident in first episode psychosis patients. We also demonstrated that brain circuitry alterations are clinically relevant by showing that these pathological signatures can be leveraged for predicting subsequent response to antipsychotic treatment. Interestingly, dopamine D2 receptor blockers alleviate neural abnormalities to some extent. Taken together, it is highly unlikely that the pathogenesis of schizophrenia is uniform, it is more plausible that there may be multiple different etiologies that converge to the behavioral phenotype of schizophrenia. Our data underscore that mechanistically oriented neuroimaging studies must take non-specific factors such as antipsychotic drug exposure or illness chronicity into consideration when interpreting disease signatures, as a clear characterization of primary pathophysiological processes is an imperative prerequisite for rational drug development and for alleviating disease burden in our patients.
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Affiliation(s)
- Nina Vanessa Kraguljac
- Neuroimaging and Translational Research Laboratory, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adrienne Carol Lahti
- Neuroimaging and Translational Research Laboratory, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
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13
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Soldevila-Matías P, Albajes-Eizagirre A, Radua J, García-Martí G, Rubio JM, Tordesillas-Gutierrez D, Fuentes-Durá I, Solanes A, Fortea L, Oliver D, Sanjuán J. Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 15:S1888-9891(20)30100-2. [PMID: 32988773 DOI: 10.1016/j.rpsm.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/02/2020] [Accepted: 08/09/2020] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.
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Affiliation(s)
- Pau Soldevila-Matías
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gracián García-Martí
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain
| | - José M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA
| | - Diana Tordesillas-Gutierrez
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Inmaculada Fuentes-Durá
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Julio Sanjuán
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
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14
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van Dellen E, Börner C, Schutte M, van Montfort S, Abramovic L, Boks MP, Cahn W, van Haren N, Mandl R, Stam CJ, Sommer I. Functional brain networks in the schizophrenia spectrum and bipolar disorder with psychosis. NPJ SCHIZOPHRENIA 2020; 6:22. [PMID: 32879316 PMCID: PMC7468123 DOI: 10.1038/s41537-020-00111-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
Psychotic experiences have been proposed to lie on a spectrum, ranging from subclinical experiences to treatment-resistant schizophrenia. We aimed to characterize functional connectivity and brain network characteristics in relation to the schizophrenia spectrum and bipolar disorder with psychosis to disentangle neural correlates to psychosis. Additionally, we studied antipsychotic medication and lithium effects on network characteristics. We analyzed functional connectivity strength and network topology in 487 resting-state functional MRI scans of individuals with schizophrenia spectrum disorder (SCZ), bipolar disorder with a history of psychotic experiences (BD), treatment-naïve subclinical psychosis (SCP), and healthy controls (HC). Since differences in connectivity strength may confound group comparisons of brain network topology, we analyzed characteristics of the minimum spanning tree (MST), a relatively unbiased backbone of the network. SCZ and SCP subjects had a lower connectivity strength than BD and HC individuals but showed no differences in network topology. In contrast, BD patients showed a less integrated network topology but no disturbances in connectivity strength. No differences in outcome measures were found between SCP and SCZ, or between BD patients that used antipsychotic medication or lithium and those that did not. We conclude that functional networks in patients prone to psychosis have different signatures for chronic SCZ patients and SCP compared to euthymic BD patients, with a limited role for medication. Connectivity strength effects may have confounded previous studies, as no functional network alterations were found in SCZ after strict correction for connectivity strength.
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Affiliation(s)
- Edwin van Dellen
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Corinna Börner
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maya Schutte
- University of Groningen, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
| | - Simone van Montfort
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marco P Boks
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neeltje van Haren
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - René Mandl
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Iris Sommer
- University of Groningen, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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15
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González-Vivas C, García-Martí G, Soldevila-Matías P, Sanz-Requena R, Aguilar EJ, Castro-Bleda MJ, Martí-Bonmatí L, Sanjuan J. First-Episode Psychotic Patients Showed Longitudinal Brain Changes Using fMRI With an Emotional Auditory Paradigm. Front Psychiatry 2020; 11:593042. [PMID: 33424663 PMCID: PMC7794005 DOI: 10.3389/fpsyt.2020.593042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
Most previous longitudinal studies of functional magnetic resonance imaging (fMRI) in first-episode psychosis (FEP) using cognitive paradigm task found an increased activation after antipsychotic medications. We designed an emotional auditory paradigm to explore brain activation during emotional and nonemotional word processing. This study aimed to analyze if longitudinal changes in brain fMRI BOLD activation is present in patients vs. healthy controls. A group of FEP patients (n = 34) received clinical assessment and had a fMRI scan at baseline and follow-up (average, 25-month interval). During the fMRI scan, both emotional and nonemotional words were presented as a block design. Results were compared with a pair of healthy control group (n = 13). Patients showed a decreased activation at follow-up fMRI in amygdala (F = 4.69; p = 0.04) and hippocampus (F = 5.03; p = 0.03) compared with controls. Middle frontal gyrus was the only area that showed a substantial increased activation in patients (F = 4.53; p = 0.04). A great heterogeneity in individual activation patterns was also found. These results support the relevance of the type of paradigm in neuroimaging for psychosis. This is, as far as we know, the first longitudinal study with an emotional auditory paradigm in FEP. Our results suggested that the amygdala and hippocampus play a key role in psychotic disease. More studies are needed to understand the heterogeneity of response at individual level.
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Affiliation(s)
| | - Gracián García-Martí
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Radiology Department, Quirónsalud Hospital, Valencia, Spain
| | - Pau Soldevila-Matías
- INCLIVA Health Research Institute, Clinical University Hospital, Valencia, Spain.,Department of Health Science, Valencia International University, Valencia, Spain
| | | | - Eduardo J Aguilar
- INCLIVA Health Research Institute, Clinical University Hospital, Valencia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, Valencia University, Valencia, Spain
| | | | | | - Julio Sanjuan
- INCLIVA Health Research Institute, Clinical University Hospital, Valencia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Medicine, Valencia University, Valencia, Spain
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16
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Hinney B, Walter A, Aghlmandi S, Andreou C, Borgwardt S. Does Hippocampal Volume Predict Transition to Psychosis in a High-Risk Group? A Meta-Analysis. Front Psychiatry 2020; 11:614659. [PMID: 33519555 PMCID: PMC7840882 DOI: 10.3389/fpsyt.2020.614659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/14/2020] [Indexed: 01/11/2023] Open
Abstract
Schizophrenia has a prodromal phase of several years in most patients, making it possible to identify patients at clinical high risk (CHR) for developing the disorder. So far, these individuals are identified based on clinical criteria alone, and there is no reliable biomarker for predicting the transition to psychosis. It is well-established that reductions in brain volume, especially in the hippocampus, are associated with schizophrenia. Therefore, hippocampal volume may serve as a biomarker for psychosis. Several studies have already investigated hippocampal volume in CHR groups. Based on these studies, the present meta-analysis compares the baseline left and right hippocampal volume of CHR patients who developed a psychosis with that of CHR patients without such a transition. Our results show no statistically significant effect of the hippocampal volume on the transition risk for psychosis.
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Affiliation(s)
- Bernd Hinney
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Anna Walter
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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