1
|
Wei Y, Su W, Zhang T, Webler R, Tang X, Zheng Y, Tang Y, Xu L, Cui H, Zhu J, Qian Z, Ju M, Long B, Zhao J, Chen C, Zeng L, Zhang T, Wang J. Structural and functional abnormalities across clinical stages of psychosis: A multimodal neuroimaging investigation. Asian J Psychiatr 2024; 99:104153. [PMID: 39047353 DOI: 10.1016/j.ajp.2024.104153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 06/27/2024] [Accepted: 07/04/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Structural and functional neurobiological abnormalities have been observed in schizophrenia. Previous studies have concentrated on specific illness stages, obscuring relationships between functional/structural changes and disorder progression. The present study aimed to quantify structural and functional abnormalities across different clinical stages using functional near-infrared spectroscopy (fNIRS) and structural magnetic resonance imaging (sMRI). METHODS Fifty-four participants with first-episode schizophrenia (FES), 120 with clinically high risk of psychosis (CHR), and 111 healthy controls (HCs) underwent functional near-infrared spectroscopy (fNIRS) to measure oxyhemoglobin (Oxy-Hb) during the verbal fluency task. Among them, 28FES, 64CHR and 55HC also finished sMRI. Oxy-Hb and gray matter volume (GMV) were compared among the three groups while controlling for covariates, including age, sex, years of education, and task performance. Mediation analysis was utilized to determine the mediating effect of GMV on Oxy-Hb and cognition. RESULTS Compared with the HC group, CHR and FES groups showed significantly reduced brain activity. However, there were no significant differences between the FES and CHR. Pronounced GMV increase in the right frontal pole area (F = 4.234, p = 0.016) was identified in the CHR and FES groups. Mediation analysis showed a significant mediation effect of the right frontal pole GMV between Channel 31 Oxy-Hb and processing speed (z = 2.105, p = 0.035) and attention/vigilance (z = 1.992, p = 0.046). CONCLUSIONS Brain activation and anatomical deficits were observed in different brain regions, suggesting that anatomical and functional abnormalities are dissociated in the early stages of psychosis. The relationship between neural activity and anatomy may reflect a specific pathophysiology related to cognitive deterioration in schizophrenia.
Collapse
Affiliation(s)
- Yanyan Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Wenjun Su
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Tingyu Zhang
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Ryan Webler
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, United States
| | - Xiaochen Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yuchen Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Junjuan Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhenying Qian
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Mingliang Ju
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Bin Long
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jian Zhao
- Department of Micro/Nano Electronics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Cheng Chen
- Department of Micro/Nano Electronics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Lingyun Zeng
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, ShenZhen, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| |
Collapse
|
2
|
Liu W, Jiang X, Deng Z, Xie Y, Guo Y, Wu Y, Sun Q, Kong L, Wu F, Tang Y. Functional and structural alterations in different durations of untreated illness in the frontal and parietal lobe in major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:629-642. [PMID: 37542558 PMCID: PMC10995069 DOI: 10.1007/s00406-023-01625-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/22/2023] [Indexed: 08/07/2023]
Abstract
Major depressive disorder (MDD) is one of the most disabling illnesses that profoundly restricts psychosocial functions and impairs quality of life. However, the treatment rate of MDD is surprisingly low because the availability and acceptability of appropriate treatments are limited. Therefore, identifying whether and how treatment delay affects the brain and the initial time point of the alterations is imperative, but these changes have not been thoroughly explored. We investigated the functional and structural alterations of MDD for different durations of untreated illness (DUI) using regional homogeneity (ReHo) and voxel-based morphometry (VBM) with a sample of 125 treatment-naïve MDD patients and 100 healthy controls (HCs). The MDD patients were subgrouped based on the DUI, namely, DUI ≤ 1 M, 1 < DUI ≤ 6 M, 6 < DUI ≤ 12 M, and 12 < DUI ≤ 48 M. Subgroup comparison (MDD with different DUIs) was applied to compare ReHo and grey matter volume (GMV) extracted from clusters of regions with significant differences (the pooled MDD patients relative to HCs). Correlations and mediation effects were analysed to estimate the relationships between the functional and structural neuroimaging changes and clinical characteristics. MDD patients exhibited decreased ReHo in the left postcentral gyrus and precentral gyrus and reduced GMV in the left middle frontal gyrus and superior frontal gyrus relative to HCs. The initial functional abnormalities were detected after being untreated for 1 month, whereas this duration was 3 months for GMV reduction. Nevertheless, a transient increase in ReHo was observed after being untreated for 3 months. No significant differences were discovered between HCs and MDD patients with a DUI less than 1 month or among MDD patients with different DUIs in either ReHo or GMV. Longer DUI was related to reduced ReHo with GMV as mediator in MDD patients. We identified disassociated functional and anatomical alterations in treatment-naïve MDD patients at different time points in distinct brain regions at the early stage of the disease. Additionally, we also discovered that GMV mediated the relationship between a longer DUI and diminished ReHo in MDD patients, disclosing the latent deleterious and neuro-progressive implications of DUI on both the structure and function of the brain and indicating the necessity of early treatment of MDD.
Collapse
Affiliation(s)
- Wen Liu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Radiology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Zijing Deng
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yu Xie
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yingrui Guo
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yifan Wu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Qikun Sun
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Lingtao Kong
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Feng Wu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China.
- Department of Gerontology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China.
- Department of Psychiatry and Geriatric Medicine, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, People's Republic of China.
| |
Collapse
|
3
|
Ma CC, Lin YY, Chung YA, Park SY, Huang CCY, Chang WC, Chang HA. The two-back task leads to activity in the left dorsolateral prefrontal cortex in schizophrenia patients with predominant negative symptoms: a fNIRS study and its implication for tDCS. Exp Brain Res 2024; 242:585-597. [PMID: 38227007 DOI: 10.1007/s00221-023-06769-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/16/2023] [Indexed: 01/17/2024]
Abstract
Transcranial direct current stimulation (tDCS) over left dorsolateral prefrontal cortex (DLPFC) has shown some potential as an adjunctive intervention for ameliorating negative symptoms of schizophrenia, but its efficacy requires optimization. Recently, 'functional targeting' of stimulation holds promise for advancing tDCS efficacy by coupling tDCS with a cognitive task where the target brain regions are activated by that task and further specifically polarized by tDCS.The study used 48-channel functional near infra-red spectroscopy (fNIRS) aiming to determine a cognitive task that can effectively induce a cortical activation of the left DLPFC in schizophrenia patients with predominant negative symptoms before running a tDCS trial. Sixty schizophrenia patients with predominant negative symptoms completed measures of clinical and psychosocial functioning characteristics and assessments across cognitive domains. Hemodynamic changes during n-back working memory tasks with different cognitive loads (1-back and 2-back) and verbal fluency test (VFT) were measured using fNIRS. For n-back tasks, greater signal changes were found when the task required elevated cognitive load. One sample t-test revealed that only 2-back task elicited significant activation in left DLPFC (t = 4.23, FDR-corrected p = 0.0007). During VFT, patients failed to show significant task-related activity in left DLPFC (one sample t-test, t = -0.25, FDR-corrected p > 0.05). Our study implies that 2-back task can effectively activate left DLPFC in schizophrenia patients with predominant negative symptoms. This neurophysiologically-validated task is considered highly potential to be executed in conjunction with high-definition tDCS for "functional targeting" of the left DLPFC to treat negative symptoms in a double-blind randomized sham-control trial, registered on ClinicalTrials.gov Registry (ID: NCT05582980).
