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Perez-Rando M, García-Martí G, Escarti MJ, Salgado-Pineda P, McKenna PJ, Pomarol-Clotet E, Grasa E, Postiguillo A, Corripio I, Nacher J. Alterations in the volume and shape of the basal ganglia and thalamus in schizophrenia with auditory hallucinations. Prog Neuropsychopharmacol Biol Psychiatry 2024; 131:110960. [PMID: 38325744 DOI: 10.1016/j.pnpbp.2024.110960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/09/2024]
Abstract
Different lines of evidence indicate that the structure and physiology of the basal ganglia and the thalamus is disturbed in schizophrenia. However, it is unknown whether the volume and shape of these subcortical structures are affected in schizophrenia with auditory hallucinations (AH), a core positive symptom of the disorder. We took structural MRI from 63 patients with schizophrenia, including 36 patients with AH and 27 patients who had never experienced AH (NAH), and 51 matched healthy controls. We extracted volumes for the left and right thalamus, globus pallidus, putamen, caudate and nucleus accumbens. Shape analysis was also carried out. When comparing to controls, the volume of the right globus pallidus, thalamus, and putamen, was only affected in AH patients. The volume of the left putamen was also increased in individuals with AH, whereas the left globus pallidus was affected in both groups of patients. The shapes of right and left putamen and thalamus were also affected in both groups. The shape of the left globus pallidus was only altered in patients lacking AH, both in comparison to controls and to cases with AH. Lastly, the general PANSS subscale was correlated with the volume of the right thalamus, and the right and left putamen, in patients with AH. We have found volume and shape alterations of many basal ganglia and thalamus in patients with and without AH, suggesting in some cases a possible relationship between this positive symptom and these morphometric alterations.
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Affiliation(s)
- Marta Perez-Rando
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain.
| | - Gracián García-Martí
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Quironsalud Hospital, Valencia, Spain
| | - Maria J Escarti
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain; Servicio de Psiquiatría, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Pilar Salgado-Pineda
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Spain
| | - Peter J McKenna
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Spain
| | - Edith Pomarol-Clotet
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Spain
| | - Eva Grasa
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Mental Health, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí, Barcelona, Spain
| | - Alba Postiguillo
- Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain
| | - Iluminada Corripio
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Mental Health and Psychiatry Department, Vic Hospital Consortium, Francesc Pla, Vic, Spain
| | - Juan Nacher
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain.
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Chen X, Tan W, Cheng Y, Huang D, Liu D, Zhang J, Li J, Liu Z, Pan Y, Palaniyappan L. Polygenic risk for schizophrenia and the language network: Putative compensatory reorganization in unaffected siblings. Psychiatry Res 2023; 326:115319. [PMID: 37352748 DOI: 10.1016/j.psychres.2023.115319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/11/2023] [Accepted: 06/18/2023] [Indexed: 06/25/2023]
Abstract
Language-related symptoms, such as disorganized, impoverished speech and communicative behaviors, are one of the core features of schizophrenia. These features most strongly correlate with cognitive deficits and polygenic risk among various symptom dimensions of schizophrenia. Nevertheless, unaffected siblings with genetic high-risk fail to show consistent deficits in language network (LN), indicating that either (1) polygenic risk has no notable effect on LN and/or (2) siblings show compensatory changes in opposing direction to patients. To answer this question, we related polygenic risk scores (PRS) to the region-level, tract-level, and systems-level structure (cortical thickness and fiber connectivity) of LN in 182 patients, 48 unaffected siblings and 135 healthy controls. We also studied the relationships between symptoms, language-related cognition, social functioning and LN structure. We observed a significantly lower thickness in LN (especially the Broca's, Wernicke's area and their right homologues) in patients. Siblings had a distinctly higher thickness in parts of the LN and a more pronounced small-world-like structural integration within the LN. Patients with reduced LN thickness had higher PRS, more disorganization and impoverished speech with lower language-related cognition and social functioning. We conclude that the genetic susceptibility and putative compensatory changes for schizophrenia operate, in part, via key regions in the Language Network.
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Affiliation(s)
- Xudong Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenjian Tan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yixin Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Danqing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Dayi Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiamei Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jinyue Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yunzhi Pan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Kanahara N, Yamanaka H, Shiko Y, Kawasaki Y, Iyo M. The effects of cumulative antipsychotic dose on brain structures in patients with schizophrenia: Observational study of multiple CT scans over a long-term clinical course. Psychiatry Res Neuroimaging 2022; 319:111422. [PMID: 34856453 DOI: 10.1016/j.pscychresns.2021.111422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
Multiple lines of evidence indicate that antipsychotic agents could affect brain structures of schizophrenia patients. However, the effect of antipsychotic dosage or type on brain structure is uncertain. The present study retrospectively analyzed brain computed tomography (CT) images from a psychiatric hospital to examine the relationship between cumulative dose of antipsychotics and brain volume reduction in schizophrenia patients. A total of 43 patients with repeated relapse episode of psychosis were included and CT scans that were performed an average of 3.2 times per patient during nearly 13 years of follow-up were analyzed. The results revealed significant positive relationships of expansion of cerebrospinal fluid space with cumulative dosage of all antipsychotics and that of typical antipsychotics. Patients treated with antipsychotics including typical antipsychotics exhibited a greater volume reduction compared to patients treated with only atypical antipsychotics. The present study was one of the longest longitudinal studies examining the effects of antipsychotics on brain volume in schizophrenia patients. These results suggest a relation between cumulative lifetime antipsychotic dosage and progressive brain volume reduction in patients with schizophrenia. However, the effects of specific agent on brain structure are still uncertain, and more detailed analysis is needed.
