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Wang HR, Liu ZQ, Nakua H, Hegarty CE, Thies MB, Patel PK, Schleifer CH, Boeck TP, McKinney RA, Currin D, Leathem L, DeRosse P, Bearden CE, Misic B, Karlsgodt KH. Decoding Early Psychoses: Unraveling Stable Microstructural Features Associated With Psychopathology Across Independent Cohorts. Biol Psychiatry 2024:S0006-3223(24)01391-X. [PMID: 38908657 DOI: 10.1016/j.biopsych.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/14/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Patients with early psychosis (EP) (within 3 years after psychosis onset) show significant variability, which makes predicting outcomes challenging. Currently, little evidence exists for stable relationships between neural microstructural properties and symptom profiles across EP diagnoses, which limits the development of early interventions. METHODS A data-driven approach, partial least squares correlation, was used across 2 independent datasets to examine multivariate relationships between white matter properties and symptomatology and to identify stable and generalizable signatures in EP. The primary cohort included patients with EP from the Human Connectome Project for Early Psychosis (n = 124). The replication cohort included patients with EP from the Feinstein Institute for Medical Research (n = 78) as part of the MEND (Multimodal Evaluation of Neural Disorders) Project. Both samples included individuals with schizophrenia, schizoaffective disorder, and psychotic mood disorders. RESULTS In both cohorts, a significant latent component corresponded to a symptom profile that combined negative symptoms, primarily diminished expression, with specific somatic symptoms. Both latent components captured comprehensive features of white matter disruption, primarily a combination of subcortical and frontal association fibers. Strikingly, the partial least squares model trained on the primary cohort accurately predicted microstructural features and symptoms in the replication cohort. Findings were not driven by diagnosis, medication, or substance use. CONCLUSIONS This data-driven transdiagnostic approach revealed a stable and replicable neurobiological signature of microstructural white matter alterations in EP across diagnoses and datasets, showing strong covariance of these alterations with a unique profile of negative and somatic symptoms. These findings suggest the clinical utility of applying data-driven approaches to reveal symptom domains that share neurobiological underpinnings.
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Affiliation(s)
- Haley R Wang
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Zhen-Qi Liu
- Montréal Neurological Institute, McGill University, Montréal, Québec, Canada
| | - Hajer Nakua
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Catherine E Hegarty
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Melanie Blair Thies
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pooja K Patel
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California; Desert Pacific Mental Illness Research, Education, and Clinical Center Greater Los Angeles VA Healthcare System, Los Angeles, California
| | - Charles H Schleifer
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Thomas P Boeck
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Rachel A McKinney
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Danielle Currin
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Logan Leathem
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Pamela DeRosse
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Carrie E Bearden
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Bratislav Misic
- Montréal Neurological Institute, McGill University, Montréal, Québec, Canada
| | - Katherine H Karlsgodt
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California.
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Zhang H, Kuang Q, Li R, Song Z, She S, Zheng Y. Association between homotopic connectivity and clinical symptoms in first-episode schizophrenia. Heliyon 2024; 10:e30347. [PMID: 38707391 PMCID: PMC11066690 DOI: 10.1016/j.heliyon.2024.e30347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 04/13/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024] Open
Abstract
Background Abnormal functional connectivity (FC) in the brain has been observed in schizophrenia patients. However, studies on FC between homotopic brain regions are limited, and the results of these studies are inconsistent. The aim of this study was to compare homotopic connectivity between first-episode schizophrenia (FES) patients and healthy subjects and assess its correlation with clinical symptoms. Methods Thirty-one FES patients and thirty-three healthy controls (HC) were included in the study. The voxel-mirrored homotopic connectivity (VMHC) method of resting-state functional magnetic resonance imaging (rs-fMRI) was used to analyse the changes in homotopic connectivity between the two groups. The 5-factor PANSS model was used to quantitatively evaluate the severity of symptoms in FES patients. Partial correlation analysis was used to assess the correlation between homotopic connectivity changes and clinical symptoms. Results Compared to those in the HC group, VMHC values were decreased in the paracentral lobule (PL), thalamus, and superior temporal gyrus (STG) in the FES group (P < 0.05, FDR correction). No significant differences in white matter volume (WMV) within the subregion of the corpus callosum or in brain regions associated with reduced VMHC were observed between the two groups. Partial correlation analyses revealed that VMHC in the bilateral STG of FES patients was positively correlated with negative symptoms (rleft = 0.46, p < 0.05; rright = 0.47, p < 0.05), and VMHC in the right thalamus was negatively correlated with disorganized/concrete symptoms (rright = 0.45, p < 0.05). Conclusion Our study revealed that homotopic connectivity is altered in the resting-state brain of FES patients and correlates with the severity of negative symptoms; this change may be independent of structural changes in white matter. These findings may contribute to the development of the abnormal connectivity hypothesis in schizophrenia patients.
