1
|
Wieting J, Baumann MV, Deest-Gaubatz S, Bleich S, Eberlein CK, Frieling H, Deest M. Structured neurological soft signs examination reveals motor coordination deficits in adults diagnosed with high-functioning autism. Sci Rep 2024; 14:16123. [PMID: 38997308 PMCID: PMC11245607 DOI: 10.1038/s41598-024-66723-5] [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: 12/02/2022] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Neurological soft signs (NSS), discrete deficits in motor coordination and sensory integration, have shown promise as markers in autism diagnosis. While motor impairments, partly associated with core behavioral features, are frequently found in children with autism, there is limited evidence in adults. In this study, NSS were assessed in adults undergoing initial diagnosis of high-functioning autism (HFA), a subgroup difficult to diagnose due to social adaptation and psychiatric comorbidity. Adults with HFA (n = 34) and 1:1 sex-, age-, and intelligence-matched neurotypical controls were administered a structured NSS examination including motor, sensory, and visuospatial tasks. We showed that adults with HFA have significantly increased motor coordination deficits compared with controls. Using hierarchical cluster analysis within the HFA group, we also identified a subgroup that was particularly highly affected by NSS. This subgroup differed from the less affected by intelligence level, but not severity of autism behavioral features nor global psychological distress. It remains questionable whether motor impairment represents a genuinely autistic trait or is more a consequence of factors such as intelligence. Nevertheless, we conclude that examining NSS in terms of motor coordination may help diagnose adults with HFA and identify HFA individuals who might benefit from motor skills interventions.
Collapse
Affiliation(s)
- Jelte Wieting
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Madita Vanessa Baumann
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stephanie Deest-Gaubatz
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefan Bleich
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christian Karl Eberlein
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Helge Frieling
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Maximilian Deest
- Oberberg Fachklinik Weserbergland, Brede 29, 32699, Extertal-Laßbruch, Germany
| |
Collapse
|
2
|
Gauld C, Baillieul S, Martin VP, Richaud A, Lopez R, Pelou M, Abi-Saab P, Coelho J, Philip P, Pépin JL, Micoulaud-Franchi JA. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med 2024; 20:1105-1117. [PMID: 38420966 PMCID: PMC11217627 DOI: 10.5664/jcsm.11086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 03/02/2024]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity of symptoms. Patient-based OSA screening questionnaires used in routine practice contain significantly varying contents that can impact the reliability and validity of the screening. We investigated to what extent common patient-based OSA screening questionnaires differ or overlap in their item content by conducting a rigorous, methodical, and quantified content overlap analysis. METHODS We conducted an item content analysis of 11 OSA screening questionnaires validated in adult populations and characterized their overlap using a 4-step approach: (1) selection of OSA screening questionnaires, (2) item extraction and selection, (3) extraction of symptoms from items, and (4) assessment of content overlap with the Jaccard index (from 0, no overlap, to 1, full overlap). RESULTS We extracted 72 items that provided 25 distinct symptoms from 11 selected OSA questionnaires. The overlap between them was weak (mean Jaccard index: 0.224; ranging from 0.138 to 0.329). All questionnaires contained symptoms of the "OSA symptom" dimension (eg, snoring or witnessed apneas). The STOP-BANG (0.329) and the Berlin (0.280) questionnaires exhibited the highest overlap content. Ten symptoms (40%) were investigated in only 1 questionnaire. CONCLUSIONS The heterogeneity of content and the low overlap across these questionnaires reflect the challenges of screening OSA. The different OSA questionnaires potentially capture varying aspects of the disorder, with the risk of biased results in studies. Suggestions are made for better OSA screening and refinement of clinical OSA phenotypes. CITATION Gauld C, Baillieul S, Martin VP, et al. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med. 2024;20(7):1105-1117.