Collapse
Affiliation(s)
- Chin-Chao Ma
- Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, Taiwan
| | - Yen-Yue Lin
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
- Department of Life Sciences, National Central University, Taoyuan, Taiwan
| | - Yong-An Chung
- Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sonya Youngju Park
- Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | - Wei-Chou Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei, Taiwan.
| |
Collapse
|
4
|
Chou PH, Liu WC, Lin WH, Hsu CW, Wang SC, Su KP. NIRS-aided differential diagnosis among patients with major depressive disorder, bipolar disorder, and schizophrenia. J Affect Disord 2023; 341:366-373. [PMID: 37634818 DOI: 10.1016/j.jad.2023.08.101] [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: 07/28/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND To establish a clinically applicable neuroimaging-guided diagnostic support system that uses near-infrared spectroscopy (NIRS) for differential diagnosis at the individual level among major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SZ). METHODS A total of 192 participants were recruited, including 40 patients with MDD, 38 patients with BPD, 65 patients with SZ, and 49 healthy individuals. We analyzed the spatiotemporal characteristics of hemodynamic responses in the frontotemporal cortex during a verbal fluency test (VFT) measured by NIRS to assess the accuracy of single-subject classification for differential diagnosis among the three psychiatric disorders. The optimal threshold of the frontal centroid value (54 seconds) was utilized on the basis of the findings of the Japanese study. RESULTS The application of the optimal threshold of the frontal centroid value (54 seconds) allowed for the accurate differentiation of patients with unipolar MDD (72.5%) from BPD (78.9%) or SZ (84.6%). CONCLUSION These results suggest that the NIRS-aided differential diagnosis of major psychiatric disorders can be a promising biomarker in Taiwan. Future multi-site studies are needed to validate our findings.
Collapse
Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, Hsinchu, Taiwan; Dr. Chou's Mental Health Clinic, Hsinchu, Taiwan
| | - Wen-Chun Liu
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Puli branch, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Wei Hsu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shao-Cheng Wang
- Department of Psychiatry, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan.
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Tainan, Taiwan; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
| |
Collapse
|
5
|
Tran BX, Nguyen TT, Boyer L, Fond G, Auquier P, Nguyen HSA, Tran HTN, Nguyen HM, Choi J, Le HT, Latkin CA, Nathan KI, Husain SF, McIntyre RS, Ho CSH, Zhang MWB, Ho RCM. Differentiating people with schizophrenia from healthy controls in a developing Country: An evaluation of portable functional near infrared spectroscopy (fNIRS) as an adjunct diagnostic tool. Front Psychiatry 2023; 14:1061284. [PMID: 36778640 PMCID: PMC9910791 DOI: 10.3389/fpsyt.2023.1061284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/05/2023] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate portable functional near-infrared spectroscopy (fNIRS) device as an adjunct diagnostic tool in Vietnam to assess hemodynamics when people with schizophrenia and healthy controls performed cognitive tasks. METHODS One hundred fifty-seven participants were divided into schizophrenia (n = 110) and healthy controls group (n = 47), which were recruited by match of age, and gender. Hemodynamic responses in the frontal cortex were monitored with a 48-channel portable device during the Stroop Color-Word Test (SCWT) and Verbal Fluency Test (VFT). General linear model compared the differences in oxyhemoglobin (HbO2) levels between the two groups. The Receiver Operating Characteristic (ROC) graph was generated for each neuroanatomical area. RESULTS People with schizophrenia did not show significant activation in the frontal lobe during the SCWT and VFT as compared to pre-task. During the VFT, the area under the ROC curve of the bilateral dorsolateral prefrontal cortex, bilateral orbitofrontal cortex, bilateral frontopolar prefrontal cortex, and bilateral ventrolateral prefrontal cortex were greater than 0.7 (p < 0.001). The area under the ROC curve (AUC) for the right orbitofrontal cortex was maximal during the VFT (AUC = 0.802, 95%CI = 0.731-0.872). The Youden's index reached a peak (0.57) at the optimal cut-point value (HbO2 cutoff <0.209 μmol/ml for schizophrenia) in which the sensitivity was 85%; specificity was 72%; positive predictive value (PPV) was 0.88; negative predictive value (NPV) was 0.68 and correct classification rate was 76%. DISCUSSION Assessing hemodynamics during VFT by portable fNIRS offers the potential as an adjunct diagnostic tool for schizophrenia in developing countries.
Collapse
Affiliation(s)
- Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Tham Thi Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Laurent Boyer
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Pascal Auquier
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | | | | | | | | | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Kalpana Isabel Nathan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Syeda F Husain
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Melvyn W B Zhang
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology, National University of Singapore, Singapore, Singapore
| |
Collapse
|
6
|
Zoghbi AW, Lieberman JA, Girgis RR. The neurobiology of duration of untreated psychosis: a comprehensive review. Mol Psychiatry 2023; 28:168-190. [PMID: 35931757 PMCID: PMC10979514 DOI: 10.1038/s41380-022-01718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 01/11/2023]
Abstract
Duration of untreated psychosis (DUP) is defined as the time from the onset of psychotic symptoms until the first treatment. Studies have shown that longer DUP is associated with poorer response rates to antipsychotic medications and impaired cognition, yet the neurobiologic correlates of DUP are poorly understood. Moreover, it has been hypothesized that untreated psychosis may be neurotoxic. Here, we conducted a comprehensive review of studies that have examined the neurobiology of DUP. Specifically, we included studies that evaluated DUP using a range of neurobiologic and imaging techniques and identified 83 articles that met inclusion and exclusion criteria. Overall, 27 out of the total 83 studies (32.5%) reported a significant neurobiological correlate with DUP. These results provide evidence against the notion of psychosis as structurally or functionally neurotoxic on a global scale and suggest that specific regions of the brain, such as temporal regions, may be more vulnerable to the effects of DUP. It is also possible that current methodologies lack the resolution needed to more accurately examine the effects of DUP on the brain, such as effects on synaptic density. Newer methodologies, such as MR scanners with stronger magnets, PET imaging with newer ligands capable of measuring subcellular structures (e.g., the PET ligand [11C]UCB-J) may be better able to capture these limited neuropathologic processes. Lastly, to ensure robust and replicable results, future studies of DUP should be adequately powered and specifically designed to test for the effects of DUP on localized brain structure and function with careful attention paid to potential confounds and methodological issues.
Collapse
Affiliation(s)
- Anthony W Zoghbi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA.
- Institute of Genomic Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA.
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, 10032, USA.
- Office of Mental Health, New York State Psychiatric Institute, New York, NY, 10032, USA.
| | - Jeffrey A Lieberman
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Ragy R Girgis
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, 10032, USA.
- Office of Mental Health, New York State Psychiatric Institute, New York, NY, 10032, USA.
| |
Collapse
|
7
|
Wei Y, Tang X, Zhang T, Su W, Xu L, Cui H, Qian Z, Zhang T, Wang J. Reduced temporal activation during a verbal fluency test in clinical high risk of psychosis: a functional near-infrared spectroscopy-based study. Gen Psychiatr 2022; 35:e100702. [PMID: 35572775 PMCID: PMC9058760 DOI: 10.1136/gpsych-2021-100702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/08/2022] [Indexed: 01/10/2023] Open
Abstract
Background Clinical high risk (CHR) of psychosis is a state in which positive symptoms cause the subjects distress but do not approach a severity level that fulfils the criteria for a psychotic episode. CHR exhibits cognitive deficits; however, the underlying neurobiological mechanisms remain unclear. This study aimed to investigate whether brain activation measured by the levels of oxygenated hemoglobin (oxy-Hb) in CHR subjects could be correlated with cognitive deficits. Methods Fifty-eight CHR individuals who fulfilled the criteria for attenuated positive syndrome as specified in the Structured Interview for Prodromal Syndrome (SIPS) and the Scale of Prodromal Syndrome (SOPS) and 58 age- and sex-matched healthy participants were included in the study. All subjects completed the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) that includes tests measuring attention, verbal memory, verbal fluency, executive function, and general intelligence. Functional near-infrared spectroscopy (fNIRS) was used to measure the level of oxy-Hb in the dorsolateral prefrontal and frontotemporal cortices. Results We observed significantly decreased oxy-Hb levels in channel 32 (located in the right superior temporal gyrus, rSTG)) within the CHR individuals compared with that in the healthy controls (HCs) (t=−3.44, Bonferroni-corrected p=0.002), indicating lower brain activity. A significant positive correlation was observed between task-related β values and working memory in the CHR group (r=0.35, p=0.008). Conclusions The brain activation of rSTG is abnormal among subjects at clinicial high risk for psychosis. This abnormality is probably associated with the neural mechanisms of deficits in the working memory during the early stage of psychosis.
