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Ma X, Yang WFZ, Zheng W, Li Z, Tang J, Yuan L, Ouyang L, Wang Y, Li C, Jin K, Wang L, Bearden CE, He Y, Chen X. Neuronal dysfunction in individuals at early stage of schizophrenia, A resting-state fMRI study. Psychiatry Res 2023; 322:115123. [PMID: 36827856 DOI: 10.1016/j.psychres.2023.115123] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
Schizophrenia has been associated with abnormal intrinsic brain activity, involving various cognitive impairments. Qualitatively similar abnormalities are seen in individuals at ultra-high risk (UHR) for psychosis. In this study, resting-state fMRI (rs-fMRI) data were collected from 44 drug-naïve first-episode schizophrenia (Dn-FES) patients, 48 UHR individuals, and 40 healthy controls (HCs). The fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and functional connectivity (FC), were performed to evaluate resting brain function. A support vector machine (SVM) was applied for classification analysis. Compared to HCs, both clinical groups showed increased fALFF in the central executive network (CEN), decreased ReHo in the ventral visual pathway (VVP) and decreased FC in temporal-sensorimotor regions. Excellent performance was achieved by using fALFF value in distinguishing both FES (sensitivity=83.21%, specificity=80.58%, accuracy=81.37%, p=0.009) and UHR (sensitivity=75.88%, specificity=85.72%, accuracy=80.72%, p<0.001) from HC group. Moreover, the study highlighted the importance of frontal and temporal alteration in the pathogenesis of schizophrenia. However, no fMRI features were observed that could well distinguish Dn-FES from UHR group. To conclude, fALFF in the CEN may provide potential power for identifying individuals at the early stage of schizophrenia and the alteration in the frontal and temporal lobe may be important to these individuals.
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Affiliation(s)
- Xiaoqian Ma
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, United States
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, United States
| | - Wenxiao Zheng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Department of Clinical Medicine, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zongchang Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Jinsong Tang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Liu Yuan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Lijun Ouyang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Yujue Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Chunwang Li
- Department of Radiology, Hunan Children's Hospital, Changsha, China
| | - Ke Jin
- Department of Radiology, Hunan Children's Hospital, Changsha, China
| | - Lingyan Wang
- Department of Deratology&Traditional Chinese Medicine, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital)
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, United States
| | - Ying He
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; National Technology Institute of Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Hunan Medical Center for Mental Health, Changsha, Hunan, China.
| | - Xiaogang Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; National Technology Institute of Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Hunan Medical Center for Mental Health, Changsha, Hunan, China.
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2
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Prieto-Alcántara M, Ibáñez-Molina A, Crespo-Cobo Y, Molina R, Soriano MF, Iglesias-Parro S. Alpha and gamma EEG coherence during on-task and mind wandering states in schizophrenia. Clin Neurophysiol 2023; 146:21-29. [PMID: 36495599 DOI: 10.1016/j.clinph.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/12/2022] [Accepted: 11/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Electroencephalographic (EEG) coherence is one of the most relevant physiological measures used to detect abnormalities in patients with schizophrenia. The present study applies a task-related EEG coherence approach to understand cognitive processing in patients with schizophrenia and healthy controls. METHODS EEG coherence for alpha and gamma frequency bands was analyzed in a group of patients with schizophrenia and a group of healthy controls during the performance of an ecological task of sustained attention. We compared EEG coherence when participants presented externally directed cognitive states (On-Task) and when they presented cognitive distraction episodes (Mind-Wandering). RESULTS Results reflect cortical differences between groups (higher coherence for schizophrenia in the frontocentral and fronto-temporal regions, and higher coherence for healthy-controls in the postero-central regions), especially in the On-Task condition for the alpha band, compared to Mind-Wandering episodes. Few individual differences in gamma coherence were found. CONCLUSIONS The current study provides evidence of neurophysiological differences underlying different cognitive states in schizophrenia and healthy controls. SIGNIFICANCE Differences between groups may reflect inhibitory processes necessary for the successful processing of information, especially in the alpha band, given its role in cortical inhibition processes. Patients may activate compensatory inhibitory mechanisms when performing the task, reflected in increased coherence in fronto-temporal regions.
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Affiliation(s)
| | | | | | - Rosa Molina
- Psychology Department, University of Jaén, 23071 Jaén, Spain
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3
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van Gool KCA, Collin G, Bauer CCC, Molokotos E, Mesholam-Gately RI, Thermenos HW, Seidman LJ, Gabrieli JDE, Whitfield-Gabrieli S, Keshavan MS. Altered working memory-related brain activity in children at familial high risk for psychosis: A preliminary study. Schizophr Res 2022; 240:186-192. [PMID: 35032903 DOI: 10.1016/j.schres.2021.12.030] [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: 05/06/2021] [Revised: 10/03/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Schizophrenia spectrum disorders are heritable illnesses that usually manifest in early adulthood but are increasingly viewed as neurodevelopmental disorders. Functional magnetic resonance imaging (fMRI) studies show altered brain activity during performance of working memory (WM) tasks in both individuals with schizophrenia and their first-degree relatives as compared to healthy controls (HC). This study examined whether similar changes are already present in pre-adolescent children at familial high-risk (FHR) for psychosis. METHODS 37 children (17 FHR, 20 HC) between 7 and 12 years old participated in this study. WM performance was assessed using the Wechsler Intelligence Scale for Children-IV (WISC-IV). To assess brain activation during WM performance, participants completed a visual block-designed n-back task with 2 conditions (2-back and 0-back) during scanning. fMRI data was preprocessed and analyzed using FSL Feat. RESULTS Compared to HC, FHR children showed significantly lower WISC-IV WM scores. In addition, FHR children exhibited hypoactivation in the 2-back (versus 0-back) condition in a cluster encompassing bilateral precuneus and cuneus and right posterior cingulate cortex. There were no significant group-differences in n-back task performance and brain activation. The precuneus cluster was not correlated with n-back performance or WISC WM scores. CONCLUSIONS The current results provide preliminary evidence of impaired WM function and altered brain activity during WM performance in children with a familial predisposition for psychosis. Longitudinal studies are needed to determine whether these findings are related to abnormal brain development and predictive of cognitive deficits and psychosis later in life.
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Affiliation(s)
- Kevin C A van Gool
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands.
| | - Guusje Collin
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands; Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Clemens C C Bauer
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychology, Northeastern University, Boston, MA, USA
| | - Elena Molokotos
- Department of Psychology, Suffolk University, Boston, MA, USA
| | | | - Heidi W Thermenos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - John D E Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychology, Northeastern University, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Mental Health, Massachusetts Mental Health Center, Boston, MA, USA
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Meyers JL, Chorlian DB, Bigdeli TB, Johnson EC, Aliev F, Agrawal A, Almasy L, Anokhin A, Edenberg HJ, Foroud T, Goate A, Kamarajan C, Kinreich S, Nurnberger J, Pandey AK, Pandey G, Plawecki MH, Salvatore JE, Zhang J, Fanous A, Porjesz B. The association of polygenic risk for schizophrenia, bipolar disorder, and depression with neural connectivity in adolescents and young adults: examining developmental and sex differences. Transl Psychiatry 2021; 11:54. [PMID: 33446638 PMCID: PMC7809462 DOI: 10.1038/s41398-020-01185-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 02/03/2023] Open
Abstract
Neurodevelopmental abnormalities in neural connectivity have been long implicated in the etiology of schizophrenia (SCZ); however, it remains unclear whether these neural connectivity patterns are associated with genetic risk for SCZ in unaffected individuals (i.e., an absence of clinical features of SCZ or a family history of SCZ). We examine whether polygenic risk scores (PRS) for SCZ are associated with functional neural connectivity in adolescents and young adults without SCZ, whether this association is moderated by sex and age, and if similar associations are observed for genetically related neuropsychiatric PRS. One-thousand four-hundred twenty-six offspring from 913 families, unaffected with SCZ, were drawn from the Collaborative Study of the Genetics of Alcoholism (COGA) prospective cohort (median age at first interview = 15.6 (12-26), 51.6% female, 98.1% European American, 41% with a family history of alcohol dependence). Participants were followed longitudinally with resting-state EEG connectivity (i.e., coherence) assessed every two years. Higher SCZ PRS were associated with elevated theta (3-7 Hz) and alpha (7-12 Hz) EEG coherence. Associations differed by sex and age; the most robust associations were observed between PRS and parietal-occipital, central-parietal, and frontal-parietal alpha coherence among males between ages 15-19 (B: 0.15-0.21, p < 10-4). Significant associations among EEG coherence and Bipolar and Depression PRS were observed, but differed from SCZ PRS in terms of sex, age, and topography. Findings reveal that polygenic risk for SCZ is robustly associated with increased functional neural connectivity among young adults without a SCZ diagnosis. Striking differences were observed between men and women throughout development, mapping onto key periods of risk for the onset of psychotic illness and underlining the critical importance of examining sex differences in associations with neuropsychiatric PRS across development.