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Affiliation(s)
- Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba, Japan; Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Hiroshi Yamanaka
- Department of Psychiatry, Chiba Psychiatric Medical Center, Chiba, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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Stein F, Meller T, Brosch K, Schmitt S, Ringwald K, Pfarr JK, Meinert S, Thiel K, Lemke H, Waltemate L, Grotegerd D, Opel N, Jansen A, Nenadić I, Dannlowski U, Krug A, Kircher T. Psychopathological Syndromes Across Affective and Psychotic Disorders Correlate With Gray Matter Volumes. Schizophr Bull 2021; 47:1740-1750. [PMID: 33860786 PMCID: PMC8530386 DOI: 10.1093/schbul/sbab037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION More than a century of research on the neurobiological underpinnings of major psychiatric disorders (major depressive disorder [MDD], bipolar disorder [BD], schizophrenia [SZ], and schizoaffective disorder [SZA]) has been unable to identify diagnostic markers. An alternative approach is to study dimensional psychopathological syndromes that cut across categorical diagnoses. The aim of the current study was to identify gray matter volume (GMV) correlates of transdiagnostic symptom dimensions. METHODS We tested the association of 5 psychopathological factors with GMV using multiple regression models in a sample of N = 1069 patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for MDD (n = 818), BD (n = 132), and SZ/SZA (n = 119). T1-weighted brain images were acquired with 3-Tesla magnetic resonance imaging and preprocessed with CAT12. Interactions analyses (diagnosis × psychopathological factor) were performed to test whether local GMV associations were driven by DSM-IV diagnosis. We further tested syndrome specific regions of interest (ROIs). RESULTS Whole brain analysis showed a significant negative association of the positive formal thought disorder factor with GMV in the right middle frontal gyrus, the paranoid-hallucinatory syndrome in the right fusiform, and the left middle frontal gyri. ROI analyses further showed additional negative associations, including the negative syndrome with bilateral frontal opercula, positive formal thought disorder with the left amygdala-hippocampus complex, and the paranoid-hallucinatory syndrome with the left angular gyrus. None of the GMV associations interacted with DSM-IV diagnosis. CONCLUSIONS We found associations between psychopathological syndromes and regional GMV independent of diagnosis. Our findings open a new avenue for neurobiological research across disorders, using syndrome-based approaches rather than categorical diagnoses.
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Affiliation(s)
- Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany,To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany; tel: +49-6421-58-63831, fax: +49-6421-58-68939, e-mail:
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Kai Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Julia Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Susanne Meinert
- Department of Psychiatry University of Münster, Münster, Germany
| | - Katharina Thiel
- Department of Psychiatry University of Münster, Münster, Germany
| | - Hannah Lemke
- Department of Psychiatry University of Münster, Münster, Germany
| | - Lena Waltemate
- Department of Psychiatry University of Münster, Münster, Germany
| | | | - Nils Opel
- Department of Psychiatry University of Münster, Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry University of Münster, Münster, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany,Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany
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Barrera A, Curwell-Parry O, Raphael MC. Hebephrenia is dead, long live hebephrenia, or why Hecker and Chaslin were on to something. BJPSYCH ADVANCES 2019. [DOI: 10.1192/bja.2019.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYSince its first description in 1863, ‘hebephrenia’ has highlighted a group of patients characterised by an early onset of illness, formal thought disorder, bizarre behaviour and incongruent emotional expression. A proportion of patients with the most severe form of mental illness have a clinical presentation that is best captured by this diagnosis. Here, we outline the construct of hebephrenia and two of its core overlapping constituent parts: bizarre behaviour and the disorganisation dimension. We argue that, despite the removal of hebephrenia (disorganised schizophrenia) from DSM-5, clinicians should consider it as a differential diagnosis, particularly in suspected personality disorder.
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Nikova AS, Sioutas G, Kotopoulos K, Ganchev D, Chatzipaulou V, Birbilis T. The Clock Is Ticking - Brain Atrophy in Case of Acute Trauma? Korean J Neurotrauma 2019; 15:117-125. [PMID: 31720265 PMCID: PMC6826082 DOI: 10.13004/kjnt.2019.15.e35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 11/15/2022] Open
Abstract
Objective Brain atrophy and brain herniation are gaining a lot of attention separately, but a limited amount of studies connected them together, and because of this, we are going to review and examine the subject in the current meta-analysis. Methods The authors collected data reporting brain atrophy of alcoholic and schizophrenic cause, as well as data on control patients, all of which was published on MEDLINE between 1996 and 2018. The included 11 articles were processed with a statistical program. Results We found that the pericerebral space is unequal among the groups, while the intracranial volume is strongly correlated to the biggest foramen of the body. The effect of this inequality, however, is expressed in emergency cases, where the patients with brain atrophy will have more time before the final stage of brain herniation. Conclusion The current study raises a controversial issue that requires careful investigation and high attention from the health care personnel.
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Affiliation(s)
- Alexandrina S Nikova
- Department of Neurosurgery, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Sioutas
- Department of Neurosurgery, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Dimitar Ganchev
- Department of Radiation Oncology, University Hospital "Tsaritsa Yoanna" - ISUL, Sofia, Bulgaria
| | | | - Theodossios Birbilis
- Department of Neurosurgery, Democritus University of Thrace, Alexandroupolis, Greece
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7
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Caldiroli A, Buoli M, van Haren NEM, de Nijs J, Altamura AC, Cahn W. The relationship of IQ and emotional processing with insula volume in schizophrenia. Schizophr Res 2018; 202:141-148. [PMID: 29954697 DOI: 10.1016/j.schres.2018.06.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The insula is involved in general and social cognition, in particular emotion regulation. Aim of this study is to investigate whether insula volume is associated with Intelligence Quotient (IQ) and emotional processing in schizophrenia patients versus healthy controls (HC). METHODS Magnetic resonance imaging (MRI) brain scans, IQ and emotional processing tests (Benton Facial Recognition Test [BFRT], Degraded Facial Affect Recognition Task [DFAR], Emotional Mentalizing Task [EMT]) were administered in 246 subjects (133 schizophrenia patients and 113 controls). First order linear regression analyses were performed with group as independent variable and IQ/emotional processing test scores as dependent variables. Second order stepwise linear regression analyses were performed with IQ/emotional processing test scores as independent variables (as well as intracranial volumes, age, gender and cannabis abuse) and right/left insula volumes as dependent ones. A final mediation analysis (Sobel test) was performed to verify if IQ or emotional processing test scores could explain the eventual differences in insula volumes between the two groups. RESULTS Schizophrenia patients presented lower insula volumes (left: F = 9.72, p < 0.01; right: F = 10.93, p < 0.01) as compared with healthy controls. Smaller insula volumes in schizophrenia patients are mediated by lower IQ scores (Sobel tests: 3.07, p < 0.01 for right insula; 2.72, p < 0.01 for left insula), but not by impairments in emotion processing. CONCLUSIONS IQ, but not emotional processing mediates smaller insula volumes in schizophrenia patients.
