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Trastulla L, Dolgalev G, Moser S, Jiménez-Barrón LT, Andlauer TFM, von Scheidt M, Budde M, Heilbronner U, Papiol S, Teumer A, Homuth G, Völzke H, Dörr M, Falkai P, Schulze TG, Gagneur J, Iorio F, Müller-Myhsok B, Schunkert H, Ziller MJ. Distinct genetic liability profiles define clinically relevant patient strata across common diseases. Nat Commun 2024; 15:5534. [PMID: 38951512 PMCID: PMC11217418 DOI: 10.1038/s41467-024-49338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
Stratified medicine holds great promise to tailor treatment to the needs of individual patients. While genetics holds great potential to aid patient stratification, it remains a major challenge to operationalize complex genetic risk factor profiles to deconstruct clinical heterogeneity. Contemporary approaches to this problem rely on polygenic risk scores (PRS), which provide only limited clinical utility and lack a clear biological foundation. To overcome these limitations, we develop the CASTom-iGEx approach to stratify individuals based on the aggregated impact of their genetic risk factor profiles on tissue specific gene expression levels. The paradigmatic application of this approach to coronary artery disease or schizophrenia patient cohorts identified diverse strata or biotypes. These biotypes are characterized by distinct endophenotype profiles as well as clinical parameters and are fundamentally distinct from PRS based groupings. In stark contrast to the latter, the CASTom-iGEx strategy discovers biologically meaningful and clinically actionable patient subgroups, where complex genetic liabilities are not randomly distributed across individuals but rather converge onto distinct disease relevant biological processes. These results support the notion of different patient biotypes characterized by partially distinct pathomechanisms. Thus, the universally applicable approach presented here has the potential to constitute an important component of future personalized medicine paradigms.
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Affiliation(s)
- Lucia Trastulla
- Max Planck Institute of Psychiatry, Munich, Germany
- Technische Universität München Medical Graduate Center Experimental Medicine, Munich, Germany
- Human Technopole, Milan, Italy
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Georgii Dolgalev
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Sylvain Moser
- Max Planck Institute of Psychiatry, Munich, Germany
- Technische Universität München Medical Graduate Center Experimental Medicine, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Laura T Jiménez-Barrón
- Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Till F M Andlauer
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Moritz von Scheidt
- Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, 80336, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, 80336, Germany
| | - Sergi Papiol
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, 80336, Germany
| | - Alexander Teumer
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Peter Falkai
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, 80336, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julien Gagneur
- School of Computation, Information and Technology, Technical University of Munich, Garching, Germany
- Institute of Human Genetics, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Computational Health Center, Helmholtz Center Munich, Neuherberg, Germany
| | | | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Heribert Schunkert
- Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Michael J Ziller
- Max Planck Institute of Psychiatry, Munich, Germany.
- Department of Psychiatry, University of Münster, Münster, Germany.
- Center for Soft Nanoscience, University of Münster, Münster, Germany.
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Trastulla L, Moser S, Jiménez-Barrón LT, Andlauer TF, von Scheidt M, Budde M, Heilbronner U, Papiol S, Teumer A, Homuth G, Falkai P, Völzke H, Dörr M, Schulze TG, Gagneur J, Iorio F, Müller-Myhsok B, Schunkert H, Ziller MJ. Distinct genetic liability profiles define clinically relevant patient strata across common diseases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289788. [PMID: 37214898 PMCID: PMC10197798 DOI: 10.1101/2023.05.10.23289788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Genome-wide association studies have unearthed a wealth of genetic associations across many complex diseases. However, translating these associations into biological mechanisms contributing to disease etiology and heterogeneity has been challenging. Here, we hypothesize that the effects of disease-associated genetic variants converge onto distinct cell type specific molecular pathways within distinct subgroups of patients. In order to test this hypothesis, we develop the CASTom-iGEx pipeline to operationalize individual level genotype data to interpret personal polygenic risk and identify the genetic basis of clinical heterogeneity. The paradigmatic application of this approach to coronary artery disease and schizophrenia reveals a convergence of disease associated variant effects onto known and novel genes, pathways, and biological processes. The biological process specific genetic liabilities are not equally distributed across patients. Instead, they defined genetically distinct groups of patients, characterized by different profiles across pathways, endophenotypes, and disease severity. These results provide further evidence for a genetic contribution to clinical heterogeneity and point to the existence of partially distinct pathomechanisms across patient subgroups. Thus, the universally applicable approach presented here has the potential to constitute an important component of future personalized medicine concepts.
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Affiliation(s)
- Lucia Trastulla
- Max Planck Institute of Psychiatry, Munich, Germany
- Technische Universität München Medical Graduate Center Experimental Medicine, Munich, Germany
- Human Technopole, Milan, Italy
| | - Sylvain Moser
- Max Planck Institute of Psychiatry, Munich, Germany
- Technische Universität München Medical Graduate Center Experimental Medicine, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Laura T. Jiménez-Barrón
- Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | | | - Moritz von Scheidt
- Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | | | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Alexander Teumer
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany
| | - Henry Völzke
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany
| | - Julien Gagneur
- Department of Informatics, Technical University of Munich, Garching, Germany
| | | | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Heribert Schunkert
- Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Michael J. Ziller
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry, University of Münster, Münster, Germany
- Center for Soft Nanoscience, University of Münster, Münster, Germany
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3
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Abraham M, Mundorf A, Brodmann K, Freund N. Unraveling the mystery of white matter in depression: A translational perspective on recent advances. Brain Behav 2022; 12:e2629. [PMID: 35652161 PMCID: PMC9304855 DOI: 10.1002/brb3.2629] [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: 11/19/2021] [Revised: 04/15/2022] [Accepted: 04/23/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Numerous cortical and subcortical structures have been studied extensively concerning alterations of their integrity as well as their neurotransmitters in depression. However, connections between these structures have received considerably less attention. OBJECTIVE This systematic review presents results from recent neuroimaging as well as neuropathologic studies conducted on humans and other mammals. It aims to provide evidence for impaired white matter integrity in individuals expressing a depressive phenotype. METHODS A systematic database search in accordance with the PRISMA guidelines was conducted to identify imaging and postmortem studies conducted on humans with a diagnosis of major depressive disorder, as well as on rodents and primates subjected to an animal model of depression. RESULTS Alterations are especially apparent in frontal gyri, as well as in structures establishing interhemispheric connectivity between frontal regions. Translational neuropathological findings point to alterations in oligodendrocyte density and morphology, as well as to alterations in the expression of genes related to myelin synthesis. An important role of early life adversities in the development of depressive symptoms and white matter alterations across species is thereby revealed. Data indicating that stress can interfere with physiological myelination patterns is presented. Altered myelination is most notably present in regions that are subject to maturation during the developmental stage of exposure to adversities. CONCLUSION Translational studies point to replicable alterations in white matter integrity in subjects suffering from depression across multiple species. Impaired white matter integrity is apparent in imaging as well as neuropathological studies. Future studies should focus on determining to what extent influencing white matter integrity is able to improve symptoms of depression in animals as well as humans.
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Affiliation(s)
- Mate Abraham
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Annakarina Mundorf
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany.,Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Katja Brodmann
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nadja Freund
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
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Matrone M, Kotzalidis GD, Romano A, Bozzao A, Cuomo I, Valente F, Gabaglio C, Lombardozzi G, Trovini G, Amici E, Perrini F, De Persis S, Iasevoli F, De Filippis S, de Bartolomeis A. Treatment-resistant schizophrenia: Addressing white matter integrity, intracortical glutamate levels, clinical and cognitive profiles between early- and adult-onset patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 114:110493. [PMID: 34883221 DOI: 10.1016/j.pnpbp.2021.110493] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Treatment-resistance in schizophrenia is 30-40%. Its neurobiology remains unclear; to explore it, we conducted a combined spectrometry/tractography/cognitive battery and psychopathological rating study on patients with treatment-resistant schizophrenia (TRS), dividing the sample into early-onset (N = 21) and adult-onset TRS (N = 20). Previous studies did not differentiate between early- (onset 13-18 years) and adult-onset (>18 years at formal diagnosis of schizophrenia) TRS. METHODS We evaluated cross-sectionally 41 TRS patients (26 male and 15 female) and 20 matched healthy controls (HCs) with psychopathological and cognitive testing prior to participating in brain imaging scanning using magnetic resonance spectroscopy and diffusion tensor imaging to determine the relationship between their symptoms and their glutamate levels and white matter integrity. RESULTS TRS patients scored lower than HCs on all cognitive domains; early-onset patients performed better than adult-onset patients only on the Symbol Coding domain. TRS correlated with symptom severity, especially negative symptoms. Glutamate levels and glutamate/creatine were increased in anterior cingulate cortex. Diffusion tensor imaging showed low fractional anisotropy in TRS patients in specific white matter tracts compared to HCs (bilateral anterior thalamic radiation, cortico-spinal tract, forceps minor, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, and right uncinate fasciculus). CONCLUSIONS We identified specific magnetic resonance spectroscopy and diffusion tensor imaging alterations in TRS patients. Adult-onset TRS differed little from early-onset TRS on most measures; this points to alterations being present since the outset of schizophrenia and may constitute a biological signature of treatment-resistance.
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Affiliation(s)
- Marta Matrone
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Georgios D Kotzalidis
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Andrea Romano
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Alessandro Bozzao
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Ilaria Cuomo
- UOC SM I Distretto ASL ROMA 1, C.C. Regina Cœli, Via della Lungara 29, 00165 Rome, Italy.
| | - Francesca Valente
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy; Department of Human Neurosciences, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Italy.
| | - Chiara Gabaglio
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Ginevra Lombardozzi
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Giada Trovini
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Emanuela Amici
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Filippo Perrini
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy; UOC SMREE Distretto ASL ROMA 6, TSMREE, Via S. Biagio, 12, 00049, Velletri, Rome, Italy.
| | - Simone De Persis
- UOSD Attività Terapeutiche Riabilitative per i Disturbi da uso di Sostanze e nuove Dipendenze, ASL Rieti, Via Salaria per Roma 36, 02100 Rieti, Italy.
| | - Felice Iasevoli
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
| | - Sergio De Filippis
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
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5
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Kristensen TD, Glenthøj LB, Ambrosen K, Syeda W, Raghava JM, Krakauer K, Wenneberg C, Fagerlund B, Pantelis C, Glenthøj BY, Nordentoft M, Ebdrup BH. Global fractional anisotropy predicts transition to psychosis after 12 months in individuals at ultra-high risk for psychosis. Acta Psychiatr Scand 2021; 144:448-463. [PMID: 34333760 DOI: 10.1111/acps.13355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychosis spectrum disorders are associated with cerebral changes, but the prognostic value and clinical utility of these findings are unclear. Here, we applied a multivariate statistical model to examine the predictive accuracy of global white matter fractional anisotropy (FA) for transition to psychosis in individuals at ultra-high risk for psychosis (UHR). METHODS 110 UHR individuals underwent 3 Tesla diffusion-weighted imaging and clinical assessments at baseline, and after 6 and 12 months. Using logistic regression, we examined the reliability of global FA at baseline as a predictor for psychosis transition after 12 months. We tested the predictive accuracy, sensitivity and specificity of global FA in a multivariate prediction model accounting for potential confounders to FA (head motion in scanner, age, gender, antipsychotic medication, parental socioeconomic status and activity level). In secondary analyses, we tested FA as a predictor of clinical symptoms and functional level using multivariate linear regression. RESULTS Ten UHR individuals had transitioned to psychosis after 12 months (9%). The model reliably predicted transition at 12 months (χ2 = 17.595, p = 0.040), accounted for 15-33% of the variance in transition outcome with a sensitivity of 0.70, a specificity of 0.88 and AUC of 0.87. Global FA predicted level of UHR symptoms (R2 = 0.055, F = 6.084, p = 0.016) and functional level (R2 = 0.040, F = 4.57, p = 0.036) at 6 months, but not at 12 months. CONCLUSION Global FA provided prognostic information on clinical outcome and symptom course of UHR individuals. Our findings suggest that the application of prediction models including neuroimaging data can inform clinical management on risk for psychosis transition.
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Affiliation(s)
- Tina D Kristensen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise B Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Karen Ambrosen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Warda Syeda
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Melbourne, Vic., Australia
| | - Jayachandra M Raghava
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Kristine Krakauer
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Christina Wenneberg
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christos Pantelis
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Melbourne, Vic., Australia
| | - Birte Y Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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6
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Shu P, Zhu H, Jin W, Zhou J, Tong S, Sun J. The Resilience and Vulnerability of Human Brain Networks Across the Lifespan. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1756-1765. [PMID: 34410925 DOI: 10.1109/tnsre.2021.3105991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Resilience, the ability for a system to maintain its basic functionality when suffering from lesions, is a critical property for human brain, especially in the brain aging process. This study adopted a novel metric of network resilience, the Resilience Index (RI), to assess human brain resilience with three different lifespan datasets. Based on the structural brain networks constructed from diffusion tensor imaging (DTI), we observed an inverted-U relationship between RI and age, that is, RI increased during development and early adulthood, reached a peak at about 35 years old, and then decreased during aging, which suggested that brain resilience could be quantified by RI. Furthermore, we studied brain network vulnerability by the decreases in RI when virtual lesions occurred to nodes (i.e., brain regions) or edges (i.e., structural brain connectivity). We found that the strong edges were markedly vulnerable, and the homotopic edges were the most prominent representatives of vulnerable edges. In other words, an arbitrary attack on homotopic edges would have a high probability to degrade brain network resilience. These findings suggest the change of human brain resilience across the lifespan and provide a new perspective for exploring human brain vulnerability.