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Affiliation(s)
| | | | - Ruikeng Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Zhen Song
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
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Wang HR, Liu ZQ, Nakua H, Hegarty CE, Thies MB, Patel PK, Schleifer CH, Boeck TP, McKinney RA, Currin D, Leathem L, DeRosse P, Bearden CE, Misic B, Karlsgodt KH. Decoding Early Psychoses: Unraveling Stable Microstructural Features Associated with Psychopathology Across Independent Cohorts. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.10.593636. [PMID: 38766080 PMCID: PMC11100779 DOI: 10.1101/2024.05.10.593636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background Early Psychosis patients (EP, within 3 years after psychosis onset) show significant variability, making outcome predictions challenging. Currently, little evidence exists for stable relationships between neural microstructural properties and symptom profiles across EP diagnoses, limiting the development of early interventions. Methods A data-driven approach, Partial Least Squares (PLS) correlation, was used across two independent datasets to examine multivariate relationships between white matter (WM) properties and symptomatology, to identify stable and generalizable signatures in EP. The primary cohort included EP patients from the Human Connectome Project-Early Psychosis (n=124). The replication cohort included EP patients from the Feinstein Institute for Medical Research (n=78). Both samples included individuals with schizophrenia, schizoaffective disorder, and psychotic mood disorders. Results In both cohorts, a significant latent component (LC) corresponded to a symptom profile combining negative symptoms, primarily diminished expression, with specific somatic symptoms. Both LCs captured comprehensive features of WM disruption, primarily a combination of subcortical and frontal association fibers. Strikingly, the PLS model trained on the primary cohort accurately predicted microstructural features and symptoms in the replication cohort. Findings were not driven by diagnosis, medication, or substance use. Conclusions This data-driven transdiagnostic approach revealed a stable and replicable neurobiological signature of microstructural WM alterations in EP, across diagnoses and datasets, showing a strong covariance of these alterations with a unique profile of negative and somatic symptoms. This finding suggests the clinical utility of applying data-driven approaches to reveal symptom domains that share neurobiological underpinnings.
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Mu Q, Cui D, Zhang K, Ru Y, Wu C, Fang Z, Jia L, Hu S, Huang M, Lu S. Volume changes of the subcortical limbic structures in major depressive disorder patients with and without anhedonia. Psychiatry Res Neuroimaging 2023; 336:111747. [PMID: 37948916 DOI: 10.1016/j.pscychresns.2023.111747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Anhedonia is a core feature of major depressive disorder (MDD) and the limbic system has been indicated to be associated with anhedonia in MDD due to its crucial role within the reward circuit. However, the relationship between different regions of the limbic system and MDD, particularly anhedonic symptoms, remains unclear. Therefore, the purpose of this study was to investigate volume changes of various parts of the subcortical limbic (ScLimbic) system in MDD with and without anhedonia. A total of 120 individuals, including 30 MDD patients with anhedonia, 43 MDD patients without anhedonia, and 47 healthy controls (HCs) were enrolled in this study. All subjects underwent structural magnetic resonance imaging scans. After that, ScLimbic system segmentation was performed using the FreeSurfer pipeline ScLimbic. Analysis of covariance (ANCOVA) was performed to identify brain regions with significant volume differences among three groups, and then, post hoc tests were calculated for inter-group comparisons. Finally, correlations between volumes of different parts of the ScLimbic and clinical characteristics in MDD patients were further analyzed. The ANCOVA revealed significant volume differences of the ScLimbic system among three groups in the bilateral fornix (Fx), and the right basal forebrain (BF). As compared with HCs, both groups of MDD patients showed decreased volume in the right Fx, meanwhile, MDD patients with anhedonia further exhibited volume reductions in the left Fx and right BF. However, no significant difference was found between MDD patients with and without anhedonia. No significant association was observed between subregion volumes of the ScLimbic system and clinical features in MDD. The present findings demonstrated that MDD patients with and without anhedonia exhibited segregated brain structural alterations in the ScLimbic system and volume loss of the ScLimbic system might be fairly extensive in MDD patients with anhedonia.
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Affiliation(s)
- Qingli Mu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dong Cui
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, China
| | - Kejing Zhang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yanghua Ru
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Psychiatry, The Fifth Peoples' Hospital of Shengzhou, Shaoxing, Zhejiang, China
| | - Congchong Wu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhe Fang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lili Jia
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Clinical Psychology, The Fifth Peoples' Hospital of Lin'an District, Hangzhou, Zhejiang, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China
| | - Shaojia Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China.