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Affiliation(s)
- Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, the Netherlands
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, the Netherlands.
| | - Neeltje E M van Haren
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Jessica de Nijs
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, the Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Wiepke Cahn
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, the Netherlands
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Craddock KES, Zhou X, Liu S, Gochman P, Dickinson D, Rapoport JL. Symptom dimensions and subgroups in childhood-onset schizophrenia. Schizophr Res 2018; 197:71-77. [PMID: 29146021 PMCID: PMC5949241 DOI: 10.1016/j.schres.2017.10.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/29/2017] [Accepted: 10/29/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study investigated symptom dimensions and subgroups in the National Institute of Mental Health (NIMH) childhood-onset schizophrenia (COS) cohort and their similarities to adult-onset schizophrenia (AOS) literature. METHOD Scores from the Scales for the Assessment of Positive and Negative Symptoms (SAPS & SANS) from 125 COS patients were assessed for fit with previously established symptom dimensions from AOS literature using confirmatory factor analysis (CFA). K-means cluster analysis of each individual's scores on the best fitting set of dimensions was used to form patient clusters, which were then compared using demographic and clinical data. RESULTS CFA showed the SAPS & SANS data was well suited to a 2-dimension solution, including positive and negative dimensions, out of five well established models. Cluster analysis identified three patient groups characterized by different dimension scores: (1) low scores on both dimensions, (2) high negative, low positive scores, and (3) high scores on both dimensions. These groups had different Full scale IQ, Children's Global Assessment Scale (CGAS) scores, ages of onset, and prevalence of some co-morbid behavior disorders (all p<3.57E-03). CONCLUSION Our analysis found distinct symptom-based subgroups within the NIMH COS cohort using an established AOS symptom structure. These findings confirm the heterogeneity of COS and were generally consistent with AOS literature.
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Affiliation(s)
- Kirsten E S Craddock
- Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States
| | - Xueping Zhou
- Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States
| | - Siyuan Liu
- Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States.
| | - Peter Gochman
- Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 3C115, Bethesda, MD 20814, United States
| | - Judith L Rapoport
- Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States
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Banaj N, Piras F, Piras F, Ciullo V, Iorio M, Battaglia C, Pantoli D, Ducci G, Spalletta G. Cognitive and psychopathology correlates of brain white/grey matter structure in severely psychotic schizophrenic inpatients. Schizophr Res Cogn 2018; 12:29-36. [PMID: 29527507 PMCID: PMC5842307 DOI: 10.1016/j.scog.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/23/2018] [Accepted: 02/01/2018] [Indexed: 01/09/2023]
Abstract
The brain structural correlates of cognitive and psychopathological symptoms within the active phase in severely psychotic schizophrenic inpatients have been rarely investigated. Twenty-eight inpatients with a DSM-5 diagnosis of Schizophrenia (SZ), admitted for acute psychotic decompensation, were assessed through a comprehensive neuropsychological and psychopathological battery. All patients underwent a high-resolution T1-weighted magnetic resonance imaging investigation. Increased psychotic severity was related to reduced grey matter volumes in the medial portion of the right superior frontal cortex, the superior orbitofrontal cortex bilaterally and to white matter volume reduction in the medial portion of the left superior frontal area. Immediate verbal memory performance was related to left insula and inferior parietal cortex volume, while long-term visuo-spatial memory was related to grey matter volume of the right middle temporal cortex, and the right (lobule VII, CRUS1) and left (lobule VI) cerebellum. Moreover, psychotic severity correlated with cognitive inflexibility and negative symptom severity was related to visuo-spatial processing and reasoning disturbances. These findings indicate that a disruption of the cortical-subcortical-cerebellar circuit, and distorted memory function contribute to the development and maintenance of psychotic exacerbation.
