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Bogie BJ, Noël C, Gu F, Nadeau S, Shvetz C, Khan H, Rivard MC, Bouchard S, Lepage M, Guimond S. Using virtual reality to improve verbal episodic memory in schizophrenia: A proof-of-concept trial. Schizophr Res Cogn 2024; 36:100305. [PMID: 38486790 PMCID: PMC10937232 DOI: 10.1016/j.scog.2024.100305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/17/2024]
Abstract
Background Schizophrenia is associated with impairments in verbal episodic memory. Strategy for Semantic Association Memory (SESAME) training represents a promising cognitive remediation program to improve verbal episodic memory. Virtual reality (VR) may be a novel tool to increase the ecological validity and transfer of learned skills of traditional cognitive remediation programs. The present proof-of-concept study aimed to assess the feasibility, acceptability, and preliminary efficacy of a VR-based cognitive remediation module inspired by SESAME principles to improve the use of verbal episodic memory strategies in schizophrenia. Methods Thirty individuals with schizophrenia/schizoaffective disorder completed this study. Participants were randomized to either a VR-based verbal episodic memory training condition inspired by SESAME principles (intervention group) or an active control condition (control group). In the training condition, a coach taught semantic encoding strategies (active rehearsal and semantic clustering) to help participants remember restaurant orders in VR. In the active control condition, participants completed visuospatial puzzles in VR. Attrition rate, participant experience ratings, and cybersickness questionnaires were used to assess feasibility and acceptability. Trial 1 of the Hopkins Verbal Learning Test - Revised was administered pre- and post-intervention to assess preliminary efficacy. Results Feasibility was demonstrated by a low attrition rate (5.88 %), and acceptability was demonstrated by limited cybersickness and high levels of enjoyment. Although the increase in the number of semantic clusters used following the module did not reach conventional levels of statistical significance in the intervention group, it demonstrated a notable trend with a medium effect size (t = 1.48, p = 0.15, d = 0.54), in contrast to the control group where it remained stable (t = 0.36, p = 0.72, d = 0.13). These findings were similar for the semantic clustering ratio in the intervention (t = 1.61, p = 0.12, d = 0.59) and control (t = 0.36, p = 0.72, d = 0.13) groups. There was no significant change in the number of recalled words in either group following VR immersion. Discussion This VR intervention was feasible, acceptable, and may be useful for improving the use of semantic encoding strategies. These findings support the use of more ecological approaches for the treatment of cognitive impairments in schizophrenia, such as VR-based cognitive remediation.
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Affiliation(s)
- Bryce J.M. Bogie
- MD/PhD Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Chelsea Noël
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Feng Gu
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Sébastien Nadeau
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Cecelia Shvetz
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Hassan Khan
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Marie-Christine Rivard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
- Centre de recherche, Centre Intégré de Santé et de Services Sociaux de l'Outaouais, Gatineau, QC, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Martin Lepage
- Douglas Research Centre, Montréal, QC, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Synthia Guimond
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
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Zhong M, Liu Z, Wang F, Yang J, Chen E, Lee E, Wu G, Yang J. Effects of long-term antipsychotic medication on brain instability in first-episode schizophrenia patients: a resting-state fMRI study. Front Pharmacol 2024; 15:1387123. [PMID: 38846088 PMCID: PMC11153814 DOI: 10.3389/fphar.2024.1387123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/02/2024] [Indexed: 06/09/2024] Open
Abstract
Early initiation of antipsychotic treatment plays a crucial role in the management of first-episode schizophrenia (FES) patients, significantly improving their prognosis. However, limited attention has been given to the long-term effects of antipsychotic drug therapy on FES patients. In this research, we examined the changes in abnormal brain regions among FES patients undergoing long-term treatment using a dynamic perspective. A total of 98 participants were included in the data analysis, comprising 48 FES patients, 50 healthy controls, 22 patients completed a follow-up period of more than 6 months with qualified data. We processed resting-state fMRI data to calculate coefficient of variation of fractional amplitude of low-frequency fluctuations (CVfALFF), which reflects the brain regional activity stability. Data analysis was performed at baseline and after long-term treatment. We observed that compared with HCs, patients at baseline showed an elevated CVfALFF in the supramarginal gyrus (SMG), parahippocampal gyrus (PHG), caudate, orbital part of inferior frontal gyrus (IOG), insula, and inferior frontal gyrus (IFG). After long-term treatment, the instability in SMG, PHG, caudate, IOG, insula and inferior IFG have ameliorated. Additionally, there was a positive correlation between the decrease in dfALFF in the SMG and the reduction in the SANS total score following long-term treatment. In conclusion, FES patients exhibit unstable regional activity in widespread brain regions at baseline, which can be ameliorated with long-term treatment. Moreover, the extent of amelioration in SMG instability is associated with the amelioration of negative symptoms.