Collapse
Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hospices Civils de Lyon and Université de Lyon 1, Lyon, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS and Université Claude Bernard Lyon 1, Lyon, France
| | - Sébastien Baillieul
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Vincent P. Martin
- University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence, France
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | | | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Jean Louis Pépin
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| |
Collapse
|
3
|
Zebrack JE, Gao J, Verhey B, Tian L, Stave C, Farhadian B, Ma M, Silverman M, Xie Y, Tran P, Thienemann M, Wilson JL, Frankovich J. Prevalence of Neurological Soft Signs at Presentation in Pediatric Acute-Onset Neuropsychiatric Syndrome. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.26.24306193. [PMID: 38746142 PMCID: PMC11092680 DOI: 10.1101/2024.04.26.24306193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Importance Studies of brain imaging and movements during REM sleep indicate basal ganglia involvement in pediatric acute-onset neuropsychiatric syndrome (PANS). Characterizing neurological findings commonly present in patients with PANS could improve diagnostic accuracy. Objective To determine the prevalence of neurological soft signs which may reflect basal ganglia dysfunction (NSS-BG) in youth presenting with PANS and whether clinical characteristics of PANS correlate with NSS-BG. Design, Setting, and Participants: 135 new patients who were evaluated at the Stanford Children's Immune Behavioral Health Clinic between November 1, 2014 and March 1, 2020 and met strict PANS criteria were retrospectively reviewed for study inclusion. 16 patients were excluded because they had no neurological exam within the first three visits and within three months of clinical presentation. Main Outcomes and Measures The following NSS-BG were recorded from medical record review: 1) glabellar tap reflex, 2) tongue movements, 3) milkmaid's grip, 4) choreiform movements, 5) spooning, and 6) overflow movements. We included data from prospectively collected symptoms and impairment scales. Results The study included 119 patients: mean age at PANS onset was 8.2 years, mean age at initial presentation was 10.4 years, 55.5% were male, and 73.9% were non-Hispanic White. At least one NSS-BG was observed in 95/119 patients (79.8%). Patients had 2.1 NSS-BG on average. Patients with 4 or more NSS-BG had higher scores of global impairment (p=0.052) and more symptoms (p=0.008) than patients with 0 NSS-BG. There was no significant difference in age at visit or reported caregiver burden. On Poisson and linear regression, the number of NSS-BG was associated with global impairment (2.857, 95% CI: 0.092-5.622, p=0.045) and the number of symptoms (1.049, 95% CI: 1.018-1.082, p=0.002), but not age or duration of PANS at presentation. Conclusions and Relevance We found a high prevalence of NSS-BG in patients with PANS and an association between NSS-BG and disease severity that is not attributable to younger age. PANS may have a unique NSS-BG profile, suggesting that targeted neurological exams may support PANS diagnosis.
Collapse
Affiliation(s)
- Jane E. Zebrack
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Jaynelle Gao
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Britta Verhey
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Christopher Stave
- Lane Medical Library, Stanford University School of Medicine, Stanford, CA, USA
| | - Bahare Farhadian
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Meiqian Ma
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Melissa Silverman
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Yuhuan Xie
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Paula Tran
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Margo Thienemann
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jenny L. Wilson
- Division of Pediatric Neurology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Jennifer Frankovich
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford PANS/Immune Behavioral Health Clinic and PANS Research Program at Lucile Packard Children's Hospital, Stanford, CA, USA
| |
Collapse
|
4
|
Petrescu C, Mihalache OA, Vilciu C, Petrescu DM, Marian G, Ciobanu CA, Ciobanu AM. Clinical and Sociodemographic Correlations with Neurological Soft Signs in Hospitalized Patients with Schizophrenia: A Preliminary Longitudinal Study. Biomedicines 2024; 12:787. [PMID: 38672143 PMCID: PMC11048323 DOI: 10.3390/biomedicines12040787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Schizophrenia is a severe, chronic neuropsychiatric disorder characterized by symptoms that profoundly impact behavior, cognition, perception, and emotions, leading to a reduced quality of life and physical impairment. Given the complexity of schizophrenia, there is a pressing need for clinical markers and tools to predict its course, enhance disease staging, facilitate early intervention, improve differential diagnosis, and tailor individualized treatment approaches. Previous studies focused on the relationship between neurological soft signs (NSS) and factors such as age, illness duration, and symptomatology, indicating NSS as state markers improving in parallel with psychotic symptom remission or predicting treatment resistance. However, there is a lack of consensus on NSS assessment tools, hindering routine clinical monitoring despite diagnostic and prognostic potential. The present longitudinal study involved 81 psychiatric inpatients diagnosed with schizophrenia. Patients were assessed at three time points: baseline, 1 month, and 6 months. The examination included the use of scales to evaluate psychotic and neurological symptoms, as well as the identification of adverse extrapyramidal reactions caused by neuroleptic treatment. The progression of NSS was correlated to both the symptomatology and the sociodemographic data of the patients. The main findings from the present investigation revealed a statistical correlation between NSS and psychopathological symptoms, especially with negative symptoms of schizophrenia. However, it is important to note that neuroleptic side effects only had a limited impact on NSS. Therefore, instead of being linked to extrapyramidal symptoms caused by neuroleptics, NSS appears to be more frequently related with symptoms of schizophrenia. Our findings provide further support for their strong association with the course of schizophrenia, independent of treatment side effects, thus emphasizing their potential as reliable assessment tools in both research and clinical settings.