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Affiliation(s)
- Nerisa Banaj
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Museo Storico della Fisica e Centro Studi e Ricerche “Enrico Fermi”, 00184 Rome, Italy
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy
| | - Mariangela Iorio
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | | | - Donatella Pantoli
- Department of Radiology, S. Filippo Neri Hospital, ASL, Roma, 1, 00135 Rome, Italy
| | - Giuseppe Ducci
- Department of Mental Health, ASL, Roma 1, 00135 Rome, Italy
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
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10
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Progressive cortical reorganisation: A framework for investigating structural changes in schizophrenia. Neurosci Biobehav Rev 2017; 79:1-13. [DOI: 10.1016/j.neubiorev.2017.04.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
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11
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Huhtaniska S, Jääskeläinen E, Hirvonen N, Remes J, Murray GK, Veijola J, Isohanni M, Miettunen J. Long-term antipsychotic use and brain changes in schizophrenia - a systematic review and meta-analysis. Hum Psychopharmacol 2017; 32. [PMID: 28370309 DOI: 10.1002/hup.2574] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 01/13/2017] [Accepted: 01/28/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The association between long-term antipsychotic treatment and changes in brain structure in schizophrenia is unclear. Our aim was to conduct a systematic review and a meta-analysis on long-term antipsychotic effects on brain structures in schizophrenia focusing on studies with at least 2 years of follow-up between MRI scans. DESIGN Studies were systematically collected using 4 databases, and we also contacted authors for unpublished data. We calculated correlations between antipsychotic dose and/or type and brain volumetric changes and used random effect meta-analysis to study correlations by brain area. RESULTS Thirty-one publications from 16 samples fulfilled our inclusion criteria. In meta-analysis, higher antipsychotic exposure associated statistically significantly with parietal lobe decrease (studies, n = 4; r = -.14, p = .013) and with basal ganglia increase (n = 4; r = .10, p = .044). Most of the reported correlations in the original studies were statistically nonsignificant. There were no clear differences between typical and atypical exposure and brain volume change. The studies were often small and highly heterogeneous in their methods and seldom focused on antipsychotic medication and brain changes as the main subject. CONCLUSIONS Antipsychotic medication may associate with brain structure changes. More long-term follow-up studies taking into account illness severity measures are needed to make definitive conclusions.
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Affiliation(s)
- Sanna Huhtaniska
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Noora Hirvonen
- Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland
| | - Jukka Remes
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Juha Veijola
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Matti Isohanni
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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12
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Wang LJ, Lin SK, Chen YC, Huang MC, Chen TT, Ree SC, Chen CK. Differences in Clinical Features of Methamphetamine Users with Persistent Psychosis and Patients with Schizophrenia. Psychopathology 2016; 49:108-15. [PMID: 27071042 DOI: 10.1159/000445065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/23/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Methamphetamine exerts neurotoxic effects and elicits psychotic symptoms. This study attempted to compare clinical differences between methamphetamine users with persistent psychosis (MAP) and patients with schizophrenia. In addition, we examined the discrimination validity by using symptom clusters to differentiate between MAP and schizophrenia. METHODS We enrolled 53 MAP patients and 53 patients with schizophrenia. The psychopathology of participants was assessed using the Chinese version of the Diagnostic Interview for Genetic Studies and the 18-item Brief Psychiatric Rating Scale. Logistic regression was used to examine the predicted probability scores of different symptom combinations on discriminating between MAP and schizophrenia. The receiver operating characteristic (ROC) analyses and area under the curve (AUC) were further applied to examine the discrimination validity of the predicted probability scores on differentiating between MAP and schizophrenia. RESULTS We found that MAP and schizophrenia demonstrated similar patterns of delusions. Compared to patients with schizophrenia, MAP experienced significantly higher proportions of visual hallucinations and of somatic or tactile hallucinations. However, MAP exhibited significantly lower severity in conceptual disorganization, mannerism/posturing, blunted affect, emotional withdrawal, and motor retardation compared to patients with schizophrenia. The ROC analysis showed that a predicted probability score combining the aforementioned 7 items of symptoms could significantly differentiate between MAP and schizophrenia (AUC = 0.77). CONCLUSION Findings in the current study suggest that nuanced differences might exist in the clinical presentation of secondary psychosis (MAP) and primary psychosis (schizophrenia). Combining the symptoms as a whole may help with differential diagnosis for MAP and schizophrenia.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC
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13
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Altamura AC, Caletti E, Paoli RA, Cigliobianco M, Zugno E, Grillo P, Prunas C, Caldiroli A, Zago S. Correlation between neuropsychological and social cognition measures and symptom dimensions in schizophrenic patients. Psychiatry Res 2015; 230:172-80. [PMID: 26350702 DOI: 10.1016/j.psychres.2015.08.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/23/2015] [Accepted: 08/17/2015] [Indexed: 12/22/2022]
Abstract
Neurocognitive and social cognition deficits have been largely reported in Schizophrenia (SKZ) but their association with psychopathology remains uncertain. Our purpose was to explore the relationship between symptom dimensions and neuropsychological performances. We enrolled 35 stabilized schizophrenic outpatients of the Department of Psychiatry of Policlinico Hospital, University of Milan, who completed psychiatric Rating Scales, the Brief Assessment of Cognition in Schizophrenia (BACS) and the Executive and Social Cognition Battery (ESCB). Disorganized dimension seems to have the most significant impact on cognition, being associated with performance in several BACS subtests (verbal memory, working memory, motor speed, symbol coding, Tower of London) and ESCB tasks (MET and Hotel task number of tasks attempted, number of broken MET rules, sum of deviations in Hotel Task). Positive dimension correlated with performance in verbal fluency, negative dimension with IOWA Test results, cognitive dimension with MET number of inefficiencies and Eyes test score. Impulsive-aggressive and depressive dimensions weakly correlated only with Faux Pas test. Our study supports the existence of a specific disorganized dimension in SKZ, separated from cognitive dimension evaluated through clinical instruments (e.g. PANSS), but capable of influencing cognitive abilities. Furthermore, it strengthens the validity of ecological tasks in evaluating cognition in SKZ.