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Affiliation(s)
- Maoxing Zhong
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Feiwen Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jun Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Eric Chen
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Edwin Lee
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Guowei Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jie Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Bogie BJM, Noël C, Alftieh A, MacDonald J, Lei YT, Mongeon J, Mayaud C, Dans P, Guimond S. Verbal memory impairments in mood disorders and psychotic disorders: A systematic review of comparative studies. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110891. [PMID: 37931773 DOI: 10.1016/j.pnpbp.2023.110891] [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: 06/20/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Mood and psychotic disorders are both associated with verbal memory impairments. Verbal memory represents an important treatment target for both disorders. However, whether the neurocognitive and neurophysiological profiles of verbal memory impairments differ between specific disorders within these two diagnostic categories and healthy controls remains unclear. The current systematic review synthesized findings from comparative studies which used behavioural and neuroimaging tasks to investigate verbal memory impairments between: (1) mood disorder, psychotic disorder, and healthy control groups; and (2) mood disorder without psychotic features, mood disorder with psychotic features, and healthy control groups. METHODS The search strategy combined terms related to three main concepts: 'mood disorders', 'psychotic disorders', and 'verbal memory'. Searches were executed in Embase, MEDLINE, PsycInfo, and PubMed databases. A total of 38 articles met the full eligibility criteria and were included in the final narrative synthesis. Findings were stratified by memory domain (overall composite score, verbal working memory, immediate recall, delayed recall, and recognition memory) and by illness phase (acute and non-acute). RESULTS Mood and psychotic disorders displayed consistent verbal memory impairments compared to healthy controls during the acute and non-acute phases. Few significant differences were identified in the literature between mood and psychotic disorders, and between mood disorders with and without psychotic features. Individuals with schizophrenia were found to have decreased immediate and delayed verbal recall performance compared to bipolar disorder groups during the acute phase. Major depressive disorder groups with psychotic features were also found to have decreased delayed verbal recall performance compared to those without psychosis during the acute phase. No consistent differences were identified between mood and psychotic disorders during the non-acute phase. Finally, preliminary evidence suggests there may be functional abnormalities in important frontal and temporal brain regions related to verbal memory difficulties in both mood and psychotic disorders. DISCUSSION The current findings have potential implications for the diagnosis and treatment of cognitive impairments in mood and psychotic disorders. Verbal recall memory may serve as a sensitive tool in the risk stratification of cognitive impairments for certain mood and psychotic disorders. Moreover, since no widespread differences between clinical groups were identified, the evidence supports providing targeted interventions for verbal memory, such as pharmacological and non-pharmacological interventions, through a trans-diagnostic approach in mood and psychotic disorders.
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Affiliation(s)
- Bryce J M Bogie
- MD/PhD Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Chelsea Noël
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Ahmad Alftieh
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Julia MacDonald
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Ya Ting Lei
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Jamie Mongeon
- The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Claire Mayaud
- Department of Psychology, University of Bordeaux, France
| | - Patrick Dans
- Temerty Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Synthia Guimond
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; The Royal's Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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Van Assche L, Takamiya A, Van den Stock J, Van de Ven L, Luyten P, Emsell L, Vandenbulcke M. A voxel- and source-based morphometry analysis of grey matter volume differences in very-late-onset schizophrenia-like psychosis. Psychol Med 2024; 54:592-600. [PMID: 37577955 DOI: 10.1017/s0033291723002258] [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] [Indexed: 08/15/2023]
Abstract
BACKGROUND Very-late-onset schizophrenia-like psychosis (VLOSLP) is associated with significant burden. Its clinical importance is increasing as the global population of older adults rises, yet owing to limited research in this population, the neurobiological underpinnings of VLOSP remain insufficiently clarified. Here we address this knowledge gap using novel morphometry techniques to investigate grey matter volume (GMV) differences between VLOSLP and healthy older adults, and their correlations with neuropsychological scores. METHODS In this cross-sectional study, we investigated whole-brain GMV differences between 35 individuals with VLOSLP (mean age 76.7, 26 female) and 36 healthy controls (mean age 75.7, 27 female) using whole-brain voxel-based morphometry (VBM) and supplementary source-based morphometry (SBM) on high resolution 3D T1-weighted MRI images. Additionally, we investigated relationships between GMV differences and cognitive function assessed with an extensive neuropsychological battery. RESULTS VBM showed lower GMV in the thalamus, left inferior frontal gyrus and left insula in patients with VLOSLP compared to healthy controls. SBM revealed lower thalamo-temporal GMV in patients with VLOSLP. Processing speed, selective attention, mental flexibility, working memory, verbal memory, semantic fluency and confrontation naming were impaired in patients with VLOSLP. Correlations between thalamic volumes and memory function were significant within the group of individuals with VLOSLP, whereas no significant associations remained in the healthy controls. CONCLUSIONS Lower GMV in the thalamus and fronto-temporal regions may be part of the underlying neurobiology of VLOSLP, with lower thalamic GMV contributing to memory impairment in the disorder.
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Affiliation(s)
- Lies Van Assche
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Akihiro Takamiya
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Jan Van den Stock
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Luc Van de Ven
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- Research Department of Clinical Educational and Health Psychology, University College London, London, UK
| | - Louise Emsell
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Translational MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
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5
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Brain Morphological Characteristics of Cognitive Subgroups of Schizophrenia-Spectrum Disorders and Bipolar Disorder: A Systematic Review with Narrative Synthesis. Neuropsychol Rev 2023; 33:192-220. [PMID: 35194692 PMCID: PMC9998576 DOI: 10.1007/s11065-021-09533-0] [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: 12/17/2020] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
Despite a growing body of research, there is yet to be a cohesive synthesis of studies examining differences in brain morphology according to patterns of cognitive function among both schizophrenia-spectrum disorder (SSD) and bipolar disorder (BD) individuals. We aimed to provide a systematic overview of the morphological differences-inclusive of grey and white matter volume, cortical thickness, and cortical surface area-between cognitive subgroups of these disorders and healthy controls, and between cognitive subgroups themselves. An initial search of PubMed and Scopus databases resulted in 1486 articles of which 20 met inclusion criteria and were reviewed in detail. The findings of this review do not provide strong evidence that cognitive subgroups of SSD or BD map to unique patterns of brain morphology. There is preliminary evidence to suggest that reductions in cortical thickness may be more strongly associated with cognitive impairment, whilst volumetric deficits may be largely tied to the presence of disease.
