1
|
Messer L, Zoabi A, Yakobi R, Natsheh H, Touitou E, Margulis K. Evaluation of nasal delivery systems of olanzapine by desorption electrospray ionization mass spectrometry imaging. Int J Pharm 2024; 650:123664. [PMID: 38061498 DOI: 10.1016/j.ijpharm.2023.123664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/15/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023]
Abstract
Nose-to-brain delivery presents an attractive administration route for neuroactive drugs that suffer from compromised bioavailability or fail to pass the blood-brain barrier. However, the conventional gauge of effectiveness for intranasal delivery platforms primarily involves detecting the presence of the administered drug within the brain, with little insight into its precise localization within brain structures. This may undermine the therapeutic efficacy of drugs and hinder the design of systems that target specific brain regions. In this study, we designed two intranasal delivery systems for the antipsychotic drug, olanzapine, and evaluated its distribution in the rat brain following intranasal administration. The first evaluated system was an olanzapine-loaded microemulsion and the second one was nanoparticulate aqueous dispersion of olanzapine. Both systems exhibited characteristics that render them compatible for intranasal administration, and successfully delivered olanzapine to the brain. We further employed an ambient mass spectrometry imaging method, called desorption electrospray ionization mass spectrometry imaging, to visualize the signal intensity of olanzapine in different brain regions following the intranasal administration of these two systems. Substantial variations in the distribution patterns of olanzapine across various brain structures were revealed, potentially highlighting the importance of mass spectrometry imaging in designing and evaluating intranasal drug delivery platforms.
Collapse
Affiliation(s)
- Lihi Messer
- The Institute for Drug Research, the School of Pharmacy, the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112192, Israel
| | - Amani Zoabi
- The Institute for Drug Research, the School of Pharmacy, the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112192, Israel
| | - Ravit Yakobi
- The Institute for Drug Research, the School of Pharmacy, the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112192, Israel
| | - Hiba Natsheh
- The Institute for Drug Research, the School of Pharmacy, the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112192, Israel
| | - Elka Touitou
- The Institute for Drug Research, the School of Pharmacy, the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112192, Israel.
| | - Katherine Margulis
- The Institute for Drug Research, the School of Pharmacy, the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112192, Israel.
| |
Collapse
|
2
|
Zheng G, Zhou Y, Zhou J, Liang S, Li X, Xu C, Xie G, Liang J. Abnormalities of the Amygdala in schizophrenia: a real world study. BMC Psychiatry 2023; 23:615. [PMID: 37608255 PMCID: PMC10463851 DOI: 10.1186/s12888-023-05031-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Amygdala plays an important role in schizophrenia (SC), but its mechanisms are still unclear. Therefore, we investigated the relationship between the resting-state magnetic resonance imaging (rsMRI) signals of the amygdala and cognitive functions, providing references for future research in this area. METHODS We collected 40 drug-naïve SC patients and 33 healthy controls (HC) from the Third People's Hospital of Foshan. We used rsMRI and the automatic segmentation tool to extract the structural volume and local neural activity values of the amygdala and conducted Pearson correlation analysis with the Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scores. Finally, we compared the clinical data, as well as the volume and functional changes of the amygdala in SC patients before and after treatment. RESULTS Compared with HC, SC had widespread cognitive impairments, significant abnormalities in left amygdala function, while the reduction in volume of SC was not significant. Further Pearson correlation analysis with Bonferroni correction showed that only Immediate memory (learning) was significantly negatively correlated with fractional amplitude of low-frequency fluctuation (FALFF, r = -0.343, p = 0.001, p' = 0.014 (Bonferroni correction)). When compared and analyzed the data difference of SC before and after treatment, we found that immediate memory and delayed memory of SC showed varying degrees of recovery after treatment (tlearning = -2.641, plearning = 0.011; tstory memory = -3.349, pstory memory = 0.001; tlist recall = -2.071, plist recall = 0.043; tstory recall = -2.424, pstory recall = 0.018). But the brain structure and function did not recover. CONCLUSION There was significant dysfunction in the amygdala in SC, and after conventional treatment, the function of the amygdala did not improve with the improvement of clinical symptoms and cognitive function.
Collapse
Affiliation(s)
- Guangen Zheng
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China
- Nanhai Public Health Hospital of Foshan City, Guangdong, People's Republic of China
| | - Yang Zhou
- Nanhai Public Health Hospital of Foshan City, Guangdong, People's Republic of China
| | - Jieming Zhou
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China
| | - Shuting Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China
| | - Xiaoling Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China
| | - Caixia Xu
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China
| | - Guojun Xie
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China.
| | - Jiaquan Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Guangdong, People's Republic of China.
| |
Collapse
|
3
|
Yang C, Zhang W, Liu J, Yao L, Bishop JR, Lencer R, Gong Q, Yang Z, Lui S. Disrupted subcortical functional connectome gradient in drug-naïve first-episode schizophrenia and the normalization effects after antipsychotic treatment. Neuropsychopharmacology 2023; 48:789-796. [PMID: 36496508 PMCID: PMC10066388 DOI: 10.1038/s41386-022-01512-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
Antipsychotics are thought to improve schizophrenia symptoms through the antagonism of dopamine D2 receptors, which are abundant mainly in subcortical regions. By introducing functional gradient, a novel approach to identify hierarchy alterations by capturing the similarity of whole brain fucntional connectivity (FC) profiles between two voxels, the present study aimed to characterize how the subcortical gradient is associated with treatment effects and response in first-episode schizophrenia in vivo. Two independent samples of first-episode schizophrenia (FES) patients with matched healthy controls (HC) were obtained: the discovery dataset included 71 patients (FES0W) and 64 HC at baseline, and patients were re-scanned after either 6 weeks (FES6W, N = 33) or 12 months (FES12M, N = 57) of antipsychotic treatment, of which 19 patients finished both 6-week and 12-month evaluation. The validation dataset included 22 patients and 24 HC at baseline and patients were re-scanned after 6 weeks. Gradient metrics were calculated using BrainSpace Toolbox. Voxel-based gradient values were generated and group-averaged gradient values were further extracted across all voxels (global), three systems (thalamus, limbic and striatum) and their subcortical subfields. The comparisons were conducted separately between FES0W and HC for investigating illness effects, and between FES6W/FES12M and FES0W for treatment effects. Correlational analyses were then conducted between the longitudinal gradient alterations and the improvement of clinical ratings. Before treatment, schizophrenia patients exhibited an expanded range of global gradient scores compared to HC which indicated functional segregation within subcortical systems. The increased gradient in limbic system and decreased gradient in thalamic and striatal system contributed to the baseline abnormalities and led to the disruption of the subcortical functional integration. After treatment, these disruptions were normalized and the longitudinal changes of gradient scores in limbic system were significantly associated with symptom improvement. Similar illness and treatment effects were also observed in the validation dataset. By measuring functional hierarchy of subcortical organization, our findings provide a novel imaging marker that is sensitive to treatment effects and may make a promising indicator of treatment response in schizophrenia.
Collapse
Affiliation(s)
- Chengmin Yang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jiajun Liu
- College of Electronic Engineering, Chengdu University of Information Technology, Chengdu, China
| | - Li Yao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Zhipeng Yang
- College of Electronic Engineering, Chengdu University of Information Technology, Chengdu, China.
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
| |
Collapse
|
4
|
Yang G, Zhang S, Zhou Y, Song Y, Hu W, Peng Y, Shi H, Zhang Y. Increased resting-state interhemispheric functional connectivity of striatum in first-episode drug-naive adolescent-onset schizophrenia. Asian J Psychiatr 2022; 76:103134. [PMID: 35551877 DOI: 10.1016/j.ajp.2022.103134] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/25/2022] [Accepted: 04/20/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Compared to adult-onset schizophrenia, relatively few neuroimaging studies have examined functional connectivity (FC) abnormalities in adolescent-onset schizophrenia (AOS). The present study was designed to investigate resting-state interhemispheric connectivity patterns among drug-naive first-episode AOS patients and potential changes following short-term antipsychotic drug treatment. METHODS This study included 107 drug-naïve, first-episode AOS patients (age: 15.33 ± 1.62, 45 males) and 67 matched healthy controls (age: 15.43 ± 1.86, 30 males). All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans, and 34 AOS patients (age: 15.12 ± 1.68, 12 males) also underwent a follow-up scan after 8 weeks of antipsychotic drug treatment. Interhemispheric functional connectivity was measured by voxel-mirrored homotopic connectivity (VMHC). RESULTS Compared to healthy controls, AOS patients showed increased VMHC values in putamen and caudate. No significant differences were observed between the patients at baseline and after 8 weeks of treatment. CONCLUSIONS First-episode, drug-naive AOS patients demonstrate abnormalities in interhemispheric FC, and these are not mitigated by short-term antipsychotic treatment.
Collapse
Affiliation(s)
- Ge Yang
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Sen Zhang
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Youqi Zhou
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Yichen Song
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Wenyan Hu
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Yue Peng
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Han Shi
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Yan Zhang
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| |
Collapse
|
5
|
Sun J, Zhang X, Cong Q, Chen D, Yi Z, Huang H, Wang C, Li M, Zeng R, Liu Y, Huai C, Chen L, Liu C, Zhang Y, Xu Y, Fan L, Wang G, Song C, Wei M, Du H, Zhu J, He L, Qin S. miR143-3p-Mediated NRG-1-Dependent Mitochondrial Dysfunction Contributes to Olanzapine Resistance in Refractory Schizophrenia. Biol Psychiatry 2022; 92:419-433. [PMID: 35662508 DOI: 10.1016/j.biopsych.2022.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/10/2021] [Accepted: 03/11/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Olanzapine is an effective antipsychotic medication for treatment-resistant schizophrenia (TRS); however, the therapeutic effectiveness of olanzapine has been found to vary in individual patients. It is imperative to unravel its resistance mechanisms and find reliable targets to develop novel precise therapeutic strategies. METHODS Unbiased RNA sequencing analysis was performed using homogeneous populations of neural stem cells derived from induced pluripotent stem cells in 3 olanzapine responder (reduction of Positive and Negative Syndrome Scale score ≥25%) and 4 nonresponder (reduction of Positive and Negative Syndrome Scale score <25%) inpatients with TRS. We also used a genotyping study from patients with TRS to assess the candidate genes associated with the olanzapine response. CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9-mediated genome editing, neurologic behavioral tests, RNA silencing, and microRNA sequencing were used to investigate the phenotypic mechanisms of an olanzapine resistance gene in patients with TRS. RESULTS Neuregulin-1 (NRG-1) deficiency-induced mitochondrial dysfunction is associated with olanzapine treatment outcomes in TRS. NRG-1 knockout mice showed schizophrenia-relevant behavioral deficits and yielded olanzapine resistance. Notably, miR143-3p is a critical NRG-1 target related to mitochondrial dysfunction, and miR143-3p levels in neural stem cells associate with severity to olanzapine resistance in TRS. Meanwhile, olanzapine resistance in NRG-1 knockout mice could be rescued by treatment with miR143-3p agomir via intracerebral injection. CONCLUSIONS Our findings provide direct evidence of olanzapine resistance resulting from NRG-1 deficiency-induced mitochondrial dysfunction, and they link olanzapine resistance and NRG-1 deficiency-induced mitochondrial dysfunction to an NRG-1/miR143-3p axis, which constitutes a novel biomarker and target for TRS.
