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Li M, Deng W, Li Y, Zhao L, Ma X, Yu H, Li X, Meng Y, Wang Q, Du X, Sham PC, Palaniyappan L, Li T. Ameliorative patterns of grey matter in patients with first-episode and treatment-naïve schizophrenia. Psychol Med 2023; 53:3500-3510. [PMID: 35164887 PMCID: PMC10277763 DOI: 10.1017/s0033291722000058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Grey matter (GM) reduction is a consistent observation in established late stages of schizophrenia, but patients in the untreated early stages of illness display an increase as well as a decrease in GM distribution relative to healthy controls (HC). The relative excess of GM may indicate putative compensatory responses, though to date its relevance is unclear. METHODS 343 first-episode treatment-naïve patients with schizophrenia (FES) and 342 HC were recruited. Multivariate source-based morphometry was performed to identify covarying 'networks' of grey matter concentration (GMC). Neurocognitive scores using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and symptom burden using the Positive and Negative Symptoms Scale (PANSS) were obtained. Bivariate linear relationships between GMC and cognition/symptoms were studied. RESULTS Compared to healthy subjects, FES had prominently lower GMC in two components; the first consists of the anterior insula, inferior frontal gyrus, anterior cingulate and the second component with the superior temporal gyrus, precuneus, inferior/superior parietal lobule, cuneus, and lingual gyrus. Higher GMC was seen in adjacent areas of the middle and superior temporal gyrus, middle frontal gyrus, inferior parietal cortex and putamen. Greater GMC of this component was associated with lower duration of untreated psychosis, less severe positive symptoms and better performance on cognitive tests. CONCLUSIONS In untreated stages of schizophrenia, both a distributed lower and higher GMC is observable. While the higher GMC is relatively modest, it occurs across frontoparietal, temporal and subcortical regions in association with reduced illness burden suggesting a compensatory role for higher GMC in the early stages of schizophrenia.
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Affiliation(s)
- Mingli Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yinfei Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Hua Yu
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaojing Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Yajing Meng
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Xiangdong Du
- Suzhou Psychiatry Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Pak Chung Sham
- Centre for Genomic Sciences and State Key Laboratory in Cognitive and Brain Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Lena Palaniyappan
- Robarts Research Institute & The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Lin B, Li XB, Ruan S, Wu YX, Zhang CY, Wang CY, Wang LB. Convergent and divergent gray matter volume abnormalities in unaffected first-degree relatives and ultra-high risk individuals of schizophrenia. SCHIZOPHRENIA 2022; 8:55. [PMID: 35853913 PMCID: PMC9261104 DOI: 10.1038/s41537-022-00261-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/24/2022] [Indexed: 01/10/2023]
Abstract
High-risk populations of schizophrenia can be mainly identified as genetic high-risk based on putative endophenotypes or ultra-high-risk (UHR) based on clinically manifested symptoms. Previous studies have consistently shown brain structural abnormalities in both genetic high-risk and UHR individuals. In this study, we aimed to disentangle the convergent and divergent pattern of gray matter alterations between UHR and unaffected first-degree relatives from genetic high-risk individuals. We used structural MRI scans and voxel-based morphometry method to examine gray matter volume (GMV) differences among 23 UHR subjects meeting the Structured Interview for Prodromal Syndromes (SIPS) criteria, 18 unaffected first-degree relatives (UFDR), 26 first-episode schizophrenia patients (FES) and 54 healthy controls (CN). We found that a number of brain regions exhibited a monotonically decreasing trend of GMV from CN to UFDR to UHR to FES. Compared with CN, the UHR subjects showed significant decreases of GMV similar to the patients in the inferior temporal gyrus, fusiform gyrus, middle occipital gyrus, insula, and limbic regions. Moreover, the UHR transformed subgroup had significantly lower GMV than UHR non-transformed subgroup in the right inferior temporal/fusiform gyrus. On the other hand, the UFDR subjects only showed significant GMV decreases in the inferior temporal gyrus and fusiform. Moreover, we found GMV in the occipital lobe was negatively correlated with the UHR subjects’ composite positive symptom of SIPS, and GMV in the cerebellum was positively correlated with FES subjects’ symptom severity. Our results suggest that GMV deficits and regional dysfunction are evident prior to the onset of psychosis and are more prominent in the UHR than the UFDR individuals.
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Mizutani-Tiebel Y, Takahashi S, Karali T, Mezger E, Bulubas L, Papazova I, Dechantsreiter E, Stoecklein S, Papazov B, Thielscher A, Padberg F, Keeser D. Differences in electric field strength between clinical and non-clinical populations induced by prefrontal tDCS: A cross-diagnostic, individual MRI-based modeling study. Neuroimage Clin 2022; 34:103011. [PMID: 35487132 PMCID: PMC9125784 DOI: 10.1016/j.nicl.2022.103011] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/17/2022] [Accepted: 04/13/2022] [Indexed: 01/25/2023]
Abstract
MDD and SCZ showed lower prefrontal tDCS-induced e-field strengths compared to HC. Average e-field strengths did not significantly differ between MDD and SCZ patients. Inter-individual variability of e-field intensities and distribution was prominent. Inter-rater variability emphasizes the importance of standardized positioning.
Introduction Prefrontal cortex (PFC) regions are promising targets for therapeutic applications of non-invasive brain stimulation, e.g. transcranial direct current stimulation (tDCS), which has been proposed as a novel intervention for major depressive disorder (MDD) and negative symptoms of schizophrenia (SCZ). However, the effects of tDCS vary inter-individually, and dose–response relationships have not been established. Stimulation parameters are often tested in healthy subjects and transferred to clinical populations. The current study investigates the variability of individual MRI-based electric fields (e-fields) of standard bifrontal tDCS across individual subjects and diagnoses. Method The study included 74 subjects, i.e. 25 patients with MDD, 24 patients with SCZ, and 25 healthy controls (HC). Individual e-fields of a common tDCS protocol (i.e. 2 mA stimulation intensity, bifrontal anode-F3/cathode-F4 montage) were modeled by two investigators using SimNIBS (2.0.1) based on structural MRI scans. Result On a whole-brain level, the average e-field strength was significantly reduced in MDD and SCZ compared to HC, but MDD and SCZ did not differ significantly. Regions of interest (ROI) analysis for PFC subregions showed reduced e-fields in Sallet areas 8B and 9 for MDD and SCZ compared to HC, whereas there was again no difference between MDD and SCZ. Within groups, we generally observed high inter-individual variability of e-field intensities at a higher percentile of voxels. Conclusion MRI-based e-field modeling revealed significant differences in e-field strengths between clinical and non-clinical populations in addition to a general inter-individual variability. These findings support the notion that dose–response relationships for tDCS cannot be simply transferred from healthy to clinical cohorts and need to be individually established for clinical groups. In this respect, MRI-based e-field modeling may serve as a proxy for individualized dosing.
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Affiliation(s)
- Yuki Mizutani-Tiebel
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; NeuroImaging Core Unit Munich (NICUM), Munich, Germany.
| | - Shun Takahashi
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan; Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan; Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Temmuz Karali
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; Department of Radiology, University Hospital LMU, Munich, Germany
| | - Eva Mezger
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Lucia Bulubas
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Irina Papazova
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; Department of Psychiatry and Psychotherapy, University of Augsburg, Germany
| | - Esther Dechantsreiter
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Boris Papazov
- NeuroImaging Core Unit Munich (NICUM), Munich, Germany; Department of Radiology, University Hospital LMU, Munich, Germany
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; NeuroImaging Core Unit Munich (NICUM), Munich, Germany; Department of Radiology, University Hospital LMU, Munich, Germany; Munich Center for Neurosciences (MCN) - Brain & Mind, 82152 Planegg-Martinsried, Germany.
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Li W, Wang L, Lyu Z, Chen J, Li Y, Sun Y, Zhu J, Wang W, Wang Y, Li Q. Difference in topological organization of white matter structural connectome between methamphetamine and heroin use disorder. Behav Brain Res 2022; 422:113752. [PMID: 35033610 DOI: 10.1016/j.bbr.2022.113752] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 11/17/2022]
Abstract
The psychological symptoms caused by heroin and methamphetamine are significantly different in people with substance use disorders. The topological organization of structural connections that may underlie these differences remains unknown. The study sample consisted of 23 males with methamphetamine use disorder (MAUD), 20 males with heroin use disorder (HUD), and 21 male healthy controls (HCs) who were demographically matched. Diffusion tensor imaging and probabilistic tractography were used for white matter network construction. Psychological symptoms were evaluated by the Symptom Checklist-90. Using graph theoretical analysis, we examined the difference in graph-level and nodal-level properties among the groups. The network Hubs distribution and the relationship between the network alterations and psychological symptoms were identified. The MAUD group demonstrated significantly higher scores on anxiety, hostility, and symptoms of schizophrenia than the HUD and HCs groups. The HUD group showed significantly higher global efficiency and network strength than the HCs group, and higher network strength than the MAUD group. Compared with the HUD group, the MAUD group showed significantly lower Nodal Strength and efficiency, distributed mainly in the temporal, parietal, and occipital regions. We also found the network Hubs were decreased in the MAUD group, but increased in the HUD group. The Nodal Strength in the right superior temporal gyrus was significantly correlated with psychological symptoms in the MAUD group. These findings reflect the significant differences in topological structural connection between HUD and MAUD. This evidence helps shed some light on the neurobiological mechanisms of the psychological differences between HUD and MAUD, and extend our understanding of the structural disruption underlying MAUD-related psychological symptoms.
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Affiliation(s)
- Wei Li
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Lei Wang
- Department of Nuclear Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Zhuomin Lyu
- Department of Pain Treatment, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Jiajie Chen
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Yongbin Li
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Yichen Sun
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Jia Zhu
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Wei Wang
- Department of Nuclear Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Yarong Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
| | - Qiang Li
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China.
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Gascoigne DA, Drobyshevsky A, Aksenov DP. The Contribution of Dysfunctional Chloride Channels to Neurovascular Deficiency and Neurodegeneration. Front Pharmacol 2021; 12:754743. [PMID: 34671264 PMCID: PMC8520995 DOI: 10.3389/fphar.2021.754743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/21/2021] [Indexed: 01/11/2023] Open
Affiliation(s)
- David A. Gascoigne
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, United States
| | - Alexander Drobyshevsky
- Department of Pediatrics, NorthShore University HealthSystem, Evanston, IL, United States
| | - Daniil P. Aksenov
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, United States,Department of Anesthesiology, NorthShore University HealthSystem, Evanston, IL, United States,*Correspondence: Daniil P. Aksenov,
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Probing depression, schizophrenia, and other psychiatric disorders using fNIRS and the verbal fluency test: A systematic review and meta-analysis. J Psychiatr Res 2021; 140:416-435. [PMID: 34146793 DOI: 10.1016/j.jpsychires.2021.06.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022]
Abstract
Accessible neuroimaging tools that can identify specific frontal lobe dysfunction associated with psychiatric disorders could be useful for improving disease diagnosis and prognosis and treatment development. Functional near-infrared spectroscopy (fNIRS), in conjunction with the verbal fluency test (VFT), has emerged as an inexpensive and convenient method for understanding psychiatric disorders. However, questions remain regarding the specificity and uniqueness of fNIRS measurements for different disorders and the soundness of the methods applied previously. To address these knowledge gaps, we conducted a systematic review and meta-analysis of fNIRS studies using the VFT to probe psychiatric disorders. A literature search was conducted using PubMed and PsycINFO on October 27, 2020. Overall, 82% and 49% of the 121 included studies reported significantly reduced changes in oxyhemoglobin concentrations (HbO) and significantly fewer produced words during the VFT in psychiatric patients compared with healthy controls, respectively. For most psychiatric disorders, changes in HbO are more sensitive than changes in deoxyhemoglobin concentrations and VFT performance to detect psychopathologies. In addition, meta-analyses based on the proportion of channels that exhibited significant differences in HbO changes between patients and controls and on the effect sizes of group differences consistently showed that for major depression and schizophrenia, hypoactivation could be found across the frontotemporal regions, but its topographical distribution is disorder-specific. Thus, the fNIRS-VFT paradigm holds promise for understanding, detecting, and differentiating psychiatric disorders, and has the potential for developing accessible neuroimaging biomarkers for different psychiatric disorders. The findings are discussed with regard to the strengths and weaknesses of the applied methods, following by recommendations.
