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Shivakumar V, Sreeraj VS, Kalmady SV, Gangadhar BN, Venkatasubramanian G. Pars Triangularis Volume Asymmetry and Schneiderian First Rank Symptoms in Antipsychotic-naïve Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:507-513. [PMID: 34294619 PMCID: PMC8316654 DOI: 10.9758/cpn.2021.19.3.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/14/2020] [Accepted: 02/02/2021] [Indexed: 11/18/2022]
Abstract
Objective Schizophrenia is a disorder of language and self, with first-rank symptoms (FRS) as one of the predominant features in a subset of patients. Abnormal language lateralization is hypothesized to underlie the neurobiology of FRS in schizophrenia. The role of Broca's area with its right-hemispheric counterpart, consisting of pars triangularis (PTr) and pars opercularis (POp) of the inferior frontal gyrus in FRS is undetermined. We compared the volumes and asymmetries of PTr & POp in anti-psychotic-naive schizophrenia patients with FRS (FRS[+]) with those without FRS (FRS[-]) and healthy-controls (HC) using three dimensional, interactive, semi-automated volumetric morphometry. Methods Antipsychotic naïve FRS(+) (n = 27), FRS(-) (n = 24) and HC (n = 51) were carefully assessed with structured and semi-structured clinical tools. T1-weighted images were acquired in a 3T scanner. Volumes of regions of interest were measured independently for both sides using slicer-3D software, and asymmetry indices were calculated. Results FRS(+) but not FRS(-) had a significant volume deficit in right PTr after controlling for the potential confounding effects of age, sex, and intracranial volume (p = 0.029). There was a significant leftward asymmetry of PTr in patients with FRS (i.e., leftward asymmetry in patients) (p = 0.026). No significant volume/asymmetry abnormalities were observed in POp. Conclusion Study findings suggest reduced right PTr volume with leftward asymmetry to be associated with FRS in schizophrenia. This is consistent with the loss of Yakovlevian torque in schizophrenia. Role of PTr in the neurobiology of schizophrenia as a disorder of self, speech, and social cognition needs further systematic evaluation in future research.
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Affiliation(s)
- Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health & NeuroSciences (NIMHANS), Bangalore, India
| | | | - Sunil Vasu Kalmady
- Alberta Machine Intelligence Institute, University of Alberta, Edmonton, AB, Canada
| | | | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health & NeuroSciences (NIMHANS), Bangalore, India
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2
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Li D, Tang W, Yan T, Zhang N, Xiang J, Niu Y, Wang B. Abnormalities in hemispheric lateralization of intra- and inter-hemispheric white matter connections in schizophrenia. Brain Imaging Behav 2021; 15:819-832. [PMID: 32767209 DOI: 10.1007/s11682-020-00292-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hemispheric lateralization is a prominent feature of the human brain and is grounded into intra- and inter-hemispheric white matter (WM) connections. However, disruptions in hemispheric lateralization involving both intra- and inter-hemispheric WM connections in schizophrenia is still unclear. Hence, a quantitative measure of the hemispheric lateralization of intra- and inter-hemispheric WM connections could provide new insights into schizophrenia. This work performed diffusion tensor imaging on 50 patients and 58 matched healthy controls. Using graph theory, the global and nodal efficiencies were computed for both intra- and inter-hemispheric networks. We found that patients with schizophrenia showed significantly decrease in both global and nodal efficiency of hemispheric networks relative to healthy controls. Specially, deficits in intra-hemispheric integration and inter-hemispheric communication were revealed in frontal and temporal regions for schizophrenia. We also found disrupted hemispheric asymmetries in brain regions associated with emotion, memory, and visual processes for schizophrenia. Moreover, abnormal hemispheric asymmetry of nodal efficiency was significantly correlated with the symptom of the patients. Our finding indicated that the hemispheric WM lateralization of intra- and inter-hemispheric connections could serve as a potential imaging biomarker for schizophrenia.
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Affiliation(s)
- Dandan Li
- College of Information and Computer, Taiyuan University of Technology, Shanxi, China
| | - Wenjing Tang
- School of Mechanical, Electrical and Information Engineering, Shandong University at Weihai, Shandong, China
| | - Ting Yan
- Translational Medicine Research Center, Shanxi Medical University, Shanxi, China
| | - Nan Zhang
- College of Information and Computer, Taiyuan University of Technology, Shanxi, China
| | - Jie Xiang
- College of Information and Computer, Taiyuan University of Technology, Shanxi, China
| | - Yan Niu
- College of Information and Computer, Taiyuan University of Technology, Shanxi, China
| | - Bin Wang
- College of Information and Computer, Taiyuan University of Technology, Shanxi, China.
- Translational Medicine Research Center, Shanxi Medical University, Shanxi, China.
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3
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Wang Y, Wei Y, Edmiston EK, Womer FY, Zhang X, Duan J, Zhu Y, Zhang R, Yin Z, Zhang Y, Jiang X, Wei S, Liu Z, Zhang Y, Tang Y, Wang F. Altered structural connectivity and cytokine levels in Schizophrenia and Genetic high-risk individuals: Associations with disease states and vulnerability. Schizophr Res 2020; 223:158-165. [PMID: 32684357 DOI: 10.1016/j.schres.2020.05.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/26/2020] [Accepted: 05/17/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Alterations of white matter (WM) integrity have been observed in both schizophrenia (SZ) and individuals at genetic high risk for SZ (GHR-SZ); however, the molecular mechanisms underlying WM disruption remain unclear. Cytokines are chemical messengers of the immune system that are closely related to inflammation and neurogenesis in the brain. This study aimed to identify abnormalities in WM integrity, cytokine levels, and their association in SZ and GHR-SZ. METHODS A total of 355 participants (126 with SZ, 99 GHR-SZ, and 130 healthy controls [HCs]) were recruited. All participants underwent diffusion tensor imaging and blood samples were obtained from 113 participants within 24 h of imaging. RESULTS In SZ, there was decreased fractional anisotropy(FA) in the genu and body of the corpus callosum (GCC/BCC), anterior corona radiata, anterior and posterior limbs of the internal capsule (ALIC/PLIC), superior fronto-occipital fasciculus, external capsule, and fornix, and elevated IL-6 levels. In both SZ and GHR-SZ, decreased FA in the splenium of the corpus callosum (SCC), posterior corona radiate (PCR), and posterior thalamic radiation (PTR) was observed, and elevated leptin levels were present. Additionally, the IL-6 levels were negatively correlated with FA in the GCC and ALIC in SZ, and leptin levels were negatively correlated with the SCC, PCR, and PTR in SZ and GHR-SZ. CONCLUSIONS Abnormal WM integrity in SZ may reflect the state of disease and is associated with increased IL-6 levels. In addition, these leptin-associated WM integrity abnormalities in both SZ and GHR-SZ may reflect a genetic vulnerability to SZ.
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Affiliation(s)
- Yang Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yange Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - E Kale Edmiston
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Xizhe Zhang
- School of Computer Science and Engineering, Northeastern University, Shenyang, Liaoning, PR China
| | - Jia Duan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Ran Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Zhiyang Yin
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yifan Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Shengnan Wei
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Zhuang Liu
- School of Public Health, China Medical University, Shenyang, Liaoning, PR China
| | - Yanbo Zhang
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Canada
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China.
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
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4
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Antipsychotic effects of sex hormones and atypical hemispheric asymmetries. Cortex 2020; 127:313-332. [DOI: 10.1016/j.cortex.2020.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/27/2020] [Accepted: 02/29/2020] [Indexed: 12/16/2022]
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Shah JL, Tandon N, Montrose DM, Mermon D, Eack SM, Miewald J, Keshavan MS. Clinical psychopathology in youth at familial high risk for psychosis. Early Interv Psychiatry 2019; 13:297-303. [PMID: 28880494 PMCID: PMC5897185 DOI: 10.1111/eip.12480] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 05/28/2017] [Accepted: 07/11/2017] [Indexed: 12/16/2022]
Abstract
AIM While the course of psychopathology has been explored from an index mental health diagnosis onwards, there are few detailed, prospective studies of the occurrence of clinical psychopathology in youth with familial risk for severe mental illnesses such as psychosis. We sought to describe the appearance of Axis I psychopathology in a unique sample of adolescents with a family history of schizophrenia (FHR). METHODS One hundred and sixty two first- and second-degree relatives (mean age 15.7 ± 3.6; range 8-25) of probands with schizophrenia or schizoaffective disorder were assessed at baseline and annual intervals for up to 3 years, focusing on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) Axis I psychopathology. RESULTS Fourteen individuals (8.6%) developed a psychotic disorder. One hundred and five subjects (65%) met criteria for an Axis I disorder over the course of the study, the most common of which was a depressive episode (40 subjects; 25%). Of the 148 individuals who did not develop psychosis, 91 (61%) had one or more Axis I disorders compared with 10/14 converters who had a comorbid Axis I disorder (71%). Ordered by increasing age of onset, diagnoses included cognitive and externalizing disorders, anxiety disorders, affective disorders, substance use disorders and psychotic disorders. CONCLUSIONS In addition to an elevated risk of psychosis, young FHR relatives manifest a broad range of non-psychotic Axis I psychopathology in childhood and adolescence. This breadth of diagnoses has implications for the structure and function of mental health services for young people.