Collapse
Affiliation(s)
- Yanyan Wei
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Tang
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingyu Zhang
- The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
| | - Wenjun Su
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lihua Xu
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiru Cui
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenying Qian
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianhong Zhang
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jijun Wang
- EEG and Neuroimaging Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
8
|
Saiga R, Uesugi M, Takeuchi A, Uesugi K, Suzuki Y, Takekoshi S, Inomoto C, Nakamura N, Torii Y, Kushima I, Iritani S, Ozaki N, Oshima K, Itokawa M, Arai M, Mizutani R. Brain capillary structures of schizophrenia cases and controls show a correlation with their neuron structures. Sci Rep 2021; 11:11768. [PMID: 34083657 PMCID: PMC8175464 DOI: 10.1038/s41598-021-91233-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/25/2021] [Indexed: 11/09/2022] Open
Abstract
Brain blood vessels constitute a micrometer-scale vascular network responsible for supply of oxygen and nutrition. In this study, we analyzed cerebral tissues of the anterior cingulate cortex and superior temporal gyrus of schizophrenia cases and age/gender-matched controls by using synchrotron radiation microtomography or micro-CT in order to examine the three-dimensional structure of cerebral vessels. Over 1 m of cerebral blood vessels was traced to build Cartesian-coordinate models, which were then used for calculating structural parameters including the diameter and curvature of the vessels. The distribution of vessel outer diameters showed a peak at 7-9 μm, corresponding to the diameter of the capillaries. Mean curvatures of the capillary vessels showed a significant correlation to the mean curvatures of neurites, while the mean capillary diameter was almost constant, independent of the cases. Our previous studies indicated that the neurites of schizophrenia cases are thin and tortuous compared to controls. The curved capillaries with a constant diameter should occupy a nearly constant volume, while neurons suffering from neurite thinning should have reduced volumes, resulting in a volumetric imbalance between the neurons and the vessels. We suggest that the observed structural correlation between neurons and blood vessels is related to neurovascular abnormalities in schizophrenia.
Collapse
Affiliation(s)
- Rino Saiga
- Department of Applied Biochemistry, Tokai University, Hiratsuka, Kanagawa, 259-1292, Japan
| | - Masayuki Uesugi
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, 679-5198, Japan
| | - Akihisa Takeuchi
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, 679-5198, Japan
| | - Kentaro Uesugi
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, 679-5198, Japan
| | - Yoshio Suzuki
- Photon Factory, High Energy Accelerator Research Organization KEK, Tsukuba, Ibaraki, 305-0801, Japan
| | - Susumu Takekoshi
- Department of Cell Biology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Chie Inomoto
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Youta Torii
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan
| | - Itaru Kushima
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan
- Medical Genomics Center, Nagoya University Hospital, Nagoya, Aichi, 466-8550, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan
- Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, 156-0057, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan
- Medical Genomics Center, Nagoya University Hospital, Nagoya, Aichi, 466-8550, Japan
| | - Kenichi Oshima
- Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, 156-0057, Japan
- Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, 156-8506, Japan
| | - Masanari Itokawa
- Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, 156-0057, Japan
- Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, 156-8506, Japan
| | - Makoto Arai
- Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, 156-8506, Japan
| | - Ryuta Mizutani
- Department of Applied Biochemistry, Tokai University, Hiratsuka, Kanagawa, 259-1292, Japan.
| |
Collapse
|
9
|
Chou PH, Lin YF, Lu MK, Chang HA, Chu CS, Chang WH, Kishimoto T, Sack AT, Su KP. Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder According to the Existing Psychiatric Comorbidity. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:190-205. [PMID: 33888649 PMCID: PMC8077054 DOI: 10.9758/cpn.2021.19.2.190] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 12/19/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS.
Collapse
Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.,Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan
| | - Yen-Feng Lin
- Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan.,Department of Public Health & Medical Humanities, Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.,Balance Psychiatric Clinic, Hsinchu, Taiwan
| | - Ming-Kuei Lu
- Ph.D. Program for Translational Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain+Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
| | - Kuan-Pin Su
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| |
Collapse
|
10
|
Almajidy RK, Mankodiya K, Abtahi M, Hofmann UG. A Newcomer's Guide to Functional Near Infrared Spectroscopy Experiments. IEEE Rev Biomed Eng 2019; 13:292-308. [PMID: 31634142 DOI: 10.1109/rbme.2019.2944351] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review presents a practical primer for functional near-infrared spectroscopy (fNIRS) with respect to technology, experimentation, and analysis software. Its purpose is to jump-start interested practitioners considering utilizing a non-invasive, versatile, nevertheless challenging window into the brain using optical methods. We briefly recapitulate relevant anatomical and optical foundations and give a short historical overview. We describe competing types of illumination (trans-illumination, reflectance, and differential reflectance) and data collection methods (continuous wave, time domain and frequency domain). Basic components (light sources, detection, and recording components) of fNIRS systems are presented. Advantages and limitations of fNIRS techniques are offered, followed by a list of very practical recommendations for its use. A variety of experimental and clinical studies with fNIRS are sampled, shedding light on many brain-related ailments. Finally, we describe and discuss a number of freely available analysis and presentation packages suited for data analysis. In conclusion, we recommend fNIRS due to its ever-growing body of clinical applications, state-of-the-art neuroimaging technique and manageable hardware requirements. It can be safely concluded that fNIRS adds a new arrow to the quiver of neuro-medical examinations due to both its great versatility and limited costs.
Collapse
|
11
|
Narita Z, Noda T, Setoyama S, Sueyoshi K, Inagawa T, Sumiyoshi T. The effect of transcranial direct current stimulation on psychotic symptoms of schizophrenia is associated with oxy-hemoglobin concentrations in the brain as measured by near-infrared spectroscopy: A pilot study. J Psychiatr Res 2018; 103:5-9. [PMID: 29754106 DOI: 10.1016/j.jpsychires.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/29/2018] [Accepted: 05/05/2018] [Indexed: 11/20/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been shown to be effective in treating some of the symptoms of schizophrenia. In the current study, we sought to determine whether oxy-hemoglobin ([oxy-Hb]), measured by near-infrared spectroscopy (NIRS), is associated with effects of transcranial direct current stimulation (tDCS) on psychotic symptoms of schizophrenia. Twenty-six patients underwent tDCS (2 mA × 20 min) two times per day for five consecutive days. The anodal electrode was placed over the left dorsolateral prefrontal cortex while the cathodal electrode was placed over the right supraorbital region. One month after the last administration of tDCS, positive, but not negative symptoms, evaluated by the Positive and Negative Syndrome Scale (PANSS), were significantly improved. At baseline, regional [oxy-Hb] concentrations in the brain were measured by a 52-channel NIRS instrument. Significant negative correlation was demonstrated between [oxy-Hb] concentrations of left temporoparietal regions throughout verbal fluency tasks vs. changes of PANSS Positive and Negative subscale scores. This is the first study to demonstrate the correlation between the response of neural activity to cognitive tasks at baseline and the ability of tDCS to improve positive and negative psychotic symptoms. Our observations suggest that NIRS provides a marker to predict the response to treatment with tDCS in schizophrenia.
