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Alonso-Sanchez MF, Z-Rivera L, Otero M, Portal J, Cavieres Á, Alfaro-Faccio P. Aberrant brain language network in schizophrenia spectrum disorder: a systematic review of its relation to language signs beyond symptoms. Front Psychiatry 2024; 15:1244694. [PMID: 39026525 PMCID: PMC11254709 DOI: 10.3389/fpsyt.2024.1244694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/07/2024] [Indexed: 07/20/2024] Open
Abstract
Background Language disturbances are a core feature of schizophrenia, often studied as a formal thought disorder. The neurobiology of language in schizophrenia has been addressed within the same framework, that language and thought are equivalents considering symptoms and not signs. This review aims to systematically examine published peer-reviewed studies that employed neuroimaging techniques to investigate aberrant brain-language networks in individuals with schizophrenia in relation to linguistic signs. Methods We employed a language model for automatic data extraction. We selected our studies according to the PRISMA recommendations, and we conducted the quality assessment of the selected studies according to the STROBE guidance. Results We analyzed the findings from 37 studies, categorizing them based on patient characteristics, brain measures, and language task types. The inferior frontal gyrus (IFG) and superior temporal gyrus (STG) exhibited the most significant differences among these studies and paradigms. Conclusions We propose guidelines for future research in this field based on our analysis. It is crucial to investigate larger networks involved in language processing, and language models with brain metrics must be integrated to enhance our understanding of the relationship between language and brain abnormalities in schizophrenia.
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Affiliation(s)
- María F. Alonso-Sanchez
- Escuela de Fonoaudiología, Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Facultad de Medicina, Universidad de Valparaíso, Viña del Mar, Chile
| | - Lucía Z-Rivera
- Advanced Center for Electrical and Electronic Engineering (AC3E), Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Mónica Otero
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad San Sebastián, Santiago de Chile, Chile
- Centro BASAL Ciencia & Vida, Universidad San Sebastián, Santiago de Chile, Chile
| | - Jorge Portal
- Advanced Center for Electrical and Electronic Engineering (AC3E), Universidad Técnica Federico Santa María, Valparaíso, Chile
- Departamento de Electrónica, Univeridad Técnica Federico Santa María (USM), Valparaíso, Chile
| | - Álvaro Cavieres
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Pedro Alfaro-Faccio
- Instituto de Literatura y Ciencias del Lenguaje, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Zouraraki C, Karamaouna P, Giakoumaki SG. Cognitive Processes and Resting-State Functional Neuroimaging Findings in High Schizotypal Individuals and Schizotypal Personality Disorder Patients: A Systematic Review. Brain Sci 2023; 13:brainsci13040615. [PMID: 37190580 DOI: 10.3390/brainsci13040615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 04/07/2023] Open
Abstract
Ample research findings indicate that there is altered brain functioning in the schizophrenia spectrum. Nevertheless, functional neuroimaging findings remain ambiguous for healthy individuals expressing high schizotypal traits and patients with schizotypal personality disorder (SPD). The purpose of this systematic review was to identify patterns of task-related and resting-state neural abnormalities across these conditions. MEDLINE-PubMed and PsycINFO were systematically searched and forty-eight studies were selected. Forty studies assessed healthy individuals with high schizotypal traits and eight studies examined SPD patients with functional neuroimaging techniques (fNIRS; fMRI; Resting-state fMRI). Functional alterations in striatal, frontal and temporal regions were found in healthy individuals with high schizotypal traits. Schizotypal personality disorder was associated with default mode network abnormalities but further research is required in order to better conceive its neural correlates. There was also evidence for functional compensatory mechanisms associated with both conditions. To conclude, the findings suggest that brain dysfunctions are evident in individuals who lie along the subclinical part of the spectrum, further supporting the continuum model for schizophrenia susceptibility. Additional research is required in order to delineate the counterbalancing processes implicated in the schizophrenia spectrum, as this approach will provide promising insights for both conversion and protection from conversion into schizophrenia.
