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Ding B, Williams SN, Dragonu I, Liebig P, Allwood-Spiers S, McElhinney P, Gunamony S, Fullerton N, Porter DA. Slice-specific B 1 + shimming improves the repeatability of multishot DWI at 7 T. Magn Reson Med 2024; 92:2560-2570. [PMID: 39091132 DOI: 10.1002/mrm.30208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Compared with lower field strengths, DWI at 7 T faces the combined challenges of increased distortion and blurring due to B0 inhomogeneity, and increased signal dropouts due to B1 + inhomogeneity. This study addresses the B1 + limitations using slice-specific static parallel transmission (pTx) in a multi-shot, readout-segmented EPI diffusion imaging sequence. METHODS DWI was performed in 7 healthy subjects using MRI at 7 T and readout-segmented EPI. Data were acquired with non-pTx circular-polarized (CP) pulses (CP-DWI) and static pTx pulses (pTx-DWI) using slice-specific B1 + shim coefficients. Each volunteer underwent two scan sessions on the same day, with two runs of each sequence in the first session and one run in the second. The sequences were evaluated by assessing image quality, flip-angle homogeneity, and intrasession and intersession repeatability in ADC estimates. RESULTS pTx-DWI significantly reduced signal voids compared with CP-DWI, particularly in inferior brain regions. The use of pTx also improved RF uniformity and symmetry across the brain. These effects translated into improved intrasession and intersession repeatability for pTx-DWI. Additionally, re-optimizing the pTx pulse between repeat scans did not have a negative effect on ADC repeatability. CONCLUSION The study demonstrates that pTx provides a reproducible image-quality increase in multishot DWI at 7 T. The benefits of pTx also extend to quantitative ADC estimation with regard to the improvement in intrasession and intersession repeatability. Overall, the combination of multishot imaging and pTx can support the development of reliable, high-resolution DWI for clinical studies at 7 T.
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Affiliation(s)
| | | | | | | | | | - Paul McElhinney
- Imaging Center of Excellence, University of Glasgow, Glasgow, UK
| | - Shajan Gunamony
- Imaging Center of Excellence, University of Glasgow, Glasgow, UK
- MR CoilTech Ltd, Glasgow, UK
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Chen M, Xia X, Kang Z, Li Z, Dai J, Wu J, Chen C, Qiu Y, Liu T, Liu Y, Zhang Z, Shen Q, Tao S, Deng Z, Lin Y, Wei Q. Distinguishing schizophrenia and bipolar disorder through a Multiclass Classification model based on multimodal neuroimaging data. J Psychiatr Res 2024; 172:119-128. [PMID: 38377667 DOI: 10.1016/j.jpsychires.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
This study aimed to identify neural biomarkers for schizophrenia (SZ) and bipolar disorder (BP) by analyzing multimodal neuroimaging. Utilizing data from structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI), and resting-state functional magnetic resonance imaging (rs-fMRI), multiclass classification models were created for SZ, BP, and healthy controls (HC). A total of 113 participants (BP: 31, SZ: 39, and HC: 43) were recruited under strict enrollment control, from which 272, 200, and 1875 features were extracted from sMRI, DTI, and rs-fMRI data, respectively. A support vector machine (SVM) with recursive feature elimination (RFE) was employed to build the models using a one-against-one approach and leave-one-out cross-validation, achieving a classification accuracy of 70.8%. The most discriminative features were primarily from rs-fMRI, along with significant findings in sMRI and DTI. Key biomarkers identified included the increased thickness of the left cuneus cortex and decreased regional functional connectivity strength (rFCS) in the left supramarginal gyrus as shared indicators for BP and SZ. Additionally, decreased fractional anisotropy in the left superior fronto-occipital fasciculus was suggested as specific to BP, while decreased rFCS in the left inferior parietal area might serve as a specific biomarker for SZ. These findings underscore the potential of multimodal neuroimaging in distinguishing between BP and SZ and contribute to the understanding of their neural underpinnings.
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Affiliation(s)
- Ming Chen
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Mental Health Institute, Guangdong ProvincialPeople's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xiaowei Xia
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhuang Kang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhinan Li
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiamin Dai
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Junyan Wu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cai Chen
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yong Qiu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, Mindfront Caring Medical, Guangzhou, China
| | - Tong Liu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Yanxi Liu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ziyi Zhang
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Medical Division, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qingni Shen
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sichu Tao
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zixin Deng
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- Department of Psychology, Sun Yat-sen University, Guangzhou, China.
| | - Qinling Wei
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Kim J, Song J, Kambari Y, Plitman E, Shah P, Iwata Y, Caravaggio F, Brown EE, Nakajima S, Chakravarty MM, De Luca V, Remington G, Graff-Guerrero A, Gerretsen P. Cortical thinning in relation to impaired insight into illness in patients with treatment resistant schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:27. [PMID: 37120642 PMCID: PMC10148890 DOI: 10.1038/s41537-023-00347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 03/12/2023] [Indexed: 05/01/2023]
Abstract
Impaired insight into illness is a common element of schizophrenia that contributes to treatment nonadherence and negative clinical outcomes. Previous studies suggest that impaired insight may arise from brain abnormalities. However, interpretations of these findings are limited due to small sample sizes and inclusion of patients with a narrow range of illness severity and insight deficits. In a large sample of patients with schizophrenia, the majority of which were designated as treatment-resistant, we investigated the associations between impaired insight and cortical thickness and subcortical volumes. A total of 94 adult participants with a schizophrenia spectrum disorder were included. Fifty-six patients (60%) had treatment-resistant schizophrenia. The core domains of insight were assessed with the VAGUS insight into psychosis scale. We obtained 3T MRI T1-weighted images, which were analysed using CIVET and MAGeT-Brain. Whole-brain vertex-wise analyses revealed impaired insight, as measured by VAGUS average scores, was related to cortical thinning in left frontotemporoparietal regions. The same analysis in treatment-resistant patients showed thinning in the same regions, even after controlling for age, sex, illness severity, and chlorpromazine antipsychotic dose equivalents. No association was found in non-treatment-resistant patients. Region-of-interest analyses revealed impaired general illness awareness was associated with cortical thinning in the left supramarginal gyrus when controlling for covariates. Reduced right and left thalamic volumes were associated with VAGUS symptom attribution and awareness of negative consequences subscale scores, respectively, but not after correction for multiple testing. Our results suggest impaired insight into illness is related to cortical thinning in left frontotemporoparietal regions in patients with schizophrenia, particularly those with treatment resistance where insight deficits may be more chronic.
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Affiliation(s)
- Julia Kim
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Jianmeng Song
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Yasaman Kambari
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Eric Plitman
- Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Parita Shah
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Yusuke Iwata
- University of Yamanashi, Faculty of Medicine, Department of Neuropsychiatry, Yamanashi, Japan
| | - Fernando Caravaggio
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Eric E Brown
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, CAMH, Toronto, ON, Canada
- Geriatric Mental Health Division, CAMH, Toronto, ON, Canada
| | - Shinichiro Nakajima
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Vincenzo De Luca
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Gary Remington
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, CAMH, Toronto, ON, Canada
- Schizophrenia Division, CAMH, Toronto, ON, Canada
| | - Ariel Graff-Guerrero
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Geriatric Mental Health Division, CAMH, Toronto, ON, Canada
- Schizophrenia Division, CAMH, Toronto, ON, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Geriatric Mental Health Division, CAMH, Toronto, ON, Canada.
- Schizophrenia Division, CAMH, Toronto, ON, Canada.
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Rasmussen JØ, Nordholm D, Glenthøj LB, Jensen MA, Garde AH, Ragahava JM, Jennum PJ, Glenthøj BY, Nordentoft M, Baandrup L, Ebdrup BH, Kristensen TD. White matter microstructure and sleep-wake disturbances in individuals at ultra-high risk of psychosis. Front Hum Neurosci 2022; 16:1029149. [PMID: 36393990 PMCID: PMC9649829 DOI: 10.3389/fnhum.2022.1029149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/07/2022] [Indexed: 11/25/2022] Open
Abstract
Aim White matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology. Methods Sixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on global and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations. Results Ultra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = -0.34, p = 0.011) and increased sleep fragmentation index (r = -0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses. Conclusion Compromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target.
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Affiliation(s)
- Jesper Ø. Rasmussen
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Dorte Nordholm
- Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Louise B. Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marie A. Jensen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anne H. Garde
- The National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jayachandra M. Ragahava
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Poul J. Jennum
- Danish Centre for Sleep Medicine, Department of Clinical Neurophysiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birte Y. Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Baandrup
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Centre Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Bjørn H. Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina D. Kristensen
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
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5
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Matrone M, Kotzalidis GD, Romano A, Bozzao A, Cuomo I, Valente F, Gabaglio C, Lombardozzi G, Trovini G, Amici E, Perrini F, De Persis S, Iasevoli F, De Filippis S, de Bartolomeis A. Treatment-resistant schizophrenia: Addressing white matter integrity, intracortical glutamate levels, clinical and cognitive profiles between early- and adult-onset patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 114:110493. [PMID: 34883221 DOI: 10.1016/j.pnpbp.2021.110493] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Treatment-resistance in schizophrenia is 30-40%. Its neurobiology remains unclear; to explore it, we conducted a combined spectrometry/tractography/cognitive battery and psychopathological rating study on patients with treatment-resistant schizophrenia (TRS), dividing the sample into early-onset (N = 21) and adult-onset TRS (N = 20). Previous studies did not differentiate between early- (onset 13-18 years) and adult-onset (>18 years at formal diagnosis of schizophrenia) TRS. METHODS We evaluated cross-sectionally 41 TRS patients (26 male and 15 female) and 20 matched healthy controls (HCs) with psychopathological and cognitive testing prior to participating in brain imaging scanning using magnetic resonance spectroscopy and diffusion tensor imaging to determine the relationship between their symptoms and their glutamate levels and white matter integrity. RESULTS TRS patients scored lower than HCs on all cognitive domains; early-onset patients performed better than adult-onset patients only on the Symbol Coding domain. TRS correlated with symptom severity, especially negative symptoms. Glutamate levels and glutamate/creatine were increased in anterior cingulate cortex. Diffusion tensor imaging showed low fractional anisotropy in TRS patients in specific white matter tracts compared to HCs (bilateral anterior thalamic radiation, cortico-spinal tract, forceps minor, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, and right uncinate fasciculus). CONCLUSIONS We identified specific magnetic resonance spectroscopy and diffusion tensor imaging alterations in TRS patients. Adult-onset TRS differed little from early-onset TRS on most measures; this points to alterations being present since the outset of schizophrenia and may constitute a biological signature of treatment-resistance.
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Affiliation(s)
- Marta Matrone
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Georgios D Kotzalidis
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Andrea Romano
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Alessandro Bozzao
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Ilaria Cuomo
- UOC SM I Distretto ASL ROMA 1, C.C. Regina Cœli, Via della Lungara 29, 00165 Rome, Italy.
| | - Francesca Valente
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy; Department of Human Neurosciences, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Italy.
| | - Chiara Gabaglio
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Ginevra Lombardozzi
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Giada Trovini
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Emanuela Amici
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Filippo Perrini
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy; UOC SMREE Distretto ASL ROMA 6, TSMREE, Via S. Biagio, 12, 00049, Velletri, Rome, Italy.
| | - Simone De Persis
- UOSD Attività Terapeutiche Riabilitative per i Disturbi da uso di Sostanze e nuove Dipendenze, ASL Rieti, Via Salaria per Roma 36, 02100 Rieti, Italy.
| | - Felice Iasevoli
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
| | - Sergio De Filippis
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
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6
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El Nagar Z, El Shahawi HH, Effat SM, El Sheikh MM, Adel A, Ibrahim YA, Aufa OM. Single episode brief psychotic disorder versus bipolar disorder: A diffusion tensor imaging and executive functions study. Schizophr Res Cogn 2022; 27:100214. [PMID: 34557386 PMCID: PMC8446778 DOI: 10.1016/j.scog.2021.100214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite fast progress in neuroscientific approaches, the neurobiological continuum links psychotic spectrum, and affective disorder is obscure. White matter WM abnormalities found utilizing Diffusion Tensor Imaging (DTI) showing impaired communication in both disorders have been consistently demonstrated; however, direct comparisons of findings between them are scarce. This study aims to study WM abnormalities in single episode bipolar I disorder, and single episode brief psychotic disorder related to healthy control with the association of executive function. METHODS A cross-sectional case-control study was used to assess 60 subjects divided into 20 patients with single episode bipolar I disorder, 20 individuals with single episode brief psychotic disorder (both groups of patients were in remission), and 20 healthy controls. The present study examined the superior longitudinal fasciculus (SLF), and cingulum bundle fractional anisotropy (FA) determined from DTI images symmetrically and connected these results with cognitive functions as assessed by the trail making test (TMT) and Wisconsin card sorting test (WCST). RESULTS DTI data indicated that the psychotic group had a significant decrease in FA of the right SLF (p-value less than 0.001), left SLF (p-value less than 0.001), and left cingulum (p-value less than 0.001) than the bipolar I group. In terms of executive functioning, the psychotic group performed significantly worse than the bipolar I group on the TMT part B (p-value less than 0.001), the WCST (number of classifications fulfilled) (p-value less than 0.001), and perseverative errors (p-value less than 0.001). CONCLUSION Even after clinical remission, individuals with single episode brief psychotic disorder had more pronounced white matter impairments and executive function deficiencies than individuals with single episode bipolar I disorder.