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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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8
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Webler RD, Hamady C, Molnar C, Johnson K, Bonilha L, Anderson BS, Bruin C, Bohning DE, George MS, Nahas Z. Decreased interhemispheric connectivity and increased cortical excitability in unmedicated schizophrenia: A prefrontal interleaved TMS fMRI study. Brain Stimul 2020; 13:1467-1475. [PMID: 32585355 DOI: 10.1016/j.brs.2020.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/08/2020] [Accepted: 06/16/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Prefrontal abnormalities in schizophrenia have consistently emerged from resting state and cognitive neuroimaging studies. However, these correlative findings require causal verification via combined imaging/stimulation approaches. To date, no interleaved transcranial magnetic stimulation and functional magnetic resonance imaging study (TMS fMRI) has probed putative prefrontal cortex abnormalities in schizophrenia. OBJECTIVE /Hypothesis: We hypothesized that subjects with schizophrenia would show significant hyperexcitability at the site of stimulation (BA9) and decreased interhemispheric functional connectivity. METHODS We enrolled 19 unmedicated subjects with schizophrenia and 22 controls. All subjects underwent brain imaging using a 3T MRI scanner with a SENSE coil. They also underwent a single TMS fMRI session involving motor threshold (rMT) determination, structural imaging, and a parametric TMS fMRI protocol with 10 Hz triplet pulses at 0, 80, 100 and 120% rMT. Scanning involved a surface MR coil optimized for bilateral prefrontal cortex image acquisition. RESULTS Of the original 41 enrolled subjects, 8 subjects with schizophrenia and 11 controls met full criteria for final data analyses. At equal TMS intensity, subjects with schizophrenia showed hyperexcitability in left BA9 (p = 0.0157; max z-score = 4.7) and neighboring BA46 (p = 0.019; max z-score = 4.47). Controls showed more contralateral functional connectivity between left BA9 and right BA9 through increased activation in right BA9 (p = 0.02; max z-score = 3.4). GM density in subjects with schizophrenia positively correlated with normalized prefrontal to motor cortex ratio of the corresponding distance from skull to cortex ratio (S-BA9/S-MC) (r = 0.83, p = 0.004). CONCLUSIONS Subjects with schizophrenia showed hyperexcitability in left BA9 and impaired interhemispheric functional connectivity compared to controls. Interleaved TMS fMRI is a promising tool to investigate prefrontal dysfunction in schizophrenia.
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Affiliation(s)
- Ryan D Webler
- University of Minnesota, Department of Psychology, USA
| | - Carmen Hamady
- American University of Beirut, Department of Psychiatry, USA
| | - Chris Molnar
- Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA
| | | | | | | | - Claartje Bruin
- American University of Beirut, Department of Psychiatry, USA
| | - Daryl E Bohning
- Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA
| | - Mark S George
- Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Ziad Nahas
- American University of Beirut, Department of Psychiatry, USA; University of Minnesota, Department of Psychiatry, USA.
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Lai A, Crosta C, Loftin M, Silverstein SM. Retinal structural alterations in chronic versus first episode schizophrenia spectrum disorders. Biomark Neuropsychiatry 2020. [DOI: 10.1016/j.bionps.2020.100013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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10
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Khansari MM, Zhang J, Qiao Y, Gahm JK, Sarabi MS, Kashani AH, Shi Y. Automated Deformation-Based Analysis of 3D Optical Coherence Tomography in Diabetic Retinopathy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:236-245. [PMID: 31247547 PMCID: PMC6928449 DOI: 10.1109/tmi.2019.2924452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Diabetic retinopathy (DR) is a significant microvascular complication of diabetes mellitus and a leading cause of vision impairment in working age adults. Optical coherence tomography (OCT) is a routinely used clinical tool to observe retinal structural and thickness alterations in DR. Pathological changes that alter the normal anatomy of the retina, such as intraretinal edema, pose great challenges for conventional layer-based analysis of OCT images. We present an alternative approach for the automated analysis of OCT volumes in DR research based on nonlinear registration. In this paper, we first obtain an anatomically consistent volume of interest (VOI) in different OCT images via carefully designed masking and affine registration. After that, efficient B-spline transformations are computed using stochastic gradient descent optimization. Using the OCT volumes of normal controls, for which layer-based segmentation works well, we demonstrate the accuracy of our registration-based analysis in aligning layer boundaries. By nonlinearly registering the OCT volumes of DR subjects to an atlas constructed from normal controls and measuring the Jacobian determinant of the deformation, we can simultaneously visualize tissue contraction and expansion due to DR pathology. Tensor-based morphometry (TBM) can also be performed for quantitative analysis of local structural changes. In our experimental results, we apply our method to a dataset of 105 subjects and demonstrate that volumetric OCT registration and TBM analysis can successfully detect local retinal structural alterations due to DR.
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Affiliation(s)
- Maziyar M. Khansari
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, US; USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
| | - Jiong Zhang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, US; USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
| | - Yuchuan Qiao
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
| | - Jin Kyu Gahm
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
| | - Mona Sharifi Sarabi
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
| | - Amir H. Kashani
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
| | - Yonggang Shi
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, US
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Mathews M, Gopal S, Singh A, Nuamah I, Pungor K, Tan W, Soares B, Kim E, Savitz AJ. Comparison of Relapse Prevention with 3 Different Paliperidone Formulations in Patients with Schizophrenia Continuing versus Discontinuing Active Antipsychotic Treatment: A Post-Hoc Analysis of 3 Similarly Designed Randomized Studies. Neuropsychiatr Dis Treat 2020; 16:1533-1542. [PMID: 32606705 PMCID: PMC7311166 DOI: 10.2147/ndt.s221242] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/17/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Sudden discontinuation from antipsychotic treatment is a common occurrence in patients with schizophrenia. Lower rates of relapse could be expected for patients discontinuing treatment from longer-acting formulations vs their shorter-acting equivalents. OBJECTIVE To compare relapse rates and time-to-relapse between the active (analogous to adherent patients) and placebo (analogous to non-adherent patients in the real-world) arms of three different formulations of paliperidone (oral paliperidone extended release [paliperidone ER], paliperidone palmitate once monthly [PP1M], and paliperidone palmitate three monthly [PP3M] long-acting injectables). METHODS Data from three similarly designed, randomized relapse prevention studies in adult patients with schizophrenia were analyzed. RESULTS In total, 922 patients were included (active treatment: 473, placebo: 449). Lowest percentage of patients experienced relapse with PP3M <PP1M <paliperidone and ER, in both the active treatment (PP3M, 9% <PP1M, 18% <paliperidone ER, 22%) and placebo (PP3M, 29% <PP1M, 48% <paliperidone ER, 52%) groups. The post-discontinuation median-time-to-relapse was significantly longer with PP3M (395 days [274 days to "not-reached"])> PP1M (172 days [134-222 days])> paliperidone ER (58 days [42-114 days]) and was "not-estimable" in the active treatment group due to low relapse rates. Hazard ratios (HR) of the three paliperidone formulations relative to their respective placebos were PP3M ([HR: 3.81; 95% CI: 2.08, 6.99; P< 0.0001]> PP1M [HR: 3.60; 95% CI: 2.45, 5.28; P<0.0001]> paliperidone ER [HR: 2.83; 95% CI: 1.73, 4.63; P<0.001]). CONCLUSION The lower percentage of relapse during active treatment and longer time to relapse after discontinuing active treatment with longer-duration antipsychotic formulations suggests the benefit of longer-acting over shorter-acting formulations, especially in patients susceptible to poor adherence.Clinical trial registration: paliperidone ER (NCT00086320), PP1M (NCT00111189), and PP3M (NCT01529515).
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Affiliation(s)
- Maju Mathews
- Global Medical Affairs, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Srihari Gopal
- Department of Neuroscience, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Arun Singh
- Department of Neuroscience, Janssen Research & Development, LLC, Pennington, PA, USA
| | - Isaac Nuamah
- Clinical Biostatistics, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Katalin Pungor
- Medical Affairs, Janssen-Cilag GmbH, Neuss, North Rhine-Westphalia, Germany
| | - Wilson Tan
- Regional Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Singapore
| | | | - Edward Kim
- Janssen Scientific Affairs, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Adam J Savitz
- Department of Neuroscience, Janssen Research & Development, LLC, Titusville, NJ, USA
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12
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A comparison of regional brain volumes and white matter connectivity in subjects with stimulant induced psychosis versus schizophrenia. Psychopharmacology (Berl) 2019; 236:3385-3399. [PMID: 31230145 DOI: 10.1007/s00213-019-05298-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/05/2019] [Indexed: 12/31/2022]
Abstract
RATIONALE Schizophrenia and stimulant-induced psychosis (SIP) represent two different forms of psychotic disorder, with different etiologies. While many of the symptoms of psychosis are common to both disorders, there have been few direct comparisons between these conditions, especially when controlling for stimulant use in individuals with schizophrenia. OBJECTIVES We directly compared both psychotic disorders with a comprehensive battery of clinical, neurocognitive and neuroanatomical measures. This included one group with SIP (and concurrent stimulant dependence) and two groups with schizophrenia (either with or without concurrent stimulant dependence). METHODS Ninety-six participants were recruited from a marginalized urban population, which included 39 with SIP (and concurrent stimulant dependence), 18 with schizophrenia (without stimulant dependence), and 39 with schizophrenia (with concurrent stimulant dependence). All subjects had extensive clinical and neurocognitive evaluations, complemented with structural MRI including diffusion tensor imaging (DTI) sequences to determine regional brain volumes and white matter connectivity. RESULTS Both positive and negative symptoms were greater in the SZ-dependent group than the other two. Neurocognitive function was broadly similar. The structural brain imaging revealed lateralized changes to the left parietal/temporal lobe, in which regional volumes were smaller in the SZ-dependent than the SZ-non-dependent group. DTI analysis indicated extensive decreases in fractional anisotropy, with parallel increases in radial diffusivity, in the SIP group compared to the SZ-dependent group. CONCLUSIONS These findings reveal both similarities and differences between SIP and schizophrenia. Furthermore, schizophrenia with concurrent stimulant dependence may be associated with a different clinical and neuroanatomical profile as compared to schizophrenia alone.
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13
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Ahn SJ, Cornea E, Murphy V, Styner M, Jarskog LF, Gilmore JH. White matter development in infants at risk for schizophrenia. Schizophr Res 2019; 210:107-114. [PMID: 31182322 PMCID: PMC6689450 DOI: 10.1016/j.schres.2019.05.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/23/2019] [Accepted: 05/26/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Schizophrenia is considered a neurodevelopmental disorder with a pathophysiology that likely begins long before the onset of clinical symptoms. White matter abnormalities have been observed in schizophrenia and we hypothesized that the first 2 years of life is a period in which white matter abnormalities associated with schizophrenia risk may emerge. METHODS 38 infants at high risk for schizophrenia and 202 healthy controls underwent diffusion tensor MRIs after birth and at 1 and 2 years of age. Quantitative tractography was used to determine diffusion properties (fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD)) of 18 white matter tracts and a general linear model was used to analyze group differences at each age. RESULTS Adjusting gestational age at birth, postnatal age at MRI, gender, MRI scanner type, and maternal education, neonates at high risk had significantly lower FA (p = 0.02) and AD (p = 0.03) in the superior segment of the left cingulate, and higher RD in the hippocampal segment of the left cingulate (p = 0.04). High risk one year olds had significantly lower FA (p < 0.01) and AD (p = 0.02) in the hippocampal segment of the left cingulate. High risk two year olds had significantly lower FA in the left prefrontal cortico-thalamic tract (p = 0.04) and higher RD in the right uncinate fasciculus (p = 0.04). None of the tract differences remained significant after correction for multiple comparisons. CONCLUSIONS There is evidence of abnormal white matter development in young children at risk for schizophrenia, especially in the hippocampal segment of left cingulum. These results support the neurodevelopmental theory of schizophrenia and indicate that impaired white matter may be present in early childhood.
