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Li X, Dai J, Liu Q, Zhao Z, Zhang X. Efficacy and safety of non-invasive brain stimulation on cognitive function for cognitive impairment associated with schizophrenia: A systematic review and meta-analysis. J Psychiatr Res 2024; 170:174-186. [PMID: 38150769 DOI: 10.1016/j.jpsychires.2023.12.003] [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: 07/27/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023]
Abstract
Based on existing evidence of the effects of the most commonly used non-invasive brain stimulation (NIBS), which includes transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), we conducted a meta-analysis to investigate the cognitive improvement and safety of NIBS on schizophrenia-related cognitive impairment. PubMed, EMBASE, Cochrane Library, and Web of Science were searched. The Cochrane Risk of Bias tool was used to assess the risk of bias of the included RCTs; Review Manager, version 5.4.1, was used to perform the statistical analysis. Twenty double-blind, randomized, sham-controlled trials involving 997 patients were included. As a result, no significant improvement in cognitive function was observed after NIBS treatment. However, the overall treatment effect of the two main NIBS modes (i.e., rTMS and tDCS) was associated with significantly larger improvements in negative symptoms and good tolerability in patients with schizophrenia compared to sham-controls (SMD = -0.56, 95% CI [-1.03, -0.08], p = 0.02, I2 = 88%). NIBS model and stimulus parameters influenced the effect of NIBS. More favorable effects were observed in patients who received rTMS stimulation (SMD = 0.25, 95% CI [0.01, 0.49], p = 0.04, I2 = 0%) in the left dorsolateral prefrontal cortex with a stimulation intensity of 20 Hz (p = 0.004) for a period longer than 1 month (p < 0.05). Yet, due to the limited number of included studies and heterogeneity in both study design and target population, the results of this analysis need to be interpreted with caution.
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Affiliation(s)
- Xueyan Li
- Neurology Department, Cangzhou City Center Hospital, Cangzhou, 061000, China.
| | - Jie Dai
- Neurology Department, Cangzhou City Center Hospital, Cangzhou, 061000, China
| | - Qingran Liu
- Neurology Department, Cangzhou City Center Hospital, Cangzhou, 061000, China
| | - Zhenying Zhao
- Neurology Department, Cangzhou City Center Hospital, Cangzhou, 061000, China
| | - Xiaofeng Zhang
- Neurology Department, Cangzhou City Center Hospital, Cangzhou, 061000, China
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2
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Lemmers-Jansen I, Velthorst E, Fett AK. The social cognitive and neural mechanisms that underlie social functioning in individuals with schizophrenia - a review. Transl Psychiatry 2023; 13:327. [PMID: 37865631 PMCID: PMC10590451 DOI: 10.1038/s41398-023-02593-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 10/23/2023] Open
Abstract
In many individuals with a diagnosis of schizophrenia social functioning is impaired across the lifespan. Social cognition has emerged as one of the possible factors that may contribute to these challenges. Neuroimaging research can give further insights into the underlying mechanisms of social (cognitive) difficulties. This review summarises the evidence on the associations between social cognition in the domains of theory of mind and emotion perception and processing, and individuals' social functioning and social skills, as well as associated neural mechanisms. Eighteen behavioural studies were conducted since the last major review and meta-analysis in the field (inclusion between 7/2017 and 1/2022). No major review has investigated the link between the neural mechanisms of social cognition and their association with social functioning in schizophrenia. Fourteen relevant studies were included (from 1/2000 to 1/2022). The findings of the behavioural studies showed that associations with social outcomes were slightly stronger for theory of mind than for emotion perception and processing. Moreover, performance in both social cognitive domains was more strongly associated with performance on social skill measures than questionnaire-based assessment of social functioning in the community. Studies on the underlying neural substrate of these associations presented mixed findings. In general, higher activation in various regions of the social brain was associated with better social functioning. The available evidence suggests some shared regions that might underlie the social cognition-social outcome link between different domains. However, due to the heterogeneity in approaches and findings, the current knowledge base will need to be expanded before firm conclusions can be drawn.
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Affiliation(s)
- Imke Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (iBBA) Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eva Velthorst
- GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands
| | - Anne-Kathrin Fett
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, City, University of London, London, UK.
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3
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Mohapatra AN, Wagner S. The role of the prefrontal cortex in social interactions of animal models and the implications for autism spectrum disorder. Front Psychiatry 2023; 14:1205199. [PMID: 37409155 PMCID: PMC10318347 DOI: 10.3389/fpsyt.2023.1205199] [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: 04/16/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023] Open
Abstract
Social interaction is a complex behavior which requires the individual to integrate various internal processes, such as social motivation, social recognition, salience, reward, and emotional state, as well as external cues informing the individual of others' behavior, emotional state and social rank. This complex phenotype is susceptible to disruption in humans affected by neurodevelopmental and psychiatric disorders, including autism spectrum disorder (ASD). Multiple pieces of convergent evidence collected from studies of humans and rodents suggest that the prefrontal cortex (PFC) plays a pivotal role in social interactions, serving as a hub for motivation, affiliation, empathy, and social hierarchy. Indeed, disruption of the PFC circuitry results in social behavior deficits symptomatic of ASD. Here, we review this evidence and describe various ethologically relevant social behavior tasks which could be employed with rodent models to study the role of the PFC in social interactions. We also discuss the evidence linking the PFC to pathologies associated with ASD. Finally, we address specific questions regarding mechanisms employed by the PFC circuitry that may result in atypical social interactions in rodent models, which future studies should address.