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Affiliation(s)
- Zeinab El Nagar
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba H. El Shahawi
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Safeya M. Effat
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mona M. El Sheikh
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Adel
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yosra A. Ibrahim
- Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ola M. Aufa
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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7
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Chen S, Tang Y, Fan X, Qiao Y, Wang J, Wen H, Wang W, Wang H, Yang F, Sheng J. The role of white matter abnormality in the left anterior corona radiata: In relation to formal thought disorder in patients with schizophrenia. Psychiatry Res 2022; 307:114302. [PMID: 34890908 DOI: 10.1016/j.psychres.2021.114302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/27/2022]
Abstract
White matter abnormality has been widely reported in patients with schizophrenia (Sz). However, few studies have focused on the relationship between the white matter deficit and formal thought disorder (FTD). Moreover, the role of genetic high risk in FTD-related white matter deficit remains unclear. The present study recruited 46 Sz patients, 18 unaffected first-degree relatives of Sz patients, and 29 healthy controls. There was a widespread fractional anisotropy (FA) reduction in Sz. In addition, reduced FA in the left anterior corona radiata was related to more severe FTD symptoms in Sz. However, the genetic high-risk group only showed lower mean FA in the left anterior limb of the internal capsule than healthy controls. Our findings suggest that abnormality in the left anterior corona radiata may only occur in Sz but not in the genetic high-risk group. Such an abnormality might be associated with the severity of FTD symptoms. Meanwhile, genetic vulnerability may contribute to the abnormality in the left anterior limb of the internal capsule. Better analytical methods are needed to validate our results.
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Affiliation(s)
- Shan Chen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai 200030, China
| | - Xiaoduo Fan
- UMass Memorial Health Care & University of Massachusetts Medical School, Worcester, MA 01605, United States
| | - Yi Qiao
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai 200030, China
| | - Hun Wen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Wenzheng Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Hongyan Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Fuzhong Yang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
| | - Jianhua Sheng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
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8
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Romero S, de la Serna E, Baeza I, Valli I, Pariente JC, Picado M, Bargalló N, Sugranyes G, Castro-Fornieles J. Altered White Matter Integrity at Illness Onset in Adolescents With a First Episode of Psychosis. Front Psychiatry 2022; 13:876793. [PMID: 35619614 PMCID: PMC9127302 DOI: 10.3389/fpsyt.2022.876793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disruption in white matter integrity has been consistently observed in individuals with psychosis. However, whether such abnormalities are already present at illness onset or are related to downstream processes remains elusive. The study of adolescents with a recent onset of psychosis provides the opportunity to evaluate white matter integrity proximally to disease onset. METHODS Twenty-six adolescents (aged 15.9 ± 1.3 years) with a first episode of psychosis (FEP) (less than 6 months duration) were compared with 26 age and sex-matched healthy controls (HC) (16.8 ± 2 years). In participants with a FEP, clinical diagnoses were confirmed after a minimum of 1 year follow-up (main categories: schizophrenia, bipolar disorder, or schizoaffective disorder). Anatomical images and diffusion tensor sequences were acquired using a 1.5T scanner. Whole brain, voxel-wise group differences in fractional anisotropy (FA) were investigated between participants with a FEP and controls. RESULTS Relative to HC, FEP participants displayed decreased FA in the right posterior cingulate gyrus, encompassing the right superior and posterior corona radiata, and the right parahippocampal gyrus, including the cingulum and fornix. FEP patients showed no areas of increased FA relative to HC. The results remained significant after controlling for medication, cannabis use and intelligence. CONCLUSION Our findings indicate that adolescents with recent onset of psychotic disorders show decreased white matter integrity in circuits implicated in cognitive functions and emotion regulation.
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Affiliation(s)
- Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Isabel Valli
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José Carlos Pariente
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marisol Picado
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain
| | - Nuria Bargalló
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Image Diagnostic Center, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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9
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Kristensen TD, Glenthøj LB, Raghava JM, Syeda W, Mandl RCW, Wenneberg C, Krakauer K, Fagerlund B, Pantelis C, Glenthøj BY, Nordentoft M, Ebdrup BH. Changes in negative symptoms are linked to white matter changes in superior longitudinal fasciculus in individuals at ultra-high risk for psychosis. Schizophr Res 2021; 237:192-201. [PMID: 34543833 DOI: 10.1016/j.schres.2021.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/05/2021] [Accepted: 09/11/2021] [Indexed: 01/23/2023]
Abstract
AIM Growing evidence suggests that subtle white matter (WM) alterations are associated with psychopathology in individuals at ultra-high risk for psychosis (UHR). However, the longitudinal relationship between symptom progression and WM changes over time remains under-explored. Here, we examine associations between changes in clinical symptoms and changes in WM over six months in a large UHR-cohort. METHODS 110 UHR-individuals and 59 healthy controls underwent diffusion weighted imaging at baseline and after six months. Group × time effects on fractional anisotropy (FA) were tested globally and in four predefined regions of interest (ROIs) bilaterally using linear modelling with repeated measures. Correlations between the changes in clinical symptoms and FA changes in the ROIs were examined with Pearson's correlation. A partial least squares correlation-technique (PLS-C) explored multivariate associations between patterns of changes in psychopathology, regional FA and additional WM indices. RESULTS At baseline, UHR-individuals displayed significantly lower FA globally (p = 0.018; F = 12.274), in right superior longitudinal fasciculus (p = 0.02; Adj R2 = 0.07) and in left uncinate fasciculus (p = 0.048; Adj R2 = 0.058) compared to controls (corrected). We identified a group × time interaction in global FA and right superior longitudinal fasciculus, but the finding did not survive multiple comparisons. However, an increase of negative symptoms in UHR-individuals correlated with FA increase in right superior longitudinal fasciculus (p = 0.048, corrected, r = 0.357), and this finding was supported by the multivariate PLS-C. CONCLUSION We found a positive correlation with a moderate effect between change in negative symptoms and FA change over 6 months in right superior longitudinal fasciculus. This link appeared mainly to reflect a subgroup of UHR-individuals, which already at baseline presented as vulnerable.
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Affiliation(s)
- Tina D Kristensen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Denmark.
| | - Louise B Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Denmark
| | - Jayachandra M Raghava
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Warda Syeda
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, and Melbourne Health, Carlton South, Victoria, Australia
| | - Rene C W Mandl
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; University Medical Center Utrecht Brain Center, Utrecht, the Netherlands
| | - Christina Wenneberg
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Denmark
| | - Kristine Krakauer
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Denmark
| | - Birgitte Fagerlund
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christos Pantelis
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, and Melbourne Health, Carlton South, Victoria, Australia
| | - Birte Y Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, and Melbourne Health, Carlton South, Victoria, Australia; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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10
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Kristensen TD, Glenthøj LB, Ambrosen K, Syeda W, Raghava JM, Krakauer K, Wenneberg C, Fagerlund B, Pantelis C, Glenthøj BY, Nordentoft M, Ebdrup BH. Global fractional anisotropy predicts transition to psychosis after 12 months in individuals at ultra-high risk for psychosis. Acta Psychiatr Scand 2021; 144:448-463. [PMID: 34333760 DOI: 10.1111/acps.13355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychosis spectrum disorders are associated with cerebral changes, but the prognostic value and clinical utility of these findings are unclear. Here, we applied a multivariate statistical model to examine the predictive accuracy of global white matter fractional anisotropy (FA) for transition to psychosis in individuals at ultra-high risk for psychosis (UHR). METHODS 110 UHR individuals underwent 3 Tesla diffusion-weighted imaging and clinical assessments at baseline, and after 6 and 12 months. Using logistic regression, we examined the reliability of global FA at baseline as a predictor for psychosis transition after 12 months. We tested the predictive accuracy, sensitivity and specificity of global FA in a multivariate prediction model accounting for potential confounders to FA (head motion in scanner, age, gender, antipsychotic medication, parental socioeconomic status and activity level). In secondary analyses, we tested FA as a predictor of clinical symptoms and functional level using multivariate linear regression. RESULTS Ten UHR individuals had transitioned to psychosis after 12 months (9%). The model reliably predicted transition at 12 months (χ2 = 17.595, p = 0.040), accounted for 15-33% of the variance in transition outcome with a sensitivity of 0.70, a specificity of 0.88 and AUC of 0.87. Global FA predicted level of UHR symptoms (R2 = 0.055, F = 6.084, p = 0.016) and functional level (R2 = 0.040, F = 4.57, p = 0.036) at 6 months, but not at 12 months. CONCLUSION Global FA provided prognostic information on clinical outcome and symptom course of UHR individuals. Our findings suggest that the application of prediction models including neuroimaging data can inform clinical management on risk for psychosis transition.
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Affiliation(s)
- Tina D Kristensen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise B Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Karen Ambrosen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Warda Syeda
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Melbourne, Vic., Australia
| | - Jayachandra M Raghava
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Kristine Krakauer
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Christina Wenneberg
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christos Pantelis
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Melbourne, Vic., Australia
| | - Birte Y Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Is treatment-resistant schizophrenia associated with distinct neurobiological callosal connectivity abnormalities? CNS Spectr 2021; 26:545-549. [PMID: 32772934 DOI: 10.1017/s1092852920001753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Resistance to antipsychotic treatment affects up to 30% of patients with schizophrenia. Although the time course of development of treatment-resistant schizophrenia (TRS) varies from patient to patient, the reasons for these variations remain unknown. Growing evidence suggests brain dysconnectivity as a significant feature of schizophrenia. In this study, we compared fractional anisotropy (FA) of brain white matter between TRS and non-treatment-resistant schizophrenia (non-TRS) patients. Our central hypothesis was that TRS is associated with reduced FA values. METHODS TRS was defined as the persistence of moderate to severe symptoms after adequate treatment with at least two antipsychotics from different classes. Diffusion-tensor brain MRI obtained images from 34 TRS participants and 51 non-TRS. Whole-brain analysis of FA and axial, radial, and mean diffusivity were performed using Tract-Based Spatial Statistics (TBSS) and FMRIB's Software Library (FSL), yielding a contrast between TRS and non-TRS patients, corrected for multiple comparisons using family-wise error (FWE) < 0.05. RESULTS We found a significant reduction in FA in the splenium of corpus callosum (CC) in TRS when compared to non-TRS. The antipsychotic dose did not relate to the splenium CC. CONCLUSION Our results suggest that the focal abnormality of CC may be a potential biomarker of TRS.
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12
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Viher PV, Stegmayer K, Bracht T, Federspiel A, Bohlhalter S, Strik W, Wiest R, Walther S. Neurological Soft Signs Are Associated With Altered White Matter in Patients With Schizophrenia. Schizophr Bull 2021; 48:220-230. [PMID: 34355246 PMCID: PMC8781326 DOI: 10.1093/schbul/sbab089] [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] [Indexed: 12/26/2022]
Abstract
Neurological soft signs (NSS) are related to grey matter and functional brain abnormalities in schizophrenia. Studies in healthy subjects suggest, that NSS are also linked to white matter. However, the association between NSS and white matter abnormalities in schizophrenia remains to be elucidated. The present study investigated, if NSS are related to white matter alterations in patients with schizophrenia. The total sample included 42 healthy controls and 41 patients with schizophrenia. We used the Neurological Evaluation Scale (NES), and we acquired diffusion weighted magnetic resonance imaging to assess white matter on a voxel-wise between subject statistic. In patients with schizophrenia, linear associations between NES with fractional anisotropy (FA), radial, axial, and mean diffusivity were analyzed with tract-based spatial statistics while controlling for age, medication dose, the severity of the disease, and motion. The main pattern of results in patients showed a positive association of NES with all diffusion measures except FA in important motor pathways: the corticospinal tract, internal capsule, superior longitudinal fascicle, thalamocortical radiations and corpus callosum. In addition, exploratory tractography analysis revealed an association of the right aslant with NES in patients. These results suggest that specific white matter alterations, that is, increased diffusivity might contribute to NSS in patients with schizophrenia.
