1
|
Kyrou A, Grünert E, Wüthrich F, Nadesalingam N, Chapellier V, Nuoffer MG, Pavlidou A, Lefebvre S, Walther S. Test-retest reliability of resting-state cerebral blood flow quantification using pulsed Arterial Spin Labeling (PASL) over 3 weeks vs 8 weeks in healthy controls. Psychiatry Res Neuroimaging 2024; 341:111823. [PMID: 38735229 DOI: 10.1016/j.pscychresns.2024.111823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 04/25/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024]
Abstract
Arterial Spin Labeling is a valuable functional imaging tool for both clinical and research purposes. However, little is known about the test-retest reliability of cerebral blood flow measurements over longer periods. In this study, we investigated the reliability of pulsed Arterial Spin Labeling in assessing cerebral blood flow over a 3 (n = 28) vs 8 (n = 19) weeks interscan interval in 47 healthy participants. As a measure of cerebral blood flow reliability, we calculated voxel-wise, whole-brain, and regions of interest intraclass correlation coefficients. The whole-brain mean resting-state cerebral blood flow showed good to excellent reliability over time for both periods (intraclass correlation coefficients = 0.85 for the 3-week delay, intraclass correlation coefficients = 0.53 for the 8-week delay). However, the voxel-wise and regions of interest intraclass correlation coefficients fluctuated at 8-week compared to the 3-week interval, especially within cortical areas. These results confirmed previous findings that Arterial Spin Labeling could be used as a reliable method to assess brain perfusion. However, as the reliability seemed to decrease over time, caution is warranted when performing correlations with other variables, especially in clinical populations.
Collapse
Affiliation(s)
- Alexandra Kyrou
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| | - Elina Grünert
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| | - Florian Wüthrich
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| | - Niluja Nadesalingam
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| | - Victoria Chapellier
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| | - Melanie G Nuoffer
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Anastasia Pavlidou
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| | - Stephanie Lefebvre
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland.
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy Bern, Translational Research Center, University of Bern, Switzerland; Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Bern, Switzerland
| |
Collapse
|
2
|
Davies C, Bossong MG, Martins D, Wilson R, Appiah-Kusi E, Blest-Hopley G, Zelaya F, Allen P, Brammer M, Perez J, McGuire P, Bhattacharyya S. Increased hippocampal blood flow in people at clinical high risk for psychosis and effects of cannabidiol. Psychol Med 2024; 54:993-1003. [PMID: 37845827 DOI: 10.1017/s0033291723002775] [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] [Indexed: 10/18/2023]
Abstract
BACKGROUND Hippocampal hyperperfusion has been observed in people at Clinical High Risk for Psychosis (CHR), is associated with adverse longitudinal outcomes and represents a potential treatment target for novel pharmacotherapies. Whether cannabidiol (CBD) has ameliorative effects on hippocampal blood flow (rCBF) in CHR patients remains unknown. METHODS Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single oral 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Hippocampal rCBF was measured using Arterial Spin Labeling. We examined differences relating to CHR status (controls v. placebo), effects of CBD in CHR (placebo v. CBD) and linear between-group relationships, such that placebo > CBD > controls or controls > CBD > placebo, using a combination of hypothesis-driven and exploratory wholebrain analyses. RESULTS Placebo-treated patients had significantly higher hippocampal rCBF bilaterally (all pFWE<0.01) compared to healthy controls. There were no suprathreshold effects in the CBD v. placebo contrast. However, we found a significant linear relationship in the right hippocampus (pFWE = 0.035) such that rCBF was highest in the placebo group, lowest in controls and intermediate in the CBD group. Exploratory wholebrain results replicated previous findings of hyperperfusion in the hippocampus, striatum and midbrain in CHR patients, and provided novel evidence of increased rCBF in inferior-temporal and lateral-occipital regions in patients under CBD compared to placebo. CONCLUSIONS These findings suggest that hippocampal blood flow is elevated in the CHR state and may be partially normalized by a single dose of CBD. CBD therefore merits further investigation as a potential novel treatment for this population.
Collapse
Affiliation(s)
- Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthijs G Bossong
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Elizabeth Appiah-Kusi
- 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
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Brammer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jesus Perez
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Biomedical Research (IBSAL), Department of Medicine, Universidad de Salamanca, Salamanca, Spain
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
3
|
Roeske MJ, McHugo M, Rogers B, Armstrong K, Avery S, Donahue M, Heckers S. Modulation of hippocampal activity in schizophrenia with levetiracetam: a randomized, double-blind, cross-over, placebo-controlled trial. Neuropsychopharmacology 2024; 49:681-689. [PMID: 37833590 PMCID: PMC10876634 DOI: 10.1038/s41386-023-01730-0] [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: 07/19/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 10/15/2023]
Abstract
Hippocampal hyperactivity is a novel pharmacological target in the treatment of schizophrenia. We hypothesized that levetiracetam (LEV), a drug binding to the synaptic vesicle glycoprotein 2 A, normalizes hippocampal activity in persons with schizophrenia and can be measured using neuroimaging methods. Thirty healthy control participants and 30 patients with schizophrenia (28 treated with antipsychotic drugs), were randomly assigned to a double-blind, cross-over trial to receive a single administration of 500 mg oral LEV or placebo during two study visits. At each visit, we assessed hippocampal function using resting state fractional amplitude of low frequency fluctuations (fALFF), cerebral blood flow (CBF) with arterial spin labeling, and hippocampal blood-oxygen-level-dependent (BOLD) signal during a scene processing task. After placebo treatment, we found significant elevations in hippocampal fALFF in patients with schizophrenia, consistent with hippocampal hyperactivity. Additionally, hippocampal fALFF in patients with schizophrenia after LEV treatment did not significantly differ from healthy control participants receiving placebo, suggesting that LEV may normalize hippocampal hyperactivity. In contrast to our fALFF findings, we did not detect significant group differences or an effect of LEV treatment on hippocampal CBF. In the context of no significant group difference in BOLD signal, we found that hippocampal recruitment during scene processing is enhanced by LEV more significantly in schizophrenia. We conclude that pharmacological modulation of hippocampal hyperactivity in schizophrenia can be studied with some neuroimaging methods, but not others. Additional studies in different cohorts, employing alternate neuroimaging methods and study designs, are needed to establish levetiracetam as a treatment for schizophrenia.
Collapse
Affiliation(s)
- Maxwell J Roeske
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Baxter Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, TN, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
4
|
Martino M, Magioncalda P. A three-dimensional model of neural activity and phenomenal-behavioral patterns. Mol Psychiatry 2024; 29:639-652. [PMID: 38114633 DOI: 10.1038/s41380-023-02356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
How phenomenal experience and behavior are related to neural activity in physiology and psychopathology represents a fundamental question in neuroscience and psychiatry. The phenomenal-behavior patterns may be deconstructed into basic dimensions, i.e., psychomotricity, affectivity, and thought, which might have distinct neural correlates. This work provides a data overview on the relationship of these phenomenal-behavioral dimensions with brain activity across physiological and pathological conditions (including major depressive disorder, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, anxiety disorders, addictive disorders, Parkinson's disease, Tourette syndrome, Alzheimer's disease, and frontotemporal dementia). Accordingly, we propose a three-dimensional model of neural activity and phenomenal-behavioral patterns. In this model, neural activity is organized into distinct units in accordance with connectivity patterns and related input/output processing, manifesting in the different phenomenal-behavioral dimensions. (1) An external neural unit, which involves the sensorimotor circuit/brain's sensorimotor network and is connected with the external environment, processes external inputs/outputs, manifesting in the psychomotor dimension (processing of exteroception/somatomotor activity). External unit hyperactivity manifests in psychomotor excitation (hyperactivity/hyperkinesia/catatonia), while external unit hypoactivity manifests in psychomotor inhibition (retardation/hypokinesia/catatonia). (2) An internal neural unit, which involves the interoceptive-autonomic circuit/brain's salience network and is connected with the internal/body environment, processes internal inputs/outputs, manifesting in the affective dimension (processing of interoception/autonomic activity). Internal unit hyperactivity manifests in affective excitation (anxiety/dysphoria-euphoria/panic), while internal unit hypoactivity manifests in affective inhibition (anhedonia/apathy/depersonalization). (3) An associative neural unit, which involves the brain's associative areas/default-mode network and is connected with the external/internal units (but not with the environment), processes associative inputs/outputs, manifesting in the thought dimension (processing of ideas). Associative unit hyperactivity manifests in thought excitation (mind-wandering/repetitive thinking/psychosis), while associative unit hypoactivity manifests in thought inhibition (inattention/cognitive deficit/consciousness loss). Finally, these neural units interplay and dynamically combine into various neural states, resulting in the complex phenomenal experience and behavior across physiology and neuropsychiatric disorders.
Collapse
Affiliation(s)
- Matteo Martino
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
| | - Paola Magioncalda
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Radiology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
- Department of Medical Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| |
Collapse
|
5
|
Conring F, Gangl N, Derome M, Wiest R, Federspiel A, Walther S, Stegmayer K. Associations of resting-state perfusion and auditory verbal hallucinations with and without emotional content in schizophrenia. Neuroimage Clin 2023; 40:103527. [PMID: 37871539 PMCID: PMC10598456 DOI: 10.1016/j.nicl.2023.103527] [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: 07/07/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
Auditory Verbal Hallucinations (AVH) are highly prevalent in patients with schizophrenia. AVH with high emotional content lead to particularly poor functional outcome. Increasing evidence shows that AVH are associated with alterations in structure and function in language and memory related brain regions. However, neural correlates of AVH with emotional content remain unclear. In our study (n = 91), we related resting-state cerebral perfusion to AVH and emotional content, comparing four groups: patients with AVH with emotional content (n = 13), without emotional content (n = 14), without hallucinations (n = 20) and healthy controls (n = 44). Patients with AVH and emotional content presented with increased perfusion within the amygdala and the ventromedial and dorsomedial prefrontal cortex (vmPFC/ dmPFC) compared to patients with AVH without emotional content. In addition, patients with any AVH showed hyperperfusion within the anterior cingulate gyrus, the vmPFC/dmPFC, the right hippocampus, and the left pre- and postcentral gyrus compared to patients without AVH. Our results indicate metabolic alterations in brain areas critical for the processing of emotions as key for the pathophysiology of AVH with emotional content. Particularly, hyperperfusion of the amygdala may reflect and even trigger emotional content of AVH, while hyperperfusion of the vmPFC/dmPFC cluster may indicate insufficient top-down amygdala regulation in patients with schizophrenia.
Collapse
Affiliation(s)
- Frauke Conring
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Nicole Gangl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Melodie Derome
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| |
Collapse
|
6
|
Boisvert M, Lungu O, Pilon F, Dumais A, Potvin S. Regional cerebral blood flow at rest in schizophrenia and major depressive disorder: A functional neuroimaging meta-analysis. Psychiatry Res Neuroimaging 2023; 335:111720. [PMID: 37804739 DOI: 10.1016/j.pscychresns.2023.111720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 09/01/2023] [Accepted: 09/27/2023] [Indexed: 10/09/2023]
Abstract
Severe mental disorders (SMDs) such as schizophrenia (SCZ), major depressive disorder (MDD) and bipolar disorder (BD) are associated with altered brain function. Neuroimaging studies have illustrated spontaneous activity alterations across SMDs, but no meta-analysis has directly compared resting-state regional cerebral blood flow (rCBF) with one another. We conducted a meta-analysis of PET, SPECT and ASL neuroimaging studies to identify specific alterations of rCBF at rest in SMDs. Included are 20 studies in MDD, and 18 studies in SCZ. Due to the insufficient number of studies in BD, this disorder was left out of the analyses. Compared to controls, the SCZ group displayed reduced rCBF in the triangular part of the left inferior frontal gyrus and in the medial orbital part of the bilateral superior frontal gyrus. After correction, only a small cluster in the right inferior frontal gyrus exhibited reduced rCBF in MDD, compared to controls. Differences were found in these brain regions between SCZ and MDD. SCZ displayed reduced rCBF at rest in regions associated with default-mode, reward processing and language processing. MDD was associated with reduced rCBF in a cluster involved in response inhibition. Our meta-analysis highlights differences in the resting-state rCBF alterations between SCZ and MDD.
