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Weng T, Zheng Y, Xie Y, Qin W, Guo L. Diagnosing schizophrenia using deep learning: Novel interpretation approaches and multi-site validation. Brain Res 2024; 1833:148876. [PMID: 38513996 DOI: 10.1016/j.brainres.2024.148876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
Schizophrenia is a profound and enduring mental disorder that imposes significant negative impacts on individuals, their families, and society at large. The development of more accurate and objective diagnostic tools for schizophrenia can be expedited through the employment of deep learning (DL), that excels at deciphering complex hierarchical non-linear patterns. However, the limited interpretability of deep learning has eroded confidence in the model and restricted its clinical utility. At the same time, if the data source is only derived from a single center, the model's generalizability is difficult to test. To enhance the model's reliability and applicability, leave-one-center-out validation with a large and diverse sample from multiple centers is crucial. In this study, we utilized Nine different global centers to train and test the 3D Resnet model's generalizability, resulting in an 82% classification performance (area under the curve) on all datasets sourced from different countries, employing a leave-one-center-out-validation approach. Per our approximation of the feature significance of each region on the atlas, we identified marked differences in the thalamus, pallidum, and inferior frontal gyrus between individuals with schizophrenia and healthy controls, lending credence to prior research findings. At the same time, in order to translate the model's output into clinically applicable insights, the SHapley Additive exPlanations (SHAP) permutation explainer method with an anatomical atlas have been refined, thereby offering precise neuroanatomical and functional interpretations of different brain regions.
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Affiliation(s)
- Tingting Weng
- School of Medical Imaging, Tianjin Medical University, Tianjin 300203, China
| | - Yuemei Zheng
- Department of Medical Imaging, Affiliated Hospital of Jining Medical University, Shandong 100038, China
| | - Yingying Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Li Guo
- School of Medical Imaging, Tianjin Medical University, Tianjin 300203, China.
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Thalhammer M, Schulz J, Scheulen F, Oubaggi MEM, Kirschner M, Kaiser S, Schmidt A, Borgwardt S, Avram M, Brandl F, Sorg C. Distinct Volume Alterations of Thalamic Nuclei Across the Schizophrenia Spectrum. Schizophr Bull 2024:sbae037. [PMID: 38577901 DOI: 10.1093/schbul/sbae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND HYPOTHESIS Abnormal thalamic nuclei volumes and their link to cognitive impairments have been observed in schizophrenia. However, whether and how this finding extends to the schizophrenia spectrum is unknown. We hypothesized a distinct pattern of aberrant thalamic nuclei volume across the spectrum and examined its potential associations with cognitive symptoms. STUDY DESIGN We performed a FreeSurfer-based volumetry of T1-weighted brain MRIs from 137 healthy controls, 66 at-risk mental state (ARMS) subjects, 89 first-episode psychosis (FEP) individuals, and 126 patients with schizophrenia to estimate thalamic nuclei volumes of six nuclei groups (anterior, lateral, ventral, intralaminar, medial, and pulvinar). We used linear regression models, controlling for sex, age, and estimated total intracranial volume, both to compare thalamic nuclei volumes across groups and to investigate their associations with positive, negative, and cognitive symptoms. STUDY RESULTS We observed significant volume alterations in medial and lateral thalamic nuclei. Medial nuclei displayed consistently reduced volumes across the spectrum compared to controls, while lower lateral nuclei volumes were only observed in schizophrenia. Whereas positive and negative symptoms were not associated with reduced nuclei volumes across all groups, higher cognitive scores were linked to lower volumes of medial nuclei in ARMS. In FEP, cognition was not linked to nuclei volumes. In schizophrenia, lower cognitive performance was associated with lower medial volumes. CONCLUSIONS Results demonstrate distinct thalamic nuclei volume reductions across the schizophrenia spectrum, with lower medial nuclei volumes linked to cognitive deficits in ARMS and schizophrenia. Data suggest a distinctive trajectory of thalamic nuclei abnormalities along the course of schizophrenia.
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Affiliation(s)
- Melissa Thalhammer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Julia Schulz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Felicitas Scheulen
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Mohamed El Mehdi Oubaggi
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Kirschner
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Kaiser
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - André Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Felix Brandl
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christian Sorg
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
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Bu L, Wang D, Fan Y, Ye H, Liu W, Fan F. Sleep disturbance and suicidal ideation mediated by psychotic-like experiences in adolescents: a two-wave longitudinal study. Sleep 2024; 47:zsae013. [PMID: 38230742 DOI: 10.1093/sleep/zsae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/10/2024] [Indexed: 01/18/2024] Open
Abstract
STUDY OBJECTIVES Sleep disturbance may cause suicidal ideation (SI). This study aimed to examine their co-occurrence rate among adolescents and investigate whether psychotic-like experiences (PLEs) mediate this association. METHODS A total of 17 722 Chinese adolescents were included in this two-wave longitudinal study. The baseline survey (time 1, T1) was conducted between April 21 and May 12, 2021, and the follow-up survey (time 2, T2) was implemented between December 17 and 26, 2021. At T1, participants completed questionnaires to assess their sleep disturbance, sleep duration, PLEs, SI, depressive symptoms, and sociodemographic characteristics. At T2, participants reported their PLEs, SI, and negative life events. RESULTS The SI prevalence decreased from 20.2% (T1) to 18.4% (T2). Participants with SI showed significantly higher prevalence of sleep disturbance and short sleep duration compared to those without SI. Baseline sleep disturbance and short sleep duration were both associated with the increased risk of SI 6 months later. These longitudinal links were mediated by PLEs, independent of baseline covariates and negative life events. CONCLUSIONS These findings provide a novel insight into the mechanism linking sleep problems and suicidality, and stress the significance of assessing and addressing sleep problems and PLEs for adolescent suicide prevention and intervention.
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Affiliation(s)
- Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
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Kim JS, Hong SB, Park KW, Lee ATC. Psychotic Symptoms in Patients With Major Neurological Diseases. J Clin Neurol 2024; 20:153-165. [PMID: 38433485 PMCID: PMC10921039 DOI: 10.3988/jcn.2023.0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 03/05/2024] Open
Abstract
Neurological diseases often manifest with neuropsychiatric symptoms such as depression, emotional incontinence, anger, apathy and fatigue. In addition, affected patients may also experience psychotic symptoms such as hallucinations and delusions. Various factors contribute to the development of psychotic symptoms, and the mechanisms of psychosis are similar, but still differ among various neurological diseases. Although psychotic symptoms are uncommon, and have been less well investigated, they may annoy patients and their families as well as impair the patients' quality of life and increase the caregiver burden. Therefore, we need to appropriately identify and treat these psychotic symptoms in patients with neurological diseases.
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Affiliation(s)
- Jong S Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
| | - Seung-Bong Hong
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keun-Woo Park
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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Li W, Li Q, Zhang P, Liu H, Ye Z. Interaction between childhood trauma experience and TPH2 rs7305115 gene polymorphism in brain gray matter volume. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2023; 19:22. [PMID: 38093326 PMCID: PMC10720107 DOI: 10.1186/s12993-023-00224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Childhood trauma is one of the most extensively studied and well-supported environmental risk factors for the development of mental health problems. The human tryptophan hydroxylase 2 (TPH2) gene is one of the most promising candidate genes in numerous psychiatric disorders. However, it is now widely acknowledged that neither genetic variation nor environmental exposure alone can fully explain all the phenotypic variance observed in psychiatric disorders. Therefore, it is necessary to consider the interaction between the two factors in psychiatric research. METHODS We enrolled a sizable nonclinical cohort of 786 young, healthy adults who underwent structural MRI scans and completed genotyping, the Childhood Trauma Questionnaire (CTQ) and behavioural scores. We identified the interaction between childhood trauma and the TPH2 rs7305115 gene polymorphism in the gray matter volume (GMV) of specific brain subregions and the behaviour in our sample using a multiple linear regression framework. We utilized mediation effect analysis to identify environment /gene-brain-behaviour relationships. RESULTS We found that childhood trauma and TPH2 rs7305115 interacted in both behaviour and the GMV of brain subregions. Our findings indicated that the GMV of the right posterior parietal thalamus served as a significant mediator supporting relationship between childhood trauma (measured by CTQ score) and anxiety scores in our study population, and the process was partly modulated by the TPH2 rs7305115 gene polymorphism. Moreover, we found only a main effect of childhood trauma in the GMV of the right parahippocampal gyrus area, supporting the relationship between childhood trauma and anxiety scores as a significant mediator. CONCLUSIONS Our findings suggest that early-life trauma may have a specific and long-term structural effect on brain GMV, potentially leading to altered cognitive and emotional processes involving the parahippocampal gyrus and thalamus that may also be modulated by the TPH2 gene polymorphism. This finding highlights the importance of considering genetic factors when examining the impact of early-life experiences on brain structure and function. Gene‒environment studies can be regarded as a powerful objective supplement for targeted therapy, early diagnosis and treatment evaluation in the future.
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Affiliation(s)
- Wei Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Qian Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Peng Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Huaigui Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China.
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Subcortical Structures in Demented Schizophrenia Patients: A Comparative Study. Biomedicines 2023; 11:biomedicines11010233. [PMID: 36672741 PMCID: PMC9855401 DOI: 10.3390/biomedicines11010233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
There are few studies on dementia and schizophrenia in older patients looking for structural differences. This paper aims to describe relation between cognitive performance and brain volumes in older schizophrenia patients. Twenty schizophrenic outpatients -10 without-dementia (SND), 10 with dementia (SD)- and fifteen healthy individuals -as the control group (CG)-, older than 50, were selected. Neuropsychological tests were used to examine cognitive domains. Brain volumes were calculated with magnetic resonance images. Cognitive performance was significantly better in CG than in schizophrenics. Cognitive performance was worst in SD than SND, except in semantic memory and visual attention. Hippocampal volumes showed significant differences between SD and CG, with predominance on the right side. Left thalamic volume was smaller in SD group than in SND. Structural differences were found in the hippocampus, amygdala, and thalamus; more evident in the amygdala and thalamus, which were mainly related to dementia. In conclusion, cognitive performance and structural changes allowed us to differentiate between schizophrenia patients and CG, with changes being more pronounced in SD than in SND. When comparing SND with SD, the functional alterations largely coincide, although sometimes in the opposite direction. Moreover, volume lost in the hippocampus, amygdala, and thalamus may be related to the possibility to develop dementia in schizophrenic patients.
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Identification of texture MRI brain abnormalities on first-episode psychosis and clinical high-risk subjects using explainable artificial intelligence. Transl Psychiatry 2022; 12:481. [PMID: 36385133 PMCID: PMC9668814 DOI: 10.1038/s41398-022-02242-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022] Open
Abstract
Structural MRI studies in first-episode psychosis and the clinical high-risk state have consistently shown volumetric abnormalities. Aim of the present study was to introduce radiomics texture features in identification of psychosis. Radiomics texture features describe the interrelationship between voxel intensities across multiple spatial scales capturing the hidden information of underlying disease dynamics in addition to volumetric changes. Structural MR images were acquired from 77 first-episode psychosis (FEP) patients, 58 clinical high-risk subjects with no later transition to psychosis (CHR_NT), 15 clinical high-risk subjects with later transition (CHR_T), and 44 healthy controls (HC). Radiomics texture features were extracted from non-segmented images, and two-classification schemas were performed for the identification of FEP vs. HC and FEP vs. CHR_NT. The group of CHR_T was used as external validation in both schemas. The classification of a subject's clinical status was predicted by importing separately (a) the difference of entropy feature map and (b) the contrast feature map, resulting in classification balanced accuracy above 72% in both analyses. The proposed framework enhances the classification decision for FEP, CHR_NT, and HC subjects, verifies diagnosis-relevant features and may potentially contribute to identification of structural biomarkers for psychosis, beyond and above volumetric brain changes.