Collapse
Affiliation(s)
- Jing Sun
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China; Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Xiaoya Zhang
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Qijie Cong
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Dong Chen
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Zhenghui Yi
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hailiang Huang
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Cong Wang
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Mo Li
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Rongsen Zeng
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Yunxi Liu
- Neurobiology & Mitochondrial Key Laboratory, School of Pharmacy, Jiangsu University, Zhenjiang, China
| | - Cong Huai
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Luan Chen
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Chuanxin Liu
- School of Mental Health, Jining Medical University, Jining, China
| | - Yan Zhang
- The Second People's Hospital of Lishui, Lishui, China
| | - Yong Xu
- Department of Psychiatry, First Hospital, First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Lingzi Fan
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Guoqiang Wang
- Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Chuanfu Song
- The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Muyun Wei
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Huihui Du
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Jinhang Zhu
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Lin He
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Shengying Qin
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
6
|
Yan H, Shan X, Li H, Liu F, Guo W. Abnormal spontaneous neural activity as a potential predictor of early treatment response in patients with obsessive-compulsive disorder. J Affect Disord 2022; 309:27-36. [PMID: 35472471 DOI: 10.1016/j.jad.2022.04.125] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to explore the value of early improvement in obsessive-compulsive disorder (OCD) along with potential imaging changes after treatment with paroxetine in building diagnostic models and predicting treatment response. METHODS The clinical symptoms of patients with OCD were assessed at baseline and post-treatment (four weeks). Resting-state functional magnetic resonance imaging, fractional amplitudes of low-frequency fluctuations (fALFF) indicator, support vector machine (SVM), support vector regression (SVR), and correlation analysis were performed to acquire and analyze the data. RESULTS In comparison with healthy controls, OCD patients at baseline had abnormal fALFF in several brain regions. The abnormal fALFF in the left precuneus/ posterior cingulate cortex (PCC) (r = -0.526, p = 0.001) and right middle cingulate cortex (MCC) (r = -0.588, p < 0.001) were negatively correlated with the severity of compulsions. Patients with OCD showed significantly clinical improvement along with significantly decreased fALFF in the left precuneus after treatment. The SVM analysis showed that the classifier had an accuracy of 90.00% based on the fALFF in the right precentral gyrus and right MCC at baseline. The SVR analysis showed that the actual remission of OCD was positively correlated with the predicted remission based on the fALFF in the left precuneus/PCC and right MCC at baseline. LIMITATIONS This monocentric study with the relatively small sample size might restrict the generalizability of the results to other centers. CONCLUSIONS Abnormal spontaneous neural activities in patients with OCD could serve as potential neuroimaging biomarkers for diagnosis and prediction of early treatment response.
Collapse
Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Department of Psychiatry, The Third People's Hospital of Foshan, Foshan 528000, Guangdong, China.
| |
Collapse
|
7
|
Adam Yaple Z, Tolomeo S, Yu R. Spatial and chronic differences in neural activity in medicated and unmedicated schizophrenia patients. Neuroimage Clin 2022; 35:103029. [PMID: 35569228 PMCID: PMC9112098 DOI: 10.1016/j.nicl.2022.103029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/10/2022] [Accepted: 04/28/2022] [Indexed: 11/07/2022]
Abstract
The medicated schizophrenia group yielded concordant activity among three right lateralized frontal clusters and a left lateralized parietal cluster. The unmedicated schizophrenia group yielded concordant activity among right lateralized frontal-parietal regions. A neural compensatory mechanism in schizophrenia.
A major caveat with investigations on schizophrenic patients is the difficulty to control for medication usage across samples as disease-related neural differences may be confounded by medication usage. Following a thorough literature search (632 records identified), we included 37 studies with a total of 740 medicated schizophrenia patients and 367 unmedicated schizophrenia patients. Here, we perform several meta-analyses to assess the neurofunctional differences between medicated and unmedicated schizophrenic patients across fMRI studies to determine systematic regions associated with medication usage. Several clusters identified by the meta-analysis on the medicated group include three right lateralized frontal clusters and a left lateralized parietal cluster, whereas the unmedicated group yielded concordant activity among right lateralized frontal-parietal regions. We further explored the prevalence of activity within these regions across illness duration and task type. These findings suggest a neural compensatory mechanism across these regions both spatially and chronically, offering new insight into the spatial and temporal dynamic neural differences among medicated and unmedicated schizophrenia patients.
Collapse
Affiliation(s)
| | - Serenella Tolomeo
- Social and Cognitive Computing Department, Institute of High Performance Computing, Agency for Science, Technology and Research, Singapore, Singapore
| | - Rongjun Yu
- Department of Management, Hong Kong Baptist University, Hong Kong, China; Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China; Department of Physics, Hong Kong Baptist University, Hong Kong, China.
| |
Collapse
|
8
|
Novel Approaches to Tackling Emotional Loss of Control of Eating Across the Weight Spectrum. Proc Nutr Soc 2022; 81:255-263. [PMID: 35260206 DOI: 10.1017/s0029665122000994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Emotional overeating is a process that is particularly relevant to people within the binge spectrum of eating disorders. Approximately a third of people with overweight share this phenotype. In addition, this behaviour may occur in neurodevelopmental disorders (attention-deficit hyperactivity disorder (ADHD)) and other psychiatric disorders. The biopsychosocial underpinnings of emotional eating include a genetic vulnerability to a higher weight and various cognitive and emotional traits. The environment also plays a key role. For example, the commodification of food and beauty and exposure to weight stigma, unpleasant eating experiences and general adversity can set the scene. The majority of people with binge-eating disorder do not seek treatment (perhaps related to internalised stigma and shame). Hence opportunities for early intervention and secondary prevention are lost. Most guidelines for binge-eating disorder (based on the limited available research) recommend forms of cognitive psychotherapies and antidepressants. However, novel treatments that target underlying mechanisms are in development. These include interventions to improve emotional regulation and inhibitory control using neuromodulation and/or brain training. New technologies have been applied to talking therapies, including apps which can offer ‘just-in-time interventions’ or virtual reality or avatar work which can deliver more personalised interventions using complex scenarios. Drugs used for the treatment of ADHD, psychiatric and metabolic disorders may have the potential to be repurposed for binge-eating disorder. Thus, this is an area of rapid change with novel solutions being applied to this problem.
Collapse
|
9
|
Increased Homotopic Connectivity in the Prefrontal Cortex Modulated by Olanzapine Predicts Therapeutic Efficacy in Patients with Schizophrenia. Neural Plast 2021; 2021:9954547. [PMID: 34512748 PMCID: PMC8429031 DOI: 10.1155/2021/9954547] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/08/2021] [Accepted: 08/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies have revealed the abnormalities in homotopic connectivity in schizophrenia. However, the relationship of these deficits to antipsychotic treatment in schizophrenia remains unclear. This study explored the effects of antipsychotic therapy on brain homotopic connectivity and whether the homotopic connectivity of these regions might predict individual treatment response in schizophrenic patients. Methods A total of 21 schizophrenic patients and 20 healthy controls were scanned by the resting-state functional magnetic resonance imaging. The patients received olanzapine treatment and were scanned at two time points. Voxel-mirrored homotopic connectivity (VMHC) and pattern classification techniques were applied to analyze the imaging data. Results Schizophrenic patients presented significantly decreased VMHC in the temporal and inferior frontal gyri, medial prefrontal cortex (MPFC), and motor and low-level sensory processing regions (including the fusiform gyrus and cerebellum lobule VI) relative to healthy controls. The VMHC in the superior/middle MPFC was significantly increased in the patients after eight weeks of treatment. Support vector regression (SVR) analyses revealed that VMHC in the superior/middle MPFC at baseline can predict the symptomatic improvement of the positive and negative syndrome scale after eight weeks of treatment. Conclusions This study demonstrated that olanzapine treatment may normalize decreased homotopic connectivity in the superior/middle MPFC in schizophrenic patients. The VMHC in the superior/middle MPFC may predict individual response for antipsychotic therapy. The findings of this study conduce to the comprehension of the therapy effects of antipsychotic medications on homotopic connectivity in schizophrenia.
Collapse
|
10
|
Cattarinussi G, Delvecchio G, Prunas C, Moltrasio C, Brambilla P. Effects of pharmacological treatments on emotional tasks in borderline personality disorder: A review of functional magnetic resonance imaging studies. J Affect Disord 2021; 288:50-57. [PMID: 33839558 DOI: 10.1016/j.jad.2021.03.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/17/2021] [Accepted: 03/29/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a common mental disorder characterized by instability in interpersonal relationships, impaired self-image, impulsivity and aggressive behaviors that often requires pharmacological treatments. Neuroimaging alterations have been extensively reported in BPD, especially in regions within the fronto-limbic system. Although medications can be an important confounding factor in functional Magnetic Resonance Imaging (fMRI) studies, their role on brain function in BPD patients still remains uncertain. Therefore, this review aims to improve our understanding on the potential effect of the most commonly prescribed drugs for BPD on brain function during processing of emotional tasks. METHODS A search on PubMed, Scopus and Web of Science of fMRI studies exploring the effect of antipsychotics, antidepressants and mood stabilizers on brain activity during processing of emotional tasks on BPD was conducted. RESULTS Overall the studies showed small or no effect of pharmacological treatments on brain activity and connectivity in BPD patients during processing of emotional tasks. LIMITATIONS The small sample size, the observational design, the elevated percentage of women, the concomitant use of psychostimulants, anticholinergics and opioids substitute treatments and the high rate of comorbidities limit the conclusion of this review. CONCLUSIONS Pharmacological treatments seem to have minor role on brain activity/connectivity in BPD patients during emotional tasks, ultimately suggesting that in BPD patients brain deficits seem not be influenced by medications. This might be due to functional brain specificities of BPD and to the differences in pharmacological regimens and compliance to therapy between BPD and other common psychiatric disorders.
Collapse
Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
11
|
O'Neill A, Wilson R, Blest-Hopley G, Annibale L, Colizzi M, Brammer M, Giampietro V, Bhattacharyya S. Normalization of mediotemporal and prefrontal activity, and mediotemporal-striatal connectivity, may underlie antipsychotic effects of cannabidiol in psychosis. Psychol Med 2021; 51:596-606. [PMID: 31994476 DOI: 10.1017/s0033291719003519] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Recent evidence suggests that cannabidiol (CBD), a non-intoxicating ingredient present in cannabis extract, has an antipsychotic effect in people with established psychosis. However, the effect of CBD on the neurocognitive mechanisms underlying psychosis is unknown. METHODS Patients with established psychosis on standard antipsychotic treatment were studied on separate days at least one week apart, to investigate the effects of a single dose of orally administered CBD (600 mg) compared to a matched placebo (PLB), using a double-blind, randomized, PLB-controlled, repeated-measures, within-subject cross-over design. Three hours after taking the study drug participants were scanned using a block design functional magnetic resonance imaging (fMRI) paradigm, while performing a verbal paired associate learning task. Fifteen psychosis patients completed both study days, 13 completed both scanning sessions. Nineteen healthy controls (HC) were also scanned using the same fMRI paradigm under identical conditions, but without any drug administration. Effects of CBD on brain activation measured using the blood oxygen level-dependent hemodynamic response fMRI signal were studied in the mediotemporal, prefrontal, and striatal regions of interest. RESULTS Compared to HC, psychosis patients under PLB had altered prefrontal activation during verbal encoding, as well as altered mediotemporal and prefrontal activation and greater mediotemporal-striatal functional connectivity during verbal recall. CBD attenuated dysfunction in these regions such that activation under its influence was intermediate between the PLB condition and HC. CBD also attenuated hippocampal-striatal functional connectivity and caused trend-level symptom reduction in psychosis patients. CONCLUSIONS This suggests that normalization of mediotemporal and prefrontal dysfunction and mediotemporal-striatal functional connectivity may underlie the antipsychotic effects of CBD.