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Cengisiz C, Misir E. Dimensional characteristics of persistent negative symptoms in schizophrenia and their relationships with schizotypy in first-degree relatives. Nord J Psychiatry 2023; 77:737-746. [PMID: 37646862 DOI: 10.1080/08039488.2023.2250777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE OF THE ARTICLE Schizophrenia with persistent negative symptoms (PNS) may have different characteristics regarding negative symptom dimensions and heritability patterns. This study aimed to investigate the dimensional characteristics of PNS and their relationships with schizotypal features in first-degree relatives (FDRs). MATERIALS AND METHODS The study included 142 patients, 142 FDRs, and 71 healthy controls (HC). Patients were evaluated with the Positive and Negative Symptom Scale (PANSS), Brief Negative Symptom Scale (BNSS), Calgary Depression Scale for Schizophrenia (CDSS), and Simpson-Angus Scale (SAS). Schizotypy Personality Questionnaire was applied to FDR and HC groups. Clinical symptoms were compared between primary-PNS, secondary-PNS, and non-PNS groups. In addition, schizotypy scores were compared between FDRs and HCs. Then, the relationship between the symptoms of the patients in the PNS group and the schizotypy scores of their relatives was evaluated by multiple regression analysis. RESULTS All negative symptom dimension scores were similar in primary-PNS and secondary-PNS and lowest in non-PNS. PNS-FDR had higher in all schizotypy scores than non-PNS-FDR and HC, except for lack of close friends and social anxiety. In the PNS group, positive symptom severity and PANSS experiential deficit scores significantly predicted positive and negative schizotypy scores in relatives. Negative schizotypy was associated with asociality. CONCLUSIONS The PNS is likely a subtype in which the genetic basis of negative symptoms is stronger and is associated with genetic abnormalities shared by positive and negative schizotypy dimensions in relatives. Family-based genetic studies will be beneficial in enlightening the genetic etiology of PNS.
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Affiliation(s)
- Cengiz Cengisiz
- Manisa Mental Health and Diseases Hospital, Psychiatry Clinic, Manisa, Turkey
| | - Emre Misir
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
- Department of Interdisciplinary Neuroscience, Ankara University, Ankara, Turkey
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Pelizza L, Leuci E, Maestri D, Quattrone E, Azzali S, Paulillo G, Pellegrini P. Longitudinal persistence of negative symptoms in young individuals with first episode schizophrenia: a 24-month multi-modal program follow-up. Nord J Psychiatry 2022; 76:530-538. [PMID: 34936855 DOI: 10.1080/08039488.2021.2015431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Persistent Negative Symptoms (PNS) affect real-world functioning already at the onset of schizophrenia. Longitudinal studies on beneficial effects of psychosocial treatments for PNS in First Episode Schizophrenia (FES) are still relatively scarce. The aim of the current study was to evaluate the longitudinal persistence of PNS in young FES individuals treated according to the multimodal "Early Intervention in Psychosis" (EIP) program over a 2-year follow-up period. MATERIALS AND METHODS 133 FES subjects (aged 12-35 years) were recruited within the Italian EIP program and completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). In accordance with the PNS criteria, we dichotomized FES individuals with and without PNS. In the FES group with PNS, a multiple linear regression analysis was conducted to examine relevant associations between longitudinal PNS levels and the specialized treatment components of our EIP protocol. RESULTS Twenty (15%) FES participants met the PNS criteria. At baseline, PNS levels had relevant positive correlations with functioning decline and PANSS total score. At the end, the 2-years follow-up period, FES subjects with PNS showed a significant decrease in PNS levels. In our linear regression analysis, this reduction was associated with a higher number of individual psychotherapy and case management sessions delivered during our follow-up (together with a shorter DUP [Duration of Untreated Psychosis]). CONCLUSIONS PNS are clinically relevant in a minority of FES individuals. Our results suggest that patient-tailored psychosocial interventions can reduce clinical severity of PNS over a 2-year period.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Davide Maestri
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
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Liang S, Wu Y, Hanxiaoran L, Greenshaw AJ, Li T. Anhedonia in Depression and Schizophrenia: Brain Reward and Aversion Circuits. Neuropsychiatr Dis Treat 2022; 18:1385-1396. [PMID: 35836582 PMCID: PMC9273831 DOI: 10.2147/ndt.s367839] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
Anhedonia, which is defined as markedly diminished interest or pleasure, is a prominent symptom of psychiatric disorders, most notably major depressive disorder (MDD) and schizophrenia. Anhedonia is considered a transdiagnostic symptom that is associated with deficits in neural reward and aversion functions. Here, we review the characteristics of anhedonia in depression and schizophrenia as well as shared or disorder-specific anhedonia-related alterations in reward and aversion pathways of the brain. In particular, we highlight that anhedonia is characterized by impairments in anticipatory pleasure and integration of reward-related information in MDD, whereas anhedonia in schizophrenia is associated with neurocognitive deficits in representing the value of rewards. Dysregulation of the frontostriatal circuit and mesocortical and mesolimbic circuit systems may be the transdiagnostic neurobiological basis of reward and aversion impairments underlying anhedonia in these two disorders. Blunted aversion processing in depression and relatively strong aversion in schizophrenia are primarily attributed to the dysfunction of the habenula, insula, amygdala, and anterior cingulate cortex. Furthermore, patients with schizophrenia appear to exhibit greater abnormal activation and extended functional coupling than those with depression. From a transdiagnostic perspective, understanding the neural mechanisms underlying anhedonia in patients with psychiatric disorders may help in the development of more targeted and efficacious treatment and intervention strategies.