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Liu S, Guo Z, Cao H, Li H, Hu X, Cheng L, Li J, Liu R, Xu Y, Cui Y. Altered asymmetries of resting‐state MRI in the left thalamus of first‐episode schizophrenia. Chronic Dis Transl Med 2022; 8:207-217. [PMID: 36161199 PMCID: PMC9481880 DOI: 10.1002/cdt3.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Schizophrenia (SCZ) is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure. Hemispheric asymmetries are a fundamental organizational principle of the human brain and relate to human psychological and behavioral characteristics. We aimed to explore the state of thalamic lateralization of SCZ. Methods We used voxel‐based morphometry (VBM) analysis, whole‐brain analysis of low‐frequency fluctuations (ALFF), fractional amplitude of low‐frequency fluctuations (fALFF), and resting‐state seed‐based functional connectivity (FC) analysis to investigate brain structural and functional deficits in SCZ. Also, we applied Pearson's correlation analysis to validate the correlation between Positive and Negative Symptom Scale (PANSS) scores and them. Results Compared with healthy controls, SCZ showed increased gray matter volume (GMV) of the left thalamus (t = 2.214, p = 0.029), which positively correlated with general psychosis (r = 0.423, p = 0.010). SCZ also showed increased ALFF in the putamen, the caudate nucleus, the thalamus, fALFF in the nucleus accumbens (NAc), and the caudate nucleus, and decreased fALFF in the precuneus. The left thalamus showed significantly weaker resting‐state FC with the amygdala and insula in SCZ. PANSS negative symptom scores were negatively correlated with the resting‐state FC between the thalamus and the insula (r = −0.414, p = 0.025). Conclusions Collectively, these results suggest the possibility of aberrant laterality in the left thalamus and its FC with other related brain regions involved in the limbic system. Experiments to explore the lateralization state of the left thalamus in schizophrenia. The thalamus is structurally and functionally impaired in schizophrenia. The limbic system may be linked to altered brain asymmetry.
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Affiliation(s)
- Sha Liu
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder First Hospital of Shanxi Medical University Taiyuan Shanxi China
| | - Zhenglong Guo
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
| | - Hongbao Cao
- School of Systems Biology George Mason University Manassas Virginia USA
| | - Hong Li
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder First Hospital of Shanxi Medical University Taiyuan Shanxi China
| | - Xiaodong Hu
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
| | - Long Cheng
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
| | - Jianying Li
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
| | - Ruize Liu
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Yong Xu
- Department of Psychiatry First Hospital/First Clinical Medical College of Shanxi Medical University Taiyuan Shanxi China
- Department of Mental Health Shanxi Medical University Taiyuan Shanxi China
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Kim WS, Shen J, Tsogt U, Odkhuu S, Chung YC. Altered thalamic subregion functional networks in patients with treatment-resistant schizophrenia. World J Psychiatry 2022; 12:693-707. [PMID: 35663295 PMCID: PMC9150031 DOI: 10.5498/wjp.v12.i5.693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/25/2021] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions. A large body of evidence points to impaired functional connectivity (FC) of the thalamocortical pathway in schizophrenia. However, the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia (TRS).
AIM To identify the neural mechanisms underlying TRS, we investigated FC of thalamic sub-regions with cortical networks and voxels, and the associations of this FC with clinical symptoms. We hypothesized that the FC of thalamic sub-regions with cortical networks and voxels would differ between TRS patients and HCs.
METHODS In total, 50 patients with TRS and 61 healthy controls (HCs) matched for age, sex, and education underwent resting-state functional magnetic resonance imaging (rs-fMRI) and clinical evaluation. Based on the rs-fMRI data, we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels, and within thalamic subregions and cortical functional networks, in the patients with TRS. A functional parcellation atlas was used to segment the thalamus into nine subregions. Correlations between altered FC and TRS symptoms were explored.
RESULTS We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and HCs. In addition, increased FC was observed between thalamic subregions and the sensorimotor cortex, frontal medial cortex, and lingual gyrus. These abnormalities were associated with the pathophysiology of TRS.
CONCLUSION Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks, and within the thalamocortical pathway, has potential as a marker for TRS. Our findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms.
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Affiliation(s)
- Woo-Sung Kim
- Department of Psychiatry, Jeonbuk National University, Jeon-ju 54907, South Korea
| | - Jie Shen
- Department of Psychiatry, Jeonbuk National University, Jeon-ju 54907, South Korea
| | - Uyanga Tsogt
- Department of Psychiatry, Jeonbuk National University, Jeon-ju 54907, South Korea
| | - Soyolsaikhan Odkhuu
- Department of Psychiatry, Jeonbuk National University, Jeon-ju 54907, South Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University, Jeon-ju 54907, South Korea
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Thalamic and striato-pallidal volumes in schizophrenia patients and individuals at risk for psychosis: A multi-atlas segmentation study. Schizophr Res 2022; 243:268-275. [PMID: 32448678 DOI: 10.1016/j.schres.2020.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 02/06/2023]
Abstract
Despite previous neuroimaging studies demonstrating morphological abnormalities of the thalamus and other subcortical structures in patients with schizophrenia, the potential role of the thalamus and its subdivisions in the pathophysiology of this illness remains elusive. It is also unclear whether similar changes of these structures occur in individuals at high risk for psychosis. In this study, magnetic resonance imaging was employed with the Multiple Automatically Generated Templates (MAGeT) brain segmentation algorithm to determine volumes of the thalamic subdivisions, the striatum (caudate, putamen, and nucleus accumbens), and the globus pallidus in 62 patients with schizophrenia, 38 individuals with an at-risk mental state (ARMS) [4 of whom (10.5%) subsequently developed schizophrenia], and 61 healthy subjects. Cognitive function of the patients was assessed by using the Brief Assessment of Cognition in Schizophrenia (BACS) and the Schizophrenia Cognition Rating Scale (SCoRS). Thalamic volume (particularly the medial dorsal and ventral lateral nuclei) was smaller in the schizophrenia group than the ARMS and control groups, while there were no differences for the striatum and globus pallidus. In the schizophrenia group, the reduction of thalamic ventral lateral nucleus volume was significantly associated with lower BACS score. The pallidal volume was positively correlated with the dose of antipsychotic treatment in the schizophrenia group. These results suggest that patients with schizophrenia, but not those with ARMS, exhibit volume reduction in specific thalamic subdivisions, which may underlie core clinical features of this illness.
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Wang J, Ke P, Zang J, Wu F, Wu K. Discriminative Analysis of Schizophrenia Patients Using Topological Properties of Structural and Functional Brain Networks: A Multimodal Magnetic Resonance Imaging Study. Front Neurosci 2022; 15:785595. [PMID: 35087373 PMCID: PMC8787107 DOI: 10.3389/fnins.2021.785595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022] Open
Abstract
Interest in the application of machine learning (ML) techniques to multimodal magnetic resonance imaging (MRI) data for the diagnosis of schizophrenia (SZ) at the individual level is growing. However, a few studies have applied the features of structural and functional brain networks derived from multimodal MRI data to the discriminative analysis of SZ patients at different clinical stages. In this study, 205 normal controls (NCs), 61 first-episode drug-naive SZ (FESZ) patients, and 79 chronic SZ (CSZ) patients were recruited. We acquired their structural MRI, diffusion tensor imaging, and resting-state functional MRI data and constructed brain networks for each participant, including the gray matter network (GMN), white matter network (WMN), and functional brain network (FBN). We then calculated 3 nodal properties for each brain network, including degree centrality, nodal efficiency, and betweenness centrality. Two classifications (SZ vs. NC and FESZ vs. CSZ) were performed using five ML algorithms. We found that the SVM classifier with the input features of the combination of nodal properties of both the GMN and FBN achieved the best performance to discriminate SZ patients from NCs [accuracy, 81.2%; area under the receiver operating characteristic curve (AUC), 85.2%; p < 0.05]. Moreover, the SVM classifier with the input features of the combination of the nodal properties of both the GMN and WMN achieved the best performance to discriminate FESZ from CSZ patients (accuracy, 86.2%; AUC, 92.3%; p < 0.05). Furthermore, the brain areas in the subcortical/cerebellum network and the frontoparietal network showed significant importance in both classifications. Together, our findings provide new insights to understand the neuropathology of SZ and further highlight the potential advantages of multimodal network properties for identifying SZ patients at different clinical stages.
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Affiliation(s)
- Jing Wang
- School of Biomedical Engineering, Guangzhou Xinhua University, Guangzhou, China
| | - Pengfei Ke
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, China
| | - Jinyu Zang
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, China
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- *Correspondence: Fengchun Wu,
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- Guangdong Engineering Technology Research Center for Diagnosis and Rehabilitation of Dementia, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, China
- Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou, China
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Kai Wu,
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12
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Jiang Y, Patton MH, Zakharenko SS. A Case for Thalamic Mechanisms of Schizophrenia: Perspective From Modeling 22q11.2 Deletion Syndrome. Front Neural Circuits 2021; 15:769969. [PMID: 34955759 PMCID: PMC8693383 DOI: 10.3389/fncir.2021.769969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/10/2021] [Indexed: 12/12/2022] Open
Abstract
Schizophrenia is a severe, chronic psychiatric disorder that devastates the lives of millions of people worldwide. The disease is characterized by a constellation of symptoms, ranging from cognitive deficits, to social withdrawal, to hallucinations. Despite decades of research, our understanding of the neurobiology of the disease, specifically the neural circuits underlying schizophrenia symptoms, is still in the early stages. Consequently, the development of therapies continues to be stagnant, and overall prognosis is poor. The main obstacle to improving the treatment of schizophrenia is its multicausal, polygenic etiology, which is difficult to model. Clinical observations and the emergence of preclinical models of rare but well-defined genomic lesions that confer substantial risk of schizophrenia (e.g., 22q11.2 microdeletion) have highlighted the role of the thalamus in the disease. Here we review the literature on the molecular, cellular, and circuitry findings in schizophrenia and discuss the leading theories in the field, which point to abnormalities within the thalamus as potential pathogenic mechanisms of schizophrenia. We posit that synaptic dysfunction and oscillatory abnormalities in neural circuits involving projections from and within the thalamus, with a focus on the thalamocortical circuits, may underlie the psychotic (and possibly other) symptoms of schizophrenia.
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Affiliation(s)
| | | | - Stanislav S. Zakharenko
- Division of Neural Circuits and Behavior, Department of Developmental Neurobiology, St. Jude Children’s Research Hospital, Memphis, TN, United States
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13
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Thalamic connectivity system across psychiatric disorders: Current status and clinical implications. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 2:332-340. [PMID: 36324665 PMCID: PMC9616255 DOI: 10.1016/j.bpsgos.2021.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 12/20/2022] Open
Abstract
The thalamic connectivity system, with the thalamus as the central node, enables transmission of the brain’s neural computations via extensive connections to cortical, subcortical, and cerebellar regions. Emerging reports suggest deficits in this system across multiple psychiatric disorders, making it a unique network of high translational and transdiagnostic utility in mapping neural alterations that potentially contribute to symptoms and disturbances in psychiatric patients. However, despite considerable research effort, it is still debated how this system contributes to psychiatric disorders. This review characterizes current knowledge regarding thalamic connectivity system deficits in psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder, and autism spectrum disorder, across multiple levels of the system. We identify the presence of common and distinct patterns of deficits in the thalamic connectivity system in major psychiatric disorders and assess their nature and characteristics. Specifically, this review assembles evidence for the hypotheses of 1) thalamic microstructure, particularly in the mediodorsal nucleus, as a state marker of psychosis; 2) thalamo-prefrontal connectivity as a trait marker of psychosis; and 3) thalamo-somatosensory/parietal connectivity as a possible marker of general psychiatric illness. Furthermore, possible mechanisms contributing to thalamocortical dysconnectivity are explored. We discuss current views on the contributions of cerebellar-thalamic connectivity to the thalamic connectivity system and propose future studies to examine its effects at multiple levels, from the molecular (e.g., glutamatergic) to the behavioral (e.g., cognition), to gain a deeper understanding of the mechanisms that underlie the disturbances observed in psychiatric disorders.
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14
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Csukly G, Szabó Á, Polgár P, Farkas K, Gyebnár G, Kozák LR, Stefanics G. Fronto-thalamic structural and effective connectivity and delusions in schizophrenia: a combined DTI/DCM study. Psychol Med 2021; 51:2083-2093. [PMID: 32329710 PMCID: PMC8426148 DOI: 10.1017/s0033291720000859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 02/07/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Schizophrenia (SZ) is a complex disorder characterized by a range of behavioral and cognitive symptoms as well as structural and functional alterations in multiple cortical and subcortical structures. SZ is associated with reduced functional network connectivity involving core regions such as the anterior cingulate cortex (ACC) and the thalamus. However, little is known whether effective coupling, the directed influence of one structure over the other, is altered during rest in the ACC-thalamus network. METHODS We collected resting-state fMRI and diffusion-weighted MRI data from 18 patients and 20 healthy controls. We analyzed fronto-thalamic effective connectivity using dynamic causal modeling for cross-spectral densities in a network consisting of the ACC and the left and right medio-dorsal thalamic regions. We studied structural connectivity using fractional anisotropy (FA). RESULTS We found decreased coupling strength from the right thalamus to the ACC and from the right thalamus to the left thalamus, as well as increased inhibitory intrinsic connectivity in the right thalamus in patients relative to controls. ACC-to-left thalamus coupling strength correlated with the Positive and Negative Syndrome Scale (PANSS) total positive syndrome score and with delusion score. Whole-brain structural analysis revealed several tracts with reduced FA in patients, with a maximum decrease in white matter tracts containing fronto-thalamic and cingulo-thalamic fibers. CONCLUSIONS We found altered effective and structural connectivity within the ACC-thalamus network in SZ. Our results indicate that ACC-thalamus network activity at rest is characterized by reduced thalamus-to-ACC coupling. We suggest that positive symptoms may arise as a consequence of compensatory measures to imbalanced fronto-thalamic coupling.
