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Sakakibara E, Satomura Y, Matsuoka J, Koike S, Okada N, Sakurada H, Yamagishi M, Kawakami N, Kasai K. Abnormal resting-state hyperconnectivity in schizophrenia: A whole-head near-infrared spectroscopy study. Schizophr Res 2024; 270:121-128. [PMID: 38901208 DOI: 10.1016/j.schres.2024.06.025] [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: 06/08/2023] [Revised: 04/04/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
Near-infrared spectroscopy (NIRS) is a noninvasive functional neuroimaging modality that can detect changes in blood oxygenation levels by tracking cortical neural activity. We recorded the resting-state brain activity of 24 individuals with schizophrenia and 90 healthy controls for 8 min using a whole-head NIRS arrangement and then used partial correlation analysis to estimate the resting-state functional connectivity (RSFC) between 17 cortical regions. We found that the RSFC between the bilateral orbitofrontal cortices (OFCs) and between the right temporal and parietal lobes was significantly higher in patients with schizophrenia than in healthy controls. The RSFC between the bilateral OFCs was positively correlated with negative symptom severity, whereas the RSFC between the right temporal and parietal lobes was positively correlated with the chlorpromazine equivalent for antipsychotics prescribed to patients with schizophrenia. This finding was consistent with that for the RSFC calculated using the anterior 52-channel signals. Our results suggest that NIRS-based RSFC measurements have potential clinical applications.
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Affiliation(s)
- Eisuke Sakakibara
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Yoshihiro Satomura
- Center for Diversity in Medical Education and Research, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Jun Matsuoka
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan; Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
| | - Hanako Sakurada
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Mika Yamagishi
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Center for Diversity in Medical Education and Research, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
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Tada M, Kirihara K, Nagai T, Koike S, Araki T, Kasai K. Gamma-band harmonic responses for beta-band auditory steady-state response are intact in patients with early stage schizophrenia. Neuropsychopharmacol Rep 2024; 44:240-245. [PMID: 38013609 PMCID: PMC10932762 DOI: 10.1002/npr2.12392] [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: 07/11/2023] [Revised: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
Gamma oscillations, thought to arise from the activity of ɣ-aminobutyric acid (GABA)ergic interneurons, have potential as a biomarker for schizophrenia. Gamma-band auditory steady-state responses (ASSRs) are notably reduced in both chronic and early-stage schizophrenia patients. Furthermore, alterations in gamma-band ASSRs have been demonstrated in animal models through translational research. However, the 40-Hz harmonic responses of the 20-Hz ASSR are not as well-characterized, despite the possibility that these harmonic oscillatory responses may reflect resonant activity in neural circuits. In this study, we investigated the 40-Hz harmonic response to the 20-Hz ASSR in the early stages of schizophrenia. The study recruited 49 participants, including 15 individuals at ultra-high-risk (UHR) for psychosis, 13 patients with first-episode schizophrenia (FES), and 21 healthy controls (HCs). The 40-Hz harmonic responses of the 20-Hz ASSR were evident in all groups. Interestingly, while previous report observed reduced 40-Hz ASSRs, the 40-Hz harmonic responses of the 20-Hz ASSR were not reduced in the UHR or FES groups. These findings suggest that the gamma-band ASSR and its harmonic responses may represent distinct aspects of pathophysiology in the early stages of schizophrenia.