Collapse
Affiliation(s)
- Aisling O'Neill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Luciano Annibale
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marco Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mick Brammer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
12
|
Rubio JM, Malhotra AK, Kane JM. Towards a framework to develop neuroimaging biomarkers of relapse in schizophrenia. Behav Brain Res 2021; 402:113099. [PMID: 33417996 DOI: 10.1016/j.bbr.2020.113099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 12/31/2022]
Abstract
Schizophrenia is a chronic disorder that often requires long-term relapse-prevention treatment. This treatment is effective for most individuals, yet approximately 20-30 % of them may still relapse despite confirmed adherence. Alternatively, for about 15 % it may be safe to discontinue medications over the long term, but since there are no means to identify who those individuals will be, the recommendation is that all individuals receive long-term relapse-prevention treatment with antipsychotic maintenance. Thus, the current approach to prevent relapse in schizophrenia may be suboptimal for over one third of individuals, either by being insufficient to protect against relapse, or by unnecessarily exposing them to medication side effects. There is great need to identify biomarkers of relapse in schizophrenia to stratify treatment according to the risk and develop therapeutics targeting its pathophysiology. In order to develop a line of research that meets those needs, it is necessary to create a framework by identifying the challenges to this type of study as well as potential areas for biomarker identification and development. In this manuscript we review the literature to create such a framework.
Collapse
Affiliation(s)
- Jose M Rubio
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA.
| | - Anil K Malhotra
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA
| | - John M Kane
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA
| |
Collapse
|
13
|
Abstract
BACKGROUND Most studies investigating antipsychotic effectiveness report either total psychopathology or symptom cluster findings. Studies focusing on a separate symptom, such as hallucinations, a hallmark symptom in schizophrenia, are scarce.Therefore, the current study aims to compare the antihallucinatory effectiveness of 3 pharmacologically different antipsychotics: olanzapine, amisulpride, and aripiprazole. METHODS The present study is part of the Bergen-Stavanger-Innsbruck-Trondheim study, a 12-month prospective, randomized, pragmatic antipsychotic drug trial in active-phase schizophrenia spectrum disorders. The primary outcome of the present study was change of hallucinations as measured by item P3 (hallucinatory behavior) from the Positive and Negative Syndrome Scale in the subgroup with hallucinations at baseline. Primary analyses were intention to treat. RESULTS A total of 144 participants were included in the study, where 105 (72%) had a score of 3 or more on the Positive and Negative Syndrome Scale P3 item at baseline, indicating the presence of hallucinations (HALL subgroup).In the HALL subgroup, a significantly less reduction of hallucinations was revealed for participants using olanzapine in weeks 12, 26, 39, and 52 when compared with amisulpride and in weeks 26 and 52 when compared with aripiprazole. In subanalyses for participants never exposed to antipsychotic drugs (antipsychotic-naive) and those who had used antipsychotics before entering the study, antihallucinatory differences were revealed only in the latter group. CONCLUSIONS A differential antihallucinatory effect of the 3 study drugs was present. The inferior effect of olanzapine seems to be driven by the subgroup of participants exposed to antipsychotic treatment before entering the study.
Collapse
|
14
|
Shan X, Liao R, Ou Y, Pan P, Ding Y, Liu F, Chen J, Zhao J, Guo W, He Y. Increased regional homogeneity modulated by metacognitive training predicts therapeutic efficacy in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2021; 271:783-798. [PMID: 32215727 PMCID: PMC8119286 DOI: 10.1007/s00406-020-01119-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 03/11/2020] [Indexed: 02/07/2023]
Abstract
Previous studies have demonstrated the efficacy of metacognitive training (MCT) in schizophrenia. However, the underlying mechanisms related to therapeutic effect of MCT remain unknown. The present study explored the treatment effects of MCT on brain regional neural activity using regional homogeneity (ReHo) and whether these regions' activities could predict individual treatment response in schizophrenia. Forty-one patients with schizophrenia and 20 healthy controls were scanned using resting-state functional magnetic resonance imaging. Patients were randomly divided into drug therapy (DT) and drug plus psychotherapy (DPP) groups. The DT group received only olanzapine treatment, whereas the DPP group received olanzapine and MCT for 8 weeks. The results revealed that ReHo in the right precuneus, left superior medial prefrontal cortex (MPFC), right parahippocampal gyrus and left rectus was significantly increased in the DPP group after 8 weeks of treatment. Patients in the DT group showed significantly increased ReHo in the left ventral MPFC/anterior cingulate cortex (ACC), left superior MPFC/middle frontal gyrus (MFG), left precuneus, right rectus and left MFG, and significantly decreased ReHo in the bilateral cerebellum VIII and left inferior occipital gyrus (IOG) after treatment. Support vector regression analyses showed that high ReHo levels at baseline in the right precuneus and left superior MPFC could predict symptomatic improvement of Positive and Negative Syndrome Scale (PANSS) after 8 weeks of DPP treatment. Moreover, high ReHo levels at baseline and alterations of ReHo in the left ventral MPFC/ACC could predict symptomatic improvement of PANSS after 8 weeks of DT treatment. This study suggests that MCT is associated with the modulation of ReHo in schizophrenia. ReHo in the right precuneus and left superior MPFC may predict individual therapeutic response for MCT in patients with schizophrenia.
Collapse
Affiliation(s)
- Xiaoxiao Shan
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China ,National Clinical Research Center on Mental Disorders, Changsha, 410011 Hunan China
| | - Rongyuan Liao
- grid.412990.70000 0004 1808 322XThe Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan China
| | - Yangpan Ou
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China ,National Clinical Research Center on Mental Disorders, Changsha, 410011 Hunan China
| | - Pan Pan
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China ,National Clinical Research Center on Mental Disorders, Changsha, 410011 Hunan China
| | - Yudan Ding
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China ,National Clinical Research Center on Mental Disorders, Changsha, 410011 Hunan China
| | - Feng Liu
- grid.412645.00000 0004 1757 9434Department of Radiology, Tianjin Medical University General Hospital, Tianjin, 300000 China
| | - Jindong Chen
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China ,National Clinical Research Center on Mental Disorders, Changsha, 410011 Hunan China
| | - Jingping Zhao
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China ,National Clinical Research Center on Mental Disorders, Changsha, 410011 Hunan China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China. .,National Clinical Research Center on Mental Disorders, Changsha, 410011, Hunan, China.
| | - Yiqun He
- The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China.
| |
Collapse
|
15
|
Psychobiology of threat appraisal in the context of psychotic experiences: A selective review. Eur Psychiatry 2020; 30:817-29. [DOI: 10.1016/j.eurpsy.2015.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 11/22/2022] Open
Abstract
AbstractA key factor in the transition to psychosis is the appraisal of anomalous experiences as threatening. Cognitive models of psychosis have identified attentional and interpretative biases underlying threat-based appraisals. While much research has been conducted into these biases within the clinical and cognitive literature, little examination has occurred at the neural level. However, neurobiological research in social cognition employing threatening stimuli mirror cognitive accounts of maladaptive appraisal in psychosis. This review attempted to integrate neuroimaging data regarding social cognition in psychosis with the concepts of attentional and interpretative threat biases. Systematic review methodology was used to identify relevant articles from Medline, PsycINFO and EMBASE, and PubMed databases. The selective review showed that attentional and interpretative threat biases relate to abnormal activation of a range of subcortical and prefrontal structures, including the amygdala, insula, hippocampus, anterior cingulate, and prefrontal cortex, as well as disrupted connectivity between these regions, when processing threatening and neutral or ambiguous stimuli. Notably, neural findings regarding the misattribution of threat to neutral or ambiguous stimuli presented a more consistent picture. Overall, however, the findings for any specific emotion were mixed, both in terms of the specific brain areas involved and the direction of effects (increased/decreased activity), possibly owing to confounds including small sample sizes, varying experimental paradigms, medication, and heterogeneous, in some cases poorly characterised, patient groups. Further neuroimaging research examining these biases by employing experimentally induced anomalous perceptual experiences and well-characterised large samples is needed for greater aetiological specificity.
Collapse
|
16
|
Gao S, Ming Y, Wang J, Gu Y, Ni S, Lu S, Zhang R, Sun J, Zhang N, Xu X. Enhanced Prefrontal Regional Homogeneity and Its Correlations With Cognitive Dysfunction/Psychopathology in Patients With First-Diagnosed and Drug-Naive Schizophrenia. Front Psychiatry 2020; 11:580570. [PMID: 33192722 PMCID: PMC7649771 DOI: 10.3389/fpsyt.2020.580570] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/14/2020] [Indexed: 01/10/2023] Open
Abstract
Background: Schizophrenia, regarded as a neurodevelopmental disorder, is characterized by positive symptoms, negative symptoms, and cognitive dysfunction. Investigating the spontaneous brain activity in patients with schizophrenia can help us understand the underlying pathophysiologic mechanism of schizophrenia. However, results concerning abnormal neural activities and their correlations with cognitive dysfunction/psychopathology of patients with schizophrenia were inconsistent. Methods: We recruited 57 first-diagnosed and drug-naive patients with schizophrenia and 50 matched healthy controls underwent magnetic resonance imaging. The Positive and Negative Syndrome Scale (PANSS) and the MATRICS Consensus Cognitive Battery were used to assess the psychopathology/cognitive dysfunction. Regional homogeneity (ReHo) was used to explore neural activities. Correlation analyses were calculated between abnormal ReHo values and PANSS scores/standardized cognitive scores. Lastly, support vector machine analyses were conducted to evaluate the accuracy of abnormal ReHo values in distinguishing patients with schizophrenia from healthy controls. Results: Patients with schizophrenia showed cognitive dysfunction, and increased ReHo values in the right gyrus rectus, right inferior frontal gyrus/insula and left inferior frontal gyrus/insula compared with those of healthy controls. The ReHo values in the right inferior frontal gyrus/insula were positively correlated with negative symptom scores and negatively correlated with Hopkins verbal learning test-revised/verbal learning. Our results showed that the combination of increased ReHo values in the left inferior frontal gyrus/insula and right gyrus rectus had 78.5% (84/107) accuracy, 85.96% (49/57) sensitivity, and 70.00% specificity, which were higher than other combinations. Conclusions: Hyperactivities were primarily located in the prefrontal regions, and increased ReHo values in the right inferior frontal gyrus/insula might reflect the severity of negative symptoms and verbal learning abilities. The combined increases of ReHo values in these regions might be an underlying biomarker in differentiating patients with schizophrenia from healthy controls.
Collapse
Affiliation(s)
- Shuzhan Gao
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yidan Ming
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Jiayin Wang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Gu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Sulin Ni
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Shuiping Lu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Rongrong Zhang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Jing Sun
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ning Zhang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,Department of Psychiatry, Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
| | - Xijia Xu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,Department of Psychiatry, Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
| |
Collapse
|
17
|
Stefanou MI, Vittore D, Wolz I, Klingberg S, Wildgruber D. Recurrent Episodes of Paraphilic Behavior Possibly Associated With Olanzapine and Aripiprazole Treatment in a Patient With Schizophrenia. Front Psychiatry 2020; 11:318. [PMID: 32425825 PMCID: PMC7212450 DOI: 10.3389/fpsyt.2020.00318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/31/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Hypersexual and paraphilic disorders have been frequently associated with concomitant psychiatric disorders, including schizophrenia. A growing number of published cases has recently indicated that hypersexual behavior may also arise in conjunction with treatment with second-generation antipsychotics. Although hypersexuality has been acknowledged as a possible side effect of antipsychotic treatment with partial dopamine agonists, including aripiprazole, only very few cases of olanzapine-associated hypersexuality have been reported in the literature. CASE PRESENTATION A 29-year-old man presented with delusions of persecution and reference, auditory hallucinations, and negative symptoms, and was diagnosed with paranoid-hallucinatory schizophrenia. One and a half months after initiation of antipsychotic treatment with olanzapine, he developed compulsive sexual behavior and paraphilia, without signs of akathisia. After olanzapine discontinuation, a full remission of the hypersexual behavior was noted within one week, and treatment was switched to risperidone. Due to hyperprolactinemia, adjunct treatment with low-dose aripiprazole was initiated and a severe recurrence of identical hypersexual behavior occurred. The hypersexual behavior resolved completely within a week after aripiprazole discontinuation. CONCLUSION This case illustrates that hypersexuality may be a rare adverse effect of treatment with second-generation antipsychotics. Although aripiprazole is a drug with a well-established risk for hypersexuality, the question of whether a causal association between hypersexuality and olanzapine exists remains currently unresolved. As the currently limited amount of available evidence precludes any definitive conclusions, additional research is warranted to delineate the possible neurobiological substrates of hypersexual and paraphilic disorders in patients treated with second-generation antipsychotics.