Collapse
Affiliation(s)
- Mélanie Boisvert
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal; Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal; Montreal, Quebec, Canada
| | - Ovidiu Lungu
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal; Montreal, Quebec, Canada
| | - Florence Pilon
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal; Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal; Montreal, Quebec, Canada
| | - Alexandre Dumais
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal; Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal; Montreal, Quebec, Canada; Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, Quebec, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal; Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal; Montreal, Quebec, Canada.
| |
Collapse
|
7
|
Nadesalingam N, Lefebvre S, Alexaki D, Baumann Gama D, Wüthrich F, Kyrou A, Kerkeni H, Kalla R, Walther S. The Behavioral Mapping of Psychomotor Slowing in Psychosis Demonstrates Heterogeneity Among Patients Suggesting Distinct Pathobiology. Schizophr Bull 2023; 49:507-517. [PMID: 36413085 PMCID: PMC10016403 DOI: 10.1093/schbul/sbac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Psychomotor slowing (PS) occurs in up to half of schizophrenia patients and is linked to poorer outcomes. As standard treatment fails to improve PS, novel approaches are needed. Here, we applied the RDoC framework using 3 units of analysis, ie, behavior, self-report, and physiology to test, whether patients with PS are different from patients without PS and controls. METHODS Motor behavior was compared between 71 schizophrenia patients with PS, 25 without PS, and 42 healthy controls (HC) using 5 different measures: (1) for behavior, an expert rating scale: Motor score of the Salpêtrière Retardation Rating Scale, (2) for self-report, the International Physical Activity Questionnaire; and for physiology, (3) Actigraphy, which accounts for gross motor behavior, (4) Gait velocity, and (5) coin rotation task to assess manual dexterity. RESULTS The ANCOVAs comparing the 3 groups revealed differences between patients with PS and HC in expert ratings, self-report, and instrumental measures (all P ≤ .001). Patients with PS also scored higher in expert ratings and had lower instrumental activity levels compared to patients without PS (all P ≤ .045). Instrumental activity levels correlated with an expert rating of PS (rho = -0.51, P-fdr corrected <.001) and classified similarly at 72% accuracy. CONCLUSIONS PS is characterized by slower gait, lower activity levels, and slower finger movements compared to HC. However, only actigraphy and observer ratings enable to clearly disentangle PS from non-PS patients. Actigraphy may become the standard assessment of PS in neuroimaging studies and clinical trials.
Collapse
Affiliation(s)
- Niluja Nadesalingam
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stéphanie Lefebvre
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Danai Alexaki
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Klinik Sonnenhalde AG Psychiatrie und Psychotherapie, Basel, Switzerland
| | - Daniel Baumann Gama
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Alexandra Kyrou
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Hassen Kerkeni
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Roger Kalla
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| |
Collapse
|
8
|
Percie du Sert O, Unrau J, Gauthier CJ, Chakravarty M, Malla A, Lepage M, Raucher-Chéné D. Cerebral blood flow in schizophrenia: A systematic review and meta-analysis of MRI-based studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110669. [PMID: 36341843 DOI: 10.1016/j.pnpbp.2022.110669] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/19/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Schizophrenia-spectrum disorders (SSD) represent one of the leading causes of disability worldwide and are usually underpinned by neurodevelopmental brain abnormalities observed on a structural and functional level. Nuclear medicine imaging studies of cerebral blood flow (CBF) have already provided insights into the pathophysiology of these disorders. Recent developments in non-invasive MRI techniques such as arterial spin labeling (ASL) have allowed broader examination of CBF across SSD prompting us to conduct an updated literature review of MRI-based perfusion studies. In addition, we conducted a focused meta-analysis of whole brain studies to provide a complete picture of the literature on the topic. METHODS A systematic OVID search was performed in Embase, MEDLINEOvid, and PsycINFO. Studies eligible for inclusion in the review involved: 1) individuals with SSD, first-episode psychosis or clinical-high risk for psychosis, or; 2) had healthy controls for comparison; 3) involved MRI-based perfusion imaging methods; and 4) reported CBF findings. No time span was specified for the database queries (last search: 08/2022). Information related to participants, MRI techniques, CBF analyses, and results were systematically extracted. Whole-brain studies were then selected for the meta-analysis procedure. The methodological quality of each included studies was assessed. RESULTS For the systematic review, the initial Ovid search yielded 648 publications of which 42 articles were included, representing 3480 SSD patients and controls. The most consistent finding was that negative symptoms were linked to cortical fronto-limbic hypoperfusion while positive symptoms seemed to be associated with hyperperfusion, notably in subcortical structures. The meta-analysis integrated results from 13 whole-brain studies, across 426 patients and 401 controls, and confirmed the robustness of the hypoperfusion in the left superior and middle frontal gyri and right middle occipital gyrus while hyperperfusion was found in the left putamen. CONCLUSION This updated review of the literature supports the implication of hemodynamic correlates in the pathophysiology of psychosis symptoms and disorders. A more systematic exploration of brain perfusion could complete the search of a multimodal biomarker of SSD.
Collapse
Affiliation(s)
- Olivier Percie du Sert
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Joshua Unrau
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Claudine J Gauthier
- Concordia University, Montreal, QC, Canada; Montreal Heart Institute, Montreal, QC, Canada
| | - Mallar Chakravarty
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Ashok Malla
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Martin Lepage
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Delphine Raucher-Chéné
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada; University of Reims Champagne-Ardenne, Cognition, Health, and Society Laboratory (EA 6291), Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| |
Collapse
|
9
|
Bojesen KB, Glenthøj BY, Sigvard AK, Tangmose K, Raghava JM, Ebdrup BH, Rostrup E. Cerebral blood flow in striatum is increased by partial dopamine agonism in initially antipsychotic-naïve patients with psychosis. Psychol Med 2023; 53:1-11. [PMID: 36754993 PMCID: PMC10600821 DOI: 10.1017/s0033291723000144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Resting cerebral blood flow (rCBF) in striatum and thalamus is increased in medicated patients with psychosis, but whether this is caused by treatment or illness pathology is unclear. Specifically, effects of partial dopamine agonism, sex, and clinical correlates on rCBF are sparsely investigated. We therefore assessed rCBF in antipsychotic-naïve psychosis patients before and after aripiprazole monotherapy and related findings to sex and symptom improvement. METHODS We assessed rCBF with the pseudo-Continuous Arterial Spin Labeling (PCASL) sequence in 49 first-episode patients (22.6 ± 5.2 years, 58% females) and 50 healthy controls (HCs) (22.3 ± 4.4 years, 63% females) at baseline and in 29 patients and 49 HCs after six weeks. RCBF in striatum and thalamus was estimated with a region-of-interest (ROI) approach. Psychopathology was assessed with the positive and negative syndrome scale. RESULTS Baseline rCBF in striatum and thalamus was not altered in the combined patient group compared with HCs, but female patients had lower striatal rCBF compared with male patients (p = 0.009). Treatment with a partial dopamine agonist increased rCBF significantly in striatum (p = 0.006) in the whole patient group, but not significantly in thalamus. Baseline rCBF in nucleus accumbens was negatively associated with improvement in positive symptoms (p = 0.046), but baseline perfusion in whole striatum and thalamus was not related to treatment outcome. CONCLUSIONS The findings suggest that striatal perfusion is increased by partial dopamine agonism and decreased in female patients prior to first treatment. This underlines the importance of treatment effects and sex differences when investigating the neurobiology of psychosis.
Collapse
Affiliation(s)
- Kirsten Borup Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Birte Yding Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Korning Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karen Tangmose
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jayachandra Mitta Raghava
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark
| | - Bjørn Hylsebeck Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
| |
Collapse
|
10
|
Dabiri M, Dehghani Firouzabadi F, Yang K, Barker PB, Lee RR, Yousem DM. Neuroimaging in schizophrenia: A review article. Front Neurosci 2022; 16:1042814. [PMID: 36458043 PMCID: PMC9706110 DOI: 10.3389/fnins.2022.1042814] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
In this review article we have consolidated the imaging literature of patients with schizophrenia across the full spectrum of modalities in radiology including computed tomography (CT), morphologic magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and magnetoencephalography (MEG). We look at the impact of various subtypes of schizophrenia on imaging findings and the changes that occur with medical and transcranial magnetic stimulation (TMS) therapy. Our goal was a comprehensive multimodality summary of the findings of state-of-the-art imaging in untreated and treated patients with schizophrenia. Clinical imaging in schizophrenia is used to exclude structural lesions which may produce symptoms that may mimic those of patients with schizophrenia. Nonetheless one finds global volume loss in the brains of patients with schizophrenia with associated increased cerebrospinal fluid (CSF) volume and decreased gray matter volume. These features may be influenced by the duration of disease and or medication use. For functional studies, be they fluorodeoxyglucose positron emission tomography (FDG PET), rs-fMRI, task-based fMRI, diffusion tensor imaging (DTI) or MEG there generally is hypoactivation and disconnection between brain regions. However, these findings may vary depending upon the negative or positive symptomatology manifested in the patients. MR spectroscopy generally shows low N-acetylaspartate from neuronal loss and low glutamine (a neuroexcitatory marker) but glutathione may be elevated, particularly in non-treatment responders. The literature in schizophrenia is difficult to evaluate because age, gender, symptomatology, comorbidities, therapy use, disease duration, substance abuse, and coexisting other psychiatric disorders have not been adequately controlled for, even in large studies and meta-analyses.
Collapse
Affiliation(s)
- Mona Dabiri
- Department of Radiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kun Yang
- Department of Psychiatry, Molecular Psychiatry Program, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, United States
| | - Roland R. Lee
- Department of Radiology, UCSD/VA Medical Center, San Diego, CA, United States
| | - David M. Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, United States
- *Correspondence: David M. Yousem,
| |
Collapse
|
11
|
A role for endothelial NMDA receptors in the pathophysiology of schizophrenia. Schizophr Res 2022; 249:63-73. [PMID: 33189520 DOI: 10.1016/j.schres.2020.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/14/2022]
Abstract
Numerous genetic and postmortem studies link N-methyl-d-aspartate receptor (NMDAR) dysfunction with schizophrenia, forming the basis of the popular glutamate hypothesis. Neuronal NMDAR abnormalities are consistently reported from both basic and clinical experiments, however, non-neuronal cells also contain NMDARs, and are rarely, if ever, considered in the discussion of glutamate action in schizophrenia. We offer an examination of recent discoveries elucidating the actions and consequences of NMDAR activation in the neuroendothelium. While there has been mixed literature regarding blood flow alterations in the schizophrenia brain, in this review, we posit that some common findings may be explained by neuroendothelial NMDAR dysfunction. In particular, we emphasize that endothelial NMDARs are key mediators of neurovascular coupling, where increased neuronal activity leads to increased blood flow. Based on the broad conclusions that hypoperfusion is a neuroanatomical finding in schizophrenia, we discuss potential mechanisms by which endothelial NMDARs contribute to this disorder. We propose that endothelial NMDAR dysfunction can be a primary cause of neurovascular abnormalities in schizophrenia. Importantly, functional MRI studies using BOLD signal as a proxy for neuron activity should be considered in a new light if neurovascular coupling is impaired in schizophrenia. This review is the first to propose that NMDARs in non-excitable cells play a role in schizophrenia.
Collapse
|
12
|
Brenner AM, Claudino FCDA, Burin LM, Scheibe VM, Padilha BL, de Souza GR, Duarte JA, da Rocha NS. Structural magnetic resonance imaging findings in severe mental disorders adult inpatients: A systematic review. Psychiatry Res Neuroimaging 2022; 326:111529. [PMID: 36058133 DOI: 10.1016/j.pscychresns.2022.111529] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/13/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022]
Abstract
In severe presentations, major depressive disorder (MDD), schizophrenia (SZ), and bipolar disorder (BD) can be categorized as severe mental disorders (SMD). Our aim is to evaluate structural magnetic resonance imaging and computed tomography findings in adult inpatients diagnosed with SMD and hospitalized at psychiatric wards. PubMed, Embase, PsycInfo, Cochrane Library, and Web of Science were searched up to May 27th, 2021. Articles were screened and extracted by two independent groups, with third-party raters for discrepancies. Quality of evidence was evaluated with the Newcastle-Ottawa Scale. Synthesis was made by qualitative analysis. This study was registered on PROSPERO (CRD42020171718) and followed the PRISMA protocol. 35 studies were included, of which none was considered to likely introduce bias in our analyses. Overlapping areas in MDD, SZ, and Affective Psychosis (AP) patients, that include BD and MDD with psychotic features, are presented in the inferior temporal and cingulate gyri. MDD and SZ had commonly affected areas in the inferior and middle frontal gyri, transverse temporal gyrus, insula, and hippocampus. SZ and AP had commonly affected areas in the temporal pole. Overlapping affected areas among SMD patients are reported, but the heterogeneity of studies' designs and findings are still a limitation for clinically relevant guidelines.
Collapse
Affiliation(s)
- Augusto Mädke Brenner
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Felipe Cesar de Almeida Claudino
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luísa Monteiro Burin
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Victória Machado Scheibe
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; School of Medicine, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil
| | - Barbara Larissa Padilha
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gianfranco Rizzotto de Souza
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliana Avila Duarte
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Neusa Sica da Rocha
- Center for Clinical Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Post-graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
13
|
Qi Z, Wang J, Gong J, Su T, Fu S, Huang L, Wang Y. Common and specific patterns of functional and structural brain alterations in schizophrenia and bipolar disorder: a multimodal voxel-based meta-analysis. J Psychiatry Neurosci 2022; 47:E32-E47. [PMID: 35105667 PMCID: PMC8812718 DOI: 10.1503/jpn.210111] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/12/2021] [Accepted: 11/16/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Schizophrenia and bipolar disorder have been linked to alterations in the functional activity and grey matter volume of some brain areas, reflected in impaired regional homogeneity and aberrant voxel-based morphometry. However, because of variable findings and methods used across studies, identifying patterns of brain alteration in schizophrenia and bipolar disorder has been difficult. METHODS We conducted a meta-analysis of differences in regional homogeneity and voxel-based morphometry between patients and healthy controls for schizophrenia and bipolar disorder separately, using seed-based d mapping. RESULTS We included 45 publications on regional homogeneity (26 in schizophrenia and 19 in bipolar disorder) and 190 publications on voxel-based morphometry (120 in schizophrenia and 70 in bipolar disorder). Patients with schizophrenia showed increased regional homogeneity in the frontal cortex and striatum and the supplementary motor area; they showed decreased regional homogeneity in the insula, primary sensory cortex (visual and auditory cortices) and sensorimotor cortex. Patients with bipolar disorder showed increased regional homogeneity in the frontal cortex and striatum; they showed decreased regional homogeneity in the insula. Patients with schizophrenia showed decreased grey matter volume in the superior temporal gyrus, inferior frontal gyrus, cingulate cortex and cerebellum. Patients with bipolar disorder showed decreased grey matter volume in the insula, cingulate cortex, frontal cortex and thalamus. Overlap analysis showed that patients with schizophrenia displayed decreased regional homogeneity and grey matter volume in the left insula and left superior temporal gyrus; patients with bipolar disorder displayed decreased regional homogeneity and grey matter volume in the left insula. LIMITATIONS The small sample size for our subgroup analysis (unmedicated versus medicated patients and substantial heterogeneity in the results for some regions could limit the interpretability and generalizability of the results. CONCLUSION Patients with schizophrenia and bipolar disorder shared a common pattern of regional functional and structural alterations in the insula and frontal cortex. Patients with schizophrenia showed more widespread functional and structural impairment, most prominently in the primary sensory motor areas.