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7
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Podwalski P, Tyburski E, Szczygieł K, Waszczuk K, Rek-Owodziń K, Mak M, Plichta P, Bielecki M, Rudkowski K, Kucharska-Mazur J, Andrusewicz W, Misiak B, Szulc A, Michalczyk A, Michałowska S, Sagan L, Samochowiec J. White Matter Integrity of the Corpus Callosum and Psychopathological Dimensions in Deficit and Non-Deficit Schizophrenia Patients. J Clin Med 2021; 10:jcm10112225. [PMID: 34063845 PMCID: PMC8196621 DOI: 10.3390/jcm10112225] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/04/2021] [Accepted: 05/19/2021] [Indexed: 12/19/2022] Open
Abstract
Deficit syndrome (DS) is a subtype of schizophrenia characterized by primary persistent negative symptoms. The corpus callosum (CC) appears to be related to psychopathology in schizophrenia. This study assessed white matter integrity in the CC using diffusion tensor imaging (DTI) in deficit and non-deficit schizophrenia (NDS) patients. We also investigated the psychopathological dimensions of schizophrenia and their relationship to CC integrity. Fifteen DS patients, 40 NDS patients, and 30 healthy controls (HC) underwent psychiatric evaluation and neuroimaging. We divided the CC into five regions and assessed their fractional anisotropy (FA) and mean diffusivity (MD). Psychopathology was assessed with the Positive and Negative Syndrome Scale. DS patients had lower FA than NDS patients and HC, and higher MD in Region 5 of the CC than did HC. NDS patients had higher MD in Region 4 of the CC. The patient groups differed in terms of negative symptoms. After differentiating clinical groups and HC, no significant correlations were observed between DTI measures and psychopathological symptoms. Our results suggest that DS and NDS are characterized by minor impairments of the posterior CC. We confirmed that DS patients have greater negative psychopathology than NDS patients. Our results are preliminary, and further studies are needed.
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Affiliation(s)
- Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
- Correspondence:
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 61-719 Poznan, Poland;
| | - Krzysztof Szczygieł
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Maksymilian Bielecki
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Wojciech Andrusewicz
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Agata Szulc
- Department of Psychiatry, Faculty of Health Sciences, Medical University in Warsaw, 05-802 Warsaw, Poland;
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Sylwia Michałowska
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, 71-004 Szczecin, Poland;
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
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Schoonover KE, Roberts RC. Markers of copper transport in the cingulum bundle in schizophrenia. Schizophr Res 2021; 228:124-133. [PMID: 33434726 PMCID: PMC7988290 DOI: 10.1016/j.schres.2020.11.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/16/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022]
Abstract
Imaging and postmortem studies indicate that schizophrenia subjects exhibit abnormal connectivity in several white matter tracts, including the cingulum bundle. Copper chelators given to experimental animals damage myelin and myelin-producing oligodendrocytes, and the substantia nigra of schizophrenia subjects shows lower levels of copper, copper transporters, and copper-utilizing enzymes. This study aimed to elucidate the potential role of copper homeostasis in white matter pathology in schizophrenia. Protein levels of the copper transporters ATP7A and CTR1, and dysbindin-1, an upstream modulator of copper metabolism and schizophrenia susceptibility factor, were measured using Western blot analyses of the postmortem cingulum bundle of schizophrenia subjects (n=16) and matched controls (n=13). Additionally, the patient group was subdivided by treatment status: off- (n=8) or on-medication (n=8). Relationships between proteins from the current study were correlated among themselves and markers of axonal integrity previously measured in the same cohort. Schizophrenia subjects exhibited similar protein levels to controls, with no effect of antipsychotic treatment. The dysbindin-1A/1BC relationship was positive in controls and schizophrenia subjects; however, antipsychotic treatment appeared to reverse this relationship in a statistically different manner from that of controls and unmedicated subjects. The relationships between dysbindin-1A/neurofilament heavy and ATP7A/α-tubulin were positively correlated in the schizophrenia group that was significantly different from the lack of correlation in controls. Copper transporters and dysbindin-1 appear to be more significantly affected in the grey matter of schizophrenia subjects. However, the relationships among proteins in white matter may be more substantial and dependent on treatment status.
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Affiliation(s)
- Kirsten E Schoonover
- Department of Psychology and Behavioral Neuroscience, University of Alabama at Birmingham, Birmingham, AL 35294, United States of America.
| | - Rosalinda C Roberts
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, United States of America.
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Zamberletti E, Rubino T. Impact of Endocannabinoid System Manipulation on Neurodevelopmental Processes Relevant to Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:616-626. [PMID: 32855107 DOI: 10.1016/j.bpsc.2020.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022]
Abstract
The neurodevelopmental hypothesis of schizophrenia has received much support from epidemiological and neuropathological studies and provides a framework to explain how early developmental abnormalities might manifest as psychosis in early adulthood. According to this theory, the onset of schizophrenia is likely the result of a complex interplay between a genetic predisposition and environmental factors whose respective influence might contribute to the etiology and progression of the disorder. The two most sensitive windows for neurodevelopment are the prenatal/perinatal and the adolescent windows, both of which are characterized by specific processes impinging upon brain structure and functionality, whose alterations may contribute to the onset of schizophrenia. An increasing number of articles suggest the involvement of the endocannabinoid system in the modulation of at least some of these processes, especially in the prenatal/perinatal window. Thus, it is not surprising that disturbing the physiological role of endocannabinoid signaling in these sensitive windows might alter the correct formation of neuronal networks, eventually predisposing to neuropsychiatric diseases later in life. We review the most recent preclinical studies that evaluated the impact of endocannabinoid system modulation in the two sensitive developmental windows on neurodevelopmental processes that possess a specific relevance to schizophrenia.
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Affiliation(s)
- Erica Zamberletti
- Department of Biotechnology and Life Sciences and Neuroscience Center, University of Insubria, Busto Arsizio, Varese, Italy
| | - Tiziana Rubino
- Department of Biotechnology and Life Sciences and Neuroscience Center, University of Insubria, Busto Arsizio, Varese, Italy.
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Ohoshi Y, Takahashi S, Yamada S, Ishida T, Tsuda K, Tsuji T, Terada M, Shinosaki K, Ukai S. Microstructural abnormalities in callosal fibers and their relationship with cognitive function in schizophrenia: A tract-specific analysis study. Brain Behav 2019; 9:e01357. [PMID: 31283112 PMCID: PMC6710197 DOI: 10.1002/brb3.1357] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/14/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The corpus callosum serves the essential role of relaying cognitive information between the homologous regions in the left and the right hemispheres of the brain. Cognitive impairment is a core dysfunction of schizophrenia, but much of its pathophysiology is unknown. The aim of this study was to elucidate the association between microstructural abnormalities of the corpus callosum and cognitive dysfunction in schizophrenia. METHODS We examined stepwise multiple regression analysis to investigate the relationship of the fractional anisotropy (FA) of callosal fibers in each segment with z-scores of each brief assessment of cognition in schizophrenia subtest and cognitive composite score in all subjects (19 patients with schizophrenia [SZ group] and 19 healthy controls [HC group]). Callosal fibers were separated into seven segments based on their cortical projection using tract-specific analysis of diffusion tensor imaging. RESULTS The FA of callosal fibers in the temporal segment was significantly associated with z-scores of token motor test, Tower of London test, and the composite score. In the SZ group, the FA of callosal fibers in the temporal segment was significantly associated with the z-score of the Tower of London test. In addition, the FA of callosal fibers in temporal segment showed significant negative association with the positive and negative syndrome scale negative score in the SZ group. Compared to the HC group, the FA in temporal segment was significantly decreased in the SZ group. CONCLUSION Our results suggest that microstructural abnormalities in the callosal white matter fibers connecting bilateral temporal lobe cortices contribute to poor executive function and severe negative symptom in patients with schizophrenia.
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Affiliation(s)
- Yuji Ohoshi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shinichi Yamada
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Takuya Ishida
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Kumi Tsuda
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Tomikimi Tsuji
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | | | - Kazuhiro Shinosaki
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan.,Asakayama General Hospital, Osaka, Japan
| | - Satoshi Ukai
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
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Li X, Wu K, Zhang Y, Kong L, Bertisch H, DeLisi LE. Altered topological characteristics of morphological brain network relate to language impairment in high genetic risk subjects and schizophrenia patients. Schizophr Res 2019; 208:338-343. [PMID: 30700398 DOI: 10.1016/j.schres.2019.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Evidence suggests relationships between abnormalities in various cortical and subcortical brain structures and language dysfunction in individuals with schizophrenia, and to some extent in those with increased genetic risk for this diagnosis. The topological features of the structural brain network at the systems-level and their impact on language function in schizophrenia and in those at high genetic risk has been less well studied. METHOD Single-subject morphological brain network was constructed in a total of 71 subjects (20 patients with schizophrenia, 19 individuals at high genetic risk for schizophrenia, and 32 controls). Among these 71 subjects, 56 were involved in our previous neuroimaging studies. Graphic Theoretical Techniques was applied to calculate the global and nodal topological characteristics of the morphological brain network of each participant. Index scores for five language-related cognitive tests were also attained from each participant. RESULTS Significantly smaller nodal degree in bilateral superior occipital gyri (SOG) were observed in individuals with schizophrenia, as compared to the controls and those at high risk; while significantly reduced nodal betweenness centrality (quantifying the level of a node in connecting other nodes in the network) in right middle frontal gyrus (MFG) was found in the high-risk group, relative to controls. The right MFG nodal efficiency and hub capacity (represented by both nodal degree and betweenness centrality) of the morphological brain network were negatively associated with the wide range achievement test (WRAT) standard performance score; while the right SOG nodal degree was positively associated with the WRAT standard performance score, in the entire study sample. CONCLUSIONS These findings enhance the understanding of structural brain abnormalities at the systems-level in individuals with schizophrenia and those at high genetic risk, which may serve as critical neural substrates for the origin of the language-related impairments and symptom manifestations of schizophrenia.
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Affiliation(s)
- Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
| | - Kai Wu
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China; Guangdong Engineering Technology Research Center for Diagnosis and Rehabilitation of Dementia, Guangzhou, China.
| | - Yue Zhang
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Lingyin Kong
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | | | - Lynn E DeLisi
- VA Boston Healthcare System, Harvard Medical School, Brockton, MA, USA
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Schoonover KE, Farmer CB, Cash AE, Roberts RC. Pathology of white matter integrity in three major white matter fasciculi: A post-mortem study of schizophrenia and treatment status. Br J Pharmacol 2019; 176:1143-1155. [PMID: 30735241 DOI: 10.1111/bph.14612] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/05/2018] [Accepted: 12/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Imaging studies have shown that people with schizophrenia exhibit abnormal connectivity termed "dysconnectivity" in several white matter tracts, including the cingulum bundle (CB), corpus callosum (CC), and arcuate fasciculus (AF). This study aimed to elucidate potential contributors to schizophrenia "dysconnectivity." EXPERIMENTAL APPROACH Western blot analysis was used to compare protein levels of myelin basic protein, neurofilament heavy, autophagosome marker LC3, and microtubule marker α-tubulin in post-mortem human CB, CC, and AF in schizophrenia subjects (SZ) and matched normal controls (NC). Additionally, SZ cases were subdivided by treatment status: off-medication (OFF) or on-medication (ON). KEY RESULTS In the CC, the combined SZ group exhibited less neurofilament heavy protein than the NCs. In the CB, the combined SZ group had similar levels of α-tubulin protein versus NC, but OFF subjects had increased α-tubulin protein versus ON and NCs. There were significant correlations between α-tubulin and all other proteins but only in the CB. The strong negative relationship between α-tubulin versus myelin basic protein and α-tubulin versus LC3 in NCs was absent in SZs; coefficients comparison showed significant differences. Preliminary race analyses revealed that African American SZ had less AF α-tubulin than Caucasian SZ and African American normal controls. CONCLUSIONS AND IMPLICATIONS The results show a relationship between tract- and protein-specific abnormalities and diagnosis, treatment, and race. These data suggest there is a dysregulation of the relationship between α-tubulin and the other markers of white matter integrity observed in the CB in schizophrenia.
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Affiliation(s)
- Kirsten E Schoonover
- Department of Psychology and Behavioral Neuroscience, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Charlene B Farmer
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew E Cash
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rosalinda C Roberts
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Mamah D, Ji A, Rutlin J, Shimony JS. White matter integrity in schizophrenia and bipolar disorder: Tract- and voxel-based analyses of diffusion data from the Connectom scanner. NEUROIMAGE-CLINICAL 2018; 21:101649. [PMID: 30639179 PMCID: PMC6411967 DOI: 10.1016/j.nicl.2018.101649] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 12/06/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
Abstract
Background Diffusion imaging abnormalities have been associated with schizophrenia (SZ) and bipolar disorder (BD), indicating impaired structural connectivity. Newer methods permit the automated reconstruction of major white matter tracts from diffusion-weighted MR images in each individual's native space. Using high-definition diffusion data from SZ and BP subjects, we investigated brain white matter integrity using both an automated tract-based and voxel-based methods. Methods Using a protocol matched to the NIH (Young-Adult) Human Connectome Project (and collected on the same customized ‘Connectom’ scanner), diffusion scans were acquired from 87 total participants (aged 18–30), grouped as SZ (n = 24), BD (n = 33) and healthy controls (n = 30). Fractional anisotropy (FA) of eighteen white matter tracks were analyzed using the TRACULA software. Voxel-wise statistical analyses of diffusion data was carried out using the tract-based spatial statistics (TBSS) software. TRACULA group effects and clinical correlations were investigated using analyses of variance and multiple regression. Results TRACULA analysis identified a trend towards lower tract FA in SZ patients, most significantly in the left anterior thalamic radiation (ATR; p = .04). TBSS results showed significantly lower FA voxels bilaterally within the cerebellum and unilaterally within the left ATR, posterior thalamic radiation, corticospinal tract, and superior longitudinal fasciculus in SZ patients compared to controls (FDR corrected p < .05). FA in BD patients did not significantly differ from controls using either TRACULA or TBSS. Multiple regression showed FA of the ATR as predicting chronic mania (p = .0005) and the cingulum-angular bundle as predicting recent mania (p = .02) in patients. TBSS showed chronic mania correlating with FA voxels within the left ATR and corpus callosum. Conclusions White matter abnormality in SZ varies in severity across different white matter tract regions. Our results indicate that voxel-based analysis of diffusion data is more sensitive than tract-based analysis in identifying such abnormalities. Absence of white matter abnormality in BD may be related to medication effects and age. Our study investigated white matter integrity in 87 young schizophrenia, bipolar disorder and control subjects with a tract-based (TRACULA) and a voxel-based (TBSS) approach, using high-definition diffusion imaging data obtained from the Human Connectome Project ‘Connectom’ scanner. TRACULA evaluated fractional anisotropy (FA) from 18 white matter tracts. TBSS evaluated regional white matter FA. TRACULA identified a trend towards lower tract FA in schizophrenia subjects across multiple tracts. TBSS results showed mainly unilaterally decreased FA voxels in schizophrenia subjects. FA in bipolar patients did not significantly differ from controls with either method. With TRACULA, multiple regression showed that anterior thalamic radiation FA predicted chronic affectivity and cingulum-angular bundle FA predicted recent mania in patients. With TBSS, chronic mania correlated with FA voxels within the left anterior thalamic radiation and corpus callosum.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
| | - Andrew Ji
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Jerrel Rutlin
- Department Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Joshua S Shimony
- Department Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
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Sex difference in association of symptoms and white matter deficits in first-episode and drug-naive schizophrenia. Transl Psychiatry 2018; 8:281. [PMID: 30563964 PMCID: PMC6298972 DOI: 10.1038/s41398-018-0346-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/10/2018] [Accepted: 11/25/2018] [Indexed: 11/10/2022] Open
Abstract
Accumulating evidence shows that disruption of white matter (WM) may be involved in the pathophysiology of schizophrenia, even at the onset of psychosis. However, very few studies have explored sex difference in its association with psychopathology in schizophrenia. This study aims to compare sex differences in clinical features and WM abnormalities in first-episode and drug-naive (FEDN) schizophrenia among Han Chinese inpatients. The WM fractional anisotropy (FA) values of the whole-brain were determined using voxel-based diffusion tensor imaging (DTI) in 39 (16 males and 23 females) FEDN patients with schizophrenia and 30 healthy controls (13 males and 17 females) matched for gender, age, and education. Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).Our results showed that compared with the controls, the patients showed widespread areas of lower FA, including corpus callosum, brainstem, internal capsule, cingulate, and cerebellum (all adjusted p < 0.01). Further, male patients showed lower FA values in left cingulate (F = 4.92, p = 0.033), but higher scores on the PANSS total, positive, and general psychopathology subscale scores (all p < 0.01) than female patients. Multivariate regression analysis showed that for male patients, FA values in right corpus callosum were positively associated with the PANSS total (beta = 0.785, t = 3.76, p = 0.002) and the negative symptom scores (beta = 0.494, t = 2.20, p = 0.044), while for female patients, FA values in left cingulate were negatively associated with the PANSS positive symptom score (beta = -0.717, t = -2.25, p = 0.041). Our findings indicate sex difference in white matter disconnectivity and its association with psychopathological symptoms in an early course of schizophrenia onset.