Collapse
Affiliation(s)
- Maria-Ioanna Stefanou
- Department of Neurology & Stroke, and Hertie-Institute for Clinical Brain Research, Eberhard-Karls University of Tübingen, Tübingen, Germany
| | - Debora Vittore
- Department of Psychiatry and Psychotherapy, Eberhard-Karls University of Tübingen, Tübingen, Germany
| | - Ines Wolz
- Department of Psychiatry and Psychotherapy, Eberhard-Karls University of Tübingen, Tübingen, Germany.,Department of Clinical Psychology and Psychotherapy, Eberhard-Karls University of Tübingen, Tübingen, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, Eberhard-Karls University of Tübingen, Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, Eberhard-Karls University of Tübingen, Tübingen, Germany
| |
Collapse
|
18
|
Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Treatment effects of olanzapine on homotopic connectivity in drug-free schizophrenia at rest. World J Biol Psychiatry 2019. [PMID: 28649941 DOI: 10.1080/15622975.2017.1346280] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Deficits in homotopic connectivity have been implicated in schizophrenia. However, alterations in homotopic connectivity associated with antipsychotic treatments in schizophrenia remain unclear due to lack of longitudinal studies. METHODS Seventeen drug-free patients with recurrent schizophrenia and 24 healthy controls underwent resting-state functional magnetic resonance imaging scans. The patients were scanned at three time points (baseline, at 6 weeks of treatment, and at 6 months of treatment). Voxel-mirrored homotopic connectivity (VMHC) was applied to analyse the imaging data to examine alterations in VMHC associated with antipsychotic treatment. RESULTS The results showed that patients with schizophrenia exhibited decreased VMHC in the default-mode network (such as the precuneus and inferior parietal lobule) and the motor and sensory processing regions (such as the lingual gyrus, fusiform gyrus and cerebellum lobule VI), which could be normalised or denormalised by olanzapine treatment. In addition, negative correlations were found between decreased VMHC and symptom severity in the patients at baseline. CONCLUSIONS The present study shows that olanzapine treatment can normalise or denormalise decreased homotopic connectivity in schizophrenia. The findings also provide a new perspective to understand treatment effects of antipsychotic drugs on homotopic connectivity in schizophrenia that contribute to the disconnection hypothesis of this disease.
Collapse
Affiliation(s)
- Wenbin Guo
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Feng Liu
- f Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology , University of Electronic Science and Technology of China , Chengdu , Sichuan , China
| | - Jindong Chen
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Renrong Wu
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China.,f Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology , University of Electronic Science and Technology of China , Chengdu , Sichuan , China
| | - Lehua Li
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Zhikun Zhang
- g Mental Health Center , The First Affiliated Hospital, Guangxi Medical University , Nanning , Guangxi , China
| | - Huafu Chen
- f Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology , University of Electronic Science and Technology of China , Chengdu , Sichuan , China
| | - Jingping Zhao
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China.,h Guangzhou Hui Ai Hospital , Affliated Brain Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
| |
Collapse
|
19
|
Longitudinal studies of functional magnetic resonance imaging in first-episode psychosis: A systematic review. Eur Psychiatry 2019; 59:60-69. [PMID: 31075523 DOI: 10.1016/j.eurpsy.2019.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/27/2019] [Accepted: 04/28/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Little is known about changes in brain functioning after first-episode psychosis (FEP). Such knowledge is important for predicting the course of disease and adapting interventions. Functional magnetic resonance imaging has become a promising tool for exploring brain function at the time of symptom onset and at follow-up. METHOD A systematic review of longitudinal fMRI studies with FEP patients according to PRISMA guidelines. Resting-state and task-activated studies were considered together. RESULTS Eleven studies were included. These reported on a total of 236 FEP patients were evaluated by two fMRI scans and clinical assessments. Five studies found hypoactivation at baseline in prefrontal cortex areas, two studies found hypoactivation in the amygdala and hippocampus, and three others found hypoactivation in the basal ganglia. Other hypoactivated areas were the anterior cingulate cortex, thalamus and posterior cingulate cortex. Ten out of eleven studies reported (partial) normalization by increased activation after antipsychotic treatment. A minority of studies observed hyperactivation at baseline. CONCLUSIONS This review of longitudinal FEP samples studies reveals a pattern of predominantly hypoactivation in several brain areas at baseline that may normalize to a certain extent after treatment. The results should be interpreted with caution given the small number of studies and their methodological and clinical heterogeneity.
Collapse
|
20
|
Del Fabro L, Delvecchio G, D'Agostino A, Brambilla P. Effects of olanzapine during cognitive and emotional processing in schizophrenia: A review of functional magnetic resonance imaging findings. Hum Psychopharmacol 2019; 34:e2693. [PMID: 30901117 DOI: 10.1002/hup.2693] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 01/25/2019] [Accepted: 02/04/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Olanzapine is an atypical antipsychotic that is widely used in the treatment of schizophrenia and has shown some degree of efficacy on negative and cognitive symptoms. We aimed to review the effects of olanzapine treatment on brain regions that are directly involved in cognitive and emotional processing. METHODS We used the PubMed database to perform a bibliographic search on functional magnetic resonance imaging studies that investigated the effects of olanzapine treatment on neural activity in patients with schizophrenia during cognitive and emotional tasks. RESULTS Despite the high variability of tasks and analysis methods employed, the weight of the evidence was consistent with the hypothesis that olanzapine treatment is associated with a normalization of brain activity in schizophrenia. Distinctive functional changes were found in frontal cortex and cingulate cortex activity during both cognitive and emotional tasks. During emotional processing, olanzapine treatment seems to specifically regulate the activity of the striatum and limbic system. CONCLUSIONS The results of the reviewed studies suggest that in patients with schizophrenia, olanzapine treatment might lead to a more physiological brain activity coupled with regulation of dopamine release. Future studies should further corroborate these hypotheses using larger samples and homogeneous experimental tasks.
Collapse
Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan.,Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| |
Collapse
|
21
|
Niendam TA, Ray KL, Iosif AM, Lesh TA, Ashby SR, Patel PK, Smucny J, Ferrer E, Solomon M, Ragland JD, Carter CS. Association of Age at Onset and Longitudinal Course of Prefrontal Function in Youth With Schizophrenia. JAMA Psychiatry 2018; 75:1252-1260. [PMID: 30285056 PMCID: PMC6583034 DOI: 10.1001/jamapsychiatry.2018.2538] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/08/2018] [Indexed: 01/19/2023]
Abstract
Importance The extent of cognitive deterioration after schizophrenia (SZ) onset is poorly understood because prior longitudinal studies used small samples of older individuals with established illness. Objective To examine the association of age at onset and subsequent longitudinal course of prefrontal activity during the first 2 years of illness in youths with SZ and healthy control participants (HCs). Design, Setting, and Participants This naturalistic, longitudinal, functional magnetic resonance imaging (fMRI) study included patients with recent-onset SZ and HCs aged 12 to 25 years enrolled in an ongoing study of cognition in recent-onset psychosis in the Sacramento, California, area from October 13, 2004, through June 25, 2013. Participants completed clinical assessments and an established measure of cognitive control, the AX Continuous Performance Task (AX-CPT), during fMRI at baseline and at 6-, 12-, and 24-month follow-up. Whole-brain, voxelwise, and an a priori dorsolateral prefrontal cortex (DLPFC) region of interest analyses were performed. Group differences in developmental trajectories were examined by focusing on behavioral performance (d'-context) and cognitive control-associated brain activity. The association of antipsychotic medication and clinical factors were also examined. Data were analyzed from April 15, 2015, through August 29, 2017. Main Outcomes and Measures Primary outcomes included group differences (HC vs SZ) in behavioral performance (d'-context from AX-CPT) and brain activity for cue B-A trials of the AX-CPT in an a priori DLPFC region of interest at baseline and across the age span. Secondary analysis examined the influence of antipsychotics on behavioral performance and DLPFC activity. Results Among the sample of 180 participants (66.1% male; mean [SD] age at baseline, 19.2 [3.2] years), 87 patients with SZ (mean [SD] age, 19.6 [3.0] years) showed impaired performance compared with 93 HCs (mean [SD] age, 18.8 [3.4] years) across the age span (estimated difference [SE], -0.571 [0.12], d'-context; P < .001). Patients with SZ showed reduced activation in the DLPFC and parietal cortex (false discovery rate cluster corrected to P < .05) compared with HCs under conditions of high cognitive control at baseline. Region-of-interest analysis showed reduced activation in the DLPFC bilaterally for patients with SZ, with a trajectory that paralleled that of HCs across the age span (left DLPFC β [SE] estimates, 0.409 [0.165] for the HC group and -0.285 [0.130] for the SZ group [main effect of group, P = .03]; right DLPFC β [SE] estimates, 0.350 [0.103] for the HC group and -0.469 [0.157] for the SZ group [P = .003]). Antipsychotic medication, clinical symptoms, and global functioning were associated with SZ performance. Conclusions and Relevance During the initial 1 to 2 years after illness onset, young individuals with SZ showed deficits in DLPFC activation and cognitive control, with developmental trajectories comparable to those of HCs. Younger age at onset was not associated with reduced cognition or activation. For individuals contributing to longitudinal analysis, results suggest that young patients do not show deterioration or disruption of ongoing brain development in the initial years after illness onset.
Collapse
Affiliation(s)
- Tara A. Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Kimberly L. Ray
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Department of Psychology, The University of Texas at Austin
| | - Ana-Maria Iosif
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Sacramento
| | - Tyler A. Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Stefania R. Ashby
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Department of Psychology, University of Oregon, Eugene
| | - Pooja K. Patel
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Department of Psychology, UCLA (University of California, Los Angeles), Westwood
| | - Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Emilio Ferrer
- Department of Psychology, University of California, Davis, Sacramento
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- MIND Institute, University of California, Davis, Sacramento
| | - J. Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
| | - Cameron S. Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento
- Center for Neuroscience, University of California, Davis, Sacramento
| |
Collapse
|
22
|
Tarcijonas G, Sarpal DK. Neuroimaging markers of antipsychotic treatment response in schizophrenia: An overview of magnetic resonance imaging studies. Neurobiol Dis 2018; 131:104209. [PMID: 29953933 DOI: 10.1016/j.nbd.2018.06.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/16/2018] [Accepted: 06/23/2018] [Indexed: 12/18/2022] Open
Abstract
Antipsychotic drugs are the primary treatment for psychosis, yet individual response to their administration remains variable. At present, no biological predictors of response exist to guide clinicians as they select treatments for patients, and our understanding of the neurobiology underlying the heterogeneity of outcomes remains limited. Magnetic Resonance Imaging (MRI) has been applied by numerous studies to examine the response to antipsychotic treatment, though a large gap remains between their results and our clinical practice. To advance patient care with precision medicine approaches, prior work must be accounted for and built upon with future studies. This review provides an overview of studies that relate treatment outcome to various MRI-related measures, including structural, spectroscopic, diffusion tensor, and functional imaging. Knowledge derived from these studies will be discussed along with future directions for the field.