Collapse
Affiliation(s)
| | - Junjing Wang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China (Qi, Su, Fu, Huang, Y. Wang); the Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China (Qi, Su, Fu, Huang, Y. Wang); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (J. Wang); and the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong)
| | | | | | | | | | | |
Collapse
|
14
|
von Känel S, Nadesalingam N, Alexaki D, Baumann Gama D, Kyrou A, Lefebvre S, Walther S. Measuring catatonia motor behavior with objective instrumentation. Front Psychiatry 2022; 13:880747. [PMID: 36061273 PMCID: PMC9428315 DOI: 10.3389/fpsyt.2022.880747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Catatonia is a neuropsychiatric syndrome, with important psychomotor features, associated with schizophrenia and other psychiatric disorders. The syndrome comprises multiple symptoms including abnormal motor control, behaviors, volition, and autonomic regulation. Catatonia assessment relies on clinical rating scales and clinicians familiar with the catatonia exam. However, objective instrumentation may aid the detection of catatonia. We aimed to investigate the relationship between movement parameters derived from actigraphy and expert ratings of catatonia symptoms measured by the Bush Francis Catatonia Rating Scale (BFCRS) and the Northoff Catatonia scale (NCS). METHODS Eighty-six acutely ill inpatients with schizophrenia spectrum disorders were assessed with the BFCRS, the NCS, and 24 h continuous actigraphy. Non-wear and sleep periods were removed from the actigraphy data prior to analysis. Associations between total catatonia scores, derived from both BFCRS and NCS, and actigraphy parameters as well as between single BFCRS items and actigraphy parameters were calculated using Spearman's rank correlation and non-parametric ANCOVAs (Quade's ANCOVAs), respectively. RESULTS Both higher BFCRS total scores (r = 0.369, p = 0.006) and NCS total scores (r = 0.384, p = 0.004) were associated with lower activity levels (AL). Higher scores on single BFCRS items such as immobility/stupor or staring were linked to lower AL (immobility/stupor: F = 17.388, p < 0.001, η2 = 0.175; staring: F = 7.849, p = 0.001, η2 = 0.162) and lower metabolic equivalents of task (MET). CONCLUSION Specific catatonia symptoms such as immobility/stupor and staring can be measured with actigraphy. This may aid the detection, staging, and monitoring of catatonia in clinical settings.
Collapse
Affiliation(s)
- Sofie von Känel
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Niluja Nadesalingam
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.,Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland
| | | | - Daniel Baumann Gama
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Alexandra Kyrou
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Stéphanie Lefebvre
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
15
|
Rampino A, Annese T, Torretta S, Tamma R, Maria Falcone R, Ribatti D. Involvement of vascular endothelial growth factor in schizophrenia. Neurosci Lett 2021; 760:136093. [PMID: 34216717 DOI: 10.1016/j.neulet.2021.136093] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022]
Abstract
Vascular endothelial growth factor (VEGF), which acts as an angiogenic and neurotrophic factor, is involved the regulation of cerebral blood volume and flow in Schizophrenia (SCZ). Several evidence indicates that modification of brain blood circulation due to alterations in the VEGF system affects cognitive performance and brain function in patients with SCZ. The aim of this study is: 1) To analyze the literature data concerning the role of VEGF in modulating the angiogenic response in SCZ. These data are controversial because some studies found elevated VEGF serum levels of VEGF in patients with SCZ, whereas others demonstrated no significant differences between SCZ patients and controls. 2)To analyze the role of VEGF as a predictive factor on the effects of antipsychotics agents used in the treatment of SCZ. In this context, high VEGF levels, associated to better responses to antipsychotics, might be predictive of the use of first generation antipsycotic drugs, whereas low VEGF levels, expression of resistance to therapy, might be predictive for the use of second generation antipsycotic drugs.
Collapse
Affiliation(s)
- Antonio Rampino
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Tiziana Annese
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Silvia Torretta
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Roberto Tamma
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Rosa Maria Falcone
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy.
| |
Collapse
|
16
|
Zhou W, Zheng H, Wang M, Zheng Y, Chen S, Wang MJ, Dong GH. The imbalance between goal-directed and habitual systems in internet gaming disorder: Results from the disturbed thalamocortical communications. J Psychiatr Res 2021; 134:121-128. [PMID: 33383495 DOI: 10.1016/j.jpsychires.2020.12.058] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/10/2020] [Accepted: 12/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Converging evidence has identified the imbalance between goal-directed systems and habitual systems in the addiction process. The thalamocortical loop plays an important role in the habitual/goal-directed system. However, little is known about the role of the thalamus in goal-directed and habitual systems in Internet gaming disorder (IGD) patients. This study investigated whether thalamocortical circuit was disrupted and how they affected goal-directed and habitual behaviors in IGD patients. METHODS This is a functional magnetic resonance imaging (fMRI) study. Twenty-five IGD patients and 25 matched recreational game users (RGUs) were scanned when they were in a resting state and were performing an instrumental learning task to obtain behavioral data related to habitual/goal-directed behavior. We used the whole-brain seed-based functional connectivity (FC) of the four thalamic nuclei (bilateral) and correlation analyses to examine the thalamocortical loop difference and relationship with habitual/goal-directed performance. RESULTS Compared with RGUs, IGD patients demonstrated significantly increased FC between the left midline nucleus (MN) and the right postcentral gyrus (PCG), and between the pulvinar and medial frontal gyrus (MFG). Correlation results showed that within the IGD group, the correct response rates of the participants to inconsistent stimulus-result pairs were positively correlated with the FC between the pulvinar and MFG. Inhibition-control scores were negatively correlated with the FC between the left MN and the PCG. CONCLUSIONS IGD patients showed disrupted thalamocortical communication that could further result in an imbalance between the goal-directed and habitual systems in IGD patients. These findings provide more information about the involvement of the thalamus in the pathophysiology of IGD, and as potential circuit-level biomarkers of IGD patients, these circuit alterations may be useful in treatment development and in monitoring treatment outcomes.
Collapse
Affiliation(s)
- Weiran Zhou
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institutes of Psychological Sciences, Hangzhou Normal University, PR China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Min Wang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institutes of Psychological Sciences, Hangzhou Normal University, PR China
| | - Yanbin Zheng
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institutes of Psychological Sciences, Hangzhou Normal University, PR China
| | - Shuaiyu Chen
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institutes of Psychological Sciences, Hangzhou Normal University, PR China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, PR China
| | - Meng-Jing Wang
- Southeast University - Monash University Joint Graduate School, Southeast University, PR China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institutes of Psychological Sciences, Hangzhou Normal University, PR China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, PR China.
| |
Collapse
|
17
|
Meyer N, Faulkner SM, McCutcheon RA, Pillinger T, Dijk DJ, MacCabe JH. Sleep and Circadian Rhythm Disturbance in Remitted Schizophrenia and Bipolar Disorder: A Systematic Review and Meta-analysis. Schizophr Bull 2020; 46:1126-1143. [PMID: 32154882 PMCID: PMC7505194 DOI: 10.1093/schbul/sbaa024] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Sleep and circadian rhythm disturbances in schizophrenia are common, but incompletely characterized. We aimed to describe and compare the magnitude and heterogeneity of sleep-circadian alterations in remitted schizophrenia and compare them with those in interepisode bipolar disorder. METHODS EMBASE, Medline, and PsycINFO were searched for case-control studies reporting actigraphic parameters in remitted schizophrenia or bipolar disorder. Standardized and absolute mean differences between patients and controls were quantified using Hedges' g, and patient-control differences in variability were quantified using the mean-scaled coefficient of variation ratio (CVR). A wald-type test compared effect sizes between disorders. RESULTS Thirty studies reporting on 967 patients and 803 controls were included. Compared with controls, both schizophrenia and bipolar groups had significantly longer total sleep time (mean difference [minutes] [95% confidence interval {CI}] = 99.9 [66.8, 133.1] and 31.1 [19.3, 42.9], respectively), time in bed (mean difference = 77.8 [13.7, 142.0] and 50.3 [20.3, 80.3]), but also greater sleep latency (16.5 [6.1, 27.0] and 2.6 [0.5, 4.6]) and reduced motor activity (standardized mean difference [95% CI] = -0.86 [-1.22, -0.51] and -0.75 [-1.20, -0.29]). Effect sizes were significantly greater in schizophrenia compared with the bipolar disorder group for total sleep time, sleep latency, and wake after sleep onset. CVR was significantly elevated in both diagnoses for total sleep time, time in bed, and relative amplitude. CONCLUSIONS In both disorders, longer overall sleep duration, but also disturbed initiation, continuity, and reduced motor activity were found. Common, modifiable factors may be associated with these sleep-circadian phenotypes and advocate for further development of transdiagnostic interventions that target them.
Collapse
Affiliation(s)
- Nicholas Meyer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Toby Pillinger
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford, Surrey, UK
- UK Dementia Research Institute, London, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
18
|
Wolf RC, Rashidi M, Fritze S, Kubera KM, Northoff G, Sambataro F, Calhoun VD, Geiger LS, Tost H, Hirjak D. A Neural Signature of Parkinsonism in Patients With Schizophrenia Spectrum Disorders: A Multimodal MRI Study Using Parallel ICA. Schizophr Bull 2020; 46:999-1008. [PMID: 32162660 PMCID: PMC7345812 DOI: 10.1093/schbul/sbaa007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Motor abnormalities in schizophrenia spectrum disorders (SSD) have increasingly attracted scientific interest in the past years. However, the neural mechanisms underlying parkinsonism in SSD are unclear. The present multimodal magnetic resonance imaging (MRI) study examined SSD patients with and without parkinsonism, as defined by a Simpson and Angus Scale (SAS) total score of ≥4 (SAS group, n = 22) or <4 (non-SAS group, n = 22). Parallel independent component analysis (p-ICA) was used to examine the covarying components among gray matter volume maps computed from structural MRI (sMRI) and fractional amplitude of low-frequency fluctuations (fALFF) maps computed from resting-state functional MRI (rs-fMRI) patient data. We found a significant correlation (P = .020, false discovery rate [FDR] corrected) between an sMRI component and an rs-fMRI component, which also significantly differed between the SAS and non-SAS group (P = .042, z = -2.04). The rs-fMRI component comprised the cortical sensorimotor network, and the sMRI component included predominantly a frontothalamic/cerebellar network. Across the patient sample, correlations adjusted for the Positive and Negative Syndrome Scale (PANSS) total scores showed a significant relationship between tremor score and loadings of the cortical sensorimotor network, as well as between glabella-salivation score, frontothalamic/cerebellar and cortical sensorimotor network loadings. These data provide novel insights into neural mechanisms of parkinsonism in SSD. Aberrant bottom-up modulation of cortical motor regions may account for these specific motor symptoms, at least in patients with SSD.
Collapse
Affiliation(s)
- Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mahmoud Rashidi
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), [Georgia State University, Georgia Institute of Technology, Emory University], Atlanta, GA
| | - Lena S Geiger
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, D-68159 Mannheim, Germany; tel: +49-621-1703-0, fax: +49-621-1703-2305, e-mail:
| |
Collapse
|
19
|
Walther S, Alexaki D, Schoretsanitis G, Weiss F, Vladimirova I, Stegmayer K, Strik W, Schäppi L. Inhibitory Repetitive Transcranial Magnetic Stimulation to Treat Psychomotor Slowing: A Transdiagnostic, Mechanism-Based Randomized Double-Blind Controlled Trial. ACTA ACUST UNITED AC 2020. [DOI: 10.1093/schizbullopen/sgaa020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract
Psychomotor slowing is frequently distressing patients with depression and schizophrenia. Increased neural activity within premotor cortices is linked to psychomotor slowing. This transdiagnostic study tested whether add-on inhibitory repetitive transcranial magnetic stimulation (rTMS) of the supplementary motor area (SMA) may alleviate psychomotor slowing. Forty-five patients with severe psychomotor slowing (26 psychosis, 19 major depression) were randomized in this transdiagnostic, double-blind, parallel-group, sham-controlled trial of 15 daily sessions of add-on rTMS over 3 weeks. Treatment arms included inhibitory 1 Hz stimulation of the SMA, facilitatory intermittent theta burst stimulation (iTBS) of the SMA, facilitatory 15 Hz stimulation of the left dorsolateral prefrontal cortex (DLPFC), and sham stimulation of the occipital cortex. The primary outcome was response (>30% reduction from baseline) according to the Salpêtrière Retardation Rating Scale (SRRS). Secondary outcomes were course of SRRS and further symptom rating scales. Last-observation carried forward method was applied to all subjects with baseline data. Response rates differed between protocols: 82% with inhibitory 1 Hz rTMS of the SMA, 0% with facilitatory iTBS of the SMA, 30% with sham, and 33% with 15 Hz DLPFC rTMS (χ 2 = 16.6, P < .001). Dropouts were similarly distributed across protocols. Response rates were similar in the completer analysis. This transdiagnostic trial of rTMS demonstrates that inhibitory SMA stimulation may ameliorate psychomotor slowing in severely ill patients. It further provides proof-of-concept that motor inhibition is linked to increased neural activity in the SMA because the inhibitory protocol performed best in reducing symptoms.