Collapse
Affiliation(s)
- Zui Narita
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
| | - Takamasa Noda
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Shiori Setoyama
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuki Sueyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| |
Collapse
|
12
|
Barahimi S, Einalou Z, Dadgostar M. STUDIES ON SCHIZOPHRENIA AND DEPRESSIVE DISEASES BASED ON FUNCTIONAL NEAR-INFRARED SPECTROSCOPY. BIOMEDICAL ENGINEERING: APPLICATIONS, BASIS AND COMMUNICATIONS 2018. [DOI: 10.4015/s101623721830002x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Many investigations have been carried out on functional near infrared spectroscopy (fNIRS) applications in depression and schizophrenia patients that are most mysterious and costliest mental disorders in current society. fNIRS is a new optical method which assesses brain cortex hemodynamic and nervous activities non-invasively and it has been used in medicine as a study tool. Most of the researches of this approach have assessed the homodynamic response of frontal and temporal regions by means of various cognitive tasks. In this research, first, the cognitive task execution techniques have been explained concisely, and then some findings of fNIRS-based researches about depression and schizophrenia have been summarized and assessed. In fNIRS studies that have used various devices with different number of channels, the brain cortex functionality in schizophrenia and depressive patients has been investigated. The results demonstrate that a decrease in prefrontal regions activities can be observed in schizophrenia and depressive patients. Also more detailed studies illustrate ventrolateral, prefrontal and frontopolar region disorders. In severe depressive patients, a decrease in activities of prefrontal and temporal regions has been detected. Therefore, by paying attention to the deficiencies in these regions’ functions, it is possible to treat these diseases.
Collapse
Affiliation(s)
- Shekoufe Barahimi
- Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Einalou
- Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mehrdad Dadgostar
- Department of Biomedical Engineering, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| |
Collapse
|
13
|
Ma Q, Zhang T, Zanetti MV, Shen H, Satterthwaite TD, Wolf DH, Gur RE, Fan Y, Hu D, Busatto GF, Davatzikos C. Classification of multi-site MR images in the presence of heterogeneity using multi-task learning. Neuroimage Clin 2018; 19:476-486. [PMID: 29984156 PMCID: PMC6029565 DOI: 10.1016/j.nicl.2018.04.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/09/2018] [Accepted: 04/28/2018] [Indexed: 12/21/2022]
Abstract
With the advent of Big Data Imaging Analytics applied to neuroimaging, datasets from multiple sites need to be pooled into larger samples. However, heterogeneity across different scanners, protocols and populations, renders the task of finding underlying disease signatures challenging. The current work investigates the value of multi-task learning in finding disease signatures that generalize across studies and populations. Herein, we present a multi-task learning type of formulation, in which different tasks are from different studies and populations being pooled together. We test this approach in an MRI study of the neuroanatomy of schizophrenia (SCZ) by pooling data from 3 different sites and populations: Philadelphia, Sao Paulo and Tianjin (50 controls and 50 patients from each site), which posed integration challenges due to variability in disease chronicity, treatment exposure, and data collection. Some existing methods are also tested for comparison purposes. Experiments show that classification accuracy of multi-site data outperformed that of single-site data and pooled data using multi-task feature learning, and also outperformed other comparison methods. Several anatomical regions were identified to be common discriminant features across sites. These included prefrontal, superior temporal, insular, anterior cingulate cortex, temporo-limbic and striatal regions consistently implicated in the pathophysiology of schizophrenia, as well as the cerebellum, precuneus, and fusiform, middle temporal, inferior parietal, postcentral, angular, lingual and middle occipital gyri. These results indicate that the proposed multi-task learning method is robust in finding consistent and reliable structural brain abnormalities associated with SCZ across different sites, in the presence of multiple sources of heterogeneity.
Collapse
Affiliation(s)
- Qiongmin Ma
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan 410073, China; Center for Biomedical Image Computing and Analytics, and Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States; Beijing Institute of System Engineering, China.
| | - Tianhao Zhang
- Center for Biomedical Image Computing and Analytics, and Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Marcus V Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Hui Shen
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan 410073, China
| | | | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, and Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Dewen Hu
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan 410073, China
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, and Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States
| |
Collapse
|
14
|
Reduced frontal activity during a verbal fluency test in fibromyalgia: A near-infrared spectroscopy study. J Clin Neurosci 2018; 50:35-40. [DOI: 10.1016/j.jocn.2018.01.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/18/2017] [Accepted: 01/05/2018] [Indexed: 11/18/2022]
|
15
|
Duration of untreated illness as a key to early intervention in schizophrenia: A review. Neurosci Lett 2018; 669:59-67. [DOI: 10.1016/j.neulet.2016.10.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 09/05/2016] [Accepted: 10/02/2016] [Indexed: 12/25/2022]
|
16
|
Koike S, Satomura Y, Kawasaki S, Nishimura Y, Kinoshita A, Sakurada H, Yamagishi M, Ichikawa E, Matsuoka J, Okada N, Takizawa R, Kasai K. Application of functional near infrared spectroscopy as supplementary examination for diagnosis of clinical stages of psychosis spectrum. Psychiatry Clin Neurosci 2017; 71:794-806. [PMID: 28692185 DOI: 10.1111/pcn.12551] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/28/2017] [Accepted: 07/05/2017] [Indexed: 12/18/2022]
Abstract
AIM Research efforts aiming at neuroimaging-aided differential diagnosis for psychiatric disorders have been progressing rapidly. A previous multisite study has developed a supplementary diagnostic system using functional near-infrared spectroscopy (fNIRS) that can be easily applied to clinical settings. However, few neuroimaging biomarkers have been developed for the psychosis spectrum with various clinical stages. METHODS We employed the fNIRS as a clinical examination device for 143 participants, comprising 47 ultra-high risk for psychosis (UHR) individuals, 30 patients with first-episode psychosis (FEP), 34 patients with chronic schizophrenia (ChSZ), and 33 healthy controls, who were independent of the previous study. A 12-month follow-up measurement was also carried out on 34 UHR individuals (72%), 21 patients with FEP (70%), and 33 controls. The fNIRS algorithm variables used for classification were the intensity and timing of prefrontal activation following the start of the cognitive task as used in the previous multisite study. RESULTS The discrimination rate by timing of activation was modest but it became acceptable after adjusting confounding factors. Discrimination by intensity of activation was not improved by similar adjustment. A total of 63.8%, 86.7%, and 81.3% patients were classified as UHR, FEP, and ChSZ, respectively; and 85.1%, 86.7%, and 71.9% of patients in these groups, respectively, were classified as being on the psychosis spectrum. In the follow-up measurement, 88.2% of individuals with UHR and 95.0% of patients with FEP were successfully classified into the psychosis spectrum group. CONCLUSION The fNIRS for supplementary clinical examination could be validly applied to differentiating people with the psychosis spectrum in various clinical stages. The fNIRS is a candidate biological marker for aiding diagnosis of psychosis spectrum in routine clinical settings.