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Affiliation(s)
- Alok Nath Mohapatra
- Sagol Department of Neurobiology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
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Hudson M, Santavirta S, Putkinen V, Seppälä K, Sun L, Karjalainen T, Karlsson HK, Hirvonen J, Nummenmaa L. Neural responses to biological motion distinguish autistic and schizotypal traits. Soc Cogn Affect Neurosci 2023; 18:nsad011. [PMID: 36847146 PMCID: PMC10032360 DOI: 10.1093/scan/nsad011] [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: 09/15/2022] [Revised: 01/26/2023] [Accepted: 02/24/2023] [Indexed: 03/01/2023] Open
Abstract
Difficulties in social interactions characterize both autism and schizophrenia and are correlated in the neurotypical population. It is unknown whether this represents a shared etiology or superficial phenotypic overlap. Both conditions exhibit atypical neural activity in response to the perception of social stimuli and decreased neural synchronization between individuals. This study investigated if neural activity and neural synchronization associated with biological motion perception are differentially associated with autistic and schizotypal traits in the neurotypical population. Participants viewed naturalistic social interactions while hemodynamic brain activity was measured with fMRI, which was modeled against a continuous measure of the extent of biological motion. General linear model analysis revealed that biological motion perception was associated with neural activity across the action observation network. However, intersubject phase synchronization analysis revealed neural activity to be synchronized between individuals in occipital and parietal areas but desynchronized in temporal and frontal regions. Autistic traits were associated with decreased neural activity (precuneus and middle cingulate gyrus), and schizotypal traits were associated with decreased neural synchronization (middle and inferior frontal gyri). Biological motion perception elicits divergent patterns of neural activity and synchronization, which dissociate autistic and schizotypal traits in the general population, suggesting that they originate from different neural mechanisms.
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Affiliation(s)
- Matthew Hudson
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
- School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK
- Brain Research & Imaging Centre, Faculty of Health, University of Plymouth, Research Way, Plymouth PL6 8BU, UK
| | - Severi Santavirta
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Vesa Putkinen
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Kerttu Seppälä
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
- Department of Medical Physics, Turku University Hospital, Turku 20520, Finland
| | - Lihua Sun
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Tomi Karjalainen
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Henry K Karlsson
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Jussi Hirvonen
- Department of Radiology, University of Turku and Turku University Hospital, Turku 20520, Finland
- Medical Imaging Centre, Department of Radiology, Tampere University and Tampere University Hospital, Tampere 33100, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Department of Psychology, University of Turku, Turku 20520, Finland
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5
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Goh KK, Chen CH, Wu TH, Chiu YH, Lu ML. Efficacy and safety of intermittent theta-burst stimulation in patients with schizophrenia: A meta-analysis of randomized sham-controlled trials. Front Pharmacol 2022; 13:944437. [PMID: 36071833 PMCID: PMC9441632 DOI: 10.3389/fphar.2022.944437] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
Theta-burst stimulation is a non-invasive brain stimulation technique that was introduced as a potential augmentation treatment for patients with schizophrenia. The purpose of this meta-analysis was to investigate the therapeutic efficacy and safety of intermittent theta-burst stimulation in patients with schizophrenia. Following the PRISMA guidelines, the MEDLINE, Embase, Cochrane, Scopus, Web of Science, and CNKI databases were searched for relevant studies from database inception to 9 January 2022. Change in symptom severity among patients with schizophrenia was the primary outcome, and changes in cognitive function and safety profiles, including the discontinuation rate and adverse events, were secondary outcomes. In total, 13 double-blind randomized sham-controlled trials with 524 patients were included. Intermittent theta-burst stimulation adjunct to antipsychotics was associated with significantly improved psychopathology in patients with schizophrenia, particularly for negative symptoms and general psychopathology but not for positive symptoms or cognitive function. The stimulation parameters influenced the effectiveness of intermittent theta-burst stimulation. A more favorable effect was observed in patients who received theta-burst stimulation at the left dorsolateral prefrontal cortex, with ≥1800 pulses per day, for ≥20 sessions, and using an inactive sham coil as a placebo comparison in the study. The intermittent theta-burst stimulation is well tolerated and safe in patients with schizophrenia. Intermittent theta-burst stimulation adjunct to antipsychotics treatment is associated with significant improvement in negative symptoms and favorable tolerability in patients with schizophrenia. This meta-analysis may provide insights into the use of intermittent theta-burst stimulation as an additional treatment to alleviate the negative symptoms of schizophrenia.
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Affiliation(s)
- Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Centre, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Hsin Chen
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Centre, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Hua Wu
- Psychiatric Research Centre, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Centre, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Centre, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Mong-Liang Lu,
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Kim JH, Joo YH, Son YD, Kim HK, Kim JH. Differences in mGluR5 Availability Depending on the Level of Social Avoidance in Drug-Naïve Young Patients with Major Depressive Disorder. Neuropsychiatr Dis Treat 2022; 18:2041-2053. [PMID: 36124236 PMCID: PMC9481450 DOI: 10.2147/ndt.s379395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/03/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous research has shown that metabotropic glutamate receptor-5 (mGluR5) signaling is significantly involved in social avoidance. We investigated the relationship between levels of social avoidance and mGluR5 availability in drug-naïve young patients with major depressive disorder (MDD). METHODS Twenty non-smoking patients and eighteen matched non-smoking healthy controls underwent [11C]ABP688 positron emission tomography (PET) and magnetic resonance imaging scans. The binding potential (BPND) of [11C]ABP688 was obtained using the simplified reference tissue model. Patients' level of social avoidance was assessed using the Social Avoidance and Distress Scale (SADS). For [11C]ABP688 BPND, the region-of-interest (ROI)-based between-group comparisons and correlations with SADS scores were investigated. The frontal cortices were chosen as a priori ROIs based on previous PET investigations in MDD, and on literature underscoring the importance of the frontal cortex in social avoidance. RESULTS Independent samples t-tests revealed no significant differences in [11C]ABP688 BPND in the frontal cortices between the MDD patient group as a whole and healthy controls. One-way analysis of variance with post-hoc tests revealed significantly lower BPND in the bilateral superior frontal cortex (SFC) and left middle frontal cortex (MFC) in MDD patients with low levels of social avoidance (L-SADS) than in healthy controls. The L-SADS patients also had significantly lower BPND in the medial part of the right SFC than both MDD patients with high levels of social avoidance (H-SADS) and healthy controls. The L-SADS patients also showed significantly lower BPND in the orbital parts of the SFC, MFC, and inferior frontal cortex than H-SADS patients. No significant group differences were found between H-SADS patients and healthy controls. The ROI-based correlation analysis revealed significant positive correlations between social avoidance levels and frontal [11C]ABP688 BPND in the entire patients. CONCLUSION Our exploratory study shows significant differences in frontal mGluR5 availability depending on the level of social avoidance in drug-naïve non-smoking MDD patients, suggesting that social avoidance should be considered as one of the clinical factors involved in mGluR5 signaling changes in depression.
