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Yao Y, Zhang S, Wang B, Lin X, Zhao G, Deng H, Chen Y. Neural dysfunction underlying working memory processing at different stages of the illness course in schizophrenia: a comparative meta-analysis. Cereb Cortex 2024; 34:bhae267. [PMID: 38960703 DOI: 10.1093/cercor/bhae267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
Schizophrenia, as a chronic and persistent disorder, exhibits working memory deficits across various stages of the disorder, yet the neural mechanisms underlying these deficits remain elusive with inconsistent neuroimaging findings. We aimed to compare the brain functional changes of working memory in patients at different stages: clinical high risk, first-episode psychosis, and long-term schizophrenia, using meta-analyses of functional magnetic resonance imaging studies. Following a systematic literature search, 56 whole-brain task-based functional magnetic resonance imaging studies (15 for clinical high risk, 16 for first-episode psychosis, and 25 for long-term schizophrenia) were included. The separate and pooled neurofunctional mechanisms among clinical high risk, first-episode psychosis, and long-term schizophrenia were generated by Seed-based d Mapping toolbox. The clinical high risk and first-episode psychosis groups exhibited overlapping hypoactivation in the right inferior parietal lobule, right middle frontal gyrus, and left superior parietal lobule, indicating key lesion sites in the early phase of schizophrenia. Individuals with first-episode psychosis showed lower activation in left inferior parietal lobule than those with long-term schizophrenia, reflecting a possible recovery process or more neural inefficiency. We concluded that SCZ represent as a continuum in the early stage of illness progression, while the neural bases are inversely changed with the development of illness course to long-term course.
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Affiliation(s)
- Yuhao Yao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Shufang Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Boyao Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoyong Lin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Gaofeng Zhao
- Department of Psychiatry, Shandong Daizhuang Hospital, Jinning, China
| | - Hong Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
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Wang Z, Zhang D, Guan M, Ren X, Li D, Yin K, Zhou P, Li B, Wang H. Increased thalamic gray matter volume induced by repetitive transcranial magnetic stimulation treatment in patients with major depressive disorder. Front Psychiatry 2023; 14:1163067. [PMID: 37252157 PMCID: PMC10218132 DOI: 10.3389/fpsyt.2023.1163067] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
Purpose Repetitive transcranial magnetic stimulation (rTMS) is an effective therapy in improving depressive symptoms in MDD patients, but the intrinsic mechanism is still unclear. In this study, we investigated the influence of rTMS on brain gray matter volume for alleviating depressive symptoms in MDD patients using structural magnetic resonance imaging (sMRI) data. Methods Patients with first episode, unmedicated patients with MDD (n = 26), and healthy controls (n = 31) were selected for this study. Depressive symptoms were assessed before and after treatment by using the HAMD-17 score. High-frequency rTMS treatment was conducted in patients with MDD over 15 days. The rTMS treatment target is located at the F3 point of the left dorsolateral prefrontal cortex. Structural magnetic resonance imaging (sMRI) data were collected before and after treatment to compare the changes in brain gray matter volume. Results Before treatment, patients with MDD had significantly reduced gray matter volumes in the right fusiform gyrus, left and right inferior frontal gyrus (triangular part), left inferior frontal gyrus (orbital part), left parahippocampal gyrus, left thalamus, right precuneus, right calcarine fissure, and right median cingulate gyrus compared with healthy controls (P < 0.05). After rTMS treatment, significant growth in gray matter volume of the bilateral thalamus was observed in depressed patients (P < 0.05). Conclusion Bilateral thalamic gray matter volumes were enlarged in the thalamus of MDD patients after rTMS treatment and may be the underlying neural mechanism for the treatment of rTMS on depression.
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Affiliation(s)
- Zhongheng Wang
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Dongning Zhang
- Department of Mental Health, Xi'an Medical College, Xi'an, China
| | - Muzhen Guan
- Department of Mental Health, Xi'an Medical College, Xi'an, China
| | - Xiaojiao Ren
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Dan Li
- Department of Psychiatry, Yulin Fifth Hospital, Yulin, China
| | - Kaiming Yin
- Department of Psychiatry, Shi Jiazhuang Psychological Hospital, Shijiazhuang, China
| | - Ping Zhou
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Baojuan Li
- School of Biomedical Engineering, Air Force Medical University, Xi'an, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China
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Wang M, Barker PB, Cascella NG, Coughlin JM, Nestadt G, Nucifora FC, Sedlak TW, Kelly A, Younes L, Geman D, Palaniyappan L, Sawa A, Yang K. Longitudinal changes in brain metabolites in healthy controls and patients with first episode psychosis: a 7-Tesla MRS study. Mol Psychiatry 2023; 28:2018-2029. [PMID: 36732587 PMCID: PMC10394114 DOI: 10.1038/s41380-023-01969-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
Seven Tesla magnetic resonance spectroscopy (7T MRS) offers a precise measurement of metabolic levels in the human brain via a non-invasive approach. Studying longitudinal changes in brain metabolites could help evaluate the characteristics of disease over time. This approach may also shed light on how the age of study participants and duration of illness may influence these metabolites. This study used 7T MRS to investigate longitudinal patterns of brain metabolites in young adulthood in both healthy controls and patients. A four-year longitudinal cohort with 38 patients with first episode psychosis (onset within 2 years) and 48 healthy controls was used to examine 10 brain metabolites in 5 brain regions associated with the pathophysiology of psychosis in a comprehensive manner. Both patients and controls were found to have significant longitudinal reductions in glutamate in the anterior cingulate cortex (ACC). Only patients were found to have a significant decrease over time in γ-aminobutyric acid, N-acetyl aspartate, myo-inositol, total choline, and total creatine in the ACC. Together we highlight the ACC with dynamic changes in several metabolites in early-stage psychosis, in contrast to the other 4 brain regions that also are known to play roles in psychosis. Meanwhile, glutathione was uniquely found to have a near zero annual percentage change in both patients and controls in all 5 brain regions during a four-year follow-up in young adulthood. Given that a reduction of the glutathione in the ACC has been reported as a feature of treatment-refractory psychosis, this observation further supports the potential of glutathione as a biomarker for this subset of patients with psychosis.
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Affiliation(s)
- Min Wang
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Peter B Barker
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer M Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frederick C Nucifora
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas W Sedlak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexandra Kelly
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laurent Younes
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Donald Geman
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Lena Palaniyappan
- Robarts Research Institution, University of Western Ontario, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Kun Yang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Sefik E, Boamah M, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan MS, Mathalon DH, Perkins DO, Stone WS, Tsuang MT, Woods SW, Cannon TD, Walker EF. Sex- and Age-Specific Deviations in Cerebellar Structure and Their Link With Symptom Dimensions and Clinical Outcome in Individuals at Clinical High Risk for Psychosis. Schizophr Bull 2023; 49:350-363. [PMID: 36394426 PMCID: PMC10016422 DOI: 10.1093/schbul/sbac169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The clinical high-risk (CHR) period offers a temporal window into neurobiological deviations preceding psychosis onset, but little attention has been given to regions outside the cerebrum in large-scale studies of CHR. Recently, the North American Prodrome Longitudinal Study (NAPLS)-2 revealed altered functional connectivity of the cerebello-thalamo-cortical circuitry among individuals at CHR; however, cerebellar morphology remains underinvestigated in this at-risk population, despite growing evidence of its involvement in psychosis. STUDY DESIGN In this multisite study, we analyzed T1-weighted magnetic resonance imaging scans obtained from N = 469 CHR individuals (61% male, ages = 12-36 years) and N = 212 healthy controls (52% male, ages = 12-34 years) from NAPLS-2, with a focus on cerebellar cortex and white matter volumes separately. Symptoms were rated by the Structured Interview for Psychosis-Risk Syndromes (SIPS). The outcome by two-year follow-up was categorized as in-remission, symptomatic, prodromal-progression, or psychotic. General linear models were used for case-control comparisons and tests for volumetric associations with baseline SIPS ratings and clinical outcomes. STUDY RESULTS Cerebellar cortex and white matter volumes differed between the CHR and healthy control groups at baseline, with sex moderating the difference in cortical volumes, and both sex and age moderating the difference in white matter volumes. Baseline ratings for major psychosis-risk dimensions as well as a clinical outcome at follow-up had tissue-specific associations with cerebellar volumes. CONCLUSIONS These findings point to clinically relevant deviations in cerebellar cortex and white matter structures among CHR individuals and highlight the importance of considering the complex interplay between sex and age when studying the neuromaturational substrates of psychosis risk.
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Affiliation(s)
- Esra Sefik
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Michelle Boamah
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
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Preston EG, Villarosa-Hurlocker MC, Raposa EB, Pearson MR, Bravo AJ. Fear of negative evaluation and suicidal ideation among college students: the moderating role of impulsivity-like traits. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:396-402. [PMID: 33759729 PMCID: PMC9007699 DOI: 10.1080/07448481.2021.1891919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/30/2020] [Accepted: 02/14/2021] [Indexed: 05/05/2023]
Abstract
Objective: Fear of negative evaluation (FNE) is a key trait of social anxiety and has been linked to isolation and low self-esteem. Impulsivity has been shown to amplify the risk of socially anxious individuals engaging in risky behaviors such as suicidal behaviors; yet little research has examined associations between FNE and suicidality or the relationship between FNE and impulsivity. Participants/Methods: This study tested whether FNE was associated with suicidal ideation in a sample of 1,816 college students from 10 universities. Analyses also examined whether impulsivity-like traits moderated the relationship between FNE and suicidal ideation. Results: Results showed that FNE was significantly associated with suicidal ideation and the positive association between FNE and suicidal ideation was strongest among individuals with higher negative urgency and lower perseverance. Conclusions: These findings highlight FNE as an important risk factor of suicidal ideation in college students and illuminates potential influence of impulsivity on this relationship.
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Affiliation(s)
- Emma G Preston
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, USA
| | | | - Elizabeth B Raposa
- Department of Psychology, Fordham University, New York City, New York, USA
| | - Matthew R Pearson
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, USA
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6
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Vouga Ribeiro N, Tavares V, Bramon E, Toulopoulou T, Valli I, Shergill S, Murray R, Prata D. Effects of psychosis-associated genetic markers on brain volumetry: a systematic review of replicated findings and an independent validation. Psychol Med 2022; 52:1-16. [PMID: 36168994 PMCID: PMC9811278 DOI: 10.1017/s0033291722002896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/13/2022] [Accepted: 08/24/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Given psychotic illnesses' high heritability and associations with brain structure, numerous neuroimaging-genetics findings have been reported in the last two decades. However, few findings have been replicated. In the present independent sample we aimed to replicate any psychosis-implicated SNPs (single nucleotide polymorphisms), which had previously shown at least two main effects on brain volume. METHODS A systematic review for SNPs showing a replicated effect on brain volume yielded 25 studies implicating seven SNPs in five genes. Their effect was then tested in 113 subjects with either schizophrenia, bipolar disorder, 'at risk mental state' or healthy state, for whole-brain and region-of-interest (ROI) associations with grey and white matter volume changes, using voxel-based morphometry. RESULTS We found FWER-corrected (Family-wise error rate) (i.e. statistically significant) associations of: (1) CACNA1C-rs769087-A with larger bilateral hippocampus and thalamus white matter, across the whole brain; and (2) CACNA1C-rs769087-A with larger superior frontal gyrus, as ROI. Higher replication concordance with existing literature was found, in decreasing order, for: (1) CACNA1C-rs769087-A, with larger dorsolateral-prefrontal/superior frontal gyrus and hippocampi (both with anatomical and directional concordance); (2) ZNF804A-rs11681373-A, with smaller angular gyrus grey matter and rectus gyri white matter (both with anatomical and directional concordance); and (3) BDNF-rs6265-T with superior frontal and middle cingulate gyri volume change (with anatomical and allelic concordance). CONCLUSIONS Most literature findings were not herein replicated. Nevertheless, high degree/likelihood of replication was found for two genome-wide association studies- and one candidate-implicated SNPs, supporting their involvement in psychosis and brain structure.
