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Merola GP, Tarchi L, Saccaro LF, Delavari F, Piguet C, Van De Ville D, Castellini G, Ricca V. Transdiagnostic markers across the psychosis continuum: a systematic review and meta-analysis of resting state fMRI studies. Front Psychiatry 2024; 15:1378439. [PMID: 38895037 PMCID: PMC11184053 DOI: 10.3389/fpsyt.2024.1378439] [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: 01/29/2024] [Accepted: 04/26/2024] [Indexed: 06/21/2024] Open
Abstract
Psychotic symptoms are among the most debilitating and challenging presentations of severe psychiatric diseases, such as schizophrenia, schizoaffective, and bipolar disorder. A pathophysiological understanding of intrinsic brain activity underlying psychosis is crucial to improve diagnosis and treatment. While a potential continuum along the psychotic spectrum has been recently described in neuroimaging studies, especially for what concerns absolute and relative amplitude of low-frequency fluctuations (ALFF and fALFF), these efforts have given heterogeneous results. A transdiagnostic meta-analysis of ALFF/fALFF in patients with psychosis compared to healthy controls is currently lacking. Therefore, in this pre-registered systematic review and meta-analysis PubMed, Scopus, and Embase were searched for articles comparing ALFF/fALFF between psychotic patients and healthy controls. A quantitative synthesis of differences in (f)ALFF between patients along the psychotic spectrum and healthy controls was performed with Seed-based d Mapping, adjusting for age, sex, duration of illness, clinical severity. All results were corrected for multiple comparisons by Family-Wise Error rates. While lower ALFF and fALFF were detected in patients with psychosis in comparison to controls, no specific finding survived correction for multiple comparisons. Lack of this correction might explain the discordant findings highlighted in previous literature. Other potential explanations include methodological issues, such as the lack of standardization in pre-processing or analytical procedures among studies. Future research on ALFF/fALFF differences for patients with psychosis should prioritize the replicability of individual studies. Systematic review registration https://osf.io/, identifier (ycqpz).
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Affiliation(s)
| | - Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Luigi F. Saccaro
- Psychiatry Department, Geneva University Hospital and Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Farnaz Delavari
- Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Camille Piguet
- Psychiatry Department, Geneva University Hospital and Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
- General Pediatric Division, Geneva University Hospital, Geneva, Switzerland
| | - Dimitri Van De Ville
- Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Xiao Q, Shen L, He H, Wang X, Fu Y, Ding J, Jiang F, Zhang J, Zhang Z, Grecucci A, Yi X, Chen BT. Alteration of prefrontal cortex and its associations with emotional and cognitive dysfunctions in adolescent borderline personality disorder. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02438-2. [PMID: 38642117 DOI: 10.1007/s00787-024-02438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024]
Abstract
The neurobiological mechanism of borderline personality disorder (BPD) in adolescents remains unclear. The study aimed to assess the alterations in neural activity within prefrontal cortex in adolescents with BPD and investigate the relationship of prefrontal activity with emotional regulation and cognitive function. This study enrolled 50 adolescents aged 12-17 years with BPD and 21 gender and age-matched healthy control (HC) participants. Study assessment for each participant included a brain resting-state functional MRI (rs-fMRI), clinical assessment questionnaires such as Borderline Personality Features Scale (BPFS), Difficulties in Emotion Regulation Scale (DERS), Ottawa Self-Injury Inventory and Childhood Trauma Questionnaire (CTQ) and cognitive testing with Stroop Color-Word Test (SCWT). Fractional amplitude of low-frequency fluctuations (fALFF) and seed-based functional connectivity (FC) were obtained from rs-fMRI analysis. Correlation analysis was also performed to evaluate the associations of the neuroimaging metrics such as fALFF and FC with clinical assessment questionnaire and cognitive testing scores. Adolescents with BPD showed increased fALFF values in the right inferior frontal gyrus and decreased activity in the left middle frontal gyrus as compared to the HC group (p < 0.05, cluster size ≥ 100, FWE correction). In adolescents with BPD, increased fALFF in the right inferior frontal gyrus was related to the BPFS (emotional dysregulation), DERS-F (lacking of emotional regulation strategies) and Ottawa Self-Injury Inventory-4 C scores (internal emotional regulation function of self-injurious behavior). The reduced fALFF in the left middle frontal gyrus was associated with the SCWT-A (reading characters) and the SCWT-B (reading color) scores. Additionally, the fALFF values in the left middle frontal gyrus and the right inferior frontal gyrus were related to the CTQ-D (emotional neglect) (p < 0.05). The left middle frontal gyrus exhibited increased FC with the right hippocampus, left inferior temporal gyrus and right inferior frontal gyrus (voxel p < 0.001, cluster p < 0.05, FWE correction). The increased FC between the left middle frontal gyrus and the right hippocampus was related to the SCWT-C (cognitive flexibility) score. We observed diverging changes in intrinsic brain activity in prefrontal cortex, and neural compensatory changes to maintain function in adolescents with BPD. In addition, decreased neural function was closely associated with emotional dysregulation, while increased neural function as indicated by brain activity and FC was associated with cognitive dysfunction. These results indicated that alterations of intrinsic brain activity may be one of the underlying neurobiological markers for clinical symptoms in adolescents with BPD.