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Affiliation(s)
- Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, 74100 Rethymno, Greece
- University of Crete Research Center for the Humanities, The Social and Education Sciences (UCRC), University of Crete, Gallos University Campus, 74100 Rethymno, Greece
| | - Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, 74100 Rethymno, Greece
- University of Crete Research Center for the Humanities, The Social and Education Sciences (UCRC), University of Crete, Gallos University Campus, 74100 Rethymno, Greece
| | - Stella G. Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, 74100 Rethymno, Greece
- University of Crete Research Center for the Humanities, The Social and Education Sciences (UCRC), University of Crete, Gallos University Campus, 74100 Rethymno, Greece
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Zhao Q, Wang WQ, Fan HZ, Li D, Li YJ, Zhao YL, Tian ZX, Wang ZR, Tan YL, Tan SP. Vocal acoustic features may be objective biomarkers of negative symptoms in schizophrenia: A cross-sectional study. Schizophr Res 2022; 250:180-185. [PMID: 36423443 DOI: 10.1016/j.schres.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are currently no objective biomarkers that allow the quantification of negative symptoms of schizophrenia. This study therefore explored the use of acoustic features in identifying the severity of negative symptoms in patients with schizophrenia. METHODS We recruited 79 inpatients who were diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (the schizophrenia group) at the Huilongguan Hospital in Beijing, China, and 79 healthy controls from the surrounding community (the control group). We assessed the clinical symptoms of the patients with schizophrenia using the Positive and Negative Syndrome Scale (PANSS) and the Brief Negative Symptom Scale (BNSS) and recorded the voice of each participant as they read emotionally positive, neutral, and negative texts. The Praat software was used to analyse and extract acoustic characteristics from the recordings, such as jitter, shimmer, and pitch. The acoustic differences between the two groups of participants and the relationship between acoustic characteristics and clinical symptoms in the patient group were analysed. RESULTS There were significant differences between the schizophrenia and control groups in pitch, voice breaks, jitter, shimmer, and the mean harmonics-to-noise ratio (p < 0.05). Jitter was negatively correlated with the blunted affect and alogia subscale scores of the BNSS, both in the positive and neutral emotion conditions, but the correlation disappeared in the negative emotion condition. However, shimmer exhibited a stable negative correlation with the blunted affect and alogia subscale scores of the BNSS in all three emotion conditions. A linear regression analysis showed that pitch, jitter, shimmer, and age were statistically significant predictors of BNSS subscale scores. CONCLUSIONS Acoustic emotional expression differs between patients with schizophrenia and healthy controls. Some acoustic characteristics are related to the severity of negative symptoms, regardless of semantic emotions, and may therefore be objective biomarkers of negative symptoms. A systematic method for assessing vocal acoustic characteristics could provide an accurate and feasible means of assessing negative symptoms in schizophrenia. TWEET Acoustic emotional expression differs between patients with schizophrenia and healthy controls. A systematic method for assessing vocal acoustics could provide an accurate and feasible means of assessing negative symptoms in schizophrenia.
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Affiliation(s)
- Qing Zhao
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Wen-Qing Wang
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Hong-Zhen Fan
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Dong Li
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Ya-Jun Li
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Yan-Li Zhao
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Zhan-Xiao Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Zhi-Ren Wang
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Yun-Long Tan
- Beijing Huilongguan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Shu-Ping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China.
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Kraus MS, Walker TM, Perkins D, Keefe RS. Basic auditory processing and emotion recognition in individuals at clinical high risk for psychosis. Schizophr Res Cogn 2022; 27:100225. [PMID: 34840961 PMCID: PMC8606262 DOI: 10.1016/j.scog.2021.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/06/2021] [Accepted: 11/07/2021] [Indexed: 11/17/2022] Open
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Zarnowski O, Ziton S, Holmberg R, Musto S, Riegle S, Van Antwerp E, Santos-Nunez G. Functional MRI findings in personality disorders: A review. J Neuroimaging 2021; 31:1049-1066. [PMID: 34468063 DOI: 10.1111/jon.12924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022] Open
Abstract
Personality disorders (PDs) have a prevalence of approximately 10% in the United States, translating to over 30 million people affected in just one country. The true prevalence of these disorders may be even higher, as the paucity of objective diagnostic criteria could be leading to underdiagnosis. Because little is known about the underlying neuropathologies of these disorders, patients are diagnosed using subjective criteria and treated nonspecifically. To better understand the neural aberrancies responsible for these patients' symptoms, a review of functional MRI literature was performed. The findings reveal that each PD is characterized by a unique set of activation changes corresponding to individual structures or specific neural networks. While unique patterns of neural activity are distinguishable within each PD, aberrations of the limbic/paralimbic structures and default mode network are noted across several of them. In addition to identifying valuable activation patterns, this review reveals a void in research pertaining to paranoid, schizoid, histrionic, narcissistic, and dependent PDs. By delineating patterns in PD neuropathology, we can more effectively direct future research efforts toward enhancing objective diagnostic techniques and developing targeted treatment modalities. Furthermore, understanding why patients are manifesting certain symptoms can advance clinical awareness and improve patient outcomes.
