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Adeli E, Zhao Q, Zahr NM, Goldstone A, Pfefferbaum A, Sullivan EV, Pohl KM. Deep learning identifies morphological determinants of sex differences in the pre-adolescent brain. Neuroimage 2020; 223:117293. [PMID: 32841716 PMCID: PMC7780846 DOI: 10.1016/j.neuroimage.2020.117293] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/06/2020] [Accepted: 08/17/2020] [Indexed: 12/11/2022] Open
Abstract
The application of data-driven deep learning to identify sex differences in developing brain structures of pre-adolescents has heretofore not been accomplished. Here, the approach identifies sex differences by analyzing the minimally processed MRIs of the first 8144 participants (age 9 and 10 years) recruited by the Adolescent Brain Cognitive Development (ABCD) study. The identified pattern accounted for confounding factors (i.e., head size, age, puberty development, socioeconomic status) and comprised cerebellar (corpus medullare, lobules III, IV/V, and VI) and subcortical (pallidum, amygdala, hippocampus, parahippocampus, insula, putamen) structures. While these have been individually linked to expressing sex differences, a novel discovery was that their grouping accurately predicted the sex in individual pre-adolescents. Another novelty was relating differences specific to the cerebellum to pubertal development. Finally, we found that reducing the pattern to a single score not only accurately predicted sex but also correlated with cognitive behavior linked to working memory. The predictive power of this score and the constellation of identified brain structures provide evidence for sex differences in pre-adolescent neurodevelopment and may augment understanding of sex-specific vulnerability or resilience to psychiatric disorders and presage sex-linked learning disabilities.
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Affiliation(s)
- Ehsan Adeli
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Qingyu Zhao
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Natalie M Zahr
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; Center for Biomedical Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Aimee Goldstone
- Center for Biomedical Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; Center for Biomedical Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Kilian M Pohl
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; Center for Biomedical Sciences, SRI International, Menlo Park, CA 94025, USA.
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2
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Keramatian K, Dhanoa T, McGirr A, Lang DJ, Honer WG, Lam RW, Yatham LN. Structural brain changes in first episode mania with and without psychosis: Data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM). World J Biol Psychiatry 2019; 19:S30-S40. [PMID: 27762161 DOI: 10.1080/15622975.2016.1249950] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The neurobiological underpinnings of bipolar I disorder are not yet understood. Previous structural neuroimaging studies of bipolar disorder have produced rather conflicting results. We hypothesise that clinical sub-phenotypes of bipolar I disorder defined by their psychotic symptoms, especially those with mood-incongruent psychotic features, may have more extensive structural brain abnormalities. METHODS We investigated structural brain alterations in patients with first-episode mania (n = 55) with mood-congruent (n = 16) and mood-incongruent (n = 32) psychotic features, as well as those without psychotic symptoms (n = 7), relative to healthy subjects (n = 56). RESULTS Total intracranial volume was significantly reduced in patients with mood-incongruent psychosis compared to healthy subjects while cerebrospinal fluid (CSF) volume was significantly increased. Patients with mood-congruent psychosis showed significant reduction in total white matter volume and significant CSF volume increase. Patients with psychosis had significant volume reduction in anterior cingulate and medial prefrontal cortices. Relative to mood-congruent psychotic features, mood-incongruent psychotic features were associated with volume reduction in the left middle temporal gyrus, right inferior parietal gyrus, right fusiform gyrus, left middle orbitofrontal gyrus and cerebellum. CONCLUSIONS While preliminary, our findings suggest that the presence and type of psychosis in first-episode mania may be phenotypic markers of underlying biological variants of bipolar disorder.
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Affiliation(s)
- Kamyar Keramatian
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Taj Dhanoa
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Alexander McGirr
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Donna J Lang
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - William G Honer
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Raymond W Lam
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
| | - Lakshmi N Yatham
- a Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada
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3
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Ohtani T, Del Re E, Levitt JJ, Niznikiewicz M, Konishi J, Asami T, Kawashima T, Roppongi T, Nestor PG, Shenton ME, Salisbury DF, McCarley RW. Progressive symptom-associated prefrontal volume loss occurs in first-episode schizophrenia but not in affective psychosis. Brain Struct Funct 2018; 223:2879-2892. [PMID: 29671056 DOI: 10.1007/s00429-018-1634-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 02/17/2018] [Indexed: 12/12/2022]
Abstract
Although smaller gray matter volumes (GMV) in the prefrontal cortex (PFC) in schizophrenia and bipolar disorder have been reported cross-sectionally, there are, to our knowledge, no reports of longitudinal comparisons using manually drawn, gyrally based ROI, and their associations with symptoms. The object of this study was to determine whether first-episode schizophrenia (FESZ) and first-episode affective psychosis (FEAFF) patients show initial and progressive PFC GMV reduction in bilateral frontal pole, superior frontal gyrus (SFG), middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) and examine their symptom associations. Twenty-one FESZ, 24 FEAFF and 23 healthy control subjects (HC) underwent 1.5T MRI with follow-up imaging on the same scanner ~ 1.5 years later. Groups were strikingly different in progressive GMV loss. FESZ showed significant progressive GMV loss in the left SFG, bilateral MFG, and bilateral IFG. In addition, left MFG and/or IFG GMV loss was associated with worsening of withdrawal-retardation and total BPRS symptoms scores. In contrast, FEAFF showed no significant difference in GMV compared with HC, either cross-sectionally or longitudinally. Of note, FreeSurfer run on the same images showed no significant changes longitudinally.
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Affiliation(s)
- Toshiyuki Ohtani
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Safety and Health Organization, Chiba University, Chiba, Japan
| | - Elisabetta Del Re
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - James J Levitt
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Margaret Niznikiewicz
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jun Konishi
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takeshi Asami
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Toshiro Kawashima
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Faculty of Medicine, Saga University, Saga, Japan
| | - Tomohide Roppongi
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Paul G Nestor
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Martha E Shenton
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA. .,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Dean F Salisbury
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert W McCarley
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, 116A, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA, 02301, USA
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4
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Cancel A, Comte M, Truillet R, Boukezzi S, Rousseau PF, Zendjidjian XY, Sage T, Lazerges PE, Guedj E, Khalfa S, Azorin JM, Blin O, Fakra E. Childhood neglect predicts disorganization in schizophrenia through grey matter decrease in dorsolateral prefrontal cortex. Acta Psychiatr Scand 2015; 132:244-56. [PMID: 26038817 DOI: 10.1111/acps.12455] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Psychosocial trauma during childhood is associated with schizophrenia vulnerability. The pattern of grey matter decrease is similar to brain alterations seen in schizophrenia. Our objective was to explore the links between childhood trauma, brain morphology and schizophrenia symptoms. METHOD Twenty-one patients with schizophrenia stabilized with atypical antipsychotic monotherapy and 30 healthy control subjects completed the study. Anatomical MRI images were analysed using optimized voxel-based morphometry (VBM). Childhood trauma was assessed with the Childhood Trauma Questionnaire, and symptoms were rated on the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) (disorganization, positive and negative symptoms). In the schizophrenia group, we used structural equation modelling in a path analysis. RESULTS Total grey matter volume was negatively associated with emotional neglect (EN) in patients with schizophrenia. Whole-brain VBM analyses of grey matter in the schizophrenia group revealed a specific inversed association between EN and the right dorsolateral prefrontal cortex (DLPFC). Path analyses identified a well-fitted model in which EN predicted grey matter density in DLPFC, which in turn predicted the disorganization score. CONCLUSION Our findings suggest that EN during childhood could have an impact on psychopathology in schizophrenia, which would be mediated by developmental effects on brain regions such as the DLPFC.