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15
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Sacchetti E, Valsecchi P, Tamussi E, Paulli L, Morigi R, Vita A. Psychomotor agitation in subjects hospitalized for an acute exacerbation of Schizophrenia. Psychiatry Res 2018; 270:357-364. [PMID: 30293014 DOI: 10.1016/j.psychres.2018.09.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022]
Abstract
The aims of this study were to establish the prevalence of moderate and severe psychomotor agitation in patients hospitalized for an active phase of schizophrenia, the associations between psychomotor agitation and patients' demographic and clinical variables, the intra-individual stability of the agitated/non-agitated dichotomy in independent psychotic breakdowns. The study was performed on a database relative to 630 inpatients hospitalized with a diagnosis of schizophrenia. Psychomotor agitation was measured with the Positive and Negative Syndrome Scale - Excited Component (PANSS-EC). Prevalence of moderate and severe psychomotor agitation was 40.5% and 23.7%, respectively. Non-agitated patients were older, with longer illness history and duration of untreated psychosis, were more frequently on antipsychotic medication, had lower incidence of recent use of substances, and functioned better before the index hospitalization than moderately and/or severely agitated patients. Non-agitated patients had lower scores for total PANSS and Emsley's positive and anxiety dimensions. Compared with the severely agitated group, non-agitated and moderately agitated patients scored more in Emsley's depression dimension. Poor functioning before index hospital admission, higher scores for negative subscale and Emsley's positive dimension and use of substances exerted an effect on risk of psychomotor agitation.
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Affiliation(s)
| | - Paolo Valsecchi
- Department of Clinical and Experimental Sciences - University of Brescia, Brescia, Italy; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Elena Tamussi
- Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Laura Paulli
- Department of Clinical and Experimental Sciences - University of Brescia, Brescia, Italy; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Raffaele Morigi
- Department of Clinical and Experimental Sciences - University of Brescia, Brescia, Italy; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences - University of Brescia, Brescia, Italy; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
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Cooper S, Alm KH, Olson IR, Ellman LM. White matter alterations in individuals experiencing attenuated positive psychotic symptoms. Early Interv Psychiatry 2018; 12:372-379. [PMID: 26818412 PMCID: PMC4965329 DOI: 10.1111/eip.12306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/15/2015] [Indexed: 01/08/2023]
Abstract
AIM Diffusion tensor imaging (DTI) studies suggest that reduced fractional anisotropy (FA) in the inferior longitudinal fasciculus (ILF) and superior longitudinal fasciculus (SLF) occurs among schizophrenia patients and those at risk for psychosis. Nevertheless, there is a dearth of knowledge investigating white matter fibre pathways in non-help-seeking individuals who endorse attenuated positive psychotic symptoms (APPS) across a range of mental disorders. The aim of the current study was to determine if alterations in ILF and SLF microstructures were specific to distressing APPS related to risk for psychosis or to APPS symptoms occurring in multiple mental disorders, which would suggest a shared phenotype among disorders. METHOD Twenty-six non-help-seeking young adults were administered the Prodromal Questionnaire. DTI was conducted on participants (n = 13) who endorsed eight or more distressing APPS (D-APPS, a potentially clinically relevant group) and those who endorsed three or fewer distressing APPS (low-APPS; n = 13). Semistructured interviews were administered to determine diagnoses, as well as clinical risk for psychosis status. RESULTS Results indicated that the D-APPS group exhibited decreased FA in the left ILF compared with the low-APPS group, even after removing four D-APPS participants who were considered at risk for psychosis. CONCLUSION Findings suggest that white matter microstructure is altered in individuals experiencing APPS across a range of disorders, independent of clinical high risk for psychosis status. Reduced FA in the left ILF may not be specific to psychosis risk, but rather for APPS that occur in a number of mental disorders.
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Affiliation(s)
- Shanna Cooper
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Kylie H Alm
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Ingrid R Olson
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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17
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Krakauer K, Ebdrup BH, Glenthøj BY, Raghava JM, Nordholm D, Randers L, Rostrup E, Nordentoft M. Patterns of white matter microstructure in individuals at ultra-high-risk for psychosis: associations to level of functioning and clinical symptoms. Psychol Med 2017; 47:2689-2707. [PMID: 28464976 DOI: 10.1017/s0033291717001210] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Individuals at ultra-high-risk (UHR) for psychosis present with emerging symptoms and decline in functioning. Previous univariate analyses have indicated widespread white matter (WM) aberrations in multiple brain regions in UHR individuals and patients with schizophrenia. Using multivariate statistics, we investigated whole brain WM microstructure and associations between WM, clinical symptoms, and level of functioning in UHR individuals. METHODS Forty-five UHR individuals and 45 matched healthy controls (HCs) underwent magnetic resonance diffusion tensor imaging (DTI) at 3 Tesla. UHR individuals were assessed with the Comprehensive Assessment of At-Risk Mental States, Scale for the Assessment of Negative Symptoms, and Social and Occupational Functioning Assessment Scale. Partial least-squares correlation analysis (PLSC) was used as statistical method. RESULTS PLSC group comparisons revealed one significant latent variable (LV) accounting for 52% of the cross-block covariance. This LV indicated a pattern of lower fractional anisotropy (FA), axial diffusivity (AD), and mode of anisotropy (MO) concomitant with higher radial diffusivity (RD) in widespread brain regions in UHR individuals compared with HCs. Within UHR individuals, PLSC revealed five significant LVs associated with symptoms and level of functioning. The first LV accounted for 31% of the cross-block covariance and indicated a pattern where higher symptom score and lower level of functioning correlated to lower FA, AD, MO, and higher RD. CONCLUSIONS UHR individuals demonstrate complex brain patterns of WM abnormalities. Despite the subtle psychopathology of UHR individuals, aberrations in WM appear associated with positive and negative symptoms as well as level of functioning.
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Affiliation(s)
- K Krakauer
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
| | - B H Ebdrup
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS,DK-2600 Glostrup,Denmark
| | - B Y Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS,DK-2600 Glostrup,Denmark
| | - J M Raghava
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS,DK-2600 Glostrup,Denmark
| | - D Nordholm
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
| | - L Randers
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
| | - E Rostrup
- Functional Imaging Unit,Clinical Physiology,Nuclear Medicine and PET,Copenhagen University Hospital Rigshospitalet,DK-2600 Glostrup,Denmark
| | - M Nordentoft
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
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18
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Dietsche B, Kircher T, Falkenberg I. Structural brain changes in schizophrenia at different stages of the illness: A selective review of longitudinal magnetic resonance imaging studies. Aust N Z J Psychiatry 2017; 51:500-508. [PMID: 28415873 DOI: 10.1177/0004867417699473] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Schizophrenia is a devastating mental disorder accompanied by aberrant structural brain connectivity. The question whether schizophrenia is a progressive brain disorder is yet to be resolved. Thus, it is not clear when these structural alterations occur and how they develop over time. METHODS In our selective review, we summarized recent findings from longitudinal magnetic resonance imaging studies investigating structural brain alterations and its impact on clinical outcome at different stages of the illness: (1) subjects at ultra-high risk of developing psychosis, (2) patients with a first episode psychosis, and (3) chronically ill patients. Moreover, we reviewed studies examining the longitudinal effects of medication on brain structure in patients with schizophrenia. RESULTS (1) Studies from pre-clinical stages to conversion showed a more pronounced cortical gray matter loss (i.e. superior temporal and inferior frontal regions) in those individuals who later made transition to psychosis. (2) Studies investigating patients with a first episode psychosis revealed a decline in multiple gray matter regions (i.e. frontal regions and thalamus) over time as well as progressive cortical thinning in the superior and inferior frontal cortex. (3) Studies focusing on patients with chronic schizophrenia showed that gray matter decreased to a greater extent (i.e. frontal and temporal areas, thalamus, and cingulate cortices)-especially in poor-outcome patients. Very few studies reported effects on white matter microstructure in the longitudinal course of the illness. CONCLUSION There is adequate evidence to suggest that schizophrenia is associated with progressive gray matter abnormalities particularly during the initial stages of illness. However, causal relationships between structural changes and illness course-especially in chronically ill patients-should be interpreted with caution. Findings might be confounded by longer periods of treatment and higher doses of antipsychotics or epiphenomena related to the illness.
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Affiliation(s)
- Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
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Pan E, Ates MA, Algul A, Aytekin A, Basoglu C, Ebrinc S, Cetin M, Kose S. Fractional Anisotropic Changes of Corpus Callosum Associated with Antipsychotic Treatment in First-Episode Antipsychotic Drug-Naive Patients with Schizophrenia. ACTA ACUST UNITED AC 2017. [DOI: 10.5455/bcp.20160319021659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Erdal Pan
- Department of Psychiatry, Eskisehir Military Hospital, Eskisehir—Turkey
| | - Mehmet Alpay Ates
- Department of Psychiatry, Gulhane Military Medical Academy Haydarpasa Research and Training Hospital, Istanbul - Turkey
| | - Ayhan Algul
- Department of Psychiatry, Gulhane Military Medical Academy Haydarpasa Research and Training Hospital, Istanbul - Turkey
| | - Aykut Aytekin
- Department of Radiology, Balikesir Military Hospital, Balıkesir - Turkey
| | - Cengiz Basoglu
- Department of Psychiatry, Gulhane Military Medical Academy Haydarpasa Research and Training Hospital, Istanbul - Turkey
| | - Servet Ebrinc
- Department of Psychiatry, Gulhane Military Medical Academy Haydarpasa Research and Training Hospital, Istanbul - Turkey
| | - Mesut Cetin
- Department of Psychiatry, Gulhane Military Medical Academy Haydarpasa Research and Training Hospital, Istanbul - Turkey
| | - Samet Kose
- H. Kalyoncu University, Department of Psychology, Gaziantep - Turkey
- University of Texas Medical School of Houston, TX, USA and Center for Neurobehavioral Research on Addictions, Houston, TX, USA
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20
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Stedehouder J, Kushner SA. Myelination of parvalbumin interneurons: a parsimonious locus of pathophysiological convergence in schizophrenia. Mol Psychiatry 2017; 22:4-12. [PMID: 27646261 PMCID: PMC5414080 DOI: 10.1038/mp.2016.147] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 07/09/2016] [Accepted: 07/13/2016] [Indexed: 12/11/2022]
Abstract
Schizophrenia is a debilitating psychiatric disorder characterized by positive, negative and cognitive symptoms. Despite more than a century of research, the neurobiological mechanism underlying schizophrenia remains elusive. White matter abnormalities and interneuron dysfunction are the most widely replicated cellular neuropathological alterations in patients with schizophrenia. However, a unifying model incorporating these findings has not yet been established. Here, we propose that myelination of fast-spiking parvalbumin (PV) interneurons could be an important locus of pathophysiological convergence in schizophrenia. Myelination of interneurons has been demonstrated across a wide diversity of brain regions and appears highly specific for the PV interneuron subclass. Given the critical influence of fast-spiking PV interneurons for mediating oscillations in the gamma frequency range (~30-120 Hz), PV myelination is well positioned to optimize action potential fidelity and metabolic homeostasis. We discuss this hypothesis with consideration of data from human postmortem studies, in vivo brain imaging and electrophysiology, and molecular genetics, as well as fundamental and translational studies in rodent models. Together, the parvalbumin interneuron myelination hypothesis provides a falsifiable model for guiding future studies of schizophrenia pathophysiology.
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Affiliation(s)
- J Stedehouder
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S A Kushner
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
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21
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Zheng Y, Li H, Ning Y, Ren J, Wu Z, Huang R, Luan G, Li T, Bi T, Wang Q, She S. Sluggishness of Early-Stage Face Processing (N170) Is Correlated with Negative and General Psychiatric Symptoms in Schizophrenia. Front Hum Neurosci 2016; 10:615. [PMID: 27965562 PMCID: PMC5124944 DOI: 10.3389/fnhum.2016.00615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/17/2016] [Indexed: 01/07/2023] Open
Abstract
Patients with schizophrenia consistently exhibit abnormalities in the N170 event-related potential (ERP) component evoked by images of faces. However, the relationship between these face-specific N170 abnormalities in patients with schizophrenia and the clinical characteristics of this disorder has not been elucidated. Here, ERP recordings were conducted for patients with schizophrenia and healthy controls. The amplitude and latency of the N170 component were recorded while participants passively viewed face and non-face (table) images to explore the correlation between face-specific processing and clinical characteristics in schizophrenia. The results provided evidence for a face-specific N170 latency delay in patients with schizophrenia. The N170 latency in patients with schizophrenia was significantly longer than that in healthy controls when images of faces were presented in both upright and inverted orientations. Importantly, the face-related N170 latencies of the left temporo-occipital electrodes (P7 and PO7) were positively correlated with both negative and general psychiatric symptoms in these patients. The N170 amplitudes were weaker in patients than in controls for inverted images of both faces and non-faces (tables), with a left-hemisphere dominance. The face inversion effect (FIE), meaning the difference in N170 amplitude between upright and inverted faces, was absent in patients with schizophrenia, suggesting an abnormality of holistic face processing. Together, these results revealed a marked symptom-relevant neural delay associated with face-specific processing in patients with schizophrenia, providing additional evidence to support the demyelination hypothesis of schizophrenia.