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Affiliation(s)
- Mariko Tada
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- International Research Center for Neurointelligence (WPI‐IRCN), UTIASThe University of TokyoTokyoJapan
- Office for Mental Health SupportCenter for Research on Counseling and Support ServicesThe University of TokyoTokyoJapan
| | - Kenji Kirihara
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- Disability Services OfficeThe University of TokyoTokyoJapan
| | - Tatsuya Nagai
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Shinsuke Koike
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- International Research Center for Neurointelligence (WPI‐IRCN), UTIASThe University of TokyoTokyoJapan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM)TokyoJapan
- Center for Evolutionary Cognitive SciencesGraduate School of Arts and SciencesThe University of TokyoTokyoJapan
| | - Tsuyoshi Araki
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- Department of PsychiatryTeikyo University HospitalKanagawaJapan
| | - Kiyoto Kasai
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- International Research Center for Neurointelligence (WPI‐IRCN), UTIASThe University of TokyoTokyoJapan
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3
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Yu SC, Hwang TJ, Liu CM, Chan HY, Kuo CJ, Yang TT, Wang JP, Liu CC, Hsieh MH, Lin YT, Chien YL, Kuo PH, Shih YW, Yu SL, Chen HY, Chen WJ. Patients with first-episode psychosis in northern Taiwan: neurocognitive performance and niacin response profile in comparison with schizophrenia patients of different familial loadings and relationship with clinical features. BMC Psychiatry 2024; 24:155. [PMID: 38389072 PMCID: PMC10885443 DOI: 10.1186/s12888-024-05598-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Examining patients with first-episode psychosis (FEP) provides opportunities to better understand the mechanism underlying these illnesses. By incorporating quantitative measures in FEP patients, we aimed to (1) determine the baseline distribution of clinical features; (2) examine the impairment magnitude of the quantitative measures by comparing with external controls and then the counterparts of schizophrenia patients of different familial loadings; and (3) evaluate whether these quantitative measures were associated with the baseline clinical features. METHODS Patients with FEP were recruited from one medical center, two regional psychiatric centers, and two private clinics in northern Taiwan with clinical features rated using the Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale. Quantitative measurements included the Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), niacin response abnormality (NRA), and minor physical anomalies and craniofacial features (MPAs). To evaluate the relative performance of the quantitative measures in our FEP patients, four external comparison groups from previous studies were used, including three independent healthy controls for the CPT, WCST, and NRA, respectively, and one group of treatment-resistant schizophrenia patients for the MPAs. Additionally, patients from simplex families and patients from multiplex families were used to assess the magnitude of FEP patients' impairment on the CPT, WCST, and NRA. RESULTS Among the 80 patients with FEP recruited in this study (58% female, mean age = 25.6 years, mean duration of untreated psychosis = 132 days), the clinical severity was mild to moderate (mean PANSS score = 67.3; mean PSP score = 61.8). Patients exhibited both neurocognitive and niacin response impairments (mean Z-scores: -1.24 for NRA, - 1.06 for undegraded d', - 0.70 for degraded d', - 0.32 for categories achieved, and 0.44 for perseverative errors) but did not show MPAs indicative of treatment resistance. Among these quantitative measures, three of the four neurocognitive indices were correlated with the baseline clinical features, whereas NRA did not show such correlation. CONCLUSIONS This FEP study of Taiwanese patients revealed the presence of neurocognitive performance and niacin response and their different relationships with clinical features, rendering this sample useful for future follow-up and incorporation of multiomics investigation.
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Affiliation(s)
- Shun-Chun Yu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Centers for Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | | | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tsung-Tsair Yang
- Department of Social Psychology, Shih Hsin University, Taipei, Taiwan
| | | | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ting Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ya-Wen Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsuan-Yu Chen
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Centers for Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
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Tada M, Kirihara K, Koshiyama D, Nagai T, Fujiouka M, Usui K, Satomura Y, Koike S, Sawada K, Matsuoka J, Morita K, Araki T, Kasai K. Alterations of auditory-evoked gamma oscillations are more pronounced than alterations of spontaneous power of gamma oscillation in early stages of schizophrenia. Transl Psychiatry 2023; 13:218. [PMID: 37365182 DOI: 10.1038/s41398-023-02511-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
Several animal models of schizophrenia and patients with chronic schizophrenia have shown increased spontaneous power of gamma oscillations. However, the most robust alterations of gamma oscillations in patients with schizophrenia are reduced auditory-oscillatory responses. We hypothesized that patients with early-stage schizophrenia would have increased spontaneous power of gamma oscillations and reduced auditory-oscillatory responses. This study included 77 participants, including 27 ultra-high-risk (UHR) individuals, 19 patients with recent-onset schizophrenia (ROS), and 31 healthy controls (HCs). The auditory steady-state response (ASSR) and spontaneous power of gamma oscillations measured as induced power during the ASSR period were calculated using electroencephalography during 40-Hz auditory click-trains. The ASSRs were lower in the UHR and ROS groups than in the HC group, whereas the spontaneous power of gamma oscillations in the UHR and ROS groups did not significantly differ from power in the HC group. Both early-latency (0-100 ms) and late-latency (300-400 ms) ASSRs were significantly reduced and negatively correlated with the spontaneous power of gamma oscillations in the ROS group. In contrast, UHR individuals exhibited reduced late-latency ASSR and a correlation between the unchanged early-latency ASSR and the spontaneous power of gamma oscillations. ASSR was positively correlated with the hallucinatory behavior score in the ROS group. Correlation patterns between the ASSR and spontaneous power of gamma oscillations differed between the UHR and ROS groups, suggesting that the neural dynamics involved in non-stimulus-locked/task modulation change with disease progression and may be disrupted after psychosis onset.