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Affiliation(s)
- A 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
| | - M Comte
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - R Truillet
- Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - S Boukezzi
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - P-F Rousseau
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Psychiatry Unit, Saint Anne Military Training Hospital, Toulon, France
| | - X Y Zendjidjian
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - T Sage
- Clinic of Mental Health, L'escale, Orpea-Clinéa, Saint-Victoret, France
| | - P-E Lazerges
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - E Guedj
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Biophysics and Nuclear Medicine Department, Timone Hospital, Marseille, France
| | - S Khalfa
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - J-M Azorin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - O Blin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - E 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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5
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Picado M, Carmona S, Hoekzema E, Pailhez G, Bergé D, Mané A, Fauquet J, Hilferty J, Moreno A, Cortizo R, Vilarroya O, Bulbena A. The neuroanatomical basis of panic disorder and social phobia in schizophrenia: a voxel based morphometric study. PLoS One 2015; 10:e0119847. [PMID: 25774979 PMCID: PMC4361479 DOI: 10.1371/journal.pone.0119847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022] Open
Abstract
Objective It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Methods Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Results Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Conclusions Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions.
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Affiliation(s)
- Marisol Picado
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- * E-mail:
| | - Susanna Carmona
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | | | - Guillem Pailhez
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Daniel Bergé
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Anna Mané
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Jordi Fauquet
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de Ciències de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Joseph Hilferty
- Departament de Filologia Anglesa i Alemanya, Facultad de Filologia, Universitat de Barcelona, Barcelona, Spain
| | - Ana Moreno
- Fundación para la Investigación y la Docencia Maria Angustias Giménez, Germanes Hospitalàries, Barcelona, Spain
| | - Romina Cortizo
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Oscar Vilarroya
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
| | - Antoni Bulbena
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
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6
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Ranta ME, Chen M, Crocetti D, Prince JL, Subramaniam K, Fischl B, Kaufmann WE, Mostofsky SH. Automated MRI parcellation of the frontal lobe. Hum Brain Mapp 2014; 35:2009-26. [PMID: 23897577 PMCID: PMC4034317 DOI: 10.1002/hbm.22309] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 03/12/2013] [Accepted: 04/02/2013] [Indexed: 01/26/2023] Open
Abstract
Examination of associations between specific disorders and physical properties of functionally relevant frontal lobe sub-regions is a fundamental goal in neuropsychiatry. Here, we present and evaluate automated methods of frontal lobe parcellation with the programs FreeSurfer(FS) and TOADS-CRUISE(T-C), based on the manual method described in Ranta et al. [2009]: Psychiatry Res 172:147-154 in which sulcal-gyral landmarks were used to manually delimit functionally relevant regions within the frontal lobe: i.e., primary motor cortex, anterior cingulate, deep white matter, premotor cortex regions (supplementary motor complex, frontal eye field, and lateral premotor cortex) and prefrontal cortex (PFC) regions (medial PFC, dorsolateral PFC, inferior PFC, lateral orbitofrontal cortex [OFC] and medial OFC). Dice's coefficient, a measure of overlap, and percent volume difference were used to measure the reliability between manual and automated delineations for each frontal lobe region. For FS, mean Dice's coefficient for all regions was 0.75 and percent volume difference was 21.2%. For T-C the mean Dice's coefficient was 0.77 and the mean percent volume difference for all regions was 20.2%. These results, along with a high degree of agreement between the two automated methods (mean Dice's coefficient = 0.81, percent volume difference = 12.4%) and a proof-of-principle group difference analysis that highlights the consistency and sensitivity of the automated methods, indicate that the automated methods are valid techniques for parcellation of the frontal lobe into functionally relevant sub-regions. Thus, the methodology has the potential to increase efficiency, statistical power and reproducibility for population analyses of neuropsychiatric disorders with hypothesized frontal lobe contributions.
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Affiliation(s)
- Marin E. Ranta
- Kennedy Krieger InstituteLaboratory for Neurocognitive Imaging and ResearchBaltimoreMaryland
| | - Min Chen
- Department of Electrical and Computer EngineeringJohns Hopkins UniversityBaltimoreMaryland
| | - Deana Crocetti
- Kennedy Krieger InstituteLaboratory for Neurocognitive Imaging and ResearchBaltimoreMaryland
| | - Jerry L. Prince
- Department of Electrical and Computer EngineeringJohns Hopkins UniversityBaltimoreMaryland
- Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreMaryland
- Department of Biomedical EngineeringJohns Hopkins UniversityBaltimoreMaryland
| | - Krish Subramaniam
- Athinoula A. Martinos Center for Biomedical ImagingCharlestownMassachusetts
| | - Bruce Fischl
- Athinoula A. Martinos Center for Biomedical ImagingCharlestownMassachusetts
- Department of RadiologyHarvard Medical SchoolCharlestownMassachusetts
- Division of Health Sciences and TechnologyMassachusetts Institute of TechnologyCambridgeMassachusetts
- Computer Science and Artificial Intelligence LaboratoryMassachusetts Institute of TechnologyCambridgeMassachusetts
- Computer Science and AI Lab (CSAIL)Massachusetts Institute of TechnologyCambridgeMassachusetts
| | - Walter E. Kaufmann
- Kennedy Krieger InstituteLaboratory for Neurocognitive Imaging and ResearchBaltimoreMaryland
- Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreMaryland
- Department of PathologyJohns Hopkins University School of MedicineBaltimoreMaryland
- Department of PediatricsJohns Hopkins University School of MedicineBaltimoreMaryland
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMaryland
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland
| | - Stewart H. Mostofsky
- Kennedy Krieger InstituteLaboratory for Neurocognitive Imaging and ResearchBaltimoreMaryland
- Department of PediatricsJohns Hopkins University School of MedicineBaltimoreMaryland
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMaryland
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7
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Schneider CE, White T, Hass J, Geisler D, Wallace SR, Roessner V, Holt DJ, Calhoun VD, Gollub RL, Ehrlich S. Smoking status as a potential confounder in the study of brain structure in schizophrenia. J Psychiatr Res 2014; 50:84-91. [PMID: 24373929 PMCID: PMC4047795 DOI: 10.1016/j.jpsychires.2013.12.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 12/05/2013] [Accepted: 12/09/2013] [Indexed: 01/25/2023]
Abstract
Several but not all MRI studies have reported volume reductions in the hippocampus and dorsolateral prefrontal cortex (DLPFC) in patients with schizophrenia. Given the high prevalence of smoking among schizophrenia patients and the fact that smoking has also been associated with alterations in brain morphology, this study evaluated whether a proportion of the known gray matter reductions in key brain regions may be attributed to smoking rather than to schizophrenia alone. We examined structural MRI data of 112 schizophrenia patients (53 smokers and 59 non-smokers) and 77 healthy non-smoker controls collected by the MCIC study of schizophrenia. An automated atlas based probabilistic method was used to generate volumetric measures of the hippocampus and DLPFC. The two patient groups were matched with respect to demographic and clinical variables. Smoker schizophrenia patients showed significantly lower hippocampal and DLPFC volumes than non-smoker schizophrenia patients. Gray matter volume reductions associated with smoking status ranged between 2.2% and 2.8%. Furthermore, we found significant volume differences between smoker patients and healthy controls in the hippocampus and DLPFC, but not between non-smoker patients and healthy controls. Our data suggest that a proportion of the volume reduction seen in the hippocampus and DLPFC in schizophrenia is associated with smoking rather than with the diagnosis of schizophrenia. These results may have important implications for brain imaging studies comparing schizophrenia patients and other groups with a lower smoking prevalence.