Collapse
Affiliation(s)
- Cristian Petrescu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Oana A. Mihalache
- Department of Doctoral Studies, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (D.M.P.)
| | - Crisanda Vilciu
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (D.M.P.)
- Neurology Clinic, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania
| | - Diana M. Petrescu
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (D.M.P.)
- Neurology Clinic, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania
| | - Gabriela Marian
- Academy of Romanian Scientists, 927180 Bucharest, Romania;
- Department of Psychiatry and Psychology, ‘Titu Maiorescu’ University of Medicine, 040051 Bucharest, Romania
| | - Constantin A. Ciobanu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020022 Bucharest, Romania
| | - Adela M. Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| |
Collapse
|
5
|
Chrobak AA, Rusinek J, Dec-Ćwiek M, Porębska K, Siwek M. Content overlap of 91 dystonia symptoms among the seven most commonly used cervical dystonia scales. Neurol Sci 2024; 45:1507-1514. [PMID: 37910323 PMCID: PMC10943139 DOI: 10.1007/s10072-023-07157-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/19/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions. Cervical dystonia (CD) is the most common focal dystonia. There are several instruments assessing the symptoms of CD. However, different scales assess different features which may lead to poor patient evaluation. AIM The aim of the study was to evaluate the degree of overlap of most often used CD rating scales identified by the literature review. METHODS A thorough search of the Medline database was conducted in September 2021. Then the frequency of each scale was calculated, and 7 most common scales were included in the content overlap analysis using Jaccard index (0 - no overlap, 1 - full overlap). RESULTS Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), Tsui score, Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Cervical Dystonia Impact Profile 58 (CDIP-58), Craniocervical Dystonia Questionnaire 24 (CDQ-24), Cervical Dystonia Severity Rating Scale (CDSS), Cervical Dystonia Severity Rating Scale (DDS) and The Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest) were the most common scales. 91 CD symptoms were distinguished from 134 items used in the scales. The mean overlap among all scales was 0.17. 52 (62%) symptoms were examined by more than one scale. The CIDP-58 captured the highest number of symptoms (63.0%), while the CDSS captured the lowest number (8.0%). None of the symptoms were examined by seven instruments. CONCLUSIONS There was a very weak overlap among scales. High inconsistency between the scales may lead to highly different dystonia severity assessment in clinical practice. Thus, the instruments should be combined.
Collapse
Affiliation(s)
- Adrian Andrzej Chrobak
- Department of Adult Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub Rusinek
- Students' Scientific Group of Neurology at the Department of Neurology, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Dec-Ćwiek
- Department of Neurology, Jagiellonian University Medical College, Kraków, Poland
| | - Karolina Porębska
- Department of Neurology, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Chair of Psychiatry, Jagiellonian University Medical College, Kopernika 21a St., 31-501, Kraków, Poland.
| |
Collapse
|
6
|
Christensen Pacella KA, Wossen L, Hagan KE. Low Overlap and High Heterogeneity Across Common Measures of Eating Disorder Pathology: A Content Analysis. Assessment 2024:10731911241238084. [PMID: 38519835 DOI: 10.1177/10731911241238084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
This study evaluated symptoms assessed in common measures of eating disorder pathology and tested overlap to evaluate the extent to which measures may be interchangeable. Six measures were included: Bulimia Test-Revised, Eating Attitudes Test-26, Eating Disorder Diagnostic Scale, Eating Disorder Examination Questionnaire, Eating Pathology Symptoms Inventory, and Questionnaire for Eating Disorder Diagnoses. Content overlap was quantitatively estimated using the Jaccard Index. Mean overlap was low (.195), likely due to the wide range of symptoms (87) assessed. The mean overlap of each measure with all others was .117 - .267, and the overlap among individual measures was .083 - .382. Implications of low overlap among measures include variable characterization of eating disorder phenotypes and the risk for lower generalizability of findings due to measurement variability.