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Affiliation(s)
- A Carlo Altamura
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Caletti
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Augusto Paoli
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Cigliobianco
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Elisa Zugno
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Grillo
- Epidemiology Unit, Department of Preventive Medicine, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Prunas
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Caldiroli
- Psychiatric Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Zago
- Neurologic Clinic, Department of Neuroscience and Mental Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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14
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Cancel A, Comte M, Truillet R, Boukezzi S, Rousseau PF, Zendjidjian XY, Sage T, Lazerges PE, Guedj E, Khalfa S, Azorin JM, Blin O, Fakra E. Childhood neglect predicts disorganization in schizophrenia through grey matter decrease in dorsolateral prefrontal cortex. Acta Psychiatr Scand 2015; 132:244-56. [PMID: 26038817 DOI: 10.1111/acps.12455] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Psychosocial trauma during childhood is associated with schizophrenia vulnerability. The pattern of grey matter decrease is similar to brain alterations seen in schizophrenia. Our objective was to explore the links between childhood trauma, brain morphology and schizophrenia symptoms. METHOD Twenty-one patients with schizophrenia stabilized with atypical antipsychotic monotherapy and 30 healthy control subjects completed the study. Anatomical MRI images were analysed using optimized voxel-based morphometry (VBM). Childhood trauma was assessed with the Childhood Trauma Questionnaire, and symptoms were rated on the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) (disorganization, positive and negative symptoms). In the schizophrenia group, we used structural equation modelling in a path analysis. RESULTS Total grey matter volume was negatively associated with emotional neglect (EN) in patients with schizophrenia. Whole-brain VBM analyses of grey matter in the schizophrenia group revealed a specific inversed association between EN and the right dorsolateral prefrontal cortex (DLPFC). Path analyses identified a well-fitted model in which EN predicted grey matter density in DLPFC, which in turn predicted the disorganization score. CONCLUSION Our findings suggest that EN during childhood could have an impact on psychopathology in schizophrenia, which would be mediated by developmental effects on brain regions such as the DLPFC.
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Affiliation(s)
- A Cancel
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - M Comte
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - R Truillet
- Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - S Boukezzi
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - P-F Rousseau
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Psychiatry Unit, Saint Anne Military Training Hospital, Toulon, France
| | - X Y Zendjidjian
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - T Sage
- Clinic of Mental Health, L'escale, Orpea-Clinéa, Saint-Victoret, France
| | - P-E Lazerges
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - E Guedj
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Biophysics and Nuclear Medicine Department, Timone Hospital, Marseille, France
| | - S Khalfa
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - J-M Azorin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - O Blin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - E Fakra
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
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15
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Anderson VM, Goldstein ME, Kydd RR, Russell BR. Extensive gray matter volume reduction in treatment-resistant schizophrenia. Int J Neuropsychopharmacol 2015; 18:pyv016. [PMID: 25716781 PMCID: PMC4540109 DOI: 10.1093/ijnp/pyv016] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Approximately one-third of people with schizophrenia are treatment-resistant and some do not achieve remission with clozapine, the gold-standard antipsychotic medication for treatment-resistant schizophrenia. This study compared global and regional brain volumes between treatment-respondent and treatment-resistant patients with schizophrenia, including a group of patients who were clozapine-resistant. METHODS T1-weighted brain MRIs were obtained on a 3T scanner in 20 controls and 52 people with schizophrenia who were selected based on their symptomatic responses to antipsychotic medication: 18 responded well to first-line atypical antipsychotics (FLR), 19 were treatment-resistant but responsive to clozapine monotherapy (TR), and 15 were ultra-treatment-resistant and did not respond to clozapine (UTR). Treatment groups were matched for disease duration and current psychopathology. SIENAX and FSL-VBM were used to investigate differences in the global brain, gray matter (GM), white matter, ventricular cerebrospinal fluid volumes, and regional GM volumes. RESULTS GM volume was significantly reduced in the TR and UTR groups compared with controls and the FLR group (p < 0.05). GM volume was significantly reduced in TR patients compared with FLRs in the superior, middle, and inferior temporal gyri, pre- and post-central gyri, middle and superior frontal gyri, right supramarginal gyrus, and right lateral occipital cortex. UTR patients showed reduced GM compared with FLRs in their right parietal operculum and left cerebellum. No significant volume differences were observed between TR and UTR groups. CONCLUSIONS These differences are unlikely to be solely due to medication effects, and reduced GM volume in treatment-resistant schizophrenia may represent an accelerated disease course or a different underlying pathology.
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Affiliation(s)
| | | | | | - Bruce R Russell
- School of Pharmacy, University of Auckland, Auckland, New Zealand (Drs Anderson, Goldstein, and Russell); Centre for Brain Research, University of Auckland, Auckland, New Zealand (Drs Anderson, Goldstein, Kydd, and Russell); Department of Psychological Medicine, University of Auckland, Auckland, New Zealand (Dr Kydd).
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16
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Barder HE, Sundet K, Rund BR, Evensen J, Haahr U, ten Velden Hegelstad W, Joa I, Johannessen JO, Langeveld J, Larsen TK, Melle I, Opjordsmoen S, Røssberg JI, Simonsen E, Vaglum P, McGlashan T, Friis SPI. 10 year course of IQ in first-episode psychosis: relationship between duration of psychosis and long-term intellectual trajectories. Psychiatry Res 2015; 225:515-21. [PMID: 25535007 DOI: 10.1016/j.psychres.2014.11.054] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 08/28/2014] [Accepted: 11/26/2014] [Indexed: 11/30/2022]
Abstract
A substantial proportion of patients suffering from schizophrenia-spectrum disorders (SSDs) exhibit a general intellectual impairment at illness onset, but the subsequent intellectual course remains unclear. Relationships between accumulated time in psychosis and long-term intellectual functioning are largely uninvestigated, but may identify subgroups with different intellectual trajectories. Eighty-nine first-episode psychosis patients were investigated on IQ at baseline and at 10-years follow-up. Total time in psychosis was defined as two separate variables; Duration of psychosis before start of treatment (i.e. duration of untreated psychosis: DUP), and duration of psychosis after start of treatment (DAT). The sample was divided in three equal groups based on DUP and DAT, respectively. To investigate if diagnosis could separate IQ-trajectories beyond that of psychotic duration, two diagnostic categories were defined: core versus non-core SSDs. No significant change in IQ was found for the total sample. Intellectual course was not related to DUP or stringency of diagnostic category. However, a subgroup with long DAT demonstrated a significant intellectual decline, mainly associated with a weaker performance on test of immediate verbal recall/working memory (WAIS-R Digit Span). This indicates a relationship between accumulated duration of psychosis and long-term intellectual course, irrespective of diagnostic category, in a significant subgroup of patients.