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6
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Oomen PP, Gangadin SS, Begemann MJH, Visser E, Mandl RCW, Sommer IEC. The neurobiological characterization of distinct cognitive subtypes in early-phase schizophrenia-spectrum disorders. Schizophr Res 2022; 241:228-237. [PMID: 35176721 DOI: 10.1016/j.schres.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Cognitive deficits are present in some, but not all patients with schizophrenia-spectrum disorders (SSD). We and others have demonstrated three cognitive clusters: cognitively intact patients, patients with deficits in a few domains and those with global cognitive deficits. This study aimed to identify cognitive subtypes of early-phase SSD with matched controls as a reference group, and evaluated cognitive subgroups regarding clinical and brain volumetric measures. METHODS Eighty-six early-phase SSD patients were included. Hierarchical cluster analysis was conducted using global performance on the Brief Assessment of Cognition in Schizophrenia (BACS). Cognitive subgroups were subsequently related to clinical and brain volumetric measures (cortical, subcortical and cortical thickness) using ANCOVA. RESULTS Three distinct cognitive clusters emerged: relative to controls we found one cluster of patients with preserved cognition (n = 25), one moderately impaired cluster (n = 38) and one severely impaired cluster (n = 23). Cognitive subgroups were characterized by differences in volume of the left postcentral gyrus, left middle caudal frontal gyrus and left insula, while differences in cortical thickness were predominantly found in fronto-parietal regions. No differences were demonstrated in subcortical brain volume. DISCUSSION Current results replicate the existence of three distinct cognitive subgroups including one relatively large group with preserved cognitive function. Cognitive subgroups were characterized by differences in cortical regional brain volume and cortical thickness, suggesting associations with cortical, but not subcortical development and cognitive functioning such as attention, executive functions and speed of processing.
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Affiliation(s)
- P P Oomen
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
| | - S S Gangadin
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - M J H Begemann
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - E Visser
- Department of Psychiatry, University Medical Center, Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - R C W Mandl
- Department of Psychiatry, University Medical Center, Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - I E C Sommer
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
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Shvetz C, Gu F, Drodge J, Torous J, Guimond S. Validation of an ecological momentary assessment to measure processing speed and executive function in schizophrenia. NPJ SCHIZOPHRENIA 2021; 7:64. [PMID: 34934063 PMCID: PMC8692600 DOI: 10.1038/s41537-021-00194-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 11/03/2021] [Indexed: 11/08/2022]
Abstract
Cognitive impairments are a core feature of schizophrenia that have negative impacts on functional outcomes. However, it remains challenging to assess these impairments in clinical settings. Smartphone apps provide the opportunity to measure cognitive impairments in an accessible way; however, more research is needed to validate these cognitive assessments in schizophrenia. We assessed the initial accessibility, validity, and reliability of a smartphone-based cognitive test to measure cognition in schizophrenia. A total of 29 individuals with schizophrenia and 34 controls were included in the analyses. Participants completed the standard pen-and-paper Trail Making Tests (TMT) A and B, and smartphone-based versions, Jewels Trail Tests (JTT) A and B, at the single in-lab visit. Participants were asked to complete the JTT remotely once per week for three months. We also investigated how subjective sleep quality and mood may affect cognitive performance longitudinally. In-lab and remote JTT scores moderately and positively correlated with in-lab TMT scores. Moderate test-retest reliability was observed across the in-lab, first remote, and last remote completion times of the JTT. Additionally, individuals with schizophrenia had significantly lower performance compared to controls on both the in-lab JTT and TMT. Self-reported mood had a significant effect on JTT A performance over time but no other significant relationships were found remotely. Our results support the initial accessibility, validity and reliability of using the JTT to measure cognition in schizophrenia. Future research to develop additional smartphone-based cognitive tests as well as with larger samples and in other psychiatric populations are warranted.
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Affiliation(s)
- Cecelia Shvetz
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
| | - Feng Gu
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
| | - Jessica Drodge
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - John Torous
- Department of Psychiatry and Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Synthia Guimond
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
- Département de Psychoéducation et Psychologie, Université du Québec en Outaouais, Gatineau, QC, Canada.
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Khalil M, Hollander P, Raucher-Chéné D, Lepage M, Lavigne KM. Structural brain correlates of cognitive function in schizophrenia: A meta-analysis. Neurosci Biobehav Rev 2021; 132:37-49. [PMID: 34822878 DOI: 10.1016/j.neubiorev.2021.11.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
Schizophrenia is characterized by cognitive impairments and widespread structural brain abnormalities. Brain structure-cognition associations have been extensively studied in schizophrenia, typically involving individual cognitive domains or brain regions of interest. Findings in overlapping and diffuse brain regions may point to structural alterations in large-scale brain networks. We performed a systematic review and meta-analysis examining whether brain structure-cognition associations can be explained in terms of biologically meaningful brain networks. Of 7,261 screened articles, 88 were included in a series of meta-analyses assessing publication bias, heterogeneity, and study quality. Significant associations were found between overall brain structure and eight MATRICS-inspired cognitive domains. Brain structure mapped onto the seven Yeo functionally defined networks and extraneous structures (amygdala, hippocampus, and cerebellum) typically showed associations with conceptually related cognitive domains, with higher-level domains (e.g., executive function, social cognition) associated with more networks. These findings synthesize the extensive literature on brain structure and cognition in schizophrenia from a contemporary network neuroscience perspective and suggest that brain structure-cognition associations in schizophrenia may follow functional network architecture.
