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Biondi M, Marino M, Mantini D, Spironelli C. Unveiling altered connectivity between cognitive networks and cerebellum in schizophrenia. Schizophr Res 2024; 271:47-58. [PMID: 39013344 DOI: 10.1016/j.schres.2024.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/12/2024] [Accepted: 06/23/2024] [Indexed: 07/18/2024]
Abstract
Cognitive functioning is a crucial aspect in schizophrenia (SZ), and when altered it has devastating effects on patients' quality of life and treatment outcomes. Several studies suggested that they could result from altered communication between the cortex and cerebellum. However, the neural correlates underlying these impairments have not been identified. In this study, we investigated resting state functional connectivity (rsFC) in SZ patients, by considering the interactions between cortical networks supporting cognition and cerebellum. In addition, we investigated the relationship between SZ patients' rsFC and their symptoms. We used fMRI data from 74 SZ patients and 74 matched healthy controls (HC) downloaded from the publicly available database SchizConnect. We implemented a seed-based connectivity approach to identify altered functional connections between specific cortical networks and cerebellum. We considered ten commonly studied resting state networks, whose functioning encompasses specific cognitive functions, and the cerebellum, whose involvement in supporting cognition has been recently identified. We then explored the relationship between altered rsFC values and Positive and Negative Syndrome Scale (PANSS) scores. The SZ group showed increased connectivity values compared with HC group for cortical networks involved in attentive processes, which were also linked to PANSS items describing attention and language-related processing. We also showed decreased connectivity between cerebellar regions, and increased connectivity between them and attentive networks, suggesting the contribution of cerebellum to attentive and affective deficits. In conclusion, our findings highlighted the link between negative symptoms in SZ and altered connectivity within the cerebellum and between the same and cortical networks supporting cognition.
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Affiliation(s)
| | - Marco Marino
- Department of General Psychology, University of Padova, Italy; Movement Control and Neuroplasticity Research Group, KU, Leuven, Belgium
| | - Dante Mantini
- Movement Control and Neuroplasticity Research Group, KU, Leuven, Belgium.
| | - Chiara Spironelli
- Padova Neuroscience Center, University of Padova, Italy; Department of General Psychology, University of Padova, Italy
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2
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Daidone C, Rai HP, Loveless K. Exploring the Impact of Auditory Hallucinations on Sudden Sensorineural Hearing Loss in Adulthood: A Case Report. Cureus 2024; 16:e53764. [PMID: 38465126 PMCID: PMC10921975 DOI: 10.7759/cureus.53764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/07/2024] [Indexed: 03/12/2024] Open
Abstract
Auditory hallucinations are sounds that patients perceive as coming from outside of their body. Though the mechanism causing auditory hallucinations is not entirely understood, there is a significant amount of evidence suggesting that auditory hallucinations leave lasting impacts on the brain in the same regions that are involved in auditory processing. Sudden sensorineural hearing loss (SSNHL) is a poorly understood condition in which patients lose their hearing typically in the fifth decade of life. Here we present a case of a 42-year-old female with a history of schizophrenia with auditory hallucinations who experienced SSNHL at age 40. As the patient had no known risk factors for SSNHL, we propose that this patient's SSNHL is linked to her history of auditory hallucinations. Through the presentation of this case, we hope to explore the pathogenesis of auditory hallucinations and investigate a potentially bidirectional association between auditory hallucinations and SSNHL. This study calls for further investigation into the impacts of auditory hallucinations on the brain, possible etiologies of SSNHL, and the possibility that auditory hallucinations serve as a risk factor for SSNHL.