Collapse
Affiliation(s)
- Goda Tarcijonas
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Deepak K Sarpal
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| |
Collapse
|
23
|
Quarto T, Paparella I, De Tullio D, Viscanti G, Fazio L, Taurisano P, Romano R, Rampino A, Masellis R, Popolizio T, Selvaggi P, Pergola G, Bertolino A, Blasi G. Familial Risk and a Genome-Wide Supported DRD2 Variant for Schizophrenia Predict Lateral Prefrontal-Amygdala Effective Connectivity During Emotion Processing. Schizophr Bull 2018; 44:834-843. [PMID: 28981847 PMCID: PMC6007415 DOI: 10.1093/schbul/sbx128] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The brain functional mechanisms translating genetic risk into emotional symptoms in schizophrenia (SCZ) may include abnormal functional integration between areas key for emotion processing, such as the amygdala and the lateral prefrontal cortex (LPFC). Indeed, investigation of these mechanisms is also complicated by emotion processing comprising different subcomponents and by disease-associated state variables. Here, our aim was to investigate the relationship between risk for SCZ and effective connectivity between the amygdala and the LPFC during different subcomponents of emotion processing. Thus, we first characterized with dynamic causal modeling (DCM) physiological patterns of LPFC-amygdala effective connectivity in healthy controls (HC) during implicit and explicit emotion processing. Then, we compared DCM patterns in a subsample of HC, in patients with SCZ and in healthy siblings of patients (SIB), matched for demographics. Finally, we investigated in HC association of LPFC-amygdala effective connectivity with a genome-wide supported variant increasing genetic risk for SCZ and possibly relevant to emotion processing (DRD2 rs2514218). In HC, we found that a "bottom-up" amygdala-to-LPFC pattern during implicit processing and a "top-down" LPFC-to-amygdala pattern during explicit processing were the most likely directional models of effective connectivity. Differently, implicit emotion processing in SIB, SCZ, and HC homozygous for the SCZ risk rs2514218 C allele was associated with decreased probability for the "bottom-up" as well as with increased probability for the "top-down" model. These findings suggest that task-specific anomaly in the directional flow of information or disconnection between the amygdala and the LPFC is a good candidate endophenotype of SCZ.
Collapse
Affiliation(s)
- Tiziana Quarto
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy,Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Isabella Paparella
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Davide De Tullio
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Giovanna Viscanti
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Leonardo Fazio
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Paolo Taurisano
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Raffaella Romano
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Antonio Rampino
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Rita Masellis
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Teresa Popolizio
- IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Pierluigi Selvaggi
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Giulio Pergola
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessandro Bertolino
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Giuseppe Blasi
- Psychiatric Neuroscience Group, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy,To whom correspondence should be addressed; tel: +390 8055 93629; fax: +390 8055 93204; e-mail:
| |
Collapse
|
24
|
de Bartolomeis A, Iasevoli F, Marmo F, Buonaguro EF, Avvisati L, Latte G, Tomasetti C. Nicotine and caffeine modulate haloperidol-induced changes in postsynaptic density transcripts expression: Translational insights in psychosis therapy and treatment resistance. Eur Neuropsychopharmacol 2018; 28:538-559. [PMID: 29475793 DOI: 10.1016/j.euroneuro.2018.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/30/2017] [Accepted: 01/26/2018] [Indexed: 02/07/2023]
Abstract
Caffeine and nicotine are widely used by schizophrenia patients and may worsen psychosis and affect antipsychotic therapies. However, they have also been accounted as augmentation strategies in treatment-resistant schizophrenia. Despite both substances are known to modulate dopamine and glutamate transmission, little is known about the molecular changes induced by these compounds in association to antipsychotics, mostly at the level of the postsynaptic density (PSD), a site of dopamine-glutamate interplay. Here we investigated whether caffeine and nicotine, alone or combined with haloperidol, elicited significant changes in the levels of both transcripts and proteins of the PSD members Homer1 and Arc, which have been implicated in synaptic plasticity, schizophrenia pathophysiology, and antipsychotics molecular action. Homer1a mRNA expression was significantly reduced by caffeine and nicotine, alone or combined with haloperidol, compared to haloperidol. Haloperidol induced significantly higher Arc mRNA levels than both caffeine and caffeine plus haloperidol in the striatum. Arc mRNA expression was significantly higher by nicotine plus haloperidol vs. haloperidol in the cortex, while in striatum gene expression by nicotine was significantly lower than that by both haloperidol and nicotine plus haloperidol. Both Homer1a and Arc protein levels were significantly increased by caffeine, nicotine, and nicotine plus haloperidol. Homer1b mRNA expression was significantly increased by nicotine and nicotine plus haloperidol, while protein levels were unaffected. Locomotor activity was not significantly affected by caffeine, while it was reduced by nicotine. These data indicate that both caffeine and nicotine trigger relevant molecular changes in PSD sites when given in association with haloperidol.
Collapse
Affiliation(s)
- Andrea de Bartolomeis
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy.
| | - Felice Iasevoli
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Federica Marmo
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Elisabetta Filomena Buonaguro
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Livia Avvisati
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Gianmarco Latte
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Carmine Tomasetti
- Section of Psychiatry, Laboratory of Molecular and Translational Psychiatry, and Unit of Treatment Resistant Psychosis Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| |
Collapse
|
25
|
Pałasz A, Pałka M, Filipczyk Ł, Menezes IC, Rojczyk E, Worthington JJ, Piwowarczyk-Nowak A, Krzystanek M, Wiaderkiewicz R. Effect of long-term treatment with classical neuroleptics on NPQ/spexin, kisspeptin and POMC mRNA expression in the male rat amygdala. J Neural Transm (Vienna) 2018; 125:1099-1105. [PMID: 29488100 PMCID: PMC5999179 DOI: 10.1007/s00702-018-1868-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/22/2018] [Indexed: 12/16/2022]
Abstract
Neuroleptics modulate the expression level of some regulatory neuropeptides in the brain. However, if these therapeutics influence the peptidergic circuits in the amygdala remains unclear. This study specifies the impact profile of the classical antipsychotic drugs on mRNA expression of the spexin/NPQ, kisspeptin-1 and POMC in the rat amygdala. Animals were treated with haloperidol and chlorpromazine for 28 days prior to transcript quantification via qPCR. Haloperidol and chlorpromazine induced a change in the expression of all neuropeptides analyzed. Both drugs led to the decrease of Kiss-1 expression, whereas in POMC and spexin/NPQ their up-regulation in the amygdala was detected. These modulating effects on may represent alternative, so far unknown mechanisms, of classical antipsychotic drugs triggering pharmacological responses.
Collapse
Affiliation(s)
- Artur Pałasz
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland.
| | - Marcelina Pałka
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland
| | - Łukasz Filipczyk
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland
| | - Itiana Castro Menezes
- Department of Neurosciences and Behaviour, Faculty of Medicine, University of São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Ewa Rojczyk
- Department of Descriptive and Topographic Anatomy, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, ul. Jordana 19, 41-808, Zabrze, Poland
| | - John J Worthington
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YQ, UK
| | - Aneta Piwowarczyk-Nowak
- Department of Anatomy, School of Medicine in Katowice, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland
| | - Marek Krzystanek
- Department and Clinic of Psychiatric Rehabilitation, School of Medicine in Katowice, Medical University of Silesia, ul. Ziolowa 45/47, 40-635, Katowice, Poland
| | - Ryszard Wiaderkiewicz
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, ul. Medyków 18, 40-752, Katowice, Poland
| |
Collapse
|
26
|
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.
Collapse
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.
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
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: 10] [Impact Index Per Article: 1.4] [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.
Collapse
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
| |
Collapse
|
29
|
Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Olanzapine modulates the default-mode network homogeneity in recurrent drug-free schizophrenia at rest. Aust N Z J Psychiatry 2017; 51:1000-1009. [PMID: 28605934 DOI: 10.1177/0004867417714952] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous studies on brain function alterations associated with antipsychotic treatment for schizophrenia have produced conflicting results because they used short treatment periods and different designs. METHODS Resting-state functional magnetic resonance imaging scans were obtained from 17 drug-free patients with recurrent schizophrenia and 24 healthy controls. The patients were treated with olanzapine for 6 months and were scanned at three time points (baseline, 6 weeks of treatment and 6 months of treatment). Network homogeneity was used to analyze the imaging data to examine default-mode network homogeneity alterations associated with antipsychotic treatment. RESULTS Compared with the controls, the patients at baseline showed increased network homogeneity in the bilateral precuneus and decreased network homogeneity in the bilateral middle temporal gyrus. Network homogeneity values in the bilateral precuneus decreased, and network homogeneity values in the left superior medial prefrontal cortex and the right middle temporal gyrus increased in patients administered olanzapine as antipsychotic treatment. By contrast, network homogeneity values in the left middle temporal gyrus remained unchanged in patients after treatment. CONCLUSION This study provides evidence that antipsychotic treatment with olanzapine modulates the default-mode network homogeneity in schizophrenia. These findings contribute to the understanding of antipsychotic treatment effects on brain functions.
Collapse
Affiliation(s)
- Wenbin Guo
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Feng Liu
- 6 Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jindong Chen
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Renrong Wu
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Lehua Li
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zhikun Zhang
- 7 Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Huafu Chen
- 6 Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingping Zhao
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| |
Collapse
|
30
|
A neuroimaging study of emotion-cognition interaction in schizophrenia: the effect of ziprasidone treatment. Psychopharmacology (Berl) 2017; 234:1045-1058. [PMID: 28210783 DOI: 10.1007/s00213-017-4533-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 01/10/2017] [Indexed: 12/15/2022]
Abstract
Functional and structural brain changes associated with the cognitive processing of emotional visual stimuli were assessed in schizophrenic patients after 16 weeks of antipsychotic treatment with ziprasidone. Forty-five adults aged 18 to 40 were recruited: 15 schizophrenia patients (DSM-IV criteria) treated with ziprasidone (mean daily dose = 120 mg), 15 patients treated with other antipsychotics, and 15 healthy controls who did not receive any medication. Functional and structural neuroimaging data were acquired at baseline and 16 weeks after treatment initiation. In each session, participants selected stimuli, taken from standardized sets, based on their emotional valence. After ziprasidone treatment, several prefrontal regions, typically involved in cognitive control (anterior cingulate and ventrolateral prefrontal cortices), were significantly activated in patients in response to positive versus negative stimuli. This effect was greater whenever they had to select negative compared to positive stimuli, indicating an asymmetric effect of cognitive treatment of emotionally laden information. No such changes were observed for patients under other antipsychotics. In addition, there was an increase in the brain volume commonly recruited by healthy controls and patients under ziprasidone, in response to cognitive processing of emotional information. The structural analysis showed no significant changes in the density of gray and white matter in ziprasidone-treated patients compared to patients receiving other antipsychotic treatments. Our results suggest that functional changes in brain activity after ziprasidone medication precede structural and clinical manifestations, as markers that the treatment is efficient in restoring the functionality of prefrontal circuits involved in processing emotionally laden information in schizophrenia.
Collapse
|
31
|
Olanzapine modulation of long- and short-range functional connectivity in the resting brain in a sample of patients with schizophrenia. Eur Neuropsychopharmacol 2017; 27:48-58. [PMID: 27887859 DOI: 10.1016/j.euroneuro.2016.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/24/2016] [Accepted: 11/08/2016] [Indexed: 01/12/2023]
Abstract
Treatment effects of antipsychotic drugs on cerebral function are seldom examined. Exploring functional connectivity (FC) in drug-free schizophrenia patients before and after antipsychotic treatment can improve the understanding of antipsychotic drug mechanisms. A total of 17 drug-free patients with recurrent schizophrenia and 24 healthy controls underwent resting-state functional magnetic resonance imaging scans. Long- and short-range FC strengths (FCS) were calculated for each participant. Compared with the controls, the patients at baseline exhibited increased long-range positive FCS (lpFCS) in the bilateral inferior parietal lobule (IPL) and decreased lpFCS in the brain regions of the default-mode network (DMN) regions and sensorimotor circuits of the brain. By contrast, increased short-range positive FCS was observed in the right IPL of the patients at baseline compared with the controls. After treatment with olanzapine, increased FC in the DMN and sensorimotor circuits of the brain was noted, whereas decreased FC was observed in the left superior temporal gyrus (STG). Moreover, the alterations of the FCS values and the reductions in symptom severity among the patients after treatment were correlated. The present study provides evidence that olanzapine normalizes the abnormalities of long- and short-range FCs in schizophrenia. FC reductions in the right IPL may be associated with early treatment response, whereas those in the left STG may be related to poor treatment outcome.