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Affiliation(s)
- J. L. Meyers
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - D. B. Chorlian
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - T. B. Bigdeli
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - E. C. Johnson
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - F. Aliev
- grid.224260.00000 0004 0458 8737Department of Psychology & College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA 23284 USA ,grid.440448.80000 0004 0384 3505Faculty of Business, Karabuk University, Karabuk, Turkey
| | - A. Agrawal
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - L. Almasy
- grid.25879.310000 0004 1936 8972Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - A. Anokhin
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - H. J. Edenberg
- grid.257413.60000 0001 2287 3919Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202 USA ,grid.257413.60000 0001 2287 3919Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - T. Foroud
- grid.257413.60000 0001 2287 3919Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - A. Goate
- grid.59734.3c0000 0001 0670 2351Departments of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA ,grid.59734.3c0000 0001 0670 2351Departments of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - C. Kamarajan
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - S. Kinreich
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - J. Nurnberger
- grid.257413.60000 0001 2287 3919Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - A. K. Pandey
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - G. Pandey
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - M. H. Plawecki
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110 USA ,grid.257413.60000 0001 2287 3919Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - J. E. Salvatore
- grid.224260.00000 0004 0458 8737Department of Psychology & College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, VA 23284 USA ,grid.224260.00000 0004 0458 8737Virginia Institute of Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23284 USA
| | - J. Zhang
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - A. Fanous
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
| | - B. Porjesz
- grid.189747.40000 0000 9554 2494Department of Psychiatry, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203 USA
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Avery SN, McHugo M, Armstrong K, Blackford JU, Vandekar S, Woodward ND, Heckers S. Habituation during encoding: A new approach to the evaluation of memory deficits in schizophrenia. Schizophr Res 2020; 223:179-185. [PMID: 32736836 PMCID: PMC7704891 DOI: 10.1016/j.schres.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/30/2020] [Accepted: 07/16/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Memory is significantly impaired in schizophrenia. However, memory measures are often complex and confounded by additional impairments such as motivation and task comprehension, which can affect behavioral performance and obscure neural function during memory tasks. Neural signatures of memory encoding that are robust to potential confounds may shed additional light on neural deficits contributing to memory impairment in schizophrenia. METHODS Here, we investigate a potential neural signature of memory-habituation-and its relationship with healthy and impaired memory function. To limit potential confounds, we used a passive depth of encoding memory task designed to elicit neural responses associated with memory encoding while limiting other cognitive demands. To determine whether habituation during encoding was predictive of intact memory processing, we first compared neural habituation over repeated encoding exposures with subsequent explicit memory in healthy individuals. We then tested whether a similar relationship existed in patients with schizophrenia. RESULTS Explicit memory performance was impaired in patients with schizophrenia relative to healthy control subjects. In healthy participants, more habituation over repeated exposures during encoding was associated with greater repetition-related increases in accuracy during testing. However, in patients with schizophrenia, better performance was associated with less habituation, or a more sustained neural response during encoding. CONCLUSIONS These results suggest that sustained neural activity is required for normal repetition-related improvements in memory performance in schizophrenia, in line with a neural inefficiency model. Habituation may serve as a valuable index of neural processes that underlie behavioral memory performance.
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Affiliation(s)
- Suzanne N. Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Jennifer U. Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
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Cortical hyperactivation at low working memory load: A primary processing abnormality in people with schizophrenia? NEUROIMAGE-CLINICAL 2020; 26:102270. [PMID: 32388334 PMCID: PMC7210598 DOI: 10.1016/j.nicl.2020.102270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/01/2020] [Accepted: 04/20/2020] [Indexed: 11/20/2022]
Abstract
A frequent finding when studying substrates of working memory (WM) deficits in people with schizophrenia (PSZ) is task-induced hyperactivation relative to healthy control subjects (HCS) when WM load is low. Hyperactivation accompanying similar performance is commonly attributed to cognitive deficits rendering relatively easy operations more resource-consuming. To test if hyperactivation at low load really is secondary to cognitive impairment in PSZ, we re-analyzed functional MRI data showing left posterior parietal cortex (PPC) hyperactivation in PSZ when holding a single color-item in WM. In subgroups matched for the number of items successfully stored in WM (K) by excluding the highest-performing HCS and lowest-performing PSZ, performance was almost identical across all set sizes (1-7). While BOLD activation at the larger set sizes did not differ between groups, PSZ still robustly hyperactivated left PPC when a single item had to be maintained. The same pattern was observed in subgroups matched for model-based estimates of WM capacity or attentional lapse rate. Given that in the K-matched subsamples PSZ performed as well as HCS even in the most challenging load conditions and that no BOLD signal difference was seen at high loads, it is implausible that PSZ over-recruited WM-related neural structures because they were more challenged by maintaining a single item in WM. Instead, the findings are consistent with a primary schizophrenia-related processing abnormality as proposed by the hyperfocusing hypothesis, which suggests that an abnormally narrow but intense focusing of processing resources is central to many aspects of impaired cognition in PSZ.
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7
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Polymorphisms in CRYBB2 encoding βB2-crystallin are associated with antisaccade performance and memory function. Transl Psychiatry 2020; 10:113. [PMID: 32317624 PMCID: PMC7174396 DOI: 10.1038/s41398-020-0791-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 02/03/2023] Open
Abstract
βB2-crystallin (gene symbol: Crybb2/CRYBB2) was first described as a structural protein of the ocular lens before it was detected in various brain regions of the mouse, including the hippocampus and the cerebral cortex. Mutations in the mouse Crybb2 gene lead to alterations of sensorimotor gating measured as prepulse inhibition (PPI) and reduced hippocampal size, combined with an altered number of parvalbumin-positive GABAergic interneurons. Decreased PPI and alterations of parvalbumin-positive interneurons are also endophenotypes that typically occur in schizophrenia. To verify the results found in mice, we genotyped 27 single nucleotide polymorphisms (SNPs) within the CRYBB2 gene and its flanking regions and investigated different schizophrenia typical endophenotypes in a sample of 510 schizophrenia patients and 1322 healthy controls. In the case-control study, no association with schizophrenia was found. However, 3 of the 4 investigated haplotype blocks indicated a decreased CRYBB2 mRNA expression. Two of these blocks were associated with poorer antisaccade task performance and altered working memory-linked functional magnetic resonance imaging signals. For the two haplotypes associated with antisaccade performance, suggestive evidence was found with visual memory and in addition, haplotype block 4 showed a nominally significant association with reduced sensorimotor gating, measured as P50 ratio. These results were not schizophrenia-specific, but could be detected in a combined sample of patients and healthy controls. This is the first study to demonstrate the importance of βB2-crystallin for antisaccade performance and memory function in humans and therefore provides implications for βB2-crystallin function in the human brain.