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Affiliation(s)
- Jai L Shah
- Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,PEPP-Montréal, Douglas Mental Health University Institute, Montréal, Canada.,Department of Psychiatry, McGill University, Montréal, Canada
| | - Neeraj Tandon
- Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Baylor College of Medicine, Houston, Texas
| | - Debra M Montrose
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Diana Mermon
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Shaun M Eack
- University of Pittsburgh School of Social Work, Pittsburgh, Pennsylvania
| | - Jean Miewald
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Matcheri S Keshavan
- Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Zaytseva Y, Fajnerová I, Dvořáček B, Bourama E, Stamou I, Šulcová K, Motýl J, Horáček J, Rodriguez M, Španiel F. Theoretical Modeling of Cognitive Dysfunction in Schizophrenia by Means of Errors and Corresponding Brain Networks. Front Psychol 2018; 9:1027. [PMID: 30026711 PMCID: PMC6042473 DOI: 10.3389/fpsyg.2018.01027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/31/2018] [Indexed: 01/22/2023] Open
Abstract
The current evidence of cognitive disturbances and brain alterations in schizophrenia does not provide the plausible explanation of the underlying mechanisms. Neuropsychological studies outlined the cognitive profile of patients with schizophrenia, that embodied the substantial disturbances in perceptual and motor processes, spatial functions, verbal and non-verbal memory, processing speed and executive functioning. Standardized scoring in the majority of the neurocognitive tests renders the index scores or the achievement indicating the severity of the cognitive impairment rather than the actual performance by means of errors. At the same time, the quantitative evaluation may lead to the situation when two patients with the same index score of the particular cognitive test, demonstrate qualitatively different performances. This may support the view why test paradigms that habitually incorporate different cognitive variables associate weakly, reflecting an ambiguity in the interpretation of noted cognitive constructs. With minor exceptions, cognitive functions are not attributed to the localized activity but eventuate from the coordinated activity in the generally dispersed brain networks. Functional neuroimaging has progressively explored the connectivity in the brain networks in the absence of the specific task and during the task processing. The spatio-temporal fluctuations of the activity of the brain areas detected in the resting state and being highly reproducible in numerous studies, resemble the activation and communication patterns during the task performance. Relatedly, the activation in the specific brain regions oftentimes is attributed to a number of cognitive processes. Given the complex organization of the cognitive functions, it becomes crucial to designate the roles of the brain networks in relation to the specific cognitive functions. One possible approach is to identify the commonalities of the deficits across the number of cognitive tests or, common errors in the various tests and identify their common "denominators" in the brain networks. The qualitative characterization of cognitive performance might be beneficial in addressing diffuse cognitive alterations presumably caused by the dysconnectivity of the distributed brain networks. Therefore, in the review, we use this approach in the description of standardized tests in the scope of potential errors in patients with schizophrenia with a subsequent reference to the brain networks.
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Affiliation(s)
- Yuliya Zaytseva
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | | | | | - Eva Bourama
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Ilektra Stamou
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Kateřina Šulcová
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Jiří Motýl
- National Institute of Mental Health, Klecany, Czechia
| | - Jiří Horáček
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | | | - Filip Španiel
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
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7
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Zouraraki C, Karamaouna P, Karagiannopoulou L, Giakoumaki SG. Schizotypy-Independent and Schizotypy-Modulated Cognitive Impairments in Unaffected First-Degree Relatives of Schizophrenia-spectrum Patients. Arch Clin Neuropsychol 2017; 32:1010-1025. [PMID: 28383650 DOI: 10.1093/arclin/acx029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 03/27/2017] [Indexed: 11/14/2022] Open
Abstract
Objective The aim of the study was to compare the neurocognitive profile of unaffected first-degree relatives of schizophrenia patients with control individuals, controlling for different schizotypal traits. Method One hundred and fifteen adult unaffected first-degree relatives of schizophrenia-spectrum patients and 122 controls were tested for schizotypy with the Schizotypal Personality Questionnaire. They also underwent a thorough neurocognitive assessment with a range of tasks covering several aspects of executive functioning. Between-group differences in cognition were examined first with multivariate analysis of variance and then with a series of multivariate analyses of covariance, including the schizotypal dimensions as covariates. Results The relatives had higher scores on all schizotypal dimensions compared with controls and poorer planning, problem solving, strategy formation and working memory, irrespective of schizotypal traits. They also scored lower in executive working memory and verbal fluency. The difference in executive working memory was sensitive to the effects of paranoid and negative schizotypy (both dimensions abolished the between-group difference) whereas the difference in verbal fluency was sensitive only to the effects of paranoid schizotypy. Neither cognitive-perceptual nor disorganized schizotypy accounted for any differences in neurocognition between relatives and the controls. Conclusions Impairments in planning, problem solving, strategy formation and working memory are "core" impairments in the schizophrenia-spectrum, possibly due to high heritability effects in these functions. Impairments in executive working memory and verbal fluency are associated with paranoid and negative schizotypy, possibly due to alterations in a common fronto-temporo-parietal neural network.
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Affiliation(s)
- Chrysoula Zouraraki
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
| | - Penny Karamaouna
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
| | - Leda Karagiannopoulou
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
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Reduced language lateralization in first episode schizophrenia: A near infrared spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:96-104. [PMID: 28499897 DOI: 10.1016/j.pnpbp.2017.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 04/25/2017] [Accepted: 05/08/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Diminished functional lateralization in language-related areas is found in chronic schizophrenia (SZ). However, whether this reduced lateralization exists at the early stage of SZ remains unclear. The present study aimed to investigate language lateralization in first episode schizophrenia (FES) using near infrared spectroscopy (NIRS) during a letter version of verbal fluency test (VFT). METHODS A total of 28 FES patients and 33 healthy controls (HCs) underwent NIRS while performing a VFT. Six regions of interests (ROIs) were defined: the bilateral frontal-, inferior frontal gyrus (IFG), and temporal regions. Laterality index (LI) was calculated and compared between the two groups in ROIs. In addition, we investigated whether language lateralization was correlated with severity of clinical symptoms. RESULTS Across all ROIs, LI was significantly reduced in FES patients (p=0.037) compared to controls in the IFG region. In addition, LI was not found to be correlated with VFT performance, the PANSS positive, negative or general psychopathology subscales. CONCLUSIONS Our study demonstrated a diminution of leftward functional lateralization in the IFG during a VFT in FES patients. This is the first NIRS study to report reduced functional lateralization in patients at the early stage of schizophrenia.
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Tzourio-Mazoyer N, Mazoyer B. Variations of planum temporale asymmetries with Heschl's Gyri duplications and association with cognitive abilities: MRI investigation of 428 healthy volunteers. Brain Struct Funct 2017; 222:2711-2726. [PMID: 28164245 DOI: 10.1007/s00429-017-1367-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/08/2017] [Indexed: 12/11/2022]
Abstract
In a large sample of 428 healthy adults balanced for gender and manual preference (MP), we investigated planum temporale (PT) surface area variability in relation with Heschl's gyrus (HG) duplication pattern, MP, and familial sinistrality (FS), considering different PT definitions. In a sub-sample of 362 participants, we also investigated whether variability of PT asymmetry was associated with differences in verbal abilities. On each participant brain hemisphere MRI, we delineated a posterior PT area (PTpost), excluding the second Heschl gyrus in case of either complete posterior duplication (CPD) or common stem partial duplication (CSD). We then defined a total PT area (PTtot) as the union of PTpost and of the second HG when present, and a HGPT area as the union of PTtot and of the first HG. The HG duplication pattern of one hemisphere was found to significantly affect the PTpost surface area of the same hemisphere, a larger reduction being present in case of CPD than in case of CSD, leading to a strong impact of both left and right HG duplication patterns on PTpost asymmetry. The HG duplication pattern had no effect on PTtot surface areas, while a significant effect of the left HG duplication was present on PTtot asymmetry that was larger in case of a CSD as compared to a single HG. By contrast, the type of HG duplication did not affect HGPT and neither left nor right HG duplication pattern had an effect on HGPT asymmetry. Meanwhile, MP had no effect on PTpost, PTtot, HGPT, or their asymmetries. The absence of a left PTpost was associated with existence of FS (FS+) (7FS+ among nine without PTpost). Removing the nine individuals lacking PTpost, a lower left PTpost surface area was observed in FS+ participants with left CPD. In the sub-sample of 362 participants, we observed a significant interaction between PTpost asymmetry and cognitive abilities due to poorer lexical performances in individuals having a symmetric PTpost as compared to individuals having either a leftward or a rightward asymmetric PTpost. By contrast, there was no significant effect of PTtot or HGPT asymmetry on cognitive abilities. This study shows that HG duplication pattern mainly affects the surface area of the most posterior part of PT and its asymmetry, this PTpost area being specifically associated with variability in verbal performances. This study also shows, for the first time, an association between decreased performances and lack of PTpost anatomical asymmetry, being rightward asymmetrical having no deleterious effect on verbal abilities, thereby supporting the idea that anatomical lateralization is necessary for optimal verbal performances.