Trial registration: NCT03275766 (www.clinicaltrials.gov).
Collapse
Affiliation(s)
- Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Danai Alexaki
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Georgios Schoretsanitis
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
| | - Florian Weiss
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Irena Vladimirova
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Lea Schäppi
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
20
|
Sukumar N, Sabesan P, Anazodo U, Palaniyappan L. Neurovascular Uncoupling in Schizophrenia: A Bimodal Meta-Analysis of Brain Perfusion and Glucose Metabolism. Front Psychiatry 2020; 11:754. [PMID: 32848931 PMCID: PMC7427579 DOI: 10.3389/fpsyt.2020.00754] [Citation(s) in RCA: 13] [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: 12/31/2019] [Accepted: 07/16/2020] [Indexed: 01/06/2023] Open
Abstract
The use of modern neuroimaging approaches has demonstrated resting-state regional cerebral blood flow (rCBF) to be tightly coupled to resting cerebral glucose metabolism (rCMRglu) in healthy brains. In schizophrenia, several lines of evidence point toward aberrant neurovascular coupling, especially in the prefrontal regions. To investigate this, we used Signed Differential Mapping to undertake a voxel-based bimodal meta-analysis examining the relationship between rCBF and rCMRglu in schizophrenia, as measured by arterial spin labeling (ASL) and 18Flurodeoxyglucose positron emission tomography (FDG-PET) respectively. We used 19 studies comprised of data from 557 patients and 584 controls. Our results suggest that several key regions implicated in the pathophysiology of schizophrenia such as the frontoinsular cortex, dorsal ACC, putamen, and temporal pole show conjoint metabolic and perfusion abnormalities in patients. In contrast, discordance between metabolism and perfusion were seen in superior frontal gyrus and cerebellum, indicating that factors contributing to neurovascular uncoupling (e.g. inflammation, mitochondrial dysfunction, oxidative stress) are likely operates at these loci. Studies enrolling patients on high doses of antipsychotics had showed larger rCBF/rCMRglu effects in patients in the left dorsal striatum. Hybrid ASL-PET studies focusing on these regions could confirm our proposition regarding neurovascular uncoupling at superior frontal gyrus in schizophrenia.
Collapse
Affiliation(s)
- Niron Sukumar
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | | | - Udunna Anazodo
- Lawson Health Research Institute, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Robarts Research Institute, University of Western Ontario, London, ON, Canada
| |
Collapse
|
21
|
Büetiger JR, Hubl D, Kupferschmid S, Schultze-Lutter F, Schimmelmann BG, Federspiel A, Hauf M, Walther S, Kaess M, Michel C, Kindler J. Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization-Derealization Disorder. Front Psychiatry 2020; 11:535652. [PMID: 33024435 PMCID: PMC7516266 DOI: 10.3389/fpsyt.2020.535652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depersonalization (DP) and derealization (DR) are symptoms of a disruption of perceptual integration leading to an altered quality of subjective experiences such as feelings of unreality and detachment from the self (DP) or the surroundings (DR). Both DP and DR often occur in concert with other symptoms, for example in subjects at clinical high-risk (CHR) for psychosis, but also appear isolated in the form of DP/DR disorder. Despite evidence that DP/DR causes immense distress, little is known about their neurobiological underpinnings. Therefore, we investigated the neural correlates of DP/DR using pseudo-continuous arterial spin labeling MRI. METHODS We evaluated the frequency of DP/DR symptoms in a clinical sample (N = 217) of help-seeking individuals from the Early Detection and Intervention Centre for Mental Crisis (CHR, n = 97; clinical controls (CC), n = 91; and first-episode psychosis (FEP), n = 29). Further, in a subsample of those CHR subjects who underwent MRI, we investigated the resting-state regional cerebral blood flow (rCBF). Here, individuals with (n = 21) and without (n = 23) DP/DR were contrasted. Finally, rCBF was measured in a small independent second sample of patients with DP/DR disorder (n = 6) and healthy controls (HC, n = 6). RESULTS In the complete clinical sample, significantly higher frequency of DP/DR was found in CHR compared to CC (50.5 vs. 16.5%; χ2 (2) = 24.218, p ≤ 0.001, Cramer's V = 0.359) as well as in FEP compared to CC (37.9 vs. 16.5%; χ2 (2) = 5.960, p = 0.015, Cramer's V = 0.223). In MRI, significantly lower rCBF was detected in the left orbitofrontal cortex in CHR with vs. without DP/DR (x/y/z = -16/42/-22, p < 0.05, FWE corrected). In patients with DP/DR disorder, significantly higher rCBF was detected in the left caudate nucleus (x/y/z = -18/-32/18, p < 0.05) compared to HC. CONCLUSIONS This study shows that DP/DR symptoms are frequently found in CHR subjects. Investigating two separate DP/DR populations with an identical neuroimaging technique, our study also indicates that there may be divergent pathophysiological mechanisms-decreased neuronal activity in the orbitofrontal cortex, but increased activity within the caudate nucleus-leading to a final common pathway with similar psychopathological symptoms. This suggests that both top-down (orbitofrontal cortex) and bottom-up (caudate nucleus) mechanisms could contribute to the emergence of DP/DR.
Collapse
Affiliation(s)
- Jessica R Büetiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Daniela Hubl
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephan Kupferschmid
- Integrated Psychiatric Services of Winterthur and Zurich Unterland (ipw), Winterthur , Switzerland
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Federspiel
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| |
Collapse
|
22
|
Legind CS, Broberg BV, Brouwer R, Mandl RCW, Ebdrup BH, Anhøj SJ, Jensen MH, Hilker R, Fagerlund B, Hulshoff Pol HE, Glenthøj BY, Rostrup E. Heritability of Cerebral Blood Flow and the Correlation to Schizophrenia Spectrum Disorders: A Pseudo-continuous Arterial Spin Labeling Twin Study. Schizophr Bull 2019; 45:1231-1241. [PMID: 30776063 PMCID: PMC6811820 DOI: 10.1093/schbul/sbz007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Whether aberrant cerebral blood flow (CBF) in schizophrenia is affected by genetic influences, and consequently a potential marker for genetic susceptibility, is unknown. Our aims were to determine the heritability of CBF in thalamic, frontal, and striatal areas, and to ascertain if associations with disease were under genetic influence. Monozygotic (MZ) twin pairs concordant (n = 2) or discordant (n = 20) for schizophrenia spectrum disorders (ICD-10 F2x.x), matched on sex and age with dizygotic (DZ; n = 20) and healthy control pairs (MZ: n = 27; DZ: n = 18; total: n = 181 individuals), were recruited via the National Danish Twin Register. CBF in thalamus, frontal lobes, and putamen was measured with pseudo-continuous arterial spin labeling on a 3 T magnetic resonance scanner. Twin statistics were performed with structural equation modeling. CBF in the frontal lobes was heritable (h2 = 0.44, 95% CI [0.22-0.60]) but not correlated to disease. CBF correlated to schizophrenia spectrum disorders in the left thalamus (r = 0.17, [0.03-0.31]; P = 0.02), as well as in the left putamen (r = 0.19, [0.05-0.32]; P = 0.007) and the right putamen (r = 0.18, [0.03-0.32]; P = 0.02). When restricting the sample to schizophrenia (F20.x) only, shared genetic influences between CBF in the left putamen and schizophrenia liability (phenotypic correlation = 0.44, [0.28-0.58], P < 0.001) were found. Our results provide heritability estimates of CBF in the frontal lobes, and we find CBF in thalamus and putamen to be altered in schizophrenia spectrum disorders. Furthermore, shared genetic factors influence schizophrenia liability and striatal perfusion. Specifically, higher perfusion in the left putamen may constitute a marker of genetic susceptibility for schizophrenia.
Collapse
Affiliation(s)
- Christian S Legind
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,To whom correspondence should be addressed; Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, Nordre Ringvej 29-67, DK-2600 Glostrup, Denmark; tel: + 45 20862904, fax: +45 38640555, e-mail:
| | - Brian V Broberg
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Rachel Brouwer
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - René C W Mandl
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bjørn H Ebdrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simon J Anhøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Maria H Jensen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Hilker
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Hilleke E Hulshoff Pol
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Birte Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet–Glostrup, Copenhagen, Denmark
| |
Collapse
|
23
|
Kindler J, Michel C, Schultze-Lutter F, Felber G, Hauf M, Schimmelmann BG, Kaess M, Hubl D, Walther S. Functional and structural correlates of abnormal involuntary movements in psychosis risk and first episode psychosis. Schizophr Res 2019; 212:196-203. [PMID: 31405623 DOI: 10.1016/j.schres.2019.07.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Abnormal involuntary movements (AIM) may occur throughout the course of psychosis. While AIM are thought to indicate striatal abnormalities, the functional and structural correlates of increased AIM remain elusive. Here, we examined the prevalence of AIM in patients with clinical high risk for psychosis (CHR), first episode psychosis (FEP) and clinical controls (CC). Furthermore, we tested the association of AIM with regional cerebral blood flow (rCBF), grey matter volume (GMV), and premorbid IQ. METHODS We conducted a video-based analysis of AIM in patients with CHR (n = 45), FEP (n = 10) and CC (n = 39), recruited in the Early Detection and Intervention Center, Bern. Premorbid intelligence was evaluated using the Peabody Picture Vocabulary test. Additionally, arterial spin labeling MRIs and structural MRIs were acquired in a subgroup of the sample to investigate the association of AIM with rCBF and GMV. RESULTS Higher total AIM scores were detected in CHR (p = 0.02) and FEP (p = 0.04) as compared to CC. When separated for different muscle groups, lips and perioral movements were significantly increased in CHR patients as compared to CC (p = 0.009). AIM scores correlated positively with rCBF in the premotor cortex, Brodmann area 6 (p < 0.05, FWE corrected). Negative correlations were found between AIM and GMV of the corresponding caudal middle frontal gyrus (p = 0.04, FWE corrected) and premorbid intelligence (p = 0.02). CONCLUSIONS AIM were more frequent in the psychosis spectrum than in clinical controls. Neuroimaging findings indicate an involvement of cortical motor areas in abnormal motor behavior, instead of pure basal ganglia pathology.
Collapse
Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland.
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Gwendolin Felber
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Clinic for Child and Adolescent Psychiatry, University Hospital Heidelberg, Germany
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
24
|
Viher PV, Docx L, Van Hecke W, Parizel PM, Sabbe B, Federspiel A, Walther S, Morrens M. Aberrant fronto-striatal connectivity and fine motor function in schizophrenia. Psychiatry Res Neuroimaging 2019; 288:44-50. [PMID: 31075716 DOI: 10.1016/j.pscychresns.2019.04.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 04/26/2019] [Accepted: 04/28/2019] [Indexed: 12/20/2022]
Abstract
Abnormal fine motor function is a frequent finding in schizophrenia and has been linked to structural and functional brain alterations. However, whether fine motor function is related to functional alterations within the motor system remains unclear. The aim of this study was to assess whether abnormalities in resting-state functional connectivity are present in schizophrenia patients and to investigate how these abnormalities may be related to fine motor function. We examined 19 schizophrenia patients and 16 healthy controls using resting-state functional connectivity for 11 bilateral regions of interest. Fine motor function was assessed on a set of copying tasks and the Symbol-Digit-Substitution Test. We found significantly reduced functional connectivity between the left caudate nucleus and bilateral dorsolateral prefrontal cortex (DLPFC) and between the left putamen and bilateral supplementary motor area (SMA) proper in patients compared to controls. Altered connectivity from DLPFC to caudate nucleus was related to fine motor tasks, which are sensitive to psychomotor speed, whereas aberrant connectivity between the SMA proper and putamen was associated to both, fine motor task, which are sensitive to psychomotor speed and to speed of information processing. Our findings emphasize the role of fronto-striatal connections in the pathogenesis of fine motor impairments in schizophrenia.