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8
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Hasan A, Roeh A, Leucht S, Langguth B, Hansbauer M, Oviedo-Salcedo T, Kirchner SK, Papazova I, Löhrs L, Wagner E, Maurus I, Strube W, Rossner MJ, Wehr MC, Bauer I, Heres S, Leucht C, Kreuzer PM, Zimmermann S, Schneider-Axmann T, Görlitz T, Karch S, Egert-Schwender S, Schossow B, Rothe P, Falkai P. Add-on spironolactone as antagonist of the NRG1-ERBB4 signaling pathway for the treatment of schizophrenia: Study design and methodology of a multicenter randomized, placebo-controlled trial. Contemp Clin Trials Commun 2020; 17:100537. [PMID: 32072071 PMCID: PMC7013159 DOI: 10.1016/j.conctc.2020.100537] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/18/2020] [Accepted: 01/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Preclinical studies recently showed that the mineralocorticoid antagonist spironolactone acts also as an antagonist of the NRG1-ERBB4 signaling pathway and improves schizophrenia-like behaviour in Nrg1 transgenic mouse model. As this signaling pathway is critically linked to the pathophysiology of schizophrenia, especially in the context of working-memory dysfunction, spironolactone may be a novel treatment option for patients with schizophrenia targeting cognitive impairments. AIMS To evaluate whether spironolactone added to an ongoing antipsychotic treatment improves cognitive functioning in schizophrenia. METHODS The add-on spironolactone for the treatment of schizophrenia trial (SPIRO-TREAT) is a multicenter randomized, placebo-controlled trial with three arms (spironolactone 100 mg, spironolactone 200 mg and placebo). Schizophrenia patients are treated for three weeks and then followed-up for additional nine weeks. As primary outcome, we investigate changes in working memory before and at the end of the intervention phase. We will randomize 90 patients. Eighty-one patients are intended to reach the primary endpoint measure at the end of the three-week intervention period. Secondary endpoints include other measures of cognition, psychopathology, safety measures and biological measures. CONCLUSIONS SPIRO-TREAT is the first study evaluating the efficacy of the mineralocorticoid receptor antagonist spironolactone to improve cognitive impairments in schizophrenia patients targeting the NRG1-ERBB4 signaling pathway. With SPIRO-TREAT, we intend to investigate a novel treatment option for cognitive impairments in schizophrenia that goes beyond the established concepts of interfering with dopaminergic neurotransmission as key pathway in schizophrenia treatment. CLINICAL TRIAL REGISTRATION International Clinical Trials Registry Platform: http://apps.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2014-001968-35-DE.
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Affiliation(s)
- Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Astrid Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Maximilian Hansbauer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Tatiana Oviedo-Salcedo
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Sophie K. Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Irina Papazova
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Lisa Löhrs
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Wolfgang Strube
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Moritz J. Rossner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Michael C. Wehr
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Ingrid Bauer
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Stephan Heres
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Claudia Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | | | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Thomas Görlitz
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Silvia Egert-Schwender
- Münchner Studienzentrum, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Beate Schossow
- Münchner Studienzentrum, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Philipp Rothe
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
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9
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Saarinen AIL, Huhtaniska S, Pudas J, Björnholm L, Jukuri T, Tohka J, Granö N, Barnett JH, Kiviniemi V, Veijola J, Hintsanen M, Lieslehto J. Structural and functional alterations in the brain gray matter among first-degree relatives of schizophrenia patients: A multimodal meta-analysis of fMRI and VBM studies. Schizophr Res 2020; 216:14-23. [PMID: 31924374 DOI: 10.1016/j.schres.2019.12.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We conducted a multimodal coordinate-based meta-analysis (CBMA) to investigate structural and functional brain alterations in first-degree relatives of schizophrenia patients (FRs). METHODS We conducted a systematic literature search from electronic databases to find studies that examined differences between FRs and healthy controls using whole-brain functional magnetic resonance imaging (fMRI) or voxel-based morphometry (VBM). A CBMA of 30 fMRI (754 FRs; 959 controls) and 11 VBM (885 FRs; 775 controls) datasets were conducted using the anisotropic effect-size version of signed differential mapping. Further, we conducted separate meta-analyses about functional alterations in different cognitive tasks: social cognition, executive functioning, working memory, and inhibitory control. RESULTS FRs showed higher fMRI activation in the right frontal gyrus during cognitive tasks than healthy controls. In VBM studies, there were no differences in gray matter density between FRs and healthy controls. Furthermore, multi-modal meta-analysis obtained no differences between FRs and healthy controls. By utilizing the BrainMap database, we showed that the brain region which showed functional alterations in FRs (i) overlapped only slightly with the brain regions that were affected in the meta-analysis of schizophrenia patients and (ii) correlated positively with the brain regions that exhibited increased activity during cognitive tasks in healthy individuals. CONCLUSIONS Based on this meta-analysis, FRs may exhibit only minor functional alterations in the brain during cognitive tasks, and the alterations are much more restricted and only slightly overlapping with the regions that are affected in schizophrenia patients. The familial risk did not relate to structural alterations in the gray matter.
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Affiliation(s)
- Aino I L Saarinen
- Research Unit of Psychology, University of Oulu, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland; Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Finland.
| | - Sanna Huhtaniska
- Center for Life Course Health Research, University of Oulu, Finland
| | - Juho Pudas
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Finland
| | - Lassi Björnholm
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Finland
| | - Tuomas Jukuri
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Finland
| | - Jussi Tohka
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Niklas Granö
- Helsinki University Hospital, Department of Adolescent Psychiatry, Finland
| | - Jennifer H Barnett
- Cambridge Cognition, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Juha Veijola
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Johannes Lieslehto
- Center for Life Course Health Research, University of Oulu, Finland; Section for Neurodiagnostic Applications, Department of Psychiatry, Ludwig Maximilian University, Nussbaumstrasse 7, 80336 Munich, Bavaria, Germany
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10
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Kim S, Kim YW, Shim M, Jin MJ, Im CH, Lee SH. Altered Cortical Functional Networks in Patients With Schizophrenia and Bipolar Disorder: A Resting-State Electroencephalographic Study. Front Psychiatry 2020; 11:661. [PMID: 32774308 PMCID: PMC7388793 DOI: 10.3389/fpsyt.2020.00661] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/25/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pathologies of schizophrenia and bipolar disorder have been poorly understood. Brain network analysis could help understand brain mechanisms of schizophrenia and bipolar disorder. This study investigates the source-level brain cortical networks using resting-state electroencephalography (EEG) in patients with schizophrenia and bipolar disorder. METHODS Resting-state EEG was measured in 38 patients with schizophrenia, 34 patients with bipolar disorder type I, and 30 healthy controls. Graph theory based source-level weighted functional networks were evaluated: strength, clustering coefficient (CC), path length (PL), and efficiency in six frequency bands. RESULTS At the global level, patients with schizophrenia or bipolar disorder showed higher strength, CC, and efficiency, and lower PL in the theta band, compared to healthy controls. At the nodal level, patients with schizophrenia or bipolar disorder showed higher CCs, mostly in the frontal lobe for the theta band. Particularly, patients with schizophrenia showed higher nodal CCs in the left inferior frontal cortex and the left ascending ramus of the lateral sulcus compared to patients with bipolar disorder. In addition, the nodal-level theta band CC of the superior frontal gyrus and sulcus (cognition-related region) correlated with positive symptoms and social and occupational functioning scale (SOFAS) scores in the schizophrenia group, while that of the middle frontal gyrus (emotion-related region) correlated with SOFAS scores in the bipolar disorder group. CONCLUSIONS Altered cortical networks were revealed and these alterations were significantly correlated with core pathological symptoms of schizophrenia and bipolar disorder. These source-level cortical network indices could be promising biomarkers to evaluate patients with schizophrenia and bipolar disorder.