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Affiliation(s)
- Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- Office for Mental Health Support, Center for Research on Counseling and Support Services, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mao Fujiouka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shinsuke Koike
- International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan
| | - Kingo Sawada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Office for Mental Health Support, Center for Research on Counseling and Support Services, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Jun Matsuoka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kentaro Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Chatterjee I, Chatterjee S. Investigating the symptomatic and morphological changes in the brain based on pre and post-treatment: A critical review from clinical to neuroimaging studies on schizophrenia. IBRO Neurosci Rep 2023. [DOI: 10.1016/j.ibneur.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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6
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Usui K, Kirihara K, Tada M, Fujioka M, Koshiyama D, Tani M, Tsuchiya M, Morita S, Kawakami S, Kanehara A, Morita K, Satomura Y, Koike S, Suga M, Araki T, Kasai K. The association between clinical symptoms and later subjective quality of life in individuals with ultra-high risk for psychosis and recent-onset psychotic disorder: A longitudinal investigation. Psychiatry Clin Neurosci 2022; 76:552-559. [PMID: 35352436 DOI: 10.1111/pcn.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/04/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
AIM Subjective quality of life is a clinically relevant outcome that is strongly associated with the severity of clinical symptoms in individuals with ultra-high risk for psychosis and patients with recent-onset psychotic disorder. Our objective was to examine whether longitudinal changes in clinical symptoms are associated with quality of life in ultra-high risk individuals and patients with recent-onset psychotic disorder. METHODS Individuals with ultra-high risk and patients with recent-onset psychosis disorder were recruited in the same clinical settings at baseline and were followed up with more than 6 months and less than 5 years later. We assessed five factors of clinical symptoms using the positive and negative syndrome scale, and quality of life using the World Health Organization quality of life questionnaire-short form. We used multiple regression to examine the relationships between clinical symptoms and quality of life while controlling for diagnosis, follow-up period, age, and sex. RESULTS Data were collected from 22 individuals with ultra-high risk and 27 patients with recent-onset psychosis disorder. The multiple regression analysis results indicated that the more severe anxiety/depression was at baseline, the poorer the quality of life at follow-up. Further, improvement of anxiety/depression and disorganized thoughts were associated with improvement in quality of life. The difference in diagnosis did not affect the association between clinical symptoms and quality of life. CONCLUSION These findings suggest that the improvement of anxiety/depression and disorganized thoughts is important in the early stages of psychosis before it becomes severe, affecting the quality of life.
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Affiliation(s)
- Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Disability Services Office, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Office for Mental Health Support, Center for Research on Counseling and Support Services, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motoko Tani
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maiko Tsuchiya
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shintaro Kawakami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Kanehara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Morita
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate school of Clinical Psychology, Teikyo Heisei University, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Teikyo University Hospital, Mizonokuchi, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
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Lee TY, Hwang WJ, Kim NS, Park I, Lho SK, Moon SY, Oh S, Lee J, Kim M, Woo CW, Kwon JS. Prediction of psychosis: model development and internal validation of a personalized risk calculator. Psychol Med 2022; 52:2632-2640. [PMID: 33315005 PMCID: PMC9647536 DOI: 10.1017/s0033291720004675] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Over the past two decades, early detection and early intervention in psychosis have become essential goals of psychiatry. However, clinical impressions are insufficient for predicting psychosis outcomes in clinical high-risk (CHR) individuals; a more rigorous and objective model is needed. This study aims to develop and internally validate a model for predicting the transition to psychosis within 10 years. METHODS Two hundred and eight help-seeking individuals who fulfilled the CHR criteria were enrolled from the prospective, naturalistic cohort program for CHR at the Seoul Youth Clinic (SYC). The least absolute shrinkage and selection operator (LASSO)-penalized Cox regression was used to develop a predictive model for a psychotic transition. We performed k-means clustering and survival analysis to stratify the risk of psychosis. RESULTS The predictive model, which includes clinical and cognitive variables, identified the following six baseline variables as important predictors: 1-year percentage decrease in the Global Assessment of Functioning score, IQ, California Verbal Learning Test score, Strange Stories test score, and scores in two domains of the Social Functioning Scale. The predictive model showed a cross-validated Harrell's C-index of 0.78 and identified three subclusters with significantly different risk levels. CONCLUSIONS Overall, our predictive model showed a predictive ability and could facilitate a personalized therapeutic approach to different risks in high-risk individuals.