Collapse
Affiliation(s)
- Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM).,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Shingo Kawasaki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo.,Application Development Office, Hitachi Medical Corporation, Chiba, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Akihide Kinoshita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Hanako Sakurada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Mika Yamagishi
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Eriko Ichikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Jun Matsuoka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Ryu Takizawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| |
Collapse
|
17
|
Noda T, Nakagome K, Setoyama S, Matsushima E. Working memory and prefrontal/temporal hemodynamic responses during post-task period in patients with schizophrenia: A multi-channel near-infrared spectroscopy study. J Psychiatr Res 2017; 95:288-298. [PMID: 28934615 DOI: 10.1016/j.jpsychires.2017.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/29/2017] [Accepted: 09/01/2017] [Indexed: 11/30/2022]
Abstract
The relationship between cognitive impairments and social dysfunction in schizophrenia is widely accepted. Neuroimaging studies in patients with schizophrenia have demonstrated abnormal function in the prefrontal region during various neurocognitive tasks. However, studies exploring the neural basis of these cognitive impairments are still limited. Multi-channel near-infrared spectroscopy (NIRS) is a non-invasive functional neuroimaging technique used to detect the spatiotemporal characteristics of brain activity. Previous NIRS studies indicated oxy-hemoglobin (oxy-Hb) increase in patients with schizophrenia during the verbal fluency task (VFT), but to a lesser extent than in healthy participants. Furthermore, aberrant re-increase in the prefrontal region was observed during the post-task period. We hypothesized that prefrontal/temporal oxy-Hb aberrant re-increase during the post-task period was associated with cognitive impairment because oxy-Hb aberrant re-increase represent inadequate suppression of neural activity in the post-task period. We recruited 30 patients with schizophrenia and 30 healthy participants in this study. All participants underwent 52-channel NIRS measurement using the VFT. The patients with schizophrenia showed oxy-Hb aberrant re-increase in prefrontal and temporal regions during the post-task period. Although there was no significant relationship between changes in the oxy-Hb during the task and the scores of the Brief Assessment of Cognition in Schizophrenia (BACS), a significant negative correlation was observed between the oxy-Hb during the post-task period and BACS working memory z-scores (in DLPFC and temporal regions). These results suggest that oxy-Hb re-increase during the post-task period in prefrontal and temporal regions is associated with WM deficits in patients with schizophrenia and NIRS may be a potential biomarker of working memory in chronic schizophrenia.
Collapse
Affiliation(s)
- Takamasa Noda
- Section of Liaison Psychiatry & Palliative Medicine Division of Comprehensive Patient Care, Graduate School of Medical & Dental Sciences, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo, Tokyo 113-8519, Japan; Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1, Ogawahigashi, Kodaira, Tokyo 187-8551, Japan; Clinical Optic Imaging Section, Department of Clinical Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo 187-8551, Japan.
| | - Kazuyuki Nakagome
- National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
| | - Shiori Setoyama
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1, Ogawahigashi, Kodaira, Tokyo 187-8551, Japan
| | - Eisuke Matsushima
- Section of Liaison Psychiatry & Palliative Medicine Division of Comprehensive Patient Care, Graduate School of Medical & Dental Sciences, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo, Tokyo 113-8519, Japan
| |
Collapse
|
18
|
Reduced language lateralization in first episode schizophrenia: A near infrared spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:96-104. [PMID: 28499897 DOI: 10.1016/j.pnpbp.2017.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 04/25/2017] [Accepted: 05/08/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Diminished functional lateralization in language-related areas is found in chronic schizophrenia (SZ). However, whether this reduced lateralization exists at the early stage of SZ remains unclear. The present study aimed to investigate language lateralization in first episode schizophrenia (FES) using near infrared spectroscopy (NIRS) during a letter version of verbal fluency test (VFT). METHODS A total of 28 FES patients and 33 healthy controls (HCs) underwent NIRS while performing a VFT. Six regions of interests (ROIs) were defined: the bilateral frontal-, inferior frontal gyrus (IFG), and temporal regions. Laterality index (LI) was calculated and compared between the two groups in ROIs. In addition, we investigated whether language lateralization was correlated with severity of clinical symptoms. RESULTS Across all ROIs, LI was significantly reduced in FES patients (p=0.037) compared to controls in the IFG region. In addition, LI was not found to be correlated with VFT performance, the PANSS positive, negative or general psychopathology subscales. CONCLUSIONS Our study demonstrated a diminution of leftward functional lateralization in the IFG during a VFT in FES patients. This is the first NIRS study to report reduced functional lateralization in patients at the early stage of schizophrenia.
Collapse
|
19
|
Kumar V, Shivakumar V, Chhabra H, Bose A, Venkatasubramanian G, Gangadhar BN. Functional near infra-red spectroscopy (fNIRS) in schizophrenia: A review. Asian J Psychiatr 2017; 27:18-31. [PMID: 28558892 DOI: 10.1016/j.ajp.2017.02.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/02/2017] [Accepted: 02/12/2017] [Indexed: 01/14/2023]
Abstract
The research on the alterations in functional connectivity in schizophrenia has been facilitated by development of an array of functional neuroimaging techniques. Functional Near Infra Red Spectroscopy (fNIRS) is a novel diffuse optical neuromonitring method with its own advantages and limitations. The advantages of fNIRS have made it to be frequently used as a research tool by medical community in different settings. In fNIRS the property of haemoglobin to absorb near infrared light is used to measure brain activity. It provides the indirect measurement of the neuronal activity in the areas of interest. The advantage of fNIRS being less restrictive has made it to be used more commonly in the research of psychiatric disorders in general, schizophrenia in particular. The fNIRS studies on patients with schizophrenia have shown haemodynamic hypo activation primarily in the prefrontal cortex during various cognitive tasks. In this review, initially we have briefly explained the basic principles of fNIRS followed by detailed review of fNIRS findings in patients with schizophrenia.
Collapse
Affiliation(s)
- Vijay Kumar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harleen Chhabra
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anushree Bose
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bangalore N Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| |
Collapse
|
20
|
Chou PH, Lin WH, Hung CA, Chang CC, Li WR, Lan TH, Huang MW. Perceived Occupational Stress is associated with Decreased Cortical Activity of the Prefrontal Cortex: A Multichannel Near-infrared Spectroscopy Study. Sci Rep 2016; 6:39089. [PMID: 27958364 PMCID: PMC5153618 DOI: 10.1038/srep39089] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/17/2016] [Indexed: 12/31/2022] Open
Abstract
Despite an increasing number of reports on the associations between chronic occupational stress and structural and functional changes of the brain, the underlying neural correlates of perceived occupational stress is still not clear. Perceived stress reflects the extents to which situations are appraised as stressful at a given point in one’s life. Using near-infrared spectroscopy, we investigated the associations between perceived occupational stress and cortical activity over the bilateral frontotemporal regions during a verbal fluency test. Sixty-eight participants (17 men, 51 women), 20–62 years of age were recruited. Perceived occupational stress was measured using the Chinese version of Job Content Questionnaire, and the Chinese version of the Copenhagen Burnout Inventory. We found statistically significant negative associations between occupational burnout and brain cortical activity over the fronto-polar and dorsolateral prefrontal cortex during the VFT (r = −0.343 to −0.464). In conclusion, our research demonstrated a possible neural basis of perceived occupational stress that are distributed across the prefrontal cortex.
Collapse
Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, Faculty of Medicine of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Photonics, National Chiao Tung University, Hsinchu, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chao-An Hung
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wan-Rung Li
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, Faculty of Medicine of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Min-Wei Huang
- Chia-Yi branch, Taichung Veterans General Hospital, Chiayi City, Taiwan
| |
Collapse
|
21
|
Wang MY, Ho NF, Sum MY, Collinson SL, Sim K. Impact of duration of untreated psychosis and premorbid intelligence on cognitive functioning in patients with first-episode schizophrenia. Schizophr Res 2016; 175:97-102. [PMID: 27146474 DOI: 10.1016/j.schres.2016.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/29/2016] [Accepted: 04/03/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND The neurotoxic hypothesis suggests that psychosis is toxic to the brain leading to clinical consequences. In this study, we hypothesized that a longer duration of untreated psychosis (DUP) in first episode schizophrenia (FES) patients is associated with poorer cognitive functioning, and that higher premorbid intelligence buffers against DUP-related cognitive impairment. METHOD Eighty-one FES patients completed a neuropsychological battery, the Brief Assessment of Cognition in Schizophrenia (BACS). Composite scores of the BACS, which were normalized to a matched healthy control of seventy-three subjects, were used as an index of general cognition. A median split using the Wide Range Achievement Test-Reading Test scores was used to divide the patients into low versus high premorbid IQ groups. Hierarchical linear regression was performed to examine predictors of general cognition, including DUP. RESULTS Longer DUP was found to be a significant predictor of poorer general cognition. In addition, DUP predicted general cognition in the low premorbid IQ group but not in the high premorbid IQ group. CONCLUSIONS Our findings demonstrate that longer DUP in FES patients is associated with worse cognitive scores, and that this association is more pronounced in a subgroup of patients who have lower premorbid intelligence. Our results suggest the importance of earlier identification and management of patients with low premorbid IQ, given that their cognition may be more vulnerable to the toxicity of psychosis.