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Affiliation(s)
- Camryn Daidone
- Research, Edward Via College of Osteopathic Medicine, Shreveport, USA
| | - Hitesh P Rai
- Research, Edward Via College of Osteopathic Medicine, Shreveport, USA
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Thomas F, Gallea C, Moulier V, Bouaziz N, Valero-Cabré A, Januel D. Local Alterations of Left Arcuate Fasciculus and Transcallosal White Matter Microstructure in Schizophrenia Patients with Medication-resistant Auditory Verbal Hallucinations: A Pilot Study. Neuroscience 2022; 507:1-13. [PMID: 36370935 DOI: 10.1016/j.neuroscience.2022.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022]
Abstract
Auditory verbal hallucinations (AVH) in schizophrenia (SZ) have been associated with abnormalities of the left arcuate fasciculus and transcallosal white matter projections linking homologous language areas of both hemispheres. While most studies have used a whole-tract approach, here we focused on analyzing local alterations of the above-mentioned pathways in SZ patients suffering medication-resistant AVH. Fractional anisotropy (FA) was estimated along the left arcuate fasciculus and interhemispheric projections of the rostral and caudal corpus callosum. Then, potential associations between white matter tracts and SZ symptoms were explored by correlating local site-by-site FA values and AVH severity estimated via the Auditory Hallucinations Rating Scale (AHRS). Compared to a sample of healthy controls, SZ patients displayed lower FA values in the rostral portion of the left arcuate fasciculus, near the frontal operculum, and in the left and right lateral regions of the rostral portion of the transcallosal pathways. In contrast, SZ patients showed higher FA values than healthy controls in the medial portion of the latter transcallosal pathway and in the midsagittal section of the interhemispheric auditory pathway. Finally, significant correlations were found between local FA values in the left arcuate fasciculus and the severity of the AVH's attentional salience. Contributing to the study of associations between local white matter alterations of language networks and SZ symptoms, our findings highlight local alterations of white matter integrity in these pathways linking language areas in SZ patients with AVH. We also hypothesize a link between the left arcuate fasciculus and the attentional capture of AVH.
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Affiliation(s)
- Fanny Thomas
- Centre de Recherche Clinique, Établissement Public de Santé de Ville-Evrard, 202 avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France; Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB, Institut du Cerveau, CNRS UMR 7225, INSERM UMRS 1127, France.
| | - Cécile Gallea
- Movement Investigations and Therapeutics, MOVIT, Institut du Cerveau, CNRS UMR 7225, INSERM UMRS 1127, France; Université Pierre et Marie Curie, 47 boulevard de l'Hôpital, 75013 Paris, France
| | - Virginie Moulier
- Centre de Recherche Clinique, Établissement Public de Santé de Ville-Evrard, 202 avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France; Centre Hospitalier du Rouvray, University Department of Psychiatry, 76301 Sotteville-lès-Rouen, France
| | - Noomane Bouaziz
- Centre de Recherche Clinique, Établissement Public de Santé de Ville-Evrard, 202 avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France
| | - Antoni Valero-Cabré
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB, Institut du Cerveau, CNRS UMR 7225, INSERM UMRS 1127, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University School of Medicine, 700 Albany Street, Boston, MA W-702A, USA; Université Pierre et Marie Curie, 47 boulevard de l'Hôpital, 75013 Paris, France
| | - Dominique Januel
- Centre de Recherche Clinique, Établissement Public de Santé de Ville-Evrard, 202 avenue Jean Jaurès, 93330 Neuilly-sur-Marne, France; Université Sorbonne Paris Nord, Campus de Bobigny, 1 rue de Chablis, 93000 Bobigny
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Xie Y, He Y, Guan M, Zhou G, Wang Z, Ma Z, Wang H, Yin H. Impact of low-frequency rTMS on functional connectivity of the dentate nucleus subdomains in schizophrenia patients with auditory verbal hallucination. J Psychiatr Res 2022; 149:87-96. [PMID: 35259665 DOI: 10.1016/j.jpsychires.2022.02.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 01/10/2023]
Abstract
Despite low-frequency repetitive transcranial magnetic stimulation (rTMS) is effective in treating schizophrenia patients with auditory verbal hallucinations (AVH), the underlying neural mechanisms of the effect still need to be clarified. Using the cerebellar dentate nucleus (DN) subdomain (dorsal and versal DN) as seeds, the present study investigated resting state functional connectivity (FC) alternations of the seeds with the whole brain and their associations with clinical responses in schizophrenia patients with AVH receiving 1 Hz rTMS treatment. The results showed that the rTMS treatment improved the psychiatric symptoms (e.g., AVH and positive symptoms) and certain neurocognitive functions (e.g., visual learning and verbal learning) in the patients. In addition, the patients at baseline showed increased FC between the DN subdomains and temporal lobes (e.g., right superior temporal gyrus and right middle temporal gyrus) and decreased FC between the DN subdomains and the left superior frontal gyrus, right postcentral gyrus, left supramarginal gyrus and regional cerebellum (e.g., lobule 4-5) compared to controls. Furthermore, these abnormal DN subdomain connectivity patterns did not persist and decreased FC of DN subdomains with cerebellum lobule 4-5 were reversed in patients after rTMS treatment. Linear regression analysis showed that the FC difference values of DN subdomains with the temporal lobes, supramarginal gyrus and cerebellum 4-5 between the patients at baseline and posttreatment were associated with clinical improvements (e.g., AVH and verbal learning) after rTMS treatment. The results suggested that rTMS treatment may modulate the neural circuits of the DN subdomains and hint to underlying neural mechanisms for low-frequency rTMS treating schizophrenia with AVH.