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Affiliation(s)
- Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Ádám Szabó
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Patrícia Polgár
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Kinga Farkas
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gyula Gyebnár
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Lajos R. Kozák
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Gábor Stefanics
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Wilfriedstrasse 6, 8032, Zurich, Switzerland
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15
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Race, Socioeconomic Status, and Cerebellum Cortex Fractional Anisotropy in Pre-Adolescents. ADOLESCENTS 2021; 1:70-94. [PMID: 34095893 DOI: 10.3390/adolescents1020007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction Cerebellum cortex fractional anisotropy is a proxy of the integrity of the cerebellum cortex. However, less is known about how it is shaped by race and socioeconomic status (SES) indicators such as parental education and household income. Purpose In a national sample of American pre-adolescents, this study had two aims: to test the effects of two SES indicators, namely parental education and household income, on cerebellum cortex fractional anisotropy, and to explore racial differences in these effects. Methods Using data from the Adolescent Brain Cognitive Development (ABCD) study, we analyzed the diffusion Magnetic Resonance Imaging (dMRI) data of 9565, 9-10-year-old pre-adolescents. The main outcomes were cerebellum cortex fractional anisotropy separately calculated for right and left hemispheres using dMRI. The independent variables were parental education and household income; both treated as categorical variables. Age, sex, ethnicity, and family marital status were the covariates. Race was the moderator. To analyze the data, we used mixed-effects regression models without and with interaction terms. We controlled for propensity score and MRI device. Results High parental education and household income were associated with lower right and left cerebellum cortex fractional anisotropy. In the pooled sample, we found significant interactions between race and parental education and household income, suggesting that the effects of parental education and household income on the right and left cerebellum cortex fractional anisotropy are all significantly larger for White than for Black pre-adolescents. Conclusions The effects of SES indicators, namely parental education and household income, on pre-adolescents' cerebellum cortex microstructure and integrity are weaker in Black than in White families. This finding is in line with the Marginalization-related Diminished Returns (MDRs), defined as weaker effects of SES indicators for Blacks and other racial and minority groups than for Whites.
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16
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Hoang D, Lizano P, Lutz O, Zeng V, Raymond N, Miewald J, Montrose D, Keshavan M. Thalamic, Amygdalar, and hippocampal nuclei morphology and their trajectories in first episode psychosis: A preliminary longitudinal study ✰. Psychiatry Res Neuroimaging 2021; 309:111249. [PMID: 33484937 PMCID: PMC7904670 DOI: 10.1016/j.pscychresns.2021.111249] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/20/2020] [Accepted: 01/06/2021] [Indexed: 11/19/2022]
Abstract
The thalamus, amygdala, and hippocampus play important pathophysiologic roles in psychosis. Few studies have prospectively examined subcortical nuclei in relation to predicting clinical outcomes after a first-episode of psychosis (FEP). Here, we examined volumetric differences and trajectories among subcortical nuclei in FEP patients and their associations with illness severity. Clinical and brain volume measures were collected using a 1.5T MRI scanner and processed using FreeSurfer 6.0 from a prospective study of antipsychotic-naïve FEP patients of FEP-schizophrenia (FEP-SZ) (baseline, n = 38; follow-up, n = 17), FEP non-schizophrenia (FEP-NSZ) (baseline, n = 23; follow-up, n = 13), and healthy controls (HCs) (baseline, n = 47; follow-up, n = 29). Compared to FEP-NSZ and HCs, FEP-SZ had significantly smaller thalamic anterior nuclei volume at baseline. Longitudinally, FEP-SZ showed a positive rate of change in the amygdala compared to controls or FEP-NSZ, as well as in the basal, central and accessory basal nuclei compared to FEP-NSZ. Enlargement in the thalamic anterior nuclei predicted a worsening in overall psychosis symptoms. Baseline thalamic anterior nuclei alterations further specify key subcortical regions associated with FEP-SZ pathophysiology. Longitudinally, anterior nuclei volume enlargement may signal symptomatic worsening. The amygdala and thalamus structures may show diagnostic differences between schizophrenia and non-schizophrenia psychoses, while the thalamus changes may reflect disease or treatment related changes in clinical outcome.
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Affiliation(s)
- Dung Hoang
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
| | - Olivia Lutz
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Victor Zeng
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Nicolas Raymond
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Jean Miewald
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, United States
| | - Deborah Montrose
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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17
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Liloia D, Brasso C, Cauda F, Mancuso L, Nani A, Manuello J, Costa T, Duca S, Rocca P. Updating and characterizing neuroanatomical markers in high-risk subjects, recently diagnosed and chronic patients with schizophrenia: A revised coordinate-based meta-analysis. Neurosci Biobehav Rev 2021; 123:83-103. [PMID: 33497790 DOI: 10.1016/j.neubiorev.2021.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 01/10/2023]
Abstract
Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess pathophysiological models of how the disorder develops is an important target for the clinical practice. We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization. Results reveal a cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region found altered among c-HR, RDSZ and ChSZ. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ. These findings support the current neuroprogressive models of SZ and integrate this deterioration with the clinical evolution of the disease.
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Affiliation(s)
- Donato Liloia
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Claudio Brasso
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
| | - Franco Cauda
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
| | - Lorenzo Mancuso
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Andrea Nani
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Jordi Manuello
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Tommaso Costa
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Paola Rocca
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
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Steullet P. Thalamus-related anomalies as candidate mechanism-based biomarkers for psychosis. Schizophr Res 2020; 226:147-157. [PMID: 31147286 DOI: 10.1016/j.schres.2019.05.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 02/08/2023]
Abstract
Identification of reliable biomarkers of prognosis in subjects with high risk to psychosis is an essential step to improve care and treatment of this population of help-seekers. Longitudinal studies highlight some clinical criteria, cognitive deficits, patterns of gray matter alterations and profiles of blood metabolites that provide some levels of prediction regarding the conversion to psychosis. Further effort is warranted to validate these results and implement these types of approaches in clinical settings. Such biomarkers may however fall short in entangling the biological mechanisms underlying the disease progression, an essential step in the development of novel therapies. Circuit-based approaches, which map on well-identified cerebral functions, could meet these needs. Converging evidence indicates that thalamus abnormalities are central to schizophrenia pathophysiology, contributing to clinical symptoms, cognitive and sensory deficits. This review highlights the various thalamus-related anomalies reported in individuals with genetic risks and in the different phases of the disorder, from prodromal to chronic stages. Several anomalies are potent endophenotypes, while others exist in clinical high-risk subjects and worsen in those who convert to full psychosis. Aberrant functional coupling between thalamus and cortex, low glutamate content and readouts from resting EEG carry predictive values for transition to psychosis or functional outcome. In this context, thalamus-related anomalies represent a valuable entry point to tackle circuit-based alterations associated with the emergence of psychosis. This review also proposes that longitudinal surveys of neuroimaging, EEG readouts associated with circuits encompassing the mediodorsal, pulvinar in high-risk individuals could unveil biological mechanisms contributing to this psychiatric disorder.
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Affiliation(s)
- Pascal Steullet
- Center of Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, Site de Cery, 1008 Prilly-Lausanne, Switzerland.
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19
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Huang AS, Rogers BP, Sheffield JM, Jalbrzikowski ME, Anticevic A, Blackford JU, Heckers S, Woodward ND. Thalamic Nuclei Volumes in Psychotic Disorders and in Youths With Psychosis Spectrum Symptoms. Am J Psychiatry 2020; 177:1159-1167. [PMID: 32911995 PMCID: PMC7708443 DOI: 10.1176/appi.ajp.2020.19101099] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Thalamus models of psychosis implicate association nuclei in the pathogenesis of psychosis and mechanisms of cognitive impairment. Studies to date have provided conflicting findings for structural deficits specific to these nuclei. The authors sought to characterize thalamic structural abnormalities in psychosis and a neurodevelopmental cohort, and to determine whether nuclear volumes were associated with cognitive function. METHODS Thalamic nuclei volumes were tested in a cross-sectional sample of 472 adults (293 with psychosis) and the Philadelphia Neurodevelopmental Cohort (PNC), consisting of 1,393 youths (398 with psychosis spectrum symptoms and 609 with other psychopathologies), using a recently developed, validated method for segmenting thalamic nuclei and complementary voxel-based morphometry. Cognitive function was measured with the Screen for Cognitive Impairment in Psychiatry in the psychosis cohort and the Penn Computerized Neurocognitive Battery in the PNC. RESULTS The psychosis group had smaller pulvinar, mediodorsal, and, to a lesser extent, ventrolateral nuclei volumes compared with the healthy control group. Youths with psychosis spectrum symptoms also had smaller pulvinar volumes, compared with both typically developing youths and youths with other psychopathologies. Pulvinar volumes were positively correlated with general cognitive function. CONCLUSIONS The study findings demonstrate that smaller thalamic association nuclei represent a neurodevelopmental abnormality associated with psychosis, risk for psychosis in youths, and cognitive impairment. Identifying specific thalamic nuclei abnormalities in psychosis has implications for early detection of psychosis risk and treatment of cognitive impairment in psychosis.
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Affiliation(s)
- Anna S. Huang
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | | | - Julia M. Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | | | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
- Research Health Scientist, Research and Development, Department of Veterans Affairs Medical Center, Nashville, TN
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
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20
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Alemán-Gómez Y, Najdenovska E, Roine T, Fartaria MJ, Canales-Rodríguez EJ, Rovó Z, Hagmann P, Conus P, Do KQ, Klauser P, Steullet P, Baumann PS, Bach Cuadra M. Partial-volume modeling reveals reduced gray matter in specific thalamic nuclei early in the time course of psychosis and chronic schizophrenia. Hum Brain Mapp 2020; 41:4041-4061. [PMID: 33448519 PMCID: PMC7469814 DOI: 10.1002/hbm.25108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/22/2020] [Accepted: 06/14/2020] [Indexed: 12/20/2022] Open
Abstract
The structural complexity of the thalamus, due to its mixed composition of gray and white matter, make it challenging to disjoint and quantify each tissue contribution to the thalamic anatomy. This work promotes the use of partial‐volume‐based over probabilistic‐based tissue segmentation approaches to better capture thalamic gray matter differences between patients at different stages of psychosis (early and chronic) and healthy controls. The study was performed on a cohort of 23 patients with schizophrenia, 41 with early psychosis and 69 age and sex‐matched healthy subjects. Six tissue segmentation approaches were employed to obtain the gray matter concentration/probability images. The statistical tests were applied at three different anatomical scales: whole thalamus, thalamic subregions and voxel‐wise. The results suggest that the partial volume model estimation of gray matter is more sensitive to detect atrophies within the thalamus of patients with psychosis. However all the methods detected gray matter deficit in the pulvinar, particularly in early stages of psychosis. This study demonstrates also that the gray matter decrease varies nonlinearly with age and between nuclei. While a gray matter loss was found in the pulvinar of patients in both stages of psychosis, reduced gray matter in the mediodorsal was only observed in early psychosis subjects. Finally, our analyses point to alterations in a sub‐region comprising the lateral posterior and ventral posterior nuclei. The obtained results reinforce the hypothesis that thalamic gray matter assessment is more reliable when the tissues segmentation method takes into account the partial volume effect.