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Affiliation(s)
- Marianne Khalil
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Philippine Hollander
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Delphine Raucher-Chéné
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France; Cognition, Health, and Society Laboratory (EA 6291), University of Reims, Champagne-Ardenne, Reims, France
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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Carruthers SP, Van Rheenen TE, Karantonis JA, Rossell SL. Characterising Demographic, Clinical and Functional Features of Cognitive Subgroups in Schizophrenia Spectrum Disorders: A Systematic Review. Neuropsychol Rev 2021; 32:807-827. [PMID: 34694542 DOI: 10.1007/s11065-021-09525-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Abstract
Considerable cognitive heterogeneity is present within the schizophrenia spectrum disorder (SSD) population. Several subgroups characterised by more homogenous cognitive profiles have been identified. It is not yet clear however, whether these subgroups represent different points along a continuum of cognitive symptom severity, or whether they reflect unique profiles of the disorder. One way to determine this is by comparing subgroups on their non-cognitive characteristics. The aim of the present review was to systematically summarise our current understanding of the non-cognitive features of the cognitive subgroups of schizophrenia spectrum disorder (SSD). Thirty-five relevant studies were identified from January 1980 to March 2020. Cognitive subgroups were consistently compared on age, sex, education, age of illness onset, illness duration, positive, negative and disorganised symptoms, depression and psychosocial functioning. It was revealed that subgroups were consistently distinguished by education, negative symptom severity and degree of functional impairment; with subgroups characterised by worse cognitive functioning performing/rated worse on these characteristics. The lack of consistent subgroup differences for the majority of the non-cognitive characteristics provides partial support for the notion that cognitive subgrouping in SSD is not simply reflecting a rehash of previously identified clinical subtypes. However, as subgroups were consistently distinguished by three characteristics known to be associated with cognition, our understanding of the extent to which the cognitive subgrouping approach is representing separate subtypes versus subdivisions along a continuum of symptom severity is still not definitive.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - James A Karantonis
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne VIC, Australia
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Blest-Hopley G, O'Neill A, Wilson R, Giampietro V, Bhattacharyya S. Disrupted parahippocampal and midbrain function underlie slower verbal learning in adolescent-onset regular cannabis use. Psychopharmacology (Berl) 2021; 238:1315-1331. [PMID: 31814047 PMCID: PMC8062355 DOI: 10.1007/s00213-019-05407-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 11/18/2019] [Indexed: 11/18/2022]
Abstract
RATIONALE Prolonged use of cannabis, the most widely used illicit drug worldwide, has been consistently associated with impairment in memory and verbal learning. Although the neurophysiological underpinnings of these impairments have been investigated previously using functional magnetic resonance imaging (fMRI), while performing memory tasks, the results of these studies have been inconsistent and no clear picture has emerged yet. Furthermore, no previous studies have investigated trial-by-trial learning. OBJECTIVES We aimed to investigate the neural underpinnings of impaired verbal learning in cannabis users as estimated over repeated learning trials. METHODS We studied 21 adolescent-onset regular cannabis users and 21 non-users using fMRI performed at least 12 h after last cannabis use, while they performed a paired associate verbal learning task that allowed us to examine trial-by-trial learning. Brain activation during repeated verbal encoding and recall conditions of the task was indexed using the blood oxygen level-dependent haemodynamic response fMRI signal. RESULTS There was a significant improvement in recall score over repeated trials indicating learning occurring across the two groups of participants. However, learning was significantly slower in cannabis users compared to non-users (p = 0.032, partial eta-squared = 0.108). While learning verbal stimuli over repeated encoding blocks, non-users displayed progressive increase in recruitment of the midbrain, parahippocampal gyrus and thalamus (p = 0.00939, partial eta-squared = 0.180). In contrast, cannabis users displayed a greater but disrupted activation pattern in these regions, which showed a stronger correlation with new word-pairs learnt over the same blocks in cannabis users than in non-users. CONCLUSIONS These results suggest that disrupted medial temporal and midbrain function underlie slower learning in adolescent-onset cannabis users.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Aisling O'Neill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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11
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Brain morphology does not clearly map to cognition in individuals on the bipolar-schizophrenia-spectrum: a cross-diagnostic study of cognitive subgroups. J Affect Disord 2021; 281:776-785. [PMID: 33246649 DOI: 10.1016/j.jad.2020.11.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/08/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Characterisation of brain morphological features common to cognitively similar individuals with bipolar disorder (BD) and schizophrenia spectrum disorders (SSD) may be key to understanding their shared neurobiological deficits. In the current study we examined whether three previously characterised cross-diagnostic cognitive subgroups differed among themselves and in comparison to healthy controls across measures of brain morphology. METHOD T1-weighted structural magnetic resonance imaging scans were obtained for 143 individuals; 65 healthy controls and 78 patients (SSD, n = 40; BD I, n = 38) classified into three cross-diagnostic cognitive subgroups: Globally Impaired (n = 24), Selectively Impaired (n = 32), and Superior/Near-Normal (n = 22). Cognitive subgroups were compared to each other and healthy controls on three separate analyses investigating (1) global, (2) regional, and (3) vertex-wise comparisons of brain volume, thickness, and surface area. RESULTS No significant subgroup differences were evident in global measures of brain morphology. In region of interest analyses, the Selectively Impaired subgroup had greater right accumbens volume than those Superior/Near-Normal subgroup and healthy controls, and the Superior/Near-Normal subgroup had reduced volume of the left entorhinal region compared to all other groups. In vertex-wise comparisons, the Globally Impaired subgroup had greater right precentral volume than the Selectively Impaired subgroup, and thicker cortex in the postcentral region relative to the Superior/Near-Normal subgroup. LIMITATIONS Exploration of medication effects was limited in our data. CONCLUSIONS Although some differences were evident in this sample, generally cross-diagnostic cognitive subgroups of individuals with SSD and BD did not appear to be clearly distinguished by patterns in brain morphology.