Collapse
Affiliation(s)
- Petra V Viher
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland.
| | - Lise Docx
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; Multiversum, Boechout, Belgium
| | - Wim Van Hecke
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Bernard Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; University Psychiatric Hospital Antwerp, Campus Duffel, Belgium
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; University Psychiatric Hospital Antwerp, Campus Duffel, Belgium
| |
Collapse
|
25
|
Servaas MN, Kos C, Gravel N, Renken RJ, Marsman JBC, van Tol MJ, Aleman A. Rigidity in Motor Behavior and Brain Functioning in Patients With Schizophrenia and High Levels of Apathy. Schizophr Bull 2019; 45:542-551. [PMID: 30053198 PMCID: PMC6483574 DOI: 10.1093/schbul/sby108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of this study was to investigate whether apathy in schizophrenia is associated with rigidity in behavior and brain functioning. To this end, we studied associations between variability in dynamic functional connectivity (DFC) in relevant functional brain networks, apathy, and variability in physical activity in schizophrenia. Thirty-one patients with schizophrenia, scoring high on apathy, were included and wore an actigraph. Activity variability was calculated on the activity counts using the root of the Mean Squared Successive Difference (MSSD). Furthermore, we calculated DFC on resting-state data as phase interactions between blood oxygen-level dependent (BOLD) signals of 270 brain regions per volume. Variability (MSSD) in DFC was calculated for 3 networks, including the default-mode network (DMN), frontoparietal network, and salience-reward network (SRN). Finally, we calculated correlations between these DFC estimates and apathy and activity variability. First, lower activity variability was associated with higher levels of apathy. Second, higher levels of apathy were associated with lower variability in DFC in the DMN and SRN. Third, higher activity variability was associated with higher variability in DFC in the SRN. In conclusion, patients with schizophrenia and more severe levels of apathy showed less variability in their physical activity and more rigid functional brain network behavior in the DMN and SRN. These networks have been shown relevant for self-reflection, mental simulation, and reward processing, processes that are pivotal for self-initiated goal-directed behavior. Functional rigidity of these networks may therefore contribute to reduced goal-directed behavior, which is characteristic for these patients.
Collapse
Affiliation(s)
- Michelle N Servaas
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Claire Kos
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicolás Gravel
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Remco J Renken
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan-Bernard C Marsman
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marie-José van Tol
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - André Aleman
- Neuroimaging Center, Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
26
|
Hua J, Blair NIS, Paez A, Choe A, Barber AD, Brandt A, Lim IAL, Xu F, Kamath V, Pekar JJ, van Zijl PCM, Ross CA, Margolis RL. Altered functional connectivity between sub-regions in the thalamus and cortex in schizophrenia patients measured by resting state BOLD fMRI at 7T. Schizophr Res 2019; 206:370-377. [PMID: 30409697 PMCID: PMC6500777 DOI: 10.1016/j.schres.2018.10.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/11/2018] [Accepted: 10/20/2018] [Indexed: 12/21/2022]
Abstract
The thalamus is a small brain structure that relays neuronal signals between subcortical and cortical regions. Abnormal thalamocortical connectivity in schizophrenia has been reported in previous studies using blood-oxygenation-level-dependent (BOLD) functional MRI (fMRI) performed at 3T. However, anatomically the thalamus is not a single entity, but is subdivided into multiple distinct nuclei with different connections to various cortical regions. We sought to determine the potential benefit of using the enhanced sensitivity of BOLD fMRI at ultra-high magnetic field (7T) in exploring thalamo-cortical connectivity in schizophrenia based on subregions in the thalamus. Seeds placed in thalamic subregions of 14 patients and 14 matched controls were used to calculate whole-brain functional connectivity. Our results demonstrate impaired thalamic connectivity to the prefrontal cortex and the cerebellum, but enhanced thalamic connectivity to the motor/sensory cortex in schizophrenia. This altered functional connectivity significantly correlated with disease duration in the patients. Remarkably, comparable effect sizes observed in previous 3T studies were detected in the current 7T study with a heterogeneous and much smaller cohort, providing evidence that ultra-high field fMRI may be a powerful tool for measuring functional connectivity abnormalities in schizophrenia. Further investigation with a larger cohort is merited to validate the current findings.
Collapse
Affiliation(s)
- Jun Hua
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Nicholas I S Blair
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Adrian Paez
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Ann Choe
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Anita D Barber
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Allison Brandt
- Department of Psychiatry and Behavioral Sciences and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Issel Anne L Lim
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Feng Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James J Pekar
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Peter C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Christopher A Ross
- Department of Psychiatry and Behavioral Sciences and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience and Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Russell L Margolis
- Department of Psychiatry and Behavioral Sciences and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
27
|
Actigraphy studies and clinical and biobehavioural correlates in schizophrenia: a systematic review. J Neural Transm (Vienna) 2019; 126:531-558. [DOI: 10.1007/s00702-019-01993-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/12/2019] [Indexed: 12/29/2022]
|
28
|
Altered coupling of spontaneous brain activities and brain temperature in patients with adolescent-onset, first-episode, drug-naïve schizophrenia. Neuroradiology 2019; 61:575-584. [PMID: 30843095 DOI: 10.1007/s00234-019-02181-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE A recent study has reported that schizophrenia patients show an uncoupled association between intraventricular brain temperature (BT) and cerebral blood flow (CBF). CBF has been found to be closely coupled with spontaneous brain activities (SBAs) derived from resting-state BOLD fMRI metrics. Yet, it is unclear so far whether the relationship between the intraventricular BT and the SBAs may change in patients with adolescent-onset schizophrenia (AOS) compared with that in healthy controls (HCs). METHODS The present study recruited 28 first-episode, drug-naïve AOS patients and 22 matched HCs. We measured the temperature of the lateral ventricles (LV) using diffusion-weighted imaging thermometry and measured SBAs using both regional homogeneity and amplitude of low-frequency fluctuation methods. A nonparametric Wilcoxon rank sum test was used to detect the difference in intraventricular BT between AOS patients and HCs with LV volume, age, and sex as covariates. We also evaluated the relationship between the intraventricular BT and the SBAs using partial correlation analysis controlling for LV volume, age, and sex. RESULTS We found that HCs showed a significant negative correlation between the intraventricular BT and the local SBAs in the bilateral putamina and left superior temporal gyrus, while such a correlation was absent in AOS patients. Additionally, no significant difference between the two groups was found in the intraventricular BT. CONCLUSION These findings suggest that AOS patients may experience an uncoupling between intraventricular BT and SBAs in several schizophrenia-related brain areas, which may be associated with the altered relationships among intraventricular BT, CBF, and metabolism.
Collapse
|
29
|
Liu S, Wang H, Song M, Lv L, Cui Y, Liu Y, Fan L, Zuo N, Xu K, Du Y, Yu Q, Luo N, Qi S, Yang J, Xie S, Li J, Chen J, Chen Y, Wang H, Guo H, Wan P, Yang Y, Li P, Lu L, Yan H, Yan J, Wang H, Zhang H, Zhang D, Calhoun VD, Jiang T, Sui J. Linked 4-Way Multimodal Brain Differences in Schizophrenia in a Large Chinese Han Population. Schizophr Bull 2019; 45:436-449. [PMID: 29897555 PMCID: PMC6403093 DOI: 10.1093/schbul/sby045] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Multimodal fusion has been regarded as a promising tool to discover covarying patterns of multiple imaging types impaired in brain diseases, such as schizophrenia (SZ). In this article, we aim to investigate the covarying abnormalities underlying SZ in a large Chinese Han population (307 SZs, 298 healthy controls [HCs]). Four types of magnetic resonance imaging (MRI) features, including regional homogeneity (ReHo) from resting-state functional MRI, gray matter volume (GM) from structural MRI, fractional anisotropy (FA) from diffusion MRI, and functional network connectivity (FNC) resulted from group independent component analysis, were jointly analyzed by a data-driven multivariate fusion method. Results suggest that a widely distributed network disruption appears in SZ patients, with synchronous changes in both functional and structural regions, especially the basal ganglia network, salience network (SAN), and the frontoparietal network. Such a multimodal coalteration was also replicated in another independent Chinese sample (40 SZs, 66 HCs). Our results on auditory verbal hallucination (AVH) also provide evidence for the hypothesis that prefrontal hypoactivation and temporal hyperactivation in SZ may lead to failure of executive control and inhibition, which is relevant to AVH. In addition, impaired working memory performance was found associated with GM reduction and FA decrease in SZ in prefrontal and superior temporal area, in both discovery and replication datasets. In summary, by leveraging multiple imaging and clinical information into one framework to observe brain in multiple views, we can integrate multiple inferences about SZ from large-scale population and offer unique perspectives regarding the missing links between the brain function and structure that may not be achieved by separate unimodal analyses.
Collapse
Affiliation(s)
- Shengfeng Liu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,School of Automation, Harbin University of Science and Technology, Harbin, China,University of Chinese Academy of Sciences, Beijing, China,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Haiying Wang
- School of Automation, Harbin University of Science and Technology, Harbin, China
| | - Ming Song
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Yue Cui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yong Liu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Lingzhong Fan
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Nianming Zuo
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Kaibin Xu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yuhui Du
- The Mind Research Network, Albuquerque, NM,School of Computer and Information Technology, Shanxi University, Taiyuan, China
| | - Qingbao Yu
- The Mind Research Network, Albuquerque, NM
| | - Na Luo
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China
| | - Shile Qi
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, China
| | - Sangma Xie
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jian Li
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yunchun Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Ping Wan
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China,Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Peng Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Hao Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Jun Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China,Department of Psychology, Xinxiang Medical University, Xinxiang, China
| | - Dai Zhang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM,Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, NM
| | - Tianzi Jiang
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China,Queensland Brain Institute, University of Queensland, Brisbane, Australia,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jing Sui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China,The Mind Research Network, Albuquerque, NM,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China,To whom correspondence should be addressed; Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; tel: +86-10-8254-4518; fax: +86-10-8254-4777; e-mail:
| |
Collapse
|
30
|
Siddiqui I, Remington G, Fervaha G, Fletcher PJ, Voineskos AN, Saperia S, Zakzanis KK, Foussias G. Objective investigation of activity preference in schizophrenia: A pilot study. Psychiatry Res 2018; 267:551-559. [PMID: 29980136 DOI: 10.1016/j.psychres.2018.05.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/23/2018] [Accepted: 05/15/2018] [Indexed: 11/29/2022]
Abstract
Amotivation and reduced goal-directed activity engagement are prominent features of schizophrenia. Previous investigations of patients' activities have relied on accounts of daily living activities, rather than objective measures. This study used wireless motion capture to objectively evaluate activity preference when individuals are provided an explicit choice between an active versus passive engagement option. Twenty outpatients with schizophrenia and twenty matched healthy controls completed the Activity Preference Task, in which participants play a motion-based game (active) or watch a film (passive), and were administered clinical and cognitive assessments. Schizophrenia participants' duration, intensity, and persistence of active engagement were associated with apathy and community functioning. No group differences emerged from comparisons of task measures; however, exploratory cluster analysis identified a distinct subgroup of schizophrenia patients with reduced engagement and increased apathy compared to other patients and controls. The Task provides a means of quantifying activity engagement, which may be particularly valuable given the lack of objective measures for intrinsically motivated behaviours. Our initial findings suggest that schizophrenia patients as a group are equally inclined as healthy individuals towards actively engaging activities when presented an explicit choice, but such provision may be insufficient for initiation and maintenance of functional behaviours among amotivated patients.
Collapse
Affiliation(s)
- Ishraq Siddiqui
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada..
| | - Gary Remington
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada.; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Gagan Fervaha
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Paul J Fletcher
- Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada; Preclinical Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Department of Psychology, University of Toronto, Sidney Smith Hall, 100 St. George St., Toronto, Ontario M5S 3G3, Canada
| | - Aristotle N Voineskos
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada.; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Sarah Saperia
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Konstantine K Zakzanis
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - George Foussias
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada.; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
| |
Collapse
|
31
|
Wei Y, Chang M, Womer FY, Zhou Q, Yin Z, Wei S, Zhou Y, Jiang X, Yao X, Duan J, Xu K, Zuo XN, Tang Y, Wang F. Local functional connectivity alterations in schizophrenia, bipolar disorder, and major depressive disorder. J Affect Disord 2018; 236:266-273. [PMID: 29751242 DOI: 10.1016/j.jad.2018.04.069] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/18/2018] [Accepted: 04/07/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Local functional connectivity (FC) indicates local or short-distance functional interactions and may serve as a neuroimaging marker to investigate the human brain connectome. Local FC alterations suggest a disrupted balance in the local functionality of the whole brain network and are increasingly implicated in schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). METHODS We aim to examine the similarities and differences in the local FC across SZ, BD, and MDD. In total, 537 participants (SZ, 126; BD, 97; MDD, 126; and healthy controls, 188) completed resting-state functional magnetic resonance imaging at a single site. The local FC at resting state was calculated and compared across SZ, BD, and MDD. RESULTS The local FC increased across SZ, BD, and MDD within the bilateral orbital frontal cortex (OFC) and additional region in the left OFC extending to putamen and decreased in the primary visual, auditory, and motor cortices, right supplemental motor area, and bilateral thalami. There was a gradient in the extent of alterations such that SZ > BD > MDD. LIMITATIONS This cross-sectional study cannot consider medications and other clinical variables. CONCLUSIONS These findings indicate a disrupted balance between network integration and segregation in SZ, BD, and MDD, including over-integration via increased local FC in the OFC and diminished segregation of neural processing with the weakening of the local FC in the primary sensory cortices and thalamus. The shared local FC abnormalities across SZ, BD, and MDD may shed new light on the potential biological mechanisms underlying these disorders.
Collapse
Affiliation(s)
- Yange Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Miao Chang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Qian Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Zhiyang Yin
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Shengnan Wei
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Xudong Yao
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Jia Duan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China
| | - Xi-Nian Zuo
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100000, PR China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China.