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Affiliation(s)
- Nuno Vouga Ribeiro
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - Vânia Tavares
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - Elvira Bramon
- Division of Psychiatry, University College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’ College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Timothea Toulopoulou
- Department of Psychology & National Magnetic Resonance Research Center (UMRAM), Aysel Sabuncu Brain Research Centre (ASBAM), Bilkent University, Ankara, Turkey
| | - Isabel Valli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’ College London, London, UK
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sukhi Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’ College London, London, UK
| | - Robin Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’ College London, London, UK
| | - Diana Prata
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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7
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Baldwin H, Radua J, Antoniades M, Haas SS, Frangou S, Agartz I, Allen P, Andreassen OA, Atkinson K, Bachman P, Baeza I, Bartholomeusz CF, Chee MWL, Colibazzi T, Cooper RE, Corcoran CM, Cropley VL, Ebdrup BH, Fortea A, Glenthøj LB, Hamilton HK, Haut KM, Hayes RA, He Y, Heekeren K, Kaess M, Kasai K, Katagiri N, Kim M, Kindler J, Klaunig MJ, Koike S, Koppel A, Kristensen TD, Bin Kwak Y, Kwon JS, Lawrie SM, Lebedeva I, Lee J, Lin A, Loewy RL, Mathalon DH, Michel C, Mizrahi R, Møller P, Nelson B, Nemoto T, Nordholm D, Omelchenko MA, Pantelis C, Raghava JM, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Smigielski L, Sugranyes G, Suzuki M, Takahashi T, Tamnes CK, Tang J, Theodoridou A, Thomopoulos SI, Tomyshev AS, Uhlhaas PJ, Værnes TG, van Amelsvoort TAMJ, Van Erp TGM, Waltz JA, Westlye LT, Wood SJ, Zhou JH, McGuire P, Thompson PM, Jalbrzikowski M, Hernaus D, Fusar-Poli P. Neuroanatomical heterogeneity and homogeneity in individuals at clinical high risk for psychosis. Transl Psychiatry 2022; 12:297. [PMID: 35882855 PMCID: PMC9325730 DOI: 10.1038/s41398-022-02057-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 12/12/2022] Open
Abstract
Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P consortium applied a harmonised analysis to neuroimaging data across 29 international sites, including 1579 CHR-P individuals and 1243 HC, offering the largest pooled CHR-P neuroimaging dataset to date. Regional heterogeneity was indexed with the Variability Ratio (VR) and Coefficient of Variation (CV) ratio applied at the group level. Personalised estimates of heterogeneity of SA, CT and SV brain profiles were indexed with the novel Person-Based Similarity Index (PBSI), with two complementary applications. First, to assess the extent of within-diagnosis similarity or divergence of neuroanatomical profiles between individuals. Second, using a normative modelling approach, to assess the 'normativeness' of neuroanatomical profiles in individuals at CHR-P. CHR-P individuals demonstrated no greater regional heterogeneity after applying FDR corrections. However, PBSI scores indicated significantly greater neuroanatomical divergence in global SA, CT and SV profiles in CHR-P individuals compared with HC. Normative PBSI analysis identified 11 CHR-P individuals (0.70%) with marked deviation (>1.5 SD) in SA, 118 (7.47%) in CT and 161 (10.20%) in SV. Psychosis transition was not significantly associated with any measure of heterogeneity. Overall, our examination of neuroanatomical heterogeneity within the CHR-P state indicated greater divergence in neuroanatomical profiles at an individual level, irrespective of psychosis conversion. Further large-scale investigations are required of those who demonstrate marked deviation.
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Affiliation(s)
- Helen Baldwin
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, Barcelona, Spain
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mathilde Antoniades
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ole A Andreassen
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Peter Bachman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Cali F Bartholomeusz
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
| | - Michael W L Chee
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York City, NY, USA
- New York State Psychiatric Institute, New York City, NY, USA
| | - Rebecca E Cooper
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Carlton South, VIC, Australia
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Mental Illness Research, Education, and Clinical Center, James J Peters VA Medical Center, New York City, NY, USA
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Carlton South, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, VIC, Australia
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Holly K Hamilton
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Rebecca A Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ying He
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Karsten Heekeren
- Department of Psychiatry and Psychotherapy I, LVR-Hospital Cologne, Cologne, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Mallory J Klaunig
- Department of Psychology, University of Maryland, Baltimore County, MD, USA
| | - Shinsuke Koike
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Alex Koppel
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Tina D Kristensen
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Irina Lebedeva
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Romina Mizrahi
- Douglas Research Center, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Maria A Omelchenko
- Department of Youth Psychiatry, Mental Health Research Center, Moscow, Russian Federation
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Center for Mental Health, Parkville, VIC, Australia
| | - Jayachandra M Raghava
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Clinical Physiology, Nuclear Medicine and PET, Functional Imaging Unit, University of Copenhagen, Glostrup, Denmark
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Jan I Røssberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre Grow Up Well, The University of Newcastle, Newcastle, NSW, Australia
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, China
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alexander S Tomyshev
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Tor G Værnes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Therese A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Theo G M Van Erp
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, USA
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lars T Westlye
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Juan H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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8
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Picó-Pérez M, Vieira R, Fernández-Rodríguez M, De Barros MAP, Radua J, Morgado P. Multimodal meta-analysis of structural gray matter, neurocognitive and social cognitive fMRI findings in schizophrenia patients. Psychol Med 2022; 52:614-624. [PMID: 35129109 DOI: 10.1017/s0033291721005523] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuroimaging research has shown that patients with schizophrenia (SCZ) present brain structural and functional alterations, but the results across imaging modalities and task paradigms are difficult to reconcile. Specifically, no meta-analyses have tested whether the same brain systems that are structurally different in SCZ patients are also involved in neurocognitive and social cognitive tasks. To answer this, we conducted separate meta-analyses of voxel-based morphometry, neurocognitive functional magnetic resonance imaging (fMRI), and social cognitive fMRI studies. Next, with a multimodal approach, we identified the common alterations across meta-analyses. Further exploratory meta-analyses were performed taking into account several clinical variables (illness duration, medication status, and symptom severity). A cluster covering the dorsomedial prefrontal cortex (dmPFC) and the supplementary motor area (SMA), and the right inferior frontal gyrus (IFG), presented shared structural and neurocognitive-related activation decreases, while the right angular gyrus presented shared decreases between structural and social cognitive-related activation. The exploratory meta-analyses replicated to some extent these findings, while new regions of alterations appeared in patient subgroups with specific clinical features. In conclusion, we found task-specific correlates of brain structure and function in SCZ, which help summarize and integrate a growing literature.
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Affiliation(s)
- Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Marcos Fernández-Rodríguez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Maria Antónia Pereira De Barros
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
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9
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Yi SY, Barnett BR, Poetzel MJ, Stowe NA, Yu JPJ. Clinical translational neuroimaging of the antioxidant effect of N-acetylcysteine on neural microstructure. Magn Reson Med 2022; 87:820-836. [PMID: 34590731 PMCID: PMC8627450 DOI: 10.1002/mrm.29035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/20/2021] [Accepted: 09/15/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Oxidative stress and downstream effectors have emerged as important pathological processes that drive psychiatric illness, suggesting that antioxidants may have a therapeutic role in psychiatric disease. However, no imaging biomarkers are currently available to track therapeutic response. The purpose of this study was to examine whether advanced DWI techniques are able to sensitively detect the potential therapeutic effects of the antioxidant N-acetylcysteine (NAC) in a Disc1 svΔ2 preclinical rat model of psychiatric illness. METHODS Male and female Disc1 svΔ2 rats and age-matched, sex-matched Sprague-Dawley wild-type controls were treated with a saline vehicle or NAC before ex vivo MRI acquisition at P50. Imaging data were fit to DTI and neurite orientation dispersion and density imaging models and analyzed for region-specific changes in quantitative diffusion metrics. Brains were further processed for cellular quantification of microglial density and morphology. All experiments were repeated for Disc1 svΔ2 rats exposed to chronic early-life stress to test how gene-environment interactions might alter effectiveness of NAC therapy. RESULTS The DTI and neurite orientation dispersion and density imaging analyses demonstrated amelioration of early-life, sex-specific neural microstructural deficits with concomitant differences in microglial morphology across multiple brain regions relevant to neuropsychiatric illness with NAC treatment, but only in male Disc1 svΔ2 rats. Addition of chronic early-life stress reduced the ability of NAC to restore microstructural deficits. CONCLUSION These findings provide evidence for a treatment pathway targeting endogenous antioxidant capacity, and the clinical translational utility of neurite orientation dispersion and density imaging microstructural imaging to sensitively detect microstructural alterations resulting from antioxidant treatment.
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Affiliation(s)
- Sue Y. Yi
- Neuroscience Training Program, Wisconsin Institutes for Medical Research, University of Wisconsin–Madison, Madison, WI 53705, USA
| | - Brian R. Barnett
- Neuroscience Training Program, Wisconsin Institutes for Medical Research, University of Wisconsin–Madison, Madison, WI 53705, USA
| | - McKenzie J. Poetzel
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Nicholas A. Stowe
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - John-Paul J. Yu
- Neuroscience Training Program, Wisconsin Institutes for Medical Research, University of Wisconsin–Madison, Madison, WI 53705, USA
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI 53706, USA
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
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10
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Hubl D, Michel C, Schultze-Lutter F, Hauf M, Schimmelmann BG, Kaess M, Kindler J. Basic symptoms and gray matter volumes of patients at clinical high risk for psychosis. Psychol Med 2021; 51:2666-2674. [PMID: 32404212 DOI: 10.1017/s0033291720001282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Clinical high-risk (CHR) for psychosis is indicated by ultra-high risk (UHR) and basic symptom (BS) criteria; however, conversion rates are highest when both UHR and BS criteria are fulfilled (UHR&BS). While BSs are considered the most immediate expression of neurobiological aberrations underlying the development of psychosis, research on neurobiological correlates of BS is scarce. METHODS We investigated gray matter volumes (GMV) of 20 regions of interest (ROI) previously associated with UHR criteria in 90 patients from the Bern early detection service: clinical controls (CC), first-episode psychosis (FEP), UHR, BS and UHR&BS. We expected lowest GMV in FEP and UHR&BS, and highest volume in CC with UHR and BS in-between. RESULTS Significantly, lower GMV was detected in FEP and UHR&BS patients relative to CC with no other significant between-group differences. When ROIs were analyzed separately, seven showed a significant group effect (FDR corrected), with five (inferior parietal, medial orbitofrontal, lateral occipital, middle temporal, precuneus) showing significantly lower GM volume in the FEP and/or UHR&BS groups than in the CC group (Bonferroni corrected). In the CHR group, only COGDIS scores correlated negatively with cortical volumes. CONCLUSIONS This is the first study to demonstrate that patients who fulfill both UHR and BS criteria - a population that has been associated with higher conversion rates - exhibit more severe GMV reductions relative to those who satisfy BS or UHR criteria alone. This result was mediated by the BS in the UHR&BS group, as only the severity of BS was linked to GMV reductions.
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Affiliation(s)
- Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
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11
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Fortea A, Batalla A, Radua J, van Eijndhoven P, Baeza I, Albajes-Eizagirre A, Fusar-Poli P, Castro-Fornieles J, De la Serna E, Luna LP, Carvalho AF, Vieta E, Sugranyes G. Cortical gray matter reduction precedes transition to psychosis in individuals at clinical high-risk for psychosis: A voxel-based meta-analysis. Schizophr Res 2021; 232:98-106. [PMID: 34029948 DOI: 10.1016/j.schres.2021.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 01/10/2023]
Abstract
Gray matter and cortical thickness reductions have been documented in individuals at clinical high-risk for psychosis and may be more pronounced in those who transition to psychosis. However, these findings rely on small samples and are inconsistent across studies. In this review and meta-analysis we aimed to investigate neuroanatomical correlates of clinical high-risk for psychosis and potential predictors of transition, using a novel meta-analytic method (Seed-based d Mapping with Permutation of Subject Images) and cortical mask, combining data from surface-based and voxel-based morphometry studies. Individuals at clinical high-risk for psychosis who later transitioned to psychosis were compared to those who did not and to controls, and included three statistical maps. Overall, individuals at clinical high-risk for psychosis did not differ from controls, however, within the clinical high-risk for psychosis group, transition to psychosis was associated with less cortical gray matter in the right temporal lobe (Hedges' g = -0.377), anterior cingulate and paracingulate (Hedges' g = -0.391). These findings have the potential to help refine prognostic and etiopathological research in early psychosis.