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Affiliation(s)
- Qian Xiao
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, 410008, Hunan, P.R. China
- National Clinical Research Center for Geriatric Disorder (Xiangya Hospital), Central South University, Changsha, 410008, Hunan, P.R. China
| | - Liying Shen
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, 410008, Hunan, P.R. China
| | - Haoling He
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, P.R. China
- Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, P.R. China
| | - Xueying Wang
- Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, P.R. China
| | - Yan Fu
- Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, P.R. China
| | - Jun Ding
- Department of Public Health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, P.R. China
| | - Furong Jiang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, 410008, Hunan, P.R. China
| | - Jinfan Zhang
- Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, P.R. China
| | - Zhejia Zhang
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, P.R. China
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Rovereto (TN), 38068, Italy
| | - Xiaoping Yi
- Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, P.R. China.
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, 91010, USA
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Tomé-Fernández M, Berbegal-Bernabeu M, Sánchez-Sansegundo M, Zaragoza-Martí A, Rubio-Aparicio M, Portilla-Tamarit I, Rumbo-Rodríguez L, Hurtado-Sánchez JA. Neurocognitive Suicide and Homicide Markers in Patients with Schizophrenia Spectrum Disorders: A Systematic Review. Behav Sci (Basel) 2023; 13:446. [PMID: 37366698 DOI: 10.3390/bs13060446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/28/2023] Open
Abstract
Suicide and homicide are considered important problems in public health. This study aims to identify the cognitive performance of suicidal and homicidal behaviors in people with schizophrenia spectrum disorders, as well as examining whether there are shared neuropsychological mechanisms. A systematic review of the recent literature was carried out from September 2012 to June 2022 using the Medline (via PubMed), Scopus, Embase, and Cochrane databases. Among the 870 studies initially identified, 23 were finally selected (15 related to suicidal behaviors and 8 to homicidal behaviors). The results evidenced a relationship between impairment of cognitive performance and homicidal behavior; meanwhile, for suicidal behaviors, no consistent results were found. High neuropsychological performance seems to act as a protective factor against violent behavior in people with schizophrenia spectrum disorders, but not against suicidal behavior; indeed, it can even act as a risk factor for suicidal behavior. To date, there is insufficient evidence that shared neurocognitive mechanisms exist. However, processing speed and visual memory seem to be affected in the presence of both behaviors.
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Affiliation(s)
- Mario Tomé-Fernández
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Marina Berbegal-Bernabeu
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Miriam Sánchez-Sansegundo
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Ana Zaragoza-Martí
- Department of Nursing, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - María Rubio-Aparicio
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Irene Portilla-Tamarit
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Lorena Rumbo-Rodríguez
- Department of Nursing, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
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Fortier A, Dumais A, Athanassiou M, Tikàsz A, Potvin S. Dysconnectivity between the anterior insula and the dorsal anterior cingulate cortex during an emotion go/nogo paradigm is associated with aggressive behaviors in male schizophrenia patients. Psychiatry Res Neuroimaging 2023; 328:111579. [PMID: 36469978 DOI: 10.1016/j.pscychresns.2022.111579] [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: 05/05/2022] [Revised: 10/12/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
This study aimed to investigate the association between past-reported violent/aggressive behaviors and brain functional connectivity in male patients suffering from schizophrenia using a task modeling the interaction between negative emotion processing and response inhibition. Forty-four male patients with schizophrenia and twenty-two healthy male controls performed an emotional go/no-go task using angry and neutral faces during a functional magnetic resonance imaging session. Generalized psycho-physiological interaction was conducted to explore task-based functional connectivity and a negative binomial regression was used to evaluate the relationship between neural alterations and violent/aggressive behaviors. Regions involved in response inhibition and emotion regulation, such as the anterior insula, dorsal anterior cingulate cortex (dACC) and dorsolateral prefrontal cortex (DLPFC), were used as seed regions. During emotion-related response inhibition, patients with schizophrenia displayed altered connectivity between the anterior insula and amygdala, the DLPFC and lateral orbitofrontal cortex (OFC), as well as the anterior insula and the dACC when compared to healthy individuals. The latter was negatively associated with aggressive behaviors in participants with schizophrenia (Wald χ2 = 9.51; p < 0.05, p-FDR corrected). Our results highlight alterations in functional connectivity in brain regions involved in cognitive control and emotion processing which are associated with aggressive behaviors in schizophrenia.
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Affiliation(s)
- Alexandra Fortier
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Alexandre Dumais
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada; Philippe-Pinel National Institute of Legal Psychiatry, Montreal, Canada
| | - Maria Athanassiou
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Andràs Tikàsz
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada.