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Affiliation(s)
- Yingjun Zheng
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Haijing Li
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Yuping Ning
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Jianjuan Ren
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Zhangying Wu
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Rongcheng Huang
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
| | - Guoming Luan
- Beijing Key Laboratory of Epilepsy, Epilepsy Center, Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical UniversityBeijing, China; Beijing Institute for Brain DisordersBeijing, China
| | - Tianfu Li
- Beijing Key Laboratory of Epilepsy, Epilepsy Center, Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical UniversityBeijing, China; Beijing Institute for Brain DisordersBeijing, China
| | - Taiyong Bi
- Key Laboratory of Cognition and Personality (SWU), Ministry of EducationChongqing, China; Faculty of Psychology, Southwest UniversityChongqing, China
| | - Qian Wang
- Beijing Key Laboratory of Epilepsy, Epilepsy Center, Department of Functional Neurosurgery, Sanbo Brain Hospital, Capital Medical University Beijing, China
| | - Shenglin She
- Department of General Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou, China
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22
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Francis AN, Mothi SS, Mathew IT, Tandon N, Clementz B, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS. Callosal Abnormalities Across the Psychosis Dimension: Bipolar Schizophrenia Network on Intermediate Phenotypes. Biol Psychiatry 2016; 80:627-35. [PMID: 26954565 PMCID: PMC5218825 DOI: 10.1016/j.biopsych.2015.12.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 11/24/2015] [Accepted: 12/15/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND The corpus callosum has been implicated in the pathogenesis of schizophrenia and bipolar disorder. However, it is unclear whether corpus callosum alterations are related to the underlying familial diathesis for psychotic disorders. We examined the corpus callosum and its subregion volumes and their relationship to cognition, psychotic symptoms, and age in probands with schizophrenia (SZ), psychotic bipolar disorder (PBD), and schizoaffective disorder; their first-degree relatives; and healthy control subjects. METHODS We present findings from morphometric and neurocognitive analyses of 1381 subjects (SZ probands, n = 224; PBD probands, n = 190; schizoaffective disorder probands, n = 142; unaffected relatives, n = 483 [SZ relatives, n = 195; PBD relatives, n = 175; schizoaffective disorder relatives, n = 113]; control subjects, n = 342). Magnetization prepared rapid acquisition gradient-echo T1 scans across five sites were obtained using 3-tesla magnets. Image processing was done using FreeSurfer Version 5.1. Neurocognitive function was measured using the Brief Assessment of Cognition in Schizophrenia scale. RESULTS Anterior and posterior splenial volumes were significantly reduced across the groups. The SZ and PBD probands showed robust and significant reductions, whereas relatives showed significant reductions of intermediate severity. The splenial volumes were positively but differentially correlated with aspects of cognition in the probands and their relatives. Proband groups showed a significant age-related decrease in the volume of the anterior splenium compared with control subjects. Among the psychosis groups, the anterior splenium in probands with PBD showed a stronger correlation with psychotic symptoms, as shown by the Positive and Negative Syndrome Scale. All five subregions showed significantly high familiality. CONCLUSIONS The splenial volumes were significantly reduced across the psychosis dimension. However, this volume reduction impacts cognition and clinical manifestation of the illnesses differentially.
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Affiliation(s)
- Alan N Francis
- Brain Imaging Center, McLean Hospital, Harvard Medical School, Belmont, Massachusetts.
| | - Suraj S Mothi
- Beth Israel Deaconess Medical Center, Harvard University, Boston
| | - Ian T Mathew
- Beth Israel Deaconess Medical Center, Harvard University, Boston
| | - Neeraj Tandon
- Beth Israel Deaconess Medical Center, Harvard University, Boston
| | - Brett Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford; Yale University School of Medicine, New Haven, Connecticut
| | - John A Sweeney
- University of Texas Southwestern Medical Center, Dallas, Texas
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23
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Diffusion Tensor MR Imaging Evaluation of Callosal Abnormalities in Schizophrenia: A Meta-Analysis. PLoS One 2016; 11:e0161406. [PMID: 27536773 PMCID: PMC4990171 DOI: 10.1371/journal.pone.0161406] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/04/2016] [Indexed: 12/16/2022] Open
Abstract
Widespread white matter (WM) abnormalities have been found in patients with schizophrenia. Corpus callosum (CC) is the key area that connects the left and right brain hemispheres. However, the results of studies considering different subregions of the CC as regions of interest in patients with schizophrenia have been inconsistent. To obtain a more consistent evaluation of the diffusion characteristics change of the corpus callosum (CC) related to schizophrenia. A meta-analysis involving fractional anisotropy (FA) values in the CC of 729 schizophrenic subjects and 682 healthy controls from 22 studies was conducted. Overall FA values in the CC of the schizophrenic group were less than that of the healthy control group [weighted mean difference (WMD) = -0.021,P< 0.001]. So were the FA values in the genus region (WMD = -0.019, P< 0.001) and the splenium region (WMD = -0.020, P< 0.001) of the CC respectively. The FA reduction was also significant in subjects with chronic schizophrenia (WMD = -0.032, P< 0.001) and first-episode schizophrenia (WMD = -0.014, P = 0.001). In present study, we demonstrated an overall FA decrease in the CC of schizophrenic patients. In the two subgroup analyses of the genu vs splenium region and chronic vs first-episode schizophrenia, the decrease of all groups was significant. Further studies with more homogenous populations and standardized DTI protocols are needed to confirm and extend these findings.
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24
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Seitz J, Zuo JX, Lyall AE, Makris N, Kikinis Z, Bouix S, Pasternak O, Fredman E, Duskin J, Goldstein JM, Petryshen TL, Mesholam-Gately RI, Wojcik J, McCarley RW, Seidman LJ, Shenton ME, Koerte IK, Kubicki M. Tractography Analysis of 5 White Matter Bundles and Their Clinical and Cognitive Correlates in Early-Course Schizophrenia. Schizophr Bull 2016; 42:762-71. [PMID: 27009248 PMCID: PMC4838095 DOI: 10.1093/schbul/sbv171] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE Tractography is the most anatomically accurate method for delineating white matter tracts in the brain, yet few studies have examined multiple tracts using tractography in patients with schizophrenia (SCZ). We analyze 5 white matter connections important in the pathophysiology of SCZ: uncinate fasciculus, cingulum bundle (CB), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus, and arcuate fasciculus (AF). Additionally, we investigate the relationship between diffusion tensor imaging (DTI) markers and neuropsychological measures. METHODS High-resolution DTI data were acquired on a 3 Tesla scanner in 30 patients with early-course SCZ and 30 healthy controls (HC) from the Boston Center for Intervention Development and Applied Research study. After manually guided tracts delineation, fractional anisotropy (FA), trace, radial diffusivity (RD), and axial diffusivity (AD) were calculated and averaged along each tract. The association of DTI measures with the Scales for the Assessment of Negative and Positive Symptoms and neuropsychological measures was evaluated. RESULTS Compared to HC, patients exhibited reduced FA and increased trace and RD in the right AF, CB, and ILF. A discriminant analysis showed the possible use of FA of these tracts for better future group membership classifications. FA and RD of the right ILF and AF were associated with positive symptoms while FA and RD of the right CB were associated with memory performance and processing speed. CONCLUSION We observed white matter alterations in the right CB, ILF, and AF, possibly caused by myelin disruptions. The structural abnormalities interact with cognitive performance, and are linked to clinical symptoms.
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Affiliation(s)
- Johanna Seitz
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Jessica X. Zuo
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Amanda E. Lyall
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Nikos Makris
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA;,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
| | - Zora Kikinis
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Sylvain Bouix
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Ofer Pasternak
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Eli Fredman
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Jonathan Duskin
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Jill M. Goldstein
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA;,Department of Medicine, Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Tracey L. Petryshen
- Department of Psychiatry and Center for Human Genetic Research, Psychiatric and Neurodevelopmental Genetic Unit, Massachusetts General Hospital, Boston, MA;,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Raquelle I. Mesholam-Gately
- Department of Psychiatry, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Joanne Wojcik
- Department of Psychiatry, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Robert W. McCarley
- Department of Psychiatry, Laboratory of Neuroscience, Clinical Neuroscience Division, VA Boston Healthcare System, Brockton, MA
| | - Larry J. Seidman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA;,Department of Psychiatry, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Martha E. Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,VA Boston Healthcare System, Brockton Division, Brockton, MA
| | - Inga K. Koerte
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Marek Kubicki
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
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25
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Wu H, Wang X, Gao Y, Lin F, Song T, Zou Y, Xu L, Lei H. NMDA receptor antagonism by repetitive MK801 administration induces schizophrenia-like structural changes in the rat brain as revealed by voxel-based morphometry and diffusion tensor imaging. Neuroscience 2016; 322:221-33. [DOI: 10.1016/j.neuroscience.2016.02.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 02/17/2016] [Accepted: 02/17/2016] [Indexed: 12/19/2022]
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26
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Abnormal white matter microstructure in drug-naive first episode schizophrenia patients before and after eight weeks of antipsychotic treatment. Schizophr Res 2016; 172:1-8. [PMID: 26852402 DOI: 10.1016/j.schres.2016.01.051] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 01/21/2016] [Accepted: 01/28/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Abnormal white matter integrity has been reported among first episode schizophrenia patients. However, findings on whether it can be reversed by short-term antipsychotic medications are inconsistent. METHOD Diffusion tensor imaging (DTI) was obtained from 55 drug-naive first episode schizophrenia patients and 61 healthy controls, and was repeated among 25 patients and 31 controls after 8 weeks during which patients were medicated with antipsychotics. White matter integrity is measured using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). These measures showing a group difference by Tract-based spatial statistics (TBSS) at baseline were extracted for longitudinal comparisons. RESULTS At baseline, patients exhibited lower FA, higher MD and higher RD versus controls in forceps, left superior longitudinal fasciculus, inferior fronto-occipital fasciculus, left corticospinal tract, left uncinate fasciculus, left anterior thalamic radiation, and bilateral inferior longitudinal fasciculi. FA values of schizophrenia patients correlated with their negative symptoms (r=-0.412, P=0.002), working memory (r=0.377, P=0.005) and visual learning (r=0.281, P=0.038). The longitudinal changes in DTI indices in these tracts did not differ between patients and controls. However, among the patients the longitudinal changes in FA values in left superior longitudinal fasciculus correlated with the change of positive symptoms (r=-0.560, p=0.004), and the change of processing speed (r=0.469, p=0.018). CONCLUSIONS White matter deficits were validated in the present study by a relatively large sample of medication naïve and first episode schizophrenia patients. They could be associated with negative symptoms and cognitive impairment, whereas improvement in white matter integrity of left superior longitudinal fasciculus correlated with improvement in psychosis and processing speed. Further examination of treatment-related changes in white matter integrity may provide clues to the mechanism of antipsychotic response and provide a biomarker for clinical studies.
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27
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Rigucci S, Marques TR, Di Forti M, Taylor H, Dell'Acqua F, Mondelli V, Bonaccorso S, Simmons A, David AS, Girardi P, Pariante CM, Murray RM, Dazzan P. Effect of high-potency cannabis on corpus callosum microstructure. Psychol Med 2016; 46:841-854. [PMID: 26610039 PMCID: PMC4754829 DOI: 10.1017/s0033291715002342] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/30/2015] [Accepted: 10/02/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND The use of cannabis with higher Δ9-tetrahydrocannabinol content has been associated with greater risk, and earlier onset, of psychosis. However, the effect of cannabis potency on brain morphology has never been explored. Here, we investigated whether cannabis potency and pattern of use are associated with changes in corpus callosum (CC) microstructural organization, in patients with first-episode psychosis (FEP) and individuals without psychosis, cannabis users and non-users. METHOD The CC of 56 FEP (37 cannabis users) and 43 individuals without psychosis (22 cannabis users) was virtually dissected and segmented using diffusion tensor imaging tractography. The diffusion index of fractional anisotropy, mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity was calculated for each segment. RESULTS Across the whole sample, users of high-potency cannabis had higher total CC MD and higher total CC AD than both low-potency users and those who never used (p = 0.005 and p = 0.004, respectively). Daily users also had higher total CC MD and higher total CC AD than both occasional users and those who never used (p = 0.001 and p < 0.001, respectively). However, there was no effect of group (patient/individuals without psychosis) or group x potency interaction for either potency or frequency of use. The within-group analysis showed in fact that the effects of potency and frequency were similar in FEP users and in users without psychosis. CONCLUSIONS Frequent use of high-potency cannabis is associated with disturbed callosal microstructural organization in individuals with and without psychosis. Since high-potency preparations are now replacing traditional herbal drugs in many European countries, raising awareness about the risks of high-potency cannabis is crucial.