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Affiliation(s)
- Sugai Liang
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
| | - Yue Wu
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
| | - Li Hanxiaoran
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Tao Li
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
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Zhu T, Wang Z, Zhou C, Fang X, Huang C, Xie C, Ge H, Yan Z, Zhang X, Chen J. Meta-analysis of structural and functional brain abnormalities in schizophrenia with persistent negative symptoms using activation likelihood estimation. Front Psychiatry 2022; 13:957685. [PMID: 36238945 PMCID: PMC9552970 DOI: 10.3389/fpsyt.2022.957685] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Persistent negative symptoms (PNS) include both primary and secondary negative symptoms that persist after adequate treatment, and represent an unmet therapeutic need. Published magnetic resonance imaging (MRI) evidence of structural and resting-state functional brain abnormalities in schizophrenia with PNS has been inconsistent. Thus, the purpose of this meta-analysis is to identify abnormalities in structural and functional brain regions in patients with PNS compared to healthy controls. METHODS We systematically searched PubMed, Web of Science, and Embase for structural and functional imaging studies based on five research methods, including voxel-based morphometry (VBM), diffusion tensor imaging (DTI), functional connectivity (FC), the amplitude of low-frequency fluctuation or fractional amplitude of low-frequency fluctuation (ALFF/fALFF), and regional homogeneity (ReHo). Afterward, we conducted a coordinate-based meta-analysis by using the activation likelihood estimation algorithm. RESULTS Twenty-five structural MRI studies and thirty-two functional MRI studies were included in the meta-analyses. Our analysis revealed the presence of structural alterations in patients with PNS in some brain regions including the bilateral insula, medial frontal gyrus, anterior cingulate gyrus, left amygdala, superior temporal gyrus, inferior frontal gyrus, cingulate gyrus and middle temporal gyrus, as well as functional differences in some brain regions including the bilateral precuneus, thalamus, left lentiform nucleus, posterior cingulate gyrus, medial frontal gyrus, and superior frontal gyrus. CONCLUSION Our study suggests that structural brain abnormalities are consistently located in the prefrontal, temporal, limbic and subcortical regions, and functional alterations are concentrated in the thalamo-cortical circuits and the default mode network (DMN). This study provides new insights for targeted treatment and intervention to delay further progression of negative symptoms. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022338669].
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Affiliation(s)
- Tingting Zhu
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zixu Wang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Zhou
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyu Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chengbing Huang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Psychiatry, The Third People's Hospital of Huai'an, Huaian, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine Southeast University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zheng Yan
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Neurocognitive functions in persistent negative symptoms following a first episode of psychosis. Eur Neuropsychopharmacol 2021; 47:86-97. [PMID: 33663901 DOI: 10.1016/j.euroneuro.2021.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/29/2021] [Accepted: 02/11/2021] [Indexed: 02/08/2023]
Abstract
Negative symptoms are present at the onset of psychosis and their persistence is significantly associated with poor psychosocial functioning and lower quality of life. Persistent negative symptoms (PNS) may be idiopathic or secondary to other factors such as depression, positive symptoms, and medication side-effects. Several studies have examined neurocognitive functions in early psychosis patients with PNS relative to non-PNS, but have not systematically controlled for secondary PNS (sPNS). The latter may have a distinct neurocognitive profile that could obscure differences between PNS and non-PNS. Using a large (n = 425) sample, we examined neurocognitive functions in PNS, sPNS, and non-PNS and hypothesized that PNS would be associated with greater impairments relative to non-PNS. Following admission to an early intervention program, a neurocognitive battery was administered after at least 3 months of treatment, and symptom data collected during a subsequent 6-month period were used to classify patients as PNS, sPNS and non-PNS. At month 12, both PNS and sPNS groups had significantly lower level of functioning relative to the non-PNS group but the sPNS group experienced higher levels of depressive and positive symptoms and were on a higher dose of antipsychotics. Relative to non-PNS, PNS patients exhibited significant impairments in verbal memory and working memory, whereas sPNS patients exhibited a trend towards greater impairments in verbal memory. This study confirms that the presence of PNS or sPNS negatively influences functioning with more selective cognitive impairments found in PNS, providing evidence that these groups of patients could benefit from different personalised interventions.