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Affiliation(s)
- Oskar Zarnowski
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Shirley Ziton
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Rylan Holmberg
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Sarafina Musto
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Sean Riegle
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Emily Van Antwerp
- West Virginia School of Osteopathic Medicine, Lewisburg, West Virginia, USA
| | - Gabriela Santos-Nunez
- University of Massachusetts Memorial Medical Center, Radiology Department, Worcester, Massachusetts, USA
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Attademo L, Bernardini F, Verdolini N. Neural Correlates of Schizotypal Personality Disorder: a Systematic Review of Neuroimaging and EEG Studies. Curr Med Imaging 2021; 17:1283-1298. [PMID: 33459241 DOI: 10.2174/1573405617666210114142206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/20/2020] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Schizotypal personality disorder (SPD) is a cluster A personality disorder affecting 1.0% of general population, characterised by disturbances in cognition and reality testing dimensions, affect regulation, and interpersonal function. SPD shares similar but attenuated phenomenological, genetic, and neurobiological abnormalities with schizophrenia (SCZ) and is described as part of schizophrenia spectrum disorders. OBJECTIVE Aim of this work was to identify the major neural correlates of SPD. METHODS This is a systematic review conducted according to PRISMA statement. The protocol was prospectively registered in PROSPERO - International prospective register of systematic reviews. The review was performed to summarise the most comprehensive and updated evidence on functional neuroimaging and neurophysiology findings obtained through different techniques (DW-MRI, DTI, PET, SPECT, fMRI, MRS, EEG) in individuals with SPD. RESULTS Of the 52 studies included in this review, 9 were on DW-MRI and DTI, 11 were on PET and SPECT, 11 were on fMRI and MRS, and 21 were on EEG. It was complex to synthesise all the functional abnormalities found into a single, unified, pathogenetic pathway, but a common theme emerged: the dysfunction of brain circuits including striatal, frontal, temporal, limbic regions (and their networks) together with a dysregulation along the dopaminergic pathways. CONCLUSION Brain abnormalities in SPD are similar, but less marked, than those found in SCZ. Furthermore, different patterns of functional abnormalities in SPD and SCZ have been found, confirming the previous literature on the 'presence' of possible compensatory factors, protecting individuals with SPD from frank psychosis and providing diagnostic specificity.
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Affiliation(s)
- Luigi Attademo
- Hospital Psychiatric Service for Diagnosis and Care (S.P.D.C.) of Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, Potenza. Italy
| | - Francesco Bernardini
- Hospital Psychiatric Service for Diagnosis and Care (S.P.D.C.) of Pordenone, Department of Mental Health, AsFO Friuli Occidentale, Italian National Health Service, Pordenone. Italy
| | - Norma Verdolini
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st., Barcelona, Catalunya. Spain
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Kraus MS, Walker TM, Jarskog LF, Millet RA, Keefe RSE. Basic auditory processing deficits and their association with auditory emotion recognition in schizophrenia. Schizophr Res 2019; 204:155-161. [PMID: 30268821 DOI: 10.1016/j.schres.2018.08.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with schizophrenia are impaired in their ability to recognize emotions based on vocal cues and these impairments are associated with poor global outcome. Basic perceptual processes, such as auditory pitch processing, are impaired in schizophrenia and contribute to difficulty identifying emotions. However, previous work has focused on a relatively narrow assessment of auditory deficits and their relation to emotion recognition impairment in schizophrenia. METHODS We have assessed 87 patients with schizophrenia and 73 healthy controls on a comprehensive battery of tasks spanning the five empirically derived domains of auditory function. We also explored the relationship between basic auditory processing and auditory emotion recognition within the patient group using correlational analysis. RESULTS Patients exhibited widespread auditory impairments across multiple domains of auditory function, with mostly medium effect sizes. Performance on all of the basic auditory tests correlated with auditory emotion recognition at the p < .01 level in the patient group, with 9 out of 13 tests correlating with emotion recognition at r = 0.40 or greater. After controlling for cognition, many of the largest correlations involved spectral processing within the phase-locking range and discrimination of vocally based stimuli. CONCLUSIONS While many auditory skills contribute to this impairment, deficient formant discrimination appears to be a key skill contributing to impaired emotion recognition as this was the only basic auditory skill to enter a step-wise multiple regression after first entering a measure of cognitive impairment, and formant discrimination accounted for significant unique variance in emotion recognition performance after accounting for deficits in pitch processing.