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Affiliation(s)
- S. Rigucci
- Department of Neurosciences,
Mental Health and Sensory Organs, Sapienza University
of Rome, Rome, Italy
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - T. R. Marques
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - M. Di Forti
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - H. Taylor
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - F. Dell'Acqua
- Centre for Neuroimaging Sciences,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - V. Mondelli
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - S. Bonaccorso
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - A. Simmons
- Centre for Neuroimaging Sciences,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
| | - A. S. David
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - P. Girardi
- Department of Neurosciences,
Mental Health and Sensory Organs, Sapienza University
of Rome, Rome, Italy
| | - C. M. Pariante
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - R. M. Murray
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
| | - P. Dazzan
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and
Neuroscience, King's College London,
London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
and King's College London, London,
UK
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Reid MA, White DM, Kraguljac NV, Lahti AC. A combined diffusion tensor imaging and magnetic resonance spectroscopy study of patients with schizophrenia. Schizophr Res 2016; 170:341-50. [PMID: 26718333 PMCID: PMC5982513 DOI: 10.1016/j.schres.2015.12.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 12/31/2022]
Abstract
Diffusion tensor imaging (DTI) studies in schizophrenia consistently show global reductions in fractional anisotropy (FA), a putative marker of white matter integrity. The cingulum bundle, which facilitates communication between the anterior cingulate cortex (ACC) and hippocampus, is frequently implicated in schizophrenia. Magnetic resonance spectroscopy (MRS) studies report metabolic abnormalities in the ACC and hippocampus of patients. Combining DTI and MRS offers exploration of the relationship between cortical neuronal biochemistry and the integrity of white matter tracts connecting specific cortical regions; however, few studies have attempted this in schizophrenia. Twenty-nine schizophrenia patients and twenty controls participated in this 3 T imaging study in which we used DTI and tract-based spatial statistics (TBSS) to assess white matter integrity and MRS to quantify metabolites in the ACC and hippocampus. We found FA reductions with overlapping radial diffusivity (RD) elevations in patients in multiple tracts, suggesting white matter abnormalities in schizophrenia are driven by loss of myelin integrity. In controls, we found significant negative correlations between hippocampal N-acetylaspartate/creatine and RD and axial diffusivity (AD) as well as a significant negative correlation between FA and ACC glutamate+glutamine/creatine in the hippocampal part of the cingulum bundle. It is possible that the extent of myelin damage could have resulted in the absence of DTI-MRS correlations in our patient group. In conclusion, we demonstrate the potential utility of a multi-modal neuroimaging approach to help further our understanding of the relationship between white matter microstructure and neurochemistry in distinct cortical regions connected by white matter tracts.
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Affiliation(s)
- Meredith A. Reid
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,To whom correspondence should be addressed: Adrienne C. Lahti, MD, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, SC 501, 1720 2 Ave S, Birmingham, AL 35294-0017, USA, +1 205-996-6776, Fax: +1 205-975-4879,
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Wu CH, Hwang TJ, Chen YJ, Hsu YC, Lo YC, Liu CM, Hwu HG, Liu CC, Hsieh MH, Chien YL, Chen CM, Isaac Tseng WY. Primary and secondary alterations of white matter connectivity in schizophrenia: A study on first-episode and chronic patients using whole-brain tractography-based analysis. Schizophr Res 2015; 169:54-61. [PMID: 26443482 DOI: 10.1016/j.schres.2015.09.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 09/15/2015] [Accepted: 09/21/2015] [Indexed: 01/12/2023]
Abstract
Schizophrenia is a debilitating mental disorder that is associated with an impaired connection of cerebral white matter. Studies on patients with chronic and first-episode schizophrenia have found widespread white matter abnormalities. However, it is unclear whether the altered connections are inherent in or secondary to the disease. Here, we sought to identify white matter tracts with altered connections and to distinguish primary or secondary alterations among 74 fiber tracts across the whole brain using an automatic tractography-based analysis method. Thirty-one chronic, 25 first-episode patients with schizophrenia and 31 healthy controls were recruited to receive diffusion spectrum magnetic resonance imaging at 3T. Seven tracts were found to exhibit significant differences between the groups; they included the right arcuate fasciculus, bilateral fornices, left superior longitudinal fasciculus I, and fibers of the corpus callosum to the bilateral dorsolateral prefrontal cortices (DLPFC), bilateral temporal poles, and bilateral hippocampi. Post-hoc between-group analyses revealed that the connection of the callosal fibers to the bilateral DLPFC was significantly decreased in chronic patients but not in first-episode patients. In a stepwise regression analysis, the decline of the tract connection was significantly predicted by the duration of illness. In contrast, the remaining six tracts showed significant alterations in both first-episode and chronic patients and did not associate with clinical variables. In conclusion, reduced white matter connectivity of the callosal fibers to the bilateral DLPFC may be a secondary change that degrades progressively in the chronic stage, whereas alterations in the other six tracts may be inherent in the disease.
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Affiliation(s)
- Chen-Hao Wu
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Jen Chen
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Chin Hsu
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Chun Lo
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Ming Chen
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Molecular Imaging Center, National Taiwan University, Taipei, Taiwan.
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Poletti S, Mazza E, Bollettini I, Locatelli C, Cavallaro R, Smeraldi E, Benedetti F. Adverse childhood experiences influence white matter microstructure in patients with schizophrenia. Psychiatry Res 2015; 234:35-43. [PMID: 26341951 DOI: 10.1016/j.pscychresns.2015.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 07/15/2015] [Accepted: 08/13/2015] [Indexed: 12/18/2022]
Abstract
Integrity of brain white matter (WM) tracts in adulthood could be detrimentally affected by exposure to adverse childhood experiences (ACE). Changes of diffusion tensor imaging (DTI) measures suggesting WM disruption have been reported in patients with schizophrenia together with a history of childhood maltreatment. We therefore hypothesized that ACE could be associated with altered DTI measures of WM integrity in patients with schizophrenia. We tested this hypothesis in 83 schizophrenia patients using whole brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial, and mean diffusivity (MD), and fractional anisotropy (FA). We observed an inverse correlation between severity of ACE and DTI measures of FA, and a positive correlation with MD in several WM tracts including corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus. Lower FA and higher MD are indexes of a reduction in fibre coherence and integrity. The association of ACE to reduced FA and increased MD in key WM tracts contributing to the functional integrity of the brain suggests that ACE might contribute to the pathophysiology of schizophrenia through a detrimental action on structural connectivity in critical cortico-limbic networks.
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Affiliation(s)
- Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
| | - Elena Mazza
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Clara Locatelli
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Enrico Smeraldi
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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Abstract
OBJECTIVES Although acute hypothalamic-pituitary-adrenal axis response to stress is often adaptive, prolonged responses may have detrimental effects. Many components of white matter structures are sensitive to prolonged cortisol exposure. We aimed to identify a behavioral laboratory assay for cortisol response related to brain pathophysiology in schizophrenia. We hypothesized that an abnormally prolonged cortisol response to stress may be linked to abnormal white matter integrity in patients with schizophrenia. METHODS Acute and prolonged salivary cortisol response was measured outside the scanner at pretest and then at 0, 20, and 40 minutes after a psychological stress task in patients with schizophrenia (n = 45) and controls (n = 53). Tract-averaged white matter was measured by 64-direction diffusion tensor imaging in a subset of patients (n = 30) and controls (n = 33). RESULTS Patients who did not tolerate the psychological stress task and quit had greater acute (t = 2.52 [p = .016] and t = 3.51 [p = .001] at 0 and 20 minutes) and prolonged (t = 3.62 [p = .001] at 40 minutes) cortisol reactivity compared with patients who finished the task. Abnormally prolonged cortisol reactivity in patients was significantly associated with reduced white matter integrity (r = -0.468, p = .009). Regardless of task completion status, acute cortisol response was not related to the white matter measures in patients or controls. CONCLUSIONS This paradigm was successful at identifying a subset of patients whose cortisol response was associated with brain pathophysiology. Abnormal cortisol response may adversely affect white matter integrity, partly explaining this pathology observed in schizophrenia. Prolonged stress responses may be targeted for intervention to test for protective effects against white matter damages.
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32
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Patel VS, Kelly S, Wright C, Gupta CN, Arias-Vasquez A, Perrone-Bizzozero N, Ehrlich S, Wang L, Bustillo JR, Morris D, Corvin A, Cannon DM, McDonald C, Donohoe G, Calhoun VD, Turner JA. MIR137HG risk variant rs1625579 genotype is related to corpus callosum volume in schizophrenia. Neurosci Lett 2015; 602:44-9. [PMID: 26123324 DOI: 10.1016/j.neulet.2015.06.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/10/2015] [Accepted: 06/17/2015] [Indexed: 10/23/2022]
Abstract
Genome-wide association studies implicate the MIR137HG risk variant rs1625579 (MIR137HGrv) within the host gene for microRNA-137 as a potential regulator of schizophrenia susceptibility. We examined the influence of MIR137HGrv genotype on 17 subcortical and callosal volumes in a large sample of individuals with schizophrenia and healthy controls (n=841). Although the volumes were overall reduced relative to healthy controls, for individuals with schizophrenia the homozygous MIR137HGrv risk genotype was associated with attenuated reduction of mid-posterior corpus callosum volume (p=0.001), along with trend-level effects in the adjacent central and posterior corpus callosum. These findings are unique in the literature and remain robust after analysis in ethnically homogenous and single-scanner subsets of the larger sample. Thus, our study suggests that the mechanisms whereby MIR137HGrv works to increase schizophrenia risk are not those that generate the corpus callosum volume reductions commonly found in the disorder.
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Affiliation(s)
- Veena S Patel
- The Mind Research Network and Lovelace Respiratory Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Sinead Kelly
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, and Trinity College Institute for Neuroscience, Trinity College Dublin, Ireland.
| | - Carrie Wright
- The Mind Research Network and Lovelace Respiratory Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
| | - Cota Navin Gupta
- The Mind Research Network and Lovelace Respiratory Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Alejandro Arias-Vasquez
- Technische Universität Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Nora Perrone-Bizzozero
- Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
| | - Stefan Ehrlich
- Technische Universität Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Lei Wang
- Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA.
| | - Juan R Bustillo
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
| | - Derek Morris
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, and Trinity College Institute for Neuroscience, Trinity College Dublin, Ireland; Clinical Neuroimaging Laboratory and Cognitive Genetics group, Departments of Psychiatry, Anatomy, Biochemistry and School of Psychology, National University of Ireland, Galway, Ireland.
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, and Trinity College Institute for Neuroscience, Trinity College Dublin, Ireland.
| | - Dara M Cannon
- Clinical Neuroimaging Laboratory and Cognitive Genetics group, Departments of Psychiatry, Anatomy, Biochemistry and School of Psychology, National University of Ireland, Galway, Ireland.
| | - Colm McDonald
- Clinical Neuroimaging Laboratory and Cognitive Genetics group, Departments of Psychiatry, Anatomy, Biochemistry and School of Psychology, National University of Ireland, Galway, Ireland.
| | - Gary Donohoe
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, and Trinity College Institute for Neuroscience, Trinity College Dublin, Ireland; Clinical Neuroimaging Laboratory and Cognitive Genetics group, Departments of Psychiatry, Anatomy, Biochemistry and School of Psychology, National University of Ireland, Galway, Ireland.
| | - Vince D Calhoun
- The Mind Research Network and Lovelace Respiratory Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; Departments of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM 87131, USA.
| | - Jessica A Turner
- The Mind Research Network and Lovelace Respiratory Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; Departments of Psychology and Neurosciences, Georgia State University, Atlanta, GA 30302, USA.
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33
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Whalley HC, Dimitrova R, Sprooten E, Dauvermann MR, Romaniuk L, Duff B, Watson AR, Moorhead B, Bastin M, Semple SI, Giles S, Hall J, Thomson P, Roberts N, Hughes ZA, Brandon NJ, Dunlop J, Whitcher B, Blackwood DHR, McIntosh AM, Lawrie SM. Effects of a Balanced Translocation between Chromosomes 1 and 11 Disrupting the DISC1 Locus on White Matter Integrity. PLoS One 2015; 10:e0130900. [PMID: 26102360 PMCID: PMC4477898 DOI: 10.1371/journal.pone.0130900] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 05/25/2015] [Indexed: 11/18/2022] Open
Abstract
Objective Individuals carrying rare, but biologically informative genetic variants provide a unique opportunity to model major mental illness and inform understanding of disease mechanisms. The rarity of such variations means that their study involves small group numbers, however they are amongst the strongest known genetic risk factors for major mental illness and are likely to have large neural effects. DISC1 (Disrupted in Schizophrenia 1) is a gene containing one such risk variant, identified in a single Scottish family through its disruption by a balanced translocation of chromosomes 1 and 11; t(1;11) (q42.1;q14.3). Method Within the original pedigree, we examined the effects of the t(1;11) translocation on white matter integrity, measured by fractional anisotropy (FA). This included family members with (n = 7) and without (n = 13) the translocation, along with a clinical control sample of patients with psychosis (n = 34), and a group of healthy controls (n = 33). Results We report decreased white matter integrity in five clusters in the genu of the corpus callosum, the right inferior fronto-occipital fasciculus, acoustic radiation and fornix. Analysis of the mixed psychosis group also demonstrated decreased white matter integrity in the above regions. FA values within the corpus callosum correlated significantly with positive psychotic symptom severity. Conclusions We demonstrate that the t(1;11) translocation is associated with reduced white matter integrity in frontal commissural and association fibre tracts. These findings overlap with those shown in affected patients with psychosis and in DISC1 animal models and highlight the value of rare but biologically informative mutations in modeling psychosis.