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Adamczyk P, Płonka O, Kruk D, Jáni M, Błądziński P, Kalisz A, Castelein S, Cechnicki A, Wyczesany M. On the relation of white matter brain abnormalities and the asociality symptoms in schizophrenia outpatients - a DTI study. Acta Neurobiol Exp (Wars) 2021; 81:80-95. [PMID: 33949167 DOI: 10.21307/ane-2021-009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/29/2021] [Indexed: 11/11/2022]
Abstract
Recent MRI studies have shown that abnormal functional connections in schizophrenia coexist with subtle changes in the structure of axons in the brain. However, there is a discrepancy in the literature concerning the relationship between white matter abnormalities and the occurrence of negative psychopathological symptoms. In the present study, we investigate the relationship between the altered white matter structure and specific psychopathology symptoms, i.e., subscales of Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptoms Scale (BNSS) in a sample of schizophrenia outpatients. For investigation on white matter abnormalities in schizophrenia, the diffusion tensor imaging analysis of between-group differences in main diffusion parameters by tract-based spatial statistics was conducted on schizophrenia outpatients and healthy controls. Hence, the correlation of PANSS and BNSS psychopathology subscales in the clinical group with fractional anisotropy was analyzed in the 17 selected cortical regions of interest. Presented between-group results revealed widespread loss of white matter integrity located across the brain in schizophrenia outpatients. Results on the white matter relationship with psychopathology revealed the negative correlation between fractional anisotropy in the left orbital prefrontal cortex, right Heschl's gyrus, bilateral precuneus and posterior cingulate cortex and the severity of asociality, as assessed with the BNSS. In conclusion, the presented study confirms the previous evidence on the widespread white matter abnormalities in schizophrenia outpatients and indicates the existence of the subtle but specific association between fractional anisotropy in the fronto-temporo-parietal regions with the asociality. Recent MRI studies have shown that abnormal functional connections in schizophrenia coexist with subtle changes in the structure of axons in the brain. However, there is a discrepancy in the literature concerning the relationship between white matter abnormalities and the occurrence of negative psychopathological symptoms. In the present study, we investigate the relationship between the altered white matter structure and specific psychopathology symptoms, i.e., subscales of Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptoms Scale (BNSS) in a sample of schizophrenia outpatients. For investigation on white matter abnormalities in schizophrenia, the diffusion tensor imaging analysis of between-group differences in main diffusion parameters by tract-based spatial statistics was conducted on schizophrenia outpatients and healthy controls. Hence, the correlation of PANSS and BNSS psychopathology subscales in the clinical group with fractional anisotropy was analyzed in the 17 selected cortical regions of interest. Presented between-group results revealed widespread loss of white matter integrity located across the brain in schizophrenia outpatients. Results on the white matter relationship with psychopathology revealed the negative correlation between fractional anisotropy in the left orbital prefrontal cortex, right Heschl’s gyrus, bilateral precuneus and posterior cingulate cortex and the severity of asociality, as assessed with the BNSS. In conclusion, the presented study confirms the previous evidence on the widespread white matter abnormalities in schizophrenia outpatients and indicates the existence of the subtle but specific association between fractional anisotropy in the fronto-temporo-parietal regions with the asociality.
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Affiliation(s)
| | - Olga Płonka
- Institute of Psychology , Jagiellonian University , Krakow , Poland
| | - Dawid Kruk
- Psychosis Research and Psychotherapy Unit , Association for the Development of Community Psychiatry and Care , Krakow , Poland ; Community Psychiatry and Psychosis Research Center , Chair of Psychiatry , Medical College , Jagiellonian University , Krakow , Poland
| | - Martin Jáni
- Institute of Psychology , Jagiellonian University , Krakow , Poland ; Department of Psychiatry , Faculty of Medicine , Masaryk University and University Hospital Brno , Brno , Czech Republic
| | - Piotr Błądziński
- Community Psychiatry and Psychosis Research Center , Chair of Psychiatry , Medical College , Jagiellonian University , Krakow , Poland
| | - Aneta Kalisz
- Community Psychiatry and Psychosis Research Center , Chair of Psychiatry , Medical College , Jagiellonian University , Krakow , Poland
| | - Stynke Castelein
- Lentis Research , Lentis Psychiatric Institute , Groningen , The Netherlands ; Faculty of Behavioural and Social Sciences , University of Groningen , Groningen , The Netherlands
| | - Andrzej Cechnicki
- Psychosis Research and Psychotherapy Unit , Association for the Development of Community Psychiatry and Care , Krakow , Poland ; Community Psychiatry and Psychosis Research Center , Chair of Psychiatry , Medical College , Jagiellonian University , Krakow , Poland
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11
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Bègue I, Kaiser S, Kirschner M. Pathophysiology of negative symptom dimensions of schizophrenia – Current developments and implications for treatment. Neurosci Biobehav Rev 2020; 116:74-88. [DOI: 10.1016/j.neubiorev.2020.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/13/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
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12
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Apathy in schizophrenia: A review of neuropsychological and neuroanatomical studies. Neuropsychologia 2018; 118:22-33. [DOI: 10.1016/j.neuropsychologia.2017.09.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/28/2017] [Accepted: 09/26/2017] [Indexed: 01/28/2023]
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13
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Grey matter reduction in the caudate nucleus in patients with persistent negative symptoms: An ALE meta-analysis. Schizophr Res 2018; 192:9-15. [PMID: 28390850 DOI: 10.1016/j.schres.2017.04.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 03/20/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES In the present study, we used Activation Likelihood Estimation (ALE) meta-analysis to quantitatively examine brain grey matter reduction in schizophrenia patients with persistent negative symptoms (PNS). METHOD A total of 12 voxel-based morphometry (VBM) studies were included in ALE meta-analysis using more stringent criterion of PNS. RESULTS Significant grey matter reduction in the PNS group relative to controls was observed in the left caudate nucleus, the left precentral region, the left middle frontal region, the bilateral parahippocampal region, the left anterior cingulate region, the bilateral medial frontal gyrus, the thalamus and the insula. CONCLUSION Our results suggest that brain regions in the reward network may be specifically related to PNS, especially the left caudate nucleus. It is possible that abnormality in reward processing may constitute the neural basis of PNS.