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Affiliation(s)
- Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Esther Koplowitz Centre, Rosselló 153, 08036 Barcelona, Spain; Medicina i Recerca Traslacional, University of Barcelona, Casanova 143, 08036 Barcelona, Spain.
| | - Albert Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Center for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Philip van Eijndhoven
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behavior, Center for Cognitive Neuroimaging, Nijmegen, the Netherlands.
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Medicina i Recerca Traslacional, University of Barcelona, Casanova 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Anton Albajes-Eizagirre
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Medicina i Recerca Traslacional, University of Barcelona, Casanova 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Elena De la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Division of Neuroradiology, 600 N Wolfe Street Phipps B100F, 21287 Baltimore, MD, USA
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Center of Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Esther Koplowitz Centre, Rosselló 153, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
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12
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The association of neuropsychiatric symptoms with regional brain volumes from patients in a tertiary multi-disciplinary memory clinic. Int Psychogeriatr 2021; 33:233-244. [PMID: 32106897 PMCID: PMC8808367 DOI: 10.1017/s1041610220000113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND To examine the interaction between structural brain volume measures derived from a clinical magnetic resonance imaging (MRI) and occurrence of neuropsychiatric symptoms (NPS) in outpatient memory clinic patients. METHODS Clinical and neuroimaging data were collected from the medical records of outpatient memory clinic patients who were seen by neurologists, geriatric neuropsychiatrists, and geriatricians. MRI scan acquisition was carried out on a 3 T Siemens Verio scanner at Johns Hopkins Bayview Medical Center. Image analyses used an automated multi-label atlas fusion method with a geriatric atlas inventory to generate 193 anatomical regions from which volumes were measured. Regions of interest were generated a priori based on previous literature review of NPS in dementia. Regional volumes for agitation, apathy, and delusions were carried forward in a linear regression analysis. RESULTS Seventy-two patients had clinical and usable neuroimaging data that were analyzed and grouped by Mini-Mental State Exam (MMSE). Neuropsychiatric Inventory Questionnaire (NPI-Q) agitation was inversely associated with rostral anterior cingulate cortex (ACC) bilaterally and left subcallosal ACC volumes in the moderate severity group. Delusions were positively associated with left ACC volumes in both severe and mild groups but inversely associated with the right dorsolateral prefrontal cortex (DLPFC) in the moderate subgroup. CONCLUSIONS Agitation, apathy, and delusions are associated with volumes of a priori selected brain regions using clinical data and clinically acquired MRI scans. The ACC is an anatomic region common to these symptoms, particularly agitation and delusions, which closely mirror the findings of research-quality studies and suggest its importance as a behavioral hub.
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13
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Vargas T, Damme KSF, Ered A, Capizzi R, Frosch I, Ellman LM, Mittal VA. Neuroimaging Markers of Resiliency in Youth at Clinical High Risk for Psychosis: A Qualitative Review. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:166-177. [PMID: 32788085 PMCID: PMC7725930 DOI: 10.1016/j.bpsc.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/26/2022]
Abstract
Psychotic disorders are highly debilitating and constitute a major public health burden. Identifying markers of psychosis risk and resilience is a necessary step toward understanding etiology and informing prevention and treatment efforts in individuals at clinical high risk (CHR) for psychosis. In this context, it is important to consider that neural risk markers have been particularly useful in identifying mechanistic determinants along with predicting clinical outcomes. Notably, despite a growing body of supportive literature and the promise of recent findings identifying potential neural markers, the current work on CHR resilience markers has received little attention. The present review provides a brief overview of brain-based risk markers with a focus on predicting symptom course. Next, the review turns to protective markers, examining research from nonpsychiatric and schizophrenia fields to build an understanding of framing, priorities, and potential, applying these ideas to contextualizing a small but informative body of resiliency-relevant CHR research. Four domains (neurocognition, emotion regulation, allostatic load, and sensory and sensorimotor function) were identified and are discussed in terms of behavioral and neural markers. Taken together, the literature suggests significant predictive value for brain-based markers for individuals at CHR for psychosis, and the limited but compelling resiliency work highlights the critical importance of expanding this promising area of inquiry.
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Affiliation(s)
- Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, Illinois.
| | | | - Arielle Ered
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Riley Capizzi
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Isabelle Frosch
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, Illinois; Department of Psychiatry, Northwestern University, Evanston, Illinois; Department of Medical Social Sciences, Northwestern University, Evanston, Illinois; Institute for Policy Research, Northwestern University, Evanston, Illinois; Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, Illinois
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14
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Liloia D, Brasso C, Cauda F, Mancuso L, Nani A, Manuello J, Costa T, Duca S, Rocca P. Updating and characterizing neuroanatomical markers in high-risk subjects, recently diagnosed and chronic patients with schizophrenia: A revised coordinate-based meta-analysis. Neurosci Biobehav Rev 2021; 123:83-103. [PMID: 33497790 DOI: 10.1016/j.neubiorev.2021.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 01/10/2023]
Abstract
Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess pathophysiological models of how the disorder develops is an important target for the clinical practice. We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization. Results reveal a cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region found altered among c-HR, RDSZ and ChSZ. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ. These findings support the current neuroprogressive models of SZ and integrate this deterioration with the clinical evolution of the disease.
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Affiliation(s)
- Donato Liloia
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Claudio Brasso
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
| | - Franco Cauda
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
| | - Lorenzo Mancuso
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Andrea Nani
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Jordi Manuello
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Tommaso Costa
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Paola Rocca
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
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15
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Andreou C, Borgwardt S. Structural and functional imaging markers for susceptibility to psychosis. Mol Psychiatry 2020; 25:2773-2785. [PMID: 32066828 PMCID: PMC7577836 DOI: 10.1038/s41380-020-0679-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/15/2020] [Accepted: 01/31/2020] [Indexed: 12/21/2022]
Abstract
The introduction of clinical criteria for the operationalization of psychosis high risk provided a basis for early detection and treatment of vulnerable individuals. However, about two-thirds of people meeting clinical high-risk (CHR) criteria will never develop a psychotic disorder. In the effort to increase prognostic precision, structural and functional neuroimaging have received growing attention as a potentially useful resource in the prediction of psychotic transition in CHR patients. The present review summarizes current research on neuroimaging biomarkers in the CHR state, with a particular focus on their prognostic utility and limitations. Large, multimodal/multicenter studies are warranted to address issues important for clinical applicability such as generalizability and replicability, standardization of clinical definitions and neuroimaging methods, and consideration of contextual factors (e.g., age, comorbidity).
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Affiliation(s)
- Christina Andreou
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.
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16
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Powell SK, O'Shea CP, Shannon SR, Akbarian S, Brennand KJ. Investigation of Schizophrenia with Human Induced Pluripotent Stem Cells. ADVANCES IN NEUROBIOLOGY 2020; 25:155-206. [PMID: 32578147 DOI: 10.1007/978-3-030-45493-7_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Schizophrenia is a chronic and severe neuropsychiatric condition manifested by cognitive, emotional, affective, perceptual, and behavioral abnormalities. Despite decades of research, the biological substrates driving the signs and symptoms of the disorder remain elusive, thus hampering progress in the development of treatments aimed at disease etiologies. The recent emergence of human induced pluripotent stem cell (hiPSC)-based models has provided the field with a highly innovative approach to generate, study, and manipulate living neural tissue derived from patients, making possible the exploration of fundamental roles of genes and early-life stressors in disease-relevant cell types. Here, we begin with a brief overview of the clinical, epidemiological, and genetic aspects of the condition, with a focus on schizophrenia as a neurodevelopmental disorder. We then highlight relevant technical advancements in hiPSC models and assess novel findings attained using hiPSC-based approaches and their implications for disease biology and treatment innovation. We close with a critical appraisal of the developments necessary for both further expanding knowledge of schizophrenia and the translation of new insights into therapeutic innovations.
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Affiliation(s)
- Samuel K Powell
- Medical Scientist Training Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Callan P O'Shea
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sara Rose Shannon
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Schahram Akbarian
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristen J Brennand
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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17
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Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia. Biomolecules 2020; 10:biom10030384. [PMID: 32121669 PMCID: PMC7175146 DOI: 10.3390/biom10030384] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia is a neurodevelopmental disorder featuring chronic, complex neuropsychiatric features. The etiology and pathogenesis of schizophrenia are not fully understood. Oxidative-antioxidant imbalance is a potential determinant of schizophrenia. Oxidative, nitrosative, or sulfuric damage to enzymes of glycolysis and tricarboxylic acid cycle, as well as calcium transport and ATP biosynthesis might cause impaired bioenergetics function in the brain. This could explain the initial symptoms, such as the first psychotic episode and mild cognitive impairment. Another concept of the etiopathogenesis of schizophrenia is associated with impaired glucose metabolism and insulin resistance with the activation of the mTOR mitochondrial pathway, which may contribute to impaired neuronal development. Consequently, cognitive processes requiring ATP are compromised and dysfunctions in synaptic transmission lead to neuronal death, preceding changes in key brain areas. This review summarizes the role and mutual interactions of oxidative damage and impaired glucose metabolism as key factors affecting metabolic complications in schizophrenia. These observations may be a premise for novel potential therapeutic targets that will delay not only the onset of first symptoms but also the progression of schizophrenia and its complications.
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18
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Worthington MA, Cao H, Cannon TD. Discovery and Validation of Prediction Algorithms for Psychosis in Youths at Clinical High Risk. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:738-747. [PMID: 31902580 DOI: 10.1016/j.bpsc.2019.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/07/2019] [Accepted: 10/26/2019] [Indexed: 12/19/2022]
Abstract
In the past 2 to 3 decades, clinicians have used the clinical high risk for psychosis (CHR-P) paradigm to better understand factors that contribute to the onset of psychotic disorders. While this paradigm is useful to identify individuals at risk, the CHR-P criteria are not sufficient to predict outcomes from the CHR-P population. Because approximately 25% of the CHR-P population will ultimately convert to psychosis, more precise methods of prediction are needed to account for heterogeneity in both risk factors and outcomes in the CHR-P population. To this end, several groups in recent years have used data-driven approaches to refine predictive algorithms to predict both conversion to psychosis and functional outcomes. These models have generally used either clinical and behavioral data, including demographics and measures of symptom severity, neurocognitive functioning, and social functioning, or neuroimaging data, including structural and functional measures, to predict conversion to psychosis in CHR-P samples. This review focuses on the empirical models that have been derived within each of these lines of research and evaluates the performance and methodology of these models. This review also serves to inform best practices for data-driven approaches and directions moving forward to improve our prediction of psychotic disorders and associated outcomes. Because sample size is still the most critical consideration in the current models, we urge that algorithms to predict conversion be conducted using multisite data in order to obtain the power necessary to conclusively determine predictive accuracy without overfitting.
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Affiliation(s)
| | - Hengyi Cao
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, Connecticut.
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19
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Yaple ZA, Stevens WD, Arsalidou M. Meta-analyses of the n-back working memory task: fMRI evidence of age-related changes in prefrontal cortex involvement across the adult lifespan. Neuroimage 2019; 196:16-31. [DOI: 10.1016/j.neuroimage.2019.03.074] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 03/20/2019] [Accepted: 03/30/2019] [Indexed: 10/27/2022] Open
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20
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Tomyshev AS, Lebedeva IS, Akhadov TA, Omelchenko MA, Rumyantsev AO, Kaleda VG. Alterations in white matter microstructure and cortical thickness in individuals at ultra-high risk of psychosis: A multimodal tractography and surface-based morphometry study. Psychiatry Res Neuroimaging 2019; 289:26-36. [PMID: 31132567 DOI: 10.1016/j.pscychresns.2019.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/24/2019] [Accepted: 05/08/2019] [Indexed: 12/11/2022]
Abstract
There is increasing evidence of white matter (WM) and grey matter pathology in subjects at ultra-high risk of psychosis (UHR), although a limited number of diffusion-weighted magnetic resonance imaging (DW-MRI) and surface-based morphometry (SBM) studies have revealed anatomically inconsistent results. The present multimodal study applies tractography and SBM to analyze WM microstructure, whole-brain cortical anatomy, and potential interconnections between WM and grey matter abnormalities in UHR subjects. Thirty young male UHR patients and 30 healthy controls underwent DW-MRI and T1-weighted MRI. Fractional anisotropy; mean, radial, and axial diffusivity in 18 WM tracts; and vertex-based cortical thickness, area, and volume were analyzed. We found increased radial diffusivity in the left anterior thalamic radiation and reduced bilateral thickness across the frontal, temporal, and parietal cortices. No correlations between WM and grey matter abnormalities were identified. These results provide further evidence that WM microstructure abnormalities and cortical anatomical changes occur in the UHR state. Disruption of structural connectivity in the prefrontal-subcortical circuitry, likely caused by myelin pathology, and cortical thickness reduction affecting the networks presumably involved in processing and coordination of external and internal information streams may underlie the widespread deficits in neurocognitive and social functioning that are consistently reported in UHR subjects.