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Affiliation(s)
- Helene Eidsmo Barder
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Department of Psychology, University of Oslo, P.O. 1094 Blindern, 0317 Oslo, Norway.
| | - Kjetil Sundet
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Department of Psychology, University of Oslo, P.O. 1094 Blindern, 0317 Oslo, Norway
| | - Bjørn Rishovd Rund
- Department of Psychology, University of Oslo, P.O. 1094 Blindern, 0317 Oslo, Norway; Vestre Viken Hospital Trust, 3004, Drammen, Norway
| | - Julie Evensen
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. 1171 Blindern, 0318 Oslo, Norway
| | - Ulrik Haahr
- Early Psychosis Intervention Center, Psychiatry Roskilde, Region Zealand, Smedegade 1-16, 4000 Roskilde, Denmark
| | - Wenche ten Velden Hegelstad
- Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, P.O. 8100, 4068 Stavanger, Norway
| | - Inge Joa
- Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, P.O. 8100, 4068 Stavanger, Norway; Faculty of social sciences, University of Stavanger, Norway
| | - Jan Olav Johannessen
- Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, P.O. 8100, 4068 Stavanger, Norway; Faculty of social sciences, University of Stavanger, Norway
| | - Johannes Langeveld
- Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, P.O. 8100, 4068 Stavanger, Norway
| | - Tor Ketil Larsen
- Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, P.O. 8100, 4068 Stavanger, Norway; Institute of Psychiatry, University of Bergen, Jonas Lies vei 65, 5021 Bergen, Norway
| | - Ingrid Melle
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. 1171 Blindern, 0318 Oslo, Norway
| | - Stein Opjordsmoen
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. 1171 Blindern, 0318 Oslo, Norway
| | - Jan Ivar Røssberg
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. 1171 Blindern, 0318 Oslo, Norway
| | - Erik Simonsen
- Psychiatric Research Unit, Zealand Region, Psychiatry Roskilde, Roskilde University and University of Copenhagen, Smedegade 10-16, 4000 Roskilde, Denmark
| | - Per Vaglum
- Department of Behavioral Sciences in Medicine, University of Oslo, P.O. 1130 Blindern, 0318 Oslo, Norway
| | - Thomas McGlashan
- Department of Psychiatry, Yale University School of Medicine, Yale Psychiatric Research at Congress Place, 301 Cedar Street, New Haven, CT 06519, USA
| | - Svein P I Friis
- Division of Mental Health and Addiction, Oslo University Hospital, N-0407 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. 1171 Blindern, 0318 Oslo, Norway
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17
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Heering HD, Koevoets GJC, Koenders L, Machielsen MWJ, Meijer CJ, Kubota M, de Nijs J, Cahn W, Hulshoff Pol HE, de Haan L, Kahn RS, van Haren NEM. Structural MRI Differences between Patients with and without First Rank Symptoms: A Delusion? Front Psychiatry 2015; 6:107. [PMID: 26283974 PMCID: PMC4518139 DOI: 10.3389/fpsyt.2015.00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 07/10/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE It has been suggested that specific psychotic symptom clusters may be explained by patterns of biological abnormalities. The presence of first rank symptoms (FRS) has been associated with cognitive abnormalities, e.g., deficits in self-monitoring or in the experience of agency, suggesting that a specific network of neural abnormalities might underlie FRS. Here, we investigate differences in cortical and subcortical brain volume between patients with and without FRS. METHODS Three independent patient samples (referred to as A, B, and C) with different mean ages and in different illness stages were included, leading to a total of 348 patients within the schizophrenia-spectrum. All underwent magnetic resonance imaging of the brain. In addition, the presence of FRS was established using a diagnostic interview. Patients with (FRS+, A: n = 63, B: n = 129, and C: n = 96) and without FRS (FRS-, A: n = 35, B: n = 17, and C: n = 8) were compared on global and local cortical volumes as well as subcortical volumes, using a whole brain (cerebrum) approach. RESULTS Nucleus accumbens volume was significantly smaller in FRS+ as compared with FRS- in sample A (p < 0.005). Furthermore, FRS+ showed a smaller volume of the pars-opercularis relative to FRS- in sample B (p < 0.001). No further significant differences were found in cortical and subcortical volumes between FRS+ and FRS- in either one of the three samples after correction for multiple comparison. CONCLUSION Brain volume differences between patients with and without FRS are, when present, subtle, and not consistent between three independent samples. Brain abnormalities related to FRS may be too subtle to become visible through structural brain imaging.