Collapse
|
7
|
Coelho J, Sanchez-Ortuño MM, Martin VP, Gauld C, Richaud A, Lopez R, Pelou M, Abi-Saab P, Philip P, Geoffroy PA, Palagini L, Micoulaud-Franchi JA. Content analysis of insomnia questionnaires: A step to better evaluate the complex and multifaceted construct of insomnia disorder. Psychiatry Res 2023; 330:115584. [PMID: 37944205 DOI: 10.1016/j.psychres.2023.115584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Insomnia disorder is a mental disorder that includes various types of symptoms (e.g., insomnia initiating, worries, mood disturbances) and impairments (e.g., distress related to sleep alterations). Self-report questionnaires are the most common method for assessing insomnia but no systematic quantified analysis of their content and overlap has been carried out. We used content analysis and a visualization method to better identify the different types of clinical manifestations that are investigated by nine commonly used insomnia questionnaires for adults and the Jaccard index to quantify the degree to which they overlap. Content analysis found and visualized 16 different clinical manifestations classified into five dimensions ("Insomnia symptoms", "Insomnia-related symptoms", "Daytime symptoms", "Insomnia-related impairments", "Sleep behaviors"). The average Jaccard Index was 0.409 (moderate overlap in content). There is a lack of distinction between symptoms and impairments, and the assessment of sleep duration and hyperarousal symptoms remains overlooked. This preliminary analysis makes it possible to visualize the content of each of the nine questionnaires and to select the most appropriate questionnaire based on the issue to be addressed. Suggestions are made regarding the development of future questionnaires to better distinguish symptoms and impairments, and the different phenotypes of insomnia disorder.
Collapse
Affiliation(s)
- Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France.
| | - Maria Montserrat Sanchez-Ortuño
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; Department of Nursing, School of Nursing, University of Murcia, Murcia, Spain
| | - Vincent P Martin
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence F-33400, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier 34000, France; Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier 34000, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, Paris 75018, France; GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, Université de Paris, NeuroDiderot, Inserm, Paris 75019, France
| | - Laura Palagini
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa 56126, Italy; Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara 44121, Italy
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| |
Collapse
|
8
|
Chrobak AA, Siuda-Krzywicka K, Soltys Z, Bielak S, Nowaczek D, Żyrkowska A, Fafrowicz M, Marek T, Pęcherzewska E, Kużdżał J, Starowicz-Filip A, Gorostowicz A, Dudek D, Siwek M. When practice does not make a perfect - paradoxical learning curve in schizophrenia and bipolar disorder revealed by different serial reaction time task variants. Front Psychiatry 2023; 14:1238473. [PMID: 37766926 PMCID: PMC10521726 DOI: 10.3389/fpsyt.2023.1238473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Our previous studies identified a paradoxical implicit motor learning curve in schizophrenia (SZ) and bipolar disorder (BD) patients. This study aimed to verify whether those previously observed deficits may be captured by a new version of the ambidextrous serial reaction time task (SRTT), prepared for use in the MRI. Methods This study involved 186 participants. A total of 97 participants (33 BD, 33 SZ, and 31 healthy controls, HCs) completed the original, unlimited time response variant of SRTT. A total of 90 individuals (30 BD, 30 SZ, and 30 HCs) underwent a newer, limited response time version of this procedure. Results There was no significant difference in terms of implicit motor learning indices between both limited and unlimited response time SRTT. Compared to HCs, SZ, and BD patients presented decreased indices of implicit motor learning. Both clinical groups showed a paradoxical learning pattern that differed significantly from the HCs. Moreover, in the SZ group, the pattern depended on the hand performing SRTT. Discussion The limited response time SRTT variant allowed us to replicate the findings of disrupted implicit motor learning in SZ and BD. The use of this paradigm in further neuroimaging studies may help to determine the neuronal underpinnings of this cognitive dysfunction in the abovementioned clinical groups.