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Affiliation(s)
- Sung Jun Ahn
- Department of Radiology, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Emil Cornea
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 27599-7160, USA
| | - Veronica Murphy
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 27599-7160, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 27599-7160, USA,Department of Computer Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - L. Fredrik Jarskog
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 27599-7160, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, 27599-7160, USA
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14
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Gallardo-Ruiz R, Crespo-Facorro B, Setién-Suero E, Tordesillas-Gutierrez D. Long-Term Grey Matter Changes in First Episode Psychosis: A Systematic Review. Psychiatry Investig 2019; 16:336-345. [PMID: 31132837 PMCID: PMC6539265 DOI: 10.30773/pi.2019.02.10.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/10/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To determine possible progressive changes of the grey matter at the first stages of the schizophrenia spectrum disorders, and to determine what regions are involved in these changes. METHODS We searched the literature concerning studies on longitudinal changes in grey matter in first-episode psychosis using magnetic resonance imaging, especially studies with an interval between scans of more than a year. Only articles published before 2018 were searched. We selected 19 magnetic resonance imaging longitudinal studies that used different neuroimaging analysis techniques to study changes in cerebral grey matter in a group of patients with a first episode of psychosis. RESULTS Patients with first episode of psychosis showed a decrease over time in cortical grey matter compared with a group of control subjects in frontal, temporal (specifically in superior regions), parietal, and subcortical regions. In addition to the above, studies indicate that patients showed a grey matter decrease in cerebellum and lateral ventricles volume. CONCLUSION The results suggest a decrease in grey matter in the years after the first episode of psychosis. Furthermore, the results of the studies showed consistency, regardless of the methods used in their analyses, as well as the time intervals between image collections.
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Affiliation(s)
- Ruth Gallardo-Ruiz
- Neuroimaging Unit, Technological Facilities,Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain.,CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain.,CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Diana Tordesillas-Gutierrez
- Neuroimaging Unit, Technological Facilities,Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain.,CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
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15
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Lin Y, Li M, Zhou Y, Deng W, Ma X, Wang Q, Guo W, Li Y, Jiang L, Hu X, Zhang N, Li T. Age-Related Reduction in Cortical Thickness in First-Episode Treatment-Naïve Patients with Schizophrenia. Neurosci Bull 2019; 35:688-696. [PMID: 30790217 DOI: 10.1007/s12264-019-00348-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 10/25/2018] [Indexed: 02/05/2023] Open
Abstract
Substantial evidence supports the neurodevelopmental hypothesis of schizophrenia. Meanwhile, progressive neurodegenerative processes have also been reported, leading to the hypothesis that neurodegeneration is a characteristic component in the neuropathology of schizophrenia. However, a major challenge for the neurodegenerative hypothesis is that antipsychotic drugs used by patients have profound impact on brain structures. To clarify this potential confounding factor, we measured the cortical thickness across the whole brain using high-resolution T1-weighted magnetic resonance imaging in 145 first-episode and treatment-naïve patients with schizophrenia and 147 healthy controls. The results showed that, in the patient group, the frontal, temporal, parietal, and cingulate gyri displayed a significant age-related reduction of cortical thickness. In the control group, age-related cortical thickness reduction was mostly located in the frontal, temporal, and cingulate gyri, albeit to a lesser extent. Importantly, relative to healthy controls, patients exhibited a significantly smaller age-related cortical thickness in the anterior cingulate, inferior temporal, and insular gyri in the right hemisphere. These results provide evidence supporting the existence of neurodegenerative processes in schizophrenia and suggest that these processes already occur in the early stage of the illness.
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Affiliation(s)
- Yin Lin
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China.,Department of Psychology, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Mingli Li
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yi Zhou
- Department of Radiology, Hospital for Chengdu Office of Tibetan Autonomous Region, Branch Hospital of West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wei Deng
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaohong Ma
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiang Wang
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wanjun Guo
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yinfei Li
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lijun Jiang
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xun Hu
- Huaxi Biobank, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Nanyin Zhang
- Department of Biomedical Engineering, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Tao Li
- Mental Health Centre and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China. .,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China.
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16
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Schwarz E, Doan NT, Pergola G, Westlye LT, Kaufmann T, Wolfers T, Brecheisen R, Quarto T, Ing AJ, Di Carlo P, Gurholt TP, Harms RL, Noirhomme Q, Moberget T, Agartz I, Andreassen OA, Bellani M, Bertolino A, Blasi G, Brambilla P, Buitelaar JK, Cervenka S, Flyckt L, Frangou S, Franke B, Hall J, Heslenfeld DJ, Kirsch P, McIntosh AM, Nöthen MM, Papassotiropoulos A, de Quervain DJF, Rietschel M, Schumann G, Tost H, Witt SH, Zink M, Meyer-Lindenberg A. Reproducible grey matter patterns index a multivariate, global alteration of brain structure in schizophrenia and bipolar disorder. Transl Psychiatry 2019; 9:12. [PMID: 30664633 PMCID: PMC6341112 DOI: 10.1038/s41398-018-0225-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/16/2018] [Indexed: 12/18/2022] Open
Abstract
Schizophrenia is a severe mental disorder characterized by numerous subtle changes in brain structure and function. Machine learning allows exploring the utility of combining structural and functional brain magnetic resonance imaging (MRI) measures for diagnostic application, but this approach has been hampered by sample size limitations and lack of differential diagnostic data. Here, we performed a multi-site machine learning analysis to explore brain structural patterns of T1 MRI data in 2668 individuals with schizophrenia, bipolar disorder or attention-deficit/ hyperactivity disorder, and healthy controls. We found reproducible changes of structural parameters in schizophrenia that yielded a classification accuracy of up to 76% and provided discrimination from ADHD, through it lacked specificity against bipolar disorder. The observed changes largely indexed distributed grey matter alterations that could be represented through a combination of several global brain-structural parameters. This multi-site machine learning study identified a brain-structural signature that could reproducibly differentiate schizophrenia patients from controls, but lacked specificity against bipolar disorder. While this currently limits the clinical utility of the identified signature, the present study highlights that the underlying alterations index substantial global grey matter changes in psychotic disorders, reflecting the biological similarity of these conditions, and provide a roadmap for future exploration of brain structural alterations in psychiatric patients.
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Affiliation(s)
- Emanuel Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Nhat Trung Doan
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Giulio Pergola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Tobias Kaufmann
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thomas Wolfers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Center for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Ralph Brecheisen
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tiziana Quarto
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Alex J Ing
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Pasquale Di Carlo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Tiril P Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | - Torgeir Moberget
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm County Council, Stockholm, Sweden
- Department of Psychiatry Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marcella Bellani
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona, Verona, VR, Italy
- Department of Neurosciences, Biomedicine and Movements Sciences, University of Verona, Verona, VR, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Institute of Psichiatry, Policlinico Bari, Azienda Ospedaliero Universitaria Consorziale Policlinico Bari, Bari, BA, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Simon Cervenka
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm County Council, Stockholm, Sweden
| | - Lena Flyckt
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm County Council, Stockholm, Sweden
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara Franke
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Departments of Human Genetics and Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Dirk J Heslenfeld
- Department of Cognitive Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
- Bernstein Center for Computational Neuroscience Heidelberg-Mannheim, Mannheim, Germany
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, George Square, Edinburgh, EH8 9JZ, UK
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Andreas Papassotiropoulos
- Division of Molecular Neuroscience, Department of Psychology, University of Basel, CH-4055, Basel, Switzerland
- Transfaculty Research Platform Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
- Psychiatric University Clinics, University of Basel, CH-4055, Basel, Switzerland
- Department Biozentrum, Life Sciences Training Facility, University of Basel, CH-4056, Basel, Switzerland
| | - Dominique J-F de Quervain
- Transfaculty Research Platform Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
- Psychiatric University Clinics, University of Basel, CH-4055, Basel, Switzerland
- Division of Cognitive Neuroscience, Department of Psychology, University of Basel, CH-4055, Basel, Switzerland
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS) and MRC-SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Mathias Zink
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- District Hospital Mittelfranken, Department of Psychiatry, Psychotherapy and Psychosomatics, Ansbach, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
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17
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Shivakumar V, Kalmady SV, Rajasekaran A, Chhabra H, Anekal AC, Narayanaswamy JC, Ravi V, Gangadhar BN, Venkatasubramanian G. Telomere length and its association with hippocampal gray matter volume in antipsychotic-naïve/free schizophrenia patients. Psychiatry Res Neuroimaging 2018; 282:11-17. [PMID: 30384145 DOI: 10.1016/j.pscychresns.2018.10.002] [Citation(s) in RCA: 8] [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] [Received: 10/26/2017] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 12/21/2022]
Abstract
Accelerated ageing processes are postulated to underlie schizophrenia pathogenesis. This postulate is supported by observations of reduced telomere length in schizophrenia patients. Hippocampus, one of the most important brain regions implicated in schizophrenia, is shown to atrophy at a faster rate in aging. In this study, telomere length (TL) was measured in 30 antipsychotic-naive/free schizophrenia patients and 60 healthy controls using quantitative PCR assay. Hippocampus volume was measured using voxel-based morphometry. Schizophrenia was associated with differential TL between sexes [Status × Sex; F(1,85) = 5.9, p = 0.017, η2 = 0.065]. Male schizophrenia patients had significantly lower relative TL than female patients [F(1,85) = 7.38, p = 0.008], while such sex difference was not observed in healthy controls [F(1,85) = 0.16, p = 0.69]. Schizophrenia patients showed a significant sex-by-telomere interaction with both right & left hippocampus, with male patients showing positive association of telomere length with volume, while female patients showed negative association. Telomere shortening and the positive association of telomere length with hippocampus volume was observed only in male patients with schizophrenia. Since correlational observations in this cross-sectional study does not necessarily support definitive causal relationship, further longitudinal studies examining hippocampus volume and telomere in schizophrenia patients are needed.
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Affiliation(s)
- Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sunil V Kalmady
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Ashwini Rajasekaran
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Harleen Chhabra
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Amaresha C Anekal
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Janardhanan C Narayanaswamy
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vasanthapuram Ravi
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Bangalore N Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
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18
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Newton R, Rouleau A, Nylander AG, Loze JY, Resemann HK, Steeves S, Crespo-Facorro B. Diverse definitions of the early course of schizophrenia-a targeted literature review. NPJ SCHIZOPHRENIA 2018; 4:21. [PMID: 30323274 PMCID: PMC6189105 DOI: 10.1038/s41537-018-0063-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder and patients experience significant comorbidity, especially cognitive and psychosocial deficits, already at the onset of disease. Previous research suggests that treatment during the earlier stages of disease reduces disease burden, and that a longer time of untreated psychosis has a negative impact on treatment outcomes. A targeted literature review was conducted to gain insight into the definitions currently used to describe patients with a recent diagnosis of schizophrenia in the early course of disease ('early' schizophrenia). A total of 483 relevant English-language publications of clinical guidelines and studies were identified for inclusion after searches of MEDLINE, MEDLINE In-Process, relevant clinical trial databases and Google for records published between January 2005 and October 2015. The extracted data revealed a wide variety of terminology and definitions used to describe patients with 'early' or 'recent-onset' schizophrenia, with no apparent consensus. The most commonly used criteria to define patients with early schizophrenia included experience of their first episode of schizophrenia or disease duration of less than 1, 2 or 5 years. These varied definitions likely result in substantial disparities of patient populations between studies and variable population heterogeneity. Better agreement on the definition of early schizophrenia could aid interpretation and comparison of studies in this patient population and consensus on definitions should allow for better identification and management of schizophrenia patients in the early course of their disease.