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Affiliation(s)
- Nathalie Tzourio-Mazoyer
- Univ. Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France. .,CNRS, IMN, UMR 5293, 33000, Bordeaux, France. .,CEA, GIN, IMN, UMR 5293, 33000, Bordeaux, France. .,IMN Institut des Maladies Neurodégénératives UMR 5293, Team 5: GIN Groupe d'Imagerie Neurofonctionnelle, CEA-CNRS-Université de Bordeaux, 146 rue Léo Saignat-CS 61292-Case 28, 33076, Bordeaux cedex, France.
| | - B Mazoyer
- Univ. Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France.,CNRS, IMN, UMR 5293, 33000, Bordeaux, France.,CEA, GIN, IMN, UMR 5293, 33000, Bordeaux, France.,IMN Institut des Maladies Neurodégénératives UMR 5293, Team 5: GIN Groupe d'Imagerie Neurofonctionnelle, CEA-CNRS-Université de Bordeaux, 146 rue Léo Saignat-CS 61292-Case 28, 33076, Bordeaux cedex, France
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Aydın E, Cansu Ülgen M, Tabo A, Devrim Balaban Ö, Yeşilyurt S, Yumrukçal H. Executive function and genetic loading in nonpsychotic relatives of schizophrenia patients. Psychiatry Res 2017; 248:105-110. [PMID: 28038438 DOI: 10.1016/j.psychres.2016.12.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 11/04/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
Abstract
Executive functions meet the "endophenotype candidate" criteria in neuropsychological measures for schizophrenic patients. To determine which area of executive functioning has the greatest value in differentiating the so called "candidate endophenotype" of schizophrenia through comparing the effect sizes of four commonly used executive function tests. A Wisconsin Card Sorting Test, a Stroop Test, a Trail Making Test and a Verbal Fluency Test were used to evaluate executive function in two study groups: healthy relatives of schizophrenia patients from simplex and multiplex families and a healthy control group. In all four tests, study groups performed poorly in contrast to the control group. In the B time, A error and B error results of the Trail Making Test, the multiplex group performed poorly compared to the simplex group; control group did better than both study groups. Our findings support that the presence of a schizophrenia patient in a family predicts worse performance on executive function tests in a group of healthy relatives of that individual. The results of our study suggest that the Trail Making Test in particular may signify a stronger endophenotypic trait.
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Affiliation(s)
- Erkan Aydın
- Institution and Department, Bakırköy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery/Psychiatry Services, Turkey.
| | - Mine Cansu Ülgen
- Institution and Department, Gaziantep Ersin Arslan Hospital/Psychiatry Services, Turkey
| | - Abdülkadir Tabo
- Institution and Department, Bakırköy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery/Psychiatry Services, Turkey
| | - Özlem Devrim Balaban
- Institution and Department, Bakırköy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery/Psychiatry Services, Turkey
| | - Sema Yeşilyurt
- Institution and Department, Bakırköy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery/Psychiatry Services, Turkey
| | - Hüseyin Yumrukçal
- Institution and Department, Bakırköy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery/Psychiatry Services, Turkey
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Chahine G, Richter A, Wolter S, Goya-Maldonado R, Gruber O. Disruptions in the left frontoparietal network underlie resting state endophenotypic markers in schizophrenia. Hum Brain Mapp 2016; 38:1741-1750. [PMID: 28009080 DOI: 10.1002/hbm.23477] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 11/12/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
Advances in functional brain imaging have improved the search for potential endophenotypic markers in schizophrenia. Here, we employed independent component analysis (ICA) and dynamic causal modeling (DCM) in resting state fMRI on a sample of 35 schizophrenia patients, 20 first-degree relatives and 35 control subjects. Analysis on ICA-derived networks revealed increased functional connectivity between the left frontoparietal network (FPN) and left temporal and parietal regions in schizophrenia patients (P < 0.001). First-degree relatives shared this hyperconnectivity, in particular in the supramarginal gyrus (SMG; P = 0.008). DCM analysis was employed to further explore underlying effective connectivity. Results showed increased inhibitory connections to the left angular gyrus (AG) in schizophrenia patients from all other nodes of the left FPN (P < 0.001), and in particular from the left SMG (P = 0.001). Relatives also showed a pattern of increased inhibitory connections to the left AG (P = 0.008). Furthermore, the patient group showed increased excitatory connectivity between the left fusiform gyrus and the left SMG (P = 0.002). This connection was negatively correlated to inhibitory afferents to the left AG (P = 0.005) and to the negative symptom score on the PANSS scale (P = 0.001, r = -0.51). Left frontoparietotemporal dysfunction in schizophrenia has been previously associated with a range of abnormalities, including formal thought disorder, working memory dysfunction and sensory hallucinations. Our analysis uncovered new potential endophenotypic markers of schizophrenia and shed light on the organization of the left FPN in patients and their first-degree relatives. Hum Brain Mapp 38:1741-1750, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- George Chahine
- Department of Psychiatry and Psychotherapy, Centre for Translational Research in Systems, Neuroscience and Clinical Psychiatry, George August University, Göttingen, Germany.,Department of Psychiatry, Maimonides Medical Center, Brooklyn, New York
| | - Anja Richter
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Sarah Wolter
- Department of Psychiatry and Psychotherapy, Centre for Translational Research in Systems, Neuroscience and Clinical Psychiatry, George August University, Göttingen, Germany
| | - Roberto Goya-Maldonado
- Department of Psychiatry and Psychotherapy, Centre for Translational Research in Systems, Neuroscience and Clinical Psychiatry, George August University, Göttingen, Germany
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
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12
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Abdolmaleky HM, Pajouhanfar S, Faghankhani M, Joghataei MT, Mostafavi A, Thiagalingam S. Antipsychotic drugs attenuate aberrant DNA methylation of DTNBP1 (dysbindin) promoter in saliva and post-mortem brain of patients with schizophrenia and Psychotic bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2015; 168:687-96. [PMID: 26285059 DOI: 10.1002/ajmg.b.32361] [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] [Received: 01/26/2015] [Accepted: 07/31/2015] [Indexed: 12/13/2022]
Abstract
Due to the lack of genetic association between individual genes and schizophrenia (SCZ) pathogenesis, the current consensus is to consider both genetic and epigenetic alterations. Here, we report the examination of DNA methylation status of DTNBP1 promoter region, one of the most credible candidate genes affected in SCZ, assayed in saliva and post-mortem brain samples. The Illumina DNA methylation profiling and bisulfite sequencing of representative samples were used to identify methylation status of the DTNBP1 promoter region. Quantitative methylation specific PCR (qMSP) was employed to assess methylation of DTNBP1 promoter CpGs flanking a SP1 binding site in the saliva of SCZ patients, their first-degree relatives and control subjects (30, 15, and 30/group, respectively) as well as in post-mortem brains of patients with SCZ and bipolar disorder (BD) versus controls (35/group). qRT-PCR was used to assess DTNBP1 expression. We found DNA hypermethylation of DTNBP1 promoter in the saliva of SCZ patients (∼12.5%, P = 0.036), particularly in drug-naïve patients (∼20%, P = 0.011), and a trend toward hypermethylation in their first-degree relatives (P = 0.085) versus controls. Analysis of post-mortem brain samples revealed an inverse correlation between DTNBP1 methylation and expression, and normalization of this epigenetic change by classic antipsychotic drugs. Additionally, BD patients with psychotic depression exhibited higher degree of methylation versus other BD patients (∼80%, P = 0.025). DTNBP1 promoter DNA methylation may become a key element in a panel of biomarkers for diagnosis, prevention, or therapy in SCZ and at risk individuals pending confirmatory studies with larger sample sizes to attain a higher degree of significance.
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Affiliation(s)
- Hamid M Abdolmaleky
- Departments of Medicine (Biomedical Genetics Section), Genetics & Genomics, Boston University School of Medicine, Boston, Massachusetts.,Mental Health Research Center, Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Pajouhanfar
- Mental Health Research Center, Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Taghi Joghataei
- Cellular and Molecular Research Center, Department of Anatomy, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ashraf Mostafavi
- Arian Salamat Counselling and Nursing Services Centre, Tehran, Iran
| | - Sam Thiagalingam
- Departments of Medicine (Biomedical Genetics Section), Genetics & Genomics, Boston University School of Medicine, Boston, Massachusetts.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
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13
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Borda JP, Sass LA. Phenomenology and neurobiology of self disorder in schizophrenia: Primary factors. Schizophr Res 2015; 169:464-473. [PMID: 26516103 DOI: 10.1016/j.schres.2015.09.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 12/13/2022]
Abstract
Schizophrenia is a heterogeneous syndrome, varying between persons and over course of illness. In this and a companion article, we argue that comprehension of this condition or set of conditions may require combining a phenomenological perspective emphasizing disorders of basic-self experience ("ipseity disturbance") with a multidimensional appreciation of possible neurobiological correlates--both primary and secondary. Previous attempts to link phenomenology and neurobiology generally focus on a single neurocognitive factor. We consider diverse aspects of schizophrenia in light of a diverse, albeit interacting, set of neurocognitive abnormalities, examining both synchronic (structural) interdependence and diachronic (temporal) succession. In this article we focus on the primary or foundational role of early perceptual and motoric disturbances that affect perceptual organization and especially intermodal or multisensory perceptual integration (“perceptual dys-integration”). These disturbances are discussed in terms of their implications for three interconnected aspects of selfhood in schizophrenia, primary forms of: disrupted "hold" or "grip" on the world, hyperreflexivity, diminished self-presence (self-affection). Disturbances of organization or integration imply forms of perceptual incoherence or diminished cognitive coordination. The effect is to disrupt one's ability to apprehend the world in holistic, vital, or contextually grounded fashion, or to fully identify with or experience the unity of one's own body or thinking--thereby generating an early and profound (albeit often subtle) disruption or diminishment of basic or core self and of the sense of existing in a coherent world. We discuss interrelationships or possible complementarities between these three aspects, and consider their relevance for a neurodevelopmental account of schizophrenia.
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Affiliation(s)
- Juan P Borda
- Dept of Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Louis A Sass
- Rutgers University, Piscataway, N.J. 08854, U.S.A.