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Affiliation(s)
- Sungkean Kim
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Yong-Wook Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Miseon Shim
- Institute of Industrial Technology, Korea University, Sejong, South Korea
| | - Min Jin Jin
- Department of Psychiatry, Wonkwang University Hospital, Iksan, South Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Psychiatry, Inje University Ilsan Paik Hospital, Ilsan, South Korea
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11
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Kelly S, Guimond S, Lyall A, Stone WS, Shenton ME, Keshavan M, Seidman LJ. Neural correlates of cognitive deficits across developmental phases of schizophrenia. Neurobiol Dis 2018; 131:104353. [PMID: 30582983 DOI: 10.1016/j.nbd.2018.12.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 11/21/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022] Open
Abstract
Schizophrenia is associated with cognitive deficits across all stages of the illness (i.e., high risk, first episode, early and chronic phases). Identifying the underlying neurobiological mechanisms of these deficits is an important area of scientific inquiry. Here, we selectively review evidence regarding the pattern of deficits across the developmental trajectory of schizophrenia using the five cognitive domains identified by the Research Domain Criteria (RDoC) initiative. We also report associated findings from neuroimaging studies. We suggest that most cognitive domains are affected across the developmental trajectory, with corresponding brain structural and/or functional differences. The idea of a common mechanism driving these deficits is discussed, along with implications for cognitive treatment in schizophrenia.
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Affiliation(s)
- Sinead Kelly
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Synthia Guimond
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Amanda Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - William S Stone
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Matcheri Keshavan
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Larry J Seidman
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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12
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Hahn B, Harvey AN, Gold JM, Ross TJ, Stein EA. Load-dependent hyperdeactivation of the default mode network in people with schizophrenia. Schizophr Res 2017; 185:190-196. [PMID: 28073606 PMCID: PMC6104387 DOI: 10.1016/j.schres.2017.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/28/2016] [Accepted: 01/01/2017] [Indexed: 02/01/2023]
Abstract
Schizophrenia is associated with impairment in a range of cognitive functions. Neuroimaging studies have reported lower, but also higher, task-induced activation accompanying impaired performance. Differences in task-load and the ability of people with schizophrenia (PSZ) to stay engaged in the cognitive operations probed appear to underlie such discrepancies. Similarly, task-induced deactivation of the default mode network (DMN) was weaker in PSZ relative to healthy control subjects (HCS) in most studies, but some reported greater deactivation. An inability to stay engaged in the cognitive operations could account for these discrepancies, too, as it would lead to more time off-task and consequently less deactivation of DMN functions. The present study employed a change detection paradigm with small to moderate set sizes (SSs) of 1, 2, and 4 items. Task training prior to fMRI scanning abolished the group difference in no-response trials. Task-positive regions of interest (ROIs) displayed greater activation with increasing SS in both groups. PSZ showed greater activation relative to HCS at SSs 1 and 2. DMN ROIs displayed greater deactivation with increasing SS in PSZ, but not in HCS, and PSZ tended to hyperdeactivate DMN regions at SS 4. No hypodeactivation was observed in PSZ. In conclusion, when minimizing differences in task-engagement, PSZ tend to over-recruit task-positive regions during low-load operations, and hyperdeactivate DMN functions at higher load, perhaps reflecting heightened non-specific vigilance or effort when dealing with cognitive challenges. This speaks against an inability to down-regulate task-independent thought processes as a primary mechanism underlying cognitive impairment in schizophrenia.
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Affiliation(s)
- Britta Hahn
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD 21228, USA.
| | - Alexander N Harvey
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD 21228, USA.
| | - James M Gold
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD 21228, USA.
| | - Thomas J Ross
- National Institute on Drug Abuse - Intramural Research Program, Neuroimaging Research Branch, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA.
| | - Elliot A Stein
- National Institute on Drug Abuse - Intramural Research Program, Neuroimaging Research Branch, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, USA.
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13
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Zhang R, Picchioni M, Allen P, Toulopoulou T. Working Memory in Unaffected Relatives of Patients With Schizophrenia: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies. Schizophr Bull 2016; 42:1068-77. [PMID: 26738528 PMCID: PMC4903055 DOI: 10.1093/schbul/sbv221] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Working memory deficits, a core cognitive feature of schizophrenia may arise from dysfunction in the frontal and parietal cortices. Numerous studies have also found abnormal neural activation during working memory tasks in patients' unaffected relatives. The aim of this study was to systematically identify and anatomically localize the evidence for those activation differences across all eligible studies. Fifteen functional magnetic resonance imaging (fMRI) manuscripts, containing 16 samples of 289 unaffected relatives of patients with schizophrenia, and 358 healthy controls were identified that met our inclusion criteria: (1) used a working memory task; and (2) reported standard space coordinates. Activation likelihood estimation (ALE) identified convergence across studies. Compared to healthy controls, patients' unaffected relatives showed decreases in neural activation in the right middle frontal gyrus (BA9), as well as right inferior frontal gyrus (BA44). Increased activation was seen in relatives in the right frontopolar (BA10), left inferior parietal lobe (BA40), and thalamus bilaterally. These results suggest that the familial risk of schizophrenia is expressed in changes in neural activation in the unaffected relatives in the cortical-subcortical working memory network that includes, but is not restricted to the middle prefrontal cortex.
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Affiliation(s)
- Ruibin Zhang
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Marco Picchioni
- St Andrew’s Academic Department, Northampton, UK;,Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, London, UK
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, UK;,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Timothea Toulopoulou
- Department of Psychology, The University of Hong Kong, Hong Kong, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Department of Psychology, Bilkent University, Ankara, Turkey; Department of Basic and Clinical Neuroscience, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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14
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Rodrigue AL, Austin BP, Dyckman KA, McDowell JE. Brain activation differences in schizophrenia during context-dependent processing of saccade tasks. Behav Brain Funct 2016; 12:19. [PMID: 27342314 PMCID: PMC4919833 DOI: 10.1186/s12993-016-0103-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 06/15/2016] [Indexed: 11/23/2022] Open
Abstract
Background Brain function in schizophrenia has been probed using saccade paradigms and functional magnetic resonance imaging, but little information exists about how changing task context impacts saccade related brain activation and behavioral performance. We recruited schizophrenia and comparison subjects to perform saccade tasks in differing contexts: (1) two single task runs (anti- or pro-saccades alternating with fixation) and (2) one dual task run (antisaccades alternating with prosaccades). Results Context-dependent differences in saccade circuitry were evaluated using ROI analyses. Distinction between anti- and pro-saccade activation across contexts (single versus dual task) suggests that the schizophrenia group did not respond to context in the same way as the comparison group. Conclusions Further investigation of context processing effects on brain activation and saccade performance measures informs models of cognitive deficits in the disorder and enhances understanding of antisaccades as a potential endophenotype for schizophrenia. Electronic supplementary material The online version of this article (doi:10.1186/s12993-016-0103-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A L Rodrigue
- Department of Psychology, University of Georgia, Psychology Building 125 Baldwin Street, Athens, GA, 30602, USA
| | - B P Austin
- Department of Psychology, University of Georgia, Psychology Building 125 Baldwin Street, Athens, GA, 30602, USA.,Department of Medicine, School of Medicine and Public Health, University of Wisconsin, 2500 Overlook Terrace, Madison, WI, 53705, USA
| | - K A Dyckman
- Department of Psychology, University of Georgia, Psychology Building 125 Baldwin Street, Athens, GA, 30602, USA
| | - J E McDowell
- Department of Psychology, University of Georgia, Psychology Building 125 Baldwin Street, Athens, GA, 30602, USA.