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, PR China.
| |
Collapse
|
32
|
Strik W, Stegmayer K, Walther S, Dierks T. Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems. Neuropsychobiology 2018; 75:100-116. [PMID: 29258073 DOI: 10.1159/000485221] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Schizophrenia research has been in a deadlock for many decades. Despite important advances in clinical treatment, there are still major concerns regarding long-term psychosocial reintegration and disease management, biological heterogeneity, unsatisfactory predictors of individual course and treatment strategies, and a confusing variety of controversial theories about its etiology and pathophysiological mechanisms. In the present perspective on schizophrenia research, we first discuss a methodological pitfall in contemporary schizophrenia research inherent in the attempt to link mental phenomena with the brain: we claim that the time-honored phenomenological method of defining mental symptoms should not be contaminated with the naturalistic approach of modern neuroscience. We then describe our Systems Neuroscience of Psychosis (SyNoPsis) project, which aims to overcome this intrinsic problem of psychiatric research. Considering schizophrenia primarily as a disorder of interindividual communication, we developed a neurobiologically informed semiotics of psychotic disorders, as well as an operational clinical rating scale. The novel psychopathology allows disentangling the clinical manifestations of schizophrenia into behavioral domains matching the functions of three well-described higher-order corticobasal brain systems involved in interindividual human communication, namely, the limbic, associative, and motor loops, including their corticocortical sensorimotor connections. The results of several empirical studies support the hypothesis that the proposed three-dimensional symptom structure, segregated into the affective, the language, and the motor domain, can be specifically mapped onto structural and functional abnormalities of the respective brain systems. New pathophysiological hypotheses derived from this brain system-oriented approach have helped to develop and improve novel treatment strategies with noninvasive brain stimulation and practicable clinical parameters. In clinical practice, the novel psychopathology allows confining the communication deficits of the individual patient, shifting attention from the symptoms to the intact resources. We have studied this approach and observed important advantages for therapeutic alliances, personalized treatment, and de-escalation strategies. Future studies will further conjoin clinical definitions of psychotic symptoms with brain structures and functions, and disentangle structural and functional deficit patterns within these systems to identify neurobiologically distinct subsyndromes. Neurobiologically homogeneous patient groups may provide new momentum for treatment research. Finally, lessons learned from schizophrenia research may contribute to developing a comprehensive perspective on human experience and behavior that integrates methodologically distinct, but internally consistent, insights from humanities and neuroscience.
Collapse
|
33
|
Cole JH. Neuroimaging Studies Illustrate the Commonalities Between Ageing and Brain Diseases. Bioessays 2018; 40:e1700221. [PMID: 29882974 DOI: 10.1002/bies.201700221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/23/2018] [Indexed: 12/19/2022]
Abstract
The lack of specificity in neuroimaging studies of neurological and psychiatric diseases suggests that these different diseases have more in common than is generally considered. Potentially, features that are secondary effects of different pathological processes may share common neurobiological underpinnings. Intriguingly, many of these mechanisms are also observed in studies of normal (i.e., non-pathological) brain ageing. Different brain diseases may be causing premature or accelerated ageing to the brain, an idea that is supported by a line of "brain ageing" research that combines neuroimaging data with machine learning analysis. In reviewing this field, I conclude that such observations could have important implications, suggesting that we should shift experimental paradigm: away from characterizing the average case-control brain differences resulting from a disease toward methods that place individuals in their age-appropriate context. This will also lead naturally to clinical applications, whereby neuroimaging can contribute to a personalized-medicine approach to improve brain health.
Collapse
Affiliation(s)
- James H Cole
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience King's College London, London, SE5 8AF, UK
| |
Collapse
|
34
|
Kübel S, Stegmayer K, Vanbellingen T, Walther S, Bohlhalter S. Deficient supplementary motor area at rest: Neural basis of limb kinetic deficits in Parkinson's disease. Hum Brain Mapp 2018; 39:3691-3700. [PMID: 29722099 DOI: 10.1002/hbm.24204] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) patients frequently suffer from limb kinetic apraxia (LKA) affecting quality of life. LKA denotes an impairment of precise and independent finger movements beyond bradykinesia, which is reliably assessed by coin rotation (CR) task. BOLD fMRI detected activation of a left inferior parietal-premotor praxis network in PD during CR. Here, we explored which network site is most critical for LKA using arterial spin labeling (ASL). Based on a hierarchical model, we hypothesized that LKA would predominantly affect the functional integrity of premotor areas including supplementary motor areas (SMA). Furthermore, we suspected that for praxis function with higher demand on temporal-spatial processing such as gesturing, inferior parietal lobule (IPL) upstream to premotor areas would be essential. A total of 21 PD patients and 20 healthy controls underwent ASL acquisition during rest. Behavioral assessment outside the scanner involved the CR, finger tapping task, and the test of upper limb apraxia (TULIA). Whole-brain analysis of activity at rest showed a significant reduction of CR-related perfusion in the left SMA of PD. Furthermore, the positive correlation between SMA perfusion and CR, seen in controls, was lost in patients. By contrast, TULIA was significantly associated with the perfusion of left IPL in both patients and controls. In conclusion, the findings suggest that LKA in PD are linked to an intrinsic disruption of the left SMA function, which may only be overcome by compensatory network activation. In addition, gestural performance relies on IPL which remains available for functional recruitment in early PD.
Collapse
Affiliation(s)
- Stefanie Kübel
- Neurocenter, Luzerner Kantonsspital, Spitalstrasse 31, Luzern 16, 6000, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry, Bolligenstrasse 111, Bern 60, 3000, Switzerland
| | - Tim Vanbellingen
- Neurocenter, Luzerner Kantonsspital, Spitalstrasse 31, Luzern 16, 6000, Switzerland.,Gerontechnology and Rehabilitation Group, University of Bern, Murtenstrasse 50, Bern, 3008, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry, Bolligenstrasse 111, Bern 60, 3000, Switzerland
| | - Stephan Bohlhalter
- Neurocenter, Luzerner Kantonsspital, Spitalstrasse 31, Luzern 16, 6000, Switzerland.,Department of Clinical Research, University of Bern, Bern, 3000, Switzerland
| |
Collapse
|
35
|
Oliveira ÍAF, Guimarães TM, Souza RM, Dos Santos AC, Machado-de-Sousa JP, Hallak JEC, Leoni RF. Brain functional and perfusional alterations in schizophrenia: an arterial spin labeling study. Psychiatry Res Neuroimaging 2018; 272:71-78. [PMID: 29229240 DOI: 10.1016/j.pscychresns.2017.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 01/10/2023]
Abstract
Schizophrenia is a severe mental disorder that affects the anatomy and function of the brain, with an impact on one's thoughts, feelings, and behavior. The purpose of the study was to investigate cerebral blood flow (CBF) and brain connectivity in a group of patients with schizophrenia. Pseudo-continuous arterial spin labeling (pCASL) images were acquired from 28 patients in treatment and 28 age-matched healthy controls. Mean CBF and connectivity patterns were assessed. Schizophrenia patients had decreased CBF in the bilateral frontal pole and superior frontal gyrus, right medial frontal gyrus, triangular and opercular parts of the inferior frontal gyrus, posterior division of the left supramarginal gyrus, superior and inferior divisions of the left lateral occipital cortex, and bilateral occipital pole. Moreover, through different methods to assess connectivity, our results showed abnormal connectivity patterns in regions involved in motor, sensorial, and cognitive functions. Using pCASL, a non-invasive technique, we found CBF deficits and altered functional organization of the brain in schizophrenia patients that are associated with the symptoms and characteristics of the disorder.
Collapse
Affiliation(s)
- Ícaro A F Oliveira
- Inbrain Lab, Department of Physics, FFCLRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Tiago M Guimarães
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Roberto M Souza
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Antônio C Dos Santos
- Department of Medical Clinic, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - João Paulo Machado-de-Sousa
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil; National Institute of Science and Technology - Translational Medicine (INCT-TM), CNPq, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil; National Institute of Science and Technology - Translational Medicine (INCT-TM), CNPq, Brazil
| | - Renata F Leoni
- Inbrain Lab, Department of Physics, FFCLRP, University of Sao Paulo, Ribeirao Preto, Brazil.
| |
Collapse
|
36
|
Jing R, Huang J, Jiang D, Lin X, Ma X, Tian H, Li J, Zhuo C. Distinct pattern of cerebral blood flow alterations specific to schizophrenics experiencing auditory verbal hallucinations with and without insight: a pilot study. Oncotarget 2018; 9:6763-6770. [PMID: 29467926 PMCID: PMC5805512 DOI: 10.18632/oncotarget.23631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/29/2017] [Indexed: 12/24/2022] Open
Abstract
Schizophrenia is associated with widespread and complex cerebral blood flow (CBF) disturbance. Auditory verbal hallucinations (AVH) and insight are the core symptoms of schizophrenia. However, to the best of our knowledge, very few studies have assessed the CBF characteristics of the AVH suffered by schizophrenic patients with and without insight. Based on our previous findings, Using a 3D pseudo-continuous ASL (pcASL) technique, we investigated the differences in AVH-related CBF alterations in schizophrenia patients with and without insight. We used statistical parametric mapping (SPM8) and statistical non-parametric mapping (SnPM13) to perform the fMRI analysis. We found that AVH-schizophrenia patients without insight showed an increased CBF in the left temporal pole and a decreased CBF in the right middle frontal gyrus when compared to AVH-schizophrenia patients with insight. Our novel findings suggest that AVH-schizophrenia patients without insight possess a more complex CBF disturbance. Simultaneously, our findings also incline to support the idea that the CBF aberrant in some specific brain regions may be the common neural basis of insight and AVH. Our findings support the mostly current hypotheses regarding AVH to some extent. Although our findings come from a small sample, it provide the evidence that indicate us to conduct a larger study to thoroughly explore the mechanisms of schizophrenia, especially the core symptoms of AVHs and insight.
Collapse
Affiliation(s)
- Rixing Jing
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jiangjie Huang
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China
| | - Deguo Jiang
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China
| | - Xiaodong Lin
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China
| | - Xiaolei Ma
- Department of Psychological Medicine, Tianjin Anning Hospital, Tianjin, China
| | - Hongjun Tian
- Department of Psychological Medicine, Tianjin Anning Hospital, Tianjin, China
| | - Jie Li
- Department of Psychiatric Neuroimaging Laboratory, Tianjin Anding Hospital, Tianjin Mental Health Center, Teaching Hospital of Tianjin Medical University, Tianjin, China
| | - Chuanjun Zhuo
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China.,Department of Psychiatric Neuroimaging Laboratory, Tianjin Anding Hospital, Tianjin Mental Health Center, Teaching Hospital of Tianjin Medical University, Tianjin, China
| |
Collapse
|
37
|
Wigand ME, Lang FU, Reichhardt L, Schulze TG, Walther S, Becker T, Jäger M. Severe clinical events in 100 patients with schizophrenia: a retrospective clinical description using a system-specific psychopathological approach. Nord J Psychiatry 2018; 72:1-8. [PMID: 28846054 DOI: 10.1080/08039488.2017.1368701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Catatonic states and numerous other severe clinical events can complicate the course of schizophrenia. Whether these severe courses are associated with particular system-specific symptom dimensions remain unclear. Aim is to assess the frequency of severe clinical events in a clinical population and to investigate the association of these events with sociodemographic data and system-specific psychopathology, combining qualitative and quantitative data. We performed a comprehensive retrospective description of a well-described and geographically stable sample of 100 patients with schizophrenia or schizoaffective disorder and linked severe clinical events with sociodemographic data at inclusion into the study (as indicators of social functioning) and symptoms at first admission, classified with the Bern Psychopathology Scale (BPS). We found 12 mentions of catatonic stupor or excitement, 45 of suicide attempts, 26 of suicidality, 18 of deliberate self-harm, 18 of self-threatening behaviour other than deliberate self-harm, 34 of violence against other persons, 18 of violence against objects and six of sexual harassment. Disinhibited language on first admission seemed to be a protective factor against suicidality and disinhibited motor behaviour seemed to predict self-threatening and violent behaviour. Catatonia and violence in particular seemed to be socially disabling. This exploratory study showed that the BPS is a promising instrument and might represent a system-specific approach in identifying patients at risk for severe sequelae of schizophrenia. This will have to be tested in future prospective studies.