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Affiliation(s)
- Richard Newton
- Austin Health, University of Melbourne, Melbourne, VIC, Australia.,Peninsula Health, Frankston, VIC, Australia
| | | | | | | | | | | | - Benedicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
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19
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Chen B. Abnormal cortical region and subsystem complexity in dynamical functional connectivity of chronic schizophrenia: A new graph index for fMRI analysis. J Neurosci Methods 2018; 311:28-37. [PMID: 30316890 DOI: 10.1016/j.jneumeth.2018.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Schizophrenia is a predominant product of pathological alterations distributed throughout interconnected neural systems. Designing new objectively diagnostic methods are burning questions. Dynamical functional connectivity (DFCs) methodology based on fMRI data is an effective lever to investigate changeability evolution in macroscopic neural activity patterns underlying critical aspects of cognition and behavior. However, region properties of brain architecture have been less investigated by special indexes of dynamical graph in general mental disorders. METHODS Embracing the network dynamics concept, we introduce topology entropy index (TE-scores) which is focused on time-varying aspects of FCs, hence develop a new framework for researching the dysfunctional roots of schizophrenia in holism significance. In this work, the important process is to uncover noticeable regions endowed with antagonistic stance in TE-scores of between morbid and normal DFCs of 63 healthy controls (HCs) and 57 chronic schizophrenia patients (SZs). RESULTS For the whole brain region levels, right olfactory, right hippocampus, left parahippocampal gyrus, right parahippocampal gyrus, left amygdala, and left cuneus in SZs are endowed with significantly different TE-scores. At brain subsystems level, TE-scores in DMN are abnormal in the SZs. Comparison with existing method(s): Topology entropy in DFCs is introduced to explore the dynamical information organization of diverse regions and their abnormal changes in mental illness. Several classical graph indexes (such as degree strength, betweenness, centrality) in the static brain network measure the region importance of FCs under senses of information integration and separation process. Although highly related to degree strength by comparing the corresponding values, topology entropy further explores the regions' aberrant adaptability of functional contact and function switching. CONCLUSION TE-scores of abnormal regions in SZs are associated to the passive apathetic social withdrawal, unusual thought content, disturbance of volition, preoccupation, active social avoidance and hallucinatory symptoms. Thought the strict contrastive study, it is worth stressing that topology entropy is a meaningful biological marker to excavating schizophrenic psychopathology.
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Affiliation(s)
- Bo Chen
- School of Science, Hangzhou Dianzi University, Hangzhou, Zhejiang, 310018, PR China.
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20
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Rund BR. The research evidence for schizophrenia as a neurodevelopmental disorder. Scand J Psychol 2018; 59:49-58. [PMID: 29356007 DOI: 10.1111/sjop.12414] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/26/2017] [Indexed: 01/27/2023]
Abstract
Schizophrenia is a neurodevelopmental disorder that starts very early. In this review we describe the empirical evidence for the neurodevelopmental model. First, by outlining the roots of psychological research that laid the foundation of the model. Thereafter, describing cognitive dysfunction observed in schizophrenia, and the course of cognitive functioning in the illness. Then, research findings that speak for and studies that speak against the view that schizophrenia is a degenerative process is discussed. We find that there is ample evidence that cognitive disturbance is a core element in schizophrenia. However, we have limited understanding of what initiates the abnormal development. This the paper ends with pointing out some of the factors that may trigger the deviant neurocognitive development in schizophrenia.
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Affiliation(s)
- Bjorn Rishovd Rund
- Department of Psychology, University of Oslo, Oslo, Norway.,Vestre Viken Hospital Trust, Drammen, Norway
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21
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Breier A, Liffick E, Hummer TA, Vohs JL, Yang Z, Mehdiyoun NF, Visco AC, Metzler E, Zhang Y, Francis MM. Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders. Schizophr Res 2018; 199:395-402. [PMID: 29588126 DOI: 10.1016/j.schres.2018.03.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Currently approved medications for schizophrenia are relatively ineffective for negative symptoms and cognitive impairment. N-Acetyl Cysteine (NAC) is a neuroprotective agent that improved general symptoms, cognitive impairment and negative symptoms in some but not all studies, but failed to improve positive symptoms in patients with schizophrenia. Progressive brain mass loss (PBML) has been consistently observed in early phase schizophrenia. NAC mitigates the deleterious effects oxidative stress, inflammation and glutamatergic excitotoxicity and these three pathological processes are hypothesized to contribute to PBML. METHODS In this study, we assessed the effects NAC (3600mg/day) in a 52-week, double-blind, placebo controlled trial on symptoms, and cognition in early phase schizophrenia spectrum disorders (N=60). In the context of the clinical trial, we explored the effects of NAC on brain morphology. RESULTS NAC significantly improved (time×group) PANSS total (F=14.7, p<0.001), negative (F=5.1, p=0.024) and disorganized thought (F=13.7, p<0.001) symptom scores. NAC failed to improve PANSS positive symptoms and BACS cognitive scores. In preliminary analyses, baseline right (r=-0.48, p=0.041) and left (r=-0.45, p=0.018) total cortical thickness, and thickness in other cortical regions, were associated with NAC related improvement in PANSS total scores, but NAC, as compared to placebo, did not significantly impact brain morphology over the study treatment period. CONCLUSIONS These results replicate some but not all previous findings of NAC efficacy. Preliminary results suggest that NAC's symptom effects may be related to structural integrity, but NAC failed to demonstrate treatment effects on longitudinal measures of brain morphology. ClinicalTrials.gov Identifier: NCT01339858.
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Affiliation(s)
- Alan Breier
- Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Emily Liffick
- Indiana University School of Medicine, Indianapolis, IN, United States; Eli Lilly and Company, Indianapolis, IN, United States
| | - Tom A Hummer
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jenifer L Vohs
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ziyi Yang
- Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Andrew C Visco
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Emmalee Metzler
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ying Zhang
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Michael M Francis
- Indiana University School of Medicine, Indianapolis, IN, United States
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22
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Atoui M, El Jamil F, El Khoury J, Doumit M, Syriani N, Khani M, Nahas Z. The relationship between clinical insight and cognitive and affective empathy in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 12:56-65. [PMID: 29928598 DOI: 10.1016/j.scog.2018.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/18/2018] [Accepted: 02/19/2018] [Indexed: 01/10/2023]
Abstract
Background Schizophrenia is often associated with poor clinical insight (unawareness of mental illness and its symptoms) and deficits in empathy, which are important for social functioning. Cognitive empathy has been linked to clinical insight while affective empathy and its role in insight and pathology have received mixed evidence. Methods Instruments assessing symptomatology (Positive and Negative Syndrome Scale; PANSS), clinical insight (Scales to assess awareness of mental disorders; SUMD), and cognitive and affective empathy were administered to 22 participants with first episode and chronic schizophrenia and 21 healthy controls. Self-report, parent-report, and performance based measures were used to assess cognitive and affective empathy (The interpersonal reactivity index; IRI/Reading the Mind in the Eyes Test/Faux Pas) to reduce bias and parse shared variance. Results Age of onset, gender, and symptomatology emerged as significant predictors of poor clinical insight. Additionally, the fantasy subscale of the IRI as reported by parents emerged as a positive predictor while the personal distress (parent report) subscale emerged as a negative predictor of awareness into mental illness. There were significant differences on performance-based measures of empathy between the control and schizophrenia groups. Conclusion Findings suggest that affective empathy is relatively intact across phases of illness whereas cognitive empathy abilities are compromised and could be targets for psychotherapy intervention.
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Affiliation(s)
- Mia Atoui
- American University of Beirut, Department of Psychology, Beirut, Lebanon
| | - Fatima El Jamil
- American University of Beirut, Department of Psychology, Beirut, Lebanon
| | - Joseph El Khoury
- American University of Beirut Medical Center, Department of Psychiatry, Beirut, Lebanon
| | - Mark Doumit
- American University of Beirut, Department of Medicine, Beirut, Lebanon
| | - Nathalie Syriani
- American University of Beirut, Department of Psychology, Beirut, Lebanon
- American University of Beirut Medical Center, Department of Psychiatry, Beirut, Lebanon
- American University of Beirut, Department of Medicine, Beirut, Lebanon
- University of Minnesota, Department of Psychiatry, MN, USA
| | - Munir Khani
- American University of Beirut Medical Center, Department of Psychiatry, Beirut, Lebanon
| | - Ziad Nahas
- University of Minnesota, Department of Psychiatry, MN, USA
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23
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A neuroanatomical account of mental time travelling in schizophrenia: A meta-analysis of functional and structural neuroimaging data. Neurosci Biobehav Rev 2017; 80:211-222. [DOI: 10.1016/j.neubiorev.2017.05.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 05/29/2017] [Indexed: 01/29/2023]
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24
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Palaniyappan L, Das T, Dempster K. The neurobiology of transition to psychosis: clearing the cache. J Psychiatry Neurosci 2017; 42:294-299. [PMID: 28834527 PMCID: PMC5573571 DOI: 10.1503/jpn.170137] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The prepsychotic phase of schizophrenia is not only important for indicated prevention strategies, but also crucial for developing mechanistic models of the emergence of frank psychosis (transition). This commentary highlights the work of Dukart and colleagues, published in this issue of the Journal of Psychiatry and Neurosicence, who sought to identify MRI-based anatomic endophenotypes of psychosis in a well-characterized sample of patients with at-risk mental state (ARMS) and first-episode psychosis (FEP). Conceptual and translational challenges in clarifying the neurobiology of transitional prepsychotic states are discussed. A role of intracortical myelin in the neurobiology of transition is proposed. Transition may not be an outcome of "progressive structural deficits"; it may occur due to inadequate compensatory responses in the predisposed. The need to revise our current "deficit-oriented" models of neurobiology of psychosis in the wake of burgeoning evidence indicating a dynamic process of cortical reorganization is emphasized.