Collapse
Affiliation(s)
- M Y Wang
- Research Division, Institute of Mental Health, Singapore
| | - N F Ho
- Research Division, Institute of Mental Health, Singapore
| | - M Y Sum
- Research Division, Institute of Mental Health, Singapore
| | - S L Collinson
- Department of Psychology, National University of Singapore, Singapore
| | - K Sim
- Research Division, Institute of Mental Health, Singapore; General Psychiatry, Institute of Mental Health, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| |
Collapse
|
22
|
Chou PH, Chu CS, Lin CH, Cheng C, Chen YH, Lan TH, Huang MW. Use of atypical antipsychotics and risks of cataract development in patients with schizophrenia: A population-based, nested case-control study. Schizophr Res 2016; 174:137-143. [PMID: 27061658 DOI: 10.1016/j.schres.2016.03.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/21/2016] [Accepted: 03/24/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Previous research has suggested a link between typical antipsychotic use and the development of cataracts, but the association between atypical antipsychotics and cataracts remains unclear in schizophrenia (SZ). METHODS A retrospective nested case-control study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2000 and 2011. A total of 2144 SZ patients with cataracts and 2222 controls matched for age, sex, and index date were included. Antipsychotic exposure was categorized by type and duration, and the association between antipsychotic exposure and cataract development was assessed using a conditional logistic regression analysis. RESULTS We found that the severity of physical comorbidities, concurrent antidepressant use, and comorbidity with glaucoma or other retinal disorders were associated with an increased risk for cataract development. Alternatively, we did not find significant associations between continuous use of clozapine, risperidone, paliperidone, ziprasidone, olanzapine, quetiapine, amisulpride, zotepine or aripiprazole and risk of cataract development in SZ patients. CONCLUSIONS We did not detect any association between atypical antipsychotic use and risk of cataract development in SZ patients. Future studies with longitudinal ocular evaluations in patients using atypical antipsychotics are warranted to confirm our findings.
Collapse
Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, School of Medicine, National Yang Ming University, Taipei, Taiwan.
| | - Che-Sheng Chu
- Department of Psychiatry, Puli Branch, Taichung Veterans General Hospital, Nantou County, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
| | - Chin Cheng
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Huey Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, School of Medicine, National Yang Ming University, Taipei, Taiwan.
| | - Min-Wei Huang
- Chia-Yi branch, Taichung Veterans General Hospital, Chiayi City, Taiwan
| |
Collapse
|
23
|
Souaiby L, Gaillard R, Krebs MO. [Duration of untreated psychosis: A state-of-the-art review and critical analysis]. Encephale 2016; 42:361-6. [PMID: 27161262 DOI: 10.1016/j.encep.2015.09.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/26/2015] [Accepted: 09/07/2015] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Prognosis of schizophrenia has not significantly improved despite extensive research. There is often a relatively long delay between onset of symptoms and treatment initiation. Lately, duration of untreated psychosis (DUP), the time between the onset of psychosis and initiation of treatment, has been one of the most studied variables in patients presenting for a first psychotic episode in order to evaluate the impact of early intervention on the prognosis of schizophrenia. In the literature, a variety of criteria have been used to define both transition to psychosis and initiation of treatment. Furthermore, the dating of both of these variables is usually retrospective, further complicating the measurement of DUP. METHODS We conducted a comprehensive review about DUP using Pubmed and Google Scholar databases up to January 2015 using the following keywords "schizophrenia", "duration of untreated psychosis", "duration of untreated illness" and "early intervention". Papers were included if they were published in French or English. RESULTS The mean DUP was found to be 2 years but it can vary according to multiple factors such as denial of illness by the patient and family, withdrawal and isolation from friends and relatives, diagnostic errors, paranoid views of the mental health treatment systems, or negative symptoms. Long DUP may also be a correlate of poor premorbid functioning or of an insidiously unfolding psychosis. Considerable discrepancies exist in the way that DUP is estimated in different studies. Although the clinical interview remains the most common way of measuring DUP, so far there is no evidence for favoring one method over another. Regardless of measurement method, a longer DUP is found to be associated with poorer outcome in schizophrenia in both the short and long-term across a number of domains: symptoms severity, remission rates, the risk of relapse, global functioning and quality of life. Its role in functional outcome appears to be mediated largely by negative symptoms, for which there is still no effective treatment. A recent meta-analysis has shown that shorter DUP is associated with less severe negative symptoms at short and long-term follow-up, especially when DUP is shorter than 9 months. The mechanism of the relationship between DUP and outcome is still undefined. A hypothesis is that the shorter the DUP, the more likely the intervention is being applied during the period in which neurobiological deficit processes in schizophrenia are most active. DISCUSSION A study of the duration of untreated illness (DUI), which is defined as the DUP and the prodromal phase, seems necessary because results of studies evaluating the effect of early detection and intervention in individuals with clinical high risk for psychosis are promising. A number of interventions such as omega 3 fatty acids and integrated psychosocial interventions seem to delay transition in the at-risk population. However, replication studies are lacking, and a great proportion of at high-risk individuals will spontaneously remit or develop diseases other than chronic psychosis, making us question the advantages and disadvantages of a treatment. Taking into consideration the high prevalence of comorbidities in individuals referred for clinical high-risk state and their effect on the individual's functioning, future interventions in the field need to address not only the preventative efficacy on psychosis transition but also their effectiveness in improving the functioning of this population and their effect on the outcome of schizophrenia when transition to psychosis has occurred. CONCLUSION Despite the huge advances in the field of schizophrenia, many questions remain unanswered and huge efforts are still necessary to understand the pathophysiology of this illness in order to improve its outcome.
Collapse
Affiliation(s)
- L Souaiby
- Service hospitalo-universitaire, -S14, centre hospitalier Sainte-Anne, 75014 Paris, France; Faculté de médecine, université Saint-Joseph, Beyrouth, Liban.