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Zhu YK, Li CB, Jin J, Wang JJ, Lachmann B, Sariyska R, Montag C. The 2D:4D ratio of the hand and schizotypal personality traits in schizophrenia patients and healthy control persons. Asian J Psychiatr 2014; 9:67-72. [PMID: 24813040 DOI: 10.1016/j.ajp.2014.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 01/06/2014] [Accepted: 01/19/2014] [Indexed: 02/06/2023]
Abstract
Prenatal estrogen/testosterone exposure is known to be involved in early brain development. In this context, the ratio of the index finger to ring finger length (2D:4D) has been put forward as an indicator of the intrauterine sex hormonal level. A previous study by Collinson et al. (2010) examined 2D:4D ratios in Asian patients with schizophrenia and found an increased 2D:4D pattern in male patients compared to male healthy controls. In the current study, we tried to replicate the result of this study on the 2D:4D ratio in schizophrenia patients and controls in a Chinese sample. Moreover, we investigated the link between 2D:4D ratios and schizotypal personality traits in the participants of the study. No significant difference between cases and controls in 2D:4D ratios for both hands could be observed. However, a positive association between right 2D:4D ratio and schizotypal personality traits was found in healthy controls (both in the male and female subsamples) suggesting that a high 2D:4D ratio could represent a vulnerability factor for schizophrenia in healthy males and females. Same results were observed for the digit ratio of the left hand and the SPQ in the healthy total and healthy female subsample. Therefore, the inclusion of personality measures to study the link between the digit ratio and schizophrenia might help to provide insights in a potential continuum from healthy to schizophrenic behavior.
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Affiliation(s)
- Yi-Kang Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Wan Ping Nan Road 600, 200030 Shanghai, China
| | - Chun-Bo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Wan Ping Nan Road 600, 200030 Shanghai, China.
| | - Jin Jin
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Wan Ping Nan Road 600, 200030 Shanghai, China
| | - Ji-Jun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Wan Ping Nan Road 600, 200030 Shanghai, China
| | - Bernd Lachmann
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany
| | - Rayna Sariyska
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany
| | - Christian Montag
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany; Center for Economics and Neuroscience, University of Bonn, Germany.
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15
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Puetz V, Günther T, Kahraman-Lanzerath B, Herpertz-Dahlmann B, Konrad K. Neuropsychological Deficits in the Prodromal Phase and Course of an Early-Onset Schizophrenia. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2014; 42:167-76. [DOI: 10.1024/1422-4917/a000286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives: Although clear advances have been achieved in the study of early-onset schizophrenia (EOS), little is known to date about premorbid and prodromal neuropsychological functioning in EOS. Method: Here, we report on a case of an adolescent male with EOS who underwent neuropsychological testing before and after illness onset. Results: Marked cognitive deficits in the domains of attention, set-shifting, and verbal memory were present both pre-onset and during the course of schizophrenia, though only deficits in verbal memory persisted after illness-onset and antipsychotic treatment. Conclusion: The findings of this case study suggest that impairments in the verbal memory domain are particularly prominent symptoms of cognitive impairment in prodromal EOS and persist in the course of the disorder, which further demonstrates the difficult clinical situation of adequate schooling opportunities for adolescent patients with EOS.
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Affiliation(s)
- Vanessa Puetz
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
| | - Thomas Günther
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
| | - Berrak Kahraman-Lanzerath
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
- JARA Translational Brain Medicine, Aachen & Jülich, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
- JARA Translational Brain Medicine, Aachen & Jülich, Germany
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16
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Self-disturbances as a possible premorbid indicator of schizophrenia risk: a neurodevelopmental perspective. Schizophr Res 2014; 152:73-80. [PMID: 23932148 PMCID: PMC3877695 DOI: 10.1016/j.schres.2013.07.038] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 07/17/2013] [Accepted: 07/19/2013] [Indexed: 02/07/2023]
Abstract
Self-disturbances (SDs) are increasingly identified in schizophrenia and are theorized to confer vulnerability to psychosis. Neuroimaging research has shed some light on the neural correlates of SDs in schizophrenia. But, the onset and trajectory of the neural alterations underlying SDs in schizophrenia remain incompletely understood. We hypothesize that the aberrant structure and function of brain areas (e.g., prefrontal, lateral temporal, and parietal cortical structures) comprising the "neural circuitry of self" may represent an early, premorbid (i.e., pre-prodromal) indicator of schizophrenia risk. Consistent with neurodevelopmental models, we argue that "early" (i.e., perinatal) dysmaturational processes (e.g., abnormal cortical neural cell migration and mini-columnar formation) affecting key prefrontal (e.g., medial prefrontal cortex), lateral temporal cortical (e.g., superior temporal sulcus), and parietal (e.g., inferior parietal lobule) structures involved in self-processing may lead to subtle disruptions of "self" during childhood in persons at risk for schizophrenia. During adolescence, progressive neurodevelopmental alterations (e.g., aberrant synaptic pruning) affecting the neural circuitry of self may contribute to worsening of SDs. This could result in the emergence of prodromal symptoms and, eventually, full-blown psychosis. To highlight why adolescence may be a period of heightened risk for SDs, we first summarize the literature regarding the neural correlates of self in typically developing children. Next, we present evidence from neuroimaging studies in genetic high-risk youth suggesting that fronto-temporal-parietal structures mediating self-reflection may be abnormal in the premorbid period. Our goal is that the ideas presented here might provide future directions for research into the neurobiology of SDs during the pre-psychosis development of youth at risk for schizophrenia.
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17
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Thermenos H, Whitfield-Gabrieli S, Seidman L, Kuperberg G, Juelich R, Divatia S, Riley C, Jabbar G, Shenton M, Kubicki M, Manschreck T, Keshavan M, DeLisi L. Altered language network activity in young people at familial high-risk for schizophrenia. Schizophr Res 2013; 151:229-37. [PMID: 24176576 PMCID: PMC3987706 DOI: 10.1016/j.schres.2013.09.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 09/20/2013] [Accepted: 09/23/2013] [Indexed: 01/01/2023]
Abstract
BACKGROUND Abnormalities in language and language neural circuitry are observed in schizophrenia (SZ). Similar, but less pronounced language deficits are also seen in young first-degree relatives of people with SZ, who are at higher familial risk (FHR) for the disorder than the general population. The neural underpinnings of these deficits in people with FHR are unclear. METHODS Participants were 43 people with FHR and 32 comparable controls. fMRI scans were collected while participants viewed associated and unrelated word pairs, and performed a lexical decision task. fMRI analyses conducted in SPM8 examined group differences in the modulation of hemodynamic activity by semantic association. RESULTS There were no group differences in demographics, IQ or behavioral semantic priming, but FHR participants had more schizotypal traits than controls. Controls exhibited the expected suppression of hemodynamic activity to associated versus unrelated word pairs. Compared to controls, FHR participants showed an opposite pattern of hemodynamic modulation to associated versus unrelated word pairs, in the left inferior frontal gyrus (IFG), right superior and middle temporal gyrus (STG) and the left cerebellum. Group differences in activation were significant, FWE-corrected for multiple comparisons (p<0.05). Activity within the IFG during the unrelated condition predicted schizotypal symptoms in FHR participants. CONCLUSIONS FHR for SZ is associated with abnormally increased neural activity to semantic associates within an inferior frontal/temporal network. This might increase the risk of developing unusual ideas, perceptions and disorganized language that characterize schizotypal traits, potentially predicting which individuals are at greater risk to develop a psychotic disorder.
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Affiliation(s)
- H.W. Thermenos
- Harvard Medical School, Boston, MA, USA,Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Corresponding author at: Athinoula A. Martinos Center for Biomedical Imaging, Building 149, 2nd Floor (Room 2602E), 13th Street, Charlestown, MA 02129, USA. Tel.: +1 617 726 6043; fax: +1 617 726 4078. (H.W. Thermenos)
| | - S. Whitfield-Gabrieli
- McGovern Institute for Brain Research and Poitras Center for Affective Disorders Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - L.J. Seidman
- Harvard Medical School, Boston, MA, USA,Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - G. Kuperberg
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Tufts University, Department of Psychology, Medford, MA, USA
| | - R.J. Juelich
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - S. Divatia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - C. Riley
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - G.A. Jabbar
- Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Brockton, MA 02301, USA
| | - M.E. Shenton
- Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Brockton, MA 02301, USA,Department of Psychiatry and Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - M. Kubicki
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry and Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - T. Manschreck
- Harvard Medical School, Boston, MA, USA,Corrigan Mental Health Center, Fall River, MA, USA
| | - M.S. Keshavan
- Harvard Medical School, Boston, MA, USA,Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - L.E. DeLisi
- Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Brockton, MA 02301, USA
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18
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Crow TJ. The XY gene hypothesis of psychosis: origins and current status. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:800-24. [PMID: 24123874 PMCID: PMC4065359 DOI: 10.1002/ajmg.b.32202] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 08/19/2013] [Indexed: 11/10/2022]
Abstract
Sex differences in psychosis and their interaction with laterality (systematic departures from 50:50 left-right symmetry across the antero-posterior neural axis) are reviewed in the context of the X-Y gene hypothesis. Aspects of laterality (handedness/cerebral asymmetry/the torque) predict (1) verbal and non-verbal ability in childhood and across adult life and (2) anatomical, physiological, and linguistic variation relating to psychosis. Neuropsychological and MRI evidence from individuals with sex chromosome aneuploidies indicates that laterality is associated with an X-Y homologous gene pair. Within each mammalian species the complement of such X-Y gene pairs reflects their potential to account for taxon-specific sexual dimorphisms. As a consequence of the mechanism of meiotic suppression of unpaired chromosomes such X-Y gene pairs generate epigenetic variation around a species defining motif that is carried to the zygote with potential to initiate embryonic gene expression in XX or XY format. The Protocadherin11XY (PCDH11XY) gene pair in Xq21.3/Yp11.2 in probable coordination with a gene or genes within PAR2 (the second pseudo-autosomal region) is the prime candidate in relation to cerebral asymmetry and psychosis in Homo sapiens. The lately-described pattern of sequence variation associated with psychosis on the autosomes may reflect a component of the human genome's adjustment to selective pressures generated by the sexually dimorphic mate recognition system.