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Affiliation(s)
- Lena Palaniyappan
- Correspondence to: L. Palaniyappan, Prevention & Early Intervention Program for Psychoses (PEPP), A2-636, LHSC-VH, 800 Commissioners Road, London, Ont., Canada N6A 5W9;
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25
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Progressive cortical reorganisation: A framework for investigating structural changes in schizophrenia. Neurosci Biobehav Rev 2017; 79:1-13. [DOI: 10.1016/j.neubiorev.2017.04.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
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26
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Hasan A, Wobrock T, Guse B, Langguth B, Landgrebe M, Eichhammer P, Frank E, Cordes J, Wölwer W, Musso F, Winterer G, Gaebel W, Hajak G, Ohmann C, Verde PE, Rietschel M, Ahmed R, Honer WG, Dechent P, Malchow B, Castro MFU, Dwyer D, Cabral C, Kreuzer PM, Poeppl TB, Schneider-Axmann T, Falkai P, Koutsouleris N. Structural brain changes are associated with response of negative symptoms to prefrontal repetitive transcranial magnetic stimulation in patients with schizophrenia. Mol Psychiatry 2017; 22:857-864. [PMID: 27725655 DOI: 10.1038/mp.2016.161] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/06/2016] [Accepted: 08/04/2016] [Indexed: 12/13/2022]
Abstract
Impaired neural plasticity may be a core pathophysiological process underlying the symptomatology of schizophrenia. Plasticity-enhancing interventions, including repetitive transcranial magnetic stimulation (rTMS), may improve difficult-to-treat symptoms; however, efficacy in large clinical trials appears limited. The high variability of rTMS-related treatment response may be related to a comparably large variation in the ability to generate plastic neural changes. The aim of the present study was to determine whether negative symptom improvement in schizophrenia patients receiving rTMS to the left dorsolateral prefrontal cortex (DLPFC) was related to rTMS-related brain volume changes. A total of 73 schizophrenia patients with predominant negative symptoms were randomized to an active (n=34) or sham (n=39) 10-Hz rTMS intervention applied 5 days per week for 3 weeks to the left DLPFC. Local brain volume changes measured by deformation-based morphometry were correlated with changes in negative symptom severity using a repeated-measures analysis of covariance design. Volume gains in the left hippocampal, parahippocampal and precuneal cortices predicted negative symptom improvement in the active rTMS group (all r⩽-0.441, all P⩽0.009), but not the sham rTMS group (all r⩽0.211, all P⩾0.198). Further analyses comparing negative symptom responders (⩾20% improvement) and non-responders supported the primary analysis, again only in the active rTMS group (F(9, 207)=2.72, P=0.005, partial η 2=0.106). Heterogeneity in clinical response of negative symptoms in schizophrenia to prefrontal high-frequency rTMS may be related to variability in capacity for structural plasticity, particularly in the left hippocampal region and the precuneus.
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Affiliation(s)
- A Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - T Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany.,Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - B Guse
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - M Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied, Agatharied, Germany
| | - P Eichhammer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - E Frank
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - W Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - F Musso
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - G Winterer
- Experimental and Clinical Research Centre, The Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - G Hajak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Sozialstiftung Bamberg, Bamberg, Germany
| | - C Ohmann
- European Clinical Research Network, Düsseldorf, Germany
| | - P E Verde
- Coordination Centre for Clinical Trials, Heinrich-Heine University, Düsseldorf, Germany
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Institute of Central Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - R Ahmed
- Institut für anwendungsorientierte Forschung und klinische Studien GmbH, Göttingen, Germany
| | - W G Honer
- Department of Genetic Epidemiology in Psychiatry, Institute of Mental Health, The University of British Columbia, Vancouver, BC, Canada
| | - P Dechent
- Department of Cognitive Neurology, Georg-August-University Goettingen, Goettingen, Germany
| | - B Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - M F U Castro
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - D Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - C Cabral
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - P M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - T B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - T Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - N Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
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27
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Shah C, Zhang W, Xiao Y, Yao L, Zhao Y, Gao X, Liu L, Liu J, Li S, Tao B, Yan Z, Fu Y, Gong Q, Lui S. Common pattern of gray-matter abnormalities in drug-naive and medicated first-episode schizophrenia: a multimodal meta-analysis. Psychol Med 2017; 47:401-413. [PMID: 27776571 DOI: 10.1017/s0033291716002683] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Studies of schizophrenia at drug-naive state and on antipsychotic medication have reported a number of regions of gray-matter (GM) abnormalities but the reports have been inconsistent. The aim of this study was to conduct multimodal meta-analysis to compare the cross-sectional voxel-based morphometry studies of brain GM in antipsychotic-naive first-episode schizophrenia (AN-FES) and those with antipsychotic treatment within 1 year (AT-FES) to determine the similarities and differences in these groups. We conducted two separate meta-analyses containing 24 studies with a sample size of 801 patients and 957 healthy controls. A multimodal meta-analysis method was used to compare the findings between AN-FES and AT-FES. Meta-regression analyses were done to determine the influence of different variables including age, duration of illness, and positive and negative symptom scores. Finally, jack-knife analyses were done to test the robustness of the results. AN-FES and AT-FES showed common patterns of GM abnormalities in frontal (gyrus rectus), superior temporal, left hippocampal and insular cortex. GM in the left supramarginal gyrus and left middle temporal gyrus were found to be increased in AN-FES but decreased in AT-FES, whereas left median cingulate/paracingulate gyri and right hippocampus GM was decreased in AN-FES but increased in AT-FES. Findings suggest that both AN-FES and AT-FES share frontal, temporal and insular regions as common anatomical regions to be affected indicating these to be the primary regions of GM abnormalities in both groups.
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Affiliation(s)
- C Shah
- Radiology Department,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,Zhejiang,China
| | - W Zhang
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - Y Xiao
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - L Yao
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - Y Zhao
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - X Gao
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - L Liu
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - J Liu
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - S Li
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - B Tao
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - Z Yan
- Radiology Department,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,Zhejiang,China
| | - Y Fu
- Radiology Department,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,Zhejiang,China
| | - Q Gong
- Department of Radiology,Huaxi MR Research Center (HMRRC), the Center for Medical Imaging, West China Hospital of Sichuan University,Chengdu,Sichuan,China
| | - S Lui
- Radiology Department,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,Zhejiang,China
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28
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Wiebels K, Waldie KE, Roberts RP, Park HR. Identifying grey matter changes in schizotypy using partial least squares correlation. Cortex 2016; 81:137-50. [DOI: 10.1016/j.cortex.2016.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/31/2016] [Accepted: 04/10/2016] [Indexed: 11/25/2022]
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29
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Liu M, Zhang D, Adeli-Mosabbeb E, Shen D. Inherent Structure-Based Multiview Learning With Multitemplate Feature Representation for Alzheimer's Disease Diagnosis. IEEE Trans Biomed Eng 2016; 63:1473-82. [PMID: 26540666 PMCID: PMC4851920 DOI: 10.1109/tbme.2015.2496233] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Multitemplate-based brain morphometric pattern analysis using magnetic resonance imaging has been recently proposed for automatic diagnosis of Alzheimer's disease (AD) and its prodromal stage (i.e., mild cognitive impairment or MCI). In such methods, multiview morphological patterns generated from multiple templates are used as feature representation for brain images. However, existing multitemplate-based methods often simply assume that each class is represented by a specific type of data distribution (i.e., a single cluster), while in reality, the underlying data distribution is actually not preknown. In this paper, we propose an inherent structure-based multiview leaning method using multiple templates for AD/MCI classification. Specifically, we first extract multiview feature representations for subjects using multiple selected templates and then cluster subjects within a specific class into several subclasses (i.e., clusters) in each view space. Then, we encode those subclasses with unique codes by considering both their original class information and their own distribution information, followed by a multitask feature selection model. Finally, we learn an ensemble of view-specific support vector machine classifiers based on their, respectively, selected features in each view and fuse their results to draw the final decision. Experimental results on the Alzheimer's Disease Neuroimaging Initiative database demonstrate that our method achieves promising results for AD/MCI classification, compared to the state-of-the-art multitemplate-based methods.
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Affiliation(s)
- Mingxia Liu
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Daoqiang Zhang
- School of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Ehsan Adeli-Mosabbeb
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Dinggang Shen
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA, and also with the Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, Republic of Korea
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30
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McKechanie AG, Moorhead TWJ, Stanfield AC, Whalley HC, Johnstone EC, Lawrie SM, Owens DGC. Negative symptoms and longitudinal grey matter tissue loss in adolescents at risk of psychosis: preliminary findings from a 6-year follow-up study. Br J Psychiatry 2016; 208:565-70. [PMID: 26635326 DOI: 10.1192/bjp.bp.114.154526] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 11/20/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Negative symptoms are perhaps the most disabling feature of schizophrenia. Their pathogenesis remains poorly understood and it has been difficult to assess their development over time with imaging techniques. AIMS To examine, using tensor-based structural imaging techniques, whether there are regions of progressive grey matter volume change associated with the development of negative symptoms. METHOD A total of 43 adolescents at risk of psychosis were examined using magnetic resonance imaging and whole brain tensor-based morphometry at two time points, 6 years apart. RESULTS When comparing the individuals with significant negative symptoms with the remaining participants, we identified five regions of significant grey matter tissue loss over the 6-year period. These regions included the left temporal lobe, the left cerebellum, the left posterior cingulate and the left inferior parietal sulcus. CONCLUSIONS Negative symptoms are associated with longitudinal grey matter tissue loss. The regions identified include areas associated with psychotic symptoms more generally but also include regions uniquely associated with negative symptoms.
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Affiliation(s)
- Andrew G McKechanie
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Thomas W J Moorhead
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Andrew C Stanfield
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Heather C Whalley
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Eve C Johnstone
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Stephen M Lawrie
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - David G C Owens
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
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Abstract
Despite several decades of research, our knowledge of the long-term course of schizophrenia (SZ) is hampered by a lack of homogeneity of both research methods and phenotypic definitions of SZ's course. We provide a comprehensive review of the course of SZ by applying stringent methodological and diagnostic study-selection criteria. We report on positive and negative symptoms, cognition, and findings obtained by neuroimaging. In addition, we perform a meta-analysis of longitudinal studies of cognition in humans. We selected 35 human studies focusing on a narrow SZ phenotype, employing a follow-up duration of six months or more and consistent methodology at the different measurement points. For the meta-analysis on global cognitive change, eight and four studies were used to compare SZ to healthy and psychiatric controls, respectively. We find that the course of SZ is characterized by a constancy or even improvement of positive and negative symptoms and by fairly stable cognitive impairment, reflecting structural frontal and temporal cortical pathology. Progressive changes of the frontal cortex appear to develop in parallel with changes in symptomatology and executive impairment. Despite stable differences in cognition between patients and controls over the time intervals studied, high heterogeneity in the magnitude of effect sizes is present, and age is identified as one of its potential sources. Meta-regression shows these magnitudes to depend on the age at study inclusion. For future research, a combination of longitudinal and cross-sectional research designs is warranted to better account for potential cohort effects.
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Regional Abnormality of Grey Matter in Schizophrenia: Effect from the Illness or Treatment? PLoS One 2016; 11:e0147204. [PMID: 26789520 PMCID: PMC4720276 DOI: 10.1371/journal.pone.0147204] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/30/2015] [Indexed: 12/25/2022] Open
Abstract
Both schizophrenia and antipsychotic treatment are known to modulate brain morphology. However, it is difficult to establish whether observed structural brain abnormalities are due to disease or the effects of treatment. The aim of this study was to investigate the effects of illness and antipsychotic treatment on brain structures in antipsychotic-naïve first-episode schizophrenia based on a longitudinal short-term design. Twenty antipsychotic-naïve subjects with first-episode schizophrenia and twenty-four age- and sex-matched healthy controls underwent 3T MRI scans. Voxel-based morphometry (VBM) was used to examine the brain structural abnormality in patients compared to healthy controls. Nine patients were included in the follow-up examination after 8 weeks of treatment. Tensor-based morphometry (TBM) was used to identify longitudinal brain structural changes. We observed significantly reduced grey matter volume in the right superior temporal gyrus in antipsychotic-naïve patients with schizophrenia compared with healthy controls. After 8 weeks of treatment, patients showed significantly increased grey matter volume primarily in the bilateral prefrontal cortex, insula, right thalamus, left superior occipital cortex and the bilateral cerebellum. In addition, a greater enlargement of the prefrontal cortex is associated with the improvement in negative symptoms, and a more enlarged thalamus is associated with greater improvement in positive symptoms. Our results suggest the following: (1) the abnormality in the right superior temporal gyrus is present in the early stages of schizophrenia, possibly representing the core region related to schizophrenia; and (2) atypical antipsychotics could modulate brain morphology involving the thalamus, cortical grey matter and cerebellum. In addition, examination of the prefrontal cortex and thalamus might facilitate an efficient response to atypical antipsychotics in terms of symptom improvement.