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15
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Landin-Romero R, McKenna PJ, Salgado-Pineda P, Sarró S, Aguirre C, Sarri C, Compte A, Bosque C, Blanch J, Salvador R, Pomarol-Clotet E. Failure of deactivation in the default mode network: a trait marker for schizophrenia? Psychol Med 2015; 45:1315-1325. [PMID: 25331916 DOI: 10.1017/s0033291714002426] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Functional imaging studies in relatives of schizophrenic patients have had inconsistent findings, particularly with respect to altered dorsolateral prefrontal cortex activation. Some recent studies have also suggested that failure of deactivation may be seen. METHOD A total of 28 patients with schizophrenia, 28 of their siblings and 56 healthy controls underwent functional magnetic resonance imaging during performance of the n-back working memory task. An analysis of variance was fitted to individual whole-brain maps from each set of patient-relative-matched pair of controls. Clusters of significant difference among the groups were then used as regions of interest to compare mean activations and deactivations among the groups. RESULTS In all, five clusters of significant differences were found. The schizophrenic patients, but not the relatives, showed reduced activation compared with the controls in the lateral frontal cortex bilaterally, the left basal ganglia and the cerebellum. In contrast, both the patients and the relatives showed significant failure of deactivation compared with the healthy controls in the medial frontal cortex, with the relatives also showing less failure than the patients. Failure of deactivation was not associated with schizotypy scores or presence of psychotic-like experiences in the relatives. CONCLUSIONS Both schizophrenic patients and their relatives show altered task-related deactivation in the medial frontal cortex. This in turn suggests that default mode network dysfunction may function as a trait marker for schizophrenia.
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Affiliation(s)
| | - P J McKenna
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | | | - S Sarró
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - C Aguirre
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - C Sarri
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - A Compte
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - C Bosque
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - J Blanch
- Hospital Sant Joan de Déu Infantil,Barcelona,Spain
| | - R Salvador
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
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16
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Schmidt A, Diwadkar VA, Smieskova R, Harrisberger F, Lang UE, McGuire P, Fusar-Poli P, Borgwardt S. Approaching a network connectivity-driven classification of the psychosis continuum: a selective review and suggestions for future research. Front Hum Neurosci 2015; 8:1047. [PMID: 25628553 PMCID: PMC4292722 DOI: 10.3389/fnhum.2014.01047] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/15/2014] [Indexed: 01/07/2023] Open
Abstract
Brain changes in schizophrenia evolve along a dynamic trajectory, emerging before disease onset and proceeding with ongoing illness. Recent investigations have focused attention on functional brain interactions, with experimental imaging studies supporting the disconnection hypothesis of schizophrenia. These studies have revealed a broad spectrum of abnormalities in brain connectivity in patients, particularly for connections integrating the frontal cortex. A critical point is that brain connectivity abnormalities, including altered resting state connectivity within the fronto-parietal (FP) network, are already observed in non-help-seeking individuals with psychotic-like experiences. If we consider psychosis as a continuum, with individuals with psychotic-like experiences at the lower and psychotic patients at the upper ends, individuals with psychotic-like experiences represent a key population for investigating the validity of putative biomarkers underlying the onset of psychosis. This paper selectively addresses the role played by FP connectivity in the psychosis continuum, which includes patients with chronic psychosis, early psychosis, clinical high risk, genetic high risk, as well as the general population with psychotic experiences. We first discuss structural connectivity changes among the FP pathway in each domain in the psychosis continuum. This may provide a basis for us to gain an understanding of the subsequent changes in functional FP connectivity. We further indicate that abnormal FP connectivity may arise from glutamatergic disturbances of this pathway, in particular from abnormal NMDA receptor-mediated plasticity. In the second part of this paper we propose some concepts for further research on the use of network connectivity in the classification of the psychosis continuum. These concepts are consistent with recent efforts to enhance the role of data in driving the diagnosis of psychiatric spectrum diseases.
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Affiliation(s)
- André Schmidt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University Detroit, Michigan, USA
| | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | | | - Undine E Lang
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland ; Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
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17
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Scognamiglio C, Houenou J. A meta-analysis of fMRI studies in healthy relatives of patients with schizophrenia. Aust N Z J Psychiatry 2014; 48:907-16. [PMID: 24972603 DOI: 10.1177/0004867414540753] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Genetically at-risk yet healthy relatives of patients with schizophrenia, sharing an important part of the genetic susceptibility to the disease, allow the study of neuroimaging endophenotypes. The aim of our study was to perform a meta-analysis of whole-brain functional magnetic resonance imaging (fMRI) studies that compared adult healthy relatives of patients with schizophrenia and controls. METHODS Twenty-one whole-brain fMRI studies were included (17 using cognitive tasks and four using emotional tasks), published between 2003 and 2013. These studies included 467 healthy relatives of patients with schizophrenia and 768 controls. To conduct the statistical analysis, we used the effect-size signed differential mapping software, a voxel-based meta-analytic approach. RESULTS In healthy relatives of patients with schizophrenia, we observed a general pattern of overactivation across the 21 fMRI studies in right-sided frontal, parietal and temporal regions compared to controls. This pattern was accompanied by an underactivation in the cingulate gyrus. Our analyses showed a very similar pattern during purely cognitive tasks; during emotional tasks, healthy relatives additionally overactivated the left parahippocampal gyrus. CONCLUSIONS This fMRI pattern of prefrontal overactivation and hypoactivation of the cingulate gyrus may represent a candidate endophenotype for schizophrenia.
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Affiliation(s)
- Claire Scognamiglio
- Paris Ile de France Ouest Medical School, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Josselin Houenou
- UNIACT, NeuroSpin, I2BM, CEA Saclay, Gif-Sur-Yvette, France INSERM U955, Equipe 15 'Psychiatrie Génétique', Créteil, France Fondation Fondamental, Créteil, France AP-HP, Hôpitaux Universitaires Mondor, Pôle de Psychiatrie, Créteil, France
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18
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Sepede G, Spano MC, Lorusso M, Berardis DD, Salerno RM, Giannantonio MD, Gambi F. Sustained attention in psychosis: Neuroimaging findings. World J Radiol 2014; 6:261-273. [PMID: 24976929 PMCID: PMC4072813 DOI: 10.4329/wjr.v6.i6.261] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/07/2014] [Accepted: 05/16/2014] [Indexed: 02/06/2023] Open
Abstract
To provide a systematic review of scientific literature on functional magnetic resonance imaging (fMRI) studies on sustained attention in psychosis. We searched PubMed to identify fMRI studies pertaining sustained attention in both affective and non-affective psychosis. Only studies conducted on adult patients using a sustained attention task during fMRI scanning were included in the final review. The search was conducted on September 10th, 2013. 15 fMRI studies met our inclusion criteria: 12 studies were focused on Schizophrenia and 3 on Bipolar Disorder Type I (BDI). Only half of the Schizophrenia studies and two of the BDI studies reported behavioral abnormalities, but all of them evidenced significant functional differences in brain regions related to the sustained attention system. Altered functioning of the insula was found in both Schizophrenia and BDI, and therefore proposed as a candidate trait marker for psychosis in general. On the other hand, other brain regions were differently impaired in affective and non-affective psychosis: alterations of cingulate cortex and thalamus seemed to be more common in Schizophrenia and amygdala dysfunctions in BDI. Neural correlates of sustained attention seem to be of great interest in the study of psychosis, highlighting differences and similarities between Schizophrenia and BDI.