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Affiliation(s)
- Timothy J Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of OxfordOxford, UK
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19
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Thermenos HW, Keshavan MS, Juelich RJ, Molokotos E, Whitfield-Gabrieli S, Brent BK, Makris N, Seidman LJ. A review of neuroimaging studies of young relatives of individuals with schizophrenia: a developmental perspective from schizotaxia to schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:604-35. [PMID: 24132894 DOI: 10.1002/ajmg.b.32170] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 04/24/2013] [Indexed: 11/08/2022]
Abstract
In an effort to identify the developing abnormalities preceding psychosis, Dr. Ming T. Tsuang and colleagues at Harvard expanded Meehl's concept of "schizotaxia," and examined brain structure and function in families affected by schizophrenia (SZ). Here, we systematically review genetic (familial) high-risk (HR) studies of SZ using magnetic resonance imaging (MRI), examine how findings inform models of SZ etiology, and suggest directions for future research. Neuroimaging studies of youth at HR for SZ through the age of 30 were identified through a MEDLINE (PubMed) search. There is substantial evidence of gray matter volume abnormalities in youth at HR compared to controls, with an accelerated volume reduction over time in association with symptoms and cognitive deficits. In structural neuroimaging studies, prefrontal cortex (PFC) alterations were the most consistently reported finding in HR. There was also consistent evidence of smaller hippocampal volume. In functional studies, hyperactivity of the right PFC during performance of diverse tasks with common executive demands was consistently reported. The only longitudinal fMRI study to date revealed increasing left middle temporal activity in association with the emergence of psychotic symptoms. There was preliminary evidence of cerebellar and default mode network alterations in association with symptoms. Brain abnormalities in structure, function and neurochemistry are observed in the premorbid period in youth at HR for SZ. Future research should focus on the genetic and environmental contributions to these alterations, determine how early they emerge, and determine whether they can be partially or fully remediated by innovative treatments.
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Affiliation(s)
- H W Thermenos
- Harvard Medical School, Boston, Massachusetts; Massachusetts Mental Health Center, Division of Public Psychiatry, Boston, Massachusetts; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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20
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Brent BK, Thermenos HW, Keshavan MS, Seidman LJ. Gray Matter Alterations in Schizophrenia High-Risk Youth and Early-Onset Schizophrenia: A Review of Structural MRI Findings. Child Adolesc Psychiatr Clin N Am 2013; 22:689-714. [PMID: 24012081 PMCID: PMC3767930 DOI: 10.1016/j.chc.2013.06.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article reviews the literature on structural magnetic resonance imaging findings in pediatric and young adult populations at clinical or genetic high-risk for schizophrenia and early-onset schizophrenia. The implications of this research are discussed for understanding the pathophysiology of schizophrenia and for early intervention strategies. The evidence linking brain structural changes in prepsychosis development and early-onset schizophrenia with disruptions of normal neurodevelopmental processes during childhood or adolescence is described. Future directions are outlined for research to address knowledge gaps regarding the neurobiological basis of brain structural abnormalities in schizophrenia and to improve the usefulness of these abnormalities for preventative interventions.
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Affiliation(s)
- Benjamin K Brent
- Harvard Medical School, Boston, MA 02115, USA; Division of Public Psychiatry, Massachusetts Mental Health Center, 75 Fenwood Road, Boston, MA 02115, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
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21
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Sheng J, Zhu Y, Lu Z, Liu N, Huang N, Zhang Z, Tan L, Li C, Yu X. Altered volume and lateralization of language-related regions in first-episode schizophrenia. Schizophr Res 2013; 148:168-74. [PMID: 23769260 DOI: 10.1016/j.schres.2013.05.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Revised: 04/29/2013] [Accepted: 05/22/2013] [Indexed: 01/06/2023]
Abstract
Neuroanatomical abnormalities are considered to be related to the pathogenesis of schizophrenia. Reversal or reduction of normal structural cerebral asymmetries in schizophrenia is particularly striking. The current study investigated the alteration of gray matter volume and cerebral asymmetry in early stage of first-episode schizophrenia (FESZ), and their correlations with clinical measures. Magnetic resonance imaging scans were obtained from a total of 89 participants. Thirty-three FESZ patients and 41 matched healthy controls were included in the analysis. Compared to healthy controls, the FESZ patients showed decreased gray matter volume (GMV) in the frontal cortex, anterior cingulate cortex, temporal cortex, parahippocampal, fusiform, insula, and lingual; and increased GMV in cerebellum. Both male and female patients displayed an increased rightward lateralization in frontal and temporal cortex, which was significantly correlated with the severity of symptoms and social functioning. These findings may provide the neurological substrate for the etiology and clinical manifestations of the illness.
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Affiliation(s)
- Jianhua Sheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
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22
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Ahmed AO, Buckley PF, Hanna M. Neuroimaging schizophrenia: a picture is worth a thousand words, but is it saying anything important? Curr Psychiatry Rep 2013; 15:345. [PMID: 23397252 DOI: 10.1007/s11920-012-0345-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Schizophrenia is characterized by neurostructural and neurofunctional aberrations that have now been demonstrated through neuroimaging research. The article reviews recent studies that have attempted to use neuroimaging to understand the relation between neurological abnormalities and aspects of the phenomenology of schizophrenia. Neuroimaging studies show that neurostructural and neurofunctional abnormalities are present in people with schizophrenia and their close relatives and may represent putative endophenotypes. Neuroimaging phenotypes predict the emergence of psychosis in individuals classified as high-risk. Neuroimaging studies have linked structural and functional abnormalities to symptoms; and progressive structural changes to clinical course and functional outcome. Neuroimaging has successfully indexed the neurotoxic and neuroprotective effects of schizophrenia treatments. Pictures can inform about aspects of the phenomenology of schizophrenia including etiology, onset, symptoms, clinical course, and treatment effects but this assertion is tempered by the scientific and practical limitations of neuroimaging.
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Affiliation(s)
- Anthony O Ahmed
- Department of Psychiatry and Health Behavior, Georgia Health Sciences University, 997 Saint Sebastian Way, Augusta, GA 30912, USA.
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Francis AN, Bhojraj TS, Prasad KM, Montrose D, Eack SM, Rajarethinam R, van Elst LT, Keshavan MS. Alterations in the cerebral white matter of genetic high risk offspring of patients with schizophrenia spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry 2013; 40:187-92. [PMID: 22910323 PMCID: PMC3635091 DOI: 10.1016/j.pnpbp.2012.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 07/23/2012] [Accepted: 08/04/2012] [Indexed: 12/01/2022]
Abstract
Alterations in white matter (WM) may be seen in young relatives at risk and may underlie vulnerability to schizophrenia. We were interested in exploring which of the WM regions were altered in adolescent offspring at familial risk for schizophrenia. We examined structural alterations in the offspring of subjects with schizophrenia or schizoaffective disorder (HR; n=65; 36 males) and healthy controls (HC; n=80: 37 males) matched for age and education. MRI images were collected using a GE 1.5 T scanner at the University of Pittsburgh Medical Center. Image processing was done using FreeSurfer (MGH) by an experienced rater blind to clinical data. We used multivariate analysis of covariance, with intracranial volume (p>0.05) and age as covariates. High Risk offspring had significant reductions in total WM, hemispheric WM and WM within left parietal and left cingulate cortices. Male offspring had more pronounced right hemisphere WM reductions than females.
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Affiliation(s)
- Alan N Francis
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Tejas S Bhojraj
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | | | - Shaun M Eack
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,University of Pittsburgh Medical Center, Pittsburgh, PA
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Agnew-Blais J, Seidman LJ. Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and qualitative review. Cogn Neuropsychiatry 2013; 18:44-82. [PMID: 22998599 PMCID: PMC3577989 DOI: 10.1080/13546805.2012.676309] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Neurocognitive dysfunction is a central feature of schizophrenia and is observed during all phases of the illness. Because schizophrenia is known to run in families, studying neurocognitive function in first-degree, nonpsychotic relatives has been a widely utilised strategy for almost 50 years for understanding presumed "genetic risk". Studying nonpsychotic relatives ("familial high-risk", or FHR) allows for identification of cognitive vulnerability markers independent of confounds associated with psychosis. METHODS Prior meta-analyses have elucidated the level and pattern of cognitive deficits in the premorbid, prodromal, and postonset periods of psychosis, and in relatives regardless of age. However, no prior quantitative analyses have specifically focused on studies of young first-degree relatives of individuals with schizophrenia who have not passed through the peak age illness risk (<age 30). The English language literature of neuropsychological studies of first-degree relatives for schizophrenia was identified up to 15 May 2011. RESULTS From 33 studies, 28 studies met our criteria for quantitative review, utilising >70 individual tests and 250 variables. CONCLUSIONS In general, young FHR individuals demonstrated deficits with a moderate level of severity compared with healthy controls. The largest average effect sizes (ESs), based on tests given in at least three independent studies, were on estimates of Full Scale IQ (d= -0.777), followed by Vocabulary (d= -0.749) and single word reading tests (d= -0.698) (often used as estimates of IQ). Measures of declarative memory, sustained attention, working memory and others had more modest ESs. Deficits were milder than in established schizophrenia, but often as severe as in clinical high-risk or putatively prodromal participants and in older relatives examined in prior meta-analyses. Additionally, while assessed from a more limited literature, youth at FHR for schizophrenia tended to show worse neurocognitive functioning than those at FHR for affective psychosis. This suggests that genetic risk for schizophrenia as reflected in a positive FHR carries an especially heavy impact on cognitive ability.