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Affiliation(s)
- Jeong-Hee Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Yo-Han Joo
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Young-Don Son
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Republic of Korea
| | - Hang-Keun Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Republic of Korea
| | - Jong-Hoon Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences & Technology, Gachon University, Incheon, Republic of Korea.,Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
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7
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Riches S, Pisani S, Bird L, Rus-Calafell M, Garety P, Valmaggia L. Virtual reality-based assessment and treatment of social functioning impairments in psychosis: a systematic review. Int Rev Psychiatry 2021; 33:337-362. [PMID: 34121587 DOI: 10.1080/09540261.2021.1918648] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People with psychosis can experience social functioning impairments. Virtual reality (VR) has been used to assess and treat these difficulties. This systematic review (Prospero CRD42015026288) provides an evaluation of these VR applications. PsycINFO, MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus were searched until May 2020. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess studies. Database searching identified 3810 titles. Fifty-eight studies (published 2005-2020; N = 2,853), comprising twenty-six head-mounted display studies (20 assessment, 6 treatment) and thirty-two immersive 2D screen studies (23 assessment, 9 treatment), were included. There were forty-eight observational studies and ten randomised controlled trials, with 1570 participants (of which, 185 were at ultra-high risk of psychosis) in VR test groups. Nearly half the studies were published since 2016. Assessments targeted cognitive and behavioural indicators of social functioning, e.g. paranoia, eye gaze, or interpersonal distance. Treatments promoted cognitive-behavioural social skills or job interview training. Studies indicate feasibility, acceptability, and effectiveness of VR for social functioning impairments in psychosis. Limitations of studies include the narrow scope of social functioning, small sample sizes, and limited randomised controlled trials and standardised interventions. Findings suggest VR has potential to be integrated with existing psychological approaches.
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Affiliation(s)
- Simon Riches
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Sara Pisani
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Leanne Bird
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Mar Rus-Calafell
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
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8
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Sofko C, Tremont G, Tan JE, Westervelt H, Ahern DC, Menard W, Phillips KA. Olfactory and Neuropsychological Functioning in Olfactory Reference Syndrome. PSYCHOSOMATICS 2020; 61:261-267. [PMID: 32107040 PMCID: PMC7211111 DOI: 10.1016/j.psym.2019.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Olfactory reference syndrome (ORS) is an underrecognized, understudied, and often severe psychiatric disorder characterized by a prominent and distressing or impairing preoccupation with a false belief of emitting an offensive body odor. As this condition has only recently been recognized in the International Classification of Diseases (the 11th Edition), no empirical evidence exists about the underlying features and etiology of the disorder. OBJECTIVE To examine the neuropsychological and olfactory functioning of individuals with ORS and address whether there is central nervous system or sensory dysfunction associated with the condition. METHODS In this preliminary investigation, 9 consecutive participants with ORS completed a structured clinical interview and neuropsychological and olfaction evaluations. RESULTS A proportion of individuals with ORS displayed deficits in aspects of cognitive functioning (i.e., processing speed, executive functioning, recognition memory bias for ORS-related words), olfaction functioning (i.e., odor detection and discrimination), and emotional processing. CONCLUSIONS Based on these preliminary findings of cognitive, olfaction, and emotional processing deficits in individuals with ORS, further neuropsychological and olfaction studies are needed that better characterize this understudied patient group and address this study's limitations.
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Affiliation(s)
- Channing Sofko
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Psychiatry, Rhode Island Hospital, Providence, RI; Department of Psychiatry, The Miriam Hospital, Providence, RI; Division of Mental Health and Behavioral Sciences, Bay Pines Veterans Affairs Health Care System, Bay Pines, Florida.
| | - Geoffrey Tremont
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Psychiatry, Rhode Island Hospital, Providence, RI
| | - Jing Ee Tan
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Psychiatry, Rhode Island Hospital, Providence, RI; Division of Neurology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Holly Westervelt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Psychiatry, Rhode Island Hospital, Providence, RI; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| | - David C Ahern
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Psychiatry, The Miriam Hospital, Providence, RI
| | - William Menard
- Department of Psychiatry, Rhode Island Hospital, Providence, RI; Department of Neurology, Butler Hospital, Providence, RI
| | - Katharine A Phillips
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Psychiatry, Rhode Island Hospital, Providence, RI; Department of Psychiatry, Weill Cornell Medical College, New York, NY; Department of Psychiatry, New York-Presbyterian Hospital, New York, NY
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9
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Andric Petrovic S, Jerotic S, Mihaljevic M, Pavlovic Z, Ristic I, Soldatovic I, Maric NP. Sex differences in facial emotion recognition in health and psychotic disorders. Cogn Neuropsychiatry 2019; 24:108-122. [PMID: 30789053 DOI: 10.1080/13546805.2019.1582411] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Previous studies examining sex-differences in facial emotion recognition (FER) in psychosis yielded inconsistent results. Although females are considered to be superior in FER in health, it remains unclear whether the specific sex-difference is present in psychosis. We aimed to examine whether women and men differ in FER ability in health and in psychosis, and to explore potential sex differences in the illness' effects on FER. METHODS Remitted psychotic patients and controls were assessed using the CANTAB Emotion Recognition Task (ERT) examining accuracies/response latencies in identifying basic emotional expressions. General linear model was performed to assess the effects of group, sex and their interactions on ERT performance. RESULTS Healthy females showed FER advantage in comparison to healthy males, while the aforementioned sex-difference was not observed in remitted psychotic patients. Our results also demonstrated the existence of overall FER deficit in psychosis in comparison to healthy controls, as well as the differential illness' effects on the recognition accuracy of facial expression of anger in males and females-suggesting that females with psychotic disorders undergo more profound deterioration of FER ability than their male counterparts. CONCLUSION The assessment of sex-differences in FER and other important features of psychosis is important for better understanding of its neurobiological basis and for the development of targeted treatments for improved functioning.