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Affiliation(s)
- Claudia E Schneider
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, Netherlands; Department of Psychiatry and the Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Johanna Hass
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Daniel Geisler
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Stuart R Wallace
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Daphne J Holt
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Vince D Calhoun
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA; The Mind Research Network, Image Analysis and MR Research, Albuquerque, NM, USA
| | - Randy L Gollub
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; Massachusetts General Hospital/Massachusetts Institute of Technology/Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA.
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8
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de Lacy N, King BH. Revisiting the relationship between autism and schizophrenia: toward an integrated neurobiology. Annu Rev Clin Psychol 2013; 9:555-87. [PMID: 23537488 DOI: 10.1146/annurev-clinpsy-050212-185627] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Schizophrenia and autism have been linked since their earliest descriptions. Both are disorders of cerebral specialization originating in the embryonic period. Genetic, molecular, and cytologic research highlights a variety of shared contributory mechanisms that may lead to patterns of abnormal connectivity arising from altered development and topology. Overt behavioral pathology likely emerges during or after neurosensitive periods in which resource demands overwhelm system resources and the individual's ability to compensate using interregional activation fails. We are at the threshold of being able to chart autism and schizophrenia from the inside out. In so doing, the door is opened to the consideration of new therapeutics that are developed based upon molecular, synaptic, and systems targets common to both disorders.
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Affiliation(s)
- Nina de Lacy
- University of Washington and Seattle Children's Hospital, Seattle, Washington 98195, USA
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9
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Selemon LD, Ceritoglu C, Ratnanather JT, Wang L, Harms MP, Aldridge K, Begović A, Csernansky JG, Miller MI, Rakic P. Distinct abnormalities of the primate prefrontal cortex caused by ionizing radiation in early or midgestation. J Comp Neurol 2013; 521:1040-53. [PMID: 22911497 DOI: 10.1002/cne.23217] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 05/31/2012] [Accepted: 08/16/2012] [Indexed: 11/10/2022]
Abstract
Prenatal exposure of the brain to environmental insult causes different neurological symptoms and behavioral outcomes depending on the time of exposure. To examine the cellular bases for these differences, we exposed rhesus macaque fetuses to x-rays during early gestation (embryonic day [E]30-E42), i.e., before the onset of corticogenesis, or in midgestation (E70-E81), when superficial cortical layers are generated. Animals were delivered at term (~E165), and the size and cellular composition of prefrontal association cortex (area 46) examined in adults using magnetic resonance imaging (MRI) and stereologic analysis. Both early and midgestational radiation exposure diminished the surface area and volume of area 46. However, early exposure spared cortical thickness and did not alter laminar composition, and due to higher cell density, neuron number was within the normal range. In contrast, exposure to x-rays at midgestation reduced cortical thickness, mainly due to elimination of neurons destined for the superficial layers. A cell-sparse gap, observed within layer III, was not filled by the later-generated neurons destined for layer II, indicating that there is no subsequent replacement of the lost neurons. The distinct areal and laminar pathology consequent to temporally segregated irradiation is consistent with basic postulates of the radial unit hypothesis of cortical development. In addition, we show that an environmental disturbance inflicted in early gestation can induce subtle cytoarchitectonic alterations without loss of neurons, such as those observed in schizophrenia, whereas midgestational exposure causes selective elimination of neurons and cortical thinning as observed in some forms of mental retardation and fetal alcohol syndrome.
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Affiliation(s)
- Lynn D Selemon
- Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut 06520-8001, USA.
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10
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Pu F, Xu L, Li D, Fan Y, Niu H, Li S. Comparison of two nonlinear registration techniques to investigate brain atrophy patterns in normal aging. J Neuroradiol 2013; 40:326-34. [PMID: 23602532 DOI: 10.1016/j.neurad.2013.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/28/2013] [Accepted: 01/30/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Automated anatomical labeling (AAL) provides an automatic brain region segmentation method to allow objective measurement of regional brain volume. Nonlinear registration plays a critical role in such automated region-based volumetry. The aim of this study was to compare age-related brain regional volume changes using two nonlinear registration methods in statistical parametric mapping (SPM). MATERIAL AND METHODS The study included 176 right-handed healthy participants (age range: 18-94years). A total of 90 brain regions for each subject were automatically extracted, based on the AAL atlas, and two nonlinear registration methods (Normalization and DARTEL Toolbox in SPM5) were applied. Three-way ANOVA was performed to estimate the effects of brain region, each registration method and each hemisphere on regional volumes. Age-related brain-volume changes were also investigated by linear regression analysis for each nonlinear registration method. RESULTS Significant differences were found in volume among different brain regions (P<0.001) with the two nonlinear registration methods (P=0.011). Volumes of the corresponding brain region were significantly different (P=0.037) between two hemispheres, and age-related volume reductions were unevenly distributed across regions. The most dramatic decreases in volume were found in the bilateral insula, middle frontal regions and cingulum. Rankings of the decreased brain regional volumes differed between the two registration techniques and adjustment methods. CONCLUSION The inferred age-related volume atrophy patterns based on the AAL atlas were largely dependent on the choice of registration methodology.