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Affiliation(s)
- Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Neuroscience, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Nahrie S. Kim
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Brain and Cognitive Neuroscience, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Inkyung Park
- Department of Brain and Cognitive Neuroscience, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Silvia Kyungjin Lho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun-Young Moon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Junhee Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minah Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Choong-Wan Woo
- Department of Brain and Cognitive Neuroscience, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Neuroscience, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
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8
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Koike S, Sakakibara E, Satomura Y, Sakurada H, Yamagishi M, Matsuoka J, Okada N, Kasai K. Shared functional impairment in the prefrontal cortex affects symptom severity across psychiatric disorders. Psychol Med 2022; 52:2661-2670. [PMID: 33336641 PMCID: PMC9647535 DOI: 10.1017/s0033291720004742] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 10/27/2020] [Accepted: 11/06/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The prefrontal deficits in psychiatric disorders have been investigated using functional neuroimaging tools; however, no studies have tested the related characteristics across psychiatric disorders considering various demographic and clinical confounders. METHODS We analyzed 1558 functional brain measurements using a functional near-infrared spectroscopy during a verbal fluency task from 1200 participants with three disease spectra [196 schizophrenia, 189 bipolar disorder (BPD), and 394 major depressive disorder (MDD)] and 369 healthy controls along with demographic characteristics (age, gender, premorbid IQ, and handedness), task performance during the measurements, clinical assessments, and medication equivalent doses (chlorpromazine, diazepam, biperiden, and imipramine) in a consistent manner. The association between brain functions and demographic and clinical variables was tested using a general linear mixed model (GLMM). Then, the direction of relationship between brain activity and symptom severity, controlling for any other associations, was estimated using a model comparison of structural equation models (SEMs). RESULTS The GLMM showed a shared functional deficit of brain activity and a schizophrenia-specific delayed activity timing in the prefrontal cortex (false discovery rate-corrected p < 0.05). Comparison of SEMs showed that brain activity was associated with the global assessment of functioning scores in the left inferior frontal gyrus opercularis (IFGOp) in BPD group and the bilateral superior temporal gyrus and middle temporal gyrus, and the left superior frontal gyrus, inferior frontal gyrus triangularis, and IFGOp in MDD group. CONCLUSION This cross-disease large-sample neuroimaging study with high-quality clinical data reveals a robust relationship between prefrontal function and behavioral outcomes across three major psychiatric disorders.