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Affiliation(s)
| | - Stefan Jerotic
- a Clinic for Psychiatry, Clinical Center of Serbia , Belgrade , Serbia
| | - Marina Mihaljevic
- a Clinic for Psychiatry, Clinical Center of Serbia , Belgrade , Serbia.,b School of Medicine , University of Belgrade , Belgrade , Serbia
| | - Zorana Pavlovic
- a Clinic for Psychiatry, Clinical Center of Serbia , Belgrade , Serbia.,b School of Medicine , University of Belgrade , Belgrade , Serbia
| | - Ivan Ristic
- b School of Medicine , University of Belgrade , Belgrade , Serbia
| | - Ivan Soldatovic
- b School of Medicine , University of Belgrade , Belgrade , Serbia
| | - Nadja P Maric
- a Clinic for Psychiatry, Clinical Center of Serbia , Belgrade , Serbia.,b School of Medicine , University of Belgrade , Belgrade , Serbia
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10
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Koshiyama D, Fukunaga M, Okada N, Morita K, Nemoto K, Yamashita F, Yamamori H, Yasuda Y, Fujimoto M, Kelly S, Jahanshad N, Kudo N, Azechi H, Watanabe Y, Donohoe G, Thompson PM, Kasai K, Hashimoto R. Role of frontal white matter and corpus callosum on social function in schizophrenia. Schizophr Res 2018; 202:180-187. [PMID: 30005932 DOI: 10.1016/j.schres.2018.07.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 06/10/2018] [Accepted: 07/01/2018] [Indexed: 12/11/2022]
Abstract
Patients with schizophrenia show severe impairment in social function and have difficulty in their daily social life. Although a recent large-scale multicenter study revealed alterations in white matter microstructures, the association between these anatomical changes and social dysfunction in schizophrenia remains unknown. Therefore, we investigated the association between the white matter integrity of regions of interest and social function in schizophrenia. A total of 149 patients with schizophrenia and 602 healthy comparison subjects (HCS) underwent DTI and completed the Picture Arrangement subtest of the Wechsler Adult Intelligence Scale-Third Edition and the Finance subscale of the University of California, San Diego, Performance-Based Skills Assessment Brief, as social indices of interest. The fractional anisotropy (FA) in the anterior corona radiata and corpus callosum was significantly lower in patients than in HCS, and the radial diffusivity (RD) in the anterior corona radiata and corpus callosum was significantly higher in patients. The Picture Arrangement and Finance scores were both significantly impaired in patients. The effect of the FA of the right anterior corona radiata on the Finance score and the Picture Arrangement score, of the RD of the right anterior corona radiata on the Picture Arrangement score, and of the RD of the corpus callosum on the Picture Arrangement score were significant. In conclusion, our results confirmed the association between structural connectivity in the right frontal white matter and corpus callosum and social function in schizophrenia. These findings may provide a foundation for developing an intervention for functional recovery in schizophrenia.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Kentaro Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Sinead Kelly
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States of America
| | - Noriko Kudo
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Hirotsugu Azechi
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Yoshiyuki Watanabe
- Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Gary Donohoe
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States of America
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan.
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11
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Li M, Deng W, Das T, Li Y, Zhao L, Ma X, Wang Y, Yu H, Li X, Meng YJ, Wang Q, Palaniyappan L, Li T. Neural substrate of unrelenting negative symptoms in schizophrenia: a longitudinal resting-state fMRI study. Eur Arch Psychiatry Clin Neurosci 2018; 268:641-651. [PMID: 29128871 DOI: 10.1007/s00406-017-0851-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/02/2017] [Indexed: 02/05/2023]
Abstract
Developing a mechanistic insight into the specific brain processes that underpin improvement in negative symptoms can help us design novel chemical and physical treatments against these unrelenting symptoms. The aim of the present study is to explore the longitudinal changes in the brain's regional functional efficiency that accompany improvement in negative symptoms seen in first-episode patients with schizophrenia when treated with antipsychotic for 1 year. Forty-seven first-episode patients with schizophrenia were scanned at a drug-naive baseline state and followed up for 1 year to identify negative symptom responders (Rn) and non-responders (NRn). Fractional amplitude of low-frequency fluctuations (fALFF) and Granger analysis of effective connectivity (EC) were used to examine the different patterns of regional function and connectivity between Rn and NRn during the 1 year follow-up. Increase of fALFF in the left superior temporal gyrus (STG) and increase of EC from the left STG to the dorsolateral prefrontal cortex (DLPFC) was found in Rn compared to NRn. We further validated that the identified changes in fALFF/EC of STG occur specifically in relation to negative symptoms only (i.e., not pseudo-specific in relation to positive, extrapyramidal or depressive symptoms), and occur irrespective of arbitrary clinical categorization of treatment response. An increase in fALFF in the precuneus and the inferior parietal lobule, and a decrease in EC from the left STG to the occipital cortex, were also found at the 1 year follow-up irrespective of improvement in negative symptoms. Interventions that improve the functional efficiency of left STG and its prefrontal connectivity may show efficacy in alleviating negative symptoms in first-episode schizophrenia.
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Affiliation(s)
- Mingli Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Tushar Das
- Robarts Research Institute and The Brain and Mind Institute, University of Western Ontario, London, ON, Canada.,Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Yinfei Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingcheng Wang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hua Yu
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaojing Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ya-Jing Meng
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Lena Palaniyappan
- Robarts Research Institute and The Brain and Mind Institute, University of Western Ontario, London, ON, Canada. .,Department of Psychiatry, University of Western Ontario, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada. .,Prevention and Early Intervention Program for Psychoses (PEPP), A2-636, LHSC-VH, 800 Commissioners Road, London, ON, N6A 5W9, Canada.
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. .,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
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12
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Okruszek Ł, Wordecha M, Jarkiewicz M, Kossowski B, Lee J, Marchewka A. Brain correlates of recognition of communicative interactions from biological motion in schizophrenia. Psychol Med 2018; 48:1862-1871. [PMID: 29173243 DOI: 10.1017/s0033291717003385] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Recognition of communicative interactions is a complex social cognitive ability which is associated with a specific neural activity in healthy individuals. However, neural correlates of communicative interaction processing from whole-body motion have not been known in patients with schizophrenia (SCZ). Therefore, the current study aims to examine the neural activity associated with recognition of communicative interactions in SCZ by using displays of the dyadic interactions downgraded to minimalistic point-light presentations. METHODS Twenty-six healthy controls (HC) and 25 SCZ were asked to judge whether two agents presented only by point-light displays were communicating or acting independently. Task-related activity and functional connectivity of brain structures were examined with General Linear Model and Generalized Psychophysiological Interaction approach, respectively. RESULTS HC were significantly more efficient in recognizing each type of action than SCZ. At the neural level, the activity of the right posterior superior temporal sulcus (pSTS) was observed to be higher in HC compared with SCZ for communicative v. individual action processing. Importantly, increased connectivity of the right pSTS with structures associated with mentalizing (left pSTS) and mirroring networks (left frontal areas) was observed in HC, but not in SCZ, during the presentation of social interactions. CONCLUSION Under-recruitment of the right pSTS, a structure known to have a pivotal role in social processing, may also be of importance for higher-order social cognitive deficits in SCZ. Furthermore, decreased task-related connectivity of the right pSTS may result in reduced use of additional sources of information (for instance motor resonance signals) during social cognitive processing in schizophrenia.