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Affiliation(s)
- Yuanjun Xie
- School of Education, Xinyang College, Xinyang, China; Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Ying He
- Department of Psychiatry, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Muzhen Guan
- Department of Mental Health, Xi'an Medical University, Xi'an, China
| | | | - Zhongheng Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhujing Ma
- Department of Military Psychology, School of Psychology, Fourth Military Medical University, Xi'an, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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Zhong S, Hu Y, Fu Y, Cao L, Zhang B. Functional MRI in the effect of transcranial magnetic stimulation therapy for patients with schizophrenia: a meta-analysis protocol. BMJ Open 2020; 10:e038557. [PMID: 33268405 PMCID: PMC7713205 DOI: 10.1136/bmjopen-2020-038557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Schizophrenia is a psychiatric illness associated with brain function alterations and varying degree of treatment resistance, often leading to severe social malfunctioning. In recent decades, numerous studies have been investigating the therapeutic potential of transcranial magnetic stimulation (TMS) as a non-invasive therapy for schizophrenia. However, its clinical efficacy remains controversial, as a number of clinical trials indicated moderate therapeutic effect while others failed to reproduce the positive result. Moreover, the neurobiological mechanism of action remains unclear, possibly constricting the application of TMS in clinical practice. The present protocol of meta-analysis aims to investigate the TMS-related functional neuroimaging (ie, functional MRI) features and alterations in subjects with schizophrenia, and to discuss the potential of functional MRI in TMS researches. METHODS AND ANALYSIS The study selection process will follow the Preferred Reporting Items for Meta-Analyses guideline and quality assessment will be conducted with a customised checklist. We plan to search in the following databases: PubMed, Embase, OVID, China National Knowledge Infrastructure and Wanfang Data, from their respective dates of inception to 1 May 2020, with language restricted to English and Chinese. Studies focusing on the brain functional alterations in patients with schizophrenia treated by TMS will be retrieved. ETHICS AND DISSEMINATION This work does not require ethics approval as it will be based on published studies. This systematic review will be publicly disseminated in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42020166288.
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Affiliation(s)
- Siqian Zhong
- PsyNI Lab, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yiru Hu
- PsyNI Lab, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Fu
- PsyNI Lab, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liping Cao
- PsyNI Lab, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin Zhang
- PsyNI Lab, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Kar SK, Menon V. Repetitive Transcranial Magnetic Stimulation in Persistent Auditory Hallucination in Schizophrenia: Predictors of Response. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00218-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Li J, Cao X, Liu S, Li X, Xu Y. Efficacy of repetitive transcranial magnetic stimulation on auditory hallucinations in schizophrenia: A meta-analysis. Psychiatry Res 2020; 290:113141. [PMID: 32521380 DOI: 10.1016/j.psychres.2020.113141] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/24/2020] [Indexed: 10/24/2022]
Abstract
To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on auditory hallucinations (AH) in schizophrenia, we conducted a meta-analysis of currently available randomized control studies (RCTs). Electronic databases were searched to identify relevant literatures. Only RCTs that met the inclusion criteria were enrolled for further analysis. Standard mean difference (SMD) and 95% confidence interval (CI) values were used to evaluate the effects of rTMS. The overall robustness of the results was assessed by analyzing the influence of single studies. Publication bias was analyzed using funnel plots. Eleven eligible studies were included in this meta-analysis. Auditory hallucinations improved more in the rTMS group than in the sham group (SMD = -0.27, 95%CI = -0.51 to -0.03). However, this result was not stable after sensitivity analysis. Despite a moderate effect for rTMS on AH, future definitive trials of rTMS with rigorous processes and high-quality reporting are needed.
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Affiliation(s)
- Jingya Li
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaohua Cao
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xinrong Li
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Yong Xu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; Department of Mental Health, Shanxi Medical University, Taiyuan, China.