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Affiliation(s)
- Fang Pu
- State Key Laboratory of Software Development Environment, Beihang University, 100191 Beijing, China; Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science & Medical Engineering, Beihang University, 100191 Beijing, China
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11
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Yang Y, Nuechterlein KH, Phillips OR, Gutman B, Kurth F, Dinov I, Thompson PM, Asarnow RF, Toga AW, Narr KL. Disease and genetic contributions toward local tissue volume disturbances in schizophrenia: a tensor-based morphometry study. Hum Brain Mapp 2012; 33:2081-91. [PMID: 22241649 DOI: 10.1002/hbm.21349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Structural brain deficits, especially frontotemporal volume reduction and ventricular enlargement, have been repeatedly reported in patients with schizophrenia. However, it remains unclear whether brain structural deformations may be attributable to disease-related or genetic factors. In this study, the structural magnetic resonance imaging data of 48 adult-onset schizophrenia patients, 65 first-degree nonpsychotic relatives of schizophrenia patients, 27 community comparison (CC) probands, and 73 CC relatives were examined using tensor-based morphometry (TBM) to isolate global and localized differences in tissue volume across the entire brain between groups. We found brain tissue contractions most prominently in frontal and temporal regions and expansions in the putamen/pallidum, and lateral and third ventricles in schizophrenia patients when compared with unrelated CC probands. Results were similar, though less prominent when patients were compared with their nonpsychotic relatives. Structural deformations observed in unaffected patient relatives compared to age-similar CC relatives were suggestive of schizophrenia-related genetic liability and were pronounced in the putamen/pallidum and medial temporal regions. Schizophrenia and genetic liability effects for the putamen/pallidum were confirmed by regions-of-interest analysis. In conclusion, TBM findings complement reports of frontal, temporal, and ventricular dysmorphology in schizophrenia and further indicate that putamen/pallidum enlargements, originally linked mainly with medication exposure in early studies, also reflect a genetic predisposition for schizophrenia. Thus, brain deformation profiles revealed in this study may help to clarify the role of specific genetic or environmental risk factors toward altered brain morphology in schizophrenia.
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Affiliation(s)
- Yaling Yang
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
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12
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Castellani U, Rossato E, Murino V, Bellani M, Rambaldelli G, Perlini C, Tomelleri L, Tansella M, Brambilla P. Classification of schizophrenia using feature-based morphometry. J Neural Transm (Vienna) 2011; 119:395-404. [PMID: 21904897 DOI: 10.1007/s00702-011-0693-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 07/16/2011] [Indexed: 11/28/2022]
Abstract
The objective of this study was to use a combined local descriptor, namely scale invariance feature transform (SIFT), and a non linear support vector machine (SVM) technique to automatically classify patients with schizophrenia. The dorsolateral prefrontal cortex (DLPFC), considered a reliable neuroanatomical marker of the disease, was chosen as region of interest (ROI). Fifty-four schizophrenia patients and 54 age- and gender-matched normal controls were studied with a 1.5T MRI (slice thickness 1.25 mm). Three steps were conducted: (1) landmark detection and description of the DLPFC, (2) feature vocabulary construction and Bag-of-Words (BoW) computation for brain representation, (3) SVM classification which adopted the local kernel to implicitly implement the feature matching. Moreover, a new weighting approach was proposed to take into account the discriminant relevance of the detected groups of features. Substantial results were obtained for the classification of the whole dataset (left side 75%, right side 66.38%). The performances were higher when females (left side 84.09%, right side 77.27%) and seniors (left side 81.25%, right side 70.83%) were considered separately. In general, the supervised weighed functions increased the efficacy in all the analyses. No effects of age, gender, antipsychotic treatment and chronicity were shown on DLPFC volumes. This integrated innovative ROI-SVM approach allows to reliably detect subjects with schizophrenia, based on a structural brain marker for the disease such as the DLPFC. Such classification should be performed in first-episode patients in future studies, by considering males and females separately.
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Affiliation(s)
- U Castellani
- Department of Computer Science, University of Verona, Verona, Italy
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13
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Bartholomeusz CF, Proffitt TM, Savage G, Simpson L, Markulev C, Kerr M, McConchie M, McGorry PD, Pantelis C, Berger GE, Wood SJ. Relational memory in first episode psychosis: implications for progressive hippocampal dysfunction after illness onset. Aust N Z J Psychiatry 2011; 45:206-13. [PMID: 21438746 DOI: 10.3109/00048674.2010.547456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Verbal episodic memory deficits are prominent in schizophrenia and have also been found in first episode psychosis (FEP) and individuals at clinical risk of the disorder. The central role of the hippocampus in verbal memory processing and the consistent findings of hippocampal volume reductions in chronic patients have prompted the suggestion that impaired verbal memory performance may be a biomarker of schizophrenia. However, it is currently unclear as to when, during the early phase of psychosis, verbal memory performance becomes significantly impaired. The current study investigated verbal relational memory in FEP using a novel verbal paired associate task, and tested whether performance was dependent on phase of illness within FEP, where patients with a diagnosis of schizophrenia were considered to be in a more advanced stage than those with schizophreniform disorder. METHOD Forty-seven currently psychotic FEP patients and 36 healthy non-psychiatric controls, aged 15-25 years old, completed a test comprising four trials of learning and cued recall of word pairs (denoted AB pairs), an interference phase comprising two trials with new second words (AC pairs), and finally cued recall for the original AB pairings. RESULTS FEP patients performed similarly to controls on the relational memory task. There was no difference in performance between FEP patients who had a diagnosis of schizophrenia and those with a diagnosis of schizophreniform disorder. CONCLUSIONS Verbal relational memory appears to be intact in FEP. This finding, along with chronic patient literature, suggests that decline in hippocampal and medial temporal lobe functioning occurs during later illness stages. Further research is needed to aid in the development of intervention strategies that may prevent decline in such cognitive domains at this crucial early stage of the illness.
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Affiliation(s)
- Cali F Bartholomeusz
- National Neuroscience Facility, Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Carlton South, Victoria, Australia.
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Walther S, Federspiel A, Horn H, Razavi N, Wiest R, Dierks T, Strik W, Müller TJ. Alterations of white matter integrity related to motor activity in schizophrenia. Neurobiol Dis 2011; 42:276-83. [PMID: 21296665 DOI: 10.1016/j.nbd.2011.01.017] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 01/03/2011] [Accepted: 01/27/2011] [Indexed: 12/22/2022] Open
Abstract
Altered structural connectivity is a key finding in schizophrenia, but the meaning of white matter alterations for behavior is rarely studied. In healthy subjects, motor activity correlated with white matter integrity in motor tracts. To explore the relation of motor activity and fractional anisotropy (FA) in schizophrenia, we investigated 19 schizophrenia patients and 24 healthy control subjects using Diffusion Tensor Imaging (DTI) and actigraphy on the same day. Schizophrenia patients had lower activity levels (AL). In both groups linear relations of AL and FA were detected in several brain regions. Schizophrenia patients had lower FA values in prefrontal and left temporal clusters. Furthermore, using a general linear model, we found linear negative associations of FA and AL underneath the right supplemental motor area (SMA), the right precentral gyrus and posterior cingulum in patients. This effect within the SMA was not seen in controls. This association in schizophrenia patients may contribute to the well known dysfunctions of motor control. Thus, structural disconnectivity could lead to disturbed motor behavior in schizophrenia.