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Affiliation(s)
- Petra Verena Viher
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland,To whom correspondence should be addressed; Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; tel: +41-31-930-97-57, fax: +41-31-930-94-04, e-mail:
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Tobias Bracht
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stephan Bohlhalter
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland,Neurocenter, Luzerner Kantonsspital, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Neuroradiology, University of Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
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13
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Guo JY, Lesh TA, Niendam TA, Ragland JD, Tully LM, Carter CS. Brain free water alterations in first-episode psychosis: a longitudinal analysis of diagnosis, course of illness, and medication effects. Psychol Med 2021; 51:1001-1010. [PMID: 31910929 PMCID: PMC7340574 DOI: 10.1017/s0033291719003969] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Multiple lines of evidence suggest the presence of altered neuroimmune processes in patients with schizophrenia (Sz) and severe mood disorders. Recent studies using a novel free water diffusion tensor imaging (FW DTI) approach, proposed as a putative biomarker of neuroinflammation, atrophy, or edema, have shown significantly increased FW in patients with Sz. However no studies to date have investigated the longitudinal stability of FW alterations during the early course of psychosis, nor have studies focused separately on FE psychosis patients with Sz or bipolar disorder (BD) with psychotic features. METHODS The current study included 188 participants who underwent diffusion magnetic resonance imaging scanning at baseline. Sixty-four participants underwent follow-up rescanning after 12 months. DTI-based alterations in patients were calculated using voxelwise tract-based spatial statistics and region of interest analyses. RESULTS Patients with FE psychosis, both Sz and BD, exhibited increased FW at illness onset which remained unchanged over the 12-month follow-up period. Preliminary analyses suggested that antipsychotic medication exposure was associated with higher FW in gray matter that reached significance in the BD group. Higher FW in white matter correlated with negative symptom severity. CONCLUSIONS Our results support the presence of elevated FW at the onset of psychosis in both Sz and BD, which remains stable during the early course of the illness, with no evidence of either progression or remission.
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Affiliation(s)
- J. Y. Guo
- Imaging Research Center, the University of California at Davis, Sacramento, CA, USA
- Center for Neuroscience, the University of California at Davis, Davis, CA, USA
| | - T. A. Lesh
- Imaging Research Center, the University of California at Davis, Sacramento, CA, USA
- Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - T. A. Niendam
- Imaging Research Center, the University of California at Davis, Sacramento, CA, USA
- Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - J. D. Ragland
- Imaging Research Center, the University of California at Davis, Sacramento, CA, USA
- Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - L. M. Tully
- Imaging Research Center, the University of California at Davis, Sacramento, CA, USA
- Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - C. S. Carter
- Imaging Research Center, the University of California at Davis, Sacramento, CA, USA
- Center for Neuroscience, the University of California at Davis, Davis, CA, USA
- Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
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14
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Adolescent Neurodevelopment and Vulnerability to Psychosis. Biol Psychiatry 2021; 89:184-193. [PMID: 32896384 PMCID: PMC9397132 DOI: 10.1016/j.biopsych.2020.06.028] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/28/2022]
Abstract
Adolescence is characterized by significant changes in several domains, including brain structure and function, puberty, and social and environmental factors. Some of these changes serve to increase the likelihood of psychosis onset during this period, while others may buffer this risk. This review characterizes our current knowledge regarding the unique aspects of adolescence that may serve as risk factors for schizophrenia spectrum disorders. In addition, we provide potential future directions for research into adolescent-specific developmental mechanisms that impart vulnerability to psychosis and the possibility of interventions that capitalize on adolescents' unique characteristics. Specifically, we explore the ways in which gray and white matter develop throughout adolescence in typically developing youth as well as in those with psychosis spectrum disorders. We also discuss current views on the function that social support and demands, as well as role expectations, play in risk for psychosis. We further highlight the importance of considering biological factors such as puberty and hormonal changes as areas of unique vulnerability for adolescents. Finally, we discuss cannabis use as a factor that may have a unique impact during adolescent neurodevelopment, and subsequently potentially impact psychosis onset. Throughout, we include discussion of resilience factors that may provide unique opportunities for intervention during this dynamic life stage.
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15
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Roalf DR, de la Garza AG, Rosen A, Calkins ME, Moore TM, Quarmley M, Ruparel K, Xia CH, Rupert PE, Satterthwaite TD, Shinohara RT, Elliott MA, Gur RC, Gur RE. Alterations in white matter microstructure in individuals at persistent risk for psychosis. Mol Psychiatry 2020; 25:2441-2454. [PMID: 30723287 PMCID: PMC6682472 DOI: 10.1038/s41380-019-0360-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/02/2019] [Accepted: 01/11/2019] [Indexed: 12/18/2022]
Abstract
Abnormalities in brain white matter (WM) are reported in youth at-risk for psychosis. Yet, the neurodevelopmental time course of these abnormalities remains unclear. Thus, longitudinal diffusion-weighted imaging (DWI) was used to investigate WM abnormalities in youth at-risk for psychosis. A subset of individuals from the Philadelphia Neurodevelopmental Cohort (PNC) completed two DWI scans approximately 20 months apart. Youths were identified through structured interview as having subthreshold persistent psychosis risk symptoms (n = 46), and were compared to healthy typically developing participants (TD; n = 98). Analyses were conducted at voxelwise and regional levels. Nonlinear developmental patterns were examined using penalized splines within a generalized additive model. Compared to TD, youth with persistent psychosis risk symptoms had lower whole-brain WM fractional anisotropy (FA) and higher radial diffusivity (RD). Voxelwise analyses revealed clusters of significant WM abnormalities within the temporal and parietal lobes. Lower FA within the cingulum bundle of hippocampus and cerebrospinal tracts were the most robust deficits in individuals with persistent psychosis symptoms. These findings were consistent over two visits. Thus, it appears that WM abnormalities are present early in youth with persistent psychosis risk symptoms, however, there is little evidence to suggest that these features emerge in late adolescence or early adulthood. Future studies should seek to characterize WM abnormalities in younger individuals and follow individuals as subthreshold psychotic symptoms emerge.
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Affiliation(s)
- David R. Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Angel Garcia de la Garza
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Adon Rosen
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tyler M. Moore
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Megan Quarmley
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cedric Huchuan Xia
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Petra E. Rupert
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T. Shinohara
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Mark A. Elliott
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.,Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Raquel E. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.,Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA.,Department of Child and Adolescent Psychiatry, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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16
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Wong HJ, Chew QH, Lee RD, Sim K. Illness remission status and commissural and associative brain white matter fiber changes in schizophrenia. Psych J 2020; 9:894-902. [PMID: 32881375 DOI: 10.1002/pchj.399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/15/2020] [Accepted: 07/23/2020] [Indexed: 01/01/2023]
Abstract
There is a paucity of studies clarifying biological basis of illness remission in schizophrenia related to white matter abnormalities, hence this study aimed to examine brain white matter anomalies via combinatorial diffusion tensor imaging (DTI) indices between remitted and nonremitted patients and evaluate predictors of remission. We examined DTI data of 178 patients who met the DSM-IV criteria for schizophrenia (120 nonremitted, 58 remitted) and 111 healthy controls. Remission was determined using Global Assessment of Functioning (GAF) and Positive and Negative Syndrome Scale (PANSS) scores. Analysis of covariance identified significantly different white matter tracts between groups, whilst covarying for clinical variables. Correlation and regression analyses were performed to determine clinical-imaging predictors of remission. Compared to controls, both nonremitted and remitted patients had reduced fractional anisotropy in the body of corpus callosum (BCC) and posterior thalamic radiation. Nonremitted patients had higher axial diffusivity (AD)/mean diffusivity (MD) values in the right cingulum than remitted patients after controlling for duration of illness, number of hospitalizations, and daily total chlorpromazine equivalents. The MD and AD of right cingulum correlated positively with the severity of psychotic psychopathology in nonremitted subjects. In addition, female sex and longer duration of illness were also significant predictors of remission. Specific DTI indices reflecting axonal processes and inflammation/edema of associative fibers (right cingulum) differentiated nonremitted from remitted patients, and together with relevant clinical factors, could serve as potential prognostic markers in schizophrenia.
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Affiliation(s)
- Hong Jie Wong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Qian Hui Chew
- Research Division, Institute of Mental Health, Singapore
| | - Renick D Lee
- Research Division, Institute of Mental Health, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore
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17
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Viher PV, Abdulkadir A, Savadijev P, Stegmayer K, Kubicki M, Makris N, Karmacharya S, Federspiel A, Bohlhalter S, Vanbellingen T, Müri R, Wiest R, Strik W, Walther S. Structural organization of the praxis network predicts gesture production: Evidence from healthy subjects and patients with schizophrenia. Cortex 2020; 132:322-333. [PMID: 33011518 DOI: 10.1016/j.cortex.2020.05.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/11/2020] [Accepted: 05/19/2020] [Indexed: 01/09/2023]
Abstract
Hand gestures are an integral part of social interactions and communication. Several imaging studies in healthy subjects and lesion studies in patients with apraxia suggest the praxis network for gesture production, involving mainly left inferior frontal, posterior parietal and temporal regions. However, little is known about the structural connectivity underlying gesture production. We recruited 41 healthy participants and 39 patients with schizophrenia. All participants performed a gesture production test, the Test of Upper Limb Apraxia, and underwent diffusion tensor imaging. We hypothesized that gesture production is associated with structural network connectivity as well as with tract integrity. We defined the praxis network as an undirected graph comprised of 13 bilateral regions of interest and derived measures of local and global structural connectivity and tract integrity from Finsler geometry. We found an association of gesture deficit with reduced global and local efficiency of the praxis network. Furthermore, reduced tract integrity, for example in the superior longitudinal fascicle, arcuate fascicle or corpus callosum were related to gesture deficits. Our findings contribute to the understanding of structural correlates of gesture production as they first present diffusion tensor imaging data in a combined sample of healthy subjects and a patient cohort with gestural deficits.
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Affiliation(s)
- Petra V Viher
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - Ahmed Abdulkadir
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Peter Savadijev
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Diagnostic Radiology, McGill University, Montreal, Canada
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sarina Karmacharya
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephan Bohlhalter
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Tim Vanbellingen
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - René Müri
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Department of Neurology, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Neuroradiology, University of Bern, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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18
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Viher PV, Stegmayer K, Federspiel A, Bohlhalter S, Wiest R, Walther S. Altered diffusion in motor white matter tracts in psychosis patients with catatonia. Schizophr Res 2020; 220:210-217. [PMID: 32295753 DOI: 10.1016/j.schres.2020.03.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 02/25/2020] [Accepted: 03/08/2020] [Indexed: 01/25/2023]
Abstract
Catatonia is a complex psychomotor symptom frequently observed in schizophrenia. Neural activity within the motor system is altered in catatonia. Likewise, white matter (WM) is also expected to be abnormal. The aim of this study was to test, if schizophrenia patients with catatonia show specific WM alterations. Forty-eight patients with schizophrenia and 43 healthy controls were included. Catatonia was currently present in 13 patients with schizophrenia. Tract-Based Spatial Statistics was used to test for differences in fractional anisotropy (FA) in the whole brain between the three groups. We detected a group effect (F-test) of WM within the corpus callosum (CC). In the t-test, patients with catatonia showed higher FA in many left lateralized WM clusters involved in motor behaviour compared to patients without catatonia, including the CC, internal and external capsule, superior longitudinal fascicle (SLF) and corticospinal tract (CST). Similarly, patients with catatonia showed also higher FA in the left internal capsule and left CST compared to healthy controls. In contrast, the group comparison between patients without catatonia and healthy controls revealed lower FA in many right lateralized clusters, comprising the CC, internal capsule, SLF, and inferior longitudinal fascicle in patients without catatonia. Our results are in line with the notion of an altered motor system in catatonia. Thus, our study provides evidence for increased WM connectivity, especially in motor tracts in schizophrenia patients with catatonia.