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Affiliation(s)
- Alexander S Tomyshev
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russia.
| | - Irina S Lebedeva
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, 34 Kashirskoe shosse, 115522 Moscow, Russia
| | - Tolibdzhon A Akhadov
- Department of Radiology, Children's Clinical and Research Institute of Emergency Surgery and Trauma, Moscow, Russia
| | - Maria A Omelchenko
- Department of Endogenous Mental Disorders, Mental Health Research Center, Moscow, Russia
| | - Andrey O Rumyantsev
- Department of Endogenous Mental Disorders, Mental Health Research Center, Moscow, Russia
| | - Vasiliy G Kaleda
- Department of Endogenous Mental Disorders, Mental Health Research Center, Moscow, Russia
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21
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Chen YH, Howell B, Edgar JC, Huang M, Kochunov P, Hunter MA, Wootton C, Lu BY, Bustillo J, Sadek JR, Miller GA, Cañive JM. Associations and Heritability of Auditory Encoding, Gray Matter, and Attention in Schizophrenia. Schizophr Bull 2019; 45:859-870. [PMID: 30099543 PMCID: PMC6581123 DOI: 10.1093/schbul/sby111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Auditory encoding abnormalities, gray-matter loss, and cognitive deficits are all candidate schizophrenia (SZ) endophenotypes. This study evaluated associations between and heritability of auditory network attributes (function and structure) and attention in healthy controls (HC), SZ patients, and unaffected relatives (UR). METHODS Whole-brain maps of M100 auditory activity from magnetoencephalography recordings, cortical thickness (CT), and a measure of attention were obtained from 70 HC, 69 SZ patients, and 35 UR. Heritability estimates (h2r) were obtained for M100, CT at each group-difference region, and the attention measure. RESULTS SZ patients had weaker bilateral superior temporal gyrus (STG) M100 responses than HC and a weaker right frontal M100 response than UR. Abnormally large M100 responses in left superior frontal gyrus were observed in UR and SZ patients. SZ patients showed smaller CT in bilateral STG and right frontal regions. Interrelatedness between 3 putative SZ endophenotypes was demonstrated, although in the left STG the M100 and CT function-structure associations observed in HC and UR were absent in SZ patients. Heritability analyses also showed that right frontal M100 and bilateral STG CT measures are significantly heritable. CONCLUSIONS Present findings indicated that the 3 SZ endophenotypes examined are not isolated markers of pathology but instead are connected. The pattern of auditory encoding group differences and the pattern of brain function-structure associations differ as a function of brain region, indicating the need for regional specificity when studying these endophenotypes, and with the presence of left STG function-structure associations in HC and UR but not in SZ perhaps reflecting disease-associated damage to gray matter that disrupts function-structure relationships in SZ.
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Affiliation(s)
- Yu-Han Chen
- Department of Radiology, Lurie Family Foundations MEG Imaging Center, Children’s Hospital of Philadelphia, Philadelphia, PA,To whom correspondence should be addressed; Department of Radiology, The Children’s Hospital of Philadelphia, Seashore House 1F Room 116B, Philadelphia, PA 19104, USA; tel: +1(267)426-0959, fax: +1(267)425-2465, e-mail:
| | - Breannan Howell
- Department of Psychology, The University of New Mexico, Albuquerque, NM,Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Research, The University of New Mexico, Albuquerque, NM
| | - J Christopher Edgar
- Department of Radiology, Lurie Family Foundations MEG Imaging Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Mingxiong Huang
- Department of Radiology, University of California, San Diego, San Diego, CA,Department of Radiology, VA San Diego Healthcare System, US Department of Veterans Affairs, San Diego, CA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, The University of Maryland, Baltimore, MD
| | - Michael A Hunter
- Department of Psychology, The University of New Mexico, Albuquerque, NM,Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Research, The University of New Mexico, Albuquerque, NM
| | - Cassandra Wootton
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Research, The University of New Mexico, Albuquerque, NM
| | - Brett Y Lu
- Department of Psychiatry, University of Hawaii at Manoa, Honolulu, HI
| | - Juan Bustillo
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Research, The University of New Mexico, Albuquerque, NM
| | - Joseph R Sadek
- Psychiatry Research, New Mexico VA Health Care System, Raymond G. Murphy VA Medical Center, US Department of Veterans Affairs, Albuquerque, NM
| | - Gregory A Miller
- Department of Psychology, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - José M Cañive
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Research, The University of New Mexico, Albuquerque, NM,Psychiatry Research, New Mexico VA Health Care System, Raymond G. Murphy VA Medical Center, US Department of Veterans Affairs, Albuquerque, NM
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22
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Shan XX, Ou YP, Pan P, Ding YD, Zhao J, Liu F, Chen JD, Guo WB, Zhao JP. Increased frontal gray matter volume in individuals with prodromal psychosis. CNS Neurosci Ther 2019; 25:987-994. [PMID: 31129924 PMCID: PMC6698969 DOI: 10.1111/cns.13143] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/27/2019] [Accepted: 04/07/2019] [Indexed: 01/10/2023] Open
Abstract
Background Brain anatomical deficits associated with cognitive dysfunction have been reported in patients with schizophrenia. However, it remains unknown whether such anatomical deficits exist in individuals with prodromal psychosis. The present study is designed to investigate anatomical deficits in prodromal individuals and their associations with clinical/cognitive features. Methods Seventy‐four prodromal individuals and seventy‐six healthy controls were scanned using structural magnetic resonance imaging. Support vector machines were applied to test whether anatomical deficits might be used to discriminate prodromal individuals from healthy controls. Results Prodromal individuals showed significantly increased gray matter volume (GMV) in the right inferior frontal gyrus (IFG) and right rectus gyrus relative to healthy controls. No correlations were observed between increased GMV and clinical/cognitive characteristics. The combination of increased GMV in the right rectus gyrus and right IFG showed a sensitivity of 74.32%, a specificity of 67.11%, and an accuracy of 70.67% in differentiating prodromal individuals from healthy controls. Conclusion Our results provide evidence of increased frontal GMV in prodromal individuals. A combination of GMV values in the two frontal brain areas may serve as potential markers to discriminate prodromal individuals from healthy controls. The results thus highlight the importance of the frontal regions in the pathophysiology of psychosis.
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Affiliation(s)
- Xiao-Xiao Shan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Yang-Pan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Pan Pan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Yu-Dan Ding
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Jin Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jin-Dong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Wen-Bin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Jing-Ping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
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23
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Lemmers-Jansen ILJ, Fett AKJ, Hanssen E, Veltman DJ, Krabbendam L. Learning to trust: social feedback normalizes trust behavior in first-episode psychosis and clinical high risk. Psychol Med 2019; 49:780-790. [PMID: 29897026 DOI: 10.1017/s003329171800140x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Psychosis is characterized by problems in social functioning that exist well before illness onset, and in individuals at clinical high risk (CHR) for psychosis. Trust is an essential element for social interactions that is impaired in psychosis. In the trust game, chronic patients showed reduced baseline trust, impaired response to positive social feedback, and attenuated brain activation in reward and mentalizing areas. We investigated whether first-episode psychosis patients (FEP) and CHR show similar abnormalities in the neural and behavioral mechanisms underlying trust. METHODS Twenty-two FEP, 17 CHR, and 43 healthy controls performed two trust games, with a cooperative and an unfair partner in the fMRI scanner. Region of interest analyses were performed on mentalizing and reward processing areas, during the investment and outcome phases of the games. RESULTS Compared with healthy controls, FEP and CHR showed reduced baseline trust, but like controls, learned to trust in response to cooperative and unfair feedback. Symptom severity was not associated with baseline trust, however in FEP associated with reduced response to feedback. The only group differences in brain activation were that CHR recruited the temporo-parietal junction (TPJ) more than FEP and controls during investment in the unfair condition. This hyper-activation in CHR was associated with greater symptom severity. CONCLUSIONS Reduced baseline trust may be associated with risk for psychotic illness, or generally with poor mental health. Feedback learning is still intact in CHR and FEP, as opposed to chronic patients. CHR however show distinct neural activation patterns of hyper-activation of the TPJ.
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Affiliation(s)
- Imke L J Lemmers-Jansen
- Department of Educational and Family studies,Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam,Vrije Universiteit Amsterdam,Van der Boechorststraat 1, 1081 BT Amsterdam,The Netherlands
| | - Anne-Kathrin J Fett
- Department of Psychology, City,University of London,Northampton Square,London EC1V 0HB,UK
| | - Esther Hanssen
- Department of Educational and Family studies,Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam,Vrije Universiteit Amsterdam,Van der Boechorststraat 1, 1081 BT Amsterdam,The Netherlands
| | - Dick J Veltman
- Department of Psychiatry,VU Medical Center,Van der Boechorststraat 7,1081 BT Amsterdam,The Netherlands
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology,Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam,Vrije Universiteit Amsterdam,Van der Boechorststraat 1, 1081 BT Amsterdam,The Netherlands
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24
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Cao H, Chén OY, Chung Y, Forsyth JK, McEwen SC, Gee DG, Bearden CE, Addington J, Goodyear B, Cadenhead KS, Mirzakhanian H, Cornblatt BA, Carrión RE, Mathalon DH, McGlashan TH, Perkins DO, Belger A, Seidman LJ, Thermenos H, Tsuang MT, van Erp TGM, Walker EF, Hamann S, Anticevic A, Woods SW, Cannon TD. Cerebello-thalamo-cortical hyperconnectivity as a state-independent functional neural signature for psychosis prediction and characterization. Nat Commun 2018; 9:3836. [PMID: 30242220 PMCID: PMC6155100 DOI: 10.1038/s41467-018-06350-7] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/30/2018] [Indexed: 02/07/2023] Open
Abstract
Understanding the fundamental alterations in brain functioning that lead to psychotic disorders remains a major challenge in clinical neuroscience. In particular, it is unknown whether any state-independent biomarkers can potentially predict the onset of psychosis and distinguish patients from healthy controls, regardless of paradigm. Here, using multi-paradigm fMRI data from the North American Prodrome Longitudinal Study consortium, we show that individuals at clinical high risk for psychosis display an intrinsic “trait-like” abnormality in brain architecture characterized as increased connectivity in the cerebello–thalamo–cortical circuitry, a pattern that is significantly more pronounced among converters compared with non-converters. This alteration is significantly correlated with disorganization symptoms and predictive of time to conversion to psychosis. Moreover, using an independent clinical sample, we demonstrate that this hyperconnectivity pattern is reliably detected and specifically present in patients with schizophrenia. These findings implicate cerebello–thalamo–cortical hyperconnectivity as a robust state-independent neural signature for psychosis prediction and characterization. Brain function alterations in schizophrenia and other psychotic disorders remain poorly understood. Here, the authors discover that increased neural connectivity in the cerebello-thalamo-cortical circuitry predicts psychosis in those at high risk, and is present in people with schizophrenia.
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Affiliation(s)
- Hengyi Cao
- Department of Psychology, Yale University, New Haven, CT, 06511, USA.
| | - Oliver Y Chén
- Department of Psychology, Yale University, New Haven, CT, 06511, USA
| | - Yoonho Chung
- Department of Psychology, Yale University, New Haven, CT, 06511, USA
| | - Jennifer K Forsyth
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Sarah C McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, CT, 06511, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, T2N 1N4, Canada
| | - Bradley Goodyear
- Departments of Radiology, Clinical Neuroscience and Psychiatry, University of Calgary, Calgary, T2N 1N4, Canada
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
| | - Heline Mirzakhanian
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
| | - Barbara A Cornblatt
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, 11004, USA
| | - Ricardo E Carrión
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, 11004, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94143, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA
| | - Heidi Thermenos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
| | - Theo G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, 92697, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, 30322, USA
| | - Stephan Hamann
- Department of Psychology, Emory University, Atlanta, GA, 30322, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, 06510, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, 06510, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, 06511, USA. .,Department of Psychiatry, Yale University, New Haven, CT, 06510, USA.