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Affiliation(s)
- Shinsuke Koike
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Tokyo 153-8902, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Tokyo 153-8902, Japan
- University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Eisuke Sakakibara
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hanako Sakurada
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Mika Yamagishi
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Jun Matsuoka
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Naohiro Okada
- The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kiyoto Kasai
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Tokyo 153-8902, Japan
- University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
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9
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Zhu Y, Nakatani H, Yassin W, Maikusa N, Okada N, Kunimatsu A, Abe O, Kuwabara H, Yamasue H, Kasai K, Okanoya K, Koike S. Application of a Machine Learning Algorithm for Structural Brain Images in Chronic Schizophrenia to Earlier Clinical Stages of Psychosis and Autism Spectrum Disorder: A Multiprotocol Imaging Dataset Study. Schizophr Bull 2022; 48:563-574. [PMID: 35352811 PMCID: PMC9077435 DOI: 10.1093/schbul/sbac030] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Machine learning approaches using structural magnetic resonance imaging (MRI) can be informative for disease classification; however, their applicability to earlier clinical stages of psychosis and other disease spectra is unknown. We evaluated whether a model differentiating patients with chronic schizophrenia (ChSZ) from healthy controls (HCs) could be applied to earlier clinical stages such as first-episode psychosis (FEP), ultra-high risk for psychosis (UHR), and autism spectrum disorders (ASDs). STUDY DESIGN Total 359 T1-weighted MRI scans, including 154 individuals with schizophrenia spectrum (UHR, n = 37; FEP, n = 24; and ChSZ, n = 93), 64 with ASD, and 141 HCs, were obtained using three acquisition protocols. Of these, data regarding ChSZ (n = 75) and HC (n = 101) from two protocols were used to build a classifier (training dataset). The remainder was used to evaluate the classifier (test, independent confirmatory, and independent group datasets). Scanner and protocol effects were diminished using ComBat. STUDY RESULTS The accuracy of the classifier for the test and independent confirmatory datasets were 75% and 76%, respectively. The bilateral pallidum and inferior frontal gyrus pars triangularis strongly contributed to classifying ChSZ. Schizophrenia spectrum individuals were more likely to be classified as ChSZ compared to ASD (classification rate to ChSZ: UHR, 41%; FEP, 54%; ChSZ, 70%; ASD, 19%; HC, 21%). CONCLUSION We built a classifier from multiple protocol structural brain images applicable to independent samples from different clinical stages and spectra. The predictive information of the classifier could be useful for applying neuroimaging techniques to clinical differential diagnosis and predicting disease onset earlier.
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Affiliation(s)
- Yinghan Zhu
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Hironori Nakatani
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
- Department of Information Media Technology, School of Information and Telecommunication Engineering, Tokai University, 2-3-23, Takanawa, Minato-ku, Tokyo 108-8619, Japan
| | - Walid Yassin
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Norihide Maikusa
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Naohiro Okada
- The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akira Kunimatsu
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
- Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hitoshi Kuwabara
- Department of Psychiatry, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka 431-3192, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka 431-3192, Japan
| | - Kiyoto Kasai
- The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
- University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Kazuo Okanoya
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
- University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
| | - Shinsuke Koike
- To whom correspondence should be addressed; Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan; tel: +81-3-5454-4327, fax: +81-3-5454-4327, e-mail:
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10
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Surface area in the insula was associated with 28-month functional outcome in first-episode psychosis. NPJ SCHIZOPHRENIA 2021; 7:56. [PMID: 34845247 PMCID: PMC8630202 DOI: 10.1038/s41537-021-00186-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022]
Abstract
Many studies have tested the relationship between demographic, clinical, and psychobiological measurements and clinical outcomes in ultra-high risk for psychosis (UHR) and first-episode psychosis (FEP). However, no study has investigated the relationship between multi-modal measurements and long-term outcomes for >2 years. Thirty-eight individuals with UHR and 29 patients with FEP were measured using one or more modalities (cognitive battery, electrophysiological response, structural magnetic resonance imaging, and functional near-infrared spectroscopy). We explored the characteristics associated with 13- and 28-month clinical outcomes. In UHR, the cortical surface area in the left orbital part of the inferior frontal gyrus was negatively associated with 13-month disorganized symptoms. In FEP, the cortical surface area in the left insula was positively associated with 28-month global social function. The left inferior frontal gyrus and insula are well-known structural brain characteristics in schizophrenia, and future studies on the pathological mechanism of structural alteration would provide a clearer understanding of the disease.