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33
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Multimodal neuroimaging as a window into the pathological physiology of schizophrenia: Current trends and issues. Neurosci Res 2016; 102:29-38. [DOI: 10.1016/j.neures.2015.07.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/08/2015] [Accepted: 07/15/2015] [Indexed: 11/18/2022]
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Lisiecka DM, Suckling J, Barnes TRE, Chaudhry IB, Dazzan P, Husain N, Jones PB, Joyce EM, Lawrie SM, Upthegrove R, Deakin B. The benefit of minocycline on negative symptoms in early-phase psychosis in addition to standard care - extent and mechanism (BeneMin): study protocol for a randomised controlled trial. Trials 2015; 16:71. [PMID: 25886254 PMCID: PMC4351843 DOI: 10.1186/s13063-015-0580-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Negative symptoms of psychosis do not respond to the traditional therapy with first- or second-generation antipsychotics and are among main causes of a decrease in quality of life observed in individuals suffering from the disorder. Minocycline, a broad-spectrum tetracyclic antibiotic displaying neuroprotective properties has been suggested as a new potential therapy for negative symptoms. In the two previous clinical trials comparing minocycline and placebo, both added to the standard care, patients receiving minocycline showed increased reduction in negative symptoms. Three routes to neuroprotection by minocycline have been identified: neuroprotection against grey matter loss, anti-inflammatory action and stabilisation of glutamate receptors. However, it is not yet certain what the extent of the benefit of minocycline in psychosis is and what its mechanism is. We present a protocol for a multi-centre double-blind randomised placebo-controlled clinical trial entitled The Benefit of Minocycline on Negative Symptoms of Psychosis: Extent and Mechanism (BeneMin). METHODS After providing informed consent, 226 participants in the early phase of psychosis will be randomised to receive either 100 mg modified-release capsules of minocycline or similar capsules with placebo for 12 months in addition to standard care. The participants will be tested for outcome variables before and after the intervention period. The extent of benefit will be tested via clinical outcome measures, namely the Positive and Negative Syndrome Scale score, social and cognitive functioning scores, antipsychotic medication dose equivalent and level of weight gain. The mechanism of action of minocycline will be tested via blood screening for circulating cytokines and magnetic resonance imaging with three-dimensional T1-weighted rapid gradient-echo, proton density T2-weighted dual echo and T2*-weighted gradient echo planar imaging with N-back task and resting state. Eight research centres in UK and 15 National Health Service Trusts and Health Boards will be involved in recruiting participants, performing the study and analysing the data. DISCUSSION The BeneMin trial can inform as to whether in minocycline we have found a new and effective therapy against negative symptoms of psychosis. The European Union Clinical Trial Register: EudraCT 2010-022463-35 with the registration finalised in July 2011. The recruitment in the trial started in January 2013 with the first patient recruited in March 2013.
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Affiliation(s)
- Danuta M Lisiecka
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, CB2 0SZ, UK.
| | - John Suckling
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, CB2 0SZ, UK.
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.
| | - Thomas R E Barnes
- Department of Medicine, Centre for Mental Health, Faculty of Medicine, Imperial College, London, UK.
- West London Mental Health NHS Trust, London, UK.
| | - Imran B Chaudhry
- Institute of Brain, Behaviour and Mental Health, Clinical and Cognitive Neurosciences, University of Manchester, Manchester, UK.
- Lancashire Care Early Intervention Service, Accrington, UK.
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, King's College, London, UK.
| | - Nusrat Husain
- Institute of Brain, Behaviour and Mental Health, Clinical and Cognitive Neurosciences, University of Manchester, Manchester, UK.
| | - Peter B Jones
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | - Eileen M Joyce
- Institute of Neurology, University College London, London, UK.
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK.
| | - Rachel Upthegrove
- School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
- Early Intervention Service, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK.
| | - Bill Deakin
- Institute of Brain, Behaviour and Mental Health, Clinical and Cognitive Neurosciences, University of Manchester, Manchester, UK.
- Manchester Mental Health and Social Care Trust, Manchester, UK.
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35
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Chaves C, Marque CR, Maia-de-Oliveira JP, Wichert-Ana L, Ferrari TB, Santos AC, Araújo D, Machado-de-Sousa JP, Bressan RA, Elkis H, Crippa JA, Guimarães FS, Zuardi AW, Baker GB, Dursun SM, Hallak JEC. Effects of minocycline add-on treatment on brain morphometry and cerebral perfusion in recent-onset schizophrenia. Schizophr Res 2015; 161:439-45. [PMID: 25497439 DOI: 10.1016/j.schres.2014.11.031] [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: 12/06/2013] [Revised: 11/14/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
Abstract
Increasing evidence suggests that the tetracycline antibiotic minocycline has neuroprotective effects and is a potential treatment for schizophrenia. However, the mechanisms of action of minocycline in the CNS remain elusive. The aim of this study was to investigate the effects of minocycline on brain morphology and cerebral perfusion in patients with recent-onset schizophrenia after 12months of a randomized double-blind, placebo-controlled clinical trial of minocycline add-on treatment. This study included 24 outpatients with recent-onset schizophrenia randomized for 12months of adjuvant treatment with minocycline (200mg/d) or placebo. MRI (1.5T) and [(99m)Tc]-ECD SPECT brain scans were performed at the end of the 12-month of trial. Between-condition comparisons of SPECT and MRI brain images were performed using statistical parametric mapping and analyzed by voxel-based morphometry (VBM). Minocycline adjuvant treatment significantly reduced positive and negative symptoms when compared with placebo. The VBM analysis of MRI scans showed that the patients in the placebo group had significant lower gray matter volumes in the midposterior cingulate cortex and in the precentral gyrus in comparison with the patients in the minocycline group. In addition, a decreased ECD uptake in the minocycline condition was observed in fronto-temporal areas. These results suggest that minocycline may protect against gray matter loss and modulate fronto-temporal areas involved in the pathophysiology of schizophrenia. Furthermore, minocycline add-on treatment may be a potential treatment in the early stages of schizophrenia and may ameliorate clinical deterioration and brain alterations observed in this period.
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Affiliation(s)
- Cristiano Chaves
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil.
| | - Cristiane R Marque
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - João P Maia-de-Oliveira
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Department of Clinical Medicine, Federal University of Rio Grande do Norte, Brazil
| | - Lauro Wichert-Ana
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Internal Medicine, Division of Nuclear Medicine, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Thiago B Ferrari
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Antonio C Santos
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Internal Medicine, Division of Radiology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - David Araújo
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Canada
| | - João P Machado-de-Sousa
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Rodrigo A Bressan
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo, Brazil
| | - Helio Elkis
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Francisco S Guimarães
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Glen B Baker
- National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Canada
| | - Serdar M Dursun
- National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Canada
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
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Liu M, Zhang D, Shen D. View-centralized multi-atlas classification for Alzheimer's disease diagnosis. Hum Brain Mapp 2015; 36:1847-65. [PMID: 25624081 DOI: 10.1002/hbm.22741] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/23/2014] [Accepted: 01/12/2015] [Indexed: 01/29/2023] Open
Abstract
Multi-atlas based methods have been recently used for classification of Alzheimer's disease (AD) and its prodromal stage, that is, mild cognitive impairment (MCI). Compared with traditional single-atlas based methods, multiatlas based methods adopt multiple predefined atlases and thus are less biased by a certain atlas. However, most existing multiatlas based methods simply average or concatenate the features from multiple atlases, which may ignore the potentially important diagnosis information related to the anatomical differences among different atlases. In this paper, we propose a novel view (i.e., atlas) centralized multi-atlas classification method, which can better exploit useful information in multiple feature representations from different atlases. Specifically, all brain images are registered onto multiple atlases individually, to extract feature representations in each atlas space. Then, the proposed view-centralized multi-atlas feature selection method is used to select the most discriminative features from each atlas with extra guidance from other atlases. Next, we design a support vector machine (SVM) classifier using the selected features in each atlas space. Finally, we combine multiple SVM classifiers for multiple atlases through a classifier ensemble strategy for making a final decision. We have evaluated our method on 459 subjects [including 97 AD, 117 progressive MCI (p-MCI), 117 stable MCI (s-MCI), and 128 normal controls (NC)] from the Alzheimer's Disease Neuroimaging Initiative database, and achieved an accuracy of 92.51% for AD versus NC classification and an accuracy of 78.88% for p-MCI versus s-MCI classification. These results demonstrate that the proposed method can significantly outperform the previous multi-atlas based classification methods.
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Affiliation(s)
- Mingxia Liu
- School of Computer Science and Technology, Nanjing University of Aeronautics & Astronautics, Nanjing, China; Department of Radiology and BRIC, University of North Carolina at Chapel Hill, North Carolina, USA; School of Information Science and Technology, Taishan University, Taian, China
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37
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Yang C, Wu S, Lu W, Bai Y, Gao H. Brain differences in first-episode schizophrenia treated with quetiapine: a deformation-based morphometric study. Psychopharmacology (Berl) 2015; 232:369-77. [PMID: 25080851 DOI: 10.1007/s00213-014-3670-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 06/24/2014] [Indexed: 02/02/2023]
Abstract
RATIONALE With the development of various imaging techniques, the deformation-based morphometry (DBM) method provides an objective automatic examination of the whole brain. OBJECTIVES This study aims to assess the abnormalities in the brains of first-episode schizophrenia (FES) patients treated with quetiapine using another advanced nonrigid registration method, hierarchical attribute matching mechanism for elastic registration, through the application of DBM in the entire brain. METHODS Thirty FES patients and 30 normal controls were grouped by age and handedness and subjected to magnetic resonance imaging examination. The patients had relatively short durations of untreated psychosis (DUP; 6.4 ± 5.2 months), and only a single antipsychotic drug, quetiapine (dosage, 200 ± 75 mg), was used for treatment. Statistically significant changes in regional volume were analyzed via DBM. In addition, a voxel-wise analysis of correlations between the duration of treatment or dosage and volume was also performed. RESULTS Compared with control subjects, FES patients showed contracted regions located in Brodmann area (BA) 42 and BA 19. By contrast, expanded regions were observed in BA 38, BA 21, BA 6 and 8, and left cerebellum. A negative correlation was observed between dosage and volume in the hippocampus, while a positive correlation was found in the caudate. Meanwhile, a negative correlation was observed between duration of treatment and volume in BA 38. CONCLUSION Both regional volume reductions and increases were detected in the brains of FES patients treated with quetiapine compared with healthy control subjects. Such differences may be partially relevant to dosage and treatment duration in clinic.
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Affiliation(s)
- Chunlan Yang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100022, China
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38
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Chou PH, Koike S, Nishimura Y, Satomura Y, Kinoshita A, Takizawa R, Kasai K. Similar age-related decline in cortical activity over frontotemporal regions in schizophrenia: a multichannel near-infrared spectroscopy study. Schizophr Bull 2015; 41:268-79. [PMID: 24948388 PMCID: PMC4266293 DOI: 10.1093/schbul/sbu086] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Although recent studies have demonstrated that patients with schizophrenia and healthy controls did not differ in the speed of age-related decline in cortical thickness and performances on cognitive tests, hemodynamic changes assessed by functional neuroimaging remain unclear. This study investigated age effects on regional brain cortical activity to determine whether there is similar age-related decline in cortical activity as those observed in cortical thickness and cognitive test performance. METHOD A total of 109 patients with schizophrenia (age range: 16-59 y) and 106 healthy controls (age range: 16-59 y) underwent near-infrared spectroscopy (NIRS) while performing a verbal fluency test (VFT). Group comparison of cortical activity was examined using 2-tailed t tests, adopting the false discovery rate method. The relationship between age and cortical activity was investigated using correlational and multiple regression analyses, adjusting for potential confounding variables. A 2-way ANOVA was conducted to investigate differences in the age effects between diagnostic groups. RESULTS The patient group exhibited significantly decreased cortical activity in several regions of the frontotemporal cortices. However, slopes of age-dependent decreases in cortical activity were similar between patients and healthy individuals at the bilateral frontotemporal regions. CONCLUSIONS Our study showed no significant between-group differences in the age-related decline in cortical activity, as measured by NIRS, over the frontotemporal regions during a VFT. The results of our study may indicate a decrease in cortical activity in a relatively limited period around illness onset rather than continuously progressing over the course of the illness.