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Reading the (functional) writing on the (structural) wall: Multimodal fusion of brain structure and function via a deep neural network based translation approach reveals novel impairments in schizophrenia. Neuroimage 2018; 181:734-747. [PMID: 30055372 DOI: 10.1016/j.neuroimage.2018.07.047] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 07/16/2018] [Accepted: 07/18/2018] [Indexed: 01/01/2023] Open
Abstract
This work presents a novel approach to finding linkage/association between multimodal brain imaging data, such as structural MRI (sMRI) and functional MRI (fMRI). Motivated by the machine translation domain, we employ a deep learning model, and consider two different imaging views of the same brain like two different languages conveying some common facts. That analogy enables finding linkages between two modalities. The proposed translation-based fusion model contains a computing layer that learns "alignments" (or links) between dynamic connectivity features from fMRI data and static gray matter patterns from sMRI data. The approach is evaluated on a multi-site dataset consisting of eyes-closed resting state imaging data collected from 298 subjects (age- and gender matched 154 healthy controls and 144 patients with schizophrenia). Results are further confirmed on an independent dataset consisting of eyes-open resting state imaging data from 189 subjects (age- and gender matched 91 healthy controls and 98 patients with schizophrenia). We used dynamic functional connectivity (dFNC) states as the functional features and ICA-based sources from gray matter densities as the structural features. The dFNC states characterized by weakly correlated intrinsic connectivity networks (ICNs) were found to have stronger association with putamen and insular gray matter pattern, while the dFNC states of profuse strongly correlated ICNs exhibited stronger links with the gray matter pattern in precuneus, posterior cingulate cortex (PCC), and temporal cortex. Further investigation with the estimated link strength (or alignment score) showed significant group differences between healthy controls and patients with schizophrenia in several key regions including temporal lobe, and linked these to connectivity states showing less occupancy in healthy controls. Moreover, this novel approach revealed significant correlation between a cognitive score (attention/vigilance) and the function/structure alignment score that was not detected when data modalities were considered separately.
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Goñi M, Basu N, Murray AD, Waiter GD. Neural Indicators of Fatigue in Chronic Diseases: A Systematic Review of MRI Studies. Diagnostics (Basel) 2018; 8:diagnostics8030042. [PMID: 29933643 PMCID: PMC6163988 DOI: 10.3390/diagnostics8030042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 02/08/2023] Open
Abstract
While fatigue is prevalent in chronic diseases, the neural mechanisms underlying this symptom remain unknown. Magnetic resonance imaging (MRI) has the potential to enable us to characterize this symptom. The aim of this review was to gather and appraise the current literature on MRI studies of fatigue in chronic diseases. We systematically searched the following databases: MedLine, PsycInfo, Embase and Scopus (inception to April 2016). We selected studies according to a predefined inclusion and exclusion criteria. We assessed the quality of the studies and conducted descriptive statistical analyses. We identified 26 studies of varying design and quality. Structural and functional MRI, alongside diffusion tensor imaging (DTI) and functional connectivity (FC) studies, identified significant brain indicators of fatigue. The most common regions were the frontal lobe, parietal lobe, limbic system and basal ganglia. Longitudinal studies offered more precise and reliable analysis. Brain structures found to be related to fatigue were highly heterogeneous, not only between diseases, but also for different studies of the same disease. Given the different designs, methodologies and variable results, we conclude that there are currently no well-defined brain indicators of fatigue in chronic diseases.
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Affiliation(s)
- María Goñi
- Aberdeen Biomedical Imaging Centre (ABIC), Lilian Sutton Building, Foresterhill, University of Aberdeen, Aberdeen AB25 2ZN, UK.
| | - Neil Basu
- Health Science Building, Foresterhill, University of Aberdeen, Aberdeen AB25 2ZN, UK.
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre (ABIC), Lilian Sutton Building, Foresterhill, University of Aberdeen, Aberdeen AB25 2ZN, UK.
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre (ABIC), Lilian Sutton Building, Foresterhill, University of Aberdeen, Aberdeen AB25 2ZN, UK.
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Structural and functional alterations in the brain during working memory in medication-naïve patients at clinical high-risk for psychosis. PLoS One 2018; 13:e0196289. [PMID: 29742121 PMCID: PMC5942777 DOI: 10.1371/journal.pone.0196289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 04/10/2018] [Indexed: 12/18/2022] Open
Abstract
Several previous studies suggest that clinical high risk for psychosis (CHR) is associated with prefrontal functional abnormalities and more widespread reduced grey matter in prefrontal, temporal and parietal areas. We investigated neural correlates to CHR in medication-naïve patients. 41 CHR patients and 37 healthy controls were examined with 1.5 Tesla MRI, yielding functional scans while performing an N-back task and structural T1-weighted brain images. Functional and structural data underwent automated preprocessing steps in SPM and Freesurfer, correspondingly. The groups were compared employing mass-univariate strategy within the generalized linear modelling framework. CHR demonstrated reduced suppression of the medial temporal lobe (MTL) regions during n-back task. We also found that, consistent with previous findings, CHR subjects demonstrated thinning in prefrontal, cingulate, insular and inferior temporal areas, as well as reduced hippocampal volumes. The present findings add to the growing evidence of specific structural and functional abnormalities in the brain as potential neuroimaging markers of psychosis vulnerability.
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28
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Li RR, Lyu HL, Liu F, Lian N, Wu RR, Zhao JP, Guo WB. Altered functional connectivity strength and its correlations with cognitive function in subjects with ultra-high risk for psychosis at rest. CNS Neurosci Ther 2018; 24:1140-1148. [PMID: 29691990 DOI: 10.1111/cns.12865] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 12/21/2022] Open
Abstract
AIMS Evidence of altered structural and functional connectivity in the frontal-occipital network is associated with cognitive deficits in patients with schizophrenia. However, the altered patterns of functional connectivity strength (FCS) in individuals with ultra-high risk (UHR) for psychosis remain unknown. In this study, whole-brain FCS was assessed to examine the altered patterns of FCS in UHR subjects. METHODS A total of 34 UHR subjects and 37 age- and sex-matched healthy controls were enrolled to undergo resting-state functional magnetic resonance imaging. The imaging data were analyzed using the graph theory method. RESULTS Compared with healthy controls, UHR subjects showed significantly decreased FCS in the left middle frontal gyrus and significantly increased FCS in the left calcarine cortex. The FCS values in the left middle frontal gyrus were positively correlated to the scores of the Brief Assessments of Cognitionin Schizophrenia Symbol Coding Test (r = 0.366, P = 0.033) in the UHR subjects. A negative correlation was found between the FCS values in the left calcarine cortex and the scores of the Stroop color-naming test (r = -0.475, P = 0.016) in the UHR subjects. A combination of the FCS values in the 2 brain areas showed an accuracy of 87.32%, a sensitivity of 73.53%, and a specificity of 100% for distinguishing UHR subjects from healthy controls. CONCLUSIONS Significantly altered FCS in the frontal-occipital network is observed in the UHR subjects. Furthermore, decreased FCS in the left middle frontal gyrus and increased FCS in the left calcarine have significant correlations with the cognitive measures of the UHR subjects and thus improve our understanding of the underlying pathophysiological mechanisms of schizophrenia. Moreover, a combination of the FCS values in the 2 brain areas can serve as a potential image marker to distinguish UHR subjects from healthy controls.
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Affiliation(s)
- Ran-Ran Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hai-Long Lyu
- Department of Psychiatry, The First Affiliated Hospital, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Lian
- The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Ren-Rong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jing-Ping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wen-Bin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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29
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Falkenberg I, Valli I, Raffin M, Broome MR, Fusar-Poli P, Matthiasson P, Picchioni M, McGuire P. Pattern of activation during delayed matching to sample task predicts functional outcome in people at ultra high risk for psychosis. Schizophr Res 2017; 181:86-93. [PMID: 27693282 DOI: 10.1016/j.schres.2016.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 09/09/2016] [Accepted: 09/15/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Clinical outcomes in people identified as at ultra-high risk (UHR) for psychosis are remarkably heterogeneous, and are difficult to predict on the basis of the presenting clinical features. Individuals at UHR are at risk of poor functional outcome regardless of development of psychotic disorder. The aim of the present study was to assess whether there is a relationship between functional neuroimaging measures at presentation and functional outcome as measured by the GAF three years after scanning. METHODS Functional magnetic resonance imaging (fMRI) data were collected during an object working memory task in 34 ultra-high risk (UHR) subjects and 20 healthy controls. On the basis of their GAF scores at follow up, the UHR participants were divided into subgroups with good and poor functional outcomes, respectively. RESULTS At baseline, the UHR group differed from controls in showing altered frontal and cuneus/posterior cingulate activation. Significant group x task interactions were found in the left cuneus and posterior cingulate gyrus, reflecting differential responses to the task conditions. Within the UHR sample, the subgroup with a poor functional outcome exhibited altered activation in frontal, temporal and striatal regions, and reduced deactivation within default-mode network regions, relative to those with a good outcome. Within the whole UHR sample, in these regions the local task response was correlated with the GAF score at follow up. CONCLUSIONS The findings suggest a potential role of functional neuroimaging in the prediction of outcomes in people at high clinical risk of psychosis.
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Affiliation(s)
- Irina Falkenberg
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
| | - Isabel Valli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marie Raffin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Matthew R Broome
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pall Matthiasson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marco Picchioni
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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30
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Kimhy D, Gill KE, Brucato G, Vakhrusheva J, Arndt L, Gross JJ, Girgis RR. The impact of emotion awareness and regulation on social functioning in individuals at clinical high risk for psychosis. Psychol Med 2016; 46:2907-2918. [PMID: 27050714 DOI: 10.1017/s0033291716000490] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Social functioning (SF) difficulties are ubiquitous among individuals at clinical high risk for psychosis (CHR), but it is not yet clear why. One possibility is suggested by the observation that effective SF requires adaptive emotion awareness and regulation. Previous reports have documented deficits in emotion awareness and regulation in individuals with schizophrenia, and have shown that such deficits predicted SF. However, it is unknown whether these deficits are present prior to the onset of psychosis or whether they are linked to SF in CHR individuals. METHOD We conducted a cross-sectional comparison of emotion awareness and regulation in 54 individuals at CHR, 87 with schizophrenia and 50 healthy controls (HC). Then, within the CHR group, we examined links between emotion awareness, emotion regulation and SF as indexed by the Global Functioning Scale: Social (Cornblatt et al. 2007). RESULTS Group comparisons indicated significant differences between HC and the two clinical groups in their ability to identify and describe feelings, as well as the use of suppression and reappraisal emotion-regulation strategies. Specifically, the CHR and schizophrenia groups displayed comparable deficits in all domains of emotion awareness and emotion regulation. A hierarchical multiple regression analysis indicated that difficulties describing feelings accounted for 23.2% of the SF variance. CONCLUSIONS The results indicate that CHR individuals display substantial emotion awareness and emotion-regulation deficits, at severity comparable with those observed in individuals with schizophrenia. Such deficits, in particular difficulties describing feelings, predate the onset of psychosis and contribute significantly to poor SF in this population.