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Chen C, Yao J, Lv Y, Zhao X, Zhang X, Lei J, Li Y, Sui Y. Aberrant Functional Connectivity of the Orbitofrontal Cortex Is Associated With Excited Symptoms in First-Episode Drug-Naïve Patients With Schizophrenia. Front Psychiatry 2022; 13:922272. [PMID: 35966466 PMCID: PMC9366470 DOI: 10.3389/fpsyt.2022.922272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/06/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Schizophrenia (SZ) is associated with the highest disability rate among serious mental disorders. Excited symptoms are the core symptoms of SZ, which appear in the early stage, followed by other stages of the disease subsequently. These symptoms are destructive and more prone to violent attacks, posing a serious economic burden to the society. Abnormal spontaneous activity in the orbitofrontal cortex had been reported to be associated with excited symptoms in patients with SZ. However, whether the abnormality appears in first-episode drug-naïve patients with SZ has still remained elusive. METHODS A total of 56 first-episode drug-naïve patients with SZ and 27 healthy controls underwent resting-state functional magnetic resonance imaging (rs-fMRI) and positive and negative syndrome scale (PANSS). First, differences in fractional amplitude of low-frequency fluctuations (fALFF) between first-episode drug-naïve patients with SZ and healthy controls were examined to identify cerebral regions exhibiting abnormal local spontaneous activity. Based on the fALFF results, the resting-state functional connectivity analysis was performed to determine changes in cerebral regions exhibiting abnormal local spontaneous activity. Finally, the correlation between abnormal functional connectivity and exciting symptoms was analyzed. RESULTS Compared with the healthy controls, first-episode drug-naïve patients with SZ showed a significant decrease in intrinsic activity in the bilateral precentral gyrus, bilateral postcentral gyrus, and the left orbitofrontal cortex. In addition, first-episode drug-naïve patients with SZ had significantly reduced functional connectivity values between the left orbitofrontal cortex and several cerebral regions, which were mainly distributed in the bilateral postcentral gyrus, the right middle frontal gyrus, bilateral paracentral lobules, the left precentral gyrus, and the right median cingulate. Further analyses showed that the functional connectivity between the left orbitofrontal cortex and the left postcentral gyrus, as well as bilateral paracentral lobules, was negatively correlated with excited symptoms in first-episode drug-naïve patients with SZ. CONCLUSION Our results indicated the important role of the left orbitofrontal cortex in first-episode drug-naïve patients with SZ and suggested that the abnormal spontaneous activity of the orbitofrontal cortex may be valuable to predict the occurrence of excited symptoms. These results may provide a new direction to explore the excited symptoms of SZ.
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Affiliation(s)
- Congxin Chen
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | | | - Yiding Lv
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaoxin Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Jiaxi Lei
- Chengdu No. 4 People's Hospital, Chengdu, China
| | - Yuan Li
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yuxiu Sui
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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Zhu T, Wang Z, Zhou C, Fang X, Huang C, Xie C, Ge H, Yan Z, Zhang X, Chen J. Meta-analysis of structural and functional brain abnormalities in schizophrenia with persistent negative symptoms using activation likelihood estimation. Front Psychiatry 2022; 13:957685. [PMID: 36238945 PMCID: PMC9552970 DOI: 10.3389/fpsyt.2022.957685] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Persistent negative symptoms (PNS) include both primary and secondary negative symptoms that persist after adequate treatment, and represent an unmet therapeutic need. Published magnetic resonance imaging (MRI) evidence of structural and resting-state functional brain abnormalities in schizophrenia with PNS has been inconsistent. Thus, the purpose of this meta-analysis is to identify abnormalities in structural and functional brain regions in patients with PNS compared to healthy controls. METHODS We systematically searched PubMed, Web of Science, and Embase for structural and functional imaging studies based on five research methods, including voxel-based morphometry (VBM), diffusion tensor imaging (DTI), functional connectivity (FC), the amplitude of low-frequency fluctuation or fractional amplitude of low-frequency fluctuation (ALFF/fALFF), and regional homogeneity (ReHo). Afterward, we conducted a coordinate-based meta-analysis by using the activation likelihood estimation algorithm. RESULTS Twenty-five structural MRI studies and thirty-two functional MRI studies were included in the meta-analyses. Our analysis revealed the presence of structural alterations in patients with PNS in some brain regions including the bilateral insula, medial frontal gyrus, anterior cingulate gyrus, left amygdala, superior temporal gyrus, inferior frontal gyrus, cingulate gyrus and middle temporal gyrus, as well as functional differences in some brain regions including the bilateral precuneus, thalamus, left lentiform nucleus, posterior cingulate gyrus, medial frontal gyrus, and superior frontal gyrus. CONCLUSION Our study suggests that structural brain abnormalities are consistently located in the prefrontal, temporal, limbic and subcortical regions, and functional alterations are concentrated in the thalamo-cortical circuits and the default mode network (DMN). This study provides new insights for targeted treatment and intervention to delay further progression of negative symptoms. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022338669].
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Affiliation(s)
- Tingting Zhu
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zixu Wang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Zhou
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyu Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chengbing Huang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Psychiatry, The Third People's Hospital of Huai'an, Huaian, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine Southeast University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zheng Yan
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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