Collapse
Affiliation(s)
| | | | - Zbigniew Soltys
- Laboratory of Experimental Neuropathology, Institute of Zoology and Biomedical Research, Jagiellonian University, Kraków, Poland
| | - Sylwia Bielak
- Department of Adult, Child and Adolescent Psychiatry, University Hospital in Cracow, Kraków, Poland
| | | | - Aleksandra Żyrkowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
- Doctoral School in the Social Sciences, Jagiellonian University, Kraków, Poland
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Tadeusz Marek
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | | | - Jan Kużdżał
- Malopolska Centre of Biotechnology, Kraków, Poland
| | - Anna Starowicz-Filip
- Medical Psychology Department, Jagiellonian University Medical College, Kraków, Poland
| | | | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Kraków, Poland
| |
Collapse
|
9
|
Gray LE, Buchanan RW, Keshavan MS, Torous J. Potential Role of Smartphone Technology in Advancing Work on Neurological Soft Signs with a Focus on Schizophrenia. Harv Rev Psychiatry 2023; 31:226-233. [PMID: 37699066 DOI: 10.1097/hrp.0000000000000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
LEARNING OBJECTIVE AFTER PARTICIPATING IN THIS CME ACTIVITY, THE PSYCHIATRIST SHOULD BE BETTER ABLE TO • Outline and Identify potential benefits of using neurological soft signs (NSS) as biomarkers of schizophrenia. ABSTRACT Since the late 1960s, NSS have been a focus of study across psychiatric illnesses, including depression, bipolar disorder, and schizophrenia in particular. Utilizing these subtle neurological impairments as biomarkers of illness has numerous benefits; NSS offer a direct connection between clinical presentation and neurological functioning, and assessments are cost-effective. However, incongruent measurement scales, confounding variables, and rating system subjectivity have hindered the advancement and scalability of NSS research and clinical implementation. This article provides a brief overview of the literature on NSS as related to schizophrenia, and proposes utilizing smartphone sensing technology to create standardized NSS assessments with objective scoring. Incorporating digital phenotyping into NSS assessment offers the potential to make measurement more scalable, accessible, and directly comparable across locations, cultures, and demographics. We conducted a narrative search in PubMed and APA PsycInfo using the following keywords: neurological soft signs, schizophrenia spectrum disorders, and psychotic illnesses. No date limitations were used. There is no other direct work on NSS and new smartphone methods like digital phenotyping; though, there is related work in neurology. Harnessing advances in smartphone technology could provide greater insight into and further our understanding of specific aspects of the NSS field. For instance, it could help us distinguish trait vs. state markers and better understand how distinct groups of signs may reflect different aspects of psychiatric illness and neurological impairment. In addition, such technology can help advance research on the capabilities of NSS as an effective diagnostic tool.
Collapse
Affiliation(s)
- Lucy E Gray
- From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Ms. Gray, and Drs. Keshavan and Torous); Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD (Dr. Buchanan); Massachusetts Mental Health Center, Boston, MA (Drs. Keshavan and Torous)
| | | | | | | |
Collapse
|
10
|
Petrescu C, Petrescu DM, Marian G, Focseneanu BE, Iliuta FP, Ciobanu CA, Papacocea S, Ciobanu AM. Neurological Soft Signs in Schizophrenia, a Picture of the Knowledge in the Last Decade: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11101471. [PMID: 37239757 DOI: 10.3390/healthcare11101471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Neurological Soft Signs (NSS) are subtle neurological abnormalities that are more common in schizophrenia patients than in healthy individuals and have been regularly observed in neuroleptic-naive first-episode patients, supporting the hypothesis that they are an intrinsic component of schizophrenia. (2) Methods: a review of articles published in the last ten years (from January 2013 to January 2023) was carried out on articles published in ScienceDirect and PubMed, by following the PRISMA Statement extension for scoping reviews (PRISMA-ScR), which evaluated the impact of NSS in correlation with the symptomatology, neuroleptic treatment, and the cerebral structural changes of patients with schizophrenia. (3) Results: thirty articles were included, among them twelve included MRI structural evaluation and four studies with a longitudinal design. (4) Conclusions: interest in researching NSS has increased in recent years, but questions remain about their origin and relationship to schizophrenia symptoms, thus this study aims to fill in information gaps in the hope that future research will help provide individualized treatment. It is suggested that NSS in schizophrenia might have an inherited genetic relationship pattern, thus being in line with a trait viewpoint. Most of the research revealed that schizophrenia patients had higher NSS scores than healthy controls, however, they were rather similar to their first-degree relatives, thus, also arguing in favor of a trait perspective. The greatest improvement in scores is seen in those with a remitting course, as shown by declining NSS ratings concurrent with symptomatology.