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Zhuo C, Ji F, Lin X, Tian H, Wang L, Xu Y, Wang W, Jiang D. Global functional connectivity density alterations in patients with bipolar disorder with auditory verbal hallucinations and modest short-term effects of transcranial direct current stimulation augmentation treatment-Baseline and follow-up study. Brain Behav 2020; 10:e01637. [PMID: 32304288 PMCID: PMC7303392 DOI: 10.1002/brb3.1637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/18/2020] [Accepted: 03/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To investigate the neuroimaging characteristics of auditory verbal hallucinations (AVHs) in patients with bipolar disorder (BP) experiencing depressive episodes with and without AVHs, and alterations in those characteristics after transcranial direct current stimulation (tDCS). METHODS For a baseline pilot study, we recruited 80 patients with BP and depressive status (40 with and 40 without AVHs), and 40 healthy controls (HCs). Their global functional connectivity density (gFCD) was screened by functional magnetic resonance imaging (fMRI). Voxel-wise one-way analysis of covariance (ANCOVA) was conducted to detect intergroup differences in gFCD. In a follow-up study, the effects of 5 weeks of tDCS augmentation treatment on clinical symptoms and gFCD were assessed in the 40 BP patients with AVHs. RESULTS Compared to HCs, BP patients with and without AVHs exhibited increased gFCD in the central parietal lobe, insular lobe, and middle cingulate cortex, with decreased gFCD in the posterior parietal cortex, lateral prefrontal cortex, and occipital lobe (all bilateral). Only patients with AVHs showed increased gFCD in the Broca and Wernicke regions, and decreased gFCD in the hippocampus (all bilateral). After 5 weeks of tDCS, AVHs were slightly alleviated and gFCD abnormalities in the hippocampus were mildly attenuated. CONCLUSIONS Patients with BP and AVHs showed disturbances in the brain's communication capacity mainly in the left frontoparietal network, control network, and memory circuitry. Five weeks of tDCS alleviated AVHs slightly, without improving depressive symptoms, and attenuated hippocampal gFCD alterations in these patients.
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Affiliation(s)
- Chuanjun Zhuo
- School of Mental Health, Jining Medical University, Jining, China.,Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China.,Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, China
| | - Feng Ji
- School of Mental Health, Jining Medical University, Jining, China
| | - Xiaodong Lin
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Wenqiang Wang
- Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, China
| | - Deguo Jiang
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
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Gong J, Wang J, Luo X, Chen G, Huang H, Huang R, Huang L, Wang Y. Abnormalities of intrinsic regional brain activity in first-episode and chronic schizophrenia: a meta-analysis of resting-state functional MRI. J Psychiatry Neurosci 2020; 45:55-68. [PMID: 31580042 PMCID: PMC6919918 DOI: 10.1503/jpn.180245] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Resting-state functional MRI (fMRI) studies have provided much evidence for abnormal intrinsic brain activity in schizophrenia, but results have been inconsistent. METHODS We conducted a meta-analysis of whole-brain, resting-state fMRI studies that explored differences in amplitude of low-frequency fluctuation (ALFF) between people with schizophrenia (including first episode and chronic) and healthy controls. RESULTS A systematic literature search identified 24 studies comparing a total of 1249 people with schizophrenia and 1179 healthy controls. Overall, patients with schizophrenia displayed decreased ALFF in the bilateral postcentral gyrus, bilateral precuneus, left inferior parietal gyri and right occipital lobe, and increased ALFF in the right putamen, right inferior frontal gyrus, left inferior temporal gyrus and right anterior cingulate cortex. In the subgroup analysis, patients with first-episode schizophrenia demonstrated decreased ALFF in the bilateral inferior parietal gyri, right precuneus and left medial prefrontal cortex, and increased ALFF in the bilateral putamen and bilateral occipital gyrus. Patients with chronic schizophrenia showed decreased ALFF in the bilateral postcentral gyrus, left precuneus and right occipital gyrus, and increased ALFF in the bilateral inferior frontal gyri, bilateral superior frontal gyrus, left amygdala, left inferior temporal gyrus, right anterior cingulate cortex and left insula. LIMITATIONS The small sample size of our subgroup analysis, predominantly Asian samples, processing steps and publication bias could have limited the accuracy of the results. CONCLUSION Our comprehensive meta-analysis suggests that findings of aberrant regional intrinsic brain activity during the initial stages of schizophrenia, and much more widespread damage with the progression of disease, may contribute to our understanding of the progressive pathophysiology of schizophrenia.