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Affiliation(s)
- Ł Okruszek
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - M Wordecha
- Clinical Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Jarkiewicz
- Institute of Psychiatry and Neurology, Warsaw, Poland
| | - B Kossowski
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - J Lee
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - A Marchewka
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
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13
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Szabó ÁG, Farkas K, Marosi C, Kozák LR, Rudas G, Réthelyi J, Csukly G. Impaired mixed emotion processing in the right ventrolateral prefrontal cortex in schizophrenia: an fMRI study. BMC Psychiatry 2017; 17:391. [PMID: 29216861 PMCID: PMC5721596 DOI: 10.1186/s12888-017-1558-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 11/27/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Schizophrenia has a negative effect on the activity of the temporal and prefrontal cortices in the processing of emotional facial expressions. However no previous research focused on the evaluation of mixed emotions in schizophrenia, albeit they are frequently expressed in everyday situations and negative emotions are frequently expressed by mixed facial expressions. METHODS Altogether 37 subjects, 19 patients with schizophrenia and 18 healthy control subjects were enrolled in the study. The two study groups did not differ in age and education. The stimulus set consisted of 10 fearful (100%), 10 happy (100%), 10 mixed fear (70% fear and 30% happy) and 10 mixed happy facial expressions. During the fMRI acquisition pictures were presented in a randomized order and subjects had to categorize expressions by button press. RESULTS A decreased activation was found in the patient group during fear, mixed fear and mixed happy processing in the right ventrolateral prefrontal cortex (VLPFC) and the right anterior insula (RAI) at voxel and cluster level after familywise error correction. No difference was found between study groups in activations to happy facial condition. Patients with schizophrenia did not show a differential activation between mixed happy and happy facial expression similar to controls in the right dorsolateral prefrontal cortex (DLPFC). CONCLUSIONS Patients with schizophrenia showed decreased functioning in right prefrontal regions responsible for salience signaling and valence evaluation during emotion recognition. Our results indicate that fear and mixed happy/fear processing are impaired in schizophrenia, while happy facial expression processing is relatively intact.
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Affiliation(s)
- Ádám György Szabó
- 0000 0001 0942 9821grid.11804.3cMR Research Center, Semmelweis University, Budapest, Hungary
| | - Kinga Farkas
- 0000 0001 0942 9821grid.11804.3cDepartment of Psychiatry and Psychotherapy, Semmelweis University, Balassa 6, Budapest, 1083 Hungary
| | - Csilla Marosi
- 0000 0001 0942 9821grid.11804.3cDepartment of Psychiatry and Psychotherapy, Semmelweis University, Balassa 6, Budapest, 1083 Hungary
| | - Lajos R. Kozák
- 0000 0001 0942 9821grid.11804.3cMR Research Center, Semmelweis University, Budapest, Hungary
| | - Gábor Rudas
- 0000 0001 0942 9821grid.11804.3cMR Research Center, Semmelweis University, Budapest, Hungary
| | - János Réthelyi
- 0000 0001 0942 9821grid.11804.3cDepartment of Psychiatry and Psychotherapy, Semmelweis University, Balassa 6, Budapest, 1083 Hungary
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa 6, Budapest, 1083, Hungary.
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14
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Comte M, Zendjidjian XY, Coull JT, Cancel A, Boutet C, Schneider FC, Sage T, Lazerges PE, Jaafari N, Ibrahim EC, Azorin JM, Blin O, Fakra E. Impaired cortico-limbic functional connectivity in schizophrenia patients during emotion processing. Soc Cogn Affect Neurosci 2017. [PMID: 29069508 DOI: 10.1093/scan/nsx083.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Functional dysconnection is increasingly recognized as a core pathological feature in schizophrenia. Aberrant interactions between regions of the cortico-limbic circuit may underpin the abnormal emotional processing associated with this illness. We used a functional magnetic resonance imaging (fMRI) paradigm designed to dissociate the various components of the cortico-limbic circuit (i.e. a ventral automatic circuit that is intertwined with a dorsal cognitive circuit), in order to explore bottom-up appraisal as well as top-down control during emotion processing. In schizophrenia patients compared to healthy controls, bottom-up processes were associated with reduced interaction between the amygdala and both the anterior cingulate cortex (ACC) and the dorsolateral prefrontal cortex (DLPFC). Contrariwise, top-down control processes led to stronger connectivity between the ventral affective and the dorsal cognitive circuits, i.e. heightened interactions between the ventral ACC and the DLPFC as well as between dorsal and ventral ACC. These findings offer a comprehensive view of the cortico-limbic dysfunction in schizophrenia. They confirm previous results of impaired propagation of information between the amygdala and the prefrontal cortex and suggest a defective functional segregation in the dorsal cognitive part of the cortico-limbic circuit.