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Affiliation(s)
| | | | - Laura Koenders
- Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands
| | | | - Carin J Meijer
- Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands
| | - Manabu Kubota
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands
| | - Jessica de Nijs
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands
| | - Wiepke Cahn
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands
| | | | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands
| | - Rene S Kahn
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands
| | - Neeltje E M van Haren
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands
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18
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Catts VS, Wong J, Fillman SG, Fung SJ, Shannon Weickert C. Increased expression of astrocyte markers in schizophrenia: Association with neuroinflammation. Aust N Z J Psychiatry 2014; 48:722-34. [PMID: 24744400 DOI: 10.1177/0004867414531078] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE While schizophrenia may have a progressive component, the evidence for neurodegenerative processes as indicated by reactive astrocytes is inconclusive. We recently identified a subgroup of individuals with schizophrenia with increased expression of inflammatory markers in prefrontal cortex, and hypothesized that this subgroup would also have reactive astrocytes. METHOD We measured glial fibrillary acidic protein (GFAP) mRNA by quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) and protein levels by immunoblotting in grey matter homogenate from 37 individuals with schizophrenia and 37 unaffected controls. We examined the morphology of GFAP-positive astrocytes in immunostained sections of middle frontal gyrus. We tested if GFAP expression or astrocyte morphology were altered in people with schizophrenia with increased expression of inflammatory markers. We used RNA-Seq data on a subset of patients and controls (n=20/group) to ascertain whether mRNA transcripts associated with astrogliosis were elevated in the individuals with active neuroinflammation. RESULTS GFAP (mRNA and protein) levels and astrocyte morphology were not significantly different between people with schizophrenia and controls overall. However, individuals with schizophrenia with neuroinflammation had increased expression of GFAP mRNA (t(33)=2.978, p=0.005), hypertrophic astrocyte morphology (χ(2)(2)=6.281, p=0.043), and statistically significant elevated expression of three mRNA transcripts previously associated with astrogliosis. CONCLUSIONS We found clear evidence of astrogliosis in a subset of people with schizophrenia. We suggest that the lack of astrogliosis reported in previous studies may be due to cohort differences in aetiopathology, illness stage, treatment exposure, or a failure to examine subsets of people with schizophrenia.
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Affiliation(s)
- Vibeke Sørensen Catts
- Schizophrenia Research Institute, Sydney, Australia Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, Australia School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Jenny Wong
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia School of Biological Sciences, University of Wollongong, Wollongong, Australia
| | - Stu Gregory Fillman
- Schizophrenia Research Institute, Sydney, Australia Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, Australia School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Samantha Jane Fung
- Schizophrenia Research Institute, Sydney, Australia Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, Australia School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Cynthia Shannon Weickert
- Schizophrenia Research Institute, Sydney, Australia Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, Australia School of Psychiatry, University of New South Wales, Sydney, Australia
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19
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Comparelli A, De Carolis A, Corigliano V, Trovini G, Dehning J, Di Pietro S, De Pisa E, Galderisi S, Girardi P. Facial emotion recognition impairment is related to disorganisation in multi-episode schizophrenia. Schizophr Res Cogn 2014; 1:122-125. [PMID: 29379745 PMCID: PMC5779113 DOI: 10.1016/j.scog.2014.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/17/2014] [Accepted: 07/21/2014] [Indexed: 11/24/2022]
Abstract
The present investigation explores the relationship between facial emotion recognition (FER) and symptom domains in three groups of schizophrenia spectrum patients (43 ultra-high-risk, 50 first episode and 44 multi-episode patients) in which the existence of FER impairment has already been demonstrated. Regression analysis showed that symptoms and FER impairment are related in multi-episode patients, regardless of the illness duration. We suggest that the link between symptoms and FER impairment is involved in the progression of the disease.
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Affiliation(s)
- Anna Comparelli
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Antonella De Carolis
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Neurology, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Valentina Corigliano
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Giada Trovini
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Julia Dehning
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Simone Di Pietro
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Eleonora De Pisa
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Silvana Galderisi
- Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Italy
| | - Paolo Girardi
- NESMOS Department (Neurosciences, Mental Health and Sense Organs) Unit of Psychiatry, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Italy
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Silverstein SM. Jung's views on causes and treatments of schizophrenia in light of current trends in cognitive neuroscience and psychotherapy research I. Aetiology and phenomenology. THE JOURNAL OF ANALYTICAL PSYCHOLOGY 2014; 59:98-129. [DOI: 10.1111/1468-5922.12057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Nishimura J, Kakeda S, Abe O, Yoshimura R, Watanabe K, Goto N, Hori H, Sato T, Takao H, Kabasawa H, Nakamura J, Korogi Y. Plasma levels of 3-methoxy-4-hydroxyphenylglycol are associated with microstructural changes within the cerebellum in the early stage of first-episode schizophrenia: a longitudinal VBM study. Neuropsychiatr Dis Treat 2014; 10:2315-23. [PMID: 25598656 PMCID: PMC4285838 DOI: 10.2147/ndt.s72715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The aims of this study are to determine how the interval changes of the brain structures in the early stage of first-episode schizophrenia relate to the interval changes in the clinical data, including the clinical symptoms of schizophrenia and catecholaminergic measures (plasma homovanillic acid [HVA] and 3-methoxy-4-hydroxyphenylglycol [MHPG]). Regional brain volumes and fractional anisotropy (FA)/mean diffusivity (MD) with diffusion tensor imaging (DTI) were measured at baseline and 6-month follow-up in a 3T magnetic resonance imaging (MRI) system in a cohort of 16 schizophrenic patients, who were in their first episode at the time of baseline MRI. At the time of baseline and follow-up MRI, all 16 patients underwent evaluations that included a psychopathological assessment (Positive and Negative Syndrome Scale [PANSS]) and peripheral catecholaminergic measures (plasma MHPG or HVA). For interval changes between baseline and follow-up MRI data (morphological change, MD, and FA), the correlation/regression analysis was performed as a series of single regression correlations in Statistical Parametric Mapping 5, with the interval changes in PANSS or plasma HVA and MHPG as the covariates of interest. Positive and inverse correlations contrasts were created, and in this preliminary analysis, a family-wise error-corrected threshold of P<0.05 was considered significant. In the correlation/regression analysis, a positive correlation between the FA in the right cerebellar vermis and the MHPG was observed. No significant correlations between the brain volume or MD and any laboratory data (plasma HVA and MHPG) were found. During the 6-month follow-up in the early stage of first-episode schizophrenia, the MHPG changes were correlated with the microstructural FA changes in the cerebellum, which may reflect the functional connections of the noradrenergic system in the cerebellum.