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MESH Headings
- Adolescent
- Adult
- Bipolar Disorder/genetics
- Bipolar Disorder/pathology
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 1/ultrastructure
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 11/ultrastructure
- Corpus Callosum/pathology
- Cyclothymic Disorder/genetics
- Cyclothymic Disorder/pathology
- Depressive Disorder, Major/genetics
- Depressive Disorder, Major/pathology
- Diffusion Tensor Imaging
- Exons/genetics
- Female
- Humans
- Male
- Middle Aged
- Nerve Tissue Proteins/deficiency
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/physiology
- Schizophrenia/genetics
- Schizophrenia/pathology
- Severity of Illness Index
- Translocation, Genetic
- White Matter/pathology
- Young Adult
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Affiliation(s)
- Heather C. Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - Rali Dimitrova
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Centre for the Developing Brain, St Thomas’ Hospital, King’s College London, London, United Kingdom
| | - Emma Sprooten
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Maria R. Dauvermann
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- McGovern Institute for Brain Research, Cambridge, MA, United States of America
| | - Liana Romaniuk
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Barbara Duff
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew R. Watson
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Bill Moorhead
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark Bastin
- Centre for Clinical Brain Sciences, Western General Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Scott I. Semple
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, United Kingdom
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Stephen Giles
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Jeremy Hall
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Pippa Thomson
- Department of Medical Genetics, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Neil Roberts
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Zoe A. Hughes
- Neuroscience Research Unit, Pfizer Inc, Cambridge, MA, United States of America
| | - Nick J. Brandon
- Neuroscience Research Unit, Pfizer Inc, Cambridge, MA, United States of America
- Current affiliation: AstraZeneca Neuroscience IMED, Cambridge, MA, United States of America
| | - John Dunlop
- Neuroscience Research Unit, Pfizer Inc, Cambridge, MA, United States of America
- Current affiliation: AstraZeneca Neuroscience IMED, Cambridge, MA, United States of America
| | - Brandon Whitcher
- Clinical and Translational Imaging, Pfizer Inc, Cambridge, MA, United States of America
| | | | - Andrew M. McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Stephen M. Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
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Ohtani T, Bouix S, Lyall AE, Hosokawa T, Saito Y, Melonakos E, Westin CF, Seidman LJ, Goldstein J, Mesholam-Gately R, Petryshen T, Wojcik J, Kubicki M. Abnormal white matter connections between medial frontal regions predict symptoms in patients with first episode schizophrenia. Cortex 2015; 71:264-76. [PMID: 26277547 DOI: 10.1016/j.cortex.2015.05.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 04/17/2015] [Accepted: 05/26/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The medial orbitofrontal cortex (mOFC) and rostral part of anterior cingulate cortex (rACC) have been suggested to be involved in the neural network of salience and emotional processing, and associated with specific clinical symptoms in schizophrenia. Considering the schizophrenia dysconnectivity hypothesis, the connectivity abnormalities between mOFC and rACC might be associated with clinical characteristics in first episode schizophrenia patients (FESZ). METHODS After parcellating mOFC into the anterior and posterior part, diffusion properties of the mOFC-rACC white matter connections for 21 patients with FESZ and 21 healthy controls (HCs) were examined using stochastic tractography, one of the most effective Diffusion Tensor Imaging (DTI) methods for examining tracts between adjacent gray matter (GM) regions. RESULTS Fractional anisotropy (FA) reductions were observed in bilateral posterior, but not anterior mOFC-rACC connections (left: p < .0001; right: p < .0001) in FESZ compared to HCs. In addition, reduced FA in the left posterior mOFC-rACC connection was associated with more severe anhedonia-asociality (rho = -.633, p = .006) and total score (rho = -.520, p = .032) in the Scale for the Assessment of Negative Symptoms (SANS); reduced FA in the right posterior mOFC-rACC connection was associated with more severe affective flattening (rho = -.644, p = .005), total score (rho = -.535, p = .027) in SANS, hallucinations (rho = -.551, p = .018), delusions (rho = -.632, p = .005) and total score (rho = -.721, p = .001) in the Scale for the Assessment of Positive Symptoms (SAPS) in FESZ. CONCLUSIONS The observed white matter abnormalities within the connections between mOFC and rACC might be associated with the psychopathology of the early stage of schizophrenia.
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Affiliation(s)
- Toshiyuki Ohtani
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA; Safety and Health Organization, Chiba University, Chiba City, Chiba, Japan
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda E Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Taiga Hosokawa
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA; Tsuchida Hospital, Tokyo, Japan
| | - Yukiko Saito
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neuropsychiatry, Kansai Medical University, Moriguchi City, Osaka, Japan
| | - Eric Melonakos
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carl-Fredrik Westin
- Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Larry J Seidman
- Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jill Goldstein
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Raquelle Mesholam-Gately
- Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Tracey Petryshen
- Stanley Center of Psychiatry Research, Broad Institute of MIT and Harvard, Boston, MA, USA; Psychiatry and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - Joanne Wojcik
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA.
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Xiu Y, Kong XR, Zhang L, Qiu X, Gao Y, Huang CX, Chao FL, Wang SR, Tang Y. The myelinated fiber loss in the corpus callosum of mouse model of schizophrenia induced by MK-801. J Psychiatr Res 2015; 63:132-40. [PMID: 25748751 DOI: 10.1016/j.jpsychires.2015.02.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 01/21/2015] [Accepted: 02/06/2015] [Indexed: 10/23/2022]
Abstract
Previous magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) investigations have shown that the white matter volume and fractional anisotropy (FA) were decreased in schizophrenia (SZ), which indicated impaired white matter integrity in SZ. However, the mechanism underlying these abnormalities has been less studied. The current study was designed to investigate the possible reasons for white matter abnormalities in the mouse model of SZ induced by NMDA receptor antagonist using the unbiased stereological methods and transmission electron microscope technique. We found that the mice treated with MK-801 demonstrated a series of schizophrenia-like behaviors including hyperlocomotor activity and more anxiety. The myelinated fibers in the corpus callosum (CC) of the mice treated with MK-801 were impaired with splitting lamellae of myelin sheaths and segmental demyelination. The CC volume and the total length of the myelinated fibers in the CC of the mice treated with MK-801 were significantly decreased by 9.4% and 16.8% when compared to those of the mice treated with saline. We further found that the loss of the myelinated fibers length was mainly due to the marked loss of the myelinated nerve fibers with the diameter of 0.4-0.5 μm. These results indicated that the splitting myelin sheaths, demyelination and the loss of myelinated fibers with small diameter might provide one of the structural bases for impaired white matter integrity of CC in the mouse model of SZ. These results might also provide a baseline for further studies searching for the treatment of SZ through targeting white matter.
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Affiliation(s)
- Yun Xiu
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, PR China; Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China
| | - Xiang-ru Kong
- Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China
| | - Lei Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China
| | - Xuan Qiu
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China
| | - Yuan Gao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Department of Geriatrics, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, PR China
| | - Chun-xia Huang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Department of Physiology, Chongqing Medical University, Chongqing 400016, PR China
| | - Feng-lei Chao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China
| | - San-rong Wang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China.
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Li HJ, Xu Y, Zhang KR, Hoptman MJ, Zuo XN. Homotopic connectivity in drug-naïve, first-episode, early-onset schizophrenia. J Child Psychol Psychiatry 2015; 56:432-43. [PMID: 25130214 PMCID: PMC4333112 DOI: 10.1111/jcpp.12307] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND The disconnection hypothesis of schizophrenia has been extensively tested in adults. Recent studies have reported the presence of brain disconnection in younger patients, adding evidence to support the neurodevelopmental hypothesis of schizophrenia. Because of drug confounds in chronic and medicated patients, it has been extremely challenging for researchers to directly investigate abnormalities in the development of connectivity and their role in the pathophysiology of schizophrenia. The present study aimed to examine functional homotopy - a measure of interhemispheric connection - and its relevance to clinical symptoms in first-episode drug-naïve early-onset schizophrenia (EOS) patients. METHODS Resting-state functional magnetic resonance imaging was performed in 26 first-episode drug-naïve EOS patients (age: 14.5 ± 1.94, 13 males) and 25 matched typically developing controls (TDCs) (age: 14.4 ± 2.97, 13 males). We were mainly concerned with the functional connectivity between any pair of symmetric interhemispheric voxels (i.e., functional homotopy) measured by voxel-mirrored homotopic connectivity (VMHC). RESULTS Early-onset schizophrenia patients exhibited both global and regional VMHC reductions in comparison with TDCs. Reduced VMHC values were observed within the superior temporal cortex and postcentral gyrus. These interhemispheric synchronization deficits were negatively correlated with negative symptom of the Positive and Negative Syndrome Scale. Moreover, regions of interest analyses based on left and right clusters of temporal cortex and postcentral gyrus revealed abnormal heterotopic connectivity in EOS patients. CONCLUSIONS Our findings provide novel neurodevelopmental evidence for the disconnection hypothesis of schizophrenia and suggest that these alterations occur early in the course of the disease and are independent of medication status.
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Affiliation(s)
- Hui-Jie Li
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Chinese Academy of Sciences, Beijing, China,Laboratory for Functional Connectome and Development, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yong Xu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ke-Rang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Matthew J. Hoptman
- Department of Psychiatry, New York University School of Medicine, New York, USA,Schizophrenia Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, USA
| | - Xi-Nian Zuo
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Chinese Academy of Sciences, Beijing, China,Laboratory for Functional Connectome and Development, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Balevich EC, Haznedar MM, Wang E, Newmark RE, Bloom R, Schneiderman JS, Aronowitz J, Tang CY, Chu KW, Byne W, Buchsbaum MS, Hazlett EA. Corpus callosum size and diffusion tensor anisotropy in adolescents and adults with schizophrenia. Psychiatry Res 2015; 231:244-51. [PMID: 25637358 PMCID: PMC4363270 DOI: 10.1016/j.pscychresns.2014.12.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 11/07/2014] [Accepted: 12/11/2014] [Indexed: 01/18/2023]
Abstract
The corpus callosum has been implicated as a region of dysfunctional connectivity in schizophrenia, but the association between age and callosal pathology is unclear. Magnetic resonance imaging (MRI) and diffusion-tensor imaging (DTI) were performed on adults (n=34) and adolescents (n=17) with schizophrenia and adult (n=33) and adolescent (n=15) age- and sex-matched healthy controls. The corpus callosum was manually traced on each participant׳s MRI, and the DTI scan was co-registered to the MRI. The corpus callosum was divided into five anteroposterior segments. Area and anisotropy were calculated for each segment. Both patient groups demonstrated reduced callosal anisotropy; however, the adolescents exhibited reductions mostly in anterior regions while the reductions were more prominent in posterior regions of the adults. The adolescent patients showed greater decreases in absolute area as compared with the adult patients, particularly in the anterior segments. However, the adults showed greater reductions when area was considered relative to whole brain white matter volume. Our results suggest that the initial stages of the illness are characterized by deficiencies in frontal connections, and the chronic phase is characterized by deficits in the posterior corpus callosum; or, alternatively, adolescent-onset schizophrenia may represent a different or more severe form of the illness.
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Affiliation(s)
- Emily C. Balevich
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA,The Graduate Center, City University of New York, New York, NY, 10016, USA
| | - M. Mehmet Haznedar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA,Outpatient Psychiatry Care Center, James J. Peters VA Medical Center, Bronx, NY, 10468, USA
| | - Eugene Wang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Randall E. Newmark
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Rachel Bloom
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jason S. Schneiderman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jonathan Aronowitz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Cheuk Y. Tang
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - King-Wai Chu
- Research and Development and VISN 3 Mental Illness Research, Education, and Clinical Care Center, James J. Peters VA Medical Center, Bronx, NY, 10468, USA
| | - William Byne
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA,Outpatient Psychiatry Care Center, James J. Peters VA Medical Center, Bronx, NY, 10468, USA,Research and Development and VISN 3 Mental Illness Research, Education, and Clinical Care Center, James J. Peters VA Medical Center, Bronx, NY, 10468, USA
| | - Monte S. Buchsbaum
- Departments of Psychiatry and Radiology, University of California, San Diego School of Medicine, 92093, USA
| | - Erin A. Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA,Research and Development and VISN 3 Mental Illness Research, Education, and Clinical Care Center, James J. Peters VA Medical Center, Bronx, NY, 10468, USA,Address correspondence to: Erin A. Hazlett, Ph.D, Tel.: (718) 584-9000 x3701, Fax: (718) 364-3576,
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38
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Gupta CN, Chen J, Liu J, Damaraju E, Wright C, Perrone-Bizzozero NI, Pearlson G, Luo L, Michael AM, Turner JA, Calhoun VD. Genetic markers of white matter integrity in schizophrenia revealed by parallel ICA. Front Hum Neurosci 2015; 9:100. [PMID: 25784871 PMCID: PMC4347454 DOI: 10.3389/fnhum.2015.00100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 02/10/2015] [Indexed: 11/13/2022] Open
Abstract
It is becoming a consensus that white matter integrity is compromised in schizophrenia (SZ), however the underlying genetics remains elusive. Evidence suggests a polygenic basis of the disorder, which involves various genetic variants with modest individual effect sizes. In this work, we used a multivariate approach, parallel independent component analysis (P-ICA), to explore the genetic underpinnings of white matter abnormalities in SZ. A pre-filtering step was first applied to locate 6527 single nucleotide polymorphisms (SNPs) discriminating patients from controls with a nominal uncorrected p-value of 0.01. These potential susceptibility loci were then investigated for associations with fractional anisotropy (FA) images in a cohort consisting of 73 SZ patients and 87 healthy controls (HC). A significant correlation (r = −0.37, p = 1.25 × 10−6) was identified between one genetic factor and one FA component after controlling for scanning site, ethnicity, age, and sex. The identified FA-SNP association remained stable in a 10-fold validation. A 5000-run permutation test yielded a p-value of 2.00 × 10−4. The FA component reflected decreased white matter integrity in the forceps major for SZ patients. The SNP component was overrepresented in genes whose products are involved in corpus callosum morphology (e.g., CNTNAP2, NPAS3, and NFIB) as well as canonical pathways of synaptic long term depression and protein kinase A signaling. Taken together, our finding delineates a part of genetic architecture underlying SZ-related FA reduction, emphasizing the important role of genetic variants involved in neural development.
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Affiliation(s)
| | - Jiayu Chen
- The Mind Research Network Albuquerque, NM, USA
| | - Jingyu Liu
- The Mind Research Network Albuquerque, NM, USA ; Department of Electrical and Computer Engineering, University of New Mexico Albuquerque, NM, USA
| | | | - Carrie Wright
- The Mind Research Network Albuquerque, NM, USA ; Department of Neurosciences, School of Medicine, University of New Mexico Albuquerque, NM, USA
| | | | - Godfrey Pearlson
- Departments of Psychiatry, Yale University School of Medicine New Haven, CT, USA ; Olin Neuropsychiatry Research Center, Institute of Living Hartford, CT, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Albuquerque, NM, USA
| | | | - Jessica A Turner
- The Mind Research Network Albuquerque, NM, USA ; Department of Psychology and Neuroscience Institute, Georgia State University Atlanta, GA, USA
| | - Vince D Calhoun
- The Mind Research Network Albuquerque, NM, USA ; Department of Electrical and Computer Engineering, University of New Mexico Albuquerque, NM, USA ; Department of Neurosciences, School of Medicine, University of New Mexico Albuquerque, NM, USA ; Departments of Psychiatry, Yale University School of Medicine New Haven, CT, USA
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Abnormal white matter integrity in antipsychotic-naïve first-episode psychosis patients assessed by a DTI principal component analysis. Schizophr Res 2015; 162:14-21. [PMID: 25620120 PMCID: PMC4339463 DOI: 10.1016/j.schres.2015.01.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/09/2015] [Accepted: 01/12/2015] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Diffusion tensor imaging (DTI) studies in patients with schizophrenia have shown abnormalities in the microstructure of white matter tracts. Specifically, reduced fractional anisotropy (FA) has been described across multiple white matter tracts, in studies that have mainly included patients treated with antipsychotic medications. OBJECTIVE To compare FA in antipsychotic-naïve patients experiencing a first episode of psychosis (FEP) to FA in healthy controls to demonstrate that the variance of FA can be grouped, in a coincidental manner, in four predetermined factors in accordance with a theoretical partition of the white matter tracts, using a principal components analysis (PCA). METHODS Thirty-five antipsychotic-naïve FEP patients and 35 age- and gender-matched healthy controls underwent DTI at 3T. Analysis was performed using a tract-based spatial statistics (TBSS) method and exploratory PCA. RESULTS DTI analysis showed extensive FA reduction in white matter tracts in FEP patients compared with the control group. The PCA grouped the white matter tracts into four factors explaining 66% of the total variance. Comparison of the FA values within each factor highlighted the differences between FEP patients and controls. DISCUSSION Our study confirms extensive white matter tracts anomalies in patients with schizophrenia, more specifically, in drug-naïve FEP patients. The results also indicate that a small number of white matter tracts share common FA anomalies that relate to deficit symptoms in FEP patients. Our study adds to a growing body of literature emphasizing the need for treatments targeting white matter function and structure in FEP patients.