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Affiliation(s)
- Petra V Viher
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephan Bohlhalter
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
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19
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Gerretsen P, Rajji TK, Shah P, Shahab S, Sanches M, Graff-Guerrero A, Menon M, Pollock BG, Mamo DC, Mulsant BH, Voineskos AN. Impaired illness awareness in schizophrenia and posterior corpus callosal white matter tract integrity. NPJ SCHIZOPHRENIA 2019; 5:8. [PMID: 31036809 PMCID: PMC6488582 DOI: 10.1038/s41537-019-0076-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Abstract
Impaired illness awareness (Imp-IA) in schizophrenia is associated with interhemispheric imbalance, resulting in left hemisphere dominance, primarily within the posterior parietal area (PPA). This may represent an interhemispheric “disconnection syndrome” between PPAs. To test this hypothesis, we aimed to determine if diffusion-based measures of white matter integrity were disrupted in the corpus callosal tracts linking PPAs (i.e., splenium) in patients with Imp-IA in schizophrenia. T1-weighted and diffusion-weighted scans were acquired on a 1.5T GE scanner for 100 participants with a DSM-IV-TR diagnosis of schizophrenia and 134 healthy controls aged 18 to 79 years. The corpus callosal white matter tracts were compared among patients with Imp-IA (n = 40), intact illness awareness (n = 60), and healthy controls. White matter disruption was measured with fractional anisotropy (FA) and mean diffusivity (MD). Group differences in FA were found in the splenium, with patients with Imp-IA having the lowest FA, which remained significant after controlling for sex, age, global cognition, and premorbid intelligence. No group differences in MD were observed. Splenial white matter tracts of the corpus callosum appear compromised in patients with Imp-IA. Transcallosal interhemispheric PPA white matter disruption may represent a “disconnection syndrome”, manifesting as Imp-IA in schizophrenia. Future studies are required to investigate the effects of noninvasive brain stimulation interventions, such as transcranial direct current or magnetic stimulation, on Imp-IA in association with white matter changes in patients with schizophrenia.
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Affiliation(s)
- Philip Gerretsen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada. .,University of Toronto, Toronto, ON, Canada.
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
| | - Parita Shah
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
| | - Saba Shahab
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
| | - Marcos Sanches
- University of Toronto, Toronto, ON, Canada.,Krembil Centre for Neuroinformatics - CAMH, Toronto, ON, Canada
| | - Ariel Graff-Guerrero
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
| | | | - Benoit H Mulsant
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, Canada.,University of Toronto, Toronto, ON, Canada
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20
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Domen P, Michielse S, Peeters S, Viechtbauer W, van Os J, Marcelis M. Childhood trauma- and cannabis-associated microstructural white matter changes in patients with psychotic disorder: a longitudinal family-based diffusion imaging study. Psychol Med 2019; 49:628-638. [PMID: 29807550 DOI: 10.1017/s0033291718001320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Decreased white matter (WM) integrity in patients with psychotic disorder has been a consistent finding in diffusion tensor imaging (DTI) studies. However, the contribution of environmental risk factors to these WM alterations is rarely investigated. The current study examines whether individuals with (increased risk for) psychotic disorder will show increased WM integrity change over time with increasing levels of childhood trauma and cannabis exposure. METHODS DTI scans were obtained from 85 patients with a psychotic disorder, 93 non-psychotic siblings and 80 healthy controls, of which 60% were rescanned 3 years later. In a whole-brain voxel-based analysis, associations between change in fractional anisotropy (ΔFA) and environmental exposures as well as interactions between group and environmental exposure in the model of FA and ΔFA were investigated. Analyses were adjusted for a priori hypothesized confounding variables: age, sex, and level of education. RESULTS At baseline, no significant associations were found between FA and both environmental risk factors. At follow-up as well as over a 3-year interval, significant interactions between group and, respectively, cannabis exposure and childhood trauma exposure in the model of FA and ΔFA were found. Patients showed more FA decrease over time compared with both controls and siblings when exposed to higher levels of cannabis or childhood trauma. CONCLUSIONS Higher levels of cannabis or childhood trauma may compromise connectivity over the course of the illness in patients, but not in individuals at low or higher than average genetic risk for psychotic disorder, suggesting interactions between the environment and illness-related factors.
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Affiliation(s)
- Patrick Domen
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
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21
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Mamah D, Ji A, Rutlin J, Shimony JS. White matter integrity in schizophrenia and bipolar disorder: Tract- and voxel-based analyses of diffusion data from the Connectom scanner. NEUROIMAGE-CLINICAL 2018; 21:101649. [PMID: 30639179 PMCID: PMC6411967 DOI: 10.1016/j.nicl.2018.101649] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 12/06/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
Abstract
Background Diffusion imaging abnormalities have been associated with schizophrenia (SZ) and bipolar disorder (BD), indicating impaired structural connectivity. Newer methods permit the automated reconstruction of major white matter tracts from diffusion-weighted MR images in each individual's native space. Using high-definition diffusion data from SZ and BP subjects, we investigated brain white matter integrity using both an automated tract-based and voxel-based methods. Methods Using a protocol matched to the NIH (Young-Adult) Human Connectome Project (and collected on the same customized ‘Connectom’ scanner), diffusion scans were acquired from 87 total participants (aged 18–30), grouped as SZ (n = 24), BD (n = 33) and healthy controls (n = 30). Fractional anisotropy (FA) of eighteen white matter tracks were analyzed using the TRACULA software. Voxel-wise statistical analyses of diffusion data was carried out using the tract-based spatial statistics (TBSS) software. TRACULA group effects and clinical correlations were investigated using analyses of variance and multiple regression. Results TRACULA analysis identified a trend towards lower tract FA in SZ patients, most significantly in the left anterior thalamic radiation (ATR; p = .04). TBSS results showed significantly lower FA voxels bilaterally within the cerebellum and unilaterally within the left ATR, posterior thalamic radiation, corticospinal tract, and superior longitudinal fasciculus in SZ patients compared to controls (FDR corrected p < .05). FA in BD patients did not significantly differ from controls using either TRACULA or TBSS. Multiple regression showed FA of the ATR as predicting chronic mania (p = .0005) and the cingulum-angular bundle as predicting recent mania (p = .02) in patients. TBSS showed chronic mania correlating with FA voxels within the left ATR and corpus callosum. Conclusions White matter abnormality in SZ varies in severity across different white matter tract regions. Our results indicate that voxel-based analysis of diffusion data is more sensitive than tract-based analysis in identifying such abnormalities. Absence of white matter abnormality in BD may be related to medication effects and age. Our study investigated white matter integrity in 87 young schizophrenia, bipolar disorder and control subjects with a tract-based (TRACULA) and a voxel-based (TBSS) approach, using high-definition diffusion imaging data obtained from the Human Connectome Project ‘Connectom’ scanner. TRACULA evaluated fractional anisotropy (FA) from 18 white matter tracts. TBSS evaluated regional white matter FA. TRACULA identified a trend towards lower tract FA in schizophrenia subjects across multiple tracts. TBSS results showed mainly unilaterally decreased FA voxels in schizophrenia subjects. FA in bipolar patients did not significantly differ from controls with either method. With TRACULA, multiple regression showed that anterior thalamic radiation FA predicted chronic affectivity and cingulum-angular bundle FA predicted recent mania in patients. With TBSS, chronic mania correlated with FA voxels within the left anterior thalamic radiation and corpus callosum.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
| | - Andrew Ji
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Jerrel Rutlin
- Department Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Joshua S Shimony
- Department Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
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22
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Cookey J, Crocker CE, Bernier D, Newman AJ, Stewart S, McAllindon D, Tibbo PG. Microstructural Findings in White Matter Associated with Cannabis and Alcohol Use in Early-Phase Psychosis: A Diffusion Tensor Imaging and Relaxometry Study. Brain Connect 2018; 8:567-576. [PMID: 30417651 DOI: 10.1089/brain.2018.0611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Accumulating evidence suggests that brain white matter (WM) abnormalities may be central to the pathophysiology of psychotic disorders. In addition, there is evidence that cannabis use and alcohol use each is associated with WM abnormalities. However, there are very limited data on the effects of these substances on WM microstructure in patients with psychosis, especially for those at the early phase of illness. This project aimed to examine the impact of cannabis use and alcohol use on WM tissue in early-phase psychosis (EPP). WM was investigated in 21 patients with EPP using diffusion tensor imaging (DTI) and transverse relaxation time of tissue water (T2), with the primary outcomes being mean fractional anisotropy (FA) and T2. DTI analyses were performed at the full-brain level using tract-based spatial statistics with both DTI and T2 analysis done within a WM volume of interest (VOI) implicated in psychosis (containing the left superior longitudinal fasciculus). Our findings revealed that younger age of onset of regular alcohol use (more than one drink per week) was associated with lower FA values in the left thalamic radiation and left parahippocampal and left amygdalar WM. More frequent lifetime cannabis use was correlated with increased mean full-brain FA. There was no significant relationship found between FA and alcohol or cannabis use within the VOI. Relaxometry analysis revealed trend-level evidence of shortened T2 with later onset of regular alcohol use and with more frequent cannabis use. This study provides novel data demonstrating cortical and subcortical WM findings related to alcohol use in EPP and is the first to combine DTI and relaxometry, relating to this patient population.
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Affiliation(s)
- Jacob Cookey
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada
| | - Candice E Crocker
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada .,3 Department of Diagnostic Radiology, Nova Scotia Health Authority , Halifax, Canada
| | - Denise Bernier
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada
| | - Aaron J Newman
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,4 Department of Psychology and Neuroscience, Dalhousie University , Halifax, Canada
| | - Sherry Stewart
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,4 Department of Psychology and Neuroscience, Dalhousie University , Halifax, Canada
| | - David McAllindon
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,5 Biomedical Translational Imaging Center , IWK Health Centre, Halifax, Canada
| | - Philip G Tibbo
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada
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23
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Breier A, Liffick E, Hummer TA, Vohs JL, Yang Z, Mehdiyoun NF, Visco AC, Metzler E, Zhang Y, Francis MM. Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders. Schizophr Res 2018; 199:395-402. [PMID: 29588126 DOI: 10.1016/j.schres.2018.03.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Currently approved medications for schizophrenia are relatively ineffective for negative symptoms and cognitive impairment. N-Acetyl Cysteine (NAC) is a neuroprotective agent that improved general symptoms, cognitive impairment and negative symptoms in some but not all studies, but failed to improve positive symptoms in patients with schizophrenia. Progressive brain mass loss (PBML) has been consistently observed in early phase schizophrenia. NAC mitigates the deleterious effects oxidative stress, inflammation and glutamatergic excitotoxicity and these three pathological processes are hypothesized to contribute to PBML. METHODS In this study, we assessed the effects NAC (3600mg/day) in a 52-week, double-blind, placebo controlled trial on symptoms, and cognition in early phase schizophrenia spectrum disorders (N=60). In the context of the clinical trial, we explored the effects of NAC on brain morphology. RESULTS NAC significantly improved (time×group) PANSS total (F=14.7, p<0.001), negative (F=5.1, p=0.024) and disorganized thought (F=13.7, p<0.001) symptom scores. NAC failed to improve PANSS positive symptoms and BACS cognitive scores. In preliminary analyses, baseline right (r=-0.48, p=0.041) and left (r=-0.45, p=0.018) total cortical thickness, and thickness in other cortical regions, were associated with NAC related improvement in PANSS total scores, but NAC, as compared to placebo, did not significantly impact brain morphology over the study treatment period. CONCLUSIONS These results replicate some but not all previous findings of NAC efficacy. Preliminary results suggest that NAC's symptom effects may be related to structural integrity, but NAC failed to demonstrate treatment effects on longitudinal measures of brain morphology. ClinicalTrials.gov Identifier: NCT01339858.
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Affiliation(s)
- Alan Breier
- Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Emily Liffick
- Indiana University School of Medicine, Indianapolis, IN, United States; Eli Lilly and Company, Indianapolis, IN, United States
| | - Tom A Hummer
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jenifer L Vohs
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ziyi Yang
- Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Andrew C Visco
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Emmalee Metzler
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ying Zhang
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Michael M Francis
- Indiana University School of Medicine, Indianapolis, IN, United States
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24
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Zhao W, Guo S, He N, Yang AC, Lin CP, Tsai SJ. Callosal and subcortical white matter alterations in schizophrenia: A diffusion tensor imaging study at multiple levels. Neuroimage Clin 2018; 20:594-602. [PMID: 30186763 PMCID: PMC6120601 DOI: 10.1016/j.nicl.2018.08.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/25/2018] [Accepted: 08/20/2018] [Indexed: 12/28/2022]
Abstract
Diffusion tensor imaging and its distinct capability to detect micro-structural changes in vivo allows the exploration of white matter (WM) abnormalities in patients who have been diagnosed with schizophrenia; however, the results regarding the anatomical positions and degree of abnormalities are inconsistent. In order to obtain more robust and stable findings, we conducted a multi-level analysis to investigate WM disruption in a relatively large sample size (142 schizophrenia patients and 163 healthy subjects). Specifically, we evaluated the univariate fractional anisotropy (FA) in voxel level; the bivariate pairwise structural connectivity between regions using deterministic tractography as the network node defined by the Human Brainnetome Atlas; and the multivariate network topological properties, including the network hub, efficiency, small-worldness, and strength. Our data demonstrated callosal and subcortical WM alterations in patients with schizophrenia. These disruptions were evident in both voxel and connectivity levels and further supported by associations between FA values and illness duration. Based on the findings regarding topological properties, the structural network showed weaker global integration in patients with schizophrenia than in healthy subjects, while brain network hubs showed decreased functionality. We replicated these findings using an automated anatomical labeling atlas to define the network node. Our study indicates that callosal and subcortical WM disruptions are biomarkers for chronic schizophrenia.