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12
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Thygesen JH, Presman A, Harju-Seppänen J, Irizar H, Jones R, Kuchenbaecker K, Lin K, Alizadeh BZ, Austin-Zimmerman I, Bartels-Velthuis A, Bhat A, Bruggeman R, Cahn W, Calafato S, Crespo-Facorro B, de Haan L, de Zwarte SMC, Di Forti M, Díez-Revuelta Á, Hall J, Hall MH, Iyegbe C, Jablensky A, Kahn R, Kalaydjieva L, Kravariti E, Lawrie S, Luykx JJ, Mata I, McDonald C, McIntosh AM, McQuillin A, Muir R, Ophoff R, Picchioni M, Prata DP, Ranlund S, Rujescu D, Rutten BPF, Schulze K, Shaikh M, Schirmbeck F, Simons CJP, Toulopoulou T, van Amelsvoort T, van Haren N, van Os J, van Winkel R, Vassos E, Walshe M, Weisbrod M, Zartaloudi E, Bell V, Powell J, Lewis CM, Murray RM, Bramon E. Genetic copy number variants, cognition and psychosis: a meta-analysis and a family study. Mol Psychiatry 2021; 26:5307-5319. [PMID: 32719466 PMCID: PMC8589646 DOI: 10.1038/s41380-020-0820-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 02/06/2023]
Abstract
The burden of large and rare copy number genetic variants (CNVs) as well as certain specific CNVs increase the risk of developing schizophrenia. Several cognitive measures are purported schizophrenia endophenotypes and may represent an intermediate point between genetics and the illness. This paper investigates the influence of CNVs on cognition. We conducted a systematic review and meta-analysis of the literature exploring the effect of CNV burden on general intelligence. We included ten primary studies with a total of 18,847 participants and found no evidence of association. In a new psychosis family study, we investigated the effects of CNVs on specific cognitive abilities. We examined the burden of large and rare CNVs (>200 kb, <1% MAF) as well as known schizophrenia-associated CNVs in patients with psychotic disorders, their unaffected relatives and controls (N = 3428) from the Psychosis Endophenotypes International Consortium (PEIC). The carriers of specific schizophrenia-associated CNVs showed poorer performance than non-carriers in immediate (P = 0.0036) and delayed (P = 0.0115) verbal recall. We found suggestive evidence that carriers of schizophrenia-associated CNVs had poorer block design performance (P = 0.0307). We do not find any association between CNV burden and cognition. Our findings show that the known high-risk CNVs are not only associated with schizophrenia and other neurodevelopmental disorders, but are also a contributing factor to impairment in cognitive domains such as memory and perceptual reasoning, and act as intermediate biomarkers of disease risk.
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Affiliation(s)
- Johan H. Thygesen
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Amelia Presman
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Jasmine Harju-Seppänen
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Haritz Irizar
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Rebecca Jones
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Karoline Kuchenbaecker
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK ,grid.83440.3b0000000121901201UCL Genetics Institute, University College London, London, UK
| | - Kuang Lin
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK ,grid.4991.50000 0004 1936 8948Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Behrooz Z. Alizadeh
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands ,grid.4494.d0000 0000 9558 4598Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Agna Bartels-Velthuis
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands
| | - Anjali Bhat
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Richard Bruggeman
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands ,grid.4830.f0000 0004 0407 1981Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Wiepke Cahn
- grid.5477.10000000120346234University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands ,grid.413664.2Altrecht, General Mental Health Care, Utrecht, The Netherlands
| | - Stella Calafato
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Benedicto Crespo-Facorro
- grid.469673.90000 0004 5901 7501CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Sevilla, Spain ,grid.7821.c0000 0004 1770 272XUniversity Hospital Marqués de Valdecilla, University of Cantabria–IDIVAL, Santander, Spain ,grid.9224.d0000 0001 2168 1229Hospital Universitario Virgen del Rocío, IBiS, Department of Psychiatry, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Liewe de Haan
- grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands ,grid.491093.60000 0004 0378 2028Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Sonja M. C. de Zwarte
- grid.5477.10000000120346234University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
| | - Marta Di Forti
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Álvaro Díez-Revuelta
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK ,grid.5690.a0000 0001 2151 2978Laboratory of Cognitive and Computational Neuroscience—Centre for Biomedical Technology (CTB), Complutense University and Technical University of Madrid, Madrid, Spain
| | - Jeremy Hall
- grid.5600.30000 0001 0807 5670School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, UK
| | - Mei-Hua Hall
- grid.38142.3c000000041936754XPsychosis Neurobiology Laboratory, Harvard Medical School, McLean Hospital, Belmont, MA USA
| | - Conrad Iyegbe
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Assen Jablensky
- grid.1012.20000 0004 1936 7910Centre for Clinical Research in Neuropsychiatry, The University of Western Australia, Perth, WA Australia
| | - Rene Kahn
- grid.5477.10000000120346234University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands ,grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Luba Kalaydjieva
- grid.1012.20000 0004 1936 7910Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, WA Australia
| | - Eugenia Kravariti
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Stephen Lawrie
- grid.4305.20000 0004 1936 7988Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland UK
| | - Jurjen J. Luykx
- grid.5477.10000000120346234University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands ,grid.7692.a0000000090126352Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands ,grid.491146.f0000 0004 0478 3153Second opinion outpatient clinic, GGNet Mental Health, Warsnveld, The Netherlands
| | - Igancio Mata
- grid.469673.90000 0004 5901 7501CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Sevilla, Spain ,Fundación Argibide, Pamplona, Spain
| | - Colm McDonald
- grid.6142.10000 0004 0488 0789The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Andrew M. McIntosh
- grid.4305.20000 0004 1936 7988Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland UK ,grid.4305.20000 0004 1936 7988Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Andrew McQuillin
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Rebecca Muir
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Roel Ophoff
- grid.19006.3e0000 0000 9632 6718Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA ,grid.5645.2000000040459992XDepartment of Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marco Picchioni
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Diana P. Prata
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK ,grid.9983.b0000 0001 2181 4263Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciencias da Universidade de Lisboa, Lisboa, Portugal ,grid.45349.3f0000 0001 2220 8863Centre for Psychological Research and Social Intervention, ISCTE-IUL, Lisboa, Portugal