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19
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Cooper D, Barker V, Radua J, Fusar-Poli P, Lawrie SM. Multimodal voxel-based meta-analysis of structural and functional magnetic resonance imaging studies in those at elevated genetic risk of developing schizophrenia. Psychiatry Res 2014; 221:69-77. [PMID: 24239093 DOI: 10.1016/j.pscychresns.2013.07.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 07/03/2013] [Accepted: 07/25/2013] [Indexed: 01/03/2023]
Abstract
Computational brain-imaging studies of individuals at familial high risk for psychosis have provided interesting results, but interpreting these findings can be a challenge due to a number of factors. We searched the literature for studies reporting whole brain voxel-based morphometry (VBM) or functional magnetic resonance imaging (fMRI) findings in people at familial high risk for schizophrenia compared with a control group. A voxel-wise meta-analysis with the effect-size version of Signed Differential Mapping (ES-SDM) identified regional abnormalities of functional brain response. Similarly, an ES-SDM meta-analysis was conducted on VBM studies. A multi-modal imaging meta-analysis was used to highlight brain regions with both structural and functional abnormalities. Nineteen studies met the inclusion criteria, in which a total of 815 familial high-risk individuals were compared to 685 controls. Our fMRI results revealed a number of regions of altered activation. VBM findings demonstrated both increases and decreases in grey matter density of relatives in a variety of brain regions. The multimodal analysis revealed relatives had decreased grey matter with hyper-activation in the left inferior frontal gyrus/amygdala, and decreased grey matter with hypo-activation in the thalamus. We found several regions of altered activation or structure in familial high-risk individuals. Reliable fMRI findings in the right posterior superior temporal gyrus further confirm that alteration in this area is a potential marker of risk.
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Affiliation(s)
- Deborah Cooper
- Division of Psychiatry, School of Clinical Sciences, Kennedy Tower, Royal Edinburgh Hospital, Morningside, Edinburgh, EH10 5HF, UK.
| | - Victoria Barker
- Division of Psychiatry, School of Clinical Sciences, Kennedy Tower, Royal Edinburgh Hospital, Morningside, Edinburgh, EH10 5HF, UK
| | - Joaquim Radua
- Institute of Psychiatry, King's College London, London, UK; FIDMAG Research Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | | | - Stephen M Lawrie
- Division of Psychiatry, School of Clinical Sciences, Kennedy Tower, Royal Edinburgh Hospital, Morningside, Edinburgh, EH10 5HF, UK
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Kam JWY, Bolbecker AR, O'Donnell BF, Hetrick WP, Brenner CA. Resting state EEG power and coherence abnormalities in bipolar disorder and schizophrenia. J Psychiatr Res 2013; 47:1893-901. [PMID: 24090715 PMCID: PMC4015517 DOI: 10.1016/j.jpsychires.2013.09.009] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/12/2013] [Accepted: 09/12/2013] [Indexed: 10/26/2022]
Abstract
Resting state electroencephalogram (EEG) abnormalities in schizophrenia and bipolar disorder patients suggest alterations in neural oscillatory activity. However, few studies directly compare these anomalies between patient groups, and none have examined EEG coherence. Therefore, this study investigated whether these electrophysiological characteristics differentiate clinical populations from one another, and from non-psychiatric controls. To address this question, resting EEG power and coherence were assessed in 76 bipolar patients (BP), 132 schizophrenia patients (SZ), and 136 non-psychiatric controls (NC). We conducted separate repeated-measures ANOVAs to examine group differences within seven frequency bands across several brain regions. BP showed significantly greater power relative to SZ at higher frequencies including Beta and Gamma across all regions. In terms of intra-hemispheric coherence, while SZ generally exhibited higher coherence at Delta compared to NC and BP, both SZ and BP showed higher coherence at Alpha1 and Alpha2. In contrast, BP and HC showed higher coherence within hemispheres compared to SZ at Beta 1. In terms of inter-hemispheric coherence, SZ displayed higher coherence compared to NC at temporal sites at both Alpha1 and Alpha2. Taken together, BP exhibited increased high frequency power with few disruptions in neural synchronization. In contrast, SZ generally exhibited enhanced synchronization within and across hemispheres. These findings suggest that resting EEG can be a sensitive measure for differentiating between clinical disorders.
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Affiliation(s)
- Julia W Y Kam
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, B.C. V6T 1Z4, Canada.
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21
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de Leeuw M, Kahn RS, Zandbelt BB, Widschwendter CG, Vink M. Working memory and default mode network abnormalities in unaffected siblings of schizophrenia patients. Schizophr Res 2013; 150:555-62. [PMID: 24051015 DOI: 10.1016/j.schres.2013.08.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 08/06/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Impaired working memory (WM) is a hallmark of schizophrenia. In addition to classical WM regions such as the dorsolateral prefrontal cortex (DLPFC) and the striatum, dysfunctions in the default-mode network (DMN) contribute to these WM deficits. Unaffected siblings of patients also show WM impairments. However, the nature of the functional deficits underlying these impairments is unclear, mainly because of impaired performance confounding neuroimaging results. METHODS Here, we investigated WM and DMN activity in 23 unaffected siblings of schizophrenia patients and 24 healthy volunteers using fMRI and a Sternberg WM task. WM load was determined prior to scanning to ensure 90% accuracy for all subjects. RESULTS Siblings showed hyperactivation during the encoding phase of WM in the right medial prefrontal cortex (MPFC) which is the anterior part of the DMN. No differences were found during the maintenance phase. During the retrieval phase, siblings showed hyperactivation in WM regions: DLPFC, inferior parietal cortex and the striatum. Siblings who showed hyperactivity in the MPFC during encoding showed DLPFC and striatum hyperactivation during retrieval. CONCLUSIONS Our finding of hyperactivation in WM and DMN areas indicates that siblings fail to adequately inhibit DMN activity during demanding cognitive tasks and subsequently hyperactivate WM areas. This failure may reflect dopamine hyperactivity in the striatum which prevents adequate DMN suppression needed for effective WM. This study provides support for the notion that aberrant WM and DMN activation patterns may represent candidate endophenotypes for schizophrenia.
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Affiliation(s)
- Max de Leeuw
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands.
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22
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Ira E, Zanoni M, Ruggeri M, Dazzan P, Tosato S. COMT, neuropsychological function and brain structure in schizophrenia: a systematic review and neurobiological interpretation. J Psychiatry Neurosci 2013; 38:366-80. [PMID: 23527885 PMCID: PMC3819150 DOI: 10.1503/jpn.120178] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Endophenotypes in genetic psychiatry may increase our understanding of the molecular mechanisms underlying disease risk and its manifestations. We sought to investigate the link between neuropsychological impairments and brain structural abnormalities associated with the COMT Val(158)Met polymorphism in patients with schizophrenia to improve understanding of the pathophysiology of this disorder. METHODS We performed a systematic review using studies identified in PubMed and MEDLINE (from the date of the first available article to July 2012). Our review examined evidence of an association between the COMT Val(158)Met polymorphism and both neuropsychological performance and brain structure in patients with psychosis, in their relatives and in healthy individuals (step 1). The review also explored whether the neuropsychological tasks and brain structures identified in step 1 met the criteria for an endophenotype (step 2). Then we evaluated evidence that the neuropsychological endophenotypes identified in step 2 are associated with the brain structure endophenotypes identified in that step (step 3). Finally, we propose a neurobiological interpretation for this evidence. RESULTS A poorer performance on the n-back task and the Continuous Performance Test (CPT) and smaller temporal and frontal brain areas were associated with the COMT Val allele in patients with schizophrenia and their relatives and met most of the criteria for an endophenotype. It is possible that the COMT Val(158)Met polymorphism therefore contributes to the development of these neuropsychological and brain structural endophenotypes of schizophrenia, in which the prefrontal cortex may represent the neural substrate underlying both n-back and CPT performances. LIMITATIONS The association between a single genetic variant and an endophenotype does not necessarily imply a causal relationship between them. CONCLUSION This evidence and the proposed interpretation contribute to explain, at least in part, the biological substrate of 4 important endophenotypes that characterize schizophrenia.