Collapse
|
32
|
Kani AS, Shinn AK, Lewandowski KE, Öngür D. Converging effects of diverse treatment modalities on frontal cortex in schizophrenia: A review of longitudinal functional magnetic resonance imaging studies. J Psychiatr Res 2017; 84:256-276. [PMID: 27776293 PMCID: PMC5135290 DOI: 10.1016/j.jpsychires.2016.10.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/11/2016] [Accepted: 10/18/2016] [Indexed: 02/08/2023]
Abstract
OBJECTIVES A variety of treatment options exist for schizophrenia, but the effects of these treatments on brain function are not clearly understood. To facilitate the development of more effective treatment strategies, it is important to identify how brain function in schizophrenia patients is affected by the diverse therapeutic approaches that are currently available. The aim of the present article is to systematically review the evidence for functional brain changes associated with different treatment modalities for schizophrenia. METHODS We searched PubMed for longitudinal functional MRI (fMRI) studies reporting on the effects of antipsychotic medications (APM), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), cognitive remediation therapy (CRT) and cognitive behavioral therapy for psychosis (CBTp) on brain function in schizophrenia. RESULTS Thirty six studies fulfilled the inclusion criteria. Functional alterations were observed in diverse brain regions. Across intervention modalities, changes in fMRI parameters were reported most commonly in frontal brain regions including prefrontal cortex, anterior cingulate and inferior frontal cortex. CONCLUSIONS We conclude that current treatments for schizophrenia commonly induce functional brain alterations in frontal brain regions. However, interpretability is limited by inconsistency in task and region of interest selection, and failures to replicate. Further task independent fMRI studies examining treatment effects with whole brain analysis are needed to deepen our insights.
Collapse
Affiliation(s)
- Ayse Sakalli Kani
- Sivas Numune State Hospital, Department of Psychiatry, Sivas, Turkey.
| | - Ann K. Shinn
- Psychotic Disorders Division, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Harvard Medical School, Department of Psychiatry, Boston, MA 02114, USA.
| | - Kathryn E. Lewandowski
- Psychotic Disorders Division, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Harvard Medical School, Department of Psychiatry, Boston, MA 02114, USA.
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, 02114, USA.
| |
Collapse
|
33
|
De Rossi P, Chiapponi C, Spalletta G. Brain Functional Effects of Psychopharmacological Treatments in Schizophrenia: A Network-based Functional Perspective Beyond Neurotransmitter Systems. Curr Neuropharmacol 2016; 13:435-44. [PMID: 26412063 PMCID: PMC4790396 DOI: 10.2174/1570159x13666150507223542] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Psychopharmacological treatments for schizophrenia have always been a matter of debate and a very important issue in public health given the chronic, relapsing and disabling nature of the disorder. A thorough understanding of the pros and cons of currently available pharmacological treatments for schizophrenia is critical to better capture the features of treatment-refractory clinical pictures and plan the developing of new treatment strategies. This review focuses on brain functional changes induced by antipsychotic drugs as assessed by modern functional neuroimaging techniques (i.e. fMRI, PET, SPECT, MRI spectroscopy). The most important papers on this topic are reviewed in order to draw an ideal map of the main functional changes occurring in the brain during antipsychotic treatment. This supports the hypothesis that a network-based perspective and a functional connectivity approach are needed to fill the currently existing gap of knowledge in the field of psychotropic drugs and their mechanisms of action beyond neurotransmitter systems.
Collapse
Affiliation(s)
| | | | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179 Rome, Italy.
| |
Collapse
|
34
|
Kumari V, Peters E, Guinn A, Fannon D, Russell T, Sumich A, Kuipers E, Williams SCR, ffytche DH. Mapping Depression in Schizophrenia: A Functional Magnetic Resonance Imaging Study. Schizophr Bull 2016; 42:802-13. [PMID: 26712855 PMCID: PMC4838102 DOI: 10.1093/schbul/sbv186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Depressive symptoms are common in schizophrenia, often left untreated, and associated with a high relapse rate, suicidal ideation, increased mortality, reduced social adjustment and poor quality of life. The neural mechanisms underlying depression in psychosis are poorly understood. Given reports of altered brain response to negative facial affect in depressive disorders, we examined brain response to emotive facial expressions in relation to levels of depression in people with psychosis. Seventy outpatients (final N= 63) and 20 healthy participants underwent functional magnetic resonance imaging during an implicit affect processing task involving presentation of facial expressions of fear, anger, happiness as well as neutral expressions and a (no face) control condition. All patients completed Beck Depression Inventory (BDI-II) and had their symptoms assessed on the Positive and Negative Syndrome Scale (PANSS). In patients, depression (BDI-II) scores associated positively with activation of the left thalamus, extending to the putamen-globus pallidus, insula, inferior-middle frontal and para-post-pre-central gyri during fearful expressions. Furthermore, patients with moderate-to-severe depression had significantly higher activity in these brain regions during fearful expressions relative to patients with no, minimal, or mild depression and healthy participants. The study provides first evidence of enhanced brain response to fearful facial expressions, which signal an uncertain source of threat in the environment, in patients with psychosis and a high level of self-reported depression.
Collapse
Affiliation(s)
- Veena Kumari
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK;
| | - Emmanuelle Peters
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Ashley Guinn
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Dominic Fannon
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Tamara Russell
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Alexander Sumich
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Elizabeth Kuipers
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;,NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Steven C. R. Williams
- Department of Neuroimaging, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Dominic H. ffytche
- Department of Old Age Psychiatry and Department of Neuroimaging Sciences, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| |
Collapse
|
35
|
Lindner C, Dannlowski U, Bauer J, Ohrmann P, Lencer R, Zwitserlood P, Kugel H, Suslow T. Affective Flattening in Patients with Schizophrenia: Differential Association with Amygdala Response to Threat-Related Facial Expression under Automatic and Controlled Processing Conditions. Psychiatry Investig 2016; 13:102-11. [PMID: 26766952 PMCID: PMC4701673 DOI: 10.4306/pi.2016.13.1.102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 04/14/2015] [Accepted: 05/07/2015] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Early neuroimaging studies have demonstrated amygdala hypoactivation in schizophrenia but more recent research based on paradigms with minimal cognitive loads or examining automatic processing has observed amygdala hyperactivation. Hyperactivation was found to be related to affective flattening. In this study, amygdala responsivity to threat-related facial expression was investigated in patients as a function of automatic versus controlled processing and patients' flat affect. METHODS Functional magnetic resonance imaging was used to measure amygdala activation in 36 patients with schizophrenia and 42 healthy controls. During scanning, a viewing task with masked and unmasked fearful and neutral faces was presented. RESULTS Patients exhibited increased amygdala response to unmasked fearful faces. With respect to masked fearful faces, no between-group differences emerged for the sample as a whole but a subsample of patients with flat affect showed heightened amygdala activation. The amygdala response to masked fearful faces was positively correlated with the degree of flat affect. Conversely, amygdala response to unmasked fearful faces was negatively correlated to the severity of affective flattening. In patients, amygdala responses to masked and unmasked fearful faces showed an inverse correlation. CONCLUSION Our findings suggest that amygdala hyperresponsivity to unmasked fearful faces might be a functional characteristic of schizophrenia. Amygdala hyperresponsivity to masked fearful faces might be a specific characteristic of patients with affective flattening. A model of flat affect as a response mechanism to emotional overload is proposed.
Collapse
Affiliation(s)
- Christian Lindner
- Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Jochen Bauer
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Patricia Ohrmann
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Rebekka Lencer
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany
- Department of Psychiatry, University of Münster, Münster, Germany
| |
Collapse
|
36
|
Pałasz A, Bandyszewska M, Rojczyk E, Wiaderkiewicz R. Effect of extended olanzapine administration on POMC and neuropeptide Y mRNA levels in the male rat amygdala and hippocampus. Pharmacol Rep 2015; 68:292-6. [PMID: 26922530 DOI: 10.1016/j.pharep.2015.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/26/2015] [Accepted: 09/29/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND Neuropeptides play an important role in various neural pathways, being able to control a wide spectrum of physiological responses. Neuropeptide Y (NPY) and proopiomelanocortin (POMC) functions are quite well studied, however little is known about their action at the level of limbic structures. The present work was focused on the expression of the aforementioned peptides in this brain structure of rats treated with olanzapine, a second generation neuroleptic drug. The detailed purpose of this experiment was the evaluation of potential relationships between chronic olanzapine administration and NPY and POMC mRNA expression in the amygdala and hippocampal formation. METHODS The studies were carried out on adult, male Sprague-Dawley rats that were divided into 2 groups: control and experimental animals treated with olanzapine (28 day-long intraperitoneal injection). All individuals were sacrificed under anaesthesia, then the amygdaloid complexes and hippocampi were excised. Total mRNA was isolated from homogenized samples of both structures and the RT-PCR method was used for estimation of NPY and POMC gene relative expression. RESULTS Prolonged olanzapine administration is reflected in qualitatively different changes in expression of NPY and POMC mRNA in the rat amygdala and hippocampus. Interestingly enough, olanzapine did not affect NPY expression, but significantly increased the POMC level in both examined regions. CONCLUSIONS Olanzapine can affect amygdalar and hippocampal neuronal populations by the modulation of neuropeptide activity. Importantly, it may suggest the existence of an alternative mode of its action. Undoubtedly this hypothetic regulatory mechanism requires further pharmacological and neurostructural study.
Collapse
Affiliation(s)
- Artur Pałasz
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Magdalena Bandyszewska
- Department of Biochemistry, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warszawa, Poland
| | - Ewa Rojczyk
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Ryszard Wiaderkiewicz
- Department of Histology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
37
|
Papazacharias A, Taurisano P, Fazio L, Gelao B, Di Giorgio A, Lo Bianco L, Quarto T, Mancini M, Porcelli A, Romano R, Caforio G, Todarello O, Popolizio T, Blasi G, Bertolino A. Aversive emotional interference impacts behavior and prefronto-striatal activity during increasing attentional control. Front Behav Neurosci 2015; 9:97. [PMID: 25954172 PMCID: PMC4404908 DOI: 10.3389/fnbeh.2015.00097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 04/03/2015] [Indexed: 12/26/2022] Open
Abstract
Earlier studies have demonstrated that emotional stimulation modulates attentional processing during goal-directed behavior and related activity of a brain network including the inferior frontal gyrus (IFG) and the caudate nucleus. However, it is not clear how emotional interference modulates behavior and brain physiology during variation in attentional control, a relevant question for everyday life situations in which both emotional stimuli and cognitive load vary. The aim of this study was to investigate the impact of negative emotions on behavior and activity in IFG and caudate nucleus during increasing levels of attentional control. Twenty two healthy subjects underwent event-related functional magnetic resonance imaging while performing a task in which neutral or fearful facial expressions were displayed before stimuli eliciting increasing levels of attentional control processing. Results indicated slower reaction time (RT) and greater right IFG activity when fearful compared with neutral facial expressions preceded the low level of attentional control. On the other hand, fearful facial expressions preceding the intermediate level of attentional control elicited faster behavioral responses and greater activity in the right and left sides of the caudate. Finally, correlation analysis indicated a relationship between behavioral correlates of attentional control after emotional interference and right IFG activity. All together, these results suggest that the impact of negative emotions on attentional processing is differentially elicited at the behavioral and physiological levels as a function of cognitive load.