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Affiliation(s)
- Wei Zhao
- College of Mathematics and Statistics, Key Laboratory of High Performance Computing and Stochastic Information Processing (Ministry of Education of China), Hunan Normal University, Changsha, PR China
| | - Shuixia Guo
- College of Mathematics and Statistics, Key Laboratory of High Performance Computing and Stochastic Information Processing (Ministry of Education of China), Hunan Normal University, Changsha, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, PR China.
| | - Ningning He
- College of Mathematics and Statistics, Key Laboratory of High Performance Computing and Stochastic Information Processing (Ministry of Education of China), Hunan Normal University, Changsha, PR China
| | - Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, USA; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
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25
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Hummer TA, Francis MM, Vohs JL, Liffick E, Mehdiyoun NF, Breier A. Characterization of white matter abnormalities in early-stage schizophrenia. Early Interv Psychiatry 2018; 12:660-668. [PMID: 27621217 DOI: 10.1111/eip.12359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/27/2016] [Accepted: 07/14/2016] [Indexed: 01/04/2023]
Abstract
AIM White matter abnormalities have been reported in schizophrenia and may indicate altered cortical network integrity and structural connectivity, which have been hypothesized as key pathophysiological components of this illness. In this study, we aimed to further characterize the nature and progression of white matter alterations during the early stages of the disorder. METHODS We employed diffusion tensor imaging (DTI) approaches to investigate fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) in 40 patients with schizophrenia and related psychotic disorders (aged 18-30 years) who were within 5 years of illness, along with an age-, sex- and race-matched sample of 21 healthy controls. Relationships with illness duration, lifetime antipsychotic medication exposure and symptom levels were examined. RESULTS Patients had lower FA and higher RD than controls in numerous white matter tracts, including the corpus callosum (CC) and the superior longitudinal fasciculus. Illness duration was associated with lower FA and higher RD, most prominently in the CC. No group differences or relationships to illness duration were detected with AD, and no relationships between any DTI measurements and lifetime antipsychotic medication use were found. CONCLUSIONS This investigation provides evidence of widespread disruptions to structural connectivity in the early stages of schizophrenia. The relationship to illness duration, coupled with an absence of relationships to AD or antipsychotic drug exposure, provides evidence of a progressive disease process, although prospective assessments with repeated DTI measurements are needed to fully characterize the trajectory of white matter abnormalities in this illness.
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Affiliation(s)
- Tom A Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael M Francis
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jenifer L Vohs
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Emily Liffick
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nicole F Mehdiyoun
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Hawco C, Voineskos AN, Radhu N, Rotenberg D, Ameis S, Backhouse FA, Semeralul M, Daskalakis ZJ. Age and gender interactions in white matter of schizophrenia and obsessive compulsive disorder compared to non-psychiatric controls: commonalities across disorders. Brain Imaging Behav 2018; 11:1836-1848. [PMID: 27915397 DOI: 10.1007/s11682-016-9657-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Schizophrenia (SCZ) and obsessive-compulsive disorder (OCD) are psychiatric disorders with abnormalities in white matter structure. These disorders share high comorbidity and family history of OCD is a risk factor for SCZ which suggests some shared neurobiology. White matter was examined using diffusion tensor imaging in relativity large samples of SCZ (N = 48), OCD (N = 38) and non-psychiatric controls (N = 45). Fractional anisotropy (FA) was calculated and tract based spatial statistics were used to compare groups. In a whole brain analysis, SCZ and OCD both showed small FA reductions relative to controls in the corpus callosum. Both SCZ and OCD showed accelerated reductions in FA with age; specifically in the left superior longitudinal fasciculus in OCD, while the SCZ group demonstrated a more widespread pattern of FA reduction. Patient groups did not differ from each other in total FA or age effects in any regions. A general linear model using 13 a-priori regions of interest showed marginal group, group*gender, and group*age interactions. When OCD and SCZ groups were analyzed together, these marginal effects became significant (p < 0.05), suggesting commonalities exist between these patient groups. Overall, our results demonstrate a similar pattern of accelerated white matter decline with age and greater white matter deficit in females in OCD and SCZ, with overlap in the spatial pattern of deficits. There was no evidence for statistical differences in overall white matter between OCD and SCZ. Taken together, the results support the notion of shared neurobiology in SCZ and OCD.
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Affiliation(s)
- Colin Hawco
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada. .,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Natasha Radhu
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - David Rotenberg
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
| | - Stephanie Ameis
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Felicity A Backhouse
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mawahib Semeralul
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Unit 4-1, Office 125, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Keymer-Gausset A, Alonso-Solís A, Corripio I, Sauras-Quetcuti RB, Pomarol-Clotet E, Canales-Rodriguez EJ, Grasa-Bello E, Álvarez E, Portella MJ. Gray and white matter changes and their relation to illness trajectory in first episode psychosis. Eur Neuropsychopharmacol 2018; 28:392-400. [PMID: 29338891 DOI: 10.1016/j.euroneuro.2017.12.117] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 12/22/2017] [Accepted: 12/27/2017] [Indexed: 11/29/2022]
Abstract
Previous works have studied structural brain characteristics in first-episode psychosis (FEP), but few have focused on the relation between brain differences and illness trajectories. The aim of this study is to analyze gray and white matter changes in FEP patients and their relation with one-year clinical outcomes. A sample of 41 FEP patients and 41 healthy controls (HC), matched by age and educational level was scanned with a 3T MRI during the first month of illness onset. One year later, patients were assigned to two illness trajectories (schizophrenia and non-schizophrenia). Voxel-based morphometry (VBM) was used for gray matter and Tract-based spatial statistics (TBSS) was used for white matter data analysis. VBM revealed significant and widespread bilateral gray matter density differences between FEP and HC groups in areas that included the right insular Cortex, the inferior frontal gyrus and orbito-frontal cortices, and segments of the occipital cortex. TBSS showed a significant lower fractional anisotropy (FA) in 8 clusters that included segments of the anterior thalamic radiation, the left body and forceps minor of corpus callosum, the right anterior segment of the inferior fronto-occipital fasciculus and the anterior segments of the cingulum. The sub-groups comparison revealed significant lower FA in the schizophrenia sub-group in two clusters: the anterior thalamic radiation and the anterior segment of left cingulum. These findings are coherent with previous morphology studies. The results suggest that gray and white matter abnormalities are present at early stages of the disease, and white matter differences may distinguish different illness prognosis.
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Affiliation(s)
- Alejandro Keymer-Gausset
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Spain
| | - Anna Alonso-Solís
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
| | | | - Edith Pomarol-Clotet
- Benito Menni Complex Assistencial en Salut Mental, Barcelona 08830, Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Erick J Canales-Rodriguez
- Benito Menni Complex Assistencial en Salut Mental, Barcelona 08830, Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Eva Grasa-Bello
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Enric Álvarez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Maria J Portella
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain; Universitat Autònoma de Barcelona (UAB), Spain
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28
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White matter correlates of the disorganized speech dimension in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2018; 268:99-104. [PMID: 28032254 DOI: 10.1007/s00406-016-0753-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 12/13/2016] [Indexed: 01/15/2023]
Abstract
Disorganized speech is related to functional abnormalities in schizophrenia. To test the association between formal thought disorders (FTDs) and white matter microstructure, we applied a behavioral rating and diffusion tensor imaging in 61 patients with schizophrenia spectrum disorders. The Bern Psychopathology Scale was used to rate the dimension of language abnormalities ranging from negative FTDs, basically unaltered speech, to positive FTDs. Tract-based spatial statistics indicated increased fractional anisotropy in left hemispheric pathways of the language system in patients with negative FTDs. Thus, altered white matter properties in relevant fiber tracts may represent vulnerability to specific formal thought disorders.
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29
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Joo SW, Chon MW, Rathi Y, Shenton ME, Kubicki M, Lee J. Abnormal asymmetry of white matter tracts between ventral posterior cingulate cortex and middle temporal gyrus in recent-onset schizophrenia. Schizophr Res 2018; 192:159-166. [PMID: 28506703 DOI: 10.1016/j.schres.2017.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/04/2017] [Accepted: 05/07/2017] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Previous studies have reported abnormalities in the ventral posterior cingulate cortex (vPCC) and middle temporal gyrus (MTG) in schizophrenia patients. However, it remains unclear whether the white matter tracts connecting these structures are impaired in schizophrenia. Our study investigated the integrity of these white matter tracts (vPCC-MTG tract) and their asymmetry (left versus right side) in patients with recent onset schizophrenia. METHOD Forty-seven patients and 24 age-and sex-matched healthy controls were enrolled in this study. We extracted left and right vPCC-MTG tract on each side from T1W and diffusion MRI (dMRI) at 3T. We then calculated the asymmetry index of diffusion measures of vPCC-MTG tracts as well as volume and thickness of vPCC and MTG using the formula: 2×(right-left)/(right+left). We compared asymmetry indices between patients and controls and evaluated their correlations with the severity of psychiatric symptoms and cognition in patients using the Positive and Negative Syndrome Scale (PANSS), video-based social cognition scale (VISC) and the Wechsler Adult Intelligence Scale (WAIS-III). RESULTS Asymmetry of fractional anisotropy (FA) and radial diffusivity (RD) in the vPCC-MTG tract, while present in healthy controls, was not evident in schizophrenia patients. Also, we observed that patients, not healthy controls, had a significant FA decrease and RD increase in the left vPCC-MTG tract. There was no significant association between the asymmetry indices of dMRI measures and IQ, VISC, or PANSS scores in schizophrenia. CONCLUSION Disruption of asymmetry of the vPCC-MTG tract in schizophrenia may contribute to the pathophysiology of schizophrenia.
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Affiliation(s)
- Sung Woo Joo
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Myong-Wuk Chon
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, 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; VA Boston Healthcare System, Brockton Division, Brockton, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Cortical Morphometry in the Psychosis Risk Period: A Comprehensive Perspective of Surface Features. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:434-443. [PMID: 31054647 DOI: 10.1016/j.bpsc.2018.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Gyrification features reflect brain development in the early prenatal environment. Clarifying the nature of these features in psychosis can help shed light on the role of early developmental insult. However, the literature is currently widely discrepant, which may reflect confounds related to formally psychotic patient populations or overreliance on a single feature of cortical surface morphometry (CSM). METHODS This study compares CSM features of gyrification in clinical high-risk (n = 43) youths during the prodromal risk period to typically developing control subjects over two time points across three metrics: local gyrification index, mean curvature index, and sulcal depth (improving resolution and examination of change over 1 year). RESULTS Gyrification was stable over time, supporting the idea that gyrification reflects early insult rather than abnormal development or reorganization associated with the disease state. Each of the indices highlighted unique, aberrant features in the clinical high-risk group with respect to control subjects. Specifically, the local gyrification index reflected hypogyrification in the lateral orbitofrontal cortex, superior bank of the superior temporal sulcus, anterior isthmus of the cingulate gyrus, and temporal poles; the mean curvature index indicated sharper gyral and flatter or wider sulcal peaks in the cingulate, postcentral, and lingual gyrus; sulcal depth identified shallow features in the parietal, superior temporal sulcus, and cingulate regions. Further, both the mean curvature index and sulcal depth converged on abnormal features in the parietal cortex. CONCLUSIONS Gyrification metrics suggest early developmental insult and provide support for neurodevelopmental hypotheses. Observations of stable CSM features across time provide context for interpreting extant studies and speak to CSM as a promising stable marker and/or endophenotype. Collectively, findings support the importance of considering multiple CSM features.