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Affiliation(s)
- Elisa Ira
- Correspondence to: E. Ira, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134 Verona, Italy;
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23
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Brodziak A, Brewczyński A, Bajor G. Clinical significance of knowledge about the structure, function, and impairments of working memory. Med Sci Monit 2013; 19:327-38. [PMID: 23645218 PMCID: PMC3659070 DOI: 10.12659/msm.883900] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/23/2013] [Indexed: 01/12/2023] Open
Abstract
A review of contemporary research on the working memory system (WMS) is important, both due to the need to focus the discussion on further necessary investigations on the structure and function of this key part of the human brain, as well as to share this knowledge with clinicians. In our introduction we try to clarify the actual terminology and provide an intuitively understandable model for 3 basic cognitive operations: perception, recognition, imagery, and manipulation of recalled mental images. We emphasize the importance of knowledge of the structure and function of the WMS for the possibility to demonstrate the links between genetic polymorphisms and the prevalence to some mental disorders. We also review current knowledge of working memory dysfunction in the most common diseases and specific clinical situations such as maturation and aging. Finally, we briefly discuss methods for assessment of WMS capacity. This article establishes a kind of compendium of knowledge for clinicians who are not familiar with the structure and operation of the WMS.
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Affiliation(s)
- Andrzej Brodziak
- Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland.
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Fryer SL, Woods SW, Kiehl KA, Calhoun VD, Pearlson GD, Roach BJ, Ford JM, Srihari VH, McGlashan TH, Mathalon DH. Deficient Suppression of Default Mode Regions during Working Memory in Individuals with Early Psychosis and at Clinical High-Risk for Psychosis. Front Psychiatry 2013; 4:92. [PMID: 24032017 PMCID: PMC3768116 DOI: 10.3389/fpsyt.2013.00092] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 08/09/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The default mode network (DMN) is a set of brain regions typically activated at rest and suppressed during extrinsic cognition. Schizophrenia has been associated with deficient DMN suppression, though the extent to which DMN dysfunction predates psychosis onset is unclear. This study examined DMN suppression during working memory (WM) performance in youth at clinical high-risk (CHR) for psychosis, early schizophrenia (ESZ) patients, and healthy controls (HC). We hypothesized that the DMN would show load-dependent suppression during WM retrieval in HC but not in ESZ, with CHR participants showing an intermediate pattern. METHODS fMRI data were collected from CHR (n = 32), ESZ (n = 22), and HC (n = 54) participants, ages 12-30. DMN regions were defined via seed-based connectivity analysis of resting-state fMRI data from an independent HC sample. Load-dependent deactivations of these DMN regions in response to WM probes were interrogated. RESULTS Healthy controls showed linear load-dependent increases in DMN deactivation. Significant Group-by-Load interactions were observed in DMN regions including medial prefrontal and lateral posterior parietal cortices. Group-by-Load effects in posterior DMN nodes resulted from less suppression at higher WM loads in ESZ relative to HC, with CHR differing from neither group. In medial prefrontal cortex, suppression of activity at higher WM loads was significantly diminished in both CHR and ESZ groups, relative to HC. In addition, investigation of dorsolateral prefrontal cortex (DLPFC) activations revealed that ESZ activated right DLPFC significantly more than HC, with CHR differing from neither group. CONCLUSION While HC showed WM load-dependent modulation of DMN suppression, CHR individuals had deficient higher-load DMN suppression that was similar to, but less pronounced than, the distributed suppression deficits evident in ESZ patients. These results suggest that DMN dysregulation associated with schizophrenia predates psychosis onset.
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Affiliation(s)
- Susanna L Fryer
- Psychiatry, University of California San Francisco , San Francisco, CA , USA ; Mental Health Service, San Francisco VA Medical Center , San Francisco, CA , USA
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25
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Smieskova R, Allen P, Simon A, Aston J, Bendfeldt K, Drewe J, Gruber K, Gschwandtner U, Klarhoefer M, Lenz C, Scheffler K, Stieglitz RD, Radue EW, McGuire P, Riecher-Rössler A, Borgwardt SJ. Different duration of at-risk mental state associated with neurofunctional abnormalities. A multimodal imaging study. Hum Brain Mapp 2011; 33:2281-94. [PMID: 21922599 DOI: 10.1002/hbm.21360] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 03/22/2011] [Accepted: 04/26/2011] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Neurofunctional alterations are correlates of vulnerability to psychosis, as well as of the disorder itself. How these abnormalities relate to different probabilities for later transition to psychosis is unclear. We investigated vulnerability- versus disease-related versus resilience biomarkers of psychosis during working memory (WM) processing in individuals with an at-risk mental state (ARMS). EXPERIMENTAL DESIGN Patients with "first-episode psychosis" (FEP, n = 21), short-term ARMS (ARMS-ST, n = 17), long-term ARMS (ARMS-LT, n = 16), and healthy controls (HC, n = 20) were investigated with an n-back WM task. We examined functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (sMRI) data in conjunction using biological parametric mapping (BPM) toolbox. PRINCIPAL OBSERVATIONS There were no differences in accuracy, but the FEP and the ARMS-ST group had longer reaction times compared with the HC and the ARMS-LT group. With the 2-back > 0-back contrast, we found reduced functional activation in ARMS-ST and FEP compared with the HC group in parietal and middle frontal regions. Relative to ARMS-LT individuals, FEP patients showed decreased activation in the bilateral inferior frontal gyrus and insula, and in the left prefrontal cortex. Compared with the ARMS-LT, the ARMS-ST subjects showed reduced activation in the right inferior frontal gyrus and insula. Reduced insular and prefrontal activation was associated with gray matter volume reduction in the same area in the ARMS-LT group. CONCLUSIONS These findings suggest that vulnerability to psychosis was associated with neurofunctional alterations in fronto-temporo-parietal networks in a WM task. Neurofunctional differences within the ARMS were related to different duration of the prodromal state and resilience factors.
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Affiliation(s)
- Renata Smieskova
- Department of Psychiatry, University of Basel, c/o University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland
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Lis S, Apostolopoulos J, Kirsch P, Gallhofer B. Sensory and motor encoding strategies in n-back tasks: a simulation of schizophrenic working memory deficits in healthy subjects. Neuropsychobiology 2011; 63:137-46. [PMID: 21228605 DOI: 10.1159/000319459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 07/15/2010] [Indexed: 11/19/2022]
Abstract
AIMS Different patterns of intact and disturbed working memory function can be observed in schizophrenic patients depending on the type of n-back task. We investigated whether these patterns can be induced in healthy subjects by experimentally preventing a motor encoding strategy. METHODS Thirty-two healthy subjects were asked to solve 2 types of n-back task. In the continuous matching task, the subjects had to compare the present stimulus with the one occurring n stimuli back. In the continuous delayed response task (CDRT), the subjects had to select a response depending on the stimulus n stimuli back. Both types of n-back task are assumed to differ with respect to the encoding strategies that can be used to solve the tasks. The use of a motor strategy was prevented by a random arrangement of the target buttons. RESULTS When the position of the target buttons was predictable, CDRT was solved faster and with higher accuracy than the continuous matching task. However, CDRT was solved more slowly and less accurately when the arrangement of the target buttons varied between the trials. This resulted in a comparable performance in both types of the n-back task. CONCLUSIONS The behavioural alteration in schizophrenic patients in n-back tasks can be induced in healthy subjects by experimentally preventing the use of a motor encoding strategy.
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Affiliation(s)
- Stefanie Lis
- Centre for Psychiatry, Justus Liebig University Giessen, Giessen, Germany.