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Affiliation(s)
- Po-Han Chou
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;,Department of Psychiatry, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;,Division for Counseling and Support, Office for Mental Health Support, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Akihide Kinoshita
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryu Takizawa
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;
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39
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Zhang F, Qiu L, Yuan L, Ma H, Ye R, Yu F, Hu P, Dong Y, Wang K. Evidence for progressive brain abnormalities in early schizophrenia: a cross-sectional structural and functional connectivity study. Schizophr Res 2014; 159:31-5. [PMID: 25176348 DOI: 10.1016/j.schres.2014.07.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 05/05/2014] [Accepted: 07/31/2014] [Indexed: 11/26/2022]
Abstract
It has long been debated whether a progressive process is involved in schizophrenia. The aim of the current study was to determine whether a progressive process was involved in patients with early schizophrenia, who were drug naive or had received short-term minimal antipsychotic treatment to avoid the distortion through medication effects. Twenty-eight patients with schizophrenia with illness-duration of up to 3 years and twenty-six matched healthy controls were recruited. Structural and functional brain networks were examined based on diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI). The intergroup differences and correlation with illness duration in the patient group were surveyed. The schizophrenic patients showed lower fractional anisotropy (FA) values in the corpus callosum and corona radiata. Negative correlations of illness duration with FA values were observed in similar regions. During functional analysis, reduced functional connectivity between bilateral temporoparietal-junction (TPJ) and the posterior cingulate cortex (PCC) were found in the default mode network (DMN) in schizophrenic patients. In addition, the left TPJ showed gradually weaker functional connectivity with PCC and the medial prefrontal cortex (MPFC) in DMN as the duration of schizophrenia increased. The results suggested that early in the disease process patients have decreased connectivity in both structural and functional networks and that the weaker structural and functional connectivity negatively correlated with illness duration, which provided evidence for progressive brain abnormalities in early schizophrenia.
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Affiliation(s)
- Fangfang Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Linlin Qiu
- Department of Medical Psychology, Anhui Medical University, Hefei, Anhui Province, PR China
| | - Lili Yuan
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Huijuan Ma
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Rong Ye
- Department of Medical Psychology, Anhui Medical University, Hefei, Anhui Province, PR China
| | - Fengqiong Yu
- Department of Medical Psychology, Anhui Medical University, Hefei, Anhui Province, PR China
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Yi Dong
- Anhui Mental Health Center, Anhui Medical University, Hefei, Anhui Province, PR China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China.
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40
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Chong CD, Dodick DW, Schlaggar BL, Schwedt TJ. Atypical age-related cortical thinning in episodic migraine. Cephalalgia 2014; 34:1115-24. [DOI: 10.1177/0333102414531157] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Prior studies demonstrate reduced cortical thickness and volume in migraineurs. However, the effect of age on cortical thickness has not been assessed in migraineurs. In this study we investigated whether the process of aging on cortical thickness affects migraineurs differently compared to age-matched healthy controls, i.e. whether aging exacerbates cortical thinning in migraineurs. Methods Cortical thickness was estimated using a general linear model vertex-by-vertex approach for 32 healthy controls (mean age = 35.3 years; SD = 11.6) and 27 episodic migraine patients (mean age = 33.6 years; SD = 12.3). Results were modeled using a main effect analysis to estimate the effect of age on cortical thickness for each group separately, and an age-by-group analysis to estimate differences in age-related cortical thinning between migraine patients and normal controls. Results Although migraineurs and normal controls both have expected age-related thinning in many regions along the cortical mantle, migraineurs have age-related thinning of regions that do not thin in healthy controls, including: bilateral postcentral, right fusiform, and right temporal pole areas. Cortical thinning of these regions is more prominent with advancing age. Conclusion Results suggest that migraine is associated with atypical cortical aging, suggesting that the migraine disease process interacts with aging to affect cortical integrity.
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Torres US, Portela-Oliveira E, Borgwardt S, Busatto GF. Structural brain changes associated with antipsychotic treatment in schizophrenia as revealed by voxel-based morphometric MRI: an activation likelihood estimation meta-analysis. BMC Psychiatry 2013; 13:342. [PMID: 24359128 PMCID: PMC3878502 DOI: 10.1186/1471-244x-13-342] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 12/09/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The results of multiple studies on the association between antipsychotic use and structural brain changes in schizophrenia have been assessed only in qualitative literature reviews to date. We aimed to perform a meta-analysis of voxel-based morphometry (VBM) studies on this association to quantitatively synthesize the findings of these studies. METHODS A systematic computerized literature search was carried out through MEDLINE/PubMed, EMBASE, ISI Web of Science, SCOPUS and PsycINFO databases aiming to identify all VBM studies addressing this question and meeting predetermined inclusion criteria. All studies reporting coordinates representing foci of structural brain changes associated with antipsychotic use were meta-analyzed by using the activation likelihood estimation technique, currently the most sophisticated and best-validated tool for voxel-wise meta-analysis of neuroimaging studies. RESULTS Ten studies (five cross-sectional and five longitudinal) met the inclusion criteria and comprised a total of 548 individuals (298 patients on antipsychotic drugs and 250 controls). Depending on the methodologies of the selected studies, the control groups included healthy subjects, drug-free patients, or the same patients evaluated repeatedly in longitudinal comparisons (i.e., serving as their own controls). A total of 102 foci associated with structural alterations were retrieved. The meta-analysis revealed seven clusters of areas with consistent structural brain changes in patients on antipsychotics compared to controls. The seven clusters included four areas of relative volumetric decrease in the left lateral temporal cortex [Brodmann area (BA) 20], left inferior frontal gyrus (BA 44), superior frontal gyrus extending to the left middle frontal gyrus (BA 6), and right rectal gyrus (BA 11), and three areas of relative volumetric increase in the left dorsal anterior cingulate cortex (BA 24), left ventral anterior cingulate cortex (BA 24) and right putamen. CONCLUSIONS Our results identify the specific brain regions where possible associations between antipsychotic drug usage and structural brain changes in schizophrenia patients are more consistently reported. Additional longitudinal VBM studies including larger and more homogeneous samples of schizophrenia patients may be needed to further disentangle such alterations from those possibly linked to the intrinsic pathological progressive process in schizophrenia.
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Affiliation(s)
- Ulysses S Torres
- Post-Graduate Program in Radiology, Institute of Radiology (INRAD), University of Sao Paulo Medical School, Sao Paulo, Brazil.
| | - Eduardo Portela-Oliveira
- Department of Radiology, Hospital de Base, São José do Rio Preto Medical School, Sao Paulo, Brazil
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland,Department of Psychosis Studies, Institute of Psychiatry, King’s College, London, UK
| | - Geraldo F Busatto
- Post-Graduate Program in Radiology, Institute of Radiology (INRAD), University of Sao Paulo Medical School, Sao Paulo, Brazil,Laboratory of Neuroimaging in Psychiatry (LIM-21), Institute of Psychiatry, University of Sao Paulo Medical School, Centro de Medicina Nuclear, 3º andar, Rua Dr. Ovídio Pires Campos, s/n, Sao Paulo, Sao Paulo, 05403-010, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Sao Paulo, Brazil
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Chiapponi C, Piras F, Fagioli S, Piras F, Caltagirone C, Spalletta G. Age-related brain trajectories in schizophrenia: a systematic review of structural MRI studies. Psychiatry Res 2013; 214:83-93. [PMID: 23972726 DOI: 10.1016/j.pscychresns.2013.05.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 03/12/2013] [Accepted: 05/19/2013] [Indexed: 12/29/2022]
Abstract
Using the Pubmed database, we performed a detailed literature search for structural magnetic resonance imaging studies on patients with schizophrenia, investigating the relationship between macroscopic and microscopic structural parameters and age, to delineate an age-related trajectory. Twenty-six studies were considered for the review, from January 2000 to June 2012. Research results are heterogeneous because of the multifactorial features of schizophrenia and the multiplicity of the methodological approaches adopted. Some areas, within the amygdala-hippocampus complex, which are affected early in life by schizophrenia, age in a physiological way. Other regions, such as the superior temporal gyrus, appear already impaired at the onset of symptoms, undergo a worsening in the acute phase but later stabilize, progressing physiologically over years. Finally, there are regions, such as the uncinate fasciculus, which are not altered early in life, but are affected around the onset of schizophrenia, with their impairment continuously worsening over time. Further extensive longitudinal studies are needed to understand the timing and the possible degenerative characteristics of structural impairment associated with schizophrenia.
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Affiliation(s)
- Chiara Chiapponi
- Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
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Welch KA, Moorhead TW, McIntosh AM, Owens DGC, Johnstone EC, Lawrie SM. Tensor-based morphometry of cannabis use on brain structure in individuals at elevated genetic risk of schizophrenia. Psychol Med 2013; 43:2087-2096. [PMID: 23190458 DOI: 10.1017/s0033291712002668] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Schizophrenia is associated with various brain structural abnormalities, including reduced volume of the hippocampi, prefrontal lobes and thalami. Cannabis use increases the risk of schizophrenia but reports of brain structural abnormalities in the cannabis-using population have not been consistent. We used automated image analysis to compare brain structural changes over time in people at elevated risk of schizophrenia for familial reasons who did and did not use cannabis. METHOD Magnetic resonance imaging (MRI) scans were obtained from subjects at high familial risk of schizophrenia at entry to the Edinburgh High Risk Study (EHRS) and approximately 2 years later. Differential grey matter (GM) loss in those exposed (n=23) and not exposed to cannabis (n=32) in the intervening period was compared using tensor-based morphometry (TBM). RESULTS Cannabis exposure was associated with significantly greater loss of right anterior hippocampal (pcorrected=0.029, t=3.88) and left superior frontal lobe GM (pcorrected=0.026, t=4.68). The former finding remained significant even after the exclusion of individuals who had used other drugs during the inter-scan interval. CONCLUSIONS Using an automated analysis of longitudinal data, we demonstrate an association between cannabis use and GM loss in currently well people at familial risk of developing schizophrenia. This observation may be important in understanding the link between cannabis exposure and the subsequent development of schizophrenia.
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Affiliation(s)
- K A Welch
- Division of Psychiatry, School of Molecular and Clinical Medicine, University of Edinburgh, Royal Edinburgh Hospital, UK.
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Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a prospective longitudinal MRI study. Am J Psychiatry 2013; 170:609-15. [PMID: 23558429 PMCID: PMC3835590 DOI: 10.1176/appi.ajp.2013.12050674] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Longitudinal structural MRI studies have shown that patients with schizophrenia have progressive brain tissue loss after onset. Recurrent relapses are believed to play a role in this loss, but the relationship between relapse and structural MRI measures has not been rigorously assessed. The authors analyzed longitudinal data to examine this question. METHODS The authors studied data from 202 patients drawn from the Iowa Longitudinal Study of first-episode schizophrenia for whom adequate structural MRI data were available (N=659 scans) from scans obtained at regular intervals over an average of 7 years. Because clinical follow-up data were obtained at 6-month intervals, the authors were able to compute measures of relapse number and duration and relate them to structural MRI measures. Because higher treatment intensity has been associated with smaller brain tissue volumes, the authors also examined this countereffect in terms of dose-years. RESULTS Relapse duration was related to significant decreases in both general (e.g., total cerebral volume) and regional (e.g., frontal) brain measures. Number of relapses was unrelated to brain measures. Significant effects were also observed for treatment intensity. CONCLUSIONS Extended periods of relapse may have a negative effect on brain integrity in schizophrenia, suggesting the importance of implementing proactive measures that may prevent relapse and improve treatment adherence. By examining the relative balance of effects, that is, relapse duration versus antipsychotic treatment intensity, this study sheds light on a troublesome dilemma that clinicians face. Relapse prevention is important, but it should be sustained using the lowest possible medication dosages that will control symptoms.