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Affiliation(s)
- Yasser Alemán-Gómez
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Medical Image Analysis Laboratory (MIAL), Centre d'Imagerie BioMédicale (CIBM), Switzerland
| | - Elena Najdenovska
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Medical Image Analysis Laboratory (MIAL), Centre d'Imagerie BioMédicale (CIBM), Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Timo Roine
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Medical Image Analysis Laboratory (MIAL), Centre d'Imagerie BioMédicale (CIBM), Switzerland
| | - Mário João Fartaria
- Medical Image Analysis Laboratory (MIAL), Centre d'Imagerie BioMédicale (CIBM), Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Erick J Canales-Rodríguez
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,FIDMAG Germanes Hospitalàries Research Foundation, Sant Boi de Llobregat, Barcelona, Spain
| | - Zita Rovó
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Kim Q Do
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Paul Klauser
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Pascal Steullet
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Philipp S Baumann
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Service of General Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Meritxell Bach Cuadra
- Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Medical Image Analysis Laboratory (MIAL), Centre d'Imagerie BioMédicale (CIBM), Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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21
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Mancini V, Zöller D, Schneider M, Schaer M, Eliez S. Abnormal Development and Dysconnectivity of Distinct Thalamic Nuclei in Patients With 22q11.2 Deletion Syndrome Experiencing Auditory Hallucinations. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:875-890. [PMID: 32620531 DOI: 10.1016/j.bpsc.2020.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Several studies in patients with schizophrenia have demonstrated an abnormal thalamic volume and thalamocortical connectivity. Specifically, hyperconnectivity with somatosensory areas has been related to the presence of auditory hallucinations (AHs). The 22q11.2 deletion syndrome is a neurogenetic disorder conferring proneness to develop schizophrenia, and deletion carriers (22qdel carriers) experience hallucinations to a greater extent than the general population. METHODS We acquired 442 consecutive magnetic resonance imaging scans from 120 22qdel carriers and 110 control subjects every 3 years (age range: 8-35 years). The volume of thalamic nuclei was obtained with FreeSurfer and was compared between 22qdel carriers and control subjects and between 22qdel carriers with and without AHs. In a subgroup of 76 22qdel carriers, we evaluated the functional connectivity between thalamic nuclei affected in patients experiencing AHs and cortical regions. RESULTS As compared with control subjects, 22qdel carriers had lower and higher volumes of nuclei involved in sensory processing and cognitive functions, respectively. 22qdel carriers with AHs had a smaller volume of the medial geniculate nucleus, with deviant trajectories showing a steeper volume decrease from childhood with respect to those without AHs. Moreover, we showed an aberrant development of nuclei intercalated between the prefrontal cortex and hippocampus (the anteroventral and medioventral reuniens nuclei) and hyperconnectivity of the medial geniculate nucleus and anteroventral nucleus with the auditory cortex and Wernicke's area. CONCLUSIONS The increased connectivity of the medial geniculate nucleus and anteroventral nucleus to the auditory cortex might be interpreted as a lack of maturation of thalamocortical connectivity. Overall, our findings point toward an aberrant development of thalamic nuclei and an immature pattern of connectivity with temporal regions in relation to AHs.
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Affiliation(s)
- Valentina Mancini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland; Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland; Clinical Psychology Unit for Developmental and Intellectual Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Department of Neuroscience, Center for Contextual Psychiatry, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland; Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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Derome M, Zöller D, Modinos G, Schaer M, Eliez S, Debbané M. Developmental trajectories of subcortical structures in relation to dimensional schizotypy expression along adolescence. Schizophr Res 2020; 218:76-84. [PMID: 32081537 DOI: 10.1016/j.schres.2020.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 12/31/2022]
Abstract
Morphological abnormalities of subcortical structures have been consistently reported along the schizophrenia clinical spectrum, and they may play an important role in the pathophysiology of psychosis. However, the question arises whether these subcortical features are consequences of medication and illness chronicity, or if they contribute to the vulnerability to develop schizophrenia spectrum disorders. If some of the subcortical abnormalities could be evidenced in community adolescents expressing higher schizotypal traits (psychometric schizotypy), they could potentially shed light on vulnerability markers. To date, very few studies have examined the link between psychometric schizotypy and volumes of subcortical regions, and none of them have used a longitudinal design. This study sets out to investigate developmental trajectories of subcortical volumes in 110 community adolescents (12 to 20 years old), for whom MRI-scans were acquired over a period of 5 years, reaching a total of 297 scans. Analyses were conducted using Freesurfer, and schizotypal traits were measured with the Schizotypal Personality Questionnaire (SPQ). Using mixed model regression analyses following a region-of-interest approach, we observed differential linear developmental trajectories in four subcortical structures when comparing higher versus lower scorers on the disorganized schizotypy dimension (bilateral hippocampus, left-lateral ventricle and left-pallidum) and the negative schizotypy dimension (bilateral pallidum, and right-thalamus). All results survived a threshold of p < .05 (FDR-corrected) while covarying for the effect of other psychological problems (externalized and internalized psychopathology). These results indicate that expression of higher levels of negative and disorganized schizotypy during adolescence was associated with neural markers linking schizotypy personality features to schizophrenia spectrum disorders.
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Affiliation(s)
- Mélodie Derome
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland.
| | - Daniela Zöller
- Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Medical Image Processing Lab, Institute of Bioengineering, EPFL, Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland.
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Marie Schaer
- Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland.
| | - Stephan Eliez
- Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Switzerland.
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Research Department of Clinical, Educational & Health Psychology, University College London, United Kingdom.
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23
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Jalbrzikowski M, Freedman D, Hegarty CE, Mennigen E, Karlsgodt KH, Olde Loohuis LM, Ophoff RA, Gur RE, Bearden CE. Structural Brain Alterations in Youth With Psychosis and Bipolar Spectrum Symptoms. J Am Acad Child Adolesc Psychiatry 2019; 58:1079-1091. [PMID: 30768396 PMCID: PMC7110691 DOI: 10.1016/j.jaac.2018.11.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/26/2018] [Accepted: 01/10/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Adults with established diagnoses of serious mental illness (bipolar disorder and schizophrenia) exhibit structural brain abnormalities, yet less is known about how such abnormalities manifest earlier in development. METHOD Cross-sectional data publicly available from the Philadelphia Neurodevelopmental Cohort (PNC) were analyzed. Structural magnetic resonance neuroimaging data were collected on a subset of the PNC (N = 989; 9-22 years old). Cortical thickness, surface area (SA), and subcortical volumes were calculated. Study participants were assessed for psychiatric symptomatology using a structured interview and the following groups were created: typically developing (n = 376), psychosis spectrum (PS; n = 113), bipolar spectrum (BP; n = 117), and BP + PS (n = 109). Group and developmental differences in structural magnetic resonance neuroimaging measures were examined. In addition, the extent to which any structural aberration was related to neurocognition, global functioning, and clinical symptomatology was examined. RESULTS Compared with other groups, PS youth exhibited significantly decreased SA in the orbitofrontal, cingulate, precentral, and postcentral regions. PS youth also exhibited deceased thalamic volume compared with all other groups. The strongest effects for precentral and posterior cingulate SA decreases were seen during early adolescence (13-15 years old) in PS youth. The strongest effects for decreases in thalamic volume and orbitofrontal and postcentral SA were observed in mid-adolescence (16-18 years) in PS youth. Across groups, better overall functioning was associated with increased lateral orbitofrontal SA. Increased postcentral SA was associated with better executive cognition and less severe negative symptoms in the entire sample. CONCLUSION In a community-based sample, decreased cortical SA and thalamic volume were present early in adolescent development in youth with PS symptoms, but not in youth with BP symptoms or with BP and PS symptoms. These findings point to potential biological distinctions between PS and BP conditions, which could suggest additional biomarkers relevant to early identification.
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Affiliation(s)
| | - David Freedman
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | - Eva Mennigen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | | | - Roel A Ophoff
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Center for Neurobehavioral Genetics, University of California, Los Angeles
| | - Raquel E Gur
- Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, PA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Center for Neurobehavioral Genetics, University of California, Los Angeles; University of California, Los Angeles
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24
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Ding Y, Ou Y, Pan P, Shan X, Chen J, Liu F, Zhao J, Guo W. Brain structural abnormalities as potential markers for detecting individuals with ultra-high risk for psychosis: A systematic review and meta-analysis. Schizophr Res 2019; 209:22-31. [PMID: 31104914 DOI: 10.1016/j.schres.2019.05.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 02/28/2019] [Accepted: 05/06/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study aims to determine whether structural alterations can be used as neuroimaging markers to detect individuals with ultra-high risk (UHR) for psychosis for the diagnosis of schizophrenia and improvement of treatment outcomes. METHODS Embase and Pubmed databases were searched for related studies in July 2018. The search was performed without restriction on time and regions or languages. A total of 188 articles on voxel-based morphometry (VBM) and 96 articles on cortical thickness were obtained, and another 6 articles were included after the reference lists were checked. Our researchers assessed and extracted the data in accordance with the PRISMA guideline. The data were processed with a seed-based mapping method. RESULTS Fourteen VBM and nine cortical thickness studies were finally included in our study. In individuals with UHR, the gray matter volumes in the bilateral median cingulate (Z = 1.034), the right fusiform gyrus (Z = 1.051), the left superior temporal gyrus (Z = 1.048), and the right thalamus (Z = 1.039) increased relative to those of healthy controls. By contrast, the gray matter volumes in the right gyrus rectus (Z = -2.109), the right superior frontal gyrus (Z = -2.321), and the left superior frontal gyrus (Z = -2.228) decreased. The robustness of these findings was verified through Jackknife sensitivity analysis, and heterogeneity across studies was low. Typically, cortical thickness alterations were not detected in individuals with UHR. CONCLUSIONS Structural abnormalities of the thalamocortical circuit may underpin the neurophysiology of psychosis and mark the vulnerability of transition to psychosis in UHR subjects.
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Affiliation(s)
- Yudan Ding
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China
| | - Yangpan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China
| | - Pan Pan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China
| | - Xiaoxiao Shan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China.
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25
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Cho KIK, Kwak YB, Hwang WJ, Lee J, Kim M, Lee TY, Kwon JS. Microstructural Changes in Higher-Order Nuclei of the Thalamus in Patients With First-Episode Psychosis. Biol Psychiatry 2019; 85:70-78. [PMID: 29961564 DOI: 10.1016/j.biopsych.2018.05.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Disruption in the thalamus, such as volume, shape, and cortical connectivity, is regarded as an important pathophysiological mechanism in schizophrenia. However, there is little evidence of nuclei-specific structural alterations in the thalamus during early-stage psychosis, mainly because of the methodological limitations of conventional structural imaging in identifying the thalamic nuclei. METHODS A total of 37 patients with first-episode psychosis and 36 matched healthy control subjects underwent diffusion tensor imaging, diffusion kurtosis imaging, and T1-weighted magnetic resonance imaging. Connectivity-based segmentation of the thalamus was performed using diffusion tensor imaging, and averages of the diffusion kurtosis values, which represent microstructural complexity, were estimated using diffusion kurtosis imaging and were compared in each thalamic nucleus between the groups. RESULTS The mean kurtosis values in the thalamic regions with strong connections to the orbitofrontal cortex (F1,70 = 8.40, p < .01) and the lateral temporal cortex (F1,70 = 8.46, p < .01) were significantly reduced in patients with first-episode psychosis compared with those of the healthy control subjects. The mean kurtosis values in the thalamic region with strong connection to the orbitofrontal cortex showed a significant correlation with spatial working memory accuracy in patients with first-episode psychosis (r = .36, p < .05), whereas no significant correlation between these variables was observed in the healthy control subjects. CONCLUSIONS The observed pattern of reduced microstructural complexity in the nuclei not only highlights the involvement of the thalamus but also emphasizes the role of the higher-order nuclei in the pathophysiology beginning in the early stage of schizophrenia.