Collapse
Affiliation(s)
- Moritz E Wigand
- a Department of Psychiatry and Psychotherapy II , Ulm University , Günzburg , Germany
| | - Fabian U Lang
- a Department of Psychiatry and Psychotherapy II , Ulm University , Günzburg , Germany.,b Medical Practice for Psychiatry and Psychotherapy Lang , Gersthofen , Germany
| | - Lea Reichhardt
- a Department of Psychiatry and Psychotherapy II , Ulm University , Günzburg , Germany
| | - Thomas G Schulze
- c Institute of Psychiatric Phenomics and Genomics , LMU München , Munich , Germany
| | - Sebastian Walther
- d Translational Research Center , University Hospital of Psychiatry , Bern , Switzerland
| | - Thomas Becker
- a Department of Psychiatry and Psychotherapy II , Ulm University , Günzburg , Germany
| | - Markus Jäger
- a Department of Psychiatry and Psychotherapy II , Ulm University , Günzburg , Germany.,e Department of Psychiatry, Psychosomatic and Psychotherapy , Bezirkskrankenhaus Kempten , Kempten , Germany
| |
Collapse
|
38
|
Schäppi L, Stegmayer K, Viher PV, Walther S. Distinct Associations of Motor Domains in Relatives of Schizophrenia Patients-Different Pathways to Motor Abnormalities in Schizophrenia? Front Psychiatry 2018; 9:129. [PMID: 29740353 PMCID: PMC5924816 DOI: 10.3389/fpsyt.2018.00129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/26/2018] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Aberrant motor function is an integral part of schizophrenia. In fact, abnormalities are frequently found in patients, in populations at risk, and in unaffected relatives. Motor abnormalities are suspected to be relevant for the clinical outcome and could probably predict the conversion from at-risk individuals to schizophrenia. Furthermore, motor function has been argued as endophenotype of the disorder. Yet, which particular motor domain may classify as a potential endophenotype is unknown. We aimed to compare schizophrenia patients, unaffected first-degree relatives and healthy controls for different motor domains. We expected impairments in all domains in patients and in some domains in relatives. METHOD We included 43 schizophrenia patients, 34 unaffected first-degree relatives of schizophrenia patients, and 29 healthy control subjects, matched for age, gender, and education level. We compared motor function of four motor domains between the groups. The domains comprise neurological soft signs (NSS), abnormal involuntary movements (dyskinesia), Parkinsonism, and fine motor function including simple [finger tapping (FT)] and complex fine motor function, (i.e., dexterity as measured with the coin rotation test). Furthermore, we tested the association of motor function of the four domains with working memory, frontal lobe function, and nonverbal intelligence for each group separately using within-group bivariate correlations. RESULTS Schizophrenia patients showed poorer motor function in all tested domains compared to healthy controls. First-degree relatives had intermediate ratings with aberrant function in two motor domains. In detail, relatives had significantly more NSS and performed poorer in the FT task than controls. In contrast, complex fine motor function was intact in relatives. Relatives did not differ from controls in dyskinesia or Parkinsonism severity. DISCUSSION Taken together, schizophrenia patients have motor abnormalities in all tested domains. Thus, motor abnormalities are a key element of the disorder. Likewise, first-degree relatives presented motor deficits in two domains. A clear difference between relatives and healthy controls was found for NSS and FT. Thus, NSS and FT may be potential markers of vulnerability for schizophrenia. The lack of association between genetic risk and dyskinesia or Parkinsonism suggests distinct pathobiological mechanisms in the various motor abnormalities in schizophrenia.
Collapse
Affiliation(s)
- Lea Schäppi
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | | | - Petra V Viher
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
39
|
Kindler J, Schultze-Lutter F, Hauf M, Dierks T, Federspiel A, Walther S, Schimmelmann BG, Hubl D. Increased Striatal and Reduced Prefrontal Cerebral Blood Flow in Clinical High Risk for Psychosis. Schizophr Bull 2018; 44:182-192. [PMID: 28575528 PMCID: PMC5768043 DOI: 10.1093/schbul/sbx070] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Increased striatal dopaminergic activity and decreased prefrontal functioning have been reported in individuals at clinical high risk (CHR) for psychosis. Abnormal metabolic rate might affect resting-state cerebral blood flow (rCBF) in the respective regions. Here, we examined if striatal and prefrontal rCBF differ between patients with CHR, first-episode psychosis (FEP), chronic schizophrenia-spectrum disorder (SZ) and controls. Two cohorts with a total of 122 participants were included and analyzed separately: 32 patients with SZ and 31 healthy controls (HC) from the University Hospital of Psychiatry, and 59 patients from the Bern Early Recognition and Intervention Center (29 with CHR, 12 with FEP, and 18 clinical controls [CC]). Ultra-high risk criteria were assessed with the Structured Interview for Psychosis-Risk Syndromes, basic symptom criteria with the Schizophrenia Proneness Instrument. rCBF was measured with pseudo-continuous arterial spin labeling 3T-Magnetic Resonance Imaging. Striatal rCBF was significantly increased and prefrontal rCBF significantly decreased in the SZ group compared to HC group and in the CHR and FEP groups compared to CC group. Striatal rCBF correlated significantly with positive symptom scores in SZ and CHR. An inverse correlation between striatal and frontal rCBF was found in controls (HC, CC), but not in patient groups (SZ, FEP, CHR). This is the first study to demonstrate increased neuronal activity within the striatum, but reduced prefrontal activity in patients with CHR, FEP, and SZ compared to the respective controls. Our results indicate that alterations in striatal and prefrontal rCBF are reflecting metabolic abnormalities preceding the onset of frank psychosis.
Collapse
Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,To whom correspondence should be addressed; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; tel: +41319328554, fax: +41319328569, e-mail:
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Thomas Dierks
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
40
|
Wigand ME, Lang FU, Müller-Stierlin AS, Reichhardt L, Trif S, Schulze TG, Strik W, Becker T, Jäger M. Psychosis Is Mutable over Time: A Longitudinal Psychopathology Study. Psychopathology 2018. [PMID: 29539617 DOI: 10.1159/000486897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND A neurobiologically informed, system-specific psychopathological approach has been suggested for use in schizophrenia. However, to our knowledge, such an approach has not been used to prospectively describe the course of schizophrenia. SAMPLING AND METHODS We assessed psychopathology in a well-described sample of 100 patients with schizophrenia or schizoaffective disorder with the Bern Psychopathology Scale (BPS) at 6-month intervals for up to 18 months. The BPS groups symptoms into the 3 domains language, affectivity and motor behaviour; each domain is rated as being normal, inhibited or disinhibited. In addition, we collected qualitative psychopathological data in the form of case reports. RESULTS Forty-eight patients completed at least 2 assessments over the course of at least 1 year. Of these, 16 patients (33.3%) showed a bipolar course pattern (i.e., a switch from inhibited to disinhibited or vice versa) in 1 domain and 6 patients (12.5%) in more than 1 domain. Shifts from 1 dominant domain to another were seen frequently (n = 20, 41.7%), but shifts between 1 dominant domain and a combination of dominant domains were more common (n = 33, 68.8%). CONCLUSIONS The course of schizophrenia is heterogeneous and shows frequent changes in psychopathology. This should be taken into account in the communication with patients and in the research on underlying illness mechanisms and treatment. A major limitation of this study is the small sample size.
Collapse
Affiliation(s)
- Moritz E Wigand
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Günzburg, Germany.,Medical Practice for Psychiatry and Psychotherapy Lang, Gersthofen, Germany
| | | | - Lea Reichhardt
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Silvana Trif
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, LMU München, München, Germany
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Thomas Becker
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Günzburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, Bezirkskrankenhaus Kempten, Kempten, Germany
| |
Collapse
|
41
|
Stegmayer K, Strik W, Federspiel A, Wiest R, Bohlhalter S, Walther S. Specific cerebral perfusion patterns in three schizophrenia symptom dimensions. Schizophr Res 2017; 190:96-101. [PMID: 28320578 DOI: 10.1016/j.schres.2017.03.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 12/18/2022]
Abstract
Dimensional concepts such as the Research Domain Criteria initiative have been proposed to disentangle the heterogeneity of schizophrenia. One model introduced three neurobiologically informed behavioral dimensions: language, affectivity and motor behavior. To study the brain-behavior associations of these three dimensions, we investigated whether current behavioral alterations were linked to resting state perfusion in distinct brain circuits in schizophrenia. In total, 47 patients with schizophrenia spectrum disorders and 44 healthy controls were included. Psychopathology was assessed with the Positive And Negative Syndrome Scale and the Bern Psychopathology scale (BPS). The BPS provides severity ratings of three behavioral dimensions (language, affectivity and motor). Patients were classified according to the severity of alterations (severe, mild, no) in each dimension. Whole brain resting state cerebral blood flow (CBF) was compared between patient subgroups and controls. Two symptom dimensions were associated with distinct CBF changes. Behavioral alterations in the language dimension were linked to increased CBF in Heschl's gyrus. Altered affectivity was related to increased CBF in amygdala. The ratings of motor behavior instead were not specifically associated with CBF. Investigating behavioral alterations in three schizophrenia symptom dimensions identified distinct regional CBF changes in the language and limbic brain circuits. The results demonstrate a hitherto unknown segregation of pathophysiological pathways underlying a limited number of specific symptom dimensions in schizophrenia.
Collapse
Affiliation(s)
- Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland.
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Lucerne, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| |
Collapse
|
42
|
Cui LB, Wang LX, Tian P, Wang HN, Cai M, Guo F, Li C, Wu YJ, Qiao PG, Xu ZL, Liu L, He H, Wu WJ, Xi YB, Yin H. Aberrant perfusion and its connectivity within default mode network of first-episode drug-naïve schizophrenia patients and their unaffected first-degree relatives. Sci Rep 2017; 7:16201. [PMID: 29170485 PMCID: PMC5700958 DOI: 10.1038/s41598-017-14343-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 10/06/2017] [Indexed: 02/03/2023] Open
Abstract
Neural substrates behind schizophrenia (SZ) and its heritability mediated by brain function are largely unknown. Cerebral blood flow (CBF), as a biomarker of activation in the brain, reflects the neuronal metabolism, and is promisingly used to detect cerebral alteration thereby shedding light on the features of individuals at high genetic risk. We performed a cross-sectional functional magnetic resonance imaging (MRI) study enrolling 45 first-episode drug-naïve patients with SZ, 32 unaffected first-degree relatives of these patients, and 51 healthy controls (HCs). We examined CBF, CBF connectivity, and CBF topological properties. SZ patients showed increased CBF in the left medial superior frontal gyrus and right precuneus compared with HCs, and decreased CBF in the left middle temporal gyrus compared with their relatives. Furthermore, unaffected relatives revealed higher level of CBF pronounced in regions within default mode network (DMN). Both SZ patients and their relatives exhibited dysconnectivity patterns. Notably, as for the network properties, unaffected relatives were with an intermediate level between SZ patients and HCs in the local efficiency and global efficiency. Our findings demonstrate the aberrant CBF of areas within DMN and the CBF connectivity pattern might be a familial feature in the brain of first-episode SZ patients and their relatives.
Collapse
Affiliation(s)
- Long-Biao Cui
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
- School of Medical Psychology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Liu-Xian Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Ping Tian
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Min Cai
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fan Guo
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chen Li
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yu-Jing Wu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Peng-Gang Qiao
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, China
| | - Zi-Liang Xu
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Lin Liu
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Hong He
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wen-Jun Wu
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yi-Bin Xi
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
| |
Collapse
|
43
|
Stegmayer K, Stettler M, Strik W, Federspiel A, Wiest R, Bohlhalter S, Walther S. Resting state perfusion in the language network is linked to formal thought disorder and poor functional outcome in schizophrenia. Acta Psychiatr Scand 2017; 136:506-516. [PMID: 28865406 PMCID: PMC5656821 DOI: 10.1111/acps.12790] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Formal thought disorder (FTD) is a core symptom in schizophrenia. Here, we focus on resting state cerebral blood flow (rCBF) linked to dimensions of FTD. METHODS We included 47 schizophrenia spectrum patients and 30 age- and gender-matched healthy controls. We assessed FTD with the assessment of thought, language, and communication (TLC) and imaging on a 3T MRI scanner. Within patients, we tested the association of FTD dimensions and in a subgroup (n = 27) the association of functional outcome after 6 months with whole brain rCBF. RESULTS Negative FTD was most prominently associated with perfusion within the superior temporal gyrus, while positive FTD was associated with perfusion within the supplementary motor area, and inferior frontal gyrus. Perfusion within the left supramarginal gyrus was associated with social functioning after 6 months. CONCLUSIONS Distinguishable associations of rCBF with FTD dimensions point to distinct underlying pathophysiology. The location of aberrant perfusion patterns suggests that negative FTD might reflect defective access to semantic memory while positive FTD likely reflects defective suppression of irrelevant information during increased speech production. Finally, the neural correlates of thought block were also predictive of poor functional outcome. Thus, functional outcome and distinct FTD dimensions may share some pathophysiology.
Collapse
Affiliation(s)
- K. Stegmayer
- Translational Research CenterUniversity Hospital of PsychiatryUniversity of BernBernSwitzerland
| | - M. Stettler
- Translational Research CenterUniversity Hospital of PsychiatryUniversity of BernBernSwitzerland
| | - W. Strik
- Translational Research CenterUniversity Hospital of PsychiatryUniversity of BernBernSwitzerland
| | - A. Federspiel
- Translational Research CenterUniversity Hospital of PsychiatryUniversity of BernBernSwitzerland
| | - R. Wiest
- Support Center of Advanced Neuroimaging (SCAN)University Institute of Diagnostic and Interventional NeuroradiologyInselspitalBernSwitzerland
| | - S. Bohlhalter
- Neurology and Neurorehabilitation CenterKantonsspital LuzernLucerneSwitzerland
| | - S. Walther
- Translational Research CenterUniversity Hospital of PsychiatryUniversity of BernBernSwitzerland
| |
Collapse
|
44
|
Abstract
PURPOSE OF REVIEW Motor abnormalities are an intrinsic feature of psychosis. Neurological soft signs, Parkinsonism, dyskinesia, and other motor phenomena are frequently observed in subjects at clinical or genetic risk for psychosis as well as first-episode patients, chronic patients. Here, we review the most recent literature on motor assessments and pathophysiology in psychosis. RECENT FINDINGS Instrumental measures of fine motor performance, balance, spontaneous motor activity, and gesture indicated motor abnormalities in subjects at risk and across stages of schizophrenia. Motor phenomena are associated with distinct symptom dimensions and may indicate poor outcomes. Neuroimaging studies demonstrated altered neural maturation within critical motor networks in subjects at risk. Furthermore, specific categories of motor dysfunction were associated with distinct structural and functional alterations in the motor system in schizophrenia. Motor abnormalities provide a unique window into the pathobiology of psychosis and have the potential to guide screening, staging, and outcome prediction.