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Affiliation(s)
- Magali Comte
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | | | - Jennifer T Coull
- Cognitive Neurosciences Laboratory, UMR 7291, CNRS and Aix-Marseille University, Marseille, France
| | - Aïda Cancel
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire Boutet
- Inserm U1059, University of Lyon, Saint-Etienne, F-42023, France.,Neuroradiology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Fabien C Schneider
- Inserm U1059, University of Lyon, Saint-Etienne, F-42023, France.,Neuroradiology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Thierry Sage
- Clinic of Mental Health, L'escale, Orpea-Clinéa, Saint-Victoret, France
| | | | - Nematollah Jaafari
- Intersector Clinical Psychiatric Research Unit, Psychobiology of Compulsive Disorders Team, Experimental and Clinical Neurosciences Laboratory, Henri Laborit Hospital, INSERM U 1084, University of Poitiers; Experimental and Clinical Neurosciences Laboratory, CIC INSERM U 802, Poitiers, France
| | - El Chérif Ibrahim
- CRN2M-UMR7286, CNRS and Aix-Marseille University, Marseille, France.,FondaMental Fundation, Fundation of Research and of mental health care, Créteil, France
| | - Jean-Michel Azorin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - Olivier Blin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), Timone Hospital, Public Assistance for Marseille Hospitals (APHM), Marseille, France
| | - Eric Fakra
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
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15
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Comte M, Zendjidjian XY, Coull JT, Cancel A, Boutet C, Schneider FC, Sage T, Lazerges PE, Jaafari N, Ibrahim EC, Azorin JM, Blin O, Fakra E. Impaired cortico-limbic functional connectivity in schizophrenia patients during emotion processing. Soc Cogn Affect Neurosci 2017; 13:381-390. [PMID: 29069508 PMCID: PMC5928402 DOI: 10.1093/scan/nsx083] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 06/19/2017] [Indexed: 01/30/2023] Open
Abstract
Functional dysconnection is increasingly recognized as a core pathological feature in schizophrenia. Aberrant interactions between regions of the cortico-limbic circuit may underpin the abnormal emotional processing associated with this illness. We used a functional magnetic resonance imaging paradigm designed to dissociate the various components of the cortico-limbic circuit (i.e. a ventral automatic circuit that is intertwined with a dorsal cognitive circuit), to explore bottom-up appraisal as well as top-down control during emotion processing. In schizophrenia patients compared with healthy controls, bottom-up processes were associated with reduced interaction between the amygdala and both the anterior cingulate cortex (ACC) and the dorsolateral prefrontal cortex. Contrariwise, top-down control processes led to stronger connectivity between the ventral affective and the dorsal cognitive circuits, i.e. heightened interactions between the ventral ACC and the dorsolateral prefrontal cortex as well as between dorsal and ventral ACC. These findings offer a comprehensive view of the cortico-limbic dysfunction in schizophrenia. They confirm previous results of impaired propagation of information between the amygdala and the prefrontal cortex and suggest a defective functional segregation in the dorsal cognitive part of the cortico-limbic circuit.
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Affiliation(s)
- Magali Comte
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | | | - Jennifer T Coull
- Cognitive Neurosciences Laboratory, UMR 7291, CNRS and Aix-Marseille University, Marseille, France
| | - Aïda Cancel
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire Boutet
- Inserm U1059, University of Lyon, Saint-Etienne, F-42023, France.,Neuroradiology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Fabien C Schneider
- Inserm U1059, University of Lyon, Saint-Etienne, F-42023, France.,Neuroradiology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Thierry Sage
- Clinic of Mental Health, L'escale, Orpea-Clinéa, Saint-Victoret, France
| | | | - Nematollah Jaafari
- Intersector Clinical Psychiatric Research Unit, Psychobiology of Compulsive Disorders Team, Experimental and Clinical Neurosciences Laboratory, Henri Laborit Hospital, INSERM U 1084, University of Poitiers; Experimental and Clinical Neurosciences Laboratory, CIC INSERM U 802, Poitiers, France
| | - El Chérif Ibrahim
- CRN2M-UMR7286, CNRS and Aix-Marseille University, Marseille, France.,FondaMental Fundation, Fundation of Research and of mental health care, Créteil, France
| | - Jean-Michel Azorin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - Olivier Blin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), Timone Hospital, Public Assistance for Marseille Hospitals (APHM), Marseille, France
| | - Eric Fakra
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
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16
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Wojtalik JA, Smith MJ, Keshavan MS, Eack SM. A Systematic and Meta-analytic Review of Neural Correlates of Functional Outcome in Schizophrenia. Schizophr Bull 2017; 43:1329-1347. [PMID: 28204755 PMCID: PMC5737663 DOI: 10.1093/schbul/sbx008] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Individuals with schizophrenia are burdened with impairments in functional outcome, despite existing interventions. The lack of understanding of the neurobiological correlates supporting adaptive function in the disorder is a significant barrier to developing more effective treatments. This research conducted a systematic and meta-analytic review of all peer-reviewed studies examining brain-functional outcome relationships in schizophrenia. A total of 53 (37 structural and 16 functional) brain imaging studies examining the neural correlates of functional outcome across 1631 individuals with schizophrenia were identified from literature searches in relevant databases occurring between January, 1968 and December, 2016. Study characteristics and results representing brain-functional outcome relationships were systematically extracted, reviewed, and meta-analyzed. Results indicated that better functional outcome was associated with greater fronto-limbic and whole brain volumes, smaller ventricles, and greater activation, especially during social cognitive processing. Thematic observations revealed that the dorsolateral prefrontal cortex, anterior cingulate, posterior cingulate, parahippocampal gyrus, superior temporal sulcus, and cerebellum may have role in functioning. The neural basis of functional outcome and disability is infrequently studied in schizophrenia. While existing evidence is limited and heterogeneous, these findings suggest that the structural and functional integrity of fronto-limbic brain regions is consistently related to functional outcome in individuals with schizophrenia. Further research is needed to understand the mechanisms and directionality of these relationships, and the potential for identifying neural targets to support functional improvement.