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Affiliation(s)
- Michael S Kraus
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA.
| | - Trina M Walker
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA
| | - L Fredrik Jarskog
- North Carolina Psychiatric Research Center, Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Dr # 1, Chapel Hill, NC 27514, USA
| | - Robert A Millet
- Carolina Behavioral Care, 4102 Ben Franklin Blvd Durham, NC 27704, USA
| | - Richard S E Keefe
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA
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Giakoumaki SG. Emotion processing deficits in the different dimensions of psychometric schizotypy. Scand J Psychol 2017; 57:256-70. [PMID: 27119257 DOI: 10.1111/sjop.12287] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 03/04/2016] [Indexed: 01/07/2023]
Abstract
Schizotypy refers to a personality structure indicating "proneness" to schizophrenia. Around 10% of the general population has increased schizotypal traits, they also share other core features with schizophrenia and are thus at heightened risk for developing schizophrenia and spectrum disorders. A key aspect in schizophrenia-spectrum pathology is the impairment observed in emotion-related processes. This review summarizes findings on impairments related to central aspects of emotional processes, such as emotional disposition, alexithymia, facial affect recognition and speech prosody, in high schizotypal individuals in the general population. Although the studies in the field are not numerous, the current findings indicate that all these aspects of emotional processing are deficient in psychometric schizotypy, in accordance to the schizophrenia-spectrum literature. A disturbed frontotemporal neural network seems to be the critical link between these impairments, schizotypy and schizophrenia. The limitations of the current studies and suggestions for future research are discussed.
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Ettinger U, Mohr C, Gooding DC, Cohen AS, Rapp A, Haenschel C, Park S. Cognition and brain function in schizotypy: a selective review. Schizophr Bull 2015; 41 Suppl 2:S417-26. [PMID: 25810056 PMCID: PMC4373634 DOI: 10.1093/schbul/sbu190] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Schizotypy refers to a set of personality traits thought to reflect the subclinical expression of the signs and symptoms of schizophrenia. Here, we review the cognitive and brain functional profile associated with high questionnaire scores in schizotypy. We discuss empirical evidence from the domains of perception, attention, memory, imagery and representation, language, and motor control. Perceptual deficits occur early and across various modalities. While the neural mechanisms underlying visual impairments may be linked to magnocellular dysfunction, further effects may be seen downstream in higher cognitive functions. Cognitive deficits are observed in inhibitory control, selective and sustained attention, incidental learning, and memory. In concordance with the cognitive nature of many of the aberrations of schizotypy, higher levels of schizotypy are associated with enhanced vividness and better performance on tasks of mental rotation. Language deficits seem most pronounced in higher-level processes. Finally, higher levels of schizotypy are associated with reduced performance on oculomotor tasks, resembling the impairments seen in schizophrenia. Some of these deficits are accompanied by reduced brain activation, akin to the pattern of hypoactivations in schizophrenia spectrum individuals. We conclude that schizotypy is a construct with apparent phenomenological overlap with schizophrenia and stable interindividual differences that covary with performance on a wide range of perceptual, cognitive, and motor tasks known to be impaired in schizophrenia. The importance of these findings lies not only in providing a fine-grained neurocognitive characterization of a personality constellation known to be associated with real-life impairments, but also in generating hypotheses concerning the aetiology of schizophrenia.