Collapse
Affiliation(s)
- Apostolos Papazacharias
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Paolo Taurisano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Leonardo Fazio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Barbara Gelao
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | | | - Luciana Lo Bianco
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Tiziana Quarto
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy ; Cognitive Brain Research Unit, Institute of Behavioral Sciences, University of Helsinki Helsinki, Finland
| | - Marina Mancini
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Annamaria Porcelli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Raffaella Romano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Grazia Caforio
- Azienda Ospedaliero-Universitaria Consorziale, Policlinico di Bari Bari, Italy
| | - Orlando Todarello
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy
| | - Teresa Popolizio
- IRCCS "Casa Sollievo della Sofferenza", S. Giovanni Rotondo Italy
| | - Giuseppe Blasi
- Azienda Ospedaliero-Universitaria Consorziale, Policlinico di Bari Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro" Bari, Italy ; pRED, NORD DTA Neuroscience, Hoffman-La Roche Ltd Basel, Switzerland
| |
Collapse
|
38
|
Bergé D, Carmona S, Salgado P, Rovira M, Bulbena A, Vilarroya O. Limbic activity in antipsychotic naïve first-episode psychotic subjects during facial emotion discrimination. Eur Arch Psychiatry Clin Neurosci 2014; 264:271-83. [PMID: 24258969 DOI: 10.1007/s00406-013-0465-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 10/16/2013] [Indexed: 11/29/2022]
Abstract
The aim of this study was to determine brain activation during facial emotion discrimination in first-episode of psychosis. Eighteen patients underwent an fMRI while performing a facial emotion discrimination task during the acute episode, before starting antipsychotic drugs. A second fMRI and clinical evaluation were performed after evident clinical improvement. An equivalent control group underwent the same two fMRIs with a similar period of time between exams. The voxel-wise approach showed pre-treatment hypoactivation in ventro-limbic regions (cluster including right hippocampus and left amygdala; cluster size 528; p cluster <0.004) and facial perception involved in ventral-posterior regions (bilateral lingual gyrus, calcarine fissure and occipital superior gyrus, (k = 1,508, p < 0.001) and fronto-temporal regions. The region of interest approach also confirmed hypoactivation in right and left amygdala (cluster corrected p = 0.035 and 0.043, respectively). After treatment and clinical improvement, the voxel-wise approach showed a significant increase in activity in lingual gyrus and calcarine fissure in the group of patients. The regions of interest analysis showed an increase in amygdala activity during anger discrimination also in the group of patients. The results suggest a state-dependent model depicting a flattened and aberrant response of amygdala to emotion discrimination that could explain the seemingly contradictory previous findings of hypo- and hyper-amygdala activation.
Collapse
Affiliation(s)
- Daniel Bergé
- Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Centre Forum Hospital del Mar, Barcelona, Spain,
| | | | | | | | | | | |
Collapse
|
39
|
Abbott CC, Jaramillo A, Wilcox CE, Hamilton DA. Antipsychotic drug effects in schizophrenia: a review of longitudinal FMRI investigations and neural interpretations. Curr Med Chem 2014; 20:428-37. [PMID: 23157635 DOI: 10.2174/0929867311320030014] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 09/10/2012] [Accepted: 09/26/2012] [Indexed: 12/11/2022]
Abstract
The evidence that antipsychotics improve brain function and reduce symptoms in schizophrenia is unmistakable, but how antipsychotics change brain function is poorly understood, especially within neuronal systems. In this review, we investigated the hypothesized normalization of the functional magnetic resonance imaging (fMRI) blood oxygen level dependent signal in the context of antipsychotic treatment. First, we conducted a systematic PubMed search to identify eight fMRI investigations that met the following inclusion criteria: case-control, longitudinal design; pre- and post-treatment contrasts with a healthy comparison group; and antipsychotic-free or antipsychotic-naive patients with schizophrenia at the start of the investigation. We hypothesized that aberrant activation patterns or connectivity between patients with schizophrenia and healthy comparisons at the first imaging assessment would no longer be apparent or "normalize" at the second imaging assessment. The included studies differed by analysis method and fMRI task but demonstrated normalization of fMRI activation or connectivity during the treatment interval. Second, we reviewed putative mechanisms from animal studies that support normalization of the BOLD signal in schizophrenia. We provided several neuronal-based interpretations of these changes of the BOLD signal that may be attributable to long-term antipsychotic administration.
Collapse
Affiliation(s)
- C C Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
| | | | | | | |
Collapse
|
40
|
Suslow T, Lindner C, Dannlowski U, Walhöfer K, Rödiger M, Maisch B, Bauer J, Ohrmann P, Lencer R, Zwitserlood P, Kersting A, Heindel W, Arolt V, Kugel H. Automatic amygdala response to facial expression in schizophrenia: initial hyperresponsivity followed by hyporesponsivity. BMC Neurosci 2013; 14:140. [PMID: 24219776 PMCID: PMC3832234 DOI: 10.1186/1471-2202-14-140] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 11/08/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND It is well established that the amygdala is crucially involved in the processing of facial emotions. In schizophrenia patients, a number of neuroimaging findings suggest hypoactivation of the amygdala in response to facial emotion, while others indicate normal or enhanced recruitment of this region. Some of this variability may be related to the baseline condition used and the length of the experiment. There is evidence that schizophrenia patients display increased activation of the amygdala to neutral faces and that this is predominantly observed during early parts of the experiment. Recent research examining the automatic processing of facial emotion has also reported amygdala hyperactivation in schizophrenia. In the present study, we focused on the time-course of amygdala activation during the automatic processing of emotional facial expression. We hypothesized that in comparison to healthy subjects, patients would initially show hyperresponsivity of the amygdala to masked emotional and neutral faces. In addition, we expected amygdala deactivation in response to masked facial emotions from the first to the second phase to be more pronounced in patients than in controls. RESULTS Amygdala activation in response to angry, happy, neutral, and no facial expression (presented for 33 ms) was measured by functional magnetic resonance imaging in 30 schizophrenia patients and 35 healthy controls. Across all subjects, the bilateral amygdala response to faces (relative to the no facial expression condition) was larger in the initial phase (first half of trials) than in the second phase (second half of trials). During the initial phase, schizophrenia patients exhibited an increased right amygdala response to all faces and an increased left amygdala response to neutral faces compared with controls. During the second phase, controls manifested a higher right amygdala response for all faces and a higher left amygdala response to angry faces than patients. CONCLUSIONS Schizophrenia patients are characterized by high initial amygdala responsivity to facial expressions at an automatic processing level, which substantially decreases with time. Amygdala deactivation over time might reflect an automatic mechanism by which schizophrenia patients suppress the processing of facial stimuli. This blocking mechanism could help patients avoid overstimulation during social interactions.
Collapse
Affiliation(s)
- Thomas Suslow
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
- Department of Psychosomatic Medicine, University of Leipzig, Semmelweisstr 10, Leipzig 04103, Germany
| | - Christian Lindner
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
- Department of Psychiatry, University of Marburg, Rudolf-Bultmann-Str. 8, Marburg 35037, Germany
| | - Kirsten Walhöfer
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Maike Rödiger
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Birgit Maisch
- Klinik am Schlossgarten, Am Schlossgarten 10, Dülmen 48249, Germany
| | - Jochen Bauer
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Patricia Ohrmann
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Rebekka Lencer
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Pienie Zwitserlood
- Department of Psychology, University of Münster, Fliednerstr. 21, Münster 48149, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine, University of Leipzig, Semmelweisstr 10, Leipzig 04103, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Campus 1, Münster 48149, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Str. 11, Münster 48149, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Campus 1, Münster 48149, Germany
| |
Collapse
|
41
|
Neural response to emotional stimuli associated with successful antidepressant treatment and behavioral activation. J Affect Disord 2013; 151:573-581. [PMID: 23948629 DOI: 10.1016/j.jad.2013.06.050] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 02/06/2013] [Accepted: 06/28/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a leading cause of disability globally. Currently available treatments have limited efficacy and combination strategies are frequently used. Several lines of research have demonstrated that MDD patients experience impairments in various components of affective processing, including regulation of affective states. AIM To identify baseline and 1-week neuroimaging predictors of response to a 6-week trial of fluoxetine/olanzapine combination treatment during an affective processing task. METHODS Twenty-one MDD patients and 18 healthy controls were enrolled in the study. MDD patients were treated for 6 weeks with fluoxetine (40-60 mg/day) and olanzapine (5-12.5mg/day). All participants viewed images from the International Affective Picture Rating System during a functional magnetic resonance (fMRI) scan at baseline and 1 week. RESULTS There was a 57% response rate (defined as a 50% decrease in Hamilton Rating Scale for Depression-17 item) at 6 weeks. At baseline, responders had increased premotor activity while viewing negative images compared to non-responders and healthy controls. Higher baseline premotor activity was also predictive of greater percent change on the HAMD-17 and improvement in negative disposition and behavioral drive. Non-responders exhibited increased insular activity at baseline compared to responders. Higher activity in the posterior cingulate cortex was also predictive of greater percent change on the HAMD-17. Change from baseline to 1 week did not produce any significant predictive findings. CONCLUSIONS Treatment with fluoxetine/olanzapine demonstrated similar biomarkers of response to monotherapeutic strategies. In particular, posterior cingulate cortex, anterior insula, and premotor cortex may show predictive differences in their response to affective images prior to treatment. Further research needs to be conducted to determine the utility of early changes in emotion circuitry in predicting antidepressant response.
Collapse
|
42
|
Clarke R, Johnstone T. Prefrontal inhibition of threat processing reduces working memory interference. Front Hum Neurosci 2013; 7:228. [PMID: 23750133 PMCID: PMC3667546 DOI: 10.3389/fnhum.2013.00228] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/13/2013] [Indexed: 01/29/2023] Open
Abstract
Bottom-up processes can interrupt ongoing cognitive processing in order to adaptively respond to emotional stimuli of high potential significance, such as those that threaten wellbeing. However it is vital that this interference can be modulated in certain contexts to focus on current tasks. Deficits in the ability to maintain the appropriate balance between cognitive and emotional demands can severely impact on day-to-day activities. This fMRI study examined this interaction between threat processing and cognition; 18 adult participants performed a visuospatial working memory (WM) task with two load conditions, in the presence and absence of anxiety induction by threat of electric shock. Threat of shock interfered with performance in the low cognitive load condition; however interference was eradicated under high load, consistent with engagement of emotion regulation mechanisms. Under low load the amygdala showed significant activation to threat of shock that was modulated by high cognitive load. A directed top-down control contrast identified two regions associated with top-down control; ventrolateral PFC and dorsal ACC. Dynamic causal modeling provided further evidence that under high cognitive load, top-down inhibition is exerted on the amygdala and its outputs to prefrontal regions. Additionally, we hypothesized that individual differences in a separate, non-emotional top-down control task would predict the recruitment of dorsal ACC and ventrolateral PFC during top-down control of threat. Consistent with this, performance on a separate dichotic listening task predicted dorsal ACC and ventrolateral PFC activation during high WM load under threat of shock, though activation in these regions did not directly correlate with WM performance. Together, the findings suggest that under high cognitive load and threat, top-down control is exerted by dACC and vlPFC to inhibit threat processing, thus enabling WM performance without threat-related interference.