| | - R Gaillard
- Service hospitalo-universitaire, -S14, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm U894, centre psychiatrie et neurosciences, université Paris-Descartes, Paris Sorbonne Cité, Paris, France; Institut de psychiatrie (GDR3557), Paris, France
| | - M-O Krebs
- Service hospitalo-universitaire, -S14, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm U894, centre psychiatrie et neurosciences, université Paris-Descartes, Paris Sorbonne Cité, Paris, France; Institut de psychiatrie (GDR3557), Paris, France
| |
Collapse
|
24
|
Ohi K, Matsuda Y, Shimada T, Yasuyama T, Oshima K, Sawai K, Kihara H, Nitta Y, Okubo H, Uehara T, Kawasaki Y. Structural alterations of the superior temporal gyrus in schizophrenia: Detailed subregional differences. Eur Psychiatry 2016; 35:25-31. [PMID: 27061374 DOI: 10.1016/j.eurpsy.2016.02.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/05/2016] [Accepted: 02/06/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Reduced gray matter volumes in the superior temporal gyrus (STG) have been reported in patients with schizophrenia. Such volumetric abnormalities might denote alterations in cortical thickness, surface area, local gyrification or all of these factors. The STG can be anatomically divided into five subregions using automatic parcellation in FreeSurfer: lateral aspect of the STG, anterior transverse temporal gyrus of Heschl gyrus (HG), planum polare (PP) of the STG, planum temporale (PT) of the STG and transverse temporal sulcus. METHODS We acquired magnetic resonance imaging (MRI) 3T scans from 40 age- and sex-matched patients with schizophrenia and 40 healthy subjects, and the scans were automatically processed using FreeSurfer. General linear models were used to assess group differences in regional volumes and detailed thickness, surface area and local gyrification. RESULTS As expected, patients with schizophrenia had significantly smaller bilateral STG volumes than healthy subjects. Of the five subregions in the STG, patients with schizophrenia showed significantly and marginally reduced volumes in the lateral aspect of the STG and PT of the STG bilaterally compared with healthy subjects. The volumetric alteration in bilateral lateral STG was derived from both the cortical thickness and surface area but not local gyrification. There was no significant laterality of the alteration in the lateral STG between patients and controls and no correlation among the structures and clinical characteristics. CONCLUSIONS These findings suggest that of five anatomical subregions in the STG, the lateral STG is one of the most meaningful regions for brain pathophysiology in schizophrenia.
Collapse
Affiliation(s)
- K Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan.
| | - Y Matsuda
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan; Project Research Center, Kanazawa Medical University, Ishikawa, Japan.
| | - T Shimada
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - T Yasuyama
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - K Oshima
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - K Sawai
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - H Kihara
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Y Nitta
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - H Okubo
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - T Uehara
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Y Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| |
Collapse
|
25
|
The association between cognitive deficits and prefrontal hemodynamic responses during performance of working memory task in patients with schizophrenia. Schizophr Res 2016; 172:114-22. [PMID: 26830318 DOI: 10.1016/j.schres.2016.01.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/23/2016] [Accepted: 01/25/2016] [Indexed: 11/23/2022]
Abstract
Schizophrenia-associated cognitive deficits are resistant to treatment and thus pose a lifelong burden. The Brief Assessment of Cognition in Schizophrenia (BACS) provides reliable and valid assessments across cognitive domains. However, because the prefrontal functional abnormalities specifically associated with the level of cognitive deficits in schizophrenia have not been examined, we explored this relationship. Patients with schizophrenia (N=87) and matched healthy controls (N=50) participated in the study. Using near-infrared spectroscopy (NIRS), we measured the hemodynamic responses in the prefrontal and superior temporal cortical surface areas during a working memory task. Correlation analyses revealed a relationship between the hemodynamics and the BACS composite and domain scores. Hemodynamic responses of the left dorsolateral prefrontal cortex (DLPFC) and left frontopolar cortex (FPC) in the higher-level-of-cognitive-function schizophrenia group were weaker than the responses of the controls but similar to those of the lower-level-of-cognitive-function schizophrenia group. However, hemodynamic responses in the right DLPFC, bilateral ventrolateral PFC (VLPFC), and right temporal regions decreased with increasing cognitive deficits. In addition, the hemodynamic response correlated positively with the level of cognitive function (BACS composite scores) in the right DLPFC, bilateral VLPFC, right FPC, and bilateral temporal regions in schizophrenia. The correlation was driven by all BACS domains. Our results suggest that the linked functional deficits in the right DLPFC, bilateral VLPFC, right FPC, and bilateral temporal regions may be related to BACS-measured cognitive impairments in schizophrenia and show that linking the neurocognitive deficits and brain abnormalities can increase our understanding of schizophrenia pathophysiology.
Collapse
|
26
|
Association between rostral prefrontal cortical activity and functional outcome in first-episode psychosis: a longitudinal functional near-infrared spectroscopy study. Schizophr Res 2016; 170:304-10. [PMID: 26792296 DOI: 10.1016/j.schres.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/24/2015] [Accepted: 01/01/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Few biomarkers can be used easily and noninvasively to measure clinical condition and future outcome in patients with first-episode psychosis (FEP). To develop such biomarker using multichannel functional near-infrared spectroscopy (fNIRS), cortical function in the prefrontal cortex was longitudinally measured during a verbal fluency task. METHODS Sixty-nine fNIRS measurements and 77 clinical assessments were obtained from 31 patients with FEP at baseline, 6-month, and 12-month follow-ups. Sixty measurements were obtained from 30 healthy controls matched for age, sex, and premorbid IQ. We initially tested signal changes for 12 months, and then investigated the relationship between fNIRS signals and clinical assessments. RESULTS Signal changes from baseline to 12-month follow-up were not evident in any group. Patients with FEP had significant positive correlation coefficients between 6-month fNIRS signals and the 12-month Global Assessment of Functioning (GAF) score in the left middle frontal gyrus (FDR-corrected p=.0016-.0052, r=.65-.59). fNIRS signals at the 12-month follow-up were associated with 12-month GAF score in the bilateral superior and middle frontal gyri (FDR-corrected p=.00085-.018, r=.72-.55), and with the difference between baseline and 12-month GAF scores in the right superior frontal gyrus (FDR-corrected p=.000067-.00012, r=.80-.78). These associations were significant even after controlling for demographic variables. No association between baseline fNIRS signals and later GAF scores was found. DISCUSSION fNIRS measurement can potentially be used as a biomarker to aid sequential assessment of neuro-clinical conditions through the early stage of psychosis.
Collapse
|
27
|
Chou PH, Lin WH, Lin CC, Hou PH, Li WR, Hung CC, Lin CP, Lan TH, Chan CH. Duration of Untreated Psychosis and Brain Function during Verbal Fluency Testing in First-Episode Schizophrenia: A Near-Infrared Spectroscopy Study. Sci Rep 2015; 5:18069. [PMID: 26656662 PMCID: PMC4674798 DOI: 10.1038/srep18069] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 11/09/2015] [Indexed: 01/17/2023] Open
Abstract
A longer duration of untreated psychosis (DUP) has been associated with poor clinical outcomes in patients with schizophrenia (SZ); however, it remains unclear whether this is due to neurotoxic effects of psychosis. The purpose of this study was to use near-infrared spectroscopy (NIRS) to investigate the influence of DUP on brain function using two verbal fluency tests (VFTs) in patients with first-episode SZ (FES). A total of 28 FES patients and 29 healthy controls (HC) underwent NIRS during VFTs. Group comparisons of cortical activity were made using two-tailed t-tests and the false discovery rate method. We then examined the associations between DUP and hemodynamic changes in each channel to identify any effects of DUP on brain cortical activity. During the letter VFT, the HC group exhibited significantly greater cortical activations over bilateral frontotemporal regions compared to FES patients. However, this distinction was not observed while performing a category version of the VFT. In addition, no associations between DUP and brain cortical activity were observed in the FES group during either VFT. In conclusion, we did not find an association between DUP and frontotemporal cortical activities. This might be because neurodevelopmental disturbances result in neurocognitive deficits long before psychotic symptoms onset.