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Affiliation(s)
- D Kimhy
- Department of Psychiatry,Columbia University,New York, NY,USA
| | - K E Gill
- Department of Psychology,The Catholic University of America,Washington, DC,USA
| | - G Brucato
- Department of Psychiatry,Columbia University,New York, NY,USA
| | - J Vakhrusheva
- Department of Psychiatry,Columbia University,New York, NY,USA
| | - L Arndt
- New York State Psychiatric Institute,New York, NY,USA
| | - J J Gross
- Department of Psychology,Stanford University,Stanford, CA,USA
| | - R R Girgis
- Department of Psychiatry,Columbia University,New York, NY,USA
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31
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Wang S, Wang G, Lv H, Wu R, Zhao J, Guo W. Abnormal regional homogeneity as potential imaging biomarker for psychosis risk syndrome: a resting-state fMRI study and support vector machine analysis. Sci Rep 2016; 6:27619. [PMID: 27272341 PMCID: PMC4897690 DOI: 10.1038/srep27619] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/23/2016] [Indexed: 11/23/2022] Open
Abstract
Subjects with psychosis risk syndrome (PRS) have structural and functional abnormalities in several brain regions. However, regional functional synchronization of PRS has not been clarified. We recruited 34 PRS subjects and 37 healthy controls. Regional homogeneity (ReHo) of resting-state functional magnetic resonance scans was employed to analyze regional functional synchronization in these participants. Receiver operating characteristic curves and support vector machines were used to detect whether abnormal regional functional synchronization could be utilized to separate PRS subjects from healthy controls. We observed that PRS subjects showed significant ReHo decreases in the left inferior temporal gyrus and increases in the right inferior frontal gyrus and right putamen compared with the controls. No correlations between abnormal regional functional synchronization in these brain regions and clinical characteristics existed. A combination of the ReHo values in the three brain regions showed sensitivity, specificity, and accuracy of 88.24%, 91.89%, and 90.14%, respectively, for discriminating PRS subjects from healthy controls. We inferred that abnormal regional functional synchronization exists in the cerebrum of PRS subjects, and a combination of ReHo values in these abnormal regions could be applied as potential image biomarker to identify PRS subjects from healthy controls.
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Affiliation(s)
- Shuai Wang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha 410011, China
| | - Guodong Wang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha 410011, China
| | - Hailong Lv
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha 410011, China
| | - Renrong Wu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha 410011, China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha 410011, China.,Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Wenbin Guo
- Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha 410011, China
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32
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Calhoun VD, Sui J. Multimodal fusion of brain imaging data: A key to finding the missing link(s) in complex mental illness. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:230-244. [PMID: 27347565 PMCID: PMC4917230 DOI: 10.1016/j.bpsc.2015.12.005] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
It is becoming increasingly clear that combining multi-modal brain imaging data is able to provide more information for individual subjects by exploiting the rich multimodal information that exists. However, the number of studies that do true multimodal fusion (i.e. capitalizing on joint information among modalities) is still remarkably small given the known benefits. In part, this is because multi-modal studies require broader expertise in collecting, analyzing, and interpreting the results than do unimodal studies. In this paper, we start by introducing the basic reasons why multimodal data fusion is important and what it can do, and importantly how it can help us avoid wrong conclusions and help compensate for imperfect brain imaging studies. We also discuss the challenges that need to be confronted for such approaches to be more widely applied by the community. We then provide a review of the diverse studies that have used multimodal data fusion (primarily focused on psychosis) as well as provide an introduction to some of the existing analytic approaches. Finally, we discuss some up-and-coming approaches to multi-modal fusion including deep learning and multimodal classification which show considerable promise. Our conclusion is that multimodal data fusion is rapidly growing, but it is still underutilized. The complexity of the human brain coupled with the incomplete measurement provided by existing imaging technology makes multimodal fusion essential in order to mitigate against misdirection and hopefully provide a key to finding the missing link(s) in complex mental illness.
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Affiliation(s)
- Vince D Calhoun
- The Mind Research Network & LBERI, Albuquerque, New Mexico.; Dept. of ECE, University of New Mexico, Albuquerque, New Mexico
| | - Jing Sui
- The Mind Research Network & LBERI, Albuquerque, New Mexico.; Brainnetome Center and National Laboratory of Pattern Recognition, Beijing, China; CAS Center for Excellence in Brain Science, Institute of Automation, Chinese Academy of Sciences, Beijing, China
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Hyperactivity of caudate, parahippocampal, and prefrontal regions during working memory in never-medicated persons at clinical high-risk for psychosis. Schizophr Res 2016; 173:1-12. [PMID: 26965745 PMCID: PMC4836956 DOI: 10.1016/j.schres.2016.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Deficits in working memory (WM) are a core feature of schizophrenia (SZ) and other psychotic disorders. We examined brain activity during WM in persons at clinical high risk (CHR) for psychosis. METHODS Thirty-seven CHR and 34 healthy control participants underwent functional MRI (fMRI) on a 3.0T scanner while performing an N-back WM task. The sample included a sub-sample of CHR participants who had no lifetime history of treatment with psychotropic medications (n=11). Data were analyzed using SPM8 (2-back>0-back contrast). Pearson correlations between brain activity, symptoms, and WM performance were examined. RESULTS The total CHR group and medication-naive CHR sub-sample were comparable to controls in most demographic features and in N-back WM performance, but had significantly lower IQ. Relative to controls, medication-naïve CHR showed hyperactivity in the left parahippocampus (PHP) and the left caudate during performance of the N-back WM task. Relative to medication-exposed CHR, medication naïve CHR exhibited hyperactivity in the left caudate and the right dorsolateral prefrontal cortex (DLPFC). DLPFC activity was significantly negatively correlated with WM performance. PHP, caudate and DLPFC activity correlated strongly with symptoms, but results did not withstand FDR-correction for multiple comparisons. When all CHR participants were combined (regardless of medication status), only trend-level PHP hyperactivity was observed in CHR relative to controls. CONCLUSIONS Medication-naïve CHR exhibit hyperactivity in regions that subserve WM. These regions are implicated in studies of schizophrenia and risk for psychosis. Results emphasize the importance of medication status in the interpretation of task - induced brain activity.
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Association between impaired brain activity and volume at the sub-region of Broca's area in ultra-high risk and first-episode schizophrenia: A multi-modal neuroimaging study. Schizophr Res 2016; 172:9-15. [PMID: 26873807 DOI: 10.1016/j.schres.2016.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/31/2016] [Accepted: 02/03/2016] [Indexed: 11/24/2022]
Abstract
Recent studies have suggested that functional abnormalities in Broca's area, which is important in language production (speech and thoughts before speech), play an important role in the pathophysiology of schizophrenia. While multi-modal approaches have proved useful in revealing the specific pathophysiology of psychosis, the association of functional abnormalities with gray matter volume (GMV) here in subjects with an ultra-high risk (UHR) of schizophrenia, those with first-episode schizophrenia (FES), and healthy controls has yet to be clarified. Therefore, the relationship between cortical activity measured using functional near-infrared spectroscopy (fNIRS) during a verbal fluency task, and GMV in the Broca's area assessed using a manual tracing in magnetic resonance imaging (MRI), which considers individual structural variation, was examined for 57 subjects (23 UHR/18 FES/16 controls). The UHR and FES group showed significantly reduced brain activity compared to control group in the left pars triangularis (PT) (P=.036, .003, respectively). Furthermore in the FES group, the reduced brain activity significantly positively correlated with the volume in the left PT (B=0.29, P=.027), while significant negative association was evident for all subjects (B=-0.18, P=.010). This correlation remained significant after adjusting for antipsychotics dosage, and voxel-wise analysis could not detect any significant correlation between impaired cortical activity and volume. The significant relationship between neural activity and GMV in the left PT may reflect a specific pathophysiology related to the onset of schizophrenia.
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Klauser P, Zhou J, Lim JK, Poh JS, Zheng H, Tng HY, Krishnan R, Lee J, Keefe RS, Adcock RA, Wood SJ, Fornito A, Chee MW. Lack of Evidence for Regional Brain Volume or Cortical Thickness Abnormalities in Youths at Clinical High Risk for Psychosis: Findings From the Longitudinal Youth at Risk Study. Schizophr Bull 2015; 41:1285-93. [PMID: 25745033 PMCID: PMC4601700 DOI: 10.1093/schbul/sbv012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is cumulative evidence that young people in an "at-risk mental state" (ARMS) for psychosis show structural brain abnormalities in frontolimbic areas, comparable to, but less extensive than those reported in established schizophrenia. However, most available data come from ARMS samples from Australia, Europe, and North America while large studies from other populations are missing. We conducted a structural brain magnetic resonance imaging study from a relatively large sample of 69 ARMS individuals and 32 matched healthy controls (HC) recruited from Singapore as part of the Longitudinal Youth At-Risk Study (LYRIKS). We used 2 complementary approaches: a voxel-based morphometry and a surface-based morphometry analysis to extract regional gray and white matter volumes (GMV and WMV) and cortical thickness (CT). At the whole-brain level, we did not find any statistically significant difference between ARMS and HC groups concerning total GMV and WMV or regional GMV, WMV, and CT. The additional comparison of 2 regions of interest, hippocampal, and ventricular volumes, did not return any significant difference either. Several characteristics of the LYRIKS sample like Asian origins or the absence of current illicit drug use could explain, alone or in conjunction, the negative findings and suggest that there may be no dramatic volumetric or CT abnormalities in ARMS.
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Affiliation(s)
- Paul Klauser
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,Monash Clinical and Imaging Neuroscience, School of Psychological Sciences & Monash Biomedical Imaging, Monash University, Clayton, Australia;,These authors contributed equally to the article
| | - Juan Zhou
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore;
| | - Joseph K.W. Lim
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Joann S. Poh
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Hui Zheng
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Han Ying Tng
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Ranga Krishnan
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Jimmy Lee
- Department of General Psychiatry 1 and Research Division, Institute of Mental Health, Singapore, Singapore;,Office of Clinical Sciences, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Richard S.E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - R. Alison Adcock
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC;,Center for Cognitive Neuroscience, Duke University, Durham, NC
| | - Stephen J. Wood
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alex Fornito
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,Monash Clinical and Imaging Neuroscience, School of Psychological Sciences & Monash Biomedical Imaging, Monash University, Clayton, Australia
| | - Michael W.L. Chee
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
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Grey matter networks in people at increased familial risk for schizophrenia. Schizophr Res 2015; 168:1-8. [PMID: 26330380 DOI: 10.1016/j.schres.2015.08.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/12/2015] [Accepted: 08/20/2015] [Indexed: 02/06/2023]
Abstract
Grey matter brain networks are disrupted in schizophrenia, but it is still unclear at which point during the development of the illness these disruptions arise and whether these can be associated with behavioural predictors of schizophrenia. We investigated if single-subject grey matter networks were disrupted in a sample of people at familial risk of schizophrenia. Single-subject grey matter networks were extracted from structural MRI scans of 144 high risk subjects, 32 recent-onset patients and 36 healthy controls. The following network properties were calculated: size, connectivity density, degree, path length, clustering coefficient, betweenness centrality and small world properties. People at risk of schizophrenia showed decreased path length and clustering in mostly prefrontal and temporal areas. Within the high risk sample, the path length of the posterior cingulate cortex and the betweenness centrality of the left inferior frontal operculum explained 81% of the variance in schizotypal cognitions, which was previously shown to be the strongest behavioural predictor of schizophrenia in the study. In contrast, local grey matter volume measurements explained 48% of variance in schizotypy. The present results suggest that single-subject grey matter networks can quantify behaviourally relevant biological alterations in people at increased risk for schizophrenia before disease onset.
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Bendfeldt K, Smieskova R, Koutsouleris N, Klöppel S, Schmidt A, Walter A, Harrisberger F, Wrege J, Simon A, Taschler B, Nichols T, Riecher-Rössler A, Lang UE, Radue EW, Borgwardt S. Classifying individuals at high-risk for psychosis based on functional brain activity during working memory processing. NEUROIMAGE-CLINICAL 2015; 9:555-63. [PMID: 26640767 PMCID: PMC4625212 DOI: 10.1016/j.nicl.2015.09.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 11/04/2022]
Abstract
The psychosis high-risk state is accompanied by alterations in functional brain activity during working memory processing. We used binary automatic pattern-classification to discriminate between the at-risk mental state (ARMS), first episode psychosis (FEP) and healthy controls (HCs) based on n-back WM-induced brain activity. Linear support vector machines and leave-one-out-cross-validation were applied to fMRI data of matched ARMS, FEP and HC (19 subjects/group). The HC and ARMS were correctly classified, with an accuracy of 76.2% (sensitivity 89.5%, specificity 63.2%, p = 0.01) using a verbal working memory network mask. Only 50% and 47.4% of individuals were classified correctly for HC vs. FEP (p = 0.46) or ARMS vs. FEP (p = 0.62), respectively. Without mask, accuracy was 65.8% for HC vs. ARMS (p = 0.03) and 65.8% for HC vs. FEP (p = 0.0047), and 57.9% for ARMS vs. FEP (p = 0.18). Regions in the medial frontal, paracingulate, cingulate, inferior frontal and superior frontal gyri, inferior and superior parietal lobules, and precuneus were particularly important for group separation. These results suggest that FEP and HC or FEP and ARMS cannot be accurately separated in small samples under these conditions. However, ARMS can be identified with very high sensitivity in comparison to HC. This might aid classification and help to predict transition in the ARMS. The ARMS was accurately identified based on an individual patient's response within a WM network. Regional cortical activations were particularly important for group separation. Based on WM alterations, FEP and HC or FEP and ARMS could not be accurately separated in small samples.