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Affiliation(s)
- Jiaying Gong
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Junjing Wang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Xiaomei Luo
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Guanmao Chen
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Huiyuan Huang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Ruiwang Huang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Li Huang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
| | - Ying Wang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou China (Gong, Luo, Chen, Huang, Wang); the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (Wang); the School of Psychology, Institute of Brain Research and Rehabilitation (IBRR), Center for the Study of Applied Psychology & MRI Center, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou China (Huang, Huang)
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Thomas F, Bouaziz N, Gallea C, Schenin-King Andrianisaina P, Durand F, Bolloré O, Benadhira R, Isaac C, Braha-Zeitoun S, Moulier V, Valero-Cabré A, Januel D. Structural and functional brain biomarkers of clinical response to rTMS of medication-resistant auditory hallucinations in schizophrenia patients: study protocol for a randomized sham-controlled double-blind clinical trial. Trials 2019; 20:229. [PMID: 31014369 PMCID: PMC6480831 DOI: 10.1186/s13063-019-3311-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 03/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The potential of non-invasive repetitive transcranial magnetic stimulation (rTMS) to improve auditory verbal hallucinations (AVH) in schizophrenia patients has been increasingly explored over the past decade. Despite highly promising results, high inter-individual variability of clinical response and ineffective outcomes in a significant number of patients underscored the need to identify factors associated with the clinical response to rTMS. It should help improve the efficacy of rTMS in patients with medication-resistant AVH, and allow a better understanding of its neural impact. Here, we describe an exploratory study protocol which aims to identify structural and functional brain biomarkers associated with clinical response after an rTMS treatment for medication-resistant AVH in schizophrenia. METHODS Forty-five schizophrenia patients with medication-resistant AVH will be enrolled in a double-blind randomized sham-controlled monocentric clinical trial. Patients will be assigned to a regime of 20 sessions of active or sham 1 Hz rTMS delivered twice a day, 5 days a week for 2 weeks over the left temporo-parietal junction. Response will be assessed after rTMS and patients will be classified in responders or non-responders to treatment. Magnetic resonance imaging (MRI) sessions including diffusion weighted imaging and resting-state functional MRI sequences will be recorded before the onset of the rTMS treatment and 3 days following its discontinuation. The primary outcome measure is difference in fractional anisotropy between responder and non-responder patients at baseline. Differences in resting-state functional MRI data at baseline will be also investigated between responder and non-responder groups. Clinical, neuropsychological, neurophysiological, and blood serum BDNF assessments will be performed at baseline, 3 days, 1 month, and 3 months following rTMS. DISCUSSION The aim of this research project is to identify and assess the biomarker value of MRI-based structural and functional biomarkers predicting clinical response to rTMS for AVH in schizophrenia patients. The outcome of the trial should improve patient care by offering them a novel suitable therapy and deepen our understanding on how rTMS may impact AVH and develop more effective therapies adapted to individual patient needs. TRIAL REGISTRATION ClinicalTrials.gov, NCT02755623 . Registered on 22 April 2016.
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Affiliation(s)
- Fanny Thomas
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France.,Cerebral Dynamics, Plasticity and Rehabilitation Group, Frontlab, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière, CNRS UMR 7225, INSERM UMRS 1127 and Université Pierre et Marie Curie, 47 boulevard de l'Hôpital, 75013, Paris, France.,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France
| | - Noomane Bouaziz
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France
| | - Cécile Gallea
- Movement Investigations and Therapeutics, MOV'IT, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière, CNRS UMR 7225, INSERM UMRS 1127 and Université Pierre et Marie Curie, 47 boulevard de l'Hôpital, 75013, Paris, France
| | - Palmyre Schenin-King Andrianisaina
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France.,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France
| | - Florence Durand
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France.,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France
| | - Ombline Bolloré
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France
| | - René Benadhira
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France.,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France
| | - Clémence Isaac
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France.,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France
| | - Sonia Braha-Zeitoun
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France.,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France
| | - Virginie Moulier
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France
| | - Antoni Valero-Cabré
- Cerebral Dynamics, Plasticity and Rehabilitation Group, Frontlab, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière, CNRS UMR 7225, INSERM UMRS 1127 and Université Pierre et Marie Curie, 47 boulevard de l'Hôpital, 75013, Paris, France. .,Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University School of Medicine, 700 Albany Street, Boston, MA, W-702A, USA.
| | - Dominique Januel
- Unité de Recherche Clinique, Établissement Public de Santé Ville-Evrard, 202 avenue Jean Jaurès, 93332, Neuilly-sur-Marne, France. .,Laboratoire de psychopathologie et de neuropsychologie, Université Paris 8, 2 rue de la Liberté, 93526, Saint-Denis, France.
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