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Affiliation(s)
- Sebastian Walther
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
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15
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Age-related increase in the number of oligodendrocytes is dysregulated in schizophrenia and mood disorders. SCHIZOPHRENIA RESEARCH AND TREATMENT 2011; 2011:174689. [PMID: 22937261 PMCID: PMC3420648 DOI: 10.1155/2011/174689] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 04/01/2011] [Indexed: 12/15/2022]
Abstract
The postnatal maturation of the human prefrontal cortex is associated with substantial increase of number of oligodendrocytes. Previously, we reported decreased numerical density of oligodendrocytes in the prefrontal cortex in schizophrenia and mood disorders. To gain further understanding of the role oligodendrocytes in pathogenesis of schizophrenia and mood disorders, we examined the effect of the age on the number of oligodendrocytes in the prefrontal cortex in schizophrenia, bipolar disorder, and major depressive disorder. We revealed the age-related increase in numerical density of oligodendrocytes in layer VI and adjacent white matter of BA10 and BA 9 in normal controls but not in schizophrenia, bipolar disorder, and major depressive disorder. The absence of normal increase in the number of oligodendrocytes in gray and white matter with age in schizophrenia and mood disorders suggests that age-related process of oligodendrocyte increase is dysregulated in schizophrenia and mood disorders.
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Maller JJ, Réglade-Meslin C, Chan P, Daskalakis ZJ, Thomson RHS, Anstey KJ, Budge M, Sachdev P, Fitzgerald PB. Hippocampal sulcal cavities: prevalence, risk factors and relationship to memory impairment. Brain Res 2010; 1368:222-30. [PMID: 21040716 DOI: 10.1016/j.brainres.2010.10.089] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/18/2010] [Accepted: 10/24/2010] [Indexed: 02/02/2023]
Abstract
While hippocampal volumes have been extensively examined in neuropsychiatric disorders and ageing, small areas of signal variation within the hippocampus commonly observed on MRI, described as hippocampal sulcal cavities (HSCs), have received less attention. We review the published literature on HSCs to examine their prevalence, putative aetiological factors such as hypertension, and possible cognitive correlates. HSCs were reported in 77% (66% weighted mean) of patients with memory disorders and 48% (47% weighted mean) of controls, and the prevalence increased with age in healthy subjects (r=0.64, p=0.047). A number of studies reported hypertension as a risk factor, and related their presence to poorer memory function. Further work is needed to fully understand the clinical significance of these lesions.
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Affiliation(s)
- Jerome J Maller
- Monash Alfred Psychiatry Research Centre, The Alfred & Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia.
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17
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Maller JJ, Daskalakis ZJ, Thomson RHS, Daigle M, Barr MS, Fitzgerald PB. Hippocampal volumetrics in treatment-resistant depression and schizophrenia: the devil's in de-tail. Hippocampus 2010; 22:9-16. [PMID: 20882552 DOI: 10.1002/hipo.20873] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2010] [Indexed: 11/05/2022]
Abstract
Studies of patients with major depressive disorder (MDD) and schizophrenia (SCH) have revealed reduced hippocampal volumes, but findings have been inconsistent due to sample and measurement differences. The current study sought to measure this structure in a large sample of MDD, SCH, and healthy subjects, using a strict measurement protocol, to elucidate morphological-specific volumetric differences. Patients with treatment-resistant MDD (N = 182) and treatment-resistant SCH with auditory-verbal hallucinations (N = 52), and healthy controls (N = 76) underwent psychiatric assessments and brain MRI. The findings indicate that (1) MDD and SCH patients have reduced total hippocampal volume which was marked in the tails (more so in patients with MDD), (2) region of interest estimation protocols and sample characteristics may help explain volumetric differences between previous SCH studies.
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Affiliation(s)
- Jerome J Maller
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology and Psychiatry, Melbourne Victoria, Australia.
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18
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Buehlmann E, Berger GE, Aston J, Gschwandtner U, Pflueger MO, Borgwardt SJ, Radue EW, Riecher-Rössler A. Hippocampus abnormalities in at risk mental states for psychosis? A cross-sectional high resolution region of interest magnetic resonance imaging study. J Psychiatr Res 2010; 44:447-53. [PMID: 19939408 DOI: 10.1016/j.jpsychires.2009.10.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 09/16/2009] [Accepted: 10/20/2009] [Indexed: 12/18/2022]
Abstract
BACKGROUND Hippocampal volume (HV) reduction is well documented in schizophrenia. However, it is still unclear whether this change is a pre-existing vulnerability factor, a sign of disease progression, a consequence of environmental factors, such as drug use, antipsychotic medication, or malnutrition. The timing of HV changes is not well established, but a lack of macrostructural hippocampal brain abnormalities before disease onset would rather support a neuroprogressive illness model. AIM To investigate the timing of HV changes in emerging psychosis. METHODS A cross-sectional MRI study of manually traced HVs in 37 individuals with an At Risk Mental State (ARMS) for psychosis, 23 individuals with First-Episode Psychosis (FEP), and 22 Healthy Controls (HC) was performed. We compared left and right HVs corrected for whole brain volume across groups using analysis of covariance (ANCOVA) with gender as a covariate. Sixteen of 37 ARMS individuals developed a psychotic disorder during follow up (ARMS-T). The mean duration of follow up in ARMS was 25.1months. RESULTS The overall ANCOVA model comparing left HVs across FEP, ARMS and HC indicated a significant general group effect (p<.05) with largest volumes in ARMS and smallest in FEP. ARMS-T subjects had significantly larger left HVs compared to FE but no HV differences compared to HC (p<0.05). Over all groups, we found an asymmetry between the left and right mean HVs and a strong effect of sex. DISCUSSION The present study suggests that macrostructural hippocampal abnormalities probably occur in the context of the first psychotic breakdown.
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Affiliation(s)
- Eva Buehlmann
- University Hospital Basel, Psychiatric Outpatient Department, Petersgraben 4, CH-4031 Basel, Switzerland
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Goghari VM, Sponheim SR, MacDonald AW. The functional neuroanatomy of symptom dimensions in schizophrenia: a qualitative and quantitative review of a persistent question. Neurosci Biobehav Rev 2010; 34:468-86. [PMID: 19772872 PMCID: PMC2813961 DOI: 10.1016/j.neubiorev.2009.09.004] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 09/09/2009] [Accepted: 09/09/2009] [Indexed: 11/30/2022]
Abstract
One of the fundamental goals in understanding schizophrenia is linking the observable symptoms to the underlying unobservable pathophysiology. Given recent advances in medical imaging, researchers are increasingly investigating brain-behavior relationships to better understand the neural substrates of negative, positive, and disorganization symptoms in schizophrenia. This review focused on 25 task-related functional magnetic resonance imaging studies and found meaningful small to moderate associations between specific symptom dimensions and regional brain activity. Negative symptoms were related to the functioning of the ventrolateral prefrontal cortex and ventral striatum. Positive symptoms, particularly persecutory ideation, were related to functioning of the medial prefrontal cortex, amygdala, and hippocampus/parahippocampal region. Disorganization symptoms, although less frequently evaluated, were related to functioning of the dorsolateral prefrontal cortex. Surprisingly, no symptom domain had a consistent relationship with the middle or superior temporal regions. While a number of adaptations in experimental design and reporting standards can facilitate this work, current neuroimaging approaches appear to provide a number of consistent links between the manifest symptoms of schizophrenia and brain dysfunction.