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İnce E, Üçok A. Relationship Between Persistent Negative Symptoms and Findings of Neurocognition and Neuroimaging in Schizophrenia. Clin EEG Neurosci 2018; 49:27-35. [PMID: 29243526 DOI: 10.1177/1550059417746213] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Negative symptoms are defined as loss or reduction of otherwise present behaviors or functions in illness situation, and they have constituted an important aspect of schizophrenia. Although negative symptoms have usually been considered as a single entity, neurobiological investigations yielded discrepant results. To overcome challenges that derive from this discrepancy, researchers have proposed several approaches to structure negative symptoms into more homogenous constructs. Concept of persistent negative symptoms (PNS) is one of the proposed approaches, and includes both primary and secondary negative symptoms that persist after adequate treatment. PNS is relatively easy to assess, and by definition, more inclusive; yet it represents an unmet therapeutic need. Therefore, it is a target of several neurobiological and pharmacological studies. There are several structural and functional brain alterations associated with negative symptoms. On the other hand, neurocognitive investigations in patients with schizophrenia have revealed deficits in several domains that showed correlations with negative symptoms. There are several shared features between negative symptoms and neurocognitive deficits in schizophrenia such as prevalence rates, course through the illness, prognostic importance, and impact on social functioning. However, exact mechanisms behind the neurobiology of PNS and how it interacts with neurocognition remain to be explained. Earlier reviews on neuroimaging and neurocognitive correlates of PNS have been focused on studies with broadly defined negative symptoms that were selected by methodological closeness to PNS. In this review, we focus on neural correlates and neurocognitive associations of PNS, and we discuss PNS findings available to date.
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Affiliation(s)
- Ezgi İnce
- 1 Department of Psychiatry, Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey
| | - Alp Üçok
- 1 Department of Psychiatry, Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey
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15
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Amodio A, Quarantelli M, Mucci A, Prinster A, Soricelli A, Vignapiano A, Giordano GM, Merlotti E, Nicita A, Galderisi S. Avolition-Apathy and White Matter Connectivity in Schizophrenia: Reduced Fractional Anisotropy Between Amygdala and Insular Cortex. Clin EEG Neurosci 2018; 49:55-65. [PMID: 29243529 DOI: 10.1177/1550059417745934] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The avolition/apathy domain of negative symptoms includes motivation- and pleasure-related impairments. In people with schizophrenia, structural and functional abnormalities were reported in key regions within the motivational reward system, including ventral-tegmental area (VTA), striatum (especially at the level of the nucleus accumbens, NAcc), orbitofrontal cortex (OFC), as well as amygdala (Amy) and insular cortex (IC). However, the association of the reported abnormalities with avoliton-apathy is still controversial. In the present study, we investigated white matter connectivity patterns within these regions, using a probabilistic analysis of diffusion tensor imaging (DTI) data, in male subjects with schizophrenia. Thirty-five male subjects with schizophrenia (SCZ) and 17 male healthy controls (HC) matched for age, underwent DTI. SCZ were evaluated using the Schedule for Deficit Syndrome (SDS), the Positive and Negative Syndrome Scale (PANSS), and the MATRICS Consensus Cognitive Battery (MCCB). Probabilistic tractography was applied to investigate pathways connecting the Amy and the NAcc with the OFC and IC. Reduced fractional anisotropy (FA) was observed in left Amy-ventral anterior IC connections, in SCZ compared with controls. This abnormality was negatively correlated with avolition/apathy but not with expressive deficit scores. SCZ showed also a reduced connectivity index between right NAcc and medial OFC, as compared with controls. Finally, the left NAcc-dorsal anterior IC connectivity index was negatively correlated with working memory scores. Our results indicate that only the avolition/apathy domain of negative symptoms is related to abnormal connectivity in the motivation-related circuits. The findings also demonstrate that distinct alterations underlie cognitive impairment and avolition/apathy.