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Affiliation(s)
- Jessica Agnew-Blais
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115
| | - Larry J. Seidman
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School Department of Psychiatry, Boston, Massachusetts 02115,Massachusetts General Hospital, Harvard Medical School Department of Psychiatry, Boston, Massachusetts 02114,Correspondence: Larry J. Seidman, Ph.D., Beth Israel Deaconess Medical Center, Department of Psychiatry, Massachusetts Mental Health Center, Commonwealth, Research Center, 5th floor, 75 Fenwood Road, Boston, MA 02115; Tel: 617-754-1238,
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Scala S, Lasalvia A, Cristofalo D, Bonetto C, Ruggeri M. Neurocognitive profile and its association with psychopathology in first-degree relatives of patients with schizophrenia. a case-control study. Psychiatry Res 2012; 200:137-43. [PMID: 22652345 DOI: 10.1016/j.psychres.2012.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 04/30/2012] [Accepted: 05/05/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND People with schizophrenia show a broad range of neurocognitive deficits, which are considered as core features of the disorder and are thought to be partly heritable. Similar deficits, albeit at a lesser degree, have been also found in their healthy biological relatives. These deficits, if better characterized, might represent underlying vulnerable traits for psychosis. METHODS This case-control study compared neurocognitive functioning of adult first-degree relatives of patients with schizophrenia (SCZ-RELs) (n=55) with healthy control subjects (n=55) and explored its association with the negative symptoms. Subjects in both study and control group were assessed with an extensive neurocognitive test battery (Trail Making test, Phonemic Verbal fluency, Wisconsin Card Sorting Test, Bushke Fuld Test, Stroop Test, n-Back and Digit span) and a set of clinical measures (SANS, GAF and DAS). RESULTS SCZ-RELs were more significantly impaired on executive function tasks (i.e. Wisconsin Card Sorting Test and the Phonemic Verbal fluency) and displayed significantly more severe negative symptoms and poorer social functioning than control subjects. Significant correlations between neurocognitive measures and negative symptoms were found in the study group, whereas no significant correlations were detected among the controls. DISCUSSION Subtle executive impairments, associated with negative symptoms, are shown to be evident in healthy relatives of patients with schizophrenia. These deficits, which reflect subtle dysfunction in concept formation, flexibility and mental shifting, may be seen as potential phenotypic markers of vulnerability for schizophrenia. This raises the question of underlying prefrontal dysfunction as core feature of the disorder.
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Affiliation(s)
- Silvia Scala
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10 37134 Verona, Italy.
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Abstract
This study sought to examine whole brain and regional gray matter (GM) phenotypes across the schizophrenia (SZ)-bipolar disorder psychosis dimension using voxel-based morphometry (VBM 8.0 with DARTEL segmentation/normalization) and semi-automated regional parcellation, FreeSurfer (FS 4.3.1/64 bit). 3T T1 MPRAGE images were acquired from 19 volunteers with schizophrenia (SZ), 16 with schizoaffective disorder (SAD), 17 with psychotic bipolar I disorder (BD-P) and 10 healthy controls (HC). Contrasted with HC, SZ showed extensive cortical GM reductions, most pronounced in fronto-temporal regions; SAD had GM reductions overlapping with SZ, albeit less extensive; and BD-P demonstrated no GM differences from HC. Within the psychosis dimension, BD-P showed larger volumes in fronto-temporal and other cortical/subcortical regions compared with SZ, whereas SAD showed intermediate GM volumes. The two volumetric methodologies, VBM and FS, revealed highly overlapping results for cortical GM, but partially divergent results for subcortical volumes (basal ganglia, amygdala). Overall, these findings suggest that individuals across the psychosis dimension show both overlapping and unique GM phenotypes: decreased GM, predominantly in fronto-temporal regions, is characteristic of SZ but not of psychotic BD-P, whereas SAD display GM deficits overlapping with SZ, albeit less extensive.
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Dissociable morphometric differences of the inferior parietal lobule in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2012; 262:579-87. [PMID: 22454243 DOI: 10.1007/s00406-012-0314-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 03/16/2012] [Indexed: 12/18/2022]
Abstract
Inferior parietal lobule (IPL) forms an integral part of a critical frontoparietal network, which has been implicated in various clinical symptoms and cognitive deficits seen in schizophrenia. Despite its functional relevance, the relatively few studies that have investigated the structural changes in the IPL report inconsistent findings concerning the nature and localization of these changes. We employed a blinded, automated labelling procedure to measure cortical thickness, surface area and the degree of cortical folding of the two distinct subregions of the IPL (Angular Gyrus and Supramarginal Gyrus) in 57 patients with schizophrenia and 41 controls using high-resolution magnetic resonance imaging. Within the IPL, we observed more pronounced morphological changes in supramarginal gyrus compared to angular gyrus in schizophrenia. While supramarginal gyrus in patients showed reduced gyrification, contracted surface area and thinning, the morphometric changes in angular gyrus were largely confined to a reduction in surface area. Significant hemispheric asymmetry was observed in the gyrification of the supramarginal gyrus. Our findings suggest that in addition to abnormalities in the neurodevelopmental processes that contribute to regional surface area and cortical thickness, a specific defect in cortical folding, especially affecting the left hemisphere, is likely to occur in schizophrenia.
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Francis AN, Seidman LJ, Jabbar GA, Mesholam-Gately R, Thermenos HW, Juelich R, Proal AC, Shenton M, Kubicki M, Mathew I, Keshavan M, DeLisi LE. Alterations in brain structures underlying language function in young adults at high familial risk for schizophrenia. Schizophr Res 2012; 141:65-71. [PMID: 22892286 PMCID: PMC3466598 DOI: 10.1016/j.schres.2012.07.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 07/19/2012] [Accepted: 07/20/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Neuroanatomical and cognitive alterations typical of schizophrenia (SZ) patients are observed to a lesser extent in their adolescent and adult first-degree relatives, likely reflecting neurodevelopmental abnormalities associated with genetic risk for the illness. The anatomical pathways for language are hypothesized to be abnormal and to underlie the positive symptoms of schizophrenia. Examining non-psychotic relatives at high familial risk (FHR) for schizophrenia may clarify if these deficits represent trait markers associated with genetic vulnerability, rather than specific markers resulting from the pathological process underlying schizophrenia. METHODS T1 MRI scans from a 3T Siemens scanner of young adult FHR subjects (N=46) and controls with no family history of illness (i.e. at low genetic risk LRC; N=31) were processed using FreeSurfer 5.0. We explored volumetric and lateralization alterations in regions associated with language processing. An extensive neuropsychological battery of language measures was administered. RESULTS No significant differences were observed between groups on any language measures. Controlling intracranial volume, significantly smaller left pars triangularis (PT) (p<0.01) and right pars orbitalis (PO) (p<0.01) volumes and reversal of the L>R pars orbitalis (p<0.001) lateralization were observed in FHR subjects. In addition, the L pars triangularis and R pars orbitalis correlated with performance on tests of linguistic function in the FHR group. CONCLUSIONS Reduced volume and reversed structural asymmetry in language-related regions hypothesized to be altered in SZ are also found in first degree relatives at FHR, despite normal language performance. To clarify if these findings are endophenotypes for Sz, future studies would need to be performed of ill and well family members no longer within the age range of risk for illness to show these deficits segregate with schizophrenia within families. Moreover, measures of complex language need to be studied to determine if FHR individuals manifest impairments in some aspects of language function.
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Affiliation(s)
- Alan N. Francis
- Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, MA
| | - Larry J. Seidman
- Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, MA,Massachusetts General Hospital; Harvard Medical School, Boston, MA
| | - Gul A. Jabbar
- Veterans Affairs, Boston Healthcare System, Brockton, MA; Harvard Medical School, Boston, MA
| | | | - Heidi W. Thermenos
- Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, MA,Massachusetts General Hospital; Harvard Medical School, Boston, MA
| | - Richard Juelich
- Massachusetts General Hospital; Harvard Medical School, Boston, MA
| | - Ashley C. Proal
- Veterans Affairs, Boston Healthcare System, Brockton, MA; Harvard Medical School, Boston, MA
| | - Martha Shenton
- Brigham and Women’s Hospital; Harvard Medical School, Boston, MA,Veterans Affairs, Boston Healthcare System, Brockton, MA; Harvard Medical School, Boston, MA
| | - Marek Kubicki
- Brigham and Women’s Hospital; Harvard Medical School, Boston, MA,Veterans Affairs, Boston Healthcare System, Brockton, MA; Harvard Medical School, Boston, MA
| | - Ian Mathew
- Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, MA
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, MA
| | - Lynn E. DeLisi
- Veterans Affairs, Boston Healthcare System, Brockton, MA; Harvard Medical School, Boston, MA,Address all correspondence to: LE DeLisi, MD, Building 2 (2-2-B), The VA Boston Healthcare System, 940 Belmont Avenue, Brockton, Massachusetts.