Collapse
Affiliation(s)
- Cristian Petrescu
- Department of Psychiatry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Diana M Petrescu
- Neurology Clinic Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Gabriela Marian
- Academy of Romanian Scientists, 050045 Bucharest, Romania
- Department of Psychiatry and Psychology, Titu Maiorescu University of Medicine, 040441 Bucharest, Romania
| | - Brindusa E Focseneanu
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Department of Psychiatry and Psychology, Titu Maiorescu University of Medicine, 040441 Bucharest, Romania
| | - Floris Petru Iliuta
- Department of Psychiatry and Psychology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | | | - Serban Papacocea
- Department of Neurosurgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adela M Ciobanu
- Department of Psychiatry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| |
Collapse
|
11
|
Chrobak AA, Soltys Z, Dudek D, Siwek M. Neurological and cerebellar soft signs in bipolar disorder: The role of staging, type and history of psychotic symptoms. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110673. [PMID: 36349610 DOI: 10.1016/j.pnpbp.2022.110673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
AIM Bipolar disorder (BD) patients show neurological abnormalities in form of neurological and cerebellar soft signs (NSS and CSS). NSS represents heterogeneous group of symptoms representing i.a. deficits of motor coordination, sequencing of complex motor acts and sensory integration. CSS were introduced as group of the neurological deficits of posture, gait, kinetic functions, eye movements and speech, associated more specifically to cerebellar abnormalities than NSS. Studies show significant effect size variability of those symptoms in BD group suggesting the existence of differing subpopulations. The aim of our study was to evaluate the effect of BD type, stage and the history of psychotic symptoms (HoPS) on the severity of CSS and NSS as none of the previous studies had verified the role of those categories. METHODS This study involved 181 participants: 116 euthymic BD patients (66 BD I, 50 BD II) and 65 healthy controls (HC). CSS was assessed with the International Cooperative Ataxia Rating Scale and NSS with Neurological Evaluation Scale. Patients were divided into early and late stage of the disorder according to Kapczinski's criteria. Rater was blind to patients' stage, type and HoPS. RESULTS Staging was related to vast majority of CSS and NSS scores. HoPS was related to oculomotor deficits. The effect of BD type was the least significant. Late stage BD showed more severe CSS and NSS than HC in every measure. There were no differences between early stage BD and HC, apart of posture and gait disturbances. Except of sensory integration scores, late stage BD showed higher CSS and NSS rates than early stage patients. CONCLUSION In this hitherto the largest study of neurological abnormalities in BD we have shown significant role of staging in CSS and NSS severity. Progression criteria based on inter-episode psychosocial functioning may stand as unrecognised factor responsible for variability observed in previous studies evaluating neurological abnormalities in BD. Our study suggests that in clinical practice NSS and CSS may be potentially used as easy-to-assess biological marker of BD staging. Observed severity of neurological impairments of BD patients may more likely correspond to the disease progression than to BD type and HoPS.
Collapse
Affiliation(s)
- Adrian Andrzej Chrobak
- Jagiellonian University Medical College, Department of Adult Psychiatry, Kopernika St. 21a, 31-501 Cracow, Poland
| | - Zbigniew Soltys
- Jagiellonian University, Institute of Zoology and Biomedical Research, Laboratory of Experimental Neuropathology, Gronostajowa 9, 30-387 Cracow, Poland
| | - Dominika Dudek
- Jagiellonian University Medical College, Department of Adult Psychiatry, Kopernika St. 21a, 31-501 Cracow, Poland
| | - Marcin Siwek
- Jagiellonian University Medical College, Department of Affective Disorders, Kopernika St. 21a, 31-501 Cracow, Poland.
| |
Collapse
|
12
|
Neurological soft signs are associated with reduced medial-lateral postural control in adolescent athletes. J Neurol Sci 2023; 445:120516. [PMID: 36702068 DOI: 10.1016/j.jns.2022.120516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/10/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Neurological soft signs (NSS) are minor deviations from the norm in motor performance that are commonly assessed using neurological examinations. NSS may be of clinical relevance for evaluating the developmental status of adolescents. Here we investigate whether quantitative force plate measures may add relevant information to observer-based neurological examinations. METHODS Male adolescent athletes (n = 141) aged 13-16 years from three European sites underwent a neurological examination including 28 tests grouped into six functional clusters. The performance of tests and functional clusters was rated as optimal/non-optimal resulting in NSS+/NSS- groups and a continuous total NSS score. Participants performed a postural control task on a Balance Tracking System measured as path length, root mean square and sway area. ANCOVAs were applied to test for group differences in postural control between the NSS+ and NSS- group, and between optimal/non-optimal performance on a cluster- and test-level. Moreover, we tested for correlations between the total NSS score and postural control variables. RESULTS There was no significant overall difference between the NSS+ and NSS- group in postural control. However, non-optimal performing participants in the diadochokinesis test swayed significantly more in the medial-lateral direction than optimal performing participants. Moreover, a lower total NSS score was associated with reduced postural control in the medial-lateral direction. CONCLUSION Our findings demonstrate that NSS are related to postural control in adolescent athletes. Thus, force plate measures may add a quantitative, objective measurement of postural control to observer-based qualitative assessments, and thus, may complement clinical testing.