Collapse
Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Chien Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Hsun Hou
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Social Work and Child Welfare, Providence University, Taichung, Taiwan
| | - Wan-Rung Li
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Chun Hung
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Brain Connectivity Lab, Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Department of Social Work and Child Welfare, Providence University, Taichung, Taiwan.,Brain Connectivity Lab, Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Hong Chan
- Department of Psychiatry, Conde S. Januário General Hospital, Macau, China
| |
Collapse
|
28
|
Quan W, Wu T, Li Z, Wang Y, Dong W, Lv B. Reduced prefrontal activation during a verbal fluency task in Chinese-speaking patients with schizophrenia as measured by near-infrared spectroscopy. Prog Neuropsychopharmacol Biol Psychiatry 2015; 58:51-8. [PMID: 25542372 DOI: 10.1016/j.pnpbp.2014.12.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 12/14/2022]
Abstract
Near-infrared spectroscopy (NIRS) has been applied to examine the possible functional alternations during the performance of cognitive tasks in schizophrenia. With this technique, previous studies have observed that patients with schizophrenia are often associated with reduced brain activation in the prefrontal cortex during the verbal fluency task (VFT) of the English version or the Japanese version. However, it remains unclear whether there is a brain functional impairment in Chinese-speaking patients with schizophrenia. In this study, we designed a Chinese version of the VFT and performed a multichannel NIRS study in a large group of patients with schizophrenia and healthy controls. We investigated brain activation during the task period of the Chinese version of the VFT within a schizophrenia group and a healthy group, respectively, and compared the relative changes between the two groups. Our results confirmed that Chinese-speaking patients with schizophrenia had significantly lower brain activation in the prefrontal cortex and superior temporal cortex when compared with healthy controls. Such findings based on the NIRS data provided us reliable evidences about brain functional deficits in the Chinese-speaking patients with schizophrenia.
Collapse
Affiliation(s)
- Wenxiang Quan
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Tongning Wu
- China Academy of Telecommunication Research of Ministry of Industry and Information Technology, Beijing, China
| | - Zhaohua Li
- School of Information and Communication Engineering, Beijing Information Science and Technology University, Beijing, China
| | - Yuduo Wang
- School of Information and Communication Engineering, Beijing Information Science and Technology University, Beijing, China
| | - Wentian Dong
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
| | - Bin Lv
- China Academy of Telecommunication Research of Ministry of Industry and Information Technology, Beijing, China.
| |
Collapse
|
29
|
Chou PH, Koike S, Nishimura Y, Satomura Y, Kinoshita A, Takizawa R, Kasai K. Similar age-related decline in cortical activity over frontotemporal regions in schizophrenia: a multichannel near-infrared spectroscopy study. Schizophr Bull 2015; 41:268-79. [PMID: 24948388 PMCID: PMC4266293 DOI: 10.1093/schbul/sbu086] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Although recent studies have demonstrated that patients with schizophrenia and healthy controls did not differ in the speed of age-related decline in cortical thickness and performances on cognitive tests, hemodynamic changes assessed by functional neuroimaging remain unclear. This study investigated age effects on regional brain cortical activity to determine whether there is similar age-related decline in cortical activity as those observed in cortical thickness and cognitive test performance. METHOD A total of 109 patients with schizophrenia (age range: 16-59 y) and 106 healthy controls (age range: 16-59 y) underwent near-infrared spectroscopy (NIRS) while performing a verbal fluency test (VFT). Group comparison of cortical activity was examined using 2-tailed t tests, adopting the false discovery rate method. The relationship between age and cortical activity was investigated using correlational and multiple regression analyses, adjusting for potential confounding variables. A 2-way ANOVA was conducted to investigate differences in the age effects between diagnostic groups. RESULTS The patient group exhibited significantly decreased cortical activity in several regions of the frontotemporal cortices. However, slopes of age-dependent decreases in cortical activity were similar between patients and healthy individuals at the bilateral frontotemporal regions. CONCLUSIONS Our study showed no significant between-group differences in the age-related decline in cortical activity, as measured by NIRS, over the frontotemporal regions during a VFT. The results of our study may indicate a decrease in cortical activity in a relatively limited period around illness onset rather than continuously progressing over the course of the illness.
Collapse
Affiliation(s)
- Po-Han Chou
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;,Department of Psychiatry, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;,Division for Counseling and Support, Office for Mental Health Support, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Akihide Kinoshita
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryu Takizawa
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan;
| |
Collapse
|
30
|
Register-Brown K, Hong LE. Reliability and validity of methods for measuring the duration of untreated psychosis: a quantitative review and meta-analysis. Schizophr Res 2014; 160:20-6. [PMID: 25464915 DOI: 10.1016/j.schres.2014.10.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/09/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The duration of untreated psychosis (DUP) has been associated with a wide range of clinical outcomes, and is considered to be one of the key parameters in managing clinical high risk and first episode psychosis patients. However, considerable discrepancies exist in the way that DUP is estimated in different studies. There is no standard or consensus on which method is most reliable and valid for assessing DUP. METHODS This review aimed to quantitatively assess different DUP measurement instruments and definitions by comparing their inter-rater reliability, and their strength of validity in predicting biological and clinical outcomes. RESULTS Nine instruments designed for measuring DUP were found. Their inter-rater reliability were found to be adequate to excellent, although quite varied. This analysis did not show that any instrument was clearly outstanding compared to the others, although the limited available data do not exclude this possibility. DUP was also significantly associated with a range of outcomes, although mostly with small effect sizes. However, non-instrument based, ad hoc clinical interviews remained the most common way of measuring DUP. Definitions of onset of psychosis and onset of treatment were inconsistent among studies. CONCLUSIONS This review did not find quantitative evidence to support the use of one instrument over another. DUP remains a promising modifiable risk factor for a range of long-term clinical outcomes. Future research should quantify and improve the reliability and validity of the structured instruments for DUP measurement.
Collapse
Affiliation(s)
- Kelly Register-Brown
- University of Maryland/Sheppard Pratt Psychiatry Residency Training Program, University of Maryland. 701W. Pratt St., 4th Floor, Baltimore, MD 21201, USA.
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD. Tawes Ct., Catonsville, MD 21228, USA
| |
Collapse
|
31
|
Peruzzo D, Castellani U, Perlini C, Bellani M, Marinelli V, Rambaldelli G, Lasalvia A, Tosato S, De Santi K, Murino V, Ruggeri M, Brambilla P. Classification of first-episode psychosis: a multi-modal multi-feature approach integrating structural and diffusion imaging. J Neural Transm (Vienna) 2014; 122:897-905. [PMID: 25344845 DOI: 10.1007/s00702-014-1324-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 10/05/2014] [Indexed: 12/23/2022]
Abstract
Currently, most of the classification studies of psychosis focused on chronic patients and employed single machine learning approaches. To overcome these limitations, we here compare, to our best knowledge for the first time, different classification methods of first-episode psychosis (FEP) using multi-modal imaging data exploited on several cortical and subcortical structures and white matter fiber bundles. 23 FEP patients and 23 age-, gender-, and race-matched healthy participants were included in the study. An innovative multivariate approach based on multiple kernel learning (MKL) methods was implemented on structural MRI and diffusion tensor imaging. MKL provides the best classification performances in comparison with the more widely used support vector machine, enabling the definition of a reliable automatic decisional system based on the integration of multi-modal imaging information. Our results show a discrimination accuracy greater than 90 % between healthy subjects and patients with FEP. Regions with an accuracy greater than 70 % on different imaging sources and measures were middle and superior frontal gyrus, parahippocampal gyrus, uncinate fascicles, and cingulum. This study shows that multivariate machine learning approaches integrating multi-modal and multisource imaging data can classify FEP patients with high accuracy. Interestingly, specific grey matter structures and white matter bundles reach high classification reliability when using different imaging modalities and indices, potentially outlining a prefronto-limbic network impaired in FEP with particular regard to the right hemisphere.
Collapse
Affiliation(s)
- Denis Peruzzo
- Department of Computer Science, University of Verona, Strada le Grazie 15, 37134, Verona, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Zephaniah PV, Kim JG. Recent functional near infrared spectroscopy based brain computer interface systems: Developments, applications and challenges. Biomed Eng Lett 2014. [DOI: 10.1007/s13534-014-0156-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|