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Affiliation(s)
- Jessica A Wojtalik
- School of Social Work, University of Pittsburgh, Pittsburgh, PA,To whom correspondence should be addressed; School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, Pittsburgh, PA 15260, US; tel: 412-624-6304, e-mail:
| | - Matthew J Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Shaun M Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA,Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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17
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Ibrahim EC, Guillemot V, Comte M, Tenenhaus A, Zendjidjian XY, Cancel A, Belzeaux R, Sauvanaud F, Blin O, Frouin V, Fakra E. Modeling a linkage between blood transcriptional expression and activity in brain regions to infer the phenotype of schizophrenia patients. NPJ SCHIZOPHRENIA 2017; 3:25. [PMID: 28883405 PMCID: PMC5589880 DOI: 10.1038/s41537-017-0027-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/05/2017] [Accepted: 07/21/2017] [Indexed: 11/20/2022]
Abstract
Hundreds of genetic loci participate to schizophrenia liability. It is also known that impaired cerebral connectivity is directly related to the cognitive and affective disturbances in schizophrenia. How genetic susceptibility and brain neural networks interact to specify a pathological phenotype in schizophrenia remains elusive. Imaging genetics, highlighting brain variations, has proven effective to establish links between vulnerability loci and associated clinical traits. As previous imaging genetics works in schizophrenia have essentially focused on structural DNA variants, these findings could be blurred by epigenetic mechanisms taking place during gene expression. We explored the meaningful links between genetic data from peripheral blood tissues on one hand, and regional brain reactivity to emotion task assayed by blood oxygen level-dependent functional magnetic resonance imaging on the other hand, in schizophrenia patients and matched healthy volunteers. We applied Sparse Generalized Canonical Correlation Analysis to identify joint signals between two blocks of variables: (i) the transcriptional expression of 33 candidate genes, and (ii) the blood oxygen level-dependent activity in 16 region of interest. Results suggested that peripheral transcriptional expression is related to brain imaging variations through a sequential pathway, ending with the schizophrenia phenotype. Generalization of such an approach to larger data sets should thus help in outlining the pathways involved in psychiatric illnesses such as schizophrenia. IMAGING SEARCHING FOR LINKS TO AID DIAGNOSIS: Researchers explore links between the expression of genes associated with schizophrenia in blood cells and variations in brain activity during emotion processing. El Chérif Ibrahim and Eric Fakra at Aix-Marseille Université, France, and colleagues have developed a method to relate the expression levels of 33 schizophrenia susceptibility genes in blood cells and functional magnetic resonance imaging (fMRI) data obtained as individuals carry out a task that triggers emotional responses. Although they found no significant differences in the expression of genes between the 26 patients with schizophrenia and 26 healthy controls they examined, variations in activity in the superior temporal gyrus were strongly linked to schizophrenia-associated gene expression and presence of disease. Similar analyses of larger data sets will shed further light on the relationship between peripheral molecular changes and disease-related behaviors and ultimately, aid the diagnosis of neuropsychiatric disease.
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Affiliation(s)
- El Chérif Ibrahim
- Aix-Marseille Univ, CNRS, CRN2M, Marseille, France.
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France.
- Aix-Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France.
| | - Vincent Guillemot
- INSERM, U 1127, Paris, France
- CNRS, 7225, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMRS_1127, Paris, France
- ICM, Département des maladies du système nerveux and Département de Génétique, Hôpital Pitié-Salpêtrière, Paris, France
| | - Magali Comte
- Aix-Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | - Arthur Tenenhaus
- Laboratoire des Signaux et Systèmes (L2S, UMR CNRS 8506), CentraleSupélec-CNRS Université Paris-Sud, Gif-sur-Yvette, France
- Bioinformatics/Biostatistics Platform IHU-A-ICM, Brain and Spine Institute, Paris, France
| | - Xavier Yves Zendjidjian
- Pôle Psychiatrie centre, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Aida Cancel
- Aix-Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France
- Service Hospitalo-Universitaire de Psychiatrie Secteur Saint-Etienne, Hôpital Nord, Saint-Etienne, France
| | - Raoul Belzeaux
- Aix-Marseille Univ, CNRS, CRN2M, Marseille, France
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Florence Sauvanaud
- Service Hospitalo-Universitaire de Psychiatrie Secteur Saint-Etienne, Hôpital Nord, Saint-Etienne, France
| | - Olivier Blin
- Aix-Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France
- CIC-UPCET et Pharmacologie Clinique, Hôpital de la Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | | | - Eric Fakra
- Aix-Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France.
- Service Hospitalo-Universitaire de Psychiatrie Secteur Saint-Etienne, Hôpital Nord, Saint-Etienne, France.
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18
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Arnold AEGF, Iaria G, Goghari VM. Efficacy of identifying neural components in the face and emotion processing system in schizophrenia using a dynamic functional localizer. Psychiatry Res Neuroimaging 2016; 248:55-63. [PMID: 26792586 DOI: 10.1016/j.pscychresns.2016.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 11/20/2015] [Accepted: 01/03/2016] [Indexed: 11/19/2022]
Abstract
Schizophrenia is associated with deficits in face perception and emotion recognition. Despite consistent behavioural results, the neural mechanisms underlying these cognitive abilities have been difficult to isolate, in part due to differences in neuroimaging methods used between studies for identifying regions in the face processing system. Given this problem, we aimed to validate a recently developed fMRI-based dynamic functional localizer task for use in studies of psychiatric populations and specifically schizophrenia. Previously, this functional localizer successfully identified each of the core face processing regions (i.e. fusiform face area, occipital face area, superior temporal sulcus), and regions within an extended system (e.g. amygdala) in healthy individuals. In this study, we tested the functional localizer success rate in 27 schizophrenia patients and in 24 community controls. Overall, the core face processing regions were localized equally between both the schizophrenia and control group. Additionally, the amygdala, a candidate brain region from the extended system, was identified in nearly half the participants from both groups. These results indicate the effectiveness of a dynamic functional localizer at identifying regions of interest associated with face perception and emotion recognition in schizophrenia. The use of dynamic functional localizers may help standardize the investigation of the facial and emotion processing system in this and other clinical populations.
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Affiliation(s)
- Aiden E G F Arnold
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Center for Neuroscience, University of California Davis, Davis, CA, USA
| | - Giuseppe Iaria
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Vina M Goghari
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
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Ryan NP, Catroppa C, Beare R, Silk TJ, Crossley L, Beauchamp MH, Yeates KO, Anderson VA. Theory of mind mediates the prospective relationship between abnormal social brain network morphology and chronic behavior problems after pediatric traumatic brain injury. Soc Cogn Affect Neurosci 2016; 11:683-92. [PMID: 26796967 DOI: 10.1093/scan/nsw007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/14/2016] [Indexed: 12/21/2022] Open
Abstract
Childhood and adolescence coincide with rapid maturation and synaptic reorganization of distributed neural networks that underlie complex cognitive-affective behaviors. These regions, referred to collectively as the 'social brain network' (SBN) are commonly vulnerable to disruption from pediatric traumatic brain injury (TBI); however, the mechanisms that link morphological changes in the SBN to behavior problems in this population remain unclear. In 98 children and adolescents with mild to severe TBI, we acquired 3D T1-weighted MRIs at 2-8 weeks post-injury. For comparison, 33 typically developing controls of similar age, sex and education were scanned. All participants were assessed on measures of Theory of Mind (ToM) at 6 months post-injury and parents provided ratings of behavior problems at 24-months post-injury. Severe TBI was associated with volumetric reductions in the overall SBN package, as well as regional gray matter structural change in multiple component regions of the SBN. When compared with TD controls and children with milder injuries, the severe TBI group had significantly poorer ToM, which was associated with more frequent behavior problems and abnormal SBN morphology. Mediation analysis indicated that impaired theory of mind mediated the prospective relationship between abnormal SBN morphology and more frequent chronic behavior problems. Our findings suggest that sub-acute alterations in SBN morphology indirectly contribute to long-term behavior problems via their influence on ToM. Volumetric change in the SBN and its putative hub regions may represent useful imaging biomarkers for prediction of post-acute social cognitive impairment, which may in turn elevate risk for chronic behavior problems.