| | - Siri Ranlund
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Dan Rujescu
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry, Ludwig-Maximilians University of Munich, Munich, Germany ,grid.9018.00000 0001 0679 2801Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle Wittenberg, Halle, Germany
| | - Bart P. F. Rutten
- grid.412966.e0000 0004 0480 1382Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382The Brain+Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
| | - Katja Schulze
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK ,grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
| | - Madiha Shaikh
- grid.451079.e0000 0004 0428 0265North East London Foundation Trust, London, UK ,grid.83440.3b0000000121901201Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Frederike Schirmbeck
- grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands ,grid.491093.60000 0004 0378 2028Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Claudia J. P. Simons
- grid.412966.e0000 0004 0480 1382Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands ,grid.491104.9GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Timothea Toulopoulou
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK ,grid.18376.3b0000 0001 0723 2427Department of Psychology, Bilkent University, Main Campus, Bilkent, Ankara Turkey
| | - Therese van Amelsvoort
- grid.412966.e0000 0004 0480 1382Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Neeltje van Haren
- grid.5477.10000000120346234University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands ,grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia’s Children Hospital, Rotterdam, The Netherlands
| | - Jim van Os
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK ,grid.412966.e0000 0004 0480 1382Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands ,grid.7692.a0000000090126352Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Ruud van Winkel
- grid.5596.f0000 0001 0668 7884KU Leuven, Department of Neuroscience, Research Group Psychiatry, Leuven, Belgium
| | - Evangelos Vassos
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Muriel Walshe
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Matthias Weisbrod
- grid.7700.00000 0001 2190 4373Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany ,grid.490718.30000000406368535SRH Klinikum, Karlsbad-Langensteinbach, Germany
| | - Eirini Zartaloudi
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - Vaughan Bell
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - John Powell
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Cathryn M. Lewis
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK
| | - Robin M. Murray
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience at King’s College London, London, UK ,grid.37640.360000 0000 9439 0839South London and Maudsley NHS Foundation Trust, London, UK
| | - Elvira Bramon
- Division of Psychiatry, University College London, London, UK. .,Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK. .,Institute of Cognitive Neuroscience, University College London, London, UK.
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13
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Curtis MT, Coffman BA, Salisbury DF. Parahippocampal area three gray matter is reduced in first-episode schizophrenia spectrum: Discovery and replication samples. Hum Brain Mapp 2020; 42:724-736. [PMID: 33219733 PMCID: PMC7814759 DOI: 10.1002/hbm.25256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/02/2020] [Accepted: 10/07/2020] [Indexed: 12/27/2022] Open
Abstract
Early course schizophrenia is associated with reduced gray matter. The specific structures affected first and how deficits impact symptoms and cognition remain unresolved. We used the Human Connectome Project multimodal parcellation (HCP‐MMP) to precisely identify cortical areas and investigate thickness abnormalities in discovery and replication samples of first‐episode schizophrenia spectrum individuals (FESz). In the discovery sample, T1w scans were acquired from 31 FESz and 31 matched healthy controls (HC). Thickness was calculated for 360 regions in Freesurfer. In the replication sample, high‐resolution T1w, T2w, and BOLD‐rest scans were acquired from 23 FESz and 32 HC and processed with HCP protocols. Thickness was calculated for regions significant in the discovery sample. After FDR correction (q < .05), left and right parahippocampal area 3 (PHA3) were significantly thinner in FESz. In the replication sample, bilateral PHA3 were again thinner in FESz (q < .05). Exploratory correlation analyses revealed left PHA3 was positively associated with hallucinations and right PHA3 was positively associated with processing speed, working memory, and verbal learning. The novel use of the HCP‐MMP in two independent FESz samples revealed thinner bilateral PHA3, suggesting this byway between cortical and limbic processing is a critical site of pathology near the emergence of psychosis.
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Affiliation(s)
- Mark T Curtis
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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14
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Makowski C, Lewis JD, Lepage C, Malla AK, Joober R, Evans AC, Lepage M. Intersection of verbal memory and expressivity on cortical contrast and thickness in first episode psychosis. Psychol Med 2020; 50:1923-1936. [PMID: 31456533 DOI: 10.1017/s0033291719002071] [Citation(s) in RCA: 4] [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] [Indexed: 01/13/2023]
Abstract
BACKGROUND Longitudinal studies of first episode of psychosis (FEP) patients are critical to understanding the dynamic clinical factors influencing functional outcomes; negative symptoms and verbal memory (VM) deficits are two such factors that remain a therapeutic challenge. This study uses white-gray matter contrast at the inner edge of the cortex, in addition to cortical thickness, to probe changes in microstructure and their relation with negative symptoms and possible intersections with verbal memory. METHODS T1-weighted images and clinical data were collected longitudinally for patients (N = 88) over a two-year period. Cognitive data were also collected at baseline. Relationships between baseline VM (immediate/delayed recall) and rate of change in two negative symptom dimensions, amotivation and expressivity, were assessed at the behavioral level, as well as at the level of brain structure. RESULTS VM, particularly immediate recall, was significantly and positively associated with a steeper rate of expressivity symptom decline (r = 0.32, q = 0.012). Significant interaction effects between baseline delayed recall and change in expressivity were uncovered in somatomotor regions bilaterally for both white-gray matter contrast and cortical thickness. Furthermore, interaction effects between immediate recall and change in expressivity on cortical thickness rates were uncovered across higher-order regions of the language processing network. CONCLUSIONS This study shows common neural correlates of language-related brain areas underlying expressivity and VM in FEP, suggesting deficits in these domains may be more linked to speech production rather than general cognitive capacity. Together, white-gray matter contrast and cortical thickness may optimally inform clinical investigations aiming to capture peri-cortical microstructural changes.