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Amodio A, Quarantelli M, Mucci A, Prinster A, Soricelli A, Vignapiano A, Giordano GM, Merlotti E, Nicita A, Galderisi S. Avolition-Apathy and White Matter Connectivity in Schizophrenia: Reduced Fractional Anisotropy Between Amygdala and Insular Cortex. Clin EEG Neurosci 2018; 49:55-65. [PMID: 29243529 DOI: 10.1177/1550059417745934] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The avolition/apathy domain of negative symptoms includes motivation- and pleasure-related impairments. In people with schizophrenia, structural and functional abnormalities were reported in key regions within the motivational reward system, including ventral-tegmental area (VTA), striatum (especially at the level of the nucleus accumbens, NAcc), orbitofrontal cortex (OFC), as well as amygdala (Amy) and insular cortex (IC). However, the association of the reported abnormalities with avoliton-apathy is still controversial. In the present study, we investigated white matter connectivity patterns within these regions, using a probabilistic analysis of diffusion tensor imaging (DTI) data, in male subjects with schizophrenia. Thirty-five male subjects with schizophrenia (SCZ) and 17 male healthy controls (HC) matched for age, underwent DTI. SCZ were evaluated using the Schedule for Deficit Syndrome (SDS), the Positive and Negative Syndrome Scale (PANSS), and the MATRICS Consensus Cognitive Battery (MCCB). Probabilistic tractography was applied to investigate pathways connecting the Amy and the NAcc with the OFC and IC. Reduced fractional anisotropy (FA) was observed in left Amy-ventral anterior IC connections, in SCZ compared with controls. This abnormality was negatively correlated with avolition/apathy but not with expressive deficit scores. SCZ showed also a reduced connectivity index between right NAcc and medial OFC, as compared with controls. Finally, the left NAcc-dorsal anterior IC connectivity index was negatively correlated with working memory scores. Our results indicate that only the avolition/apathy domain of negative symptoms is related to abnormal connectivity in the motivation-related circuits. The findings also demonstrate that distinct alterations underlie cognitive impairment and avolition/apathy.
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Affiliation(s)
- Antonella Amodio
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Quarantelli
- 2 Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Armida Mucci
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Anna Prinster
- 2 Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Andrea Soricelli
- 3 Department of Integrated Imaging, IRCCS SDN, Naples, Italy.,4 Department of Motor Sciences & Healthiness, University of Naples Parthenope, Naples, Italy
| | - Annarita Vignapiano
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia Maria Giordano
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Eleonora Merlotti
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessia Nicita
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silvana Galderisi
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Shahab S, Stefanik L, Foussias G, Lai MC, Anderson KK, Voineskos AN. Sex and Diffusion Tensor Imaging of White Matter in Schizophrenia: A Systematic Review Plus Meta-analysis of the Corpus Callosum. Schizophr Bull 2018; 44:203-221. [PMID: 28449132 PMCID: PMC5767963 DOI: 10.1093/schbul/sbx049] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sex is considered an understudied variable in health research. Schizophrenia is a brain disorder with known sex differences in epidemiology and clinical presentation. We systematically reviewed the literature for sex-based differences of diffusion properties of white matter tracts in schizophrenia. We then conducted a meta-analysis examining sex-based differences in the genu and splenium of the corpus callosum in schizophrenia. Medline and Embase were searched to identify relevant papers. Studies fulfilling the following criteria were included: (1) included individuals with a diagnosis of schizophrenia, (2) included a control group of healthy individuals, (3) included both sexes in the patient and the control groups, (4) used diffusion tensor imaging, and (5) involved analyzing metrics of white matter microstructural integrity. Fractional anisotropy (FA) was used as the measure of interest in the meta-analysis. Of 730 studies reviewed, 75 met the inclusion criteria. Most showed no effect of sex, however, those that did found either that females have lower FA than males, or that the effect of disease in females is larger than that in males. The findings of the meta-analysis in the corpus callosum supported this result. There is a recognized need for studies on schizophrenia with a sufficient sample of female patients. Lack of power undermines the ability to detect sex-based differences. Understanding the sex-specific impact of illness on neural circuits may help inform development of new treatments, and improvement of existing interventions.
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Affiliation(s)
- Saba Shahab
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health and Slaight Family Centre for Youth in Transition, Toronto, ON, Canada
| | - Laura Stefanik
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health and Slaight Family Centre for Youth in Transition, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - George Foussias
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health and Slaight Family Centre for Youth in Transition, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Meng-Chuan Lai
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health and Slaight Family Centre for Youth in Transition, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Kelly K Anderson
- Centre for Addiction and Mental Health and Slaight Family Centre for Youth in Transition, Toronto, ON, Canada,Department of Epidemiology & Biostatistics and Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health and Slaight Family Centre for Youth in Transition, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,To whom correspondence should be addressed; 250 College Street, Toronto, ON M5T 1R8, Canada; tel: 416-535-8501 ext. 33977, fax: 416-260-4162, e-mail:
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Elucidation of shared and specific white matter findings underlying psychopathology clusters in schizophrenia. Asian J Psychiatr 2017; 30:144-151. [PMID: 28938151 DOI: 10.1016/j.ajp.2017.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/28/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Schizophrenia is associated with diverse white matter (WM) brain abnormalities. In this study, we sought to examine the WM microstructural findings which underlie clinical psychopathology clusters in schizophrenia and hypothesized that these symptom clusters are associated with common and unique WM tracts. METHODS Overall, 76 healthy controls (HC), and 148 patients with schizophrenia (SZ) were recruited and severity of symptomatology in schizophrenia was assessed using the Positive and Negative Syndrome Scale. WM fractional anisotropy (FA) values were extracted from their diffusion tensor images. Psychopathology clusters were first determined using factor analysis and the relationship between these symptom factors and FA values were then assessed with structural equation modelling, which included covariates such as age, sex, duration of illness and medications prescribed. RESULTS Patients with schizophrenia had reduced FA in the genu of corpus callosum (gCC) compared to HC. A three-factor model, namely Positive, Negative, Disorganised factors, was determined as the best fit for the data. All three psychopathology factors were associated with decreased FA in the gCC and bilateral cingulate gyrus. Higher Negative factor scores were uniquely associated with decreased FA in the right sagittal striatum and right superior longitudinal fasciculus. CONCLUSIONS This study found shared and specific WM changes and their associations with specific symptom clusters, which potentially allows for monitoring of such white matter findings associated with clinical presentations in schizophrenia over treatment and illness course.
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Michielse S, Gronenschild E, Domen P, van Os J, Marcelis M. The details of structural disconnectivity in psychotic disorder: A family-based study of non-FA diffusion weighted imaging measures. Brain Res 2017; 1671:121-130. [PMID: 28709907 DOI: 10.1016/j.brainres.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/01/2017] [Accepted: 07/04/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies in psychotic disorder have shown reduced FA, often interpreted as disturbed white matter integrity. The observed 'dysintegrity' may be of multifactorial origin, as changes in FA are thought to reflect a combination of changes in myelination, fiber organization and number of axons. Examining the structural substrate of the diffusion tensor in individuals with (risk for) psychotic disorder may provide better understanding of the underlying structural changes. METHODS DTI scans were acquired from 85 patients with psychotic disorder, 93 siblings of patients with psychotic disorder and 80 controls. Cross-sectional group comparisons were performed using Tract-Based Spatial Statistics (TBSS) on six DTI measures: axial diffusivity (AXD), radial diffusivity (RD), mean diffusivity (MD), and the case linear (CL), case planar (CP) and case spherical (CS) tensor shape measures. RESULTS AXD did not differ between the groups. RD and CS values were significantly increased in patients compared to controls and siblings, with no significant differences between the latter two groups. MD was higher in patients compared to controls (but not siblings), with no difference between siblings and controls. CL was smaller in patients than in siblings and controls, and CP was smaller in both patients and siblings as compared to controls. CONCLUSION The differences between individuals with psychotic disorder and healthy controls, derived from detailed diffusion data analyses, suggest less fiber orientation and increased free water movement in the patients. There was some evidence for association with familial risk expressed by decreased fiber orientation.
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Affiliation(s)
- Stijn Michielse
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | - Ed Gronenschild
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Patrick Domen
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
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Bopp MHA, Zöllner R, Jansen A, Dietsche B, Krug A, Kircher TTJ. White matter integrity and symptom dimensions of schizophrenia: A diffusion tensor imaging study. Schizophr Res 2017; 184:59-68. [PMID: 28012640 DOI: 10.1016/j.schres.2016.11.045] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/27/2016] [Accepted: 11/28/2016] [Indexed: 01/15/2023]
Abstract
Impaired fiber bundle connectivity between brain regions is a key neuropathological finding in schizophrenia. Symptom dimensions in schizophrenia can be clustered into factor models. Single syndromes have been related to grey and white matter brain structure alterations. We associated all core syndromes of schizophrenia in a single patient group with changes in white matter integrity. Diffusion weighted images (3T MRI) and SAPS/SANS scores were measured in 26 male patients and 26 healthy controls. First, group differences in fractional anisotropy (FA) were calculated with TBSS. Second, core symptom dimensions of schizophrenia were correlated with FA within these altered tracts. We found differences between groups in nine white matter tracts. Hallucinations were positively correlated with FA in the left uncinate fasciculus and left corticospinal tract. Ego-disturbances (passivity phenomena) showed a positive correlation with FA in the right anterior thalamic radiation. Positive formal thought disorders (FTD) corresponded negatively with FA in the right cingulum bundle. Negative symptoms were positively associated with the right anterior thalamic radiation and negatively with the right ventral cingulum bundle. For the first time, we analyzed the whole range of psychopathological factors in one schizophrenia patient group. We could validate our novel results for positive FTD and passivity phenomena by replicating findings for hallucinations and negative symptoms. Only those brain circuits which are most vulnerable at a given time during neurodevelopment are affected by a particular pathological impact (genetic, environmental). This scenario could explain the predominance of particular psychopathological syndromes related to specific white matter anomalies.
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Affiliation(s)
- Miriam H A Bopp
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany; Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; International Clinical Research Center, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic.
| | - Rebecca Zöllner
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany; Core Facility Brain Imaging, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
| | - Tilo T J Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany
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Schizophrenia symptomatic associations with diffusion tensor imaging measured fractional anisotropy of brain: a meta-analysis. Neuroradiology 2017; 59:699-708. [PMID: 28550466 DOI: 10.1007/s00234-017-1844-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 05/02/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE Several studies have examined the relationships between diffusion tensor imaging (DTI)-measured fractional anisotropy (FA) and the symptoms of schizophrenia, but results vary across the studies. The aim of this study was to carry out a meta-analysis of correlation coefficients reported by relevant studies to evaluate the correlative relationships between FA of various parts of the brain and schizophrenia symptomatic assessments. METHODS Literature was searched in several electronic databases, and study selection was based on précised eligibility criteria. Correlation coefficients between FA of a part of the brain and schizophrenia symptom were first converted into Fisher's z-scores for meta-analyses, and then overall effect sizes were back transformed to correlation coefficients. RESULTS Thirty-three studies (1121 schizophrenia patients; age 32.66 years [95% confidence interval (CI) 30.19, 35.13]; 65.95 % [57.63, 74.28] males) were included in this meta-analysis. Age was inversely associated with brain FA (z-scores [95% CI] -0.23 [-0.14, -0.32]; p ˂ 0.00001). Brain FA of various areas was inversely associated with negative symptoms of schizophrenia (z-score -0.30 [-0.23, -0.36]; p ˂ 0.00001) but was positively associated with positive symptoms of schizophrenia (z-score 0.16 [0.04, 0.27]; p = 0.007) and general psychopathology of schizophrenia (z-score 0.26 [0.15, 0.37]; p = 0.00001). CONCLUSION Although, DTI-measured brain FA is found to be inversely associated with negative symptoms and positively associated with positive symptoms and general psychopathology of schizophrenia, the effect sizes of these correlations are low and may not be clinically significant. Moreover, brain FA was also negatively associated with age of patients.
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Li Q, Shi L, Lu G, Yu HL, Yeung FK, Wong NK, Sun L, Liu K, Yew D, Pan F, Wang DF, Sham PC. Chronic Ketamine Exposure Causes White Matter Microstructural Abnormalities in Adolescent Cynomolgus Monkeys. Front Neurosci 2017; 11:285. [PMID: 28579941 PMCID: PMC5437169 DOI: 10.3389/fnins.2017.00285] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/02/2017] [Indexed: 01/05/2023] Open
Abstract
Acute and repeated exposures to ketamine mimic aspects of positive, negative, and cognitive symptoms of schizophrenia in humans. Recent studies by our group and others have shown that chronicity of ketamine use may be a key element for establishing a more valid model of cognitive symptoms of schizophrenia. However, current understanding on the long-term consequences of ketamine exposure on brain circuits has remained incomplete, particularly with regard to microstructural changes of white matter tracts that underpin the neuropathology of schizophrenia. Thus, the present study aimed to expand on previous investigations by examining causal effects of repeated ketamine exposure on white matter integrity in a non-human primate model. Ketamine or saline (control) was administered intravenously for 3 months to male adolescent cynomolgus monkeys (n = 5/group). Diffusion tensor imaging (DTI) experiments were performed and tract-based spatial statistics (TBSS) was used for data analysis. Fractional anisotropy (FA) was quantified across the whole brain. Profoundly reduced FA on the right side of sagittal striatum, posterior thalamic radiation (PTR), retrolenticular limb of the internal capsule (RLIC) and superior longitudinal fasciculus (SLF), and on the left side of PTR, middle temporal gyrus and inferior frontal gyrus were observed in the ketamine group compared to controls. Diminished white matter integrity found in either fronto-thalamo-temporal or striato-thalamic connections with tracts including the SLF, PTR, and RLIC lends support to similar findings from DTI studies on schizophrenia in humans. This study suggests that chronic ketamine exposure is a useful pharmacological paradigm that might provide translational insights into the pathophysiology and treatment of schizophrenia.