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Haukvik UK, Schaer M, Nesvåg R, McNeil T, Hartberg CB, Jönsson EG, Eliez S, Agartz I. Cortical folding in Broca's area relates to obstetric complications in schizophrenia patients and healthy controls. Psychol Med 2012; 42:1329-1337. [PMID: 22029970 DOI: 10.1017/s0033291711002315] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increased occurrence of obstetric complications (OCs) in patients with schizophrenia suggests that alterations in neurodevelopment may be of importance to the aetiology of the illness. Abnormal cortical folding may reflect subtle deviation from normal neurodevelopment during the foetal or neonatal period. In the present study, we hypothesized that OCs would be related to cortical folding abnormalities in schizophrenia patients corresponding to areas where patients with schizophrenia display altered cortical folding when compared with healthy controls. METHOD In total, 54 schizophrenia patients and 54 healthy control subjects underwent clinical examination and magnetic resonance image scanning on a 1.5 T scanner. Information on OCs was collected from original birth records. An automated algorithm was used to calculate a three-dimensional local gyrification index (lGI) at numerous points across the cortical mantle. RESULTS In both schizophrenia patients and healthy controls, an increasing number of OCs was significantly related to lower lGI in the left pars triangularis (p<0.0005) in Broca's area. For five other anatomical cortical parcellations in the left hemisphere, a similar trend was demonstrated. No significant relationships between OCs and lGI were found in the right hemisphere and there were no significant case-control differences in lGI. CONCLUSIONS The reduced cortical folding in the left pars triangularis, associated with OCs in both patients and control subjects suggests that the cortical effect of OCs is caused by factors shared by schizophrenia patients and healthy controls rather than factors related to schizophrenia alone.
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Affiliation(s)
- U K Haukvik
- Department of Clinical Medicine, section Vinderen, University of Oslo, Oslo, Norway.
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A functional promoter polymorphism of neuronal nitric oxide synthase moderates prefrontal functioning in schizophrenia. Int J Neuropsychopharmacol 2011; 14:887-97. [PMID: 21281558 DOI: 10.1017/s1461145710001677] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cognitive deficits in tasks involving the prefrontal cortex such as working memory or verbal fluency are a key component of schizophrenia. This led to the hypofrontality hypothesis of schizophrenia, which is widely accepted even though molecular underpinnings are elusive. While disturbances of glutamatergic neurotransmission might play a role, other components have rarely been investigated. Recently, the promoter region of nitric oxide (NO) synthase-I (NOS-I, encoded by the gene NOS1), impacting on prefrontal glutamate transmission, has repeatedly been associated with schizophrenia. We thus tested whether an associated schizophrenia risk variant (rs41279104), leading to reduced expression of the transcript, influences prefrontal brain functioning. Forty-three patients suffering from chronic schizophrenia and 44 controls were genotyped for NOS1 rs41279104 and investigated by means of functional near-infrared spectroscopy (fNIRS), while completing a working-memory task (2-back test) and a verbal fluency test (VFT). After matching for genotype, behavioural and brain activation data of 26 patients and 28 comparable controls were correlated to rs41279104. Healthy controls showed significant activation of large parts of the lateral prefrontal cortex during both tasks, whereas task-related changes in oxygenation were significantly reduced in patients. Schizophrenia patients also performed worse in both tasks. The NOS1 schizophrenia risk genotype rs41279104 AA/AG was associated with slower reaction time in the 2-back task, as well as with reduced right-hemispheric activation of the frontal cortex for VFT in patients only. Our fNIRS data extend previous studies suggesting disturbed prefrontal functioning in schizophrenia and suggest that genetic variation of NOS1 has a role in cognitive dysfunction, probably by mediating glutamatergic tone.
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Reduced activation of superior temporal gyrus during auditory comprehension in young offspring of patients with schizophrenia. Schizophr Res 2011; 130:101-5. [PMID: 21684722 DOI: 10.1016/j.schres.2011.05.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 05/23/2011] [Accepted: 05/25/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Smaller Superior Temporal Gyrus (STG) and reduced activation with language tasks have been found in schizophrenia emphasizing the involvement of parts of language network. Recently, we reported smaller STG in individuals at risk for psychosis. In this study, we examined the brain activation for auditory comprehension using fMRI in a group of young offspring of schizophrenia patients (HR) with a hypothesis that HR subjects will not activate STG as well as comparison subjects. METHODS Fifteen HR (7M, 8F, mean age 15.9±3.1) and 17 comparison subjects (9M and 8F, mean age 14.5±3.5) participated. BOLD fMRI images were obtained using a 4 Tesla scanner with a multi echo-planar imaging sequence. The participants were asked to listen to 30 sec blocks of a story alternated with blocks of the same reading played backwards. The data were analyzed using Statistical Parametric Mapping (SPM5) and a BOLD activation exceeding a threshold of T>2.58 (p<0.01, uncorrected) was considered significant. RESULTS The HR showed significantly lower BOLD activation at the STG bilaterally compared to normal controls (left STG; x=-64, y=-48, z=12, Z=2.95, right STG; x=62, y=-50, z=-16, Z=2.77). The effect was more pronounced in males and on left STG. CONCLUSIONS These data suggest that adolescents at risk for schizophrenia show reduced activation of the STG compared to control subjects during a language related task (listening). This finding adds support to the idea that abnormal development of the language related cortex is a marker of increased susceptibility to schizophrenia and that such deviant development may be mediated by familial/genetic factors.
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Alexithymia and regional gray matter alterations in schizophrenia. Neurosci Res 2011; 70:206-13. [DOI: 10.1016/j.neures.2011.01.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 12/29/2010] [Accepted: 01/31/2011] [Indexed: 11/19/2022]
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Bhojraj TS, Prasad KM, Eack S, Rajarethinam R, Francis AN, Montrose DM, Keshavan MS, Keshavan MS. Progressive alterations of the auditory association areas in young non-psychotic offspring of schizophrenia patients. J Psychiatr Res 2011; 45:205-12. [PMID: 20541772 PMCID: PMC2982933 DOI: 10.1016/j.jpsychires.2010.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 05/10/2010] [Accepted: 05/17/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizophrenia may involve progressive alterations of structure and hemispheric lateralization of auditory association areas (AAA) within the superior temporal gyrus. These alterations may be greater in male patients. It is unclear if these deficits are state-dependent or whether they predate illness onset and reflect familial diathesis. AIMS We sought to compare AAA cortical thickness, surface area and lateralization across adolescent and young adult non-psychotic offspring of schizophrenia patients (OS) and healthy controls at baseline and one year follow-up. We also assessed the moderating effect of gender on these measures. METHODS Fifty-six OS and thirty-six control subjects were assessed at baseline and at follow-up on AAA surface area and thickness using FreeSurfer to process T1-MRI-images. We used repeated measures ANCOVAs, controlling intra cranial volume and age with assessment-time and side as within-subject factors and gender and study group as between-subject factors. RESULTS Surface area deficit in OS was greater on the left than on the right, as reflected in a lower surface area laterality-index (left-right/left + right × 100) in OS compared to controls. Left, but not right surface area and surface area laterality-index showed a longitudinal decline in OS compared to controls. Male OS declined more than controls on surface area and thickness. CONCLUSIONS Left AAA surface area may progressively decline in young non-psychotic offspring at familial diathesis for schizophrenia causing a continuing reversal of the leftward AAA lateralization. Progressive surface area reduction and thinning of AAA may be more prominent in young non-psychotic male offspring at risk for schizophrenia.
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Affiliation(s)
- Tejas S. Bhojraj
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center; Harvard Medical School, Boston, MA, USA
| | | | - Shaun Eack
- Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA
| | | | - Alan N. Francis
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center; Harvard Medical School, Boston, MA, USA
| | - Debra M. Montrose
- Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center; Harvard Medical School, Boston, MA, USA, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA, Wayne State University, Detroit, Michigan, USA
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Francis A, Bhojraj TS, Prasad K, Kulkarni S, Montrose D, Eack S, Keshavan MS. Abnormalities of the corpus callosum in non-psychotic high-risk offspring of schizophrenia patients. Psychiatry Res 2011; 191:9-15. [PMID: 21145214 PMCID: PMC3124091 DOI: 10.1016/j.pscychresns.2010.09.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 08/06/2010] [Accepted: 09/14/2010] [Indexed: 01/10/2023]
Abstract
Alterations in the structure of the corpus callosum (CC) have been observed in schizophrenia. Offspring of schizophrenia parents have 10-15 times higher risk for developing schizophrenia. We examined CC volume in offspring at genetic high-risk (HR) subjects. Since the sub-regions of the CC are topographically mapped to cortical brain regions, we hypothesized that HR subjects may show a decrement in total volume and differential volume decreases in sub-regions of the CC. The offspring of schizophrenia parents (HR; n=70; 36 males) and healthy volunteers with no family or personal history of psychotic disorders (healthy controls (HC); n=73; 37 males) matched for age, gender and education were selected for the study. Magnetic resonance images were collected using a GE 1.5 T scanner and processed using FreeSurfer image analysis software. The CC was divided into five neuroanatomically based partitions. The volume of total CC and the five sub-regions were measured blind to clinical information. With covariation for intracranial volume, HR subjects had significantly reduced total CC, more prominently observed in the anterior splenium. An age-related increase in CC volume was found in the anterior and posterior splenium of healthy controls but not in HR subjects. The volume reduction was greater in male than female HR subjects. The volume reduction in the CC may reflect a reduction in axonal fibers crossing the hemispheres and/or myelination between the left and right temporo-parietal cortices. The absence of an age-related volume increase suggests an abnormal developmental trajectory that may underlie susceptibility to schizophrenia.