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Affiliation(s)
- Antonella Amodio
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Quarantelli
- 2 Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Armida Mucci
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Anna Prinster
- 2 Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Andrea Soricelli
- 3 Department of Integrated Imaging, IRCCS SDN, Naples, Italy.,4 Department of Motor Sciences & Healthiness, University of Naples Parthenope, Naples, Italy
| | - Annarita Vignapiano
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia Maria Giordano
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Eleonora Merlotti
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessia Nicita
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silvana Galderisi
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Mørch-Johnsen L, Agartz I, Jensen J. The Neural Correlates of Negative Symptoms in Schizophrenia: Examples From MRI Literature. Clin EEG Neurosci 2018; 49:12-17. [PMID: 29243527 DOI: 10.1177/1550059417746214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Negative symptoms of schizophrenia have a negative impact on psychosocial functioning and disease outcome. It is therefore important to investigate the pathophysiology underlying negative symptoms as this may aid the development of better treatment. In the current article, examples from studies investigating neural correlates of negative symptoms in schizophrenia are given. Investigations using both structural and functional magnetic resonance imaging are presented at different levels of symptomatology descriptions, from the more heterogenous construct of negative symptoms to more single discrete symptoms. Some methods to improve imaging studies of negative symptoms in schizophrenia are also suggested.
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Affiliation(s)
- Lynn Mørch-Johnsen
- 1 Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,2 NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- 1 Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,2 NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,3 Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jimmy Jensen
- 4 Centre for Psychology, Kristianstad University, Kristianstad, Sweden
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Nenadić I, Hoof A, Dietzek M, Langbein K, Reichenbach JR, Sauer H, Güllmar D. Diffusion tensor imaging of cingulum bundle and corpus callosum in schizophrenia vs. bipolar disorder. Psychiatry Res Neuroimaging 2017; 266:96-100. [PMID: 28644999 DOI: 10.1016/j.pscychresns.2017.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 05/21/2017] [Accepted: 05/23/2017] [Indexed: 01/09/2023]
Abstract
Both schizophrenia and bipolar disorder show abnormalities of white matter, as seen in diffusion tensor imaging (DTI) analyses of major brain fibre bundles. While studies in each of the two conditions have indicated possible overlap in anatomical location, there are few direct comparisons between the disorders. Also, it is unclear whether phenotypically similar subgroups (e.g. patients with bipolar disorder and psychotic features) might share white matter pathologies or be rather similar. Using region-of-interest (ROI) analysis of white matter with diffusion tensor imaging (DTI) at 3 T, we analysed fractional anisotropy (FA), radial diffusivity (RD), and apparent diffusion coefficient (ADC) of the corpus callosum and cingulum bundle in 33 schizophrenia patients, 17 euthymic (previously psychotic) bipolar disorder patients, and 36 healthy controls. ANOVA analysis showed significant main effects of group for RD and ADC (both elevated in schizophrenia). Across the corpus callosum ROIs, there was not group effect on FA, but for RD (elevated in schizophrenia, lower in bipolar disorder) and ADC (higher in schizophrenia, intermediate in bipolar disorder). Our findings show similarities and difference (some gradual) across regions of the two major fibre tracts implicated in these disorders, which would be consistent with a neurobiological overlap of similar clinical phenotypes.
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Affiliation(s)
- Igor Nenadić
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Psychiatry and Psychotherapy, Philipps University Marburg & Marburg University Hospital / UKGM, Marburg, Germany.
| | - Anna Hoof
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Maren Dietzek
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology (IDIR), Jena University Hospital, Jena, Germany
| | - Heinrich Sauer
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Daniel Güllmar
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology (IDIR), Jena University Hospital, Jena, Germany
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Age-related cortical thickness trajectories in first episode psychosis patients presenting with early persistent negative symptoms. NPJ SCHIZOPHRENIA 2016; 2:16029. [PMID: 27602388 PMCID: PMC5007985 DOI: 10.1038/npjschz.2016.29] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/15/2016] [Accepted: 07/07/2016] [Indexed: 12/23/2022]
Abstract
Recent work has clearly established that early persistent negative symptoms (ePNS) can be observed following a first episode of psychosis (FEP), and can negatively affect functional outcome. There is also evidence for cortical changes associated with ePNS. Given that a FEP often occurs during a period of ongoing complex brain development and maturation, neuroanatomical changes may have a specific age-related component. The current study examines cortical thickness (CT) and trajectories with age using longitudinal structural imaging. Structural T1 volumes were acquired at three time points for ePNS (N=21), PNS due to secondary factors (N=31), non-PNS (N=45) patients, and controls (N=48). Images were processed using the CIVET pipeline. Linear mixed models were applied to test for the main effects of (a) group, (b) time, and interactions between (c) time and group membership, and (d) age and group membership. Compared with the non-PNS and secondary PNS patient groups, the ePNS group showed cortical thinning over time in temporal regions and a thickening with age primarily in prefrontal areas. Early PNS patients also had significantly different linear and quadratic age relationships with CT compared with other groups within cingulate, prefrontal, and temporal cortices. The current study demonstrates that FEP patients with ePNS show significantly different CT trajectories with age. Increased CT may be indicative of disruptions in cortical maturation processes within higher-order brain regions. Individuals with ePNS underline a unique subgroup of FEP patients that are differentiated at the clinical level and who exhibit distinct neurobiological patterns compared with their non-PNS peers.