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Rasetti R, Weinberger DR. Intermediate phenotypes in psychiatric disorders. Curr Opin Genet Dev 2011; 21:340-8. [PMID: 21376566 PMCID: PMC3138621 DOI: 10.1016/j.gde.2011.02.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 02/04/2011] [Indexed: 02/06/2023]
Abstract
The small effect size of most individual risk factors for psychiatric disorders likely reflects biological heterogeneity and diagnostic imprecision, which has encouraged genetic studies of intermediate biological phenotypes that are closer to the molecular effects of risk genes than are the clinical symptoms. Neuroimaging-based intermediate phenotypes have emerged as particularly promising because they map risk associated gene effects onto physiological processes in brain that are altered in patients and in their healthy relatives. Recent evidence using this approach has elucidated discrete, dissociable biological mechanisms of risk genes at the level of neural circuitries, and their related cognitive functions. This approach may greatly contribute to our understanding of the genetics and pathophysiology of psychiatric disorders.
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Affiliation(s)
- Roberta Rasetti
- Clinical Brain Disorders Branch: Genes, Cognition, and Psychosis Program, NIMH, NIH, Bethesda, MD, USA
| | - Daniel R. Weinberger
- Clinical Brain Disorders Branch: Genes, Cognition, and Psychosis Program, NIMH, NIH, Bethesda, MD, USA
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28
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Ettinger U, Williams SCR, Fannon D, Premkumar P, Kuipers E, Möller HJ, Kumari V. Functional magnetic resonance imaging of a parametric working memory task in schizophrenia: relationship with performance and effects of antipsychotic treatment. Psychopharmacology (Berl) 2011; 216:17-27. [PMID: 21331519 PMCID: PMC3111549 DOI: 10.1007/s00213-011-2214-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 01/17/2011] [Indexed: 11/05/2022]
Abstract
RATIONALE Working memory dysfunction is frequently observed in schizophrenia. The neural mechanisms underlying this dysfunction remain unclear, with functional neuroimaging studies reporting increased, decreased or unchanged activation compared to controls. OBJECTIVES We investigated the neural correlates of spatial working memory in schizophrenia with particular consideration of effects of antipsychotic treatment and relation to performance levels in the patient group. METHOD We used functional magnetic resonance imaging and studied the blood-oxygen-level-dependent (BOLD) response of 45 schizophrenia outpatients and 19 healthy controls during a parametric spatial n-back task. RESULTS Performance in both groups deteriorated with increasing memory load (0-back, 1-back, 2-back), but the two groups did not significantly differ in performance overall or as a function of load. Patients produced stronger BOLD signal in occipital and lateral prefrontal cortex during task performance than controls. This difference increased with increasing working memory load in the prefrontal areas. We also found that in patients with good task performance, the BOLD response in left prefrontal cortex showed a stronger parametric increase with working memory load than in patients with poor performance. Second-generation antipsychotics were independently associated with left prefrontal BOLD increase in response to working memory load, whereas first-generation antipsychotics were associated with BOLD decrease with increasing load in this area. CONCLUSIONS Together, these findings suggest that in schizophrenia patients, normal working memory task performance may be achieved through compensatory neural activity, especially in well-performing patients and in those treated with second-generation antipsychotics.
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Affiliation(s)
- Ulrich Ettinger
- Department of Psychiatry, University of Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - Steven C. R. Williams
- Department of Neuroimaging, King’s College London, Institute of Psychiatry, London, UK
| | - Dominic Fannon
- Division of Psychological Medicine, King’s College London, Institute of Psychiatry, London, UK ,Department of Psychology, King’s College London, Institute of Psychiatry, London, UK
| | - Preethi Premkumar
- Department of Psychology, King’s College London, Institute of Psychiatry, London, UK
| | - Elizabeth Kuipers
- Department of Psychology, King’s College London, Institute of Psychiatry, London, UK
| | - Hans-Jürgen Möller
- Department of Psychiatry, University of Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Veena Kumari
- Department of Psychology, King’s College London, Institute of Psychiatry, London, UK
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Carter JD, Bizzell J, Kim C, Bellion C, Carpenter KL, Dichter G, Belger A. Attention deficits in schizophrenia--preliminary evidence of dissociable transient and sustained deficits. Schizophr Res 2010; 122:104-12. [PMID: 20554160 PMCID: PMC2933272 DOI: 10.1016/j.schres.2010.03.019] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 03/15/2010] [Accepted: 03/17/2010] [Indexed: 01/03/2023]
Abstract
Attention deficits are considered to be fundamental in patients with schizophrenia. During attention tasks, patients with schizophrenia have been shown to display increased brain activity in some neuroimaging studies but reduced brain activity in others. These conflicting findings may be due to some study designs primarily eliciting transient engagement of attention and other study designs primarily eliciting sustained engagement of attention. In the present study, ten males with schizophrenia and fourteen age-matched, male controls performed a visual selective attention task. A mixed block/event-related fMRI design was used, allowing for separate analysis of transient and sustained phases of attention. Results revealed that the schizophrenia group made significantly fewer correct responses and displayed a significantly slower mean response time than the control group. Voxel-wise random effects analyses revealed that both groups displayed activation in regions considered to constitute a core attentional network including the anterior cingulate gyrus, dorsolateral prefrontal cortex, insula and inferior parietal sulcus. Region of Interest (ROI) analyses revealed that across the entire sequence of task and non-task blocks, the schizophrenia group displayed a greater percentage of active voxels than controls in many ROIs. However, during transient periods most pertinent to task performance, the schizophrenia group displayed a lower percentage of active voxels than controls. These results help to explain contrasting findings across previous studies and suggest that attention deficits displayed by patients with schizophrenia are more likely to reflect deficits in modulating brain activity in response to variations in transient, attention demanding stimuli, rather than deficits in sustained attention.
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Affiliation(s)
- James D. Carter
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine
- Duke-UNC Brain Imaging and Analysis Center
| | - Josh Bizzell
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine
- Duke-UNC Brain Imaging and Analysis Center
| | - Cy Kim
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine
- Duke-UNC Brain Imaging and Analysis Center
| | - Carolyn Bellion
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine
| | | | - Gabriel Dichter
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine
- Duke-UNC Brain Imaging and Analysis Center
- Neurodevelopmental Disorders Research Center, University of North Carolina at Chapel Hill School of Medicine
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine
- Duke-UNC Brain Imaging and Analysis Center
- Neurodevelopmental Disorders Research Center, University of North Carolina at Chapel Hill School of Medicine
- Address correspondence by to: , or by mail to: Dr. Aysenil Belger, Department of Psychiatry, University of North Carolina School of Medicine, CB# 7160, 101 Manning Drive, Chapel Hill, NC 27599-7160
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Lepage M, Pelletier M, Achim A, Montoya A, Menear M, Lal S. Parietal cortex and episodic memory retrieval in schizophrenia. Psychiatry Res 2010; 182:191-9. [PMID: 20488673 DOI: 10.1016/j.pscychresns.2010.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 12/15/2009] [Accepted: 03/06/2010] [Indexed: 10/19/2022]
Abstract
People with schizophrenia consistently show memory impairment on varying tasks including item recognition memory. Relative to the correct rejection of distracter items, the correct recognition of studied items consistently produces an effect termed the old/new effect that is characterized by increased activity in parietal and frontal cortical regions. This effect has received only scant attention in schizophrenia. We examined the old/new effect in 15 people with schizophrenia and 18 controls during an item recognition test, and neural activity was examined with event-related functional magnetic resonance imaging. Both groups performed equally well during the recognition test and showed increased activity in a left dorsolateral prefrontal region and in the precuneus bilaterally during the successful recognition of old items relative to the correct rejection of new items. The control group also exhibited increased activity in the dorsal left parietal cortex. This region has been implicated in the top-down modulation of memory which involves control processes that support memory-retrieval search, monitoring and verification. Although these processes may not be of paramount importance in item recognition memory performance, the present findings suggest that people with schizophrenia may have difficulty with such top-down modulation, a finding consistent with many other studies in information processing.
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Affiliation(s)
- Martin Lepage
- Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montréal, Canada.
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