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Affiliation(s)
- Ulrich Ettinger
- Department of Psychology, University of Bonn, Bonn, Germany;
| | - Christine Mohr
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Diane C. Gooding
- Department of Psychology and,Department of Psychiatry, University of Wisconsin-Madison, Madison, WI
| | - Alex S. Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA
| | - Alexander Rapp
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | | | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN
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Ettinger U, Meyhöfer I, Steffens M, Wagner M, Koutsouleris N. Genetics, cognition, and neurobiology of schizotypal personality: a review of the overlap with schizophrenia. Front Psychiatry 2014; 5:18. [PMID: 24600411 PMCID: PMC3931123 DOI: 10.3389/fpsyt.2014.00018] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/06/2014] [Indexed: 01/22/2023] Open
Abstract
Schizotypy refers to a set of temporally stable traits that are observed in the general population and that resemble the signs and symptoms of schizophrenia. Here, we review evidence from studies on genetics, cognition, perception, motor and oculomotor control, brain structure, brain function, and psychopharmacology in schizotypy. We specifically focused on identifying areas of overlap between schizotypy and schizophrenia. Evidence was corroborated that significant overlap exists between the two, covering the behavioral brain structural and functional as well molecular levels. In particular, several studies showed that individuals with high levels of schizotypal traits exhibit alterations in neurocognitive task performance and underlying brain function similar to the deficits seen in patients with schizophrenia. Studies of brain structure have shown both volume reductions and increase in schizotypy, pointing to schizophrenia-like deficits as well as possible protective or compensatory mechanisms. Experimental pharmacological studies have shown that high levels of schizotypy are associated with (i) enhanced dopaminergic response in striatum following administration of amphetamine and (ii) improvement of cognitive performance following administration of antipsychotic compounds. Together, this body of work suggests that schizotypy shows overlap with schizophrenia across multiple behavioral and neurobiological domains, suggesting that the study of schizotypal traits may be useful in improving our understanding of the etiology of schizophrenia.
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Affiliation(s)
- Ulrich Ettinger
- Department of Psychology, University of Bonn , Bonn , Germany
| | - Inga Meyhöfer
- Department of Psychology, University of Bonn , Bonn , Germany
| | - Maria Steffens
- Department of Psychology, University of Bonn , Bonn , Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn , Bonn , Germany
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Vu MAT, Thermenos HW, Terry DP, Wolfe DJ, Voglmaier MM, Niznikiewicz MA, McCarley RW, Seidman LJ, Dickey CC. Working memory in schizotypal personality disorder: fMRI activation and deactivation differences. Schizophr Res 2013; 151:113-23. [PMID: 24161536 DOI: 10.1016/j.schres.2013.09.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/19/2013] [Accepted: 09/16/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Schizotypal personality disorder (SPD) is considered a schizophrenia spectrum disorder, sharing with schizophrenia cognitive, neuropsychological, epidemiological, and biological characteristics. Working memory may be one area of shared deficit, although to date, this is only the second study to investigate working memory in SPD using fMRI. METHODS In a block-design fMRI study, fifteen antipsychotic-naïve SPD and sixteen healthy control subjects performed blocks of a 2back visual working memory task and 0back continuous performance task while undergoing whole-brain fMRI at 3T. Whole-brain analyses were performed for the 0back>rest (fixation baseline) and the 2back>0back contrasts (isolating the working memory component from the visual perception and attention component). Parameter estimates were extracted to determine whether observed differences were due to task-induced activation and/or deactivation. RESULTS Activation differences emerged between the two groups, without differences in task performance. In the 0back task, SPD showed decreased task-induced activation of the left postcentral gyrus. In the 2back>0back contrast, HC showed greater task-induced activation of the left posterior cingulate gyrus, superior temporal gyrus, insula, and middle frontal gyrus. These differences were due to SPD subjects' decreased task-induced activation in the left posterior cingulate gyrus, and task-induced deactivation in the remaining regions. CONCLUSIONS These findings suggest that compared to HC subjects, individuals with SPD may achieve comparable working memory performance. However, differences emerge at the level of functional neural activation, attributable to different task-induced activation and deactivation patterns. Such differential recruitment of neural resources may be beneficial, contributing to SPD subjects' ability to perform these tasks comparably to HC subjects.