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Affiliation(s)
- Kang Ik K Cho
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Junhee Lee
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Minah Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Tae Young Lee
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea; Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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26
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Pillinger T, D’Ambrosio E, McCutcheon R, Howes OD. Is psychosis a multisystem disorder? A meta-review of central nervous system, immune, cardiometabolic, and endocrine alterations in first-episode psychosis and perspective on potential models. Mol Psychiatry 2019; 24:776-794. [PMID: 29743584 PMCID: PMC6124651 DOI: 10.1038/s41380-018-0058-9] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/01/2018] [Accepted: 02/21/2018] [Indexed: 01/02/2023]
Abstract
People with psychotic disorders show abnormalities in several organ systems in addition to the central nervous system (CNS); and this contributes to excess mortality. However, it is unclear how strong the evidence is for alterations in non-CNS systems at the onset of psychosis, how the alterations in non-CNS systems compare to those in the CNS, or how they relate to symptoms. Here, we consider these questions, and suggest potential models to account for findings. We conducted a systematic meta-review to summarize effect sizes for both CNS (focusing on brain structural, neurophysiological, and neurochemical parameters) and non-CNS dysfunction (focusing on immune, cardiometabolic, and hypothalamic-pituitary-adrenal (HPA) systems) in first-episode psychosis (FEP). Relevant meta-analyses were identified in a systematic search of Pubmed and the methodological quality of these was assessed using the AMSTAR checklist (A Measurement Tool to Assess Systematic Reviews). Case-control data were extracted from studies included in these meta-analyses. Random effects meta-analyses were re-run and effect size magnitudes for individual parameters were calculated, as were summary effect sizes for each CNS and non-CNS system. We also grouped studies to obtain overall effect sizes for non-CNS and CNS alterations. Robustness of data for non-CNS and CNS parameters was assessed using Rosenthal's fail-safe N. We next statistically compared summary effect size for overall CNSand overall non-CNS alterations, as well as for each organ system separately. We also examined how non-CNS alterations correlate CNS alterations, and with psychopathological symptoms. Case-control data were extracted for 165 studies comprising a total sample size of 13,440. For people with first episode psychosis compared with healthy controls, we observed alterations in immune parameters (summary effect size: g = 1.19), cardiometabolic parameters (g = 0.23); HPA parameters (g = 0.68); brain structure (g = 0.40); neurophysiology (g = 0.80); and neurochemistry (g = 0.43). Grouping non-CNS organ systems together provided an effect size for overall non-CNS alterations in patients compared with controls (g = 0.58), which was not significantly different from the overall CNS alterations effect size (g = 0.50). However, the summary effect size for immune alterations was significantly greater than that for brain structural (P < 0.001) and neurochemical alterations (P < 0.001), while the summary effect size for cardiometabolic alterations was significantly lower than neurochemical (P = 0.04), neurophysiological (P < 0.001), and brain structural alterations (P = 0.001). The summary effect size for HPA alterations was not significantly different from brain structural (P = 0.14), neurophysiological (P = 0.54), or neurochemical alterations (P = 0.22). These outcomes remained similar in antipsychotic naive sensitivity analyses. We found some, but limited and inconsistent, evidence that non-CNS alterations were associated with CNS changes and symptoms in first episode psychosis. Our findings indicate that there are robust alterations in non-CNS systems in psychosis, and that these are broadly similar in magnitude to a range of CNS alterations. We consider models that could account for these findings and discuss implications for future research and treatment.
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Affiliation(s)
- Toby Pillinger
- 0000 0001 2322 6764grid.13097.3cIoPPN, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Enrico D’Ambrosio
- 0000 0001 2322 6764grid.13097.3cIoPPN, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Robert McCutcheon
- 0000 0001 2322 6764grid.13097.3cIoPPN, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Oliver D. Howes
- 0000 0001 2322 6764grid.13097.3cIoPPN, King’s College London, De Crespigny Park, London, SE5 8AF UK ,0000000122478951grid.14105.31MRC London Institute of Medical Sciences (LMS), Du Cane Road, London, W12 0NN UK ,0000 0001 2113 8111grid.7445.2Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, Du Cane Road, London, W12 0NN UK
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27
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Development of Neuroimaging-Based Biomarkers in Psychiatry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:159-195. [PMID: 31705495 DOI: 10.1007/978-981-32-9721-0_9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This chapter presents an overview of accumulating neuroimaging data with emphasis on translational potential. The subject will be described in the context of three disease states, i.e., schizophrenia, bipolar disorder, and major depressive disorder, and for three clinical goals, i.e., disease risk assessment, subtyping, and treatment decision.
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28
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de Pierrefeu A, Löfstedt T, Laidi C, Hadj-Selem F, Bourgin J, Hajek T, Spaniel F, Kolenic M, Ciuciu P, Hamdani N, Leboyer M, Fovet T, Jardri R, Houenou J, Duchesnay E. Identifying a neuroanatomical signature of schizophrenia, reproducible across sites and stages, using machine learning with structured sparsity. Acta Psychiatr Scand 2018; 138:571-580. [PMID: 30242828 DOI: 10.1111/acps.12964] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Structural MRI (sMRI) increasingly offers insight into abnormalities inherent to schizophrenia. Previous machine learning applications suggest that individual classification is feasible and reliable and, however, is focused on the predictive performance of the clinical status in cross-sectional designs, which has limited biological perspectives. Moreover, most studies depend on relatively small cohorts or single recruiting site. Finally, no study controlled for disease stage or medication's effect. These elements cast doubt on previous findings' reproducibility. METHOD We propose a machine learning algorithm that provides an interpretable brain signature. Using large datasets collected from 4 sites (276 schizophrenia patients, 330 controls), we assessed cross-site prediction reproducibility and associated predictive signature. For the first time, we evaluated the predictive signature regarding medication and illness duration using an independent dataset of first-episode patients. RESULTS Machine learning classifiers based on neuroanatomical features yield significant intersite prediction accuracies (72%) together with an excellent predictive signature stability. This signature provides a neural score significantly correlated with symptom severity and the extent of cognitive impairments. Moreover, this signature demonstrates its efficiency on first-episode psychosis patients (73% accuracy). CONCLUSION These results highlight the existence of a common neuroanatomical signature for schizophrenia, shared by a majority of patients even from an early stage of the disorder.
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Affiliation(s)
| | - T Löfstedt
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - C Laidi
- NeuroSpin, CEA, Gif-sur-Yvette, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U955, Institut Mondor de Recherche Biomédicale, Psychiatrie Translationnelle, Créteil, France.,Fondation Fondamental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine de Créteil, DHU PePsy, Hôpitaux Universitaires Mondor, Créteil, France
| | - F Hadj-Selem
- Energy Transition Institute: VeDeCoM, Versailles, France
| | - J Bourgin
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, Colombes, France.,INSERM U894, Centre for Psychiatry and Neurosciences, Paris, France
| | - T Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,National Institute of Mental Health, Klecany, Czech Republic
| | - F Spaniel
- National Institute of Mental Health, Klecany, Czech Republic
| | - M Kolenic
- National Institute of Mental Health, Klecany, Czech Republic
| | - P Ciuciu
- NeuroSpin, CEA, Gif-sur-Yvette, France.,INRIA, CEA, Parietal team, University of Paris-Saclay, Lille, France
| | - N Hamdani
- Institut National de la Santé et de la Recherche Médicale (INSERM), U955, Institut Mondor de Recherche Biomédicale, Psychiatrie Translationnelle, Créteil, France.,Fondation Fondamental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine de Créteil, DHU PePsy, Hôpitaux Universitaires Mondor, Créteil, France
| | - M Leboyer
- Institut National de la Santé et de la Recherche Médicale (INSERM), U955, Institut Mondor de Recherche Biomédicale, Psychiatrie Translationnelle, Créteil, France.,Fondation Fondamental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine de Créteil, DHU PePsy, Hôpitaux Universitaires Mondor, Créteil, France
| | - T Fovet
- Laboratoire de Sciences Cognitives et Sciences Affectives (SCALab-PsyCHIC), CNRS UMR 9193, University of Lille, Lille, France.,Pôle de Psychiatrie, Unité CURE, CHU Lille, Lille, France
| | - R Jardri
- INRIA, CEA, Parietal team, University of Paris-Saclay, Lille, France.,Laboratoire de Sciences Cognitives et Sciences Affectives (SCALab-PsyCHIC), CNRS UMR 9193, University of Lille, Lille, France.,Pôle de Psychiatrie, Unité CURE, CHU Lille, Lille, France
| | - J Houenou
- NeuroSpin, CEA, Gif-sur-Yvette, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U955, Institut Mondor de Recherche Biomédicale, Psychiatrie Translationnelle, Créteil, France.,Fondation Fondamental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de Médecine de Créteil, DHU PePsy, Hôpitaux Universitaires Mondor, Créteil, France
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Zhao W, Guo S, He N, Yang AC, Lin CP, Tsai SJ. Callosal and subcortical white matter alterations in schizophrenia: A diffusion tensor imaging study at multiple levels. Neuroimage Clin 2018; 20:594-602. [PMID: 30186763 PMCID: PMC6120601 DOI: 10.1016/j.nicl.2018.08.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/25/2018] [Accepted: 08/20/2018] [Indexed: 12/28/2022]
Abstract
Diffusion tensor imaging and its distinct capability to detect micro-structural changes in vivo allows the exploration of white matter (WM) abnormalities in patients who have been diagnosed with schizophrenia; however, the results regarding the anatomical positions and degree of abnormalities are inconsistent. In order to obtain more robust and stable findings, we conducted a multi-level analysis to investigate WM disruption in a relatively large sample size (142 schizophrenia patients and 163 healthy subjects). Specifically, we evaluated the univariate fractional anisotropy (FA) in voxel level; the bivariate pairwise structural connectivity between regions using deterministic tractography as the network node defined by the Human Brainnetome Atlas; and the multivariate network topological properties, including the network hub, efficiency, small-worldness, and strength. Our data demonstrated callosal and subcortical WM alterations in patients with schizophrenia. These disruptions were evident in both voxel and connectivity levels and further supported by associations between FA values and illness duration. Based on the findings regarding topological properties, the structural network showed weaker global integration in patients with schizophrenia than in healthy subjects, while brain network hubs showed decreased functionality. We replicated these findings using an automated anatomical labeling atlas to define the network node. Our study indicates that callosal and subcortical WM disruptions are biomarkers for chronic schizophrenia.
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Affiliation(s)
- Wei Zhao
- College of Mathematics and Statistics, Key Laboratory of High Performance Computing and Stochastic Information Processing (Ministry of Education of China), Hunan Normal University, Changsha, PR China
| | - Shuixia Guo
- College of Mathematics and Statistics, Key Laboratory of High Performance Computing and Stochastic Information Processing (Ministry of Education of China), Hunan Normal University, Changsha, PR China; Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, PR China.
| | - Ningning He
- College of Mathematics and Statistics, Key Laboratory of High Performance Computing and Stochastic Information Processing (Ministry of Education of China), Hunan Normal University, Changsha, PR China
| | - Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, USA; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
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30
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Wolf R, Dobrowolny H, Nullmeier S, Bogerts B, Schwegler H. Effects of neonatal excitotoxic lesions in ventral thalamus on social interaction in the rat. Eur Arch Psychiatry Clin Neurosci 2018; 268:461-470. [PMID: 28361258 DOI: 10.1007/s00406-017-0781-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 03/06/2017] [Indexed: 12/31/2022]
Abstract
The role of the thalamus in schizophrenia has increasingly been studied in recent years. Deficits in the ventral thalamus have been described in only few postmortem and neuroimaging studies. We utilised our previously introduced neurodevelopmental animal model, the neonatal excitotoxic lesion of the ventral thalamus of Sprague-Dawley rats (Wolf et al., Pharmacopsychiatry 43:99-109, 22). At postnatal day (PD7), male pubs received bilateral thalamic infusions with ibotenic acid (IBA) or artificial cerebrospinal fluid (control). In adulthood, social interaction of two animals not familiar to each other was studied by a computerised video tracking system. This study displays clear lesion effects on social interaction of adult male rats. The significant reduction of total contact time and the significant increase in distance between the animals in the IBA group compared to controls can be interpreted as social withdrawal modelling a negative symptom of schizophrenia. The significant increase of total distance travelled in the IBA group can be hypothesised as agitation modelling a positive symptom of schizophrenia. Using a triple concept of social interaction, the percentage of no social interaction (Non-SI%) was significantly larger, and inversely, the percentage of passive social interaction (SI-passive%) was significantly smaller in the IBA group when compared to controls. In conclusion, on the background of findings in schizophrenic patients, the effects of neonatal ventral thalamic IBA lesions in adult male rats support the hypothesis of face and construct validity as animal model of schizophrenia.
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Affiliation(s)
- Rainer Wolf
- Department of Psychiatry, Ruhr-University Bochum, Alexandrinenstr. 1, 44791, Bochum, Germany.