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Affiliation(s)
- Qi Li
- Department of Psychiatry, The University of Hong KongHong Kong, Hong Kong.,State Key Laboratory for Cognitive and Brain Sciences, The University of Hong KongHong Kong, Hong Kong.,The University of Hong Kong Shenzhen Institute of Research and Innovation (HKU-SIRI), The University of Hong KongHong Kong, Hong Kong
| | - Lin Shi
- Department of Medicine and Therapeutics, Chinese University of Hong KongHong Kong, Hong Kong.,Chow Yuk Ho Center of Innovative Technology for Medicine, Chinese University of Hong KongHong Kong, Hong Kong
| | - Gang Lu
- School of Biomedical Sciences, Chinese University of Hong KongHong Kong, Hong Kong
| | - Hong-Luan Yu
- Department of Psychology, Qilu Hospital of Shandong UniversityJinan, China
| | - Fu-Ki Yeung
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, Chinese University of Hong KongHong Kong, Hong Kong
| | - Nai-Kei Wong
- Chemical Biology Laboratory for Infectious Diseases, Shenzhen Institute of Hepatology, The Third People's Hospital of ShenzhenShenzhen, China
| | - Lin Sun
- Department of Psychology, Weifang Medical UniversityWeifang, China
| | - Kai Liu
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, Chinese University of Hong KongHong Kong, Hong Kong
| | - David Yew
- School of Chinese Medicine, Chinese University of Hong KongHong Kong, Hong Kong
| | - Fang Pan
- Department of Medical Psychology, Shandong University School of MedicineJinan, China
| | - De-Feng Wang
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, Chinese University of Hong KongHong Kong, Hong Kong
| | - Pak C Sham
- Department of Psychiatry, The University of Hong KongHong Kong, Hong Kong.,State Key Laboratory for Cognitive and Brain Sciences, The University of Hong KongHong Kong, Hong Kong.,Genome Research Centre, The University of Hong KongHong Kong, Hong Kong
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White Matter Integrity in Genetic High-Risk Individuals and First-Episode Schizophrenia Patients: Similarities and Disassociations. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3107845. [PMID: 28401151 PMCID: PMC5376415 DOI: 10.1155/2017/3107845] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 02/16/2017] [Indexed: 02/01/2023]
Abstract
White matter (WM) neuroimaging studies have shown varied findings at different stages of schizophrenia (SZ). Understanding these variations may elucidate distinct markers of genetic vulnerability and conversion to psychosis. To examine the similarities and differences in WM connectivity between those at-risk for and in early stages of SZ, a cross-sectional diffusion tensor imaging study of 48 individuals diagnosed with first-episode SZ (FE-SZ), 37 nonpsychotic individuals at a high genetic risk of SZ (GHR-SZ), and 67 healthy controls (HC) was conducted. Decreased fractional anisotropy (FA) in the corpus callosum (CC), anterior cingulum (AC), and uncinate fasciculus (UF) was observed in both the GHR-SZ and FE-SZ groups, while decreased FAs in the superior longitudinal fasciculus (SLF) and the fornix were only seen in the FE-SZ participants. Additionally, both GHR-SZ and FE-SZ showed worse executive performance than HC. The left SLF III FA was significantly positively correlated with hallucinations, and right SLF II was positively correlated with thought disorder. The presence of shared WM deficits in both FE-SZ and GHR-SZ individuals may reflect the genetic liability to SZ, while the disparate FA changes in the FE-SZ group may represent symptom-generating circuitry that mediates perceptual and cognitive disturbances of SZ and ultimately culminates in the onset of psychotic episodes.
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Docx L, Emsell L, Van Hecke W, De Bondt T, Parizel PM, Sabbe B, Morrens M. White matter microstructure and volitional motor activity in schizophrenia: A diffusion kurtosis imaging study. Psychiatry Res Neuroimaging 2017; 260:29-36. [PMID: 28012424 DOI: 10.1016/j.pscychresns.2016.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 09/18/2016] [Accepted: 10/14/2016] [Indexed: 12/13/2022]
Abstract
Avolition is a core feature of schizophrenia and may arise from altered brain connectivity. Here we used diffusion kurtosis imaging (DKI) to investigate the association between white matter (WM) microstructure and volitional motor activity. Multi-shell diffusion MRI and 24-h actigraphy data were obtained from 20 right-handed patients with schizophrenia and 16 right-handed age and gender matched healthy controls. We examined correlations between fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and motor activity level, as well as group differences in these measures. In the patient group, increasing motor activity level was positively correlated with MK in the inferior, medial and superior longitudinal fasciculus, the corpus callosum, the posterior fronto-occipital fasciculus and the posterior cingulum. This association was not found in control subjects or in DTI measures. These results show that a lack of volitional motor activity in schizophrenia is associated with potentially altered WM microstructure in posterior brain regions associated with cognitive function and motivation. This could reflect both illness related dysconnectivity which through altered cognition, manifests as reduced volitional motor activity, and/or the effects of reduced physical activity on brain WM.
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Affiliation(s)
- Lise Docx
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; PC Broeders Alexianen Boechout, Provinciesteenweg 408, 2530 Boechout, Belgium.
| | - Louise Emsell
- University Psychiatry Centre (UPC)-KU Leuven, Leuven, Belgium
| | - Wim Van Hecke
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Timo De Bondt
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Bernard Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; PZ St Norbertus Duffel, Stationsstraat 25c, 2570 Duffel, Belgium
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; PC Broeders Alexianen Boechout, Provinciesteenweg 408, 2530 Boechout, Belgium
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40
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Domen P, Peeters S, Michielse S, Gronenschild E, Viechtbauer W, Roebroeck A, Os JV, Marcelis M. Differential Time Course of Microstructural White Matter in Patients With Psychotic Disorder and Individuals at Risk: A 3-Year Follow-up Study. Schizophr Bull 2017; 43:160-170. [PMID: 27190279 PMCID: PMC5216846 DOI: 10.1093/schbul/sbw061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although widespread reduced white matter (WM) integrity is a consistent finding in cross-sectional diffusion tensor imaging (DTI) studies of schizophrenia, little is known about the course of these alterations. This study examined to what degree microstructural WM alterations display differential trajectories over time as a function of level of psychosis liability. METHODS Two DTI scans with a 3-year time interval were acquired from 159 participants (55 patients with a psychotic disorder, 55 nonpsychotic siblings and 49 healthy controls) and processed with tract-based spatial statistics. The mean fractional anisotropy (FA) change over time was calculated. Main effects of group, as well as group × region interactions in the model of FA change were examined with multilevel (mixed-effects) models. RESULTS Siblings revealed a significant mean FA decrease over time compared to controls (B = -0.004, P = .04), resulting in a significant sibling-control difference at follow-up (B = -0.007, P = .03). Patients did not show a significant change over time, but their mean FA was lower than controls both at baseline and at follow-up. A significant group × region interaction (χ2 = 105.4, P = .01) revealed group differences in FA change in the right cingulum, left posterior thalamic radiation, right retrolenticular part of the internal capsule, and the right posterior corona radiata. CONCLUSION Whole brain mean FA remained stable over a 3-year period in patients with psychotic disorder and declined over time in nonaffected siblings, so that at follow-up both groups had lower FA with respect to controls. The results suggest that liability for psychosis may involve a process of WM alterations.
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Affiliation(s)
- Patrick Domen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands;
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ed Gronenschild
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alard Roebroeck
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
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DeRosse P, Ikuta T, Karlsgodt KH, Peters BD, Gopin CB, Szeszko PR, Malhotra AK. White Matter Abnormalities Associated With Subsyndromal Psychotic-Like Symptoms Predict Later Social Competence in Children and Adolescents. Schizophr Bull 2017; 43:152-159. [PMID: 27190281 PMCID: PMC5216847 DOI: 10.1093/schbul/sbw062] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Recent data suggest that healthy children and adolescents who report psychotic-like experiences (PLEs) evidence abnormalities in white matter (WM). To date, no study has examined whether WM abnormalities associated with PLEs are predictive of outcome at a later time-point. The present study examined whether abnormalities in WM associated with PLEs in children and adolescents at a baseline assessment were predictive of social functioning at a 12-month follow-up. SUBJECTS AND METHODS Healthy children and adolescents aged 8-18 years (N = 56) were recruited from the community and received a diffusion tensor imaging exam and a clinical exam at baseline. Voxel-wise statistical analysis of fractional anisotropy (FA), using Tract-Based Spatial Statistics, and probabilistic tractography were used to identify WM abnormalities associated with PLEs at baseline. These abnormalities were then examined for association to social problems and social competence in 28 participants at 12-month follow-up. RESULTS Lower FA in regions proximal to the superior longitudinal fasciculus (SLF) and corticospinal tract bilaterally as well as in the left inferior fronto-occipital fasciculus and inferior longitudinal fasciculus were associated with higher levels of PLEs at baseline. Moreover, baseline FA in the SLF, but not baseline severity of PLEs, was significantly predictive of social competence at a 12-month follow-up. In contrast, baseline severity of PLEs, but not baseline FA in the SLF, predicted social problems at 12-month follow-up. DISCUSSION These findings suggest that alterations in WM, which are associated with symptoms of psychosis well below the threshold of clinical significance, may have significant ramifications for later social development.
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Affiliation(s)
- Pamela DeRosse
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY; .,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, University, MS;,These authors contributed equally to the article
| | - Katherine H. Karlsgodt
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Hofstra North Shore–LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY
| | - Bart D. Peters
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY
| | | | - Philip R. Szeszko
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Hofstra North Shore–LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY
| | - Anil K. Malhotra
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Hofstra North Shore–LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY;,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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Zheng Y, Li H, Ning Y, Ren J, Wu Z, Huang R, Luan G, Li T, Bi T, Wang Q, She S. Sluggishness of Early-Stage Face Processing (N170) Is Correlated with Negative and General Psychiatric Symptoms in Schizophrenia. Front Hum Neurosci 2016; 10:615. [PMID: 27965562 PMCID: PMC5124944 DOI: 10.3389/fnhum.2016.00615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/17/2016] [Indexed: 01/07/2023] Open
Abstract
Patients with schizophrenia consistently exhibit abnormalities in the N170 event-related potential (ERP) component evoked by images of faces. However, the relationship between these face-specific N170 abnormalities in patients with schizophrenia and the clinical characteristics of this disorder has not been elucidated. Here, ERP recordings were conducted for patients with schizophrenia and healthy controls. The amplitude and latency of the N170 component were recorded while participants passively viewed face and non-face (table) images to explore the correlation between face-specific processing and clinical characteristics in schizophrenia. The results provided evidence for a face-specific N170 latency delay in patients with schizophrenia. The N170 latency in patients with schizophrenia was significantly longer than that in healthy controls when images of faces were presented in both upright and inverted orientations. Importantly, the face-related N170 latencies of the left temporo-occipital electrodes (P7 and PO7) were positively correlated with both negative and general psychiatric symptoms in these patients. The N170 amplitudes were weaker in patients than in controls for inverted images of both faces and non-faces (tables), with a left-hemisphere dominance. The face inversion effect (FIE), meaning the difference in N170 amplitude between upright and inverted faces, was absent in patients with schizophrenia, suggesting an abnormality of holistic face processing. Together, these results revealed a marked symptom-relevant neural delay associated with face-specific processing in patients with schizophrenia, providing additional evidence to support the demyelination hypothesis of schizophrenia.