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Affiliation(s)
- Mai-Anh T Vu
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Avsar KB, Weller RE, Cox JE, Reid MA, White DM, Lahti AC. An fMRI investigation of delay discounting in patients with schizophrenia. Brain Behav 2013; 3:384-401. [PMID: 24381810 PMCID: PMC3869680 DOI: 10.1002/brb3.135] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/18/2013] [Accepted: 02/15/2013] [Indexed: 01/15/2023] Open
Abstract
Schizophrenia (SZ) is associated with a reduced ability to set meaningful goals to reach desired outcomes. The delay-discounting (DD) task, in which one chooses between sooner smaller and later larger rewards, has proven useful in revealing executive function and reward deficits in various clinical groups. We used fMRI in patients with SZ and healthy controls (HC) to compare brain activation during performance of a DD task. Prior to the neuroimaging session, we obtained each participant's rate of DD, k, on a DD task and used it to select a version of the DD task for each participant's fMRI session. Because of the importance of comparing fMRI results from groups matched on performance, we used a criterion value of R (2) > 0.60 for response consistency on the DD task to analyze fMRI activation to DD task versus control trials from consistent SZ (n = 14) and consistent HC (n = 14). We also compared activation between the groups on contrasts related to trial difficulty. Finally, we contrasted the inconsistent SZ (n = 9) with the consistent HC and consistent SZ; these results should be interpreted with caution because of inconsistent SZ's aberrant performance on the task. Compared with consistent HC, consistent SZ showed reduced activation to DD task versus control trials in executive function and reward areas. In contrast, consistent SZ showed more activation in the precuneus and posterior cingulate, regions of the default mode network (DMN) that are typically deactivated during tasks, and in the insula, a region linked to emotional processing. Furthermore, consistent SZ had abnormal activation of lateral and medial frontal regions in relation to trial difficulty. These results point to disruption of several neural networks during decision making, including the executive, reward, default mode, and emotional networks, and suggest processes that are impaired during decision making in schizophrenia.
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Affiliation(s)
- Kathy Burton Avsar
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-0017 ; Department of Psychology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-1170
| | - Rosalyn Eve Weller
- Department of Psychology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-1170
| | - James Edward Cox
- Department of Psychology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-1170
| | - Meredith Amanda Reid
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-0017 ; Department of Biomedical Engineering, The University of Alabama at Birmingham Birmingham, Alabama, 35294-2182
| | - David Matthew White
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-0017
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham Birmingham, Alabama, 35294-0017
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Fervaha G, Remington G. Neuroimaging findings in schizotypal personality disorder: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:96-107. [PMID: 23220094 DOI: 10.1016/j.pnpbp.2012.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/10/2012] [Accepted: 11/28/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizotypal personality disorder is the prototypical schizophrenia-spectrum condition, sharing similar phenomenological, cognitive, genetic, physiological, neurochemical, neuroanatomical and neurofunctional abnormalities with schizophrenia. Investigations into SPD circumvent many confounds inherent to schizophrenia such as medication and institutionalization. Hence, SPD offers a unique vantage point from which to study schizophrenia-spectrum conditions. METHODS We systematically reviewed the neuroimaging literature in SPD to establish: (1) whether there are concordant findings in SPD and schizophrenia, possibly reflective of core pathology between the two conditions and (2) whether there are discordant findings in SPD and schizophrenia, possibly reflecting protective factors in the former. The findings are synthesized across structural and functional neuroimaging domains. RESULTS A total of 54 studies were identified. Medial temporal lobe structures seem to be compromised in both SPD and schizophrenia. In schizophrenia prefrontal structures are further compromised, whereas in SPD these seem to be larger-than-normal, possibly reflecting a compensatory mechanism. Additional pathology is discussed, including evidence of aberrant subcortical dopaminergic functioning. CONCLUSIONS SPD is a schizophrenia-spectrum condition that shares pathology with schizophrenia, but is distinct in showing unique neural findings. Future studies are needed to confirm and localize regions of common and disparate pathology between SPD and schizophrenia.