Collapse
Affiliation(s)
- Robert Clarke
- Centre for Integrative Neuroscience and Neurodynamics, The University of Reading Reading, UK
| | | |
Collapse
|
43
|
Nejad AB, Ebdrup BH, Glenthøj BY, Siebner HR. Brain connectivity studies in schizophrenia: unravelling the effects of antipsychotics. Curr Neuropharmacol 2013; 10:219-30. [PMID: 23449679 PMCID: PMC3468876 DOI: 10.2174/157015912803217305] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 06/27/2012] [Accepted: 07/05/2012] [Indexed: 11/22/2022] Open
Abstract
Impaired brain connectivity is a hallmark of schizophrenia brain dysfunction. However, the effect of drug treatment and challenges on the dysconnectivity of functional networks in schizophrenia is an understudied area. In this review, we provide an overview of functional magnetic resonance imaging studies examining dysconnectivity in schizophrenia and discuss the few studies which have also attempted to probe connectivity changes with antipsychotic drug treatment. We conclude with a discussion of possible avenues for further investigation.
Collapse
Affiliation(s)
- Ayna B Nejad
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark ; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Center Glostrup, Denmark
| | | | | | | |
Collapse
|
44
|
Serotonin-glutamate and serotonin-dopamine reciprocal interactions as putative molecular targets for novel antipsychotic treatments: from receptor heterodimers to postsynaptic scaffolding and effector proteins. Psychopharmacology (Berl) 2013. [PMID: 23179966 DOI: 10.1007/s00213-012-2921-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The physical and functional interactions between serotonin-glutamate and serotonin-dopamine signaling have been suggested to be involved in psychosis pathophysiology and are supposed to be relevant for antipsychotic treatment. Type II metabotropic glutamate receptors (mGluRs) and serotonin 5-HT(2A) receptors have been reported to form heterodimers that modulate G-protein-mediated intracellular signaling differentially compared to mGluR2 and 5-HT(2A) homomers. Additionally, direct evidence has been provided that D(2) and 5-HT(2A) receptors form physical heterocomplexes which exert a functional cross-talk, as demonstrated by studies on hallucinogen-induced signaling. Moving from receptors to postsynaptic density (PSD) scenario, the scaffolding protein PSD-95 is known to interact with N-methyl-D-aspartate (NMDA), D(2) and 5-HT(2) receptors, regulating their activation state. Homer1a, the inducible member of the Homer family of PSD proteins that is implicated in glutamatergic signal transduction, is induced in striatum by antipsychotics with high dopamine receptor affinity and in the cortex by antipsychotics with mixed serotonergic/dopaminergic profile. Signaling molecules, such as Akt and glycogen-synthase-kinase-3 (GSK-3), could be involved in the mechanism of action of antipsychotics, targeting dopamine, serotonin, and glutamate neurotransmission. Altogether, these proteins stand at the crossroad of glutamate-dopamine-serotonin signaling pathways and may be considered as valuable molecular targets for current and new antipsychotics. The aim of this review is to provide a critical appraisal on serotonin-glutamate and serotonin-dopamine interplay to support the idea that next generation schizophrenia pharmacotherapy should not exclusively rely on receptor targeting strategies.
Collapse
|
45
|
Anticevic A, Repovs G, Barch DM. Emotion effects on attention, amygdala activation, and functional connectivity in schizophrenia. Schizophr Bull 2012; 38:967-80. [PMID: 21415225 PMCID: PMC3446234 DOI: 10.1093/schbul/sbq168] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2010] [Indexed: 11/14/2022]
Abstract
Emotional abnormalities are a critical clinical feature of schizophrenia (SCZ), but complete understanding of their underlying neuropathology is lacking. Numerous studies have examined amygdala activation in response to affective stimuli in SCZ, but no consensus has emerged. However, behavioral studies examining 'in-the-moment' processing of affect have suggested intact emotional processing in SCZ. To examine which aspects of emotional processing may be impaired in SCZ, we combined behavior and neuroimaging to investigate effects of aversive stimuli during minimal cognitive engagement, at the level of behavior, amygdala recruitment, and its whole-brain task-based functional connectivity (tb-fcMRI) because impairments may manifest when examining across-region functional integration. Twenty-eight patients and 24 matched controls underwent rapid event-related fMRI at 3 T while performing a simple perceptual decision task with negative or neutral distraction. We examined perceptual decision slowing, amygdala activation, and whole-brain amygdala tb-fcMRI, while ensuring group signal-to-noise profile matching. Following scanning, subjects rated all images for experienced arousal and valence. No significant group differences emerged for negative vs neutral reaction time, emotional ratings across groups, or amygdala activation. However, even in the absence of behavioral or activation differences, SCZ subjects demonstrated significantly weaker amygdala-prefrontal cortical coupling, specifically during negative distraction. Whereas in-the-moment perception, behavioral response, and amygdala recruitment to negative stimuli during minimal cognitive load seem to be intact, there is evidence of aberrant amygdala-prefrontal integration in SCZ subjects. Such abnormalities may prove critical for understanding disturbances in patients' ability to use affective cues when guiding higher level cognitive processes needed in social interactions.
Collapse
Affiliation(s)
- Alan Anticevic
- Department of Psychology, Washington University, St. Louis, MO, USA.
| | | | | |
Collapse
|
46
|
Liemburg EJ, Knegtering H, Klein HC, Kortekaas R, Aleman A. Antipsychotic medication and prefrontal cortex activation: a review of neuroimaging findings. Eur Neuropsychopharmacol 2012; 22:387-400. [PMID: 22300864 DOI: 10.1016/j.euroneuro.2011.12.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 10/04/2011] [Accepted: 12/16/2011] [Indexed: 11/17/2022]
Abstract
Decreased prefrontal activation (hypofrontality) in schizophrenia is thought to underlie negative symptoms and cognitive impairments, and may contribute to poor social outcome. Hypofrontality does not always improve during treatment with antipsychotics. We hypothesized that antipsychotics, which share antagonism at dopamine receptors, with a relatively low dopamine receptor affinity and high serotonin receptor affinity may have a sparing effect on prefrontal function compared to strong dopamine receptor antagonists. We systematically investigated the relation between serotonin and dopamine antagonism of antipsychotics and prefrontal functioning by reviewing neuroimaging studies. The weight of the evidence was consistent with our hypothesis that antipsychotics with low dopaminergic receptor affinity and moderate to high serotonergic affinity were associated with higher activation of the prefrontal cortex. However, clozapine, a weak dopamine and strong serotonin antagonist, was associated with decrease in prefrontal activation. Future studies should further elucidate the link between prefrontal activation and negative symptoms using prospective designs and advanced neuroimaging techniques, which may ultimately benefit the development of treatments for disabling negative symptoms.
Collapse
Affiliation(s)
- Edith J Liemburg
- Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 2 9713 AW Groningen, The Netherlands.
| | | | | | | | | |
Collapse
|
47
|
No amygdala attenuation in schizophrenic patients treated with atypical antipsychotics. Psychiatry Res 2012; 202:168-71. [PMID: 22703618 DOI: 10.1016/j.pscychresns.2012.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 01/27/2012] [Accepted: 02/24/2012] [Indexed: 11/24/2022]
Abstract
Functional magnetic resonance (fMRI) imaging was used to measure amygdala activation in an emotional valence discrimination task in clinically stable patients with schizophrenia treated with atypical antipsychotics and healthy controls. No difference was detected between patients with schizophrenia and controls.
Collapse
|
48
|
Anticevic A, Van Snellenberg JX, Cohen RE, Repovs G, Dowd EC, Barch DM. Amygdala recruitment in schizophrenia in response to aversive emotional material: a meta-analysis of neuroimaging studies. Schizophr Bull 2012; 38:608-21. [PMID: 21123853 PMCID: PMC3329999 DOI: 10.1093/schbul/sbq131] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Emotional dysfunction has long been established as a critical clinical feature of schizophrenia. In the past decade, there has been extensive work examining the potential contribution of abnormal amygdala activation to this dysfunction in patients with schizophrenia. A number of studies have demonstrated under-recruitment of the amygdala in response to emotional stimuli, while others have shown intact recruitment of this region. To date, there have been few attempts to synthesize this literature using quantitative criteria or to use a formal meta-analytic approach to examine which variables may moderate the magnitude of between-group differences in amygdala activation in response to aversive emotional stimuli. We conducted a meta-analysis of amygdala activation in patients with schizophrenia, using a bootstrapping approach to investigate: (a) evidence for amygdala under-recruitment in schizophrenia and (b) variables that may moderate the magnitude of between-group differences in amygdala activation. We demonstrate that patients with schizophrenia show statistically significant, but modest, under-recruitment of bilateral amygdala (mean effect size = -0.20 SD). However, present findings indicate that this under-recruitment is dependent on the use of a neutral vs emotion interaction contrast and is not apparent if amygdala activation by patients and controls is evaluated in a negative emotional condition only.
Collapse
Affiliation(s)
- Alan Anticevic
- Department of Psychology, Washington University in St. Louis, St. Louis, MO 63130, USA.
| | | | | | | | | | | |
Collapse
|
49
|
Elevated amygdala activity to negative faces in young adults with early onset major depressive disorder. Psychiatry Res 2012; 201:107-12. [PMID: 22398297 DOI: 10.1016/j.pscychresns.2011.06.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 05/13/2011] [Accepted: 06/08/2011] [Indexed: 11/20/2022]
Abstract
Abnormalities in amygdala activity have been implicated in adolescents and older adults with major depressive disorder (MDD), but few studies have focused on young adults with early-onset MDD. In this study, we measured amygdala activity in 27 young adults with early-onset MDD and 25 healthy controls (HC) using functional magnetic resonance imaging (fMRI) with an emotional processing task. Both groups showed significant bilateral activation within the amygdala to threat-related facial expressions. In the matching face task, the activations of the left amygdala, thalamus, prefrontal and temporal cortex were significantly greater while the activation of the right prefrontal was significantly lower for the MDD group compared with the HC group. For the MDD group, there was a significant positive correlation between the activity of the amygdala and scores on the Chinese version of the Center for Epidemiologic Studies Depression Scale. Overall, our findings suggest that young adults with early-onset MDD may be characterized by abnormalities in nodes along the fronto-limbic pathways when facing threat-related facial expression.
Collapse
|
50
|
Benedetti F, Radaelli D, Poletti S, Falini A, Cavallaro R, Dallaspezia S, Riccaboni R, Scotti G, Smeraldi E. Emotional reactivity in chronic schizophrenia: structural and functional brain correlates and the influence of adverse childhood experiences. Psychol Med 2011; 41:509-519. [PMID: 20529416 DOI: 10.1017/s0033291710001108] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite behavioural signs of flattened affect, patients affected by schizophrenia show enhanced sensitivity to negative stimuli. The current literature concerning neural circuitry for emotions supports dysregulations of cortico-limbic networks, but gives contrasting results. Adverse childhood experiences (ACEs) could persistently influence emotional regulation and neural correlates of response to emotional stimuli in healthy humans. This study evaluated the effect of ACEs and chronic undifferentiated schizophrenia on neural responses to emotional stimuli (negative facial expression). METHOD Brain blood-oxygen-level-dependent functional magnetic resonance imaging neural responses to a face-matching paradigm, and regional grey matter (GM) volumes were studied at 3.0 T in the amygdala, hippocampus, anterior cingulated cortex (ACC) and prefrontal cortex (PFC). The severity of ACEs was assessed. Participants included 20 consecutively admitted in-patients affected by chronic undifferentiated schizophrenia, and 20 unrelated healthy volunteers from the general population. RESULTS Patients reported higher ACEs than controls. Worse ACEs proportionally led to decreasing responses in the amygdala and hippocampus, and to increasing responses in the PFC and ACC in all participants. Patients showed higher activations in the amygdala and hippocampus, and lower activations in the PFC and ACC. Higher ACEs were associated with higher GM volumes in the PFC and ACC, and schizophrenia was associated with GM reduction in all studied regions. CONCLUSIONS Structural and functional brain correlates of emotional reactivity are influenced by both current chronic undifferentiated schizophrenia and the severity of past ACEs.
Collapse
Affiliation(s)
- F Benedetti
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|