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11
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Morimoto C, Uematsu A, Nakatani H, Takano Y, Iwashiro N, Abe O, Yamasue H, Kasai K, Koike S. Volumetric differences in gray and white matter of cerebellar Crus I/II across the different clinical stages of schizophrenia. Psychiatry Clin Neurosci 2021; 75:256-264. [PMID: 34081816 DOI: 10.1111/pcn.13277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/15/2022]
Abstract
AIM Schizophrenia is considered to be a disorder of progressive structural brain abnormalities. Previous studies have indicated that the cerebellar Crus I/II plays a critical role in schizophrenia. We aimed to investigate how specific morphological features in the Crus I/II at different critical stages of the schizophrenia spectrum contribute to the disease. METHODS The study involved 73 participants on the schizophrenia spectrum (28 with ultra-high risk for psychosis [UHR], 17 with first-episode schizophrenia [FES], and 28 with chronic schizophrenia) and 79 healthy controls. We undertook a detailed investigation into differences in Crus I/II volume using a semiautomated segmentation method optimized for the cerebellum. We analyzed the effects of group and sex, as well as their interaction, on Crus I/II volume in gray matter (GM) and white matter (WM). RESULTS Significant group × sex interactions were found in WM volumes of the bilateral Crus I/II; the males with UHR demonstrated significantly larger WM volumes compared with the other male groups, whereas no significant group differences were found in the female groups. Additionally, WM and GM volumes of the Crus I/II had positive associations with symptom severity in the UHR group, whereas, in contrast, GM volumes in the FES group were negatively associated with symptom severity. CONCLUSIONS The present findings provide evidence that the morphology of Crus I/II is involved in schizophrenia in a sex- and disease stage-dependent manner. Additionally, alterations of WM volumes of Crus I/II may have potential as a biological marker of early detection and treatment for individuals with UHR.
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Affiliation(s)
- Chie Morimoto
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Uematsu
- Center for Evolutionary Cognitive Science, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Hironori Nakatani
- Department of Information Media Technology, School of Information and Telecommunication Engineering, Tokai University, Tokyo, Japan
| | - Yosuke Takano
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norichika Iwashiro
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), Tokyo, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Science, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), Tokyo, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan
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12
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Reduced cortical thickness of the paracentral lobule in at-risk mental state individuals with poor 1-year functional outcomes. Transl Psychiatry 2021; 11:396. [PMID: 34282119 PMCID: PMC8289863 DOI: 10.1038/s41398-021-01516-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023] Open
Abstract
Although widespread cortical thinning centered on the fronto-temporal regions in schizophrenia has been reported, the findings in at-risk mental state (ARMS) patients have been inconsistent. In addition, it remains unclear whether abnormalities of cortical thickness (CT) in ARMS individuals, if present, are related to their functional decline irrespective of future psychosis onset. In this multicenter study in Japan, T1-weighted magnetic resonance imaging was performed at baseline in 107 individuals with ARMS, who were subdivided into resilient (77, good functional outcome) and non-resilient (13, poor functional outcome) groups based on the change in Global Assessment of Functioning scores during 1-year follow-up, and 104 age- and sex-matched healthy controls recruited at four scanning sites. We measured the CT of the entire cortex and performed group comparisons using FreeSurfer software. The relationship between the CT and cognitive functioning was examined in an ARMS subsample (n = 70). ARMS individuals as a whole relative to healthy controls exhibited a significantly reduced CT, predominantly in the fronto-temporal regions, which was partly associated with cognitive impairments, and an increased CT in the left parietal and right occipital regions. Compared with resilient ARMS individuals, non-resilient ARMS individuals exhibited a significantly reduced CT of the right paracentral lobule. These findings suggest that ARMS individuals partly share CT abnormalities with patients with overt schizophrenia, potentially representing general vulnerability to psychopathology, and also support the role of cortical thinning in the paracentral lobule as a predictive biomarker for short-term functional decline in the ARMS population.