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Affiliation(s)
- Carolina Makowski
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
- Department of Psychiatry, McGill University, Verdun, Canada
| | - John D Lewis
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| | - Claude Lepage
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| | - Ashok K Malla
- Department of Psychiatry, McGill University, Verdun, Canada
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Verdun, Canada
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Verdun, Canada
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
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15
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Carruthers SP, Van Rheenen TE, Gurvich C, Sumner PJ, Rossell SL. Characterising the structure of cognitive heterogeneity in schizophrenia spectrum disorders. A systematic review and narrative synthesis. Neurosci Biobehav Rev 2019; 107:252-278. [PMID: 31505202 DOI: 10.1016/j.neubiorev.2019.09.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Abstract
The aim of the present review was to systematically summarise our current understanding of the structure of the cognitive heterogeneity that exists within schizophrenia spectrum disorder (SSD). Fifty-two relevant studies were identified from January 1980 to March 2019 that investigated cognitive subgroups within SSD. Twenty-five studies employed classification criteria based on current neuropsychological function, 14 studies employed various data-driven subgrouping methodologies and 13 studies investigated putative cognitive symptom trajectories. Despite considerable methodological variability, three distinct cognitive subgroups reliability emerged; a relatively intact cognitive subgroup characterised by high cognitive performance, an intermediate cognitive subgroup defined by mixed or moderate levels of cognitive function/dysfunction and a globally impaired subgroup characterised by severe cognitive deficits. Whilst preliminary evidence suggests that these subgroups may have further investigative relevance in and of themselves, additional research is required and discussed. A set of reporting guidelines are also presented to overcome the methodological inconsistencies identified in the reviewed literature.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia.
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred Hospital, Melbourne, 3004, Australia
| | - Philip J Sumner
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
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Neuroimaging Studies of Cognitive Function in Schizophrenia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1118:117-134. [PMID: 30747420 DOI: 10.1007/978-3-030-05542-4_6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Persons suffering from schizophrenia present cognitive impairments that have a major functional impact on their lives. Particularly, executive functions and episodic memory are consistently found to be impaired. Neuroimaging allows the investigation of affected areas of the brain associated with these impairments and, moreover, the detection of brain functioning improvements after cognitive remediation interventions. For instance, executive function impairments have been associated with prefrontal cortex volume and thickness; cognitive control impairments are correlated with an increased activation in the anterior cingulate cortex, and episodic memory impairments are linked to hippocampal reduction. Some findings suggest the presence of brain compensatory mechanisms in schizophrenia, e.g. recruiting broader cortical areas to perform identical tasks. Similarly, neuroimaging studies of cognitive remediation in schizophrenia focus differentially on structural, functional and connectivity changes. Cognitive remediation improvements have been reported in two main areas: the prefrontal and thalamic regions. It has been suggested that those changes imply a functional reorganisation of neural networks, and cognitive remediation interventions might have a neuroprotective effect. Future studies should use multimodal neuroimaging procedures and more complex theoretical models to identify, confirm and clarify these and newer outcomes. This chapter highlights neuroimaging findings in anatomical and functional brain correlates of schizophrenia, as well as its application and potential use for identifying brain changes after cognitive remediation.
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Kelly S, Guimond S, Lyall A, Stone WS, Shenton ME, Keshavan M, Seidman LJ. Neural correlates of cognitive deficits across developmental phases of schizophrenia. Neurobiol Dis 2018; 131:104353. [PMID: 30582983 DOI: 10.1016/j.nbd.2018.12.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 11/21/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022] Open
Abstract
Schizophrenia is associated with cognitive deficits across all stages of the illness (i.e., high risk, first episode, early and chronic phases). Identifying the underlying neurobiological mechanisms of these deficits is an important area of scientific inquiry. Here, we selectively review evidence regarding the pattern of deficits across the developmental trajectory of schizophrenia using the five cognitive domains identified by the Research Domain Criteria (RDoC) initiative. We also report associated findings from neuroimaging studies. We suggest that most cognitive domains are affected across the developmental trajectory, with corresponding brain structural and/or functional differences. The idea of a common mechanism driving these deficits is discussed, along with implications for cognitive treatment in schizophrenia.
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Affiliation(s)
- Sinead Kelly
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Synthia Guimond
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Amanda Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - William S Stone
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Matcheri Keshavan
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Larry J Seidman
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Udala M, Clark J, Miller H, Leitner D, Libben M. Psychological disturbance and cognitive functioning in TBI patients. APPLIED NEUROPSYCHOLOGY-ADULT 2018; 26:581-590. [PMID: 30183362 DOI: 10.1080/23279095.2018.1460370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The current study examined psychopathology and neuropsychological test performance in a traumatic brain injury (TBI) patient sample. Previous research has found that the Minnesota Multiphasic Personality Inventory - Second Edition (MMPI-2) indices of psychological disturbance were related to specific neuropsychological tests of attention and memory. Furthermore, higher scores on clinical scale 2 (Depression) and higher scores on the content scales of Fears and Bizarre Mentation of the MMPI-2 were related to poorer performance in, most notably, Attention and List Learning factors. The present study sought to extend the research by adding a neuropsychological measure of conceptual reasoning. A sample of 116 TBI patients referred for evaluation at a private practice clinic were administered a battery of neuropsychological measures of list learning, working memory, verbal memory, visuographic memory, and conceptual reasoning, as well as the MMPI-2 to assess emotional functioning. Regression analysis indicated that an overall model of MMPI-2 indices significantly predicted poorer performance on List Learning. More specifically, higher scores on the content scales of Obsessions and Fears were most robustly associated with poorer neuropsychological test performance for List Learning and Working Memory respectively. Findings suggest psychopathology is correlated with performance on neuropsychological measures for TBI patients.