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Affiliation(s)
- Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia,
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia, Department of Psychology, Royal Children's Hospital, Melbourne, Australia
| | - Richard Beare
- Developmental Imaging, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Timothy J Silk
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Louise Crossley
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Canada, Ste-Justine Research Center, Montreal, Quebec, Canada, and
| | - Keith Owen Yeates
- Department of Psychology, Hotchkiss, Brain Institute, and Alberta Children's Hospital Research Institute, The University of Calgary, Calgary, Alberta, Canada
| | - Vicki A Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Melbourne, Australia, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia, Department of Psychology, Royal Children's Hospital, Melbourne, Australia
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Bicks LK, Koike H, Akbarian S, Morishita H. Prefrontal Cortex and Social Cognition in Mouse and Man. Front Psychol 2015; 6:1805. [PMID: 26635701 PMCID: PMC4659895 DOI: 10.3389/fpsyg.2015.01805] [Citation(s) in RCA: 327] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/09/2015] [Indexed: 12/15/2022] Open
Abstract
Social cognition is a complex process that requires the integration of a wide variety of behaviors, including salience, reward-seeking, motivation, knowledge of self and others, and flexibly adjusting behavior in social groups. Not surprisingly, social cognition represents a sensitive domain commonly disrupted in the pathology of a variety of psychiatric disorders including Autism Spectrum Disorder (ASD) and Schizophrenia (SCZ). Here, we discuss convergent research from animal models to human disease that implicates the prefrontal cortex (PFC) as a key regulator in social cognition, suggesting that disruptions in prefrontal microcircuitry play an essential role in the pathophysiology of psychiatric disorders with shared social deficits. We take a translational perspective of social cognition, and review three key behaviors that are essential to normal social processing in rodents and humans, including social motivation, social recognition, and dominance hierarchy. A shared prefrontal circuitry may underlie these behaviors. Social cognition deficits in animal models of neurodevelopmental disorders like ASD and SCZ have been linked to an altered balance of excitation and inhibition (E/I ratio) within the cortex generally, and PFC specifically. A clear picture of the mechanisms by which altered E/I ratio in the PFC might lead to disruptions of social cognition across a variety of behaviors is not well understood. Future studies should explore how disrupted developmental trajectory of prefrontal microcircuitry could lead to altered E/I balance and subsequent deficits in the social domain.
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Affiliation(s)
- Lucy K Bicks
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Hiroyuki Koike
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Schahram Akbarian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Hirofumi Morishita
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA ; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York NY, USA
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Choudhary M, Kumar A, Tripathi M, Bhatia T, Shivakumar V, Beniwal RP, Gur RC, Gur RE, Nimgaonkar VL, Deshpande SN. F-18 fluorodeoxyglucose positron emission tomography study of impaired emotion processing in first episode schizophrenia. Schizophr Res 2015; 162:103-7. [PMID: 25655909 PMCID: PMC4339502 DOI: 10.1016/j.schres.2015.01.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Schizophrenia cases have been consistently shown to have behavioural and neurofunctional abnormalities but studies during early course are scarce. The present work assesses the performance of acute first episode schizophrenia cases on correlation of a facial emotion perception task with brain function using fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET). METHODS Twenty First episode schizophrenia cases and 20 matched healthy controls living in the community were enrolled. For cases, longest duration of illness was one year and treatment with neuroleptic did not exceed two weeks on the day of scan. To measure facial emotion perception (FEP) both groups were administered the Emotion battery from the Penn Computerized Battery followed by PET acquisition. SPM 8 analysis for group differences at p<0.001 was performed. RESULTS Schizophrenia subjects showed hypoactivation of bilateral prefrontal cortices and fusiform gyrii, with significant hyperactivation of bilateral basal ganglia and left precuneus. Positive correlation of metabolism in prefrontal cortex and performance indices on emotions domain was seen. No correlation of chlorpromazine equivalent days with metabolism in basal ganglia was observed. CONCLUSIONS The performance of schizophrenia cases on FEP task was significantly impaired in comparison to the control group. Brain regions implicated in emotion processing showed hypometabolism in cases as compared to controls. Failure of schizophrenia cases to optimally recruit brain circuitry may be contributing to deficits on FEP task. These findings suggest inherent deficits in neural circuitry of emotion processing in schizophrenia; devoid of confounding effects of neuroleptics and duration of illness.
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Affiliation(s)
- Mona Choudhary
- Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital (PGIMER-RMLH), Park Street, New Delhi, India
| | - Arvind Kumar
- Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital (PGIMER-RMLH), Park Street, New Delhi, India
| | - Madhavi Tripathi
- Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India
| | - Triptish Bhatia
- Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital (PGIMER-RMLH), Park Street, New Delhi, India
| | - Venkataram Shivakumar
- Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Center, National Institute of Mental Health and Neuro Science, Bangaluru, India
| | - Ram Pratap Beniwal
- Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital (PGIMER-RMLH), Park Street, New Delhi, India
| | - Ruben C. Gur
- Schizophrenia Research Centre, Neuropsychiatry Section, Department of Psychiatry, The University of Pennsylvania, Philadelphia, PA USA
| | - Raquel E. Gur
- Schizophrenia Research Centre, Neuropsychiatry Section, Department of Psychiatry, The University of Pennsylvania, Philadelphia, PA USA
| | - Vishwajit L. Nimgaonkar
- Department of Psychiatry and Department of Human Genetics, University of Pittsburgh, Pittsburgh, USA
| | - Smita N. Deshpande
- Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital (PGIMER-RMLH), Park Street, New Delhi, India
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