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13
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Koike S, Tanaka SC, Okada T, Aso T, Yamashita A, Yamashita O, Asano M, Maikusa N, Morita K, Okada N, Fukunaga M, Uematsu A, Togo H, Miyazaki A, Murata K, Urushibata Y, Autio J, Ose T, Yoshimoto J, Araki T, Glasser MF, Van Essen DC, Maruyama M, Sadato N, Kawato M, Kasai K, Okamoto Y, Hanakawa T, Hayashi T. Brain/MINDS beyond human brain MRI project: A protocol for multi-level harmonization across brain disorders throughout the lifespan. Neuroimage Clin 2021; 30:102600. [PMID: 33741307 PMCID: PMC8209465 DOI: 10.1016/j.nicl.2021.102600] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 01/31/2021] [Accepted: 02/12/2021] [Indexed: 01/03/2023]
Abstract
Psychiatric and neurological disorders are afflictions of the brain that can affect individuals throughout their lifespan. Many brain magnetic resonance imaging (MRI) studies have been conducted; however, imaging-based biomarkers are not yet well established for diagnostic and therapeutic use. This article describes an outline of the planned study, the Brain/MINDS Beyond human brain MRI project (BMB-HBM, FY2018 ~ FY2023), which aims to establish clinically-relevant imaging biomarkers with multi-site harmonization by collecting data from healthy traveling subjects (TS) at 13 research sites. Collection of data in psychiatric and neurological disorders across the lifespan is also scheduled at 13 sites, whereas designing measurement procedures, developing and analyzing neuroimaging protocols, and databasing are done at three research sites. A high-quality scanning protocol, Harmonization Protocol (HARP), was established for five high-quality 3 T scanners to obtain multimodal brain images including T1 and T2-weighted, resting-state and task functional and diffusion-weighted MRI. Data are preprocessed and analyzed using approaches developed by the Human Connectome Project. Preliminary results in 30 TS demonstrated cortical thickness, myelin, functional connectivity measures are comparable across 5 scanners, suggesting sensitivity to subject-specific connectome. A total of 75 TS and more than two thousand patients with various psychiatric and neurological disorders are scheduled to participate in the project, allowing a mixed model statistical harmonization. The HARP protocols are publicly available online, and all the imaging, demographic and clinical information, harmonizing database will also be made available by 2024. To the best of our knowledge, this is the first project to implement a prospective, multi-level harmonization protocol with multi-site TS data. It explores intractable brain disorders across the lifespan and may help to identify the disease-specific pathophysiology and imaging biomarkers for clinical practice.
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Affiliation(s)
- Shinsuke Koike
- Center for Evolutionary Cognitive Sciences (ECS), Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Tokyo 153-8902, Japan; University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Tokyo 153-8902, Japan; University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan; The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan
| | - Saori C Tanaka
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International (ATR), Kyoto 619-0288, Japan
| | - Tomohisa Okada
- Human Brain Research Center, Kyoto University, Kyoto 606-8507, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Hyogo 650-0047, Japan
| | - Ayumu Yamashita
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International (ATR), Kyoto 619-0288, Japan
| | - Okito Yamashita
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International (ATR), Kyoto 619-0288, Japan
| | - Michiko Asano
- Center for Evolutionary Cognitive Sciences (ECS), Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Tokyo 153-8902, Japan
| | - Norihide Maikusa
- Center for Evolutionary Cognitive Sciences (ECS), Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Tokyo 153-8902, Japan; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo 187-8551, Japan
| | - Kentaro Morita
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Naohiro Okada
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Tokyo 153-8902, Japan; The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki 444-8585, Japan
| | - Akiko Uematsu
- Center for Evolutionary Cognitive Sciences (ECS), Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Tokyo 153-8902, Japan
| | - Hiroki Togo
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo 187-8551, Japan
| | - Atsushi Miyazaki
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | | | | | - Joonas Autio
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Hyogo 650-0047, Japan
| | - Takayuki Ose
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Hyogo 650-0047, Japan
| | - Junichiro Yoshimoto
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International (ATR), Kyoto 619-0288, Japan
| | - Toshiyuki Araki
- Department of Peripheral Nervous System Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan
| | - Matthew F Glasser
- Department of Neuroscience, Washington University School of Medicine, St Louis, MO USA; Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - David C Van Essen
- Department of Neuroscience, Washington University School of Medicine, St Louis, MO USA
| | - Megumi Maruyama
- Research Enhancement Strategy Office, National Institute for Physiological Sciences, Okazaki 444-8585, Japan
| | - Norihiro Sadato
- Division of Cerebral Integration, Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki 444-8585, Japan
| | - Mitsuo Kawato
- Brain Information Communication Research Laboratory Group, Advanced Telecommunications Research Institutes International (ATR), Kyoto 619-0288, Japan; Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
| | - Kiyoto Kasai
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Tokyo 153-8902, Japan; University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan; The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Takashi Hanakawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo 187-8551, Japan; Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto 606-8303, Japan
| | - Takuya Hayashi
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Hyogo 650-0047, Japan.