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40
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Wigand M, Kubicki M, von Hohenberg CC, Leicht G, Karch S, Eckbo R, Pelavin PE, Hawley K, Rujescu D, Bouix S, Shenton ME, Mulert C. Auditory verbal hallucinations and the interhemispheric auditory pathway in chronic schizophrenia. World J Biol Psychiatry 2015; 16:31-44. [PMID: 25224883 PMCID: PMC4698973 DOI: 10.3109/15622975.2014.948063] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The interhemispheric auditory pathway has been shown to play a crucial role in the processing of acoustic stimuli, and alterations of structural and functional connectivity between bilateral auditory areas are likely relevant to the pathogenesis of auditory verbal hallucinations (AVHs). The aim of this study was to examine this pathway in patients with chronic schizophrenia regarding their lifetime history of AVHs. METHODS DTI scans were acquired from 33 healthy controls (HC), 24 schizophrenia patients with a history of AVHs (LT-AVH) and nine schizophrenia patients without any lifetime hallucinations (N-LT-AVH). The interhemispheric auditory fibre bundles were extracted using streamline tractography. Subsequently, diffusivity indices, namely Fractional Anisotropy (FA), Trace, Mode, Axial and Radial diffusivity, were calculated. RESULTS FA was decreased over the entire pathway in LT-AVH compared with N-LT-AVH. Moreover, LT-AVH displayed decreased FA and Mode as well as increased radial diffusivity in the midsagittal section of the fibre tract. CONCLUSIONS These findings indicate complex microstructural changes in the interhemispheric auditory pathway of schizophrenia patients with a history of AVHs. Alterations appear to be absent in patients who have never hallucinated.
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Affiliation(s)
- Marlene Wigand
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marek Kubicki
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Christian Clemm von Hohenberg
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Gregor Leicht
- Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Karch
- Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Ryan Eckbo
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Paula E. Pelavin
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Hawley
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Dan Rujescu
- Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychiatry, University Hospital and Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sylvain Bouix
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Martha E. Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Veterans Affairs Boston Healthcare System and Harvard Medical School, Brockton, MA, USA
| | - Christoph Mulert
- Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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41
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Canu E, Agosta F, Filippi M. A selective review of structural connectivity abnormalities of schizophrenic patients at different stages of the disease. Schizophr Res 2015; 161:19-28. [PMID: 24893909 DOI: 10.1016/j.schres.2014.05.020] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 05/02/2014] [Accepted: 05/09/2014] [Indexed: 12/22/2022]
Abstract
Schizophrenia has long been hypothesized to result from a disconnection syndrome due to a disruption of the association fibers of the brain. However, only with the advent of in vivo neuroimaging, a formal disconnectivity hypothesis for schizophrenia has been developed. Diffusion tensor MRI, a non-invasive technique which is sensitive to features of tissue microstructure and to the anatomy of the white matter fibers, has gained a crucial role in the field. Here, we provide a state-of-the-art review of structural connectivity abnormalities detected in schizophrenia and discuss the most relevant findings at preclinical, first episode drug-naïve, and chronic stages. Imaging studies showed white matter alterations from the preclinical to the chronic stage of the disease, which involve the corticospinal tracts, interhemispheric connections, long association white matter tracts, cerebello-thalamo-cortical circuit, and limbic system. Such abnormalities were found to be associated with the psychiatric and cognitive manifestations of the disease and to predict, at least partially, the patient clinical evolution and response to treatment.
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Affiliation(s)
- Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
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42
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Peters BD, Karlsgodt KH. White matter development in the early stages of psychosis. Schizophr Res 2015; 161:61-9. [PMID: 24893908 PMCID: PMC4250450 DOI: 10.1016/j.schres.2014.05.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/06/2014] [Accepted: 05/09/2014] [Indexed: 12/19/2022]
Abstract
Schizophrenia has been conceptualized as a disorder of both neurodevelopment and a disorder of connectivity. One important aspect of the neurodevelopmental hypothesis is that schizophrenia is no longer thought to have discrete illness time points, but rather a long trajectory of brain changes, spanning many years, across a series of stages of the disease including the prodrome, first episode, and chronic period. As the disease progresses, there is a complex relationship between age related changes and disease related changes. Therefore, neural changes, and specifically white matter based connectivity changes, in schizophrenia may be best conceptualized based on a lifespan trajectory. In this selective review, we discuss healthy changes in white matter integrity that occur with age, as well as changes that occur across illness stages. We further propose a set of models that might explain lifespan changes in white matter integrity in schizophrenia, with the conclusion that the evidence most strongly supports a pattern of disrupted maturation during adolescence, with the potential for later changes that may be a result of disease neurotoxicity, abnormal or excessive aging effects, as well as medication, cohort or other effects. Thus, when considering white matter integrity in psychosis, it is critical to consider age in addition to other contributing factors including disease specific effects. Discovery of the factors driving healthy white matter development across the lifespan and deviations from the normal developmental trajectory may provide insights relevant to the discovery of early treatment interventions.
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Affiliation(s)
- Bart D. Peters
- Division of Psychiatry Research, Zucker Hillside Hospital, NorthShore-LIJ Health System, Glen Oaks, NY
| | - Katherine H. Karlsgodt
- Division of Psychiatry Research, Zucker Hillside Hospital, NorthShore-LIJ Health System, Glen Oaks, NY,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY,Department of Psychiatry, Hofstra NorthShore-LIJ School of Medicine, Hempstead, NY
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43
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Jalbrzikowski M, Villalon-Reina JE, Karlsgodt KH, Senturk D, Chow C, Thompson PM, Bearden CE. Altered white matter microstructure is associated with social cognition and psychotic symptoms in 22q11.2 microdeletion syndrome. Front Behav Neurosci 2014; 8:393. [PMID: 25426042 PMCID: PMC4227518 DOI: 10.3389/fnbeh.2014.00393] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 10/22/2014] [Indexed: 12/26/2022] Open
Abstract
22q11.2 Microdeletion Syndrome (22q11DS) is a highly penetrant genetic mutation associated with a significantly increased risk for psychosis. Aberrant neurodevelopment may lead to inappropriate neural circuit formation and cerebral dysconnectivity in 22q11DS, which may contribute to symptom development. Here we examined: (1) differences between 22q11DS participants and typically developing controls in diffusion tensor imaging (DTI) measures within white matter tracts; (2) whether there is an altered age-related trajectory of white matter pathways in 22q11DS; and (3) relationships between DTI measures, social cognition task performance, and positive symptoms of psychosis in 22q11DS and typically developing controls. Sixty-four direction diffusion weighted imaging data were acquired on 65 participants (36 22q11DS, 29 controls). We examined differences between 22q11DS vs. controls in measures of fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD), using both a voxel-based and region of interest approach. Social cognition domains assessed were: Theory of Mind and emotion recognition. Positive symptoms were assessed using the Structured Interview for Prodromal Syndromes. Compared to typically developing controls, 22q11DS participants showed significantly lower AD and RD in multiple white matter tracts, with effects of greatest magnitude for AD in the superior longitudinal fasciculus. Additionally, 22q11DS participants failed to show typical age-associated changes in FA and RD in the left inferior longitudinal fasciculus. Higher AD in the left inferior fronto-occipital fasciculus (IFO) and left uncinate fasciculus was associated with better social cognition in 22q11DS and controls. In contrast, greater severity of positive symptoms was associated with lower AD in bilateral regions of the IFO in 22q11DS. White matter microstructure in tracts relevant to social cognition is disrupted in 22q11DS, and may contribute to psychosis risk.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles Los Angeles, CA, USA
| | - Julio E Villalon-Reina
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Marina del Rey, CA, USA
| | - Katherine H Karlsgodt
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research Manhasset, NY, USA ; Division of Psychiatric Research, Zucker Hillside Hospital Glen Oaks, NY, USA ; Psychiatry, Hofstra Northshore-LIJ School of Medicine Hempstead, NY, USA
| | - Damla Senturk
- Department of Biostatistics, School of Public Health, University of California at Los Angeles Los Angeles, CA, USA
| | - Carolyn Chow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles Los Angeles, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Marina del Rey, CA, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles Los Angeles, CA, USA ; Department of Psychology, University of California at Los Angeles Los Angeles, CA, USA
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44
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Wheeler AL, Voineskos AN. A review of structural neuroimaging in schizophrenia: from connectivity to connectomics. Front Hum Neurosci 2014; 8:653. [PMID: 25202257 PMCID: PMC4142355 DOI: 10.3389/fnhum.2014.00653] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 08/05/2014] [Indexed: 11/13/2022] Open
Abstract
In patients with schizophrenia neuroimaging studies have revealed global differences with some brain regions showing focal abnormalities. Examining neurocircuitry, diffusion-weighted imaging studies have identified altered structural integrity of white matter in frontal and temporal brain regions and tracts such as the cingulum bundles, uncinate fasciculi, internal capsules and corpus callosum associated with the illness. Furthermore, structural co-variance analyses have revealed altered structural relationships among regional morphology in the thalamus, frontal, temporal and parietal cortices in schizophrenia patients. The distributed nature of these abnormalities in schizophrenia suggests that multiple brain circuits are impaired, a neural feature that may be better addressed with network level analyses. However, even with the advent of these newer analyses, a large amount of variability in findings remains, likely partially due to the considerable heterogeneity present in this disorder.
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Affiliation(s)
- Anne L Wheeler
- Kimel Family Translational Imaging Genetics Laboratory, Centre for Addiction and Mental Health, Research Imaging Centre Toronto, ON, Canada ; Department of Psychiatry, University of Toronto Toronto, ON, Canada
| | - Aristotle N Voineskos
- Kimel Family Translational Imaging Genetics Laboratory, Centre for Addiction and Mental Health, Research Imaging Centre Toronto, ON, Canada ; Department of Psychiatry, University of Toronto Toronto, ON, Canada
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45
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Cookey J, Bernier D, Tibbo PG. White matter changes in early phase schizophrenia and cannabis use: an update and systematic review of diffusion tensor imaging studies. Schizophr Res 2014; 156:137-42. [PMID: 24842540 DOI: 10.1016/j.schres.2014.04.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/11/2014] [Accepted: 04/16/2014] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The impact of cannabis use on the brain tissue is still unclear, both in the healthy developing brain and in people with schizophrenia. The focus of this review is on white matter, the primary connective infrastructure of the brain. METHODS We systematically reviewed diffusion tensor imaging (DTI) studies of early phase schizophrenia (illness effect), of cannabis use in otherwise healthy brains (drug effect), and of early phase schizophrenia with cannabis use (combined effects). Studies had to include a healthy, non-cannabis using, control group as well as report on fractional anisotropy as it is the most commonly used DTI index. We excluded cohorts with heavy alcohol or illicit drug use and studies with a sample size of less than 20 in the clinical group. RESULTS We retained 17 studies of early phase schizophrenia, which together indicate deficits in white matter integrity observed in all fiber tract families, but most frequently in association, callosal and projection fibers. In otherwise healthy cannabis users (2 studies), deficits in white matter tracts were reported mainly in callosal fibers, but also in projection and limbic fibers. In cannabis users with early phase schizophrenia (1 study), deficits in white matter integrity were also observed in all fiber tract families, except for limbic fibers. CONCLUSIONS The current literature points to several families of white matter tracts being differentially affected in early phase schizophrenia. Further work is required to reveal the impact of cannabis use in otherwise healthy people as well as those with schizophrenia. LIMITATIONS Paucity of available studies as well as restricting analysis to FA values represent the main limitations of this review.
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Affiliation(s)
- Jacob Cookey
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Rm. 8206 Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, Canada, B3H 2E2; Capital District Health Authority, Room 3030, 3rd Floor, AJLB, 5909 Veterans' Memorial Lane, Halifax, NS, Canada, B3H 2E2
| | - Denise Bernier
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Rm. 8206 Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, Canada, B3H 2E2; Capital District Health Authority, Room 3030, 3rd Floor, AJLB, 5909 Veterans' Memorial Lane, Halifax, NS, Canada, B3H 2E2
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Rm. 8206 Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, Canada, B3H 2E2; Capital District Health Authority, Room 3030, 3rd Floor, AJLB, 5909 Veterans' Memorial Lane, Halifax, NS, Canada, B3H 2E2.
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Ellison-Wright I, Nathan PJ, Bullmore ET, Zaman R, Dudas RB, Agius M, Fernandez-Egea E, Müller U, Dodds CM, Forde NJ, Scanlon C, Leemans A, McDonald C, Cannon DM. Distribution of tract deficits in schizophrenia. BMC Psychiatry 2014; 14:99. [PMID: 24693962 PMCID: PMC4108049 DOI: 10.1186/1471-244x-14-99] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 03/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gray and white matter brain changes have been found in schizophrenia but the anatomical organizing process underlying these changes remains unknown. We aimed to identify gray and white matter volumetric changes in a group of patients with schizophrenia and to quantify the distribution of white matter tract changes using a novel approach which applied three complementary analyses to diffusion imaging data. METHODS 21 patients with schizophrenia and 21 matched control subjects underwent brain magnetic resonance imaging. Gray and white matter volume differences were investigated using Voxel-based Morphometry (VBM). White matter diffusion changes were located using Tract Based Spatial Statistics (TBSS) and quantified within a standard atlas. Tracts where significant regional differences were located were examined using fiber tractography. RESULTS No significant differences in gray or white matter volumetry were found between the two groups. Using TBSS the schizophrenia group showed significantly lower fractional anisotropy (FA) compared to the controls in regions (false discovery rate <0.05) including the genu, body and splenium of the corpus callosum and the left anterior limb of the internal capsule (ALIC). Using fiber tractography, FA was significantly lower in schizophrenia in the corpus callosum genu (p = 0.003). CONCLUSIONS In schizophrenia, white matter diffusion deficits are prominent in medial frontal regions. These changes are consistent with the results of previous studies which have detected white matter changes in these areas. The pathology of schizophrenia may preferentially affect the prefrontal-thalamic white matter circuits traversing these regions.