- Department of Psychiatry, Otto-von-Guericke University, Magdeburg, Germany.
| | - Henrik Dobrowolny
- Department of Psychiatry, Otto-von-Guericke University, Magdeburg, Germany
| | - Sven Nullmeier
- Institute of Anatomy, Otto-von-Guericke University, Magdeburg, Germany
| | - Bernhard Bogerts
- Department of Psychiatry, Otto-von-Guericke University, Magdeburg, Germany
| | - Herbert Schwegler
- Institute of Anatomy, Otto-von-Guericke University, Magdeburg, Germany
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31
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A Neurophysiological Perspective on a Preventive Treatment against Schizophrenia Using Transcranial Electric Stimulation of the Corticothalamic Pathway. Brain Sci 2017; 7:brainsci7040034. [PMID: 28350371 PMCID: PMC5406691 DOI: 10.3390/brainsci7040034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/11/2017] [Accepted: 03/24/2017] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia patients are waiting for a treatment free of detrimental effects. Psychotic disorders are devastating mental illnesses associated with dysfunctional brain networks. Ongoing brain network gamma frequency (30–80 Hz) oscillations, naturally implicated in integrative function, are excessively amplified during hallucinations, in at-risk mental states for psychosis and first-episode psychosis. So, gamma oscillations represent a bioelectrical marker for cerebral network disorders with prognostic and therapeutic potential. They accompany sensorimotor and cognitive deficits already present in prodromal schizophrenia. Abnormally amplified gamma oscillations are reproduced in the corticothalamic systems of healthy humans and rodents after a single systemic administration, at a psychotomimetic dose, of the glutamate N-methyl-d-aspartate receptor antagonist ketamine. These translational ketamine models of prodromal schizophrenia are thus promising to work out a preventive noninvasive treatment against first-episode psychosis and chronic schizophrenia. In the present essay, transcranial electric stimulation (TES) is considered an appropriate preventive therapeutic modality because it can influence cognitive performance and neural oscillations. Here, I highlight clinical and experimental findings showing that, together, the corticothalamic pathway, the thalamus, and the glutamatergic synaptic transmission form an etiopathophysiological backbone for schizophrenia and represent a potential therapeutic target for preventive TES of dysfunctional brain networks in at-risk mental state patients against psychotic disorders.
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32
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Huang X, Pu W, Li X, Greenshaw AJ, Dursun SM, Xue Z, Liu H, Liu Z. Decreased Left Putamen and Thalamus Volume Correlates with Delusions in First-Episode Schizophrenia Patients. Front Psychiatry 2017; 8:245. [PMID: 29209237 PMCID: PMC5702009 DOI: 10.3389/fpsyt.2017.00245] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/06/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Delusional thinking is one of the hallmark symptoms of schizophrenia. However, the underlying neural substrate for delusions in schizophrenia remains unknown. In an attempt to further our understanding of the neural basis of delusions, we explored gray matter deficits and their clinical associations in first-episode schizophrenia patients with and without delusions. METHODS Twenty-four first-episode schizophrenia patients with delusions and 18 without delusions as well as 26 healthy controls (HC) underwent clinical assessment and whole-brain structural imaging which were acquired a 3.0 T scanner. Voxel-based morphometry was used to explore inter-group differences in gray matter volume using analysis of covariance, and Spearman correlation coefficients (rho) between the Scale for the Assessment of Positive Symptoms (SAPS)-delusion scores and mean regional brain volumes was obtained. RESULTS Patients with delusions showed decreased brain gray matter volumes in the left putamen, thalamus, and caudate regions compared with HC. Patients with delusions also showed decreased regional volume in the left putamen and thalamus compared with patients without delusions. SAPS-delusion scores were negatively correlated with the gray matter volumes of the left putamen and thalamus. DISCUSSION Left putamen and thalamus volume loss may be biological correlates of delusions in schizophrenia.
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Affiliation(s)
- Xiaojun Huang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.,The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Weidan Pu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinmin Li
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Serdar M Dursun
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Zhimin Xue
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.,The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Haihong Liu
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.,The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
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33
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Willi TS, Lang DJ, Honer WG, Smith GN, Thornton AE, Panenka WJ, Procyshyn RM, Vila-Rodriguez F, Su W, Vertinsky AT, Leonova O, Rauscher A, MacEwan GW, Barr AM. Subcortical grey matter alterations in cocaine dependent individuals with substance-induced psychosis compared to non-psychotic cocaine users. Schizophr Res 2016; 176:158-163. [PMID: 27499362 DOI: 10.1016/j.schres.2016.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 11/28/2022]
Abstract
After prolonged psychostimulant abuse, transient psychotic symptoms referred to as "substance-induced psychosis" (SIP) can develop - closely resembling symptoms observed in schizophrenia spectrum disorders. The comparability in psychotic presentation between SIP and schizophrenias suggests that similar underlying neural deficits may contribute to the expression of psychosis across these disorders. To date, neuroanatomical characterization of grey matter structural alterations in SIP has been limited to methamphetamine associated psychosis, with no studies controlling for potential neurotoxic effects of the psychostimulant that precipitates psychosis. To investigate grey matter subcortical alterations in SIP, a voxel-based analysis of magnetic resonance images (MRI) was performed between a group of 74 cocaine dependent nonpsychotic individuals and a group of 29 individuals with cocaine-associated psychosis. The cocaine-associated psychosis group had significantly smaller volumes of the thalamus and left hippocampus, controlling for age, total brain volume, current methamphetamine dependence, and current marijuana dependence. No differences were present in bilateral caudate structures. The findings of reduced thalamic and hippocampal volumes agree with previous reports in the schizophrenia literature, suggesting alterations of these structures are not specific to schizophrenia, but may be common to multiple forms of psychosis.
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Affiliation(s)
- Taylor S Willi
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver V5Z 1M9, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Geoff N Smith
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby B.C. V5A 1S6, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Ric M Procyshyn
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Fidel Vila-Rodriguez
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Wayne Su
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - A Talia Vertinsky
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Alexander Rauscher
- Department of Radiology, University of British Columbia, Vancouver V5Z 1M9, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada
| | - Alasdair M Barr
- Department of Pharmacology, 2176 Health Sciences Mall, University of British Columbia, Vancouver B.C. V6T 1Z3, Canada.
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34
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Harrisberger F, Buechler R, Smieskova R, Lenz C, Walter A, Egloff L, Bendfeldt K, Simon AE, Wotruba D, Theodoridou A, Rössler W, Riecher-Rössler A, Lang UE, Heekeren K, Borgwardt S. Alterations in the hippocampus and thalamus in individuals at high risk for psychosis. NPJ SCHIZOPHRENIA 2016; 2:16033. [PMID: 27738647 PMCID: PMC5040554 DOI: 10.1038/npjschz.2016.33] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 02/04/2023]
Abstract
Reduction in hippocampal volume is a hallmark of schizophrenia and already present in the
clinical high-risk state. Nevertheless, other subcortical structures, such as the
thalamus, amygdala and pallidum can differentiate schizophrenia patients from controls. We
studied the role of hippocampal and subcortical structures in clinical high-risk
individuals from two cohorts. High-resolution T1-weighted structural MRI brain
scans of a total of 91 clinical high-risk individuals and 64 healthy controls were
collected in two centers. The bilateral volume of the hippocampus, the thalamus, the
caudate, the putamen, the pallidum, the amygdala, and the accumbens were automatically
segmented using FSL-FIRST. A linear mixed-effects model and a prospective meta-analysis
were applied to assess group-related volumetric differences. We report reduced hippocampal
and thalamic volumes in clinical high-risk individuals compared to healthy controls. No
volumetric alterations were detected for the caudate, the putamen, the pallidum, the
amygdala, or the accumbens. Moreover, we found comparable medium effect sizes for
group-related comparison of the thalamus in the two analytical methods. These findings
underline the relevance of specific alterations in the hippocampal and subcortical volumes
in the high-risk state. Further analyses may allow hippocampal and thalamic volumes to be
used as biomarkers to predict psychosis.
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Affiliation(s)
| | - Roman Buechler
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Renata Smieskova
- Department of Psychiatry, University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University of Basel, Basel, Switzerland
| | - Claudia Lenz
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Anna Walter
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Laura Egloff
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Kerstin Bendfeldt
- Medical Image Analysis Centre, University of Basel , Basel, Switzerland
| | - Andor E Simon
- Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry , Bruderholz, Switzerland
| | - Diana Wotruba
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | | | - Undine E Lang
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University of Basel, Basel, Switzerland; Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK
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35
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Waters F, Blom JD, Dang-Vu TT, Cheyne AJ, Alderson-Day B, Woodruff P, Collerton D. What Is the Link Between Hallucinations, Dreams, and Hypnagogic-Hypnopompic Experiences? Schizophr Bull 2016; 42:1098-109. [PMID: 27358492 PMCID: PMC4988750 DOI: 10.1093/schbul/sbw076] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
By definition, hallucinations occur only in the full waking state. Yet similarities to sleep-related experiences such as hypnagogic and hypnopompic hallucinations, dreams and parasomnias, have been noted since antiquity. These observations have prompted researchers to suggest a common aetiology for these phenomena based on the neurobiology of rapid eye movement (REM) sleep. With our recent understanding of hallucinations in different population groups and at the neurobiological, cognitive and interpersonal levels, it is now possible to draw comparisons between the 2 sets of experiences as never before. In the current article, we make detailed comparisons between sleep-related experiences and hallucinations in Parkinson's disease, schizophrenia and eye disease, at the levels of phenomenology (content, sensory modalities involved, perceptual attributes) and of brain function (brain activations, resting-state networks, neurotransmitter action). Findings show that sleep-related experiences share considerable overlap with hallucinations at the level of subjective descriptions and underlying brain mechanisms. Key differences remain however: (1) Sleep-related perceptions are immersive and largely cut off from reality, whereas hallucinations are discrete and overlaid on veridical perceptions; and (2) Sleep-related perceptions involve only a subset of neural networks implicated in hallucinations, reflecting perceptual signals processed in a functionally and cognitively closed-loop circuit. In summary, both phenomena are non-veridical perceptions that share some phenomenological and neural similarities, but insufficient evidence exists to fully support the notion that the majority of hallucinations depend on REM processes or REM intrusions into waking consciousness.
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Affiliation(s)
- Flavie Waters
- Clinical Research Centre, Graylands Hospital, North Metro Health Service Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Perth, Australia;
| | | | - Thien Thanh Dang-Vu
- Center for Studies in Behavioral Neurobiology, PERFORM Center and Department of Exercise Science, Concordia University; and Centre de Recherches de l’Institut Universitaire de Gériatrie de Montréal and Department of Neurosciences, University of Montreal, Montreal, QC, Canada
| | - Allan J. Cheyne
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | | | - Peter Woodruff
- University of Sheffield, UK, Hamad Medical Corporation, Doha, Qatar
| | - Daniel Collerton
- Clinical Psychology, Northumberland, Tyne and Wear NHS Foundation Trust, and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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36
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De Rossi P, Dacquino C, Piras F, Caltagirone C, Spalletta G. Left nucleus accumbens atrophy in deficit schizophrenia: A preliminary study. Psychiatry Res Neuroimaging 2016; 254:48-55. [PMID: 27322868 DOI: 10.1016/j.pscychresns.2016.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 06/02/2016] [Accepted: 06/04/2016] [Indexed: 01/21/2023]
Abstract
A question that remains to be answered is whether schizophrenia can be characterized by a single etiopathophysiology or whether separate sub-syndromes should be differentiated to define specific mechanisms for each sub-type. Individuals affected by the deficit subtype of schizophrenia (DSZ) display avolitional/amotivational features that respond poorly to conventional treatments. Characterizing DSZ from a neuroanatomical point of view may help clarify this issue and develop new treatment strategies. To determine if DSZ is associated with structural alterations in specific deep grey matter structures linked to its key clinical features, 22 DSZ patients, 22 non-deficit schizophrenia (NDSZ) patients and 22 healthy controls (HC) were recruited for a case-control cross-sectional study. High-resolution magnetic resonance imaging was performed in all subjects and volumes of deep grey matter structures were measured using FreeSurfer. DSZ patients displayed smaller left accumbens volumes compared to both NDSZ patients and HC. Moreover, age and duration of illness were significantly associated with lower volume of the left accumbens in DSZ but not in NDSZ. Findings indicate that DSZ is associated with lower volume of the nucleus accumbens in the dominant hemisphere. This is consistent with the psychopathological features and functional impairments present in DSZ and thus indicates a potential mechanism.