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Affiliation(s)
- Gagan Fervaha
- Schizophrenia Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
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Koeda M, Takahashi H, Matsuura M, Asai K, Okubo Y. Cerebral responses to vocal attractiveness and auditory hallucinations in schizophrenia: a functional MRI study. Front Hum Neurosci 2013; 7:221. [PMID: 23745111 PMCID: PMC3662879 DOI: 10.3389/fnhum.2013.00221] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 05/08/2013] [Indexed: 11/17/2022] Open
Abstract
Impaired self-monitoring and abnormalities of cognitive bias have been implicated as cognitive mechanisms of hallucination; regions fundamental to these processes including inferior frontal gyrus (IFG) and superior temporal gyrus (STG) are abnormally activated in individuals that hallucinate. A recent study showed activation in IFG-STG to be modulated by auditory attractiveness, but no study has investigated whether these IFG-STG activations are impaired in schizophrenia. We aimed to clarify the cerebral function underlying the perception of auditory attractiveness in schizophrenia patients. Cerebral activation was examined in 18 schizophrenia patients and 18 controls when performing Favorability Judgment Task (FJT) and Gender Differentiation Task (GDT) for pairs of greetings using event-related functional MRI. A full-factorial analysis revealed that the main effect of task was associated with activation of left IFG and STG. The main effect of Group revealed less activation of left STG in schizophrenia compared with controls, whereas significantly greater activation in schizophrenia than in controls was revealed at the left middle frontal gyrus (MFG), right temporo-parietal junction (TPJ), right occipital lobe, and right amygdala (p < 0.05, FDR-corrected). A significant positive correlation was observed at the right TPJ and right MFG between cerebral activation under FJT minus GDT contrast and the score of hallucinatory behavior on the Positive and Negative Symptom Scale. Findings of hypo-activation in the left STG could designate brain dysfunction in accessing vocal attractiveness in schizophrenia, whereas hyper-activation in the right TPJ and MFG may reflect the process of mentalizing other person's behavior by auditory hallucination by abnormality of cognitive bias.
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Affiliation(s)
- Michihiko Koeda
- Voice Neurocognition Laboratory, The Centre for Cognitive Neuroimaging, The Institute of Neuroscience and Psychology, University of Glasgow Glasgow, UK ; Department of Neuropsychiatry, Nippon Medical School Tokyo, Japan
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Castagna F, Montemagni C, Maria Milani A, Rocca G, Rocca P, Casacchia M, Bogetto F. Prosody recognition and audiovisual emotion matching in schizophrenia: the contribution of cognition and psychopathology. Psychiatry Res 2013; 205:192-8. [PMID: 22985542 DOI: 10.1016/j.psychres.2012.08.038] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 08/16/2012] [Accepted: 08/25/2012] [Indexed: 01/12/2023]
Abstract
This study aimed to evaluate the ability to decode emotion in the auditory and audiovisual modality in a group of patients with schizophrenia, and to explore the role of cognition and psychopathology in affecting these emotion recognition abilities. Ninety-four outpatients in a stable phase and 51 healthy subjects were recruited. Patients were assessed through a psychiatric evaluation and a wide neuropsychological battery. All subjects completed the comprehensive affect testing system (CATS), a group of computerized tests designed to evaluate emotion perception abilities. With respect to the controls, patients were not impaired in the CATS tasks involving discrimination of nonemotional prosody, naming of emotional stimuli expressed by voice and judging the emotional content of a sentence, whereas they showed a specific impairment in decoding emotion in a conflicting auditory condition and in the multichannel modality. Prosody impairment was affected by executive functions, attention and negative symptoms, while deficit in multisensory emotion recognition was affected by executive functions and negative symptoms. These emotion recognition deficits, rather than being associated purely with emotion perception disturbances in schizophrenia, are affected by core symptoms of the illness.