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Affiliation(s)
- Yingjun Zheng
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Haijing Li
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Yuping Ning
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Jianjuan Ren
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Zhangying Wu
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Rongcheng Huang
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Guoming Luan
- Beijing Key Laboratory of Epilepsy, Epilepsy Center, Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical UniversityBeijing, China; Beijing Institute for Brain DisordersBeijing, China
| | - Tianfu Li
- Beijing Key Laboratory of Epilepsy, Epilepsy Center, Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical UniversityBeijing, China; Beijing Institute for Brain DisordersBeijing, China
| | - Taiyong Bi
- Key Laboratory of Cognition and Personality (SWU), Ministry of EducationChongqing, China; Faculty of Psychology, Southwest UniversityChongqing, China
| | - Qian Wang
- Beijing Key Laboratory of Epilepsy, Epilepsy Center, Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical University Beijing, China
| | - Shenglin She
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
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Spalletta G, Long JD, Robinson RG, Trequattrini A, Pizzoli S, Caltagirone C, Orfei MD. Longitudinal Neuropsychiatric Predictors of Death in Alzheimer's Disease. J Alzheimers Dis 2016; 48:627-36. [PMID: 26402103 DOI: 10.3233/jad-150391] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Characteristics associated with life expectancy in Alzheimer's disease (AD) are still far from known. Here we aimed at examining the ability of baseline/longitudinal clinical variables to predict time to death. One-hundred fifty AD outpatients underwent diagnostic, neuropsychiatric, and functional assessment at baseline (when ApoE ɛ4 was also investigated) and at each subsequent annual visit. A random effects joint modeling approach was used to simultaneously model the baseline and longitudinal trajectory of each factor and predict the time to death, adjusting for demographic covariates. An ancillary analysis of ApoE ɛ4 status as a predictor was also conducted. Kaplan-Meier survival curves were constructed to elucidate the relationship between each factor and the estimated probability of death over time. Shorter survival was associated with male gender, higher education, older age, lower cognition, and worse functioning in daily life, but not ApoE ɛ4 status. Longitudinal trajectories increased predictive power over using just baseline levels highlighting apathy, and secondarily aberrant motor behaviors and sleep disorders, as a highly reliable predictor for mortality. Apathy was the strongest neuropsychiatric predictor of time to death, which supports its role in the pathogenesis of the disorder. An increased knowledge of factors modulating survival in AD is a strategic prerequisite to plan therapeutic interventions.
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Affiliation(s)
- Gianfranco Spalletta
- IRCCS Santa Lucia Foundation, Rome, Italy.,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey D Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA.,Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | | | | | | | - Carlo Caltagirone
- IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Medicine of Systems, Tor Vergata University, Rome, Italy
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Viher PV, Stegmayer K, Giezendanner S, Federspiel A, Bohlhalter S, Vanbellingen T, Wiest R, Strik W, Walther S. Cerebral white matter structure is associated with DSM-5 schizophrenia symptom dimensions. NEUROIMAGE-CLINICAL 2016; 12:93-99. [PMID: 27408794 PMCID: PMC4925890 DOI: 10.1016/j.nicl.2016.06.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/09/2016] [Accepted: 06/15/2016] [Indexed: 12/21/2022]
Abstract
Diffusion tensor imaging (DTI) studies have provided evidence of widespread white matter (WM) abnormalities in schizophrenia. Although these abnormalities appear clinically significant, the relationship to specific clinical symptoms is limited and heterogeneous. This study examined the association between WM microstructure and the severity of the five main DSM-5 schizophrenia symptom dimensions. DTI was measured in forty patients with schizophrenia spectrum disorders. Using Tract-Based Spatial Statistics controlling for age, gender and antipsychotic dosage, our analyses revealed significant negative relationships between WM microstructure and two DSM-5 symptom dimensions: Whereas abnormal psychomotor behavior was particularly related to WM of motor tracts, negative symptoms were associated with WM microstructure of the prefrontal and right temporal lobes. However, we found no associations between WM microstructure and delusions, hallucinations or disorganized speech. These data highlight the relevance of characteristic WM disconnectivity patterns as markers for negative symptoms and abnormal psychomotor behavior in schizophrenia and provide evidence for relevant associations between brain structure and aberrant behavior. DTI study of brain-behavior associations of the new DSM-5 schizophrenia dimensions. The severity of the DSM-5 abnormal psychomotor behavior dimension is related to white matter microstructure in motor tracts. Associations of the DSM-5 negative symptom dimension with white matter microstructure are found in prefrontal and temporal clusters. Characteristic patterns of white matter microstructure argue for relevant associations between brain structure and aberrant behavior in schizophrenia.
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Affiliation(s)
- Petra V Viher
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | | | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Stephan Bohlhalter
- Department of Clinical Research, Inselspital, Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - Tim Vanbellingen
- Department of Clinical Research, Inselspital, Bern, Switzerland; Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
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45
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Structural brain correlates of defective gesture performance in schizophrenia. Cortex 2016; 78:125-137. [DOI: 10.1016/j.cortex.2016.02.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/12/2015] [Accepted: 02/27/2016] [Indexed: 01/13/2023]
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46
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Sheffield JM, Repovs G, Harms MP, Carter CS, Gold JM, MacDonald AW, Ragland JD, Silverstein SM, Godwin D, Barch DM. Evidence for Accelerated Decline of Functional Brain Network Efficiency in Schizophrenia. Schizophr Bull 2016; 42:753-61. [PMID: 26472685 PMCID: PMC4838081 DOI: 10.1093/schbul/sbv148] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Previous work suggests that individuals with schizophrenia display accelerated aging of white matter integrity, however, it is still unknown whether functional brain networks also decline at an elevated rate in schizophrenia. Given the known degradation of functional connectivity and the normal decline in cognitive functioning throughout healthy aging, we aimed to test the hypothesis that efficiency of large-scale functional brain networks supporting overall cognition, as well as integrity of hub nodes within those networks, show evidence of accelerated aging in schizophrenia. Using pseudo-resting state data in 54 healthy controls and 46 schizophrenia patients, in which task-dependent signal from 3 tasks was regressed out to approximate resting-state data, we observed a significant diagnosis by age interaction in the prediction of both global and local efficiency of the cingulo-opercular network, and of the local efficiency of the fronto-parietal network, but no interaction when predicting both default mode network and whole brain efficiency. We also observed a significant diagnosis by age interaction for the node degree of the right anterior insula, left dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex. All interactions were driven by stronger negative associations between age and network metrics in the schizophrenia group than the healthy controls. These data provide evidence that is consistent with accelerated aging of large-scale functional brain networks in schizophrenia that support higher-order cognitive ability.
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Affiliation(s)
- Julia M. Sheffield
- Department of Psychology, Washington University in St Louis, St Louis, MO;,*To whom correspondence should be addressed; Department of Psychology, Washington University in St Louis, 1 Brookings Drive, St Louis, MO 63130, US; tel: 314-935-6565, fax: 314-935-7588, e-mail:
| | - Grega Repovs
- Department of Psychiatry and Behavioral Science, University of Ljubljana, Ljubljana, Slovenia
| | - Michael P. Harms
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
| | - Cameron S. Carter
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Davis, CA
| | - James M. Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Baltimore, MD
| | | | - J. Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Davis, CA
| | - Steven M. Silverstein
- Rutgers, The State University of New Jersey, University Behavioral Health Care, Piscataway, NJ;,Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Douglass Godwin
- Department of Psychology, Vanderbilt University, Nashville, TN
| | - Deanna M. Barch
- Department of Psychology, Washington University in St Louis, St Louis, MO;,Department of Psychiatry, Washington University in St Louis, St Louis, MO;,Department of Radiology, Washington University in St Louis, St Louis, MO
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47
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Karlsgodt KH. Diffusion Imaging of White Matter In Schizophrenia: Progress and Future Directions. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:209-217. [PMID: 27453952 PMCID: PMC4955654 DOI: 10.1016/j.bpsc.2015.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Diffusion tensor imaging (DTI) is a powerful tool for the in-vivo assessment of white matter microstructure. The application of DTI methodologies to the study of schizophrenia has supported and advanced the hypothesis of schizophrenia as a disorder of disrupted connectivity. In the context of impaired structural connectivity, the extended time frame of white matter development may offer unique opportunities for treatment that can capitalize on the neural flexibility that is still present in the period leading up to and after disease onset. Therefore, it is important to gain a clear understanding of white matter deficits and how they may emerge and change across the illness. However, while there is broad consistency in the findings of white matter deficits in patients with schizophrenia, there is also a great deal of variability in specific findings across studies. In this review, the aim is to move beyond summarizing case-control analyses, to consider the many factors that may impact DTI measures, to explain variability of findings, and to explore future directions for the field. The topics explored include ways to parse DTI patterns associated with different disease subtypes, ways in which novel and established treatments might interact with or enhance white matter, ways of dissociating developmental change from the disease process itself, and understanding the role of emerging analytic methodologies.
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Affiliation(s)
- Katherine H Karlsgodt
- Psychiatry Research Division, Zucker Hillside Hospital and Feinstein Institute for Medical Research; Department of Psychiatry, Hofstra NorthShore LIJ School of Medicine
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48
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Mohammad SA, Sakr HM, Bondok SMY, Mahmoud DAM, Azzam HM, Effat S. Fronto-temporal connectivity in never-medicated patients with first-episode schizophrenia: A DTI study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2015.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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49
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Wu CH, Hwang TJ, Chen YJ, Hsu YC, Lo YC, Liu CM, Hwu HG, Liu CC, Hsieh MH, Chien YL, Chen CM, Isaac Tseng WY. Primary and secondary alterations of white matter connectivity in schizophrenia: A study on first-episode and chronic patients using whole-brain tractography-based analysis. Schizophr Res 2015; 169:54-61. [PMID: 26443482 DOI: 10.1016/j.schres.2015.09.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 09/15/2015] [Accepted: 09/21/2015] [Indexed: 01/12/2023]
Abstract
Schizophrenia is a debilitating mental disorder that is associated with an impaired connection of cerebral white matter. Studies on patients with chronic and first-episode schizophrenia have found widespread white matter abnormalities. However, it is unclear whether the altered connections are inherent in or secondary to the disease. Here, we sought to identify white matter tracts with altered connections and to distinguish primary or secondary alterations among 74 fiber tracts across the whole brain using an automatic tractography-based analysis method. Thirty-one chronic, 25 first-episode patients with schizophrenia and 31 healthy controls were recruited to receive diffusion spectrum magnetic resonance imaging at 3T. Seven tracts were found to exhibit significant differences between the groups; they included the right arcuate fasciculus, bilateral fornices, left superior longitudinal fasciculus I, and fibers of the corpus callosum to the bilateral dorsolateral prefrontal cortices (DLPFC), bilateral temporal poles, and bilateral hippocampi. Post-hoc between-group analyses revealed that the connection of the callosal fibers to the bilateral DLPFC was significantly decreased in chronic patients but not in first-episode patients. In a stepwise regression analysis, the decline of the tract connection was significantly predicted by the duration of illness. In contrast, the remaining six tracts showed significant alterations in both first-episode and chronic patients and did not associate with clinical variables. In conclusion, reduced white matter connectivity of the callosal fibers to the bilateral DLPFC may be a secondary change that degrades progressively in the chronic stage, whereas alterations in the other six tracts may be inherent in the disease.
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Affiliation(s)
- Chen-Hao Wu
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Jen Chen
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Chin Hsu
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Chun Lo
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Ming Chen
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Molecular Imaging Center, National Taiwan University, Taipei, Taiwan.
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50
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Savadjiev P, Seidman LJ, Thermenos H, Keshavan M, Whitfield-Gabrieli S, Crow TJ, Kubicki M. Sexual dimorphic abnormalities in white matter geometry common to schizophrenia and non-psychotic high-risk subjects: Evidence for a neurodevelopmental risk marker? Hum Brain Mapp 2015; 37:254-61. [PMID: 26467751 DOI: 10.1002/hbm.23026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/30/2015] [Accepted: 10/04/2015] [Indexed: 12/23/2022] Open
Abstract
The characterization of neurodevelopmental aspects of brain alterations require neuroimaging methods that reflect correlates of neurodevelopment, while being robust to other progressive pathological processes. Newly developed neuroimaging methods for measuring geometrical features of the white matter fall exactly into this category. Our recent work shows that such features, measured in the anterior corpus callosum in diffusion MRI data, correlate with psychosis symptoms in patients with adolescent onset schizophrenia and subside a reversal of normal sexual dimorphism. Here, we test the hypothesis that similar developmental deviations will also be present in nonpsychotic subjects at familial high risk (FHR) for schizophrenia, due to genetic predispositions. Demonstrating such changes would provide a strong indication of neurodevelopmental deviation extant before, and independent of pathological changes occurring after disease onset. We examined the macrostructural geometry of corpus callosum white matter in diffusion MRI data of 35 non-psychotic subjects with genetic (familial) risk for schizophrenia, and 26 control subjects, both male and female. We report a reversal of normal sexual dimorphism in callosal white matter geometry consistent with recent results in adolescent onset schizophrenia. This pattern may be indicative of an error in neurogenesis and a possible trait marker of schizophrenia.
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Affiliation(s)
- Peter Savadjiev
- Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Larry J Seidman
- Massachusetts Mental Health Center, Division of Public Psychiatry, Boston, Massachusetts.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Heidi Thermenos
- Massachusetts Mental Health Center, Division of Public Psychiatry, Boston, Massachusetts.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Tim J Crow
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry and Radiology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
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