Collapse
|
13
|
Gauld C, Martin VP, Richaud A, Baillieul S, Vicente L, Perromat JL, Zreik I, Taillard J, Geoffroy PA, Lopez R, Micoulaud-Franchi JA. Systematic Item Content and Overlap Analysis of Self-Reported Multiple Sleep Disorder Screening Questionnaires in Adults. J Clin Med 2023; 12:jcm12030852. [PMID: 36769500 PMCID: PMC9918039 DOI: 10.3390/jcm12030852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Sleep disorders are defined on the basis of diagnostic criteria presented in medical classifications. However, no consensus has emerged on the exact list of operational symptoms that should be systematically investigated in the field of sleep medicine. We propose a systematic analysis of sleep symptoms that figure in a set of self-reported multiple sleep disorder screening questionnaires for adult populations, to identify the content overlap of symptoms that probe the presence of central sleep symptoms, and to highlight the potential level of heterogeneity among sleep disorder questionnaires. The method comprises three steps: (i) the selection of self-reported multiple sleep disorder screening questionnaires; (ii) item extraction and selection; (iii) the extraction of symptoms from items. Frequency of sleep symptoms and content overlap (Jaccard Index) are analyzed. We extracted 469 items that provide 60 different symptoms from 12 questionnaires. Insomnia, somnolence, and sleep-related breathing symptoms were found in all the questionnaires. The mean overlap among all questionnaires evaluated with the Jaccard Index is 0.44, i.e., moderate similarity. Despite limitations related to the selection of questionnaires and the symptom extraction and harmonization, this study underlines the need to standardize sleep symptom contents for sleep medicine in order to enhance the practicability, reliability, and validity of sleep disorder diagnoses.
Collapse
Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hospices Civils de Lyon & Université de Lyon 1, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, 69500 Bron, France
| | - Vincent P. Martin
- CNRS, Bordeaux INP, LaBRI, UMR 5800, University of Bordeaux, 33400 Talence, France
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France
| | - Sébastien Baillieul
- HP2 Laboratory, INSERM U1042, Grenoble Alpes University, 38400 Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, 38700 Grenoble, France
| | - Lucie Vicente
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | | | - Issa Zreik
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Jacques Taillard
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, 75018 Paris, France
- GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, 75014 Paris, France
- NeuroDiderot, Inserm, Université de Paris, FHU I2-D2, 75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), Université de Montpellier, 34000 Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, 34000 Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France
- Correspondence: ; Tel.: +33-622-364-019
| |
Collapse
|
14
|
Bonke EM, Bonfert MV, Hillmann SM, Seitz-Holland J, Gaubert M, Wiegand TLT, De Luca A, Cho KIK, Sandmo SB, Yhang E, Tripodis Y, Seer C, Kaufmann D, Kaufmann E, Muehlmann M, Gooijers J, Lin AP, Leemans A, Swinnen SP, Bahr R, Shenton ME, Pasternak O, Tacke U, Heinen F, Koerte IK. Neurological soft signs in adolescents are associated with brain structure. Cereb Cortex 2022; 33:5547-5556. [PMID: 36424865 DOI: 10.1093/cercor/bhac441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Neurological soft signs (NSS) are minor deviations in motor performance. During childhood and adolescence, NSS are examined for functional motor phenotyping to describe development, to screen for comorbidities, and to identify developmental vulnerabilities. Here, we investigate underlying brain structure alterations in association with NSS in physically trained adolescents. Male adolescent athletes (n = 136, 13–16 years) underwent a standardized neurological examination including 28 tests grouped into 6 functional clusters. Non-optimal performance in at least 1 cluster was rated as NSS (NSS+ group). Participants underwent T1- and diffusion-weighted magnetic resonance imaging. Cortical volume, thickness, and local gyrification were calculated using Freesurfer. Measures of white matter microstructure (Free-water (FW), FW-corrected fractional anisotropy (FAt), axial and radial diffusivity (ADt, RDt)) were calculated using tract-based spatial statistics. General linear models with age and handedness as covariates were applied to assess differences between NSS+ and NSS− group. We found higher gyrification in a large cluster spanning the left superior frontal and parietal areas, and widespread lower FAt and higher RDt compared with the NSS− group. This study shows that NSS in adolescents are associated with brain structure alterations. Underlying mechanisms may include alterations in synaptic pruning and axon myelination, which are hallmark processes of brain maturation.