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Affiliation(s)
- Joji Nishimura
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Shingo Kakeda
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, Nihon University, Tokyo, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Keita Watanabe
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Naoki Goto
- Department of Psychiatry, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Hikaru Hori
- Department of Psychiatry, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Toru Sato
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Hidemasa Takao
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroyuki Kabasawa
- MR Applied Science Laboratory Japan, GE Yokogawa Medical Systems, Hino-shi, Tokyo, Japan
| | - Jun Nakamura
- Department of Psychiatry, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
| | - Yukunori Korogi
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan
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Comparelli A, De Carolis A, Corigliano V, Di Pietro S, Trovini G, Granese C, Romano S, Serata D, Ferracuti S, Girardi P. Symptom correlates of facial emotion recognition impairment in schizophrenia. Psychopathology 2014; 47:65-70. [PMID: 23796958 DOI: 10.1159/000350453] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 02/09/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The ability to facial emotion recognition (FER), a key component of socioemotional competence, is often impaired in schizophrenic disorders. The purpose of the present study was to examine the relationship between emotion recognition performance and symptoms in a group of patients with schizophrenia spectrum disorders. SAMPLING AND METHODS Seventy-nine patients meeting DSM-IV-TR criteria for schizophrenia, schizophreniform disorder and schizoaffective disorder were assessed by the Positive and Negative Syndrome Scale and a FER task. In schizophrenia patients and healthy control subjects, FER performance was compared. In order to avoid a possible confounding role of cognitive impairment, we carried out partial correlations corrected for an index of global cognition. RESULTS Patients performed worse than a healthy control group on all negative emotions. Partial correlations showed that cognitive/disorganized symptoms correlated with a worse performance in the FER task, whereas no correlations were found with positive, negative, excitement and depressive symptoms. CONCLUSIONS Our findings support that in schizophrenia FER impairment is specific for negative emotions and that there is a relationship between this deficit and cognitive/disorganized symptoms, regardless of the general cognitive level.
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Affiliation(s)
- Anna Comparelli
- Unit of Psychiatry, NESMOS Department (Neurosciences, Mental Health and Sense Organs), Sant'Andrea Hospital, Rome, Italy
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Fusar-Poli P, Smieskova R, Kempton MJ, Ho BC, Andreasen NC, Borgwardt S. Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal MRI studies. Neurosci Biobehav Rev 2013; 37:1680-91. [PMID: 23769814 PMCID: PMC3964856 DOI: 10.1016/j.neubiorev.2013.06.001] [Citation(s) in RCA: 353] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 12/15/2022]
Abstract
Context Antipsychotic treatment is the first-line treatment option for schizophrenia. Individual studies suggested they can significantly affect brain structure and account for progressive brain changes observed during the illness. Objectives To quantitatively examine the effect of antipsychotics as compared to illness related factors on progressive brain changes in schizophrenia. Data sources Electronic databases were searched until April 2012. All magnetic resonance imaging studies reporting progressive brain changes in schizophrenia subjects and antipsychotic exposure were retrieved. Study selection 30 longitudinal MRI studies with antipsychotic administration in schizophrenia patients met the inclusion criteria. Data extraction Brain volumes before and after antipsychotic exposure, duration of illness, severity of psychotic symptoms as well as demographic, clinical, and methodological variables were extracted from each publication, or obtained directly from its authors. Data synthesis The overall sample was of 1046 schizophrenia patients and 780 controls for a median duration of follow-up of 72.4 weeks. At baseline, patients showed significant whole brain volume reductions and enlarged lateral ventricle (LV) volumes compared to controls. No baseline volumetric abnormalities were detected in the gray matter volumes (GMV), white matter volumes, cerebrospinal fluid and caudate nucleus. Longitudinally, there were progressive GMV decreases and LV enlargements in patients but not in controls. The GMV decreases were inversely correlated with cumulative exposure to antipsychotic treatments, while no effects were observed for duration of illness or illness severity. Conclusions Schizophrenia is characterized by progressive gray matter volume decreases and lateral ventricular volume increases. Some of these neuroanatomical alterations may be associated with antipsychotic treatment.
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Affiliation(s)
- P Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, United Kingdom.
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Derks EM, Boks MPM, Vermunt JK. The identification of family subtype based on the assessment of subclinical levels of psychosis in relatives. BMC Psychiatry 2012; 12:71. [PMID: 22759464 PMCID: PMC3504553 DOI: 10.1186/1471-244x-12-71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 06/08/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Schizophrenia is a complex psychiatric disorder characterized by high phenotypic heterogeneity. Previous studies have distinguished between familial and sporadic forms of schizophrenia and have suggested clinical differentiation between patients and relatives from sporadic and multiplex families. We will introduce a more refined method to distinguish between family subtypes based on psychosis dimension profiles in the relatives of schizophrenia patients. METHODS Positive, negative, disorganization, mania, and depression scores were assessed in 1,392 relatives. Mixed Model Latent Class Analysis was used to identify family subtypes. A family subtype is a relatively homogeneous group of families with similar symptom profiles in the relatives in these families. Next, we investigated in 616 schizophrenia patients whether family subtype was associated with symptom profiles, IQ, cannabis dependence/abuse, or age of onset of psychosis. RESULTS Based on the data of relatives, we identified two different family types: "healthy" and "at risk for psychiatric disorder". Patients from at risk families obtained higher positive scores compared to patients from healthy families (Wald(1) =6.6293, p=0.010). No significant differences were found in any of the remaining variables. CONCLUSIONS Our findings confirm the existence of high-risk families and although we did not establish an etiological basis for the distinction between family types, genetic studies might reveal whether family subtype is associated with genetic heterogeneity.
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Affiliation(s)
- Eske M Derks
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, AMC-APC, room PA1-179 Meibergdreef, Amsterdam, AZ 51105, The Netherlands.
| | - Marco PM Boks
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, AMC-APC, room PA1-179 Meibergdreef, Amsterdam, AZ 51105, The Netherlands
| | - Jeroen K Vermunt
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
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