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Affiliation(s)
- Ian Ellison-Wright
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge CB2 0SZ, UK,Avon and Wiltshire Mental Health Partnership NHS Trust, Heathwood, Fountain Way, Salisbury SP2 7FD, UK
| | - Pradeep J Nathan
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge CB2 0SZ, UK,School of Psychology and Psychiatry, Monash University, Building 17, Clayton Campus, Wellington Road, Clayton, VIC 3800, Australia,New Medicines, UCB Pharma, Chemin du Foriest B-1420, Braine-l'Alleud, Belgium
| | - Edward T Bullmore
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge CB2 0SZ, UK,GlaxoSmithKline, Clinical Unit Cambridge (CUC), Addenbrooke’s Centre for Clinical Investigation (ACCI), Addenbrooke’s Hospital, Hills Road, PO Box 128, Cambridge CB2 0GG, UK
| | - Rashid Zaman
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 189, Cambridge CB2 2QQ, UK,South Essex Partnership University NHS Foundation Trust (SEPT), The Lodge, The Chase, Wickford, Essex SS11 7XX, United Kingdom
| | - Robert B Dudas
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 189, Cambridge CB2 2QQ, UK,Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) Elizabeth House, Fulbourn Hospital, Fulbourn, Cambridge CB21 5EF, UK
| | - Mark Agius
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 189, Cambridge CB2 2QQ, UK,South Essex Partnership University NHS Foundation Trust (SEPT), The Lodge, The Chase, Wickford, Essex SS11 7XX, United Kingdom
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 189, Cambridge CB2 2QQ, UK,Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) Elizabeth House, Fulbourn Hospital, Fulbourn, Cambridge CB21 5EF, UK,Behavioural Clinical Neuroscience Institute (BCNI), University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 189, Cambridge CB2 2QQ, UK
| | - Ulrich Müller
- Department of Psychiatry, Brain Mapping Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge CB2 0SZ, UK,Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) Elizabeth House, Fulbourn Hospital, Fulbourn, Cambridge CB21 5EF, UK
| | - Chris M Dodds
- GlaxoSmithKline, Clinical Unit Cambridge (CUC), Addenbrooke’s Centre for Clinical Investigation (ACCI), Addenbrooke’s Hospital, Hills Road, PO Box 128, Cambridge CB2 0GG, UK
| | - Natalie J Forde
- Clinical Neuroimaging Laboratory, Departments of Anatomy & Psychiatry, College of Medicine, Nursing and Health Sciences, 202 Comerford Suite, Clinical Sciences Institute, National University of Ireland, Galway, Republic of Ireland
| | - Cathy Scanlon
- Clinical Neuroimaging Laboratory, Departments of Anatomy & Psychiatry, College of Medicine, Nursing and Health Sciences, 202 Comerford Suite, Clinical Sciences Institute, National University of Ireland, Galway, Republic of Ireland
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Q.S.459, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Colm McDonald
- Clinical Neuroimaging Laboratory, Departments of Anatomy & Psychiatry, College of Medicine, Nursing and Health Sciences, 202 Comerford Suite, Clinical Sciences Institute, National University of Ireland, Galway, Republic of Ireland
| | - Dara M Cannon
- Clinical Neuroimaging Laboratory, Departments of Anatomy & Psychiatry, College of Medicine, Nursing and Health Sciences, 202 Comerford Suite, Clinical Sciences Institute, National University of Ireland, Galway, Republic of Ireland
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47
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Holleran L, Ahmed M, Anderson-Schmidt H, McFarland J, Emsell L, Leemans A, Scanlon C, Dockery P, McCarthy P, Barker GJ, McDonald C, Cannon DM. Altered interhemispheric and temporal lobe white matter microstructural organization in severe chronic schizophrenia. Neuropsychopharmacology 2014; 39:944-54. [PMID: 24150571 PMCID: PMC3924528 DOI: 10.1038/npp.2013.294] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 09/11/2013] [Accepted: 09/14/2013] [Indexed: 12/15/2022]
Abstract
Diffusion MRI investigations in schizophrenia provide evidence of abnormal white matter (WM) microstructural organization as indicated by reduced fractional anisotropy (FA) primarily in interhemispheric, left frontal and temporal WM. Using tract-based spatial statistics (TBSS), we examined diffusion parameters in a sample of patients with severe chronic schizophrenia. Diffusion MRI data were acquired on 19 patients with chronic severe schizophrenia and 19 age- and gender-matched healthy controls using a 64 gradient direction sequence, (b=1300 s/mm(2)) collected on a Siemens 1.5T MRI scanner. Diagnosis of schizophrenia was determined by Diagnostic and Statistical Manual for Mental Disorders 4th Edition (DSM-IV) Structured Clinical Interview for DSM disorder (SCID). Patients were treatment resistance, having failed to respond to at least two antipsychotic medications, and had prolonged periods of moderate to severe positive or negative symptoms. Analysis of diffusion parameters was carried out using TBSS. Individuals with chronic severe schizophrenia had significantly reduced FA with corresponding increased radial diffusivity in the genu, body, and splenium of the corpus callosum, the right posterior limb of the internal capsule, right external capsule, and the right temporal inferior longitudinal fasciculus. There were no voxels of significantly increased FA in patients compared with controls. A decrease in splenium FA was shown to be related to a longer illness duration. We detected widespread abnormal diffusivity properties in the callosal and temporal lobe WM regions in individuals with severe chronic schizophrenia who have not previously been exposed to clozapine. These deficits can be driven by a number of factors that are indistinguishable using in vivo diffusion-weighted imaging, but may be related to reduced axonal number or packing density, abnormal glial cell arrangement or function, and reduced myelin.
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Affiliation(s)
- Laurena Holleran
- Clinical Neuroimaging Laboratory, Department of Anatomy, School of Medicine, College of Medicine, Nursing and Health Sciences, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland,Clinical Neuroimaging Laboratory, Department of Anatomy, School of Medicine, College of Medicine, Nursing and Health Sciences, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland, Tel: +087 92 13388, Fax: +353 (0)91 494520, E-mail:
| | - Mohamed Ahmed
- Clinical Neuroimaging Laboratory, Department of Psychiatry, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Heike Anderson-Schmidt
- Clinical Neuroimaging Laboratory, Department of Psychiatry, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland,Department of Psychiatry and Psychotherapy, University Medical Centre Goettingen, Goettingen, Germany
| | - John McFarland
- Clinical Neuroimaging Laboratory, Department of Psychiatry, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Louise Emsell
- Clinical Neuroimaging Laboratory, Department of Psychiatry, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland,Department of Radiology, University Hospital of KU Leuven, Leuven, Belgium
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cathy Scanlon
- Clinical Neuroimaging Laboratory, Department of Psychiatry, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Peter Dockery
- Clinical Neuroimaging Laboratory, Department of Anatomy, School of Medicine, College of Medicine, Nursing and Health Sciences, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Peter McCarthy
- Clinical Neuroimaging Laboratory, Department of Radiology, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Gareth J Barker
- King's College London, Centre for Neuroimaging Sciences, Department of Neuroimaging, Institute of Psychiatry, London, UK
| | - Colm McDonald
- Clinical Neuroimaging Laboratory, Department of Psychiatry, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Dara M Cannon
- Clinical Neuroimaging Laboratory, Department of Anatomy, School of Medicine, College of Medicine, Nursing and Health Sciences, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
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48
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Li J, Kale Edmiston E, Chen K, Tang Y, Ouyang X, Jiang Y, Fan G, Ren L, Liu J, Zhou Y, Jiang W, Liu Z, Xu K, Wang F. A comparative diffusion tensor imaging study of corpus callosum subregion integrity in bipolar disorder and schizophrenia. Psychiatry Res 2014; 221:58-62. [PMID: 24300086 DOI: 10.1016/j.pscychresns.2013.10.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 08/18/2013] [Accepted: 10/25/2013] [Indexed: 02/08/2023]
Abstract
Structural magnetic resonance imaging (MRI) studies have provided evidence for corpus callosum (CC) white matter abnormalities in bipolar disorder (BD) and schizophrenia (SZ). These findings include alterations in shape, volume, white matter intensity and structural integrity compared to healthy control populations. Although CC alterations are implicated in both SZ and BD, no study of which we are aware has investigated callosal subregion differences between these two patient populations. We used diffusion tensor imaging (DTI) to assess CC integrity in patients with BD (n=16), SZ (n=19) and healthy controls (HC) (n=24). Fractional anisotropy (FA) of CC subregions was measured using region of interest (ROI) analysis and compared in the three groups. Significant group differences of FA values were revealed in five CC subregions, including the anterior genu, middle genu, posterior genu, posterior body and anterior splenium. FA values of the same subregions were significantly reduced in patients with SZ compared with HC. FA values were also significantly reduced in patients with BD compared to the HC group in the same subregions, excepting the middle genu. No significant difference was found between patient groups in any region. Most of the alterations in CC subregions were present in both the BD and SZ groups. These results imply an overlap in potential pathology, possibly relating to risk factors common to both disorders. The one region that differed between patient groups, the middle genu area, may serve as an illness marker and is perhaps involved in the different cognitive impairments observed in BD and SZ.
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Affiliation(s)
- Jian Li
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China
| | - Elliot Kale Edmiston
- Vanderbilt Neuroscience Graduate Program, Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN 37232, United States
| | - Kaiyuan Chen
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China.
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China
| | - Xuan Ouyang
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Yifeng Jiang
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Guoguang Fan
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China
| | - Ling Ren
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China
| | - Jie Liu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Yifang Zhou
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China
| | - Wenyan Jiang
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China
| | - Zhening Liu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, PR China
| | - Ke Xu
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China.
| | - Fei Wang
- Department of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, PR China; Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, United States.
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49
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Zhang R, Wei Q, Kang Z, Zalesky A, Li M, Xu Y, Li L, Wang J, Zheng L, Wang B, Zhao J, Zhang J, Huang R. Disrupted brain anatomical connectivity in medication-naïve patients with first-episode schizophrenia. Brain Struct Funct 2014; 220:1145-59. [PMID: 24449342 DOI: 10.1007/s00429-014-0706-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 01/04/2014] [Indexed: 01/16/2023]
Abstract
Previous studies suggested that the topological properties of brain anatomical networks may be aberrant in schizophrenia (SCZ), and most of them focused on the chronic and antipsychotic-medicated SCZ patients which may introduce various confounding factors due to antipsychotic medication and duration of illness. To avoid those potential confounders, a desirable approach is to select medication-naïve, first-episode schizophrenia (FE-SCZ) patients. In this study, we acquired diffusion tensor imaging datasets from 30 FE-SCZ patients and 34 age- and gender-matched healthy controls. Taking a distinct gray matter region as a node, inter-regional connectivity as edge and the corresponding streamline counts as edge weight, we constructed whole-brain anatomical networks for both groups, calculated their topological parameters using graph theory, and compared their between-group differences using nonparametric permutation tests. In addition, network-based statistic method was utilized to identify inter-regional connections which were impaired in the FE-SCZ patients. We detected only significantly decreased inter-regional connections in the FE-SCZ patients compared to the controls. These connections were primarily located in the frontal, parietal, occipital, and subcortical regions. Although small-worldness was conserved in the FE-SCZ patients, we found that the network strength and global efficiency as well as the degree were significantly decreased, and shortest path length was significantly increased in the FE-SCZ patients compared to the controls. Most of the regions that showed significantly decreased nodal parameters belonged to the top-down control, sensorimotor, basal ganglia, and limbic-visual system systems. Correlation analysis indicated that the nodal efficiency in the sensorimotor system was negatively correlated with the severity of psychosis symptoms in the FE-SCZ patients. Our results suggest that the network organization is changed in the early stages of the SCZ disease process. Our findings provide useful information for further understanding the brain white matter dysconnectivity of schizophrenia.
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Affiliation(s)
- Ruibin Zhang
- Brain Imaging Center, Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for the Study of Applied Psychology, School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
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50
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Liu X, Lai Y, Wang X, Hao C, Chen L, Zhou Z, Yu X, Hong N. A combined DTI and structural MRI study in medicated-naïve chronic schizophrenia. Magn Reson Imaging 2013; 32:1-8. [PMID: 24161847 DOI: 10.1016/j.mri.2013.08.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 08/01/2013] [Accepted: 08/19/2013] [Indexed: 12/15/2022]
Abstract
Disconnection in white matter (WM) pathway and alterations in gray matter (GM) structure have been hypothesized as pathogenesis in schizophrenia. However, the relationship between the abnormal WM integrity and the alteration of GM in anatomically connected areas remains uncertain. Moreover, the potential influence of antipsychotic medication on WM anisotropy and cortical morphology was not excluded in previous studies. In this study, a total number of 34 subjects were enrolled, including 17 medicated-naïve chronic schizophrenia patients and 17 healthy controls. Tract-based spatial statistics (TBSS) were applied to investigate the level of WM integrity. The FreeSurfer surface-based analysis was used to determine GM volume, cortical thickness and the surface area of GM regions which corresponded to abnormal WM fiber tracts. We observed that patients possessed lower fractional anisotropy (FA) values in the left inferior fronto-occipital fasciculus (IFOF) and left inferior longitudinal fasciculus (ILF), along with smaller GM volume and cortical thinning in temporal lobe than the healthy controls, which reflected the underlying WM and GM disruption that contributed to the disease. In the patient population, the lower connectivity of ILF and IFOF was positively associated with cortical thickness in left lateral orbitofrontal cortex, superior temporal gyrus and lingual gyrus in males, and positively correlated with GM volume in left lateral orbitofrontal cortex in females. On the other hand, it was negatively correlated with cortical area of middle temporal gyrus in males and temporal pole in females respectively, but not when genders were combined. These findings suggested that abnormal WM integrity and anatomical correspondence of GM alterations in schizophrenia were interdependent on gender-separated analysis in patients with schizophrenia. Moreover, combining TBSS and FreeSurfer might be a useful method to provide significant insight into interacting processes related to WM fiber tracts and GM changes in schizophrenia.
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Affiliation(s)
- Xiaoyi Liu
- Department of Radiology, People's Hospital, Peking University, Beijing, China
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