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Affiliation(s)
- Filomena Castagna
- Department of Neuroscience, Psychiatric Section, University of Turin, Via Cherasco, 11, 10126 Turin, Italy
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Dickey CC, Vu MAT, Voglmaier MM, Niznikiewicz MA, McCarley RW, Panych LP. Prosodic abnormalities in schizotypal personality disorder. Schizophr Res 2012; 142:20-30. [PMID: 23068317 PMCID: PMC3502641 DOI: 10.1016/j.schres.2012.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/31/2012] [Accepted: 09/05/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Patients with schizophrenia speak with blunted vocal affect but little is known regarding the prosody of persons with schizotypal personality disorder (SPD). This work examined expressive prosody in SPD, its relationship to brain structure, and outlined a framework for measuring elements of prosody in clinical populations. METHODS Twenty-eight antipsychotic-naïve SPD subjects were matched with 27 healthy comparison (HC) subjects. Subjects read aloud short sentences and responded to probes to record both predetermined and self-generated speech samples. Samples were analyzed acoustically (pause proportion, duration, attack, and pitch variability) and subjectively by raters (amount of pauses, degree of emotion portrayed, and how much they wanted to hear more from the subjects) on paragraph, sentence, word, word-fragment, and syllable levels. Alexithymia and ability to self-monitor behavior were compared between groups. The pars opercularis was manually traced on structural MRI data. RESULTS SPD subjects' speech had significantly more pauses, was slower, had less pitch variability, and expressed less emotion than HC subjects. Pitch variability correlated with socio-economic status achievement. There was no difference between groups in left or right pars opercularis volumes. A statistically significant correlation suggested that smaller left pars opercularis volumes in SPD subjects correlated with more pauses and less emotion. SPD subjects reported more alexithymia and difficulty self-monitoring their behavior compared with controls. In SPD subjects the high alexithymia correlated with raters not wanting to hear more from them and SPD subjects' inability to modulate their social behavior correlated with their having fewer friends. Thus, the SPD subjects exhibited insight. CONCLUSIONS SPD subjects displayed significant prosodic deficits that were measurable in speech samples as brief as a word-fragment. The determinants of these deficits are not known although these may include a dysfunctional pars opercularis. These data add to the nascent literature describing social cognition deficits in SPD.
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Affiliation(s)
- Chandlee C. Dickey
- VA Boston Healthcare System, Harvard Medical School Psychiatry 116A-7, 940 Belmont St., Brockton, MA 02301,Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301,Corresponding Author: Chandlee Dickey, M.D. VA Boston Healthcare System, Psychiatry 116A-7, 940 Belmont St., Brockton, MA 02301 Phone: (774) 826-2457 Fax: (774) 826-1859
| | - Mai-Anh T Vu
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School 1249 Boylston St, Boston, MA 02215
| | - Martina M. Voglmaier
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301
| | - Margaret A. Niznikiewicz
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301,Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School 1249 Boylston St, Boston, MA 02215
| | - Robert W. McCarley
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301
| | - Lawrence P. Panych
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School 75 Francis St., Boston, MA 02216
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Ebisch SJH, Salone A, Ferri F, De Berardis D, Romani GL, Ferro FM, Gallese V. Out of touch with reality? Social perception in first-episode schizophrenia. Soc Cogn Affect Neurosci 2012; 8:394-403. [PMID: 22275166 DOI: 10.1093/scan/nss012] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Social dysfunction has been recognized as an elementary feature of schizophrenia, but it remains a crucial issue whether social deficits in schizophrenia concern the inter-subjective domain or primarily have their roots in disturbances of self-experience. Social perception comprises vicarious processes grounding an experiential inter-relationship with others as well as self-regulation processes allowing to maintain a coherent sense of self. The present study investigated whether the functional neural basis underlying these processes is altered in first-episode schizophrenia (FES). Twenty-four FES patients and 22 healthy control participants underwent functional magnetic resonance imaging during a social perception task requiring them to watch videos depicting other individuals' inanimate and animate/social tactile stimulations, and a tactile localizer condition. Activation in ventral premotor cortex for observed bodily tactile stimulations was reduced in the FES group and negatively correlated with self-experience disturbances. Moreover, FES patients showed aberrant differential activation in posterior insula for first-person tactile experiences and observed affective tactile stimulations. These findings suggest that social perception in FES at a pre-reflective level is characterized by disturbances of self-experience, including impaired multisensory representations and self-other distinction. However, the results also show that social perception in FES involves more complex alterations of neural activation at multiple processing levels.
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Affiliation(s)
- Sjoerd J H Ebisch
- Institute of Advanced Biomedical Technologies, Department of Neuroscience and Imaging, G d'Annunzio University, Via dei Vestini 33, 66013 Chieti, CH, Italy.
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