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Affiliation(s)
- Megan Udala
- Psychology, University of British Columbia - Okanagan , Kelowna , British Columbia , Canada
| | - Jeneya Clark
- Psychology, University of British Columbia - Okanagan , Kelowna , British Columbia , Canada
| | - Harry Miller
- Psychology, University of British Columbia - Okanagan , Kelowna , British Columbia , Canada
| | - Damian Leitner
- Psychology, University of British Columbia - Okanagan , Kelowna , British Columbia , Canada
| | - Maya Libben
- Psychology, University of British Columbia - Okanagan , Kelowna , British Columbia , Canada
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Fernandez VG, Asarnow R, Narr KL, Subotnik KL, Kuppinger H, Fogelson D, Nuechterlein KH. Temporal lobe thickness and verbal memory in first-degree relatives of individuals with schizophrenia. Schizophr Res 2018; 199:221-225. [PMID: 29499968 PMCID: PMC6110998 DOI: 10.1016/j.schres.2018.02.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 01/17/2023]
Abstract
Cortical thinning in frontal and temporal regions has been reported in individuals diagnosed with schizophrenia and, less consistently, among their unaffected first-degree relatives. Likewise, first-degree relatives demonstrate attenuated differences in neurocognitive performance relative to healthy controls, indicating that neurocognitive performance may be an important endophenotype of the disorder. Less is known about how cortical thickness relates to neurocognitive performance in these individuals. Given the robust nature of temporal structural abnormalities in schizophrenia, this study aimed to identify how temporal lobe cortical thickness might relate to verbal memory in first-degree relatives. Unaffected parents and siblings of individuals with adult-onset schizophrenia (N=62) and individuals in healthy control families (N=70) participating in the UCLA Family Study received a structural MRI and completed a battery of neurocognitive tests. Cortical thickness was estimated across the cortex and thickness measures of all regions in the temporal lobe were summed, averaged, and residualized for age and sex to produce a variable. A verbal learning factor was derived from two common tests of verbal learning and memory, the CVLT-II and Logical Memory of the WMS-III. Results demonstrated a significant interaction between group and verbal learning in relationship to temporal lobe thickness. Post-hoc analyses revealed significant correlations between verbal learning and cortical thickness in the relatives of schizophrenia patients which were driven by immediate recall scores on the CVLT-II and Logical Memory. These findings indicate that cortical thickness in the temporal cortex may represent a structural correlate for encoding verbal information in unaffected relatives of individuals with schizophrenia.
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Affiliation(s)
- Vindia G. Fernandez
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA,Department of Psychology, UCLA, Los Angeles, CA
| | - Robert Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Katherine L. Narr
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA,Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, CA
| | - Kenneth L. Subotnik
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Heidi Kuppinger
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - David Fogelson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA,Department of Psychology, UCLA, Los Angeles, CA
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Association of monoamine oxidase-A genetic variants and amygdala morphology in violent offenders with antisocial personality disorder and high psychopathic traits. Sci Rep 2017; 7:9607. [PMID: 28851912 PMCID: PMC5575239 DOI: 10.1038/s41598-017-08351-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/11/2017] [Indexed: 01/18/2023] Open
Abstract
Violent offending is elevated among individuals with antisocial personality disorder (ASPD) and high psychopathic traits (PP). Morphological abnormalities of the amygdala and orbitofrontal cortex (OFC) are present in violent offenders, which may relate to the violence enacted by ASPD + PP. Among healthy males, monoamine oxidase-A (MAO-A) genetic variants linked to low in vitro transcription (MAOA-L) are associated with structural abnormalities of the amygdala and OFC. However, it is currently unknown whether amygdala and OFC morphology in ASPD relate to MAO-A genetic polymorphisms. We studied 18 ASPD males with a history of violent offending and 20 healthy male controls. Genomic DNA was extracted from peripheral leukocytes to determine MAO-A genetic polymorphisms. Subjects underwent a T1-weighted MRI anatomical brain scan that provided vertex-wise measures of amygdala shape and surface area and OFC cortical thickness. We found that ASPD + PP subjects with MAOA-L exhibited decreased surface area in the right basolateral amygdala nucleus and increased surface area in the right anterior cortical amygdaloid nucleus versus healthy MAOA-L carriers. This study is the first to describe genotype-related morphological differences of the amygdala in a population marked by high aggression. Deficits in emotional regulation that contribute to the violence of ASPD + PP may relate to morphological changes of the amygdala under genetic control.
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Guimond S, Hawco C, Lepage M. Prefrontal activity and impaired memory encoding strategies in schizophrenia. J Psychiatr Res 2017; 91:64-73. [PMID: 28325680 DOI: 10.1016/j.jpsychires.2017.02.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/21/2016] [Accepted: 02/28/2017] [Indexed: 02/02/2023]
Abstract
Schizophrenia patients have significant memory difficulties that have far-reaching implications in their daily life. These impairments are partly attributed to an inability to self-initiate effective memory encoding strategies, but its core neurobiological correlates remain unknown. The current study addresses this critical gap in our knowledge of episodic memory impairments in schizophrenia. Schizophrenia patients (n = 35) and healthy controls (n = 23) underwent a Semantic Encoding Memory Task (SEMT) during an fMRI scan. Brain activity was examined for conditions where participants were a) prompted to use semantic encoding strategies, or b) not prompted but required to self-initiate such strategies. When prompted to use semantic encoding strategies, schizophrenia patients exhibited similar recognition performance and brain activity as healthy controls. However, when required to self-initiate these strategies, patients had significant reduced recognition performance and brain activity in the left dorsolateral prefrontal cortex, as well as in the left temporal gyrus, left superior parietal lobule, and cerebellum. When patients were divided based on performance on the SEMT, the subgroup with more severe deficits in self-initiation also showed greater reduction in left dorsolateral prefrontal activity. These results suggest that impaired self-initiation of elaborative encoding strategies is a driving feature of memory deficits in schizophrenia. We also identified the neural correlates of impaired self-initiation of semantic encoding strategies, in which a failure to activate the left dorsolateral prefrontal cortex plays a key role. These findings provide important new targets in the development of novel treatments aiming to improve memory and ultimately patients' outcome.
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Affiliation(s)
- Synthia Guimond
- Department of Psychology, McGill University, Montréal, Canada; Douglas Mental Health University Institute, Montréal, Canada; Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Colin Hawco
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada.
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