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Affiliation(s)
- Vina M Goghari
- Clinical Neuroscience of Schizophrenia (CNS) Laboratory, Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada.
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20
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Fornito A, Yücel M, Dean B, Wood SJ, Pantelis C. Anatomical abnormalities of the anterior cingulate cortex in schizophrenia: bridging the gap between neuroimaging and neuropathology. Schizophr Bull 2009; 35:973-93. [PMID: 18436528 PMCID: PMC2728810 DOI: 10.1093/schbul/sbn025] [Citation(s) in RCA: 184] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The anterior cingulate cortex (ACC) is a functionally heterogeneous region involved in diverse cognitive and emotional processes that support goal-directed behaviour. Structural magnetic resonance imaging (MRI) and neuropathological findings over the past two decades have converged to suggest abnormalities in the region may represent a neurobiological basis for many of the clinical manifestations of schizophrenia. However, while each approach offers complimentary information that can provide clues regarding underlying patholophysiological processes, the findings from these 2 fields are seldom integrated. In this article, we review structural neuroimaging and neuropathological studies of the ACC, focusing on the unique information they provide. The available imaging data suggest grey matter reductions in the ACC precede psychosis onset in some categories of high-risk individuals, show sub-regional specificity, and may progress with illness duration. The available post-mortem findings indicate these imaging-related changes are accompanied by reductions in neuronal, synaptic, and dendritic density, as well as increased afferent input, suggesting the grey matter differences observed with MRI arise from alterations in both neuronal and non-neuronal tissue compartments. We discuss the potential mechanisms that might facilitate integration of these findings and consider strategies for future research.
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Affiliation(s)
- Alex Fornito
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia.
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia,ORYGEN Research Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Brian Dean
- The Rebecca L Cooper Research Laboratories, The Mental Health Research Institute, Parkville, Victoria, Australia,Departments of Pathology and Psychiatry, The University of Melbourne, Victoria, Australia,Department of Psychological Medicine, Monash University, Victoria, Australia
| | - Stephen J. Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia,Howard Florey Institute, The University of Melbourne, Victoria, Australia
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Sanches M, Caetano S, Nicoletti M, Monkul ES, Chen HH, Hatch JP, Yeh PH, Mullis RL, Keshavan MS, Rajowska G, Soares JC. An MRI-based approach for the measurement of the dorsolateral prefrontal cortex in humans. Psychiatry Res 2009; 173:150-4. [PMID: 19545981 PMCID: PMC2778758 DOI: 10.1016/j.pscychresns.2009.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 11/24/2008] [Accepted: 02/19/2009] [Indexed: 10/20/2022]
Abstract
The dorsolateral prefrontal cortex (DLPFC) has been implicated in the pathophysiology of mental disorders. Previous region-of-interest MRI studies that attempted to delineate this region adopted various landmarks and measurement techniques, with inconsistent results. We developed a new region-of-interest measurement method to obtain morphometric data of this region from structural MRI scans, taking into account knowledge from cytoarchitectonic postmortem studies and the large inter-individual variability of this region. MRI scans of 10 subjects were obtained, and DLPFC tracing was performed in the coronal plane by two independent raters using the semi-automated software Brains2. The intra-class correlation coefficients between two independent raters were 0.94 for the left DLPFC and 0.93 for the right DLPFC. The mean +/- S.D. DLPFC volumes were 9.23 +/- 2.35 ml for the left hemisphere and 8.20 +/- 2.08 ml for the right hemisphere. Our proposed method has high inter-rater reliability and is easy to implement, permitting the standardized measurement of this region for clinical research applications
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Affiliation(s)
- Marsal Sanches
- Department of Psychiatry, Federal University of São Paulo, Rua Botucatu, São Paulo, 740 CEP 04023-900, Brazil
| | - Sheila Caetano
- Department of Psychiatry, University of São Paolo, Caixa Postal 66281 São Paulo 05311-970, Brazil
| | - Mark Nicoletti
- 10612 Neurosciences Hospital CB#7160, Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - E. Serap Monkul
- 7703 Floyd Curl Dr, Division of Mood and Anxiety Disorders, Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Hua Hsuan Chen
- 7703 Floyd Curl Dr, Division of Mood and Anxiety Disorders, Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - John P. Hatch
- 7703 Floyd Curl Dr, Division of Mood and Anxiety Disorders, Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Ping-Hong Yeh
- 10612 Neurosciences Hospital CB#7160, Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Rachel L. Mullis
- 10612 Neurosciences Hospital CB#7160, Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Matcheri S. Keshavan
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
| | - Grazyna Rajowska
- 2500 N. State St, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jair C. Soares
- 10612 Neurosciences Hospital CB#7160, Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA,Correspondence should be addressed to: Jair C. Soares, M.D., Center of Excellence for Research and Treatment of Bipolar Disorder, 10612 Neurosciences Hospital, Department of Psychiatry, CB # 7160, University of North Carolina, Chapel Hill, NC 27599-7160, , Telephone: 919-966-8832, Fax: 919-843-3950
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Voormolen EHJ, Wei C, Chow EWC, Bassett AS, Mikulis DJ, Crawley AP. Voxel-based morphometry and automated lobar volumetry: the trade-off between spatial scale and statistical correction. Neuroimage 2009; 49:587-96. [PMID: 19619660 DOI: 10.1016/j.neuroimage.2009.07.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 06/30/2009] [Accepted: 07/09/2009] [Indexed: 10/20/2022] Open
Abstract
Voxel-based morphometry (VBM) and automated lobar region of interest (ROI) volumetry are comprehensive and fast methods to detect differences in overall brain anatomy on magnetic resonance images. However, VBM and automated lobar ROI volumetry have detected dissimilar gray matter differences within identical image sets in our own experience and in previous reports. To gain more insight into how diverging results arise and to attempt to establish whether one method is superior to the other, we investigated how differences in spatial scale and in the need to statistically correct for multiple spatial comparisons influence the relative sensitivity of either technique to group differences in gray matter volumes. We assessed the performance of both techniques on a small dataset containing simulated gray matter deficits and additionally on a dataset of 22q11-deletion syndrome patients with schizophrenia (22q11DS-SZ) vs. matched controls. VBM was more sensitive to simulated focal deficits compared to automated ROI volumetry, and could detect global cortical deficits equally well. Moreover, theoretical calculations of VBM and ROI detection sensitivities to focal deficits showed that at increasing ROI size, ROI volumetry suffers more from loss in sensitivity than VBM. Furthermore, VBM and automated ROI found corresponding GM deficits in 22q11DS-SZ patients, except in the parietal lobe. Here, automated lobar ROI volumetry found a significant deficit only after a smaller sub-region of interest was employed. Thus, sensitivity to focal differences is impaired relatively more by averaging over larger volumes in automated ROI methods than by the correction for multiple comparisons in VBM. These findings indicate that VBM is to be preferred over automated lobar-scale ROI volumetry for assessing gray matter volume differences between groups.