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Affiliation(s)
- Kerstin Bendfeldt
- Medical Image Analysis Centre, University Hospital Basel, Mittlere Strasse 83, Basel 4031, Switzerland
| | - Renata Smieskova
- Medical Image Analysis Centre, University Hospital Basel, Mittlere Strasse 83, Basel 4031, Switzerland ; Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Nussbaumstr. 7, Munich 80336, Germany
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, University Medical Center, Freiburg, Freiburg, Germany
| | - André Schmidt
- Medical Image Analysis Centre, University Hospital Basel, Mittlere Strasse 83, Basel 4031, Switzerland ; Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Anna Walter
- Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Fabienne Harrisberger
- Medical Image Analysis Centre, University Hospital Basel, Mittlere Strasse 83, Basel 4031, Switzerland ; Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Johannes Wrege
- Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Andor Simon
- University Hospital of Psychiatry, University of Bern, Bern 3010, Switzerland
| | - Bernd Taschler
- Dept. of Statistics, University of Warwick, Coventry, UK
| | - Thomas Nichols
- Dept. of Statistics, University of Warwick, Coventry, UK
| | - Anita Riecher-Rössler
- Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Undine E Lang
- Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland
| | - Ernst-Wilhelm Radue
- Medical Image Analysis Centre, University Hospital Basel, Mittlere Strasse 83, Basel 4031, Switzerland
| | - Stefan Borgwardt
- Medical Image Analysis Centre, University Hospital Basel, Mittlere Strasse 83, Basel 4031, Switzerland ; Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, 27, Basel 4056, Switzerland ; Department of Psychosis Studies, King's College London, Institute of Psychiatry, De Crespigny Park 16, London SE58AF, UK
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Brandt CL, Doan NT, Tønnesen S, Agartz I, Hugdahl K, Melle I, Andreassen OA, Westlye LT. Assessing brain structural associations with working-memory related brain patterns in schizophrenia and healthy controls using linked independent component analysis. Neuroimage Clin 2015; 9:253-63. [PMID: 26509112 PMCID: PMC4576364 DOI: 10.1016/j.nicl.2015.08.010] [Citation(s) in RCA: 15] [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: 05/06/2015] [Revised: 07/17/2015] [Accepted: 08/17/2015] [Indexed: 01/01/2023]
Abstract
Schizophrenia (SZ) is a psychotic disorder with significant cognitive dysfunction. Abnormal brain activation during cognitive processing has been reported, both in task-positive and task-negative networks. Further, structural cortical and subcortical brain abnormalities have been documented, but little is known about how task-related brain activation is associated with brain anatomy in SZ compared to healthy controls (HC). Utilizing linked independent component analysis (LICA), a data-driven multimodal analysis approach, we investigated structure-function associations in a large sample of SZ (n = 96) and HC (n = 142). We tested for associations between task-positive (fronto-parietal) and task-negative (default-mode) brain networks derived from fMRI activation during an n-back working memory task, and brain structural measures of surface area, cortical thickness, and gray matter volume, and to what extent these associations differed in SZ compared to HC. A significant association (p < .05, corrected for multiple comparisons) was found between a component reflecting the task-positive fronto-parietal network and another component reflecting cortical thickness in fronto-temporal brain regions in SZ, indicating increased activation with increased thickness. Other structure-function associations across, between and within groups were generally moderate and significant at a nominal p-level only, with more numerous and stronger associations in SZ compared to HC. These results indicate a complex pattern of moderate associations between brain activation during cognitive processing and brain morphometry, and extend previous findings of fronto-temporal brain abnormalities in SZ by suggesting a coupling between cortical thickness of these brain regions and working memory-related brain activation.
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Affiliation(s)
- Christine Lycke Brandt
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nhat Trung Doan
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siren Tønnesen
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway ; Department of Psychiatric Research, Diakonhjemmet Hospital, Diakonhjemmet, Norway ; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Hugdahl
- Norwegian Centre for Mental Disorders Research, Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway ; Division of Psychiatry, Haukeland University Hospital, Haukeland, Norway ; Department of Radiology, Haukeland University Hospital, Haukeland, Norway ; KG Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway ; Department of Psychology, University of Oslo, Oslo, Norway
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39
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Fonville L, Cohen Kadosh K, Drakesmith M, Dutt A, Zammit S, Mollon J, Reichenberg A, Lewis G, Jones DK, David AS. Psychotic Experiences, Working Memory, and the Developing Brain: A Multimodal Neuroimaging Study. Cereb Cortex 2015; 25:4828-38. [PMID: 26286920 PMCID: PMC4635922 DOI: 10.1093/cercor/bhv181] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Psychotic experiences (PEs) occur in the general population, especially in children and adolescents, and are associated with poor psychosocial outcomes, impaired cognition, and increased risk of transition to psychosis. It is unknown how the presence and persistence of PEs during early adulthood affects cognition and brain function. The current study assessed working memory as well as brain function and structure in 149 individuals, with and without PEs, drawn from a population cohort. Observer-rated PEs were classified as persistent or transient on the basis of longitudinal assessments. Working memory was assessed using the n-back task during fMRI. Dynamic causal modeling (DCM) was used to characterize frontoparietal network configuration and voxel-based morphometry was utilized to examine gray matter. Those with persistent, but not transient, PEs performed worse on the n-back task, compared with controls, yet showed no significant differences in regional brain activation or brain structure. DCM analyses revealed greater emphasis on frontal connectivity within a frontoparietal network in those with PEs compared with controls. We propose that these findings portray an altered configuration of working memory function in the brain, potentially indicative of an adaptive response to atypical development associated with the manifestation of PEs.
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Affiliation(s)
- Leon Fonville
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Mark Drakesmith
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Anirban Dutt
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stanley Zammit
- Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Josephine Mollon
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Abraham Reichenberg
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Department of Psychiatry, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Anthony S David
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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40
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Roche E, Creed L, MacMahon D, Brennan D, Clarke M. The Epidemiology and Associated Phenomenology of Formal Thought Disorder: A Systematic Review. Schizophr Bull 2015; 41:951-62. [PMID: 25180313 PMCID: PMC4466171 DOI: 10.1093/schbul/sbu129] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Authors of the Diagnostic and Statistical Manual, Fifth Edition (DSM-V) have recommended to "integrate dimensions into clinical practice." The epidemiology and associated phenomenology of formal thought disorder (FTD) have been described but not reviewed. We aimed to carry out a systematic review of FTD to this end. METHODS A systematic review of FTD literature, from 1978 to 2013, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A total of 881 abstracts were reviewed and 120 articles met inclusion criteria; articles describing FTD factor structure (n = 15), prevalence and longitudinal course (n = 41), role in diagnosis (n = 22), associated clinical variables (n = 56), and influence on outcome (n = 35) were included. Prevalence estimates for FTD in psychosis range from 5% to 91%. Dividing FTD into domains, by factor analysis, can accurately identify 91% of psychotic diagnoses. FTD is associated with increased clinical severity. Poorer outcomes are predicted by negative thought disorder, more so than the typical construct of "disorganized speech." CONCLUSION FTD is a common symptom of psychosis and may be considered a marker of illness severity. Detailed dimensional assessment of FTD can clarify diagnosis and may help predict prognosis.
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Affiliation(s)
- Eric Roche
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland;
| | - Lisa Creed
- Cluain Mhuire Community Mental Health Service, Dublin, Ireland
| | | | | | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
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41
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Falkenberg I, Chaddock C, Murray RM, McDonald C, Modinos G, Bramon E, Walshe M, Broome M, McGuire P, Allen P. Failure to deactivate medial prefrontal cortex in people at high risk for psychosis. Eur Psychiatry 2015; 30:633-40. [PMID: 25841662 DOI: 10.1016/j.eurpsy.2015.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/04/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022] Open
Abstract
Impaired working memory is a core feature of schizophrenia and is linked with altered engagement the lateral prefrontal cortex. Although altered PFC activation has been reported in people with increased risk of psychosis, at present it is not clear if this neurofunctional alteration differs between familial and clinical risk states and/or increases in line with the level of psychosis risk. We addressed this issue by using functional MRI and a working memory paradigm to study familial and clinical high-risk groups. We recruited 17 subjects at ultra-high-risk (UHR) for psychosis, 10 non-affected siblings of patients with schizophrenia (familial high risk [FHR]) and 15 healthy controls. Subjects were scanned while performing the N-back working memory task. There was a relationship between the level of task-related deactivation in the medial PFC and precuneus and the level of psychosis risk, with deactivation weakest in the UHR group, greatest in healthy controls, and at an intermediate level in the FHR group. In the high-risk groups, activation in the precuneus was associated with the level of negative symptoms. These data suggest that increased vulnerability to psychosis is associated with a failure to deactivate in the medial PFC and precuneus during a working memory task, and appears to be most evident in subjects at clinical, as opposed to familial high risk.
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Affiliation(s)
- I Falkenberg
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
| | - C Chaddock
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - R M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - C McDonald
- Department of Psychiatry, Clinical Science Institute, National University of Ireland, Galway, Galway, Ireland
| | - G Modinos
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - E Bramon
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, United Kingdom
| | - M Walshe
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - M Broome
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7AL, United Kingdom
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - P Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
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43
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Pettersson-Yeo W, Benetti S, Frisciata S, Catani M, Williams SC, Allen P, McGuire P, Mechelli A. Does neuroanatomy account for superior temporal dysfunction in early psychosis? A multimodal MRI investigation. J Psychiatry Neurosci 2015; 40:100-7. [PMID: 25338016 PMCID: PMC4354815 DOI: 10.1503/jpn.140082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Neuroimaging studies of ultra-high risk (UHR) and first-episode psychosis (FEP) have revealed widespread alterations in brain structure and function. Recent evidence suggests there is an intrinsic relationship between these 2 types of alterations; however, there is very little research linking these 2 modalities in the early stages of psychosis. METHODS To test the hypothesis that functional alteration in UHR and FEP articipants would be associated with corresponding structural alteration, we examined brain function and structure in these participants as well as in a group of healthy controls using multimodal MRI. The data were analyzed using statistical parametric mapping. RESULTS We included 24 participants in the FEP group, 18 in the UHR group and 21 in the control group. Patients in the FEP group showed a reduction in functional activation in the left superior temporal gyrus relative to controls, and the UHR group showed intermediate values. The same region showed a corresponding reduction in grey matter volume in the FEP group relative to controls. However, while the difference in grey matter volume remained significant after including functional activation as a covariate of no interest, the reduction in functional activation was no longer evident after including grey matter volume as a covariate of no interest. LIMITATIONS Our sample size was relatively small. All participants in the FEP group and 2 in the UHR group had received antipsychotic medication, which may have impacted neurofunction and/or neuroanatomy. CONCLUSION Our results suggest that superior temporal dysfunction in early psychosis is accounted for by a corresponding alteration in grey matter volume. This finding has important implications for the interpretation of functional alteration in early psychosis.