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Longitudinal gray matter change in young people who are at enhanced risk of schizophrenia due to intellectual impairment. Biol Psychiatry 2013; 73:985-92. [PMID: 23332356 DOI: 10.1016/j.biopsych.2012.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Existing studies of brain structural changes before the onset of schizophrenia have considered individuals with either familial risk factors or prodromal symptomatology. We aimed to determine whether findings from these studies are also applicable to those at enhanced risk of developing schizophrenia for another reason-intellectual impairment. METHODS Participants with intellectual impairment (mean IQ: 78.2) received magnetic resonance imaging of the brain at baseline (mean age: 16 years old) and again 6 years later. The Positive and Negative Syndrome Scale was used to assess psychotic symptoms. Participants were dichotomized using their Positive and Negative Syndrome Scale scores at follow-up and gray matter changes were compared between the groups using tensor based morphometry and semiautomated region of interest analysis. RESULTS Forty-six individuals had scans of sufficient quality to be included in the study. The tensor based morphometry analyses revealed that those with psychotic symptoms at follow-up showed significantly greater gray matter reductions over 6 years in the medial temporal lobes bilaterally. Region of interest analyses revealed that those individuals with psychotic symptoms at follow-up showed a reduced right hippocampal volume at age 16 and reduced bilateral hippocampal volumes at follow-up. CONCLUSIONS This unique study of individuals vulnerable to schizophrenia due to intellectual impairment highlights aberrant development in the medial temporal lobe associated with the occurrence of psychotic symptoms. These developmental changes are also evident in populations at enhanced risk of schizophrenia for familial and symptomatic reasons, suggesting they are central to the development of the disorder regardless of the nature of the vulnerability state.
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Fiber pathway pathology, synapse loss and decline of cortical function in schizophrenia. PLoS One 2013; 8:e60518. [PMID: 23593232 PMCID: PMC3620229 DOI: 10.1371/journal.pone.0060518] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 02/28/2013] [Indexed: 11/19/2022] Open
Abstract
A quantitative cortical model is developed, based on both computational and simulation approaches, which relates measured changes in cortical activity of gray matter with changes in the integrity of longitudinal fiber pathways. The model consists of modules of up to 5,000 neurons each, 80% excitatory and 20% inhibitory, with these having different degrees of synaptic connectiveness both within a module as well as between modules. It is shown that if the inter-modular synaptic connections are reduced to zero while maintaining the intra-modular synaptic connections constant, then activity in the modules is reduced by about 50%. This agrees with experimental observations in which cortical electrical activity in a region of interest, measured using the rate of oxidative glucose metabolism (CMRglc(ox)), is reduced by about 50% when the cortical region is isolated, either by surgical means or by transient cold block. There is also a 50% decrease in measured cortical activity following inactivation of the nucleus of Meynert and the intra-laminar nuclei of the thalamus, which arise either following appropriate lesions or in sleep. This occurs in the model if the inter-modular synaptic connections require input from these nuclei in order to function. In schizophrenia there is a 24% decrease in functional anisotropy of longitudinal fasciculi accompanied by a 7% decrease in cortical activity (CMRglc(ox)).The cortical model predicts this, namely for a 24% decrease in the functioning of the inter-modular connections, either through the complete loss of 24% of axons subserving the connections or due to such a decrease in the efficacy of all the inter-modular connections, there will be about a 7% decrease in the activity of the modules. This work suggests that deterioration of longitudinal fasciculi in schizophrenia explains the loss of activity in the gray matter.
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González-Ortega I, de Los Mozos V, Echeburúa E, Mezo M, Besga A, Ruiz de Azúa S, González-Pinto A, Gutierrez M, Zorrilla I, González-Pinto A. Working memory as a predictor of negative symptoms and functional outcome in first episode psychosis. Psychiatry Res 2013; 206:8-16. [PMID: 22985548 DOI: 10.1016/j.psychres.2012.08.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 07/26/2012] [Accepted: 08/25/2012] [Indexed: 12/15/2022]
Abstract
The relationship of neurocognitive course with clinical and functional outcomes in psychosis is not well known, especially in the long term. The aim of the study was to examine the clinical and neuropsychological course of first-episode psychosis patients at 5-year follow-up and analyze the relationship of cognitive performance with clinical and functional outcome. The 5-year follow-up was conducted with 26 first-episode psychosis patients. Psychotic symptoms were measured by the Positive and Negative Syndrome Scale, manic and depressive symptoms by the Young Mania Rating Scale and Hamilton Depression Rating Scale respectively, and psychosocial functioning by the Functioning Assessment Short Test. The cognitive domains were assessed by the Wechsler Adult Intelligence Scale, the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test, the Stroop Colour-Word Test and the Wechsler Memory Scale. Patients showed symptomatic improvement in the follow-up except in negative psychotic symptoms. There was also improvement in most cognitive domains except in working memory and processing speed in the follow-up. Working memory impairment was associated to negative psychotic symptoms and poor functional outcomes. Negative symptoms mediated the relationship between working memory and outcome. Therefore, negative symptoms should be a primary target of treatment to improve functional outcomes.
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Affiliation(s)
- Itxaso González-Ortega
- Department of Psychiatry, Alava University Hospital-Santiago, Department of Neurosciences, University of the Basque Country, CIBERSAM, Vitoria, Spain.
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Chew LJ, Fusar-Poli P, Schmitz T. Oligodendroglial alterations and the role of microglia in white matter injury: relevance to schizophrenia. Dev Neurosci 2013; 35:102-29. [PMID: 23446060 PMCID: PMC4531048 DOI: 10.1159/000346157] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 11/07/2012] [Indexed: 12/12/2022] Open
Abstract
Schizophrenia is a chronic and debilitating mental illness characterized by a broad range of abnormal behaviors, including delusions and hallucinations, impaired cognitive function, as well as mood disturbances and social withdrawal. Due to the heterogeneous nature of the disease, the causes of schizophrenia are very complex; its etiology is believed to involve multiple brain regions and the connections between them, and includes alterations in both gray and white matter regions. The onset of symptoms varies with age and severity, and there is some debate over a degenerative or developmental etiology. Longitudinal magnetic resonance imaging studies have detected progressive gray matter loss in the first years of disease, suggesting neurodegeneration; but there is also increasing recognition of a temporal association between clinical complications at birth and disease onset that supports a neurodevelopmental origin. Presently, neuronal abnormalities in schizophrenia are better understood than alterations in myelin-producing cells of the brain, the oligodendrocytes, which are the predominant constituents of white matter structures. Proper white matter development and its structural integrity critically impacts brain connectivity, which affects sensorimotor coordination and cognitive ability. Evidence of defective white matter growth and compromised white matter integrity has been found in individuals at high risk of psychosis, and decreased numbers of mature oligodendrocytes are detected in schizophrenia patients. Inflammatory markers, including proinflammatory cytokines and chemokines, are also associated with psychosis. A relationship between risk of psychosis, white matter defects and prenatal inflammation is being established. Animal models of perinatal brain injury are successful in producing white matter damage in the brain, typified by hypomyelination and/or dysmyelination, impaired motor coordination and prepulse inhibition of the acoustic startle reflex, recapitulating structural and functional characteristics observed in schizophrenia. In addition, elevated expression of inflammation-related genes in brain tissue and increased production of cytokines by blood cells from patients with schizophrenia indicate immunological dysfunction and abnormal inflammatory responses, which are also important underlying features in experimental models. Microglia, resident immune defenders of the central nervous system, play important roles in the development and protection of neural cells, but can contribute to injury under pathological conditions. This article discusses oligodendroglial changes in schizophrenia and focuses on microglial activity in the context of the disease, in neonatal brain injury and in various experimental models of white matter damage. These include disorders associated with premature birth, and animal models of perinatal bacterial and viral infection, oxygen deprivation (hypoxia) and excess (hyperoxia), and elevated systemic proinflammatory cytokine levels. We briefly review the effects of treatment with antipsychotic and anti-inflammatory agents in models of perinatal brain injury, and comment on the therapeutic potential of these strategies. By understanding the neurobiological basis of oligodendroglial abnormalities in schizophrenia, it is hoped that patients will benefit from the availability of targeted and more efficacious treatment options.
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Affiliation(s)
- Li-Jin Chew
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA.
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49
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Excessive extracellular volume reveals a neurodegenerative pattern in schizophrenia onset. J Neurosci 2013. [PMID: 23197727 DOI: 10.1523/jneurosci.2904-12.2012] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Diffusion MRI has been successful in identifying the existence of white matter abnormalities in schizophrenia in vivo. However, the role of these abnormalities in the etiology of schizophrenia is not well understood. Accumulating evidence from imaging, histological, genetic, and immunochemical studies support the involvement of axonal degeneration and neuroinflammation--ubiquitous components of neurodegenerative disorders--as the underlying pathologies of these abnormalities. Nevertheless, the current imaging modalities cannot distinguish neuroinflammation from axonal degeneration, and therefore provide little specificity with respect to the pathophysiology progression and whether it is related to a neurodegenerative process. Free-water imaging is a new methodology that is sensitive to water molecules diffusing in the extracellular space. Excessive extracellular volume is a surrogate biomarker for neuroinflammation and can be separated out to reveal abnormalities such as axonal degeneration that affect diffusion characteristics in the tissue. We applied free-water imaging on diffusion MRI data acquired from schizophrenia-diagnosed human subjects with a first psychotic episode. We found a significant increase in the extracellular volume in both white and gray matter. In contrast, significant signs of axonal degeneration were limited to focal areas in the frontal lobe white matter. Our findings demonstrate that neuroinflammation is more prominent than axonal degeneration in the early stage of schizophrenia, revealing a pattern shared by many neurodegenerative disorders, in which prolonged inflammation leads to axonal degeneration. These findings promote anti-inflammatory treatment for early diagnosed schizophrenia patients.
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Abnormalities of middle longitudinal fascicle and disorganization in patients with schizophrenia. Schizophr Res 2013; 143:253-9. [PMID: 23290607 PMCID: PMC3587354 DOI: 10.1016/j.schres.2012.11.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 11/23/2012] [Accepted: 11/28/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The middle longitudinal fascicle (MdLF) is a long association fiber connecting the superior temporal gyrus (STG) and temporal pole with the angular gyrus through the white matter of the STG, structures which are known to play a crucial role in the pathology of schizophrenia. Functions of MdLF are thought to be related to language and thought processing in the left hemisphere, and with attention in the right hemisphere. While deficits of these functions are core clinical features of schizophrenia, no study has investigated the structural abnormalities of MdLF in schizophrenia. METHOD 3T diffusion tensor data was acquired from twenty-six patients with schizophrenia and twenty-five healthy control subjects. Streamline tractography technique was used to extract MdLF. Fractional anisotropy (FA) was compared between the two groups. In addition, relationships were investigated between FA in the left MdLF and the Disorganized Thoughts Factor derived from the Positive and Negative Symptom Scale five factor model, and between FA in the right MdLF and the Poor Attention. RESULT Relative to control subjects, the patients with chronic schizophrenia showed significant mean FA reductions in the bilateral MdLF. The FA of the left MdLF demonstrated a significant negative association with the Disorganized Thoughts Factor, and the FA of the right MdLF showed a significant negative relationship with the Poor Attention. CONCLUSIONS This study provides new evidence for structural deficits in the bilateral MdLF in patients with chronic schizophrenia. It further demonstrates the contribution of these abnormalities to the core clinical features - especially to disorganization and attention deficit.
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