Collapse
Affiliation(s)
- Elena M Bonke
- University Hospital, Ludwig-Maximilians-Universität cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Munich, Germany
- Graduate School of Systemic Neurosciences , Ludwig-Maximilians-Universität, Munich , Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilians-Universität , Munich, Germany
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA , United States
| | - Michaela V Bonfert
- University Hospital Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics at Dr. von Hauner Children's Hospital, , , Munich, Germany
- Ludwig-Maximilians-Universität Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics at Dr. von Hauner Children's Hospital, , , Munich, Germany
| | - Stefan M Hillmann
- University Hospital Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics at Dr. von Hauner Children's Hospital, , , Munich, Germany
- Ludwig-Maximilians-Universität Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics at Dr. von Hauner Children's Hospital, , , Munich, Germany
| | - Johanna Seitz-Holland
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA , United States
| | - Malo Gaubert
- University Hospital, Ludwig-Maximilians-Universität cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Munich, Germany
- CHU Rennes Radiology Department, , Rennes, France
- University of Rennes Inria, CNRS, Inserm, IRISA UMR 6074, Empenn ERL, , Rennes, France
| | - Tim L T Wiegand
- University Hospital, Ludwig-Maximilians-Universität cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilians-Universität , Munich, Germany
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA , United States
| | - Alberto De Luca
- University Medical Center Utrecht Image Sciences Institute, , Utrecht, the Netherlands
- University Medical Center Utrecht Department of Neurology, , Utrecht, the Netherlands
| | - Kang Ik K Cho
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA, United States
| | - Stian B Sandmo
- Norwegian School of Sport Sciences Oslo Sports Trauma Research Center, Department of Sports Medicine, , Oslo, Norway
- Oslo University Hospital Division of Mental Health and Addiction, , Oslo, Norway
| | - Eukyung Yhang
- Boston University School of Public Health Department of Biostatistics, , Boston, MA , United States
| | - Yorghos Tripodis
- Boston University School of Public Health Department of Biostatistics, , Boston, MA , United States
- Boston University School of Medicine Alzheimer’s Disease and CTE Centers, , Boston, MA , United States
| | - Caroline Seer
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven , Leuven, Belgium
| | - David Kaufmann
- University Hospital, Ludwig-Maximilians-Universität cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Munich, Germany
- University Hospital Augsburg Department of Diagnostic and Interventional Radiology and Neuroradiology, , Augsburg, Germany
| | - Elisabeth Kaufmann
- University Hospital, Ludwig-Maximilians-Universität cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Munich, Germany
- Ludwig-Maximilians-Universität Department of Neurology, , Munich, Germany
| | - Marc Muehlmann
- University Hospital Department of Clinical Radiology, , Ludwig-Maximilians-Universität, Munich, Germany
| | - Jolien Gooijers
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven , Leuven, Belgium
| | - Alexander P Lin
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA, United States
- Harvard Medical School Department of Radiology, Brigham and Women's Hospital, , Boston, MA, United States
- Harvard Medical School Center for Clinical Spectroscopy, Brigham and Women’s Hospital, , Boston, MA, United States
| | - Alexander Leemans
- University Medical Center Utrecht Image Sciences Institute, , Utrecht, the Netherlands
| | - Stephan P Swinnen
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven , Leuven, Belgium
| | - Roald Bahr
- Norwegian School of Sport Sciences Oslo Sports Trauma Research Center, Department of Sports Medicine, , Oslo, Norway
| | - Martha E Shenton
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA, United States
- Harvard Medical School Department of Radiology, Brigham and Women's Hospital, , Boston, MA, United States
| | - Ofer Pasternak
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA, United States
- Harvard Medical School Department of Radiology, Brigham and Women's Hospital, , Boston, MA, United States
| | - Uta Tacke
- University Children's Hospital (UKBB) , Basel, Switzerland
| | - Florian Heinen
- University Hospital Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics at Dr. von Hauner Children's Hospital, , , Munich, Germany
- Ludwig-Maximilians-Universität Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics at Dr. von Hauner Children's Hospital, , , Munich, Germany
| | - Inga K Koerte
- University Hospital, Ludwig-Maximilians-Universität cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Munich, Germany
- Graduate School of Systemic Neurosciences , Ludwig-Maximilians-Universität, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilians-Universität , Munich , Germany
- Harvard Medical School Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, , Boston, MA , United States
- Harvard Medical School Department of Psychiatry, Massachusetts General Hospital, , Boston, MA , United States
| |
Collapse
|