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Affiliation(s)
- William Pettersson-Yeo
- Correspondence to: W. Pettersson-Yeo, Department of Psychosis Studies, PO Box 67, Institute of Psychiatry, King’s College London, De Crespigny Park, London UK SE5 8AF;
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44
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Dutt A, Tseng HH, Fonville L, Drakesmith M, Su L, Evans J, Zammit S, Jones D, Lewis G, David AS. Exploring neural dysfunction in 'clinical high risk' for psychosis: a quantitative review of fMRI studies. J Psychiatr Res 2015; 61:122-34. [PMID: 25479766 DOI: 10.1016/j.jpsychires.2014.08.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 08/06/2014] [Accepted: 08/26/2014] [Indexed: 01/10/2023]
Abstract
Individuals at clinical high risk (CHR) of developing psychosis present with widespread functional abnormalities in the brain. Cognitive deficits, including working memory (WM) problems, as commonly elicited by n-back tasks, are observed in CHR individuals. However, functional MRI (fMRI) studies, comprising a heterogeneous cluster of general and social cognition paradigms, have not necessarily demonstrated consistent and conclusive results in this population. Hence, a comprehensive review of fMRI studies, spanning almost one decade, was carried out to observe for general trends with respect to brain regions and cognitive systems most likely to be dysfunctional in CHR individuals. 32 studies were included for this review, out of which 22 met the criteria for quantitative analysis using activation likelihood estimation (ALE). Task related contrast activations were firstly analysed by comparing CHR and healthy control participants in the total pooled sample, followed by a comparison of general cognitive function studies (excluding social cognition paradigms), and finally by only looking at n-back working memory task based studies. Findings from the ALE implicated four key dysfunctional and distinct neural regions in the CHR group, namely the right inferior parietal lobule (rIPL), the left medial frontal gyrus (lmFG), the left superior temporal gyrus (lSTG) and the right fronto-polar cortex (rFPC) of the superior frontal gyrus (SFG). Narrowing down to relatively few significant dysfunctional neural regions is a step forward in reducing the apparent ambiguity of overall findings, which would help to target specific neural regions and pathways of interest for future research in CHR populations.
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Affiliation(s)
- Anirban Dutt
- Institute of Psychiatry, King's College London, London, UK.
| | | | - Leon Fonville
- Institute of Psychiatry, King's College London, London, UK
| | - Mark Drakesmith
- Cardiff University Brain Research Imaging Centre, Cardiff, UK
| | - Liang Su
- Institute of Psychiatry, King's College London, London, UK
| | - John Evans
- Cardiff University Brain Research Imaging Centre, Cardiff, UK
| | - Stanley Zammit
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Derek Jones
- Cardiff University Brain Research Imaging Centre, Cardiff, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
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45
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Schmidt A, Diwadkar VA, Smieskova R, Harrisberger F, Lang UE, McGuire P, Fusar-Poli P, Borgwardt S. Approaching a network connectivity-driven classification of the psychosis continuum: a selective review and suggestions for future research. Front Hum Neurosci 2015; 8:1047. [PMID: 25628553 PMCID: PMC4292722 DOI: 10.3389/fnhum.2014.01047] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/15/2014] [Indexed: 01/07/2023] Open
Abstract
Brain changes in schizophrenia evolve along a dynamic trajectory, emerging before disease onset and proceeding with ongoing illness. Recent investigations have focused attention on functional brain interactions, with experimental imaging studies supporting the disconnection hypothesis of schizophrenia. These studies have revealed a broad spectrum of abnormalities in brain connectivity in patients, particularly for connections integrating the frontal cortex. A critical point is that brain connectivity abnormalities, including altered resting state connectivity within the fronto-parietal (FP) network, are already observed in non-help-seeking individuals with psychotic-like experiences. If we consider psychosis as a continuum, with individuals with psychotic-like experiences at the lower and psychotic patients at the upper ends, individuals with psychotic-like experiences represent a key population for investigating the validity of putative biomarkers underlying the onset of psychosis. This paper selectively addresses the role played by FP connectivity in the psychosis continuum, which includes patients with chronic psychosis, early psychosis, clinical high risk, genetic high risk, as well as the general population with psychotic experiences. We first discuss structural connectivity changes among the FP pathway in each domain in the psychosis continuum. This may provide a basis for us to gain an understanding of the subsequent changes in functional FP connectivity. We further indicate that abnormal FP connectivity may arise from glutamatergic disturbances of this pathway, in particular from abnormal NMDA receptor-mediated plasticity. In the second part of this paper we propose some concepts for further research on the use of network connectivity in the classification of the psychosis continuum. These concepts are consistent with recent efforts to enhance the role of data in driving the diagnosis of psychiatric spectrum diseases.
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Affiliation(s)
- André Schmidt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University Detroit, Michigan, USA
| | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | | | - Undine E Lang
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland ; Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
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Modinos G, Allen P, Grace AA, McGuire P. Translating the MAM model of psychosis to humans. Trends Neurosci 2014; 38:129-38. [PMID: 25554679 DOI: 10.1016/j.tins.2014.12.005] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/12/2014] [Accepted: 12/02/2014] [Indexed: 12/13/2022]
Abstract
Elevated dopamine function and alterations in medial temporal lobe (MTL) structure and function are two of the most robust findings in schizophrenia, but how interactions between these abnormalities underlie the onset of psychosis is unclear. The methylazoxymethanol acetate (MAM) rodent model proposes that psychosis develops as a result of a perturbation of MTL function, leading to elevated striatal dopamine dysfunction. Here, we review several recent neuroimaging studies that examine components of the putative model in humans with an ultra high risk (UHR) of the psychosis. While data from these studies are broadly consistent with the MAM model, caution is required when comparing data across animal and human studies.
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Affiliation(s)
- Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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What drives poor functioning in the at-risk mental state? A systematic review. Schizophr Res 2014; 159:267-77. [PMID: 25261041 DOI: 10.1016/j.schres.2014.09.012] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/18/2014] [Accepted: 09/04/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Transition to psychotic disorder has been the traditional outcome of interest for research in the at-risk mental state (ARMS). However, there is growing recognition that individuals with ARMS may function poorly regardless of whether they develop psychosis. We aimed to review the literature to determine whether there are specific factors associated with, or predictive of, functional impairment in the ARMS population. METHOD An electronic database search of MEDLINE, PsycINFO and Embase from inception until May 2014 was conducted using keyword search terms synonymous with the at-risk mental state and functioning. Eligible studies were original peer-reviewed English language research articles with populations that met validated at-risk diagnostic criteria and examined the cross-sectional or longitudinal association between any variable and a measure of functioning. RESULTS Seventy-two eligible studies were identified. Negative symptoms and neurocognitive impairment were associated with poor functioning in cross-sectional studies. Negative and disorganised symptoms, neurocognitive deficits and poor functioning at baseline were predictive of poor functional outcome in longitudinal studies. Positive symptoms were unrelated to functioning in both cross-sectional and longitudinal studies. Functional disability was persistent and resistant to current treatments. CONCLUSIONS Negative and disorganised symptoms and cognitive deficits pre-date frank psychotic symptoms and are risk factors for poor functioning. This is consistent with a subgroup of ARMS individuals potentially having neurodevelopmental schizophrenia. Treatments aimed at improving functioning must be considered a priority on par with preventing transition to psychosis in the development of future interventions in the ARMS group.
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Schmidt A, Smieskova R, Simon A, Allen P, Fusar-Poli P, McGuire PK, Bendfeldt K, Aston J, Lang UE, Walter M, Radue EW, Riecher-Rössler A, Borgwardt SJ. Abnormal effective connectivity and psychopathological symptoms in the psychosis high-risk state. J Psychiatry Neurosci 2014; 39:239-48. [PMID: 24506946 PMCID: PMC4074235 DOI: 10.1503/jpn.130102] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Recent evidence has revealed abnormal functional connectivity between the frontal and parietal brain regions during working memory processing in patients with schizophrenia and first-episode psychosis. However, it still remains unclear whether abnormal frontoparietal connectivity during working memory processing is already evident in the psychosis high-risk state and whether the connection strengths are related to psychopathological outcomes. METHODS Healthy controls and antipsychotic-naive individuals with an at-risk mental state (ARMS) performed an n-back working memory task while undergoing functional magnetic resonance imaging. Effective connectivity between frontal and parietal brain regions during working memory processing were characterized using dynamic causal modelling. RESULTS Our study included 19 controls and 27 individuals with an ARMS. In individuals with an ARMS, we found significantly lower task performances and reduced activity in the right superior parietal lobule and middle frontal gyrus than in controls. Furthermore, the working memory-induced modulation of the connectivity from the right middle frontal gyrus to the right superior parietal lobule was significantly reduced in individuals with an ARMS, while the extent of this connectivity was negatively related to the Brief Psychiatric Rating Scale total score. LIMITATIONS The modest sample size precludes a meaningful subgroup analysis for participants with a later transition to psychosis. CONCLUSION This study demonstrates that abnormal frontoparietal connectivity during working memory processing is already evident in individuals with an ARMS and is related to psychiatric symptoms. Thus, our results provide further insight into the pathophysiological mechanisms of the psychosis high-risk state by linking functional brain imaging, computational modelling and psychopathology.
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Affiliation(s)
- André Schmidt
- Correspondence to: A. Schmidt, University of Basel, University Hospital of Basel, Department of Psychiatry, Medical Image Analysis Centre, Petersgraben 4, 4031 Basel, Switzerland;
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Mukkala S, Ilonen T, Koskela J, Nordström T, Loukkola J, Miettunen J, Barnett JH, Murray GK, Jones PB, Heinimaa M, Jääskeläinen E, Mäki P, Moilanen I, Veijola J. Response initiation in young adults at risk for psychosis in the Northern Finland 1986 Birth Cohort. Cogn Neuropsychiatry 2014; 19:226-40. [PMID: 24131203 DOI: 10.1080/13546805.2013.840569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION This is one of the very few studies to investigate the specific executive function/processing speed component of response initiation in subjects at familial risk (FR) for psychosis, and the first such study in subjects at clinical risk (CR) for psychosis. METHODS Participants (N = 177) were members of the general population-based Northern Finland 1986 Birth Cohort in the following four groups: FR for psychosis (n = 62), CR for psychosis (n = 21), psychosis (n = 25) and control subjects (n = 69). The response initiation of these groups was compared in three different tests: Semantic fluency, Stockings of Cambridge and Spatial working memory. RESULTS The two risk groups did not differ significantly from control group, but differed from, and outperformed the psychosis group in semantic fluency response initiation. CONCLUSIONS Response initiation deficits were not evident in a non-help seeking psychosis high-risk sample.
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Affiliation(s)
- S Mukkala
- a Department of Psychiatry , Institute of Clinical Medicine, University of Oulu , Oulu , Finland
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Roman-Urrestarazu A, Murray GK, Barnes A, Miettunen J, Jääskeläinen E, Mäki P, Nikkinen J, Remes J, Mukkala S, Koivukangas J, Heinimaa M, Moilanen I, Suckling J, Kiviniemi V, Jones PB, Veijola J. Brain structure in different psychosis risk groups in the Northern Finland 1986 birth cohort. Schizophr Res 2014; 153:143-9. [PMID: 24462264 DOI: 10.1016/j.schres.2013.12.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 12/01/2013] [Accepted: 12/27/2013] [Indexed: 10/25/2022]
Abstract
We tested the hypothesis that family risk for psychosis (FR) and clinical risk for psychosis (CR) are associated with structural brain abnormalities, with increased deficits in those at both family risk and clinical risk for psychosis (FRCR). The study setting was the Oulu Brain and Mind Study, with subjects drawn from the Northern Finland 1986 Birth Cohort (n=9479) using register and questionnaire based screening, and interviews using the Structured Interview for Prodromal Symptoms. After this procedure, 172 subjects were included in the study, classified as controls (n=73) and three risk groups: FR excluding CR (FR, n=60), CR without FR (CR, n=26), and individuals at both FR and CR (FRCR, n=13). T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. In the comparison between FRCR versus controls, we found lower grey matter volume (GMV) in a cluster (1689 voxels at -4.00, -72.00, -18.00mm) covering both cerebellar hemispheres and the vermis. This cluster was subsequently used as a mask to extract mean GMV in all four groups: FR had a volume intermediate between controls and FRCR. Within FRCR there was an association between cerebellar cluster brain volume and motor function. These findings are consistent with an evolving pattern of cerebellar deficits in psychosis risk with the most pronounced deficits in those at highest risk of psychosis.
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Affiliation(s)
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
| | - Anna Barnes
- Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jouko Miettunen
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland; Institute of Health Sciences, Department of Public Health Sciences and General Practice, University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Pirjo Mäki
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Juha Nikkinen
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jukka Remes
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Sari Mukkala
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jenni Koivukangas
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Markus Heinimaa
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Irma Moilanen
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland; Institute of Clinical Medicine, Clinic of Child Psychiatry, University of Oulu, Oulu, Finland
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Vesa Kiviniemi
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Juha Veijola
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
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