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Affiliation(s)
- Pietro De Rossi
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department NESMOS, Faculty of Medicine and Psychology, University "Sapienza" of Rome, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
| | - Claudia Dacquino
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Fabrizio Piras
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department of Neuroscience, "Tor Vergata" University, 00173, Rome, Italy
| | - Gianfranco Spalletta
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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37
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Cho KIK, Shenton ME, Kubicki M, Jung WH, Lee TY, Yun JY, Kim SN, Kwon JS. Altered Thalamo-Cortical White Matter Connectivity: Probabilistic Tractography Study in Clinical-High Risk for Psychosis and First-Episode Psychosis. Schizophr Bull 2016; 42:723-31. [PMID: 26598740 PMCID: PMC4838094 DOI: 10.1093/schbul/sbv169] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Disrupted thalamo-cortical connectivity is regarded as a core psychopathology in patients diagnosed with schizophrenia. However, whether the thalamo-cortical white matter connectivity is disrupted before the onset of psychosis is still unknown. To determine this gap in knowledge, the strength of thalamo-cortical white matter anatomical connectivity in subjects at clinical-high risk for psychosis (CHR) was compared to that of first-episode psychosis (FEP) and healthy controls. A total of 37 CHR, 21 FEP, and 37 matched healthy controls underwent diffusion-weighted magnetic resonance imaging to examine the number of probabilistic tractography "counts" representing thalamo-cortical white matter connectivity. We also investigated the relationship with psychopathology. For FEP, the connectivity between the thalamus and parietal cortex was significantly increased (F= 5.65,P< .05) compared to that of healthy controls. However, the connectivity between thalamus and orbitofrontal cortex was significantly reduced compared to both healthy controls (F= 11.86,P< .005) and CHR (F= 6.63,P< .05). Interestingly, CHR exhibited a similar pattern as FEP, albeit with slightly reduced magnitude. Compared to healthy controls, there was a significant decrease (F= 4.16,P< .05) in CHR thalamo-orbitofrontal connectivity. Also, the strength of the thalamo-orbitofrontal connectivity was correlated with the Global Assessment of Functioning score in CHR (r= .35,P< .05). This observed pattern of white matter connectivity disruptions in FEP and in CHR suggests that this pattern of disconnectivity not only highlights the involvement of thalamus but also might be useful as an early biomarker for psychosis.
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Affiliation(s)
- Kang Ik K. Cho
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea;,Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Martha E. Shenton
- Department of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,VA Boston Healthcare System, Brockton Campus, Brocton, MA
| | - Marek Kubicki
- Department of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Wi Hoon Jung
- Department of Psychology, University of Pennsylvania, Philadelphia, PA
| | - Tae Young Lee
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea;,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea;,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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38
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van Erp TGM, Hibar DP, Rasmussen JM, Glahn DC, Pearlson GD, Andreassen OA, Agartz I, Westlye LT, Haukvik UK, Dale AM, Melle I, Hartberg CB, Gruber O, Kraemer B, Zilles D, Donohoe G, Kelly S, McDonald C, Morris DW, Cannon DM, Corvin A, Machielsen MWJ, Koenders L, de Haan L, Veltman DJ, Satterthwaite TD, Wolf DH, Gur RC, Gur RE, Potkin SG, Mathalon DH, Mueller BA, Preda A, Macciardi F, Ehrlich S, Walton E, Hass J, Calhoun VD, Bockholt HJ, Sponheim SR, Shoemaker JM, van Haren NEM, Pol HEH, Ophoff RA, Kahn RS, Roiz-Santiañez R, Crespo-Facorro B, Wang L, Alpert KI, Jönsson EG, Dimitrova R, Bois C, Whalley HC, McIntosh AM, Lawrie SM, Hashimoto R, Thompson PM, Turner JA. Subcortical brain volume abnormalities in 2028 individuals with schizophrenia and 2540 healthy controls via the ENIGMA consortium. Mol Psychiatry 2016; 21:547-53. [PMID: 26033243 PMCID: PMC4668237 DOI: 10.1038/mp.2015.63] [Citation(s) in RCA: 624] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 03/05/2015] [Accepted: 03/18/2015] [Indexed: 12/17/2022]
Abstract
The profile of brain structural abnormalities in schizophrenia is still not fully understood, despite decades of research using brain scans. To validate a prospective meta-analysis approach to analyzing multicenter neuroimaging data, we analyzed brain MRI scans from 2028 schizophrenia patients and 2540 healthy controls, assessed with standardized methods at 15 centers worldwide. We identified subcortical brain volumes that differentiated patients from controls, and ranked them according to their effect sizes. Compared with healthy controls, patients with schizophrenia had smaller hippocampus (Cohen's d=-0.46), amygdala (d=-0.31), thalamus (d=-0.31), accumbens (d=-0.25) and intracranial volumes (d=-0.12), as well as larger pallidum (d=0.21) and lateral ventricle volumes (d=0.37). Putamen and pallidum volume augmentations were positively associated with duration of illness and hippocampal deficits scaled with the proportion of unmedicated patients. Worldwide cooperative analyses of brain imaging data support a profile of subcortical abnormalities in schizophrenia, which is consistent with that based on traditional meta-analytic approaches. This first ENIGMA Schizophrenia Working Group study validates that collaborative data analyses can readily be used across brain phenotypes and disorders and encourages analysis and data sharing efforts to further our understanding of severe mental illness.
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Affiliation(s)
- T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D P Hibar
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - J M Rasmussen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
| | - O A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - I Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - L T Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - U K Haukvik
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - A M Dale
- MMIL, Department of Radiology, University of California, San Diego, CA, USA
- Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, CA, USA
| | - I Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - C B Hartberg
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - O Gruber
- Department of Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - B Kraemer
- Department of Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - D Zilles
- Department of Psychiatry, University Medical Center Göttingen, Göttingen, Germany
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, Georg August University, Göttingen, Germany
| | - G Donohoe
- Cognitive Genetics and Therapy Group, School of Psychology, National University of Ireland, Galway, Ireland
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - S Kelly
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - C McDonald
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - D W Morris
- Cognitive Genetics and Therapy Group, School of Psychology, National University of Ireland, Galway, Ireland
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - D M Cannon
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - A Corvin
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - M W J Machielsen
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - L Koenders
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - L de Haan
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - D J Veltman
- University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - S G Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D H Mathalon
- Department of Psychiatry, University of California, San Francisco, CA, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - B A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - A Preda
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - F Macciardi
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - S Ehrlich
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Technische Universität, Dresden, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - E Walton
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Technische Universität, Dresden, Germany
| | - J Hass
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Technische Universität, Dresden, Germany
| | - V D Calhoun
- Mind Research Network, Albuquerque, NM, USA
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - H J Bockholt
- Mind Research Network, Albuquerque, NM, USA
- Advanced Biomedical Informatics Group, LLC, Iowa City, IA, USA
- The University of Iowa, Iowa City, IA, USA
| | - S R Sponheim
- Minneapolis VA Healthcare System & Department of Psychiatry, University of Minnesota, Twin Cities, MN, USA
| | | | - N E M van Haren
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H E H Pol
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R A Ophoff
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
| | - R S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Roiz-Santiañez
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - B Crespo-Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - L Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
- Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - K I Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - E G Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R Dimitrova
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - C Bois
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - S M Lawrie
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - P M Thompson
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - J A Turner
- Mind Research Network, Albuquerque, NM, USA
- Departments of Psychology and Neuroscience, Georgia State University, Atlanta, GA, USA
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Pina-Camacho L, Del Rey-Mejías Á, Janssen J, Bioque M, González-Pinto A, Arango C, Lobo A, Sarró S, Desco M, Sanjuan J, Lacalle-Aurioles M, Cuesta MJ, Saiz-Ruiz J, Bernardo M, Parellada M. Age at First Episode Modulates Diagnosis-Related Structural Brain Abnormalities in Psychosis. Schizophr Bull 2016; 42:344-57. [PMID: 26371339 PMCID: PMC4753597 DOI: 10.1093/schbul/sbv128] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Brain volume and thickness abnormalities have been reported in first-episode psychosis (FEP). However, it is unclear if and how they are modulated by brain developmental stage (and, therefore, by age at FEP as a proxy). This is a multicenter cross-sectional case-control brain magnetic resonance imaging (MRI) study. Patients with FEP (n = 196), 65.3% males, with a wide age at FEP span (12-35 y), and healthy controls (HC) (n = 157), matched for age, sex, and handedness, were scanned at 6 sites. Gray matter volume and thickness measurements were generated for several brain regions using FreeSurfer software. The nonlinear relationship between age at scan (a proxy for age at FEP in patients) and volume and thickness measurements was explored in patients with schizophrenia spectrum disorders (SSD), affective psychoses (AFP), and HC. Earlier SSD cases (ie, FEP before 15-20 y) showed significant volume and thickness deficits in frontal lobe, volume deficits in temporal lobe, and volume enlargements in ventricular system and basal ganglia. First-episode AFP patients had smaller cingulate cortex volume and thicker temporal cortex only at early age at FEP (before 18-20 y). The AFP group also had age-constant (12-35-y age span) volume enlargements in the frontal and parietal lobe. Our study suggests that age at first episode modulates the structural brain abnormalities found in FEP patients in a nonlinear and diagnosis-dependent manner. Future MRI studies should take these results into account when interpreting samples with different ages at onset and diagnosis.
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Affiliation(s)
| | - Ángel Del Rey-Mejías
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain;,Department of Methodology, School of Psychology, Universidad Complutense, Madrid, Spain
| | - Joost Janssen
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Miquel Bioque
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Barcelona, Spain
| | - Ana González-Pinto
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Psychiatry, Hospital Universitario de Álava (Sede Santiago), EHU/University of the Basque Country, Vitoria, Spain
| | - Celso Arango
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Antonio Lobo
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Medicine and Psychiatry, Hospital Clínico, University of Zaragoza, IIS Aragón, Zaragoza, Spain
| | - Salvador Sarró
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,FIDMAG Hermanas Hospitalarias,Barcelona, Spain
| | - Manuel Desco
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Madrid, Spain;,Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Julio Sanjuan
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Psychiatry, Hospital Clinic, University of Valencia, INCLIVA, Valencia, Spain
| | - Maria Lacalle-Aurioles
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Madrid, Spain;,Laboratory of Cerebrovascular Research, Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Jerónimo Saiz-Ruiz
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Department of Psychiatry, Hospital Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - Miguel Bernardo
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Barcelona, Spain;,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Mara Parellada
- Ciber del Area de Salud Mental (CIBERSAM), Spain;,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
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Li Y, Xie S, Liu B, Song M, Chen Y, Li P, Lu L, Lv L, Wang H, Yan H, Yan J, Zhang H, Zhang D, Jiang T. Diffusion magnetic resonance imaging study of schizophrenia in the context of abnormal neurodevelopment using multiple site data in a Chinese Han population. Transl Psychiatry 2016; 6:e715. [PMID: 26784969 PMCID: PMC5068876 DOI: 10.1038/tp.2015.202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 11/05/2015] [Indexed: 12/19/2022] Open
Abstract
Schizophrenia has increasingly been considered a neurodevelopmental disorder, and the advancement of neuroimaging techniques and associated computational methods has enabled quantitative re-examination of this important theory on the pathogenesis of the disease. Inspired by previous findings from neonatal brains, we proposed that an increase in diffusion magnetic resonance imaging (dMRI) mean diffusivity (MD) should be observed in the cerebral cortex of schizophrenia patients compared with healthy controls, corresponding to lower tissue complexity and potentially a failure to reach cortical maturation. We tested this hypothesis using dMRI data from a Chinese Han population comprising patients from four different hospital sites. Utilizing data-driven methods based on the state-of-the-art tensor-based registration algorithm, significantly increased MD measurements were consistently observed in the cortex of schizophrenia patients across all four sites, despite differences in psychopathology, exposure to antipsychotic medication and scanners used for image acquisition. Specifically, we found increased MD in the limbic system of the schizophrenic brain, mainly involving the bilateral insular and prefrontal cortices. In light of the existing literature, we speculate that this may represent a neuroanatomical signature of the disorder, reflecting microstructural deficits due to developmental abnormalities. Our findings not only provide strong support to the abnormal neurodevelopment theory of schizophrenia, but also highlight an important neuroimaging endophenotype for monitoring the developmental trajectory of high-risk subjects of the disease, thereby facilitating early detection and prevention.
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Affiliation(s)
- Y Li
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - S Xie
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - B Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - M Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Y Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - P Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - L Lu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - L Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - H Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - H Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - J Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - H Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- Department of Psychology, Xinxiang Medical University, Xinxiang, China
| | - D Zhang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
- Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - T Jiang
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
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41
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Reeve S, Sheaves B, Freeman D. The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review. Clin Psychol Rev 2015; 42:96-115. [PMID: 26407540 PMCID: PMC4786636 DOI: 10.1016/j.cpr.2015.09.001] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/24/2015] [Accepted: 09/03/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as delusions and hallucinations. OBJECTIVES The review aims to evaluate the evidence for a relationship between sleep dysfunction and individual psychotic experiences, make links between the theoretical understanding of each, and highlight areas for future research. METHOD A systematic search was conducted to identify studies investigating sleep and psychotic experiences across clinical and non-clinical populations. RESULTS 66 papers were identified. This literature robustly supports the co-occurrence of sleep dysfunction and psychotic experiences, particularly insomnia with paranoia. Sleep dysfunction predicting subsequent psychotic experiences receives support from epidemiological surveys, research on the transition to psychosis, and relapse studies. There is also evidence that reducing sleep elicits psychotic experiences in non-clinical individuals, and that improving sleep in individuals with psychosis may lessen psychotic experiences. Anxiety and depression consistently arise as (partial) mediators of the sleep and psychosis relationship. CONCLUSION Studies are needed that: determine the types of sleep dysfunction linked to individual psychotic experiences; establish a causal connection between sleep and psychotic experiences; and assess treatments for sleep dysfunction in patients with non-affective psychotic disorders such as schizophrenia.