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Affiliation(s)
- Eduard H J Voormolen
- Image Sciences Institute, University Medical Centre Utrecht, Utrecht, The Netherlands
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Neural functional organization of hallucinations in schizophrenia: Multisensory dissolution of pathological emergence in consciousness. Conscious Cogn 2009; 18:449-57. [DOI: 10.1016/j.concog.2008.12.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 12/11/2008] [Accepted: 12/13/2008] [Indexed: 11/24/2022]
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Chan WY, Chia MY, Yang GL, Woon PS, Sitoh YY, Collinson SL, Nowinski WL, Sim K. Duration of Illness, Regional Brain Morphology and Neurocognitive Correlates in Schizophrenia. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2009. [DOI: 10.47102/annals-acadmedsg.v38n5p388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction: Previous studies examining brain effects of duration of illness in schizophrenia have focused on either cortical or subcortical structures. Hence this study sought to elucidate the regional grey matter changes (both cortical and subcortical) and neurocognitive correlates with increased duration of illness in a large sample of patients with schizophrenia using voxel-based morphometry.
Materials and Methods: Ninety patients (72 males and 18 females) with DSM-IV diagnosis of schizophrenia were recruited and assessed using magnetic resonance imaging and a battery of neuropsychological tests.
Results: A longer duration of illness was associated with smaller grey matter volumes in the left superior frontal gyrus, bilateral putamen, right superior temporal gyrus, right superior occipital gyrus as well as the right thalamus. No region showed increased grey matter volume above threshold with longer duration of illness. Longer duration of illness was correlated with poorer attention.
Conclusions: The grey matter reductions in different brain regions highlighted that a distributed network of cortical and subcortical regions was associated with duration of illness. This is consistent with neural models that implicate involvement of thalamo-cortical circuitry as the disruption in these neural pathways can result in specific deficits such as poorer attention. The results have implications for the understanding of brain changes in schizophrenia, and with further studies, may guide better tailored and targeted clinical management in terms of reducing the impact of duration of illness on neural substrates in schizophrenia in the future.
Key words: Duration of Illness, Grey Matter, Magnetic resonance imaging, Voxel-based Morphometry
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Affiliation(s)
| | | | | | | | | | | | | | - Kang Sim
- Woodbridge Hospital/ Institute of Mental Health, Singapore
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Bennett A O M. Criminal law as it pertains to 'mentally incompetent defendants': a McNaughton rule in the light of cognitive neuroscience. Aust N Z J Psychiatry 2009; 43:289-99. [PMID: 19296283 DOI: 10.1080/00048670902721137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The McNaughton rules for determining whether a person can be successfully defended on the grounds of mental incompetence were determined by a committee of the House of Lords in 1843. They arose as a consequence of the trial of Daniel McNaughton for the killing of Prime Minister Sir Robert Peel's secretary. In retrospect it is clear that McNaughton suffered from schizophrenia. The successful defence of McNaughton on the grounds of mental incompetence by his advocate Sir Alexander Cockburn involved a profound shift in the criteria for such a defence, and was largely based on the then recently published 'scientific' thesis of the great US psychiatrist Isaac Ray, entitled 'A treatise on the medical jurisprudence of insanity'. Subsequent discussion of this defence in the House of Lords led to the McNaughton rules, still the basis of the defence of mental incompetence in the courts of much of the English-speaking world. This essay argues that the rules need to be reconsidered in the light of the discoveries of cognitive neuroscience made during the 160 years since Ray's treatise. It is shown, for instance, how the conflation of 'the power of self-control' with 'irresistible impulse' by Cockburn is not supported by cognitive neuroscience because these are separate capacities requiring normal activity in distinct brain structures for their expression. In this way cognitive neuroscience assists in distinguishing between different capacities. It is further shown that failure of appropriate restraint in the expression of a capacity can be related to failure of synapses in particular parts of the brain. This raises the question as to what level of synaptic loss will the legislature and the courts rule as sufficient for a subject to be no longer held responsible for their lack of restraint.
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Lawyer G, Nesvåg R, Varnäs K, Frigessi A, Agartz I. Investigating possible subtypes of schizophrenia patients and controls based on brain cortical thickness. Psychiatry Res 2008; 164:254-64. [PMID: 19022629 DOI: 10.1016/j.pscychresns.2007.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 09/03/2007] [Accepted: 12/22/2007] [Indexed: 10/21/2022]
Abstract
Schizophrenia is a heterogeneous disease in which different dimensions could be associated with localized subtypes in cortical thickness of the brain. Subtypes in data that includes patients and controls could be associated with patient/control could associate with patient/control groupings. Testing for subtypes provides a non-parametric investigation of group differences. Cortical thickness maps, generated from magnetic resonance images of 96 patients with schizophrenia and 106 controls, were co-registered and corrected for age-related thinning. At multiple map locations, the number of (sub)types best explaining cortical thickness in the patients, the controls, and both combined was determined. Grey matter volumes of selected regions were measured. Both patients and controls, considered independently, were predominantly homogeneous in cortical thickness. The few bimodal regions were similar in both groups. The combined subjects' cortical thickness was bimodal over 34% of the cortical mantle and otherwise unimodal. Further probing of these bimodal regions showed that subjects tending to belong to thinner modes were significantly more likely to be patients, and grey matter volumes of most bimodal regions were significantly smaller in patients. The study found no subtypes specific to patients. It suggested, however, that associations between abnormally thin cortex and schizophrenia are more widespread than shown by previously published results based on significance testing.
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Affiliation(s)
- Glenn Lawyer
- Institute of Psychiatry, University of Oslo, Oslo, Norway.
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Premkumar P, Fannon D, Kuipers E, Cooke MA, Simmons A, Kumari V. Association between a longer duration of illness, age and lower frontal lobe grey matter volume in schizophrenia. Behav Brain Res 2008; 193:132-9. [PMID: 18586335 DOI: 10.1016/j.bbr.2008.05.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 05/07/2008] [Accepted: 05/10/2008] [Indexed: 11/19/2022]
Abstract
The frontal lobe has an extended maturation period and may be vulnerable to the long-term effects of schizophrenia. We tested this hypothesis by studying the relationship between duration of illness (DoI), grey matter (GM) and cerebro-spinal fluid (CSF) volume across the whole brain. Sixty-four patients with schizophrenia and 25 healthy controls underwent structural MRI scanning and neuropsychological assessment. We performed regression analyses in patients to examine the relationship between DoI and GM and CSF volumes across the whole brain, and correlations in controls between age and GM or CSF volume of the regions where GM or CSF volumes were associated with DoI in patients. Correlations were also performed between GM volume in the regions associated with DoI and neuropsychological performance. A longer DoI was associated with lower GM volume in the left dorsomedial prefrontal cortex (PFC), right middle frontal cortex, left fusiform gyrus (FG) and left cerebellum (lobule III). Additionally, age was inversely associated with GM volume in the left dorsomedial PFC in patients, and in the left FG and CSF excess near the left cerebellum in healthy controls. Greater GM volume in the left dorsomedial PFC was associated with better working memory, attention and psychomotor speed in patients. Our findings suggest that the right middle frontal cortex is particularly vulnerable to the long-term effect of schizophrenia illness whereas the dorsomedial PFC, FG and cerebellum are affected by both a long DoI and aging. The effect of illness chronicity on GM volume in the left dorsomedial PFC may be extended to brain structure-neuropsychological function relationships.