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Psomiades M, Fonteneau C, Mondino M, Luck D, Haesebaert F, Suaud-Chagny MF, Brunelin J. Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study. NEUROIMAGE-CLINICAL 2016; 12:970-975. [PMID: 27995063 PMCID: PMC5153606 DOI: 10.1016/j.nicl.2016.04.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
Auditory verbal hallucinations (AVH) of schizophrenia are associated with a disrupted connectivity between frontal and temporoparietal language areas. We hypothesized that this dysconnectivity is underpinned by white matter abnormalities in the left arcuate fasciculus, the main fiber bundle connecting speech production and perception areas. We therefore investigated the relationship between AVH severity and the integrity of the arcuate fasciculus measured by diffusion tensor imaging (DTI) tractography in patients with schizophrenia. Thirty-eight patients with treatment-resistant schizophrenia were included: 26 presented with daily severe treatment-resistant AVH, 12 reported prominent negative symptoms and no AVH. Fractional anisotropy (FA) was measured along the length of the left and right anterior arcuate fasciculi and severity of AVH was assessed using P3 PANSS item. FA values were significantly higher in the left arcuate fasciculus in patients with AVH than in no AVH patients (F(1,35) = 3.86; p = 0.05). No difference was observed in the right arcuate fasciculus. There was a significant positive correlation between FA value in the left arcuate fasciculus and the severity of AVH (r = 0.36; p = 0.02). No correlation was observed between FA values and PANSS total score suggesting a specific relationship between AVH severity and the left arcuate fasciculus integrity. These results support the hypothesis of a relationship between left frontotemporal connectivity and AVH in patients with schizophrenia and suggest that whilst a disruption of frontotemporal connectivity might be present to ensure the emergence of AVH, more severe anatomical alterations may prevent the occurrence of AVH in patients with schizophrenia. Fractional anisotropy (FA) in the left arcuate fasciculus (AF) correlated with severity of hallucinations. Hallucinating patients had greater FA in the left AF than non-hallucinating patients. We did not find any association between hallucinations and FA in the right AF.
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Affiliation(s)
- Marion Psomiades
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Clara Fonteneau
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marine Mondino
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
| | - David Luck
- Institut Universitaire en Santé Mentale de Montréal Research Center, Québec, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada
| | - Frederic Haesebaert
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marie-Françoise Suaud-Chagny
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France; Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
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Shah JL, Chakravarty MM, Joober R, Lepage M. Dynamic endophenotypes and longitudinal trajectories: capturing changing aspects of development in early psychosis. J Psychiatry Neurosci 2016; 41:148-51. [PMID: 27116900 PMCID: PMC4853205 DOI: 10.1503/jpn.160053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jai L. Shah
- From PEPP-Montréal, Douglas Mental Health University Institute (Shah, Chakravarty, Joober, Lepage); Cerebral Imaging Centre, Douglas Mental Health University Institute (Chakravarty); and the Department of Psychiatry, McGill University (Shah, Chakravarty, Joober, Lepage), Montreal, Que., Canada
| | - M. Mallar Chakravarty
- From PEPP-Montréal, Douglas Mental Health University Institute (Shah, Chakravarty, Joober, Lepage); Cerebral Imaging Centre, Douglas Mental Health University Institute (Chakravarty); and the Department of Psychiatry, McGill University (Shah, Chakravarty, Joober, Lepage), Montreal, Que., Canada
| | - Ridha Joober
- From PEPP-Montréal, Douglas Mental Health University Institute (Shah, Chakravarty, Joober, Lepage); Cerebral Imaging Centre, Douglas Mental Health University Institute (Chakravarty); and the Department of Psychiatry, McGill University (Shah, Chakravarty, Joober, Lepage), Montreal, Que., Canada
| | - Martin Lepage
- From PEPP-Montréal, Douglas Mental Health University Institute (Shah, Chakravarty, Joober, Lepage); Cerebral Imaging Centre, Douglas Mental Health University Institute (Chakravarty); and the Department of Psychiatry, McGill University (Shah, Chakravarty, Joober, Lepage), Montreal, Que., Canada
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