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Affiliation(s)
- Sarah Reeve
- Department of Psychiatry, University of Oxford, UK
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42
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Tu PC, Lee YC, Chen YS, Hsu JW, Li CT, Su TP. Network-specific cortico-thalamic dysconnection in schizophrenia revealed by intrinsic functional connectivity analyses. Schizophr Res 2015; 166:137-43. [PMID: 26081977 DOI: 10.1016/j.schres.2015.05.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/15/2015] [Accepted: 05/01/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cortico-thalamic connections are thought to be abnormal in schizophrenia due to their important roles in sensory relay and higher cognitive control, both of which are affected by this devastating illness. This study tested the cortico-thalamic dysconnection hypothesis in schizophrenia and further explored cortico-thalamic network properties using functional connectivity MRI (fcMRI). METHODS Forty-eight participants with schizophrenia and 48 healthy controls underwent resting fMRI scans and clinical evaluations. Six a priori cortical regions of interests (ROIs) were used to derive the six networks: dorsal default mode network (dDMN), fronto-parietal network (FPN), cingulo-opercular network (CON), primary sensorimotor network (SM1), primary auditory network (A1) and primary visual network (V1). The cortico-thalamic connectivity for each network was calculated for each participant and then compared between groups. RESULTS A repeated measures analysis of variance (ANOVA) showed significant group×network interactions (F(5, 90)=9.5, P<0.001), which were driven by a significant increase in FC within the SM1 (t(94)=4.1, P<0.001) and A1 (t(94)=4.2, P<0.001) networks in schizophrenics, as well as a significant decrease within the CON (t(94)=-2.8, P=0.04). The cortico-thalamic dysconnection did not correlate with symptom severity, representing a state independent abnormality. CONCLUSION The network analysis indicates that cortico-thalamic dysconnection in schizophrenia involves multiple networks and shows network specific changes. The findings provide support for dysfunctional thalamus-related networks in schizophrenia and further elaborate their network properties.
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Affiliation(s)
- Pei-Chi Tu
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Chiao Lee
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Shiue Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
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43
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The role of the thalamus in schizophrenia from a neuroimaging perspective. Neurosci Biobehav Rev 2015; 54:57-75. [DOI: 10.1016/j.neubiorev.2015.01.013] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/19/2014] [Accepted: 01/12/2015] [Indexed: 02/06/2023]
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Abstract
OBJECTIVE This review provides a brief account of the clinically relevant functional neuroanatomy of the thalamus, before considering the utility of various modalities utilized to image the thalamus and technical challenges therein, and going on to provide an overview of studies utilizing structural imaging techniques to map thalamic morphology in the spectrum of neurodegenerative disorders. METHODS A systematic search was conducted for peer-reviewed studies involving structural neuroimaging modalities investigating the morphology (shape and/or size) of the thalamus in the spectrum of neurodegenerative disorders. RESULTS While the precise role of the thalamus in the healthy brain remains unclear, there is a large body of knowledge accumulating which defines more precisely its functional connectivity within the connectome, and a burgeoning literature implicating its involvement in neurodegenerative disorders. It is proposed that correlation of clinical features with thalamic morphology (as a component of a quantifiable subcortical connectome) will provide a better understanding of neuropsychiatric dysfunction in various neurodegenerative disorders, potentially yielding clinically useful endophenotypes and disease biomarkers. CONCLUSION Thalamic biomarkers in the neurodegenerative disorders have great potential to provide clinically meaningful knowledge regarding not only disease onset and progression but may yield targets of and perhaps a way of gauging response to future disease-modifying modalities.
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Affiliation(s)
- Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, WA, Australia Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, WA, Australia
| | - Jeffrey C L Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
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45
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Brucato N, Guadalupe T, Franke B, Fisher SE, Francks C. A schizophrenia-associated HLA locus affects thalamus volume and asymmetry. Brain Behav Immun 2015; 46:311-8. [PMID: 25728236 DOI: 10.1016/j.bbi.2015.02.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/20/2015] [Accepted: 02/07/2015] [Indexed: 02/02/2023] Open
Abstract
Genes of the Major Histocompatibility Complex (MHC) have recently been shown to have neuronal functions in the thalamus and hippocampus. Common genetic variants in the Human Leukocyte Antigens (HLA) region, human homologue of the MHC locus, are associated with small effects on susceptibility to schizophrenia, while volumetric changes of the thalamus and hippocampus have also been linked to schizophrenia. We therefore investigated whether common variants of the HLA would affect volumetric variation of the thalamus and hippocampus. We analysed thalamus and hippocampus volumes, as measured using structural magnetic resonance imaging, in 1.265 healthy participants. These participants had also been genotyped using genome-wide single nucleotide polymorphism (SNP) arrays. We imputed genotypes for single nucleotide polymorphisms at high density across the HLA locus, as well as HLA allotypes and HLA amino acids, by use of a reference population dataset that was specifically targeted to the HLA region. We detected a significant association of the SNP rs17194174 with thalamus volume (nominal P=0.0000017, corrected P=0.0039), as well as additional SNPs within the same region of linkage disequilibrium. This effect was largely lateralized to the left thalamus and is localized within a genomic region previously associated with schizophrenia. The associated SNPs are also clustered within a potential regulatory element, and a region of linkage disequilibrium that spans genes expressed in the thalamus, including HLA-A. Our data indicate that genetic variation within the HLA region influences the volume and asymmetry of the human thalamus. The molecular mechanisms underlying this association may relate to HLA influences on susceptibility to schizophrenia.
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Affiliation(s)
- Nicolas Brucato
- Language & Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands; Leiden University Centre for Linguistics, Leiden, The Netherlands.
| | - Tulio Guadalupe
- Language & Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands; International Max Planck Research School for Language Sciences, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Simon E Fisher
- Language & Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, The Netherlands
| | - Clyde Francks
- Language & Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, The Netherlands
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Validation of a protocol for manual segmentation of the thalamus on magnetic resonance imaging scans. Psychiatry Res 2015; 232:98-105. [PMID: 25752844 DOI: 10.1016/j.pscychresns.2015.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/14/2014] [Accepted: 02/04/2015] [Indexed: 01/18/2023]
Abstract
We present a validated protocol for manual segmentation of the thalamus on T1-weighted magnetic resonance imaging (MRI) scans using brain image analysis software. The MRI scans of five normal control subjects were randomly selected from a larger cohort recruited from Lund University Hospital and Landskrona Hospital, Sweden. MRIs were performed using a 3.0T Philips MR scanner, with an eight-channel head coil, and high resolution images were acquired using a T1-weighted turbo field echo (T1 TFE) pulse sequence, with resulting voxel size 1×1×1 mm3. Manual segmentation of the left and right thalami and volume measurement was performed on 28-30 contiguous coronal slices, using ANALYZE 11.0 software. Reliability of image analysis was performed by measuring intra-class correlations between initial segmentation and random repeated segmentation of the left and right thalami (in total 10 thalami for segmentation); inter-rater reliability was measured using volumes obtained by two other experienced tracers. Intra-class correlations for two independent raters were 0.95 and 0.98; inter-class correlations between the expert rater and two independent raters were 0.92 and 0.98. We anticipate that mapping thalamic morphology in various neuropsychiatric disorders may yield clinically useful disease-specific biomarkers.
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47
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48
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Liu B, Fan L, Cui Y, Zhang X, Hou B, Li Y, Qin W, Wang D, Yu C, Jiang T. DISC1 Ser704Cys impacts thalamic-prefrontal connectivity. Brain Struct Funct 2015; 220:91-100. [PMID: 24146131 PMCID: PMC4286634 DOI: 10.1007/s00429-013-0640-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 09/12/2013] [Indexed: 11/25/2022]
Abstract
The Disrupted-in-Schizophrenia 1 (DISC1) gene has been thought as a putative susceptibility gene for various psychiatric disorders, and DISC1 Ser704Cys is associated with variations of brain morphology and function. Moreover, our recent diffusion magnetic resonance imaging (dMRI) study reported that DISC1 Ser704Cys was associated with information transfer efficiency in the brain anatomical network. However, the effects of the DISC1 gene on functional brain connectivity and networks, especially for thalamic-prefrontal circuit, which are disrupted in various psychiatric disorders, are largely unknown. Using a functional connectivity density (FCD) mapping method based on functional magnetic resonance imaging data in a large sample of healthy Han Chinese subjects, we first investigated the association between DISC1 Ser704Cys and short- and long-range FCD hubs. Compared with Ser homozygotes, Cys-allele individuals had increased long-range FCD hubs in the bilateral thalami. The functional and anatomical connectivity of the thalamus to the prefrontal cortex was further analyzed. Significantly increased thalamic-prefrontal functional connectivity and decreased thalamic-prefrontal anatomical connectivity were found in DISC1 Cys-allele carriers. Our findings provide consistent evidence that the DISC1 Ser704Cys polymorphism influences the thalamic-prefrontal circuits in humans and may provide new insights into the neural mechanisms that link DISC1 and the risk for psychiatric disorders.
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Affiliation(s)
- Bing Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - Lingzhong Fan
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - Yue Cui
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - Xiaolong Zhang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - Bing Hou
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - Yonghui Li
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072 Australia
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052 China
| | - Dawei Wang
- Department of Radiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052 China
| | - Chunshui Yu
- Department of Radiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052 China
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072 Australia
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 China
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Matheson SL, Shepherd AM, Carr VJ. How much do we know about schizophrenia and how well do we know it? Evidence from the Schizophrenia Library. Psychol Med 2014; 44:3387-3405. [PMID: 25065407 DOI: 10.1017/s0033291714000166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND True findings about schizophrenia remain elusive; many findings are not replicated and conflicting results are common. Well-conducted systematic reviews have the ability to make robust, generalizable conclusions, with good meta-analyses potentially providing the closest estimate of the true effect size. In this paper, we undertake a systematic approach to synthesising the available evidence from well-conducted systematic reviews on schizophrenia. METHOD Reviews were identified by searching Medline, EMBASE, CINAHL, Current Contents and PsycINFO. The decision to include or exclude reviews, data extraction and quality assessments were conducted in duplicate. Evidence was graded as high quality if reviews contained large samples and robust results; and as moderate quality if reviews contained imprecision, inconsistency, smaller samples or study designs that may be prone to bias. RESULTS High- and moderate-quality evidence shows that numerous psychosocial and biomedical treatments are effective. Patients have relatively poor cognitive functioning, and subtle, but diverse, structural brain alterations, altered electrophysiological functioning and sleep patterns, minor physical anomalies, neurological soft signs, and sensory alterations. There are markers of infection, inflammation or altered immunological parameters; and there is increased mortality from a range of causes. Risk for schizophrenia is increased with cannabis use, pregnancy and birth complications, prenatal exposure to Toxoplasma gondii, childhood central nervous system viral infections, childhood adversities, urbanicity and immigration (first and second generation), particularly in certain ethnic groups. Developmental motor delays and lower intelligence quotient in childhood and adolescence are apparent. CONCLUSIONS We conclude that while our knowledge of schizophrenia is very substantial, our understanding of it remains limited.
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Affiliation(s)
- S L Matheson
- Schizophrenia Research Institute, Darlinghurst, Sydney, NSW,Australia
| | - A M Shepherd
- Schizophrenia Research Institute, Darlinghurst, Sydney, NSW,Australia
| | - V J Carr
- Schizophrenia Research Institute, Darlinghurst, Sydney, NSW,Australia
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Affiliation(s)
- Deanna M. Barch
- *To whom correspondence should be addressed; Departments of Psychology, Psychiatry, and Radiology, Washington University in St. Louis, Box 1125, One Brookings Drive, St. Louis, MO 63130, US; tel: 314-935-8729 or 314-362-2608, fax: 314-935-8790, e-mail:
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