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Affiliation(s)
- Preethi Premkumar
- Department of Psychology, Institute of Psychiatry, De Crespigny Park, King's College London, London SE5 8AF, United Kingdom.
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Raizada RDS, Richards TL, Meltzoff A, Kuhl PK. Socioeconomic status predicts hemispheric specialisation of the left inferior frontal gyrus in young children. Neuroimage 2008; 40:1392-401. [PMID: 18308588 PMCID: PMC2679945 DOI: 10.1016/j.neuroimage.2008.01.021] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 12/12/2007] [Accepted: 01/10/2008] [Indexed: 11/17/2022] Open
Abstract
Reading is a complex skill that is not mastered by all children. At the age of 5, on the cusp of prereading development, many factors combine to influence a child's future reading success, including neural and behavioural factors such as phonological awareness and the auditory processing of phonetic input, and environmental factors, such as socioeconomic status (SES). We investigated the interactions between these factors in 5-year-old children by administering a battery of standardised cognitive and linguistic tests, measuring SES with a standardised scale, and using fMRI to record neural activity during a behavioral task, rhyming, that is predictive of reading skills. Correlation tests were performed, and then corrected for multiple comparisons using the false discovery rate (FDR) procedure. It emerged that only one relationship linking neural with behavioural or environmental factors survived as significant after FDR correction: a correlation between SES and the degree of hemispheric specialisation in the left inferior frontal gyrus (IFG), a region which includes Broca's area. This neural-environmental link remained significant even after controlling for the children's scores on the standardised language and cognition tests. In order to investigate possible environmental influences on the left IFG further, grey and white matter volumes were calculated. Marginally significant correlations with SES were found, indicating that environmental effects may manifest themselves in the brain anatomically as well as functionally. Collectively, these findings suggest that the weaker language skills of low-SES children are related to reduced underlying neural specialisation, and that these neural problems go beyond what is revealed by behavioural tests alone.
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Affiliation(s)
- Rajeev D S Raizada
- Institute for Learning and Brain Sciences, University of Washington, Box 357988, Seattle, WA 98195, USA.
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Galderisi S, Quarantelli M, Volpe U, Mucci A, Cassano GB, Invernizzi G, Rossi A, Vita A, Pini S, Cassano P, Daneluzzo E, De Peri L, Stratta P, Brunetti A, Maj M. Patterns of structural MRI abnormalities in deficit and nondeficit schizophrenia. Schizophr Bull 2008; 34:393-401. [PMID: 17728266 PMCID: PMC2632416 DOI: 10.1093/schbul/sbm097] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Negative symptoms of schizophrenia have generally been found in association with ventricular enlargement and prefrontal abnormalities. These relationships, however, have not been observed consistently, most probably because negative symptoms are heterogeneous and result from different pathophysiological mechanisms. The concept of deficit schizophrenia (DS) was introduced by Carpenter et al to identify a clinically homogeneous subgroup of patients characterized by the presence of primary and enduring negative symptoms. Findings of brain structural abnormalities reported by magnetic resonance imaging (MRI) studies focusing on DS have been mixed. The present study included 34 patients with DS, 32 with nondeficit schizophrenia (NDS), and 31 healthy comparison subjects, providing the largest set of MRI findings in DS published so far. The Schedule for the Deficit Syndrome was used to categorize patients as DS or NDS patients. The 2 patient groups were matched on age and gender and did not differ on clinical variables, except for higher scores on the negative dimension and more impaired interpersonal relationships in DS than in NDS subjects. Lateral ventricles were larger in NDS than in control subjects but were not enlarged in patients with DS. The cingulate gyri volume was smaller in NDS but not in DS patients as compared with healthy subjects. Both groups had smaller dorsolateral prefrontal cortex and temporal lobes than healthy subjects, but DS patients had significantly less right temporal lobe volume as compared with NDS patients. These findings do not support the hypothesis that DS is the extreme end of a severity continuum within schizophrenia.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy.
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Abstract
Neuroimaging and electrophysiological investigations have demonstrated numerous differences in brain morphology and function of chronic schizophrenia patients compared to healthy controls. Studying patients at the beginning of their disease without the confounding effects of chronicity, medication, and institutionalization may provide a better understanding of schizophrenia. Recently, at many institutions around the world, special projects have been launched for specialized treatment and research of this interesting patient group. Using the PubMed search engine in this update, the authors summarize recent investigations between January 2002 and September 2006 that focus on whether signs of disconnectivity already exist early in the disease process. They discuss gray and white matter changes, their impact on symptomatology, electroencephalogram-based studies on connectivity, and possible influences of medication. NEUROSCIENTIST 14(1):19—45, 2008. DOI: 10.1177/1073858406298391
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Affiliation(s)
- S Begré
- Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital Bern, Switzerland.
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Crespo-Facorro B, Barbadillo L, Pelayo-Terán JM, Rodríguez-Sánchez JM. Neuropsychological functioning and brain structure in schizophrenia. Int Rev Psychiatry 2007; 19:325-36. [PMID: 17671866 DOI: 10.1080/09540260701486647] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cognitive deficits are core features of schizophrenia that are already evident at early phases of the illness. The study of specific relationships between cognition and brain structure might provide valuable clues about neural basis of schizophrenia and its phenomenology. The aim of this article was to review the most consistent findings of the studies exploring the relationships between cognitive deficits and brain anomalies in schizophrenia. Besides several important methodological shortcomings to bear in mind before drawing any consistent conclusion from the revised literature, we have attempted to systematically summarize these findings. Thus, this review has revealed that whole brain volume tends to positively correlate with a range of cognitive domains in healthy volunteers and female patients. An association between prefrontal morphological characteristics and general inability to control behaviour seems to be present in schizophrenia patients. Parahippocampal volume is related to semantic cognitive functions. Thalamic anomalies have been associated with executive deficits specifically in patients. Available evidence on the relationship between cognitive functions and cerebellar structure is still contradictory. Nonetheless, a larger cerebellum appears to be associated with higher IQ in controls and in female patients. Enlarged ventricles, including lateral and third ventricles, are associated with deficits in attention, executive and premorbid cognitive functioning in patients. Several of these reported findings seem to be counterintuitive according to neural basis of cognitive functioning drawn from animal, lesion, and functional imaging investigations. Therefore, there is still a great need for more methodologically stringent investigations that would help in the advance of our understanding of the cognition/brain structure relationships in schizophrenia.
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Affiliation(s)
- Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University Hospital Marqués de Valdecilla, Avenida aldecilla s/n, 39008 Santander, Spain.
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