Collapse
Affiliation(s)
- Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Murtenstrasse 21, 3008, Bern, Switzerland.
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA.,Department of Psychiatry, Northwestern University, Evanston, IL, USA.,Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA.,Institute for Developmental Science, Northwestern University, Evanston, IL, USA
| |
Collapse
|
45
|
Zhu J, Zhuo C, Xu L, Liu F, Qin W, Yu C. Altered Coupling Between Resting-State Cerebral Blood Flow and Functional Connectivity in Schizophrenia. Schizophr Bull 2017; 43:1363-1374. [PMID: 28521048 PMCID: PMC5737873 DOI: 10.1093/schbul/sbx051] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Respective changes in resting-state cerebral blood flow (CBF) and functional connectivity in schizophrenia have been reported. However, their coupling alterations in schizophrenia remain largely unknown. METHODS 89 schizophrenia patients and 90 sex- and age-matched healthy controls underwent resting-state functional MRI to calculate functional connectivity strength (FCS) and arterial spin labeling imaging to compute CBF. The CBF-FCS coupling of the whole gray matter and the CBF/FCS ratio (the amount of blood supply per unit of connectivity strength) of each voxel were compared between the 2 groups. RESULTS Whole gray matter CBF-FCS coupling was decreased in schizophrenia patients relative to healthy controls. In schizophrenia patients, the decreased CBF/FCS ratio was predominantly located in cognitive- and emotional-related brain regions, including the dorsolateral prefrontal cortex, insula, hippocampus and thalamus, whereas an increased CBF/FCS ratio was mainly identified in the sensorimotor regions, including the putamen, and sensorimotor, mid-cingulate and visual cortices. CONCLUSION These findings suggest that the neurovascular decoupling in the brain may be a possible neuropathological mechanism of schizophrenia.
Collapse
Affiliation(s)
- Jiajia Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Chuanjun Zhuo
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China,Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China,Tianjin Anning Hospital, Tianjin, China
| | - Lixue Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Feng Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China,To whom correspondence should be addressed; Department of Radiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China; tel: +86-22-63062026, fax: +86-22-63062290, e-mail:
| |
Collapse
|
46
|
Walther S, Schäppi L, Federspiel A, Bohlhalter S, Wiest R, Strik W, Stegmayer K. Resting-State Hyperperfusion of the Supplementary Motor Area in Catatonia. Schizophr Bull 2017; 43:972-981. [PMID: 27729486 PMCID: PMC5581902 DOI: 10.1093/schbul/sbw140] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Catatonia is a psychomotor syndrome that not only frequently occurs in the context of schizophrenia but also in other conditions. The neural correlates of catatonia remain unclear due to small-sized studies. We therefore compared resting-state cerebral blood flow (rCBF) and gray matter (GM) density between schizophrenia patients with current catatonia and without catatonia and healthy controls. We included 42 schizophrenia patients and 41 controls. Catatonia was currently present in 15 patients (scoring >2 items on the Bush Francis Catatonia Rating Scale screening). Patients did not differ in antipsychotic medication or positive symptoms. We acquired whole-brain rCBF using arterial spin labeling and GM density. We compared whole-brain perfusion and GM density over all and between the groups using 1-way ANCOVAs (F and T tests). We found a group effect (F test) of rCBF within bilateral supplementary motor area (SMA), anterior cingulate cortex, dorsolateral prefrontal cortex, left interior parietal lobe, and cerebellum. T tests indicated 1 cluster (SMA) to be specific to catatonia. Moreover, catatonia of excited and retarded types differed in SMA perfusion. Furthermore, increased catatonia severity was associated with higher perfusion in SMA. Finally, catatonia patients had a distinct pattern of GM density reduction compared to controls with prominent GM loss in frontal and insular cortices. SMA resting-state hyperperfusion is a marker of current catatonia in schizophrenia. This is highly compatible with a dysregulated motor system in catatonia, particularly affecting premotor areas. Moreover, SMA perfusion was differentially altered in retarded and excited catatonia subtypes, arguing for distinct pathobiology.
Collapse
Affiliation(s)
- Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland;,To whom correspondence should be addressed; Translational Research Center, University Hospital of Psychiatry, Bolligenstrasse 111, 3060 Bern, Switzerland; tel: +41-31-930-9483, fax: +41-31-930-9404, e-mail:
| | - Lea Schäppi
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| |
Collapse
|
47
|
Walther S, Stegmayer K, Federspiel A, Bohlhalter S, Wiest R, Viher PV. Aberrant Hyperconnectivity in the Motor System at Rest Is Linked to Motor Abnormalities in Schizophrenia Spectrum Disorders. Schizophr Bull 2017; 43:982-992. [PMID: 28911049 PMCID: PMC5581901 DOI: 10.1093/schbul/sbx091] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Motor abnormalities are frequently observed in schizophrenia and structural alterations of the motor system have been reported. The association of aberrant motor network function, however, has not been tested. We hypothesized that abnormal functional connectivity would be related to the degree of motor abnormalities in schizophrenia. In 90 subjects (46 patients) we obtained resting stated functional magnetic resonance imaging (fMRI) for 8 minutes 40 seconds at 3T. Participants further completed a motor battery on the scanning day. Regions of interest (ROI) were cortical motor areas, basal ganglia, thalamus and motor cerebellum. We computed ROI-to-ROI functional connectivity. Principal component analyses of motor behavioral data produced 4 factors (primary motor, catatonia and dyskinesia, coordination, and spontaneous motor activity). Motor factors were correlated with connectivity values. Schizophrenia was characterized by hyperconnectivity in 3 main areas: motor cortices to thalamus, motor cortices to cerebellum, and prefrontal cortex to the subthalamic nucleus. In patients, thalamocortical hyperconnectivity was linked to catatonia and dyskinesia, whereas aberrant connectivity between rostral anterior cingulate and caudate was linked to the primary motor factor. Likewise, connectivity between motor cortex and cerebellum correlated with spontaneous motor activity. Therefore, altered functional connectivity suggests a specific intrinsic and tonic neural abnormality in the motor system in schizophrenia. Furthermore, altered neural activity at rest was linked to motor abnormalities on the behavioral level. Thus, aberrant resting state connectivity may indicate a system out of balance, which produces characteristic behavioral alterations.
Collapse
Affiliation(s)
- Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland;,To whom correspondence should be addressed; Translational Research Center, University Hospital of Psychiatry, University of Bern, Murtenstrasse 21, 3008 Bern, Switzerland; tel: +41-31-632-8841, fax: +41-31-632-8950, e-mail:
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | | | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Neuroradiology, University of Bern, Bern, Switzerland
| | - Petra V Viher
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
48
|
Jann K, Hauf M, Kellner Weldon F, El Koussy M, Kiefer C, Federspiel A, Schroth G. Implication of cerebral circulation time in intracranial stenosis measured by digital subtraction angiography on cerebral blood flow estimation measured by arterial spin labeling. Diagn Interv Radiol 2017; 22:481-8. [PMID: 27411297 DOI: 10.5152/dir.2016.15204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Arterial spin labeling (ASL) magnetic resonance imaging to assess cerebral blood flow (CBF) is of increasing interest in basic research and in diagnostic applications, since ASL provides similar information to positron emission tomography about perfusion in vascular territories. However, in patients with steno-occlusive arterial disease (SOAD), CBF as measured by ASL might be underestimated due to delayed bolus arrival, and thus increased spin relaxation. We aimed to estimate the extent to which bolus arrival time (BAT) was delayed in patients with SOAD and whether this resulted in underestimation of CBF. METHODS BAT was measured using digital subtraction angiography (DSA) in ten patients with high-grade stenosis of the middle carotid artery (MCA). Regional CBF was assessed with pseudocontinuous ASL. RESULTS BATs were nonsignificantly prolonged in the stenotic hemisphere 4.1±2.0 s compared with the healthy hemisphere 3.3±0.9 s; however, there were substantial individual differences on the stenotic side. CBF in the anterior and posterior MCA territories were significantly reduced on the stenotic hemisphere. Severe stenosis was correlated with longer BAT and lower quantified CBF. CONCLUSION ASL-based perfusion measurement involves a race between the decay of the spins and the delivery of labeled blood to the region of interest. Special caution is needed when interpreting CBF values quantified in individuals with altered blood flow and delayed circulation times. However, from a clinician's point of view, an accentuation of hypoperfusion (even if caused by underestimation of CBF due to prolonged BATs) might be desirable since it indexes potentially harmful physiologic deficits.
Collapse
Affiliation(s)
- Kay Jann
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry and University of Bern, Bern, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
49
|
Hua J, Brandt AS, Lee S, Blair NIS, Wu Y, Lui S, Patel J, Faria AV, Lim IAL, Unschuld PG, Pekar JJ, van Zijl PCM, Ross CA, Margolis RL. Abnormal Grey Matter Arteriolar Cerebral Blood Volume in Schizophrenia Measured With 3D Inflow-Based Vascular-Space-Occupancy MRI at 7T. Schizophr Bull 2017; 43:620-632. [PMID: 27539951 PMCID: PMC5464028 DOI: 10.1093/schbul/sbw109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Metabolic dysfunction and microvascular abnormality may contribute to the pathogenesis of schizophrenia. Most previous studies of cerebral perfusion in schizophrenia measured total cerebral blood volume (CBV) and cerebral blood flow (CBF) in the brain, which reflect the ensemble signal from the arteriolar, capillary, and venular compartments of the microvasculature. As the arterioles are the most actively regulated blood vessels among these compartments, they may be the most sensitive component of the microvasculature to metabolic disturbances. In this study, we adopted the inflow-based vascular-space-occupancy (iVASO) MRI approach to investigate alterations in the volume of small arterial (pial) and arteriolar vessels (arteriolar cerebral blood volume [CBVa]) in the brain of schizophrenia patients. The iVASO approach was extended to 3-dimensional (3D) whole brain coverage, and CBVa was measured in the brains of 12 schizophrenia patients and 12 matched controls at ultra-high magnetic field (7T). Significant reduction in grey matter (GM) CBVa was found in multiple areas across the whole brain in patients (relative changes of 14%-51% and effect sizes of 0.7-2.3). GM CBVa values in several regions in the temporal cortex showed significant negative correlations with disease duration in patients. GM CBVa increase was also found in a few brain regions. Our results imply that microvascular abnormality may play a role in schizophrenia, and suggest GM CBVa as a potential marker for the disease. Further investigation is needed to elucidate whether such effects are due to primary vascular impairment or secondary to other causes, such as metabolic dysfunction.
Collapse
Affiliation(s)
- Jun Hua
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD;,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Allison S. Brandt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - SeungWook Lee
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | | | - Yuankui Wu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD;,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD;,Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Su Lui
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China;,Department of Radiology, the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jaymin Patel
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Andreia V. Faria
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Issel Anne L. Lim
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD;,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Paul G. Unschuld
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - James J. Pekar
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD;,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Peter C. M. van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD;,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Christopher A. Ross
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD;,Department of Neurology and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD;,Departments of Neuroscience and Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Russell L. Margolis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD;,Department of Neurology and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
50
|
Steinau S, Stegmayer K, Lang FU, Jäger M, Strik W, Walther S. Comparison of psychopathological dimensions between major depressive disorder and schizophrenia spectrum disorders focusing on language, affectivity and motor behavior. Psychiatry Res 2017; 250:169-176. [PMID: 28167432 DOI: 10.1016/j.psychres.2017.01.084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/25/2016] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
Abstract
This study tested whether patients with major depressive disorder (MDD) and schizophrenia spectrum disorders would differ in three dimensions of psychopathology (language, affectivity and motor behavior) as assessed by the Bern Psychopathology Scale (BPS) in a cohort of 58 patients with MDD and 146 patients with schizophrenia spectrum disorders. The overall estimation of severity of each of the three dimensions was rated on a seven-point Likert scale from severely inhibited to severely disinhibited. Here, more than half of the patients endorsed ratings that showed normal or mildly (dis-)inhibited behavior. At group level more pronounced negative ratings of affect were seen in MDD. Group comparisons of the severity ratings on language or motor behavior yielded no differences between schizophrenia spectrum disorders and MDD. At the individuals' levels, extreme ratings in the language and motor dimensions were more frequent in schizophrenia spectrum disorders and in the affectivity dimension more frequent in MDD. Shared psychopathological features could be seen across diagnoses, supporting a dimensional approach to psychopathology in endogenous psychoses. However, the groups differ in the severity of affect ratings as well as in the distribution of language, affectivity and motor ratings with more variance among the group of schizophrenia spectrum disorders.
Collapse
Affiliation(s)
- Sarah Steinau
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Fabian U Lang
- Department of Psychiatry and Psychotherapy II, Ulm University, Günzburg, Germany
| | - Markus Jäger
- Department of Psychiatry and Psychotherapy II, Ulm University, Günzburg, Germany
| | - Werner Strik
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| |
Collapse
|