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Affiliation(s)
- A. Francis
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA
| | - TS Bhojraj
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA
| | - K Prasad
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - S Kulkarni
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA
| | - D Montrose
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - S Eack
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - MS Keshavan
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA, University of Pittsburgh Medical Center, Pittsburgh, PA
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Diederen KMJ, De Weijer AD, Daalman K, Blom JD, Neggers SFW, Kahn RS, Sommer IEC. Decreased language lateralization is characteristic of psychosis, not auditory hallucinations. ACTA ACUST UNITED AC 2010; 133:3734-44. [PMID: 21097491 DOI: 10.1093/brain/awq313] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Decreased language lateralization is a well-replicated finding in psychotic patients. It is currently unclear, however, whether this abnormality is related to a particular symptom of psychosis or to psychosis in general. It has been argued that decreased language lateralization may be related to auditory verbal hallucinations. To elucidate this, these hallucinations should be studied in isolation. Thirty-five patients with a psychotic disorder, 35 non-psychotic subjects with relatively isolated auditory verbal hallucinations and 35 healthy control subjects participated in this study. All subjects were scanned on a 3T magnetic resonance imaging scanner, while covertly performing a paced verbal fluency task. In order to measure performance on the task, one additional task block was presented during which subjects had to generate words overtly. In addition to calculating language lateralization indices, group-wise brain activation during verbal fluency was compared between the three groups. Task performance was nearly maximal for all groups and did not differ significantly between the groups. Compared with the healthy control subjects and non-psychotic subjects with auditory verbal hallucinations, language lateralization was significantly reduced for the patient group. In addition, the patients displayed significantly greater activity in the right precentral gyrus and left insula when compared with the healthy control subjects and the non-psychotic subjects with auditory verbal hallucinations. Furthermore, the patients showed greater activity in the right superior parietal lobule when compared with the healthy control subjects. Lateralization indices did not differ significantly between the non-psychotic subjects with auditory verbal hallucinations and the healthy control subjects. Moreover, there were no significant differences in brain activation during verbal fluency between the two non-psychotic groups. As language lateralization was not significantly reduced in the non-psychotic individuals with auditory verbal hallucinations, a direct relationship between auditory verbal hallucinations and decreased language lateralization can not be established at present.
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Affiliation(s)
- Kelly M J Diederen
- Neuroscience Division, Department of Psychiatry, University Medical Centre Utrecht and Rudolf Magnus Institute for Neuroscience, Heidelberglaan, The Netherlands.
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Blanchard MM, Jacobson S, Clarke MC, Connor D, Kelleher I, Garavan H, Harley M, Cannon M. Language, motor and speed of processing deficits in adolescents with subclinical psychotic symptoms. Schizophr Res 2010; 123:71-6. [PMID: 20580205 DOI: 10.1016/j.schres.2010.05.028] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 03/14/2010] [Accepted: 05/22/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Neuropsychological impairment is a core feature of schizophrenia. Adolescents reporting subclinical psychotic symptoms are considered to be at greater risk of developing a psychotic illness later in life than adolescents who do not report such symptoms and, thus, may represent an at-risk group for further study. We wished to investigate neuropsychological functioning in early adolescence in relation to reports of psychotic symptoms. METHODS Participants were recruited from local primary schools after a two-stage screening and parental consent process. In brief, 277 adolescents were screened and 37 attended for testing. Seventeen adolescents who were deemed to report 'definite' psychotic symptoms after clinical interview and 20 control adolescents underwent a clinical interview and a one-hour neuropsychological battery. RESULTS Adolescents who report psychotic symptoms exhibited significant impairments in receptive language (as measured by the British Picture Vocabulary Scale), motor function (as measured by the Pegboard test) and executive function/speed of processing (as measured by the Trail-Making test). There were no significant differences between the groups on measures of attention, memory or expressive language, abstract reasoning or overall scholastic ability. CONCLUSIONS Taken together with the results from birth cohort, genetic high risk and prodromal studies, these findings are consistent with a neural inefficiency/disconnectivity hypothesis in those at risk for psychosis. These results highlight the need to investigate developmental brain circuits subserving language and motor function and processing speed and how these change over time in at-risk adolescents.
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Affiliation(s)
- Mathieu M Blanchard
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 9, Ireland
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Bhojraj TS, Sweeney JA, Prasad KM, Eack SM, Francis AN, Miewald JM, Montrose DM, Keshavan MS. Gray matter loss in young relatives at risk for schizophrenia: relation with prodromal psychopathology. Neuroimage 2010; 54 Suppl 1:S272-9. [PMID: 20441795 DOI: 10.1016/j.neuroimage.2010.04.257] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Revised: 03/26/2010] [Accepted: 04/28/2010] [Indexed: 11/18/2022] Open
Abstract
The maturation of neocortical regions mediating social cognition during adolescence and young adulthood in relatives of schizophrenia patients may be vulnerable to heritable alterations of neurodevelopment. Prodromal psychotic symptoms, commonly emerging during this period in relatives, have been hypothesized to result from alterations in brain regions mediating social cognition. We hypothesized these regions to show longitudinal alterations and these alterations to predict prodromal symptoms in adolescent and young adult relatives of schizophrenia patients. 27 Healthy controls and 23 relatives were assessed at baseline and one-year follow-up using scale of prodromal symptoms and gray matter volumes of hypothesized regions from T1-MRI images. Regional volumes showing deficits on ANCOVA and repeated-measures ANCOVAs (controlling intra cranial volume, age and gender) were correlated with prodromal symptoms. At baseline, bilateral amygdalae, bilateral pars triangulares, left lateral orbitofrontal, right frontal pole, angular and supramarginal gyrii were smaller in relatives compared to controls. Relatives declined but controls increased or remained stable on bilateral lateral orbitofrontal, left rostral anterior cingulate, left medial prefrontal, right inferior frontal gyrus and left temporal pole volumes at follow-up relative to baseline. Smaller volumes predicted greater severity of prodromal symptoms at both cross-sectional assessments. Longitudinally, smaller baseline volumes predicted greater prodromal symptoms at follow-up; greater longitudinal decreases in volumes predicted worsening (increase) of prodromal symptoms over time. These preliminary findings suggest that abnormal longitudinal gray matter loss may occur in regions mediating social cognition and may convey risk for prodromal symptoms during adolescence and early adulthood in individuals with a familial diathesis for schizophrenia.
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Affiliation(s)
- Tejas S Bhojraj
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
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Bhojraj TS, Francis AN, Montrose DM, Keshavan MS. Grey matter and cognitive deficits in young relatives of schizophrenia patients. Neuroimage 2010; 54 Suppl 1:S287-92. [PMID: 20362681 DOI: 10.1016/j.neuroimage.2010.03.069] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 01/28/2010] [Accepted: 03/23/2010] [Indexed: 11/28/2022] Open
Abstract
Grey-matter volumetric and cognitive deficits in young, high-risk relatives of schizophrenia patients may be vulnerability markers of the illness. Although these markers may be correlated, it is unclear if their distributions in relatives overlap. We examined convergence of these markers in 94 young first and second-degree relatives (HR) and 81 healthy controls. Subjects were assessed using WCST, CPT-IP and Benton-Hamscher tests and on grey-matter volumes of brain regions related to language, attention and executive function using FreeSurfer to process T1-MR-images. K-means clustering using cognitive performance scores split relatives into sub-samples with better (HR+C, n=35) and worse (HR-C, n=59) cognition after controlling for age and gender. All regional volumes and language related regional laterality-indices were compared between HR-C, HR+C and control subjects, controlling for age, gender and intra-cranial volume. Volumes of caudate nuclei, thalami, hippocampi, inferior frontal gyri, Heschl's gyri, superior parietal cortices, supramarginal gyri, right angular gyrus, right middle frontal gyrus and right superior frontal gyrus, leftward laterality of supramarginal and inferior frontal gyri and rightward laterality of the angular gyrus were reduced in HR-C compared to controls. Volumes of Heschl's gyri, left supramarginal gyrus, inferior frontal gyri, hippocampi and caudate nuclei HR-C were smaller in HR-C compared to HR+C. HR+C showed deficits compared to controls only for the superior parietal and right angular volumes. Premorbid neuroanatomical and laterality alterations in schizophrenia may selectively manifest in cognitively compromised relatives. Overlapping structural and cognitive deficits may define a hyper vulnerable sub-sample among individuals at familial predisposition to schizophrenia.
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Affiliation(s)
- Tejas S Bhojraj
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
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Keshavan MS, Kulkarni S, Bhojraj T, Francis A, Diwadkar V, Montrose DM, Seidman LJ, Sweeney J. Premorbid cognitive deficits in young relatives of schizophrenia patients. Front Hum Neurosci 2010; 3:62. [PMID: 20300465 PMCID: PMC2839849 DOI: 10.3389/neuro.09.062.2009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Accepted: 11/20/2009] [Indexed: 02/05/2023] Open
Abstract
Neurocognitive deficits in schizophrenia (SZ) are thought to be stable trait markers that predate the illness and manifest in relatives of patients. Adolescence is the age of maximum vulnerability to the onset of SZ and may be an opportune "window" to observe neurocognitive impairments close to but prior to the onset of psychosis. We reviewed the extant studies assessing neurocognitive deficits in young relatives at high risk (HR) for SZ and their relation to brain structural alterations. We also provide some additional data pertaining to the relation of these deficits to psychopathology and brain structural alterations from the Pittsburgh Risk Evaluation Program (PREP). Cognitive deficits are noted in the HR population, which are more severe in first-degree relatives compared to second-degree relatives and primarily involve psychomotor speed, memory, attention, reasoning, and social-cognition. Reduced general intelligence is also noted, although its relationship to these specific domains is underexplored. Premorbid cognitive deficits may be related to brain structural and functional abnormalities, underlining the neurobiological basis of this illness. Cognitive impairments might predict later emergence of psychopathology in at-risk subjects and may be targets of early remediation and preventive strategies. Although evidence for neurocognitive deficits in young relatives abounds, further studies on their structural underpinnings and on their candidate status as endophenotypes are needed.
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Affiliation(s)
- Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School Boston, MA, USA
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