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14
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Shi J, Kirihara K, Tada M, Fujioka M, Usui K, Koshiyama D, Araki T, Chen L, Kasai K, Aihara K. Criticality in the Healthy Brain. FRONTIERS IN NETWORK PHYSIOLOGY 2021; 1:755685. [PMID: 36925577 PMCID: PMC10013033 DOI: 10.3389/fnetp.2021.755685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022]
Abstract
The excellence of the brain is its robustness under various types of noise and its flexibility under various environments. However, how the brain works is still a mystery. The critical brain hypothesis proposes a possible mechanism and states that criticality plays an important role in the healthy brain. Herein, using an electroencephalography dataset obtained from patients with psychotic disorders (PDs), ultra-high risk (UHR) individuals and healthy controls (HCs), and its dynamical network analysis, we show that the brain of HCs remains around a critical state, whereas that of patients with PD falls into more stable states. Meanwhile, the brain of UHR individuals is similar to that of PD in terms of entropy but is analogous to that of HCs in causality patterns. These results not only provide evidence for the criticality of the normal brain but also highlight the practicability of using an analytic biophysical tool to study the dynamical properties of mental diseases.
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Affiliation(s)
- Jifan Shi
- International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan.,Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Disability Services Office, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Luonan Chen
- Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, China.,Guangdong Institute of Intelligence Science and Technology, Zhuhai, China.,School of Life Science and Technology, ShanghaiTech University, Shanghai, China.,Key Laboratory of Systems Biology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinse Academy of Sciences, Hangzhou, China
| | - Kiyoto Kasai
- International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuyuki Aihara
- International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan.,Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
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15
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Sasabayashi D, Takayanagi Y, Takahashi T, Katagiri N, Sakuma A, Obara C, Katsura M, Okada N, Koike S, Yamasue H, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State. Schizophr Bull 2020; 46:834-845. [PMID: 32162659 PMCID: PMC7342178 DOI: 10.1093/schbul/sbaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan; tel: +81-76-434-7323, fax: +81-76-434-5030, e-mail:
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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16
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Salazar de Pablo G, Catalan A, Fusar-Poli P. Clinical Validity of DSM-5 Attenuated Psychosis Syndrome: Advances in Diagnosis, Prognosis, and Treatment. JAMA Psychiatry 2020; 77:311-320. [PMID: 31746950 DOI: 10.1001/jamapsychiatry.2019.3561] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Since the release of the DSM-5 diagnosis of attenuated psychosis syndrome (DSM-5-APS) in 2013, several research studies have investigated its clinical validity. Although critical and narrative reviews have reviewed these progresses, no systematic review has comprehensively summarized the available evidence regarding the clinical validity of DSM-5-APS. OBJECTIVE To provide current evidence on the clinical validity of DSM-5-APS, focusing on recent advances in diagnosis, prognosis, and treatment. EVIDENCE REVIEW A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, conference proceedings, and trial registries from database inception to June 16, 2019, was conducted following PRISMA and MOOSE guidelines and PROSPERO protocol. Studies with original data investigating individuals diagnosed using DSM-5-APS or meeting comparable criteria were included. The results of the systematic review were summarized in tables and narratively synthesized against established evidence-based antecedent, concurrent, and prognostic validators. A quantitative meta-analysis was conducted to explore the cumulative risk of psychosis onset at 6, 12, 24, and 36 months in individuals diagnosed using DSM-5-APS criteria. FINDINGS The systematic review included 56 articles, which reported on 124 validators, including 15 antecedent, 55 concurrent, and 54 prognostic validators. The epidemiological prevalence of the general non-help-seeking young population meeting DSM-5-APS criteria was 0.3%; the prevalence of individuals meeting DSM-5-APS criteria was variable in clinical samples. The interrater reliability for DSM-5-APS criteria was comparable with that of other DSM-5 mental disorders and can be optimized by the use of specific psychometric instruments. DSM-5-APS criteria were associated with frequent depressive comorbid disorders, distress, suicidality, and functional impairment. The meta-analysis included 23 prospective cohort studies, including 2376 individuals. The meta-analytical risk of psychosis onset was 11% at 6 months, 15% at 12 months, 20% at 24 months, and 23% at 36 months. Research into predisposing and precipitating epidemiological factors, neurobiological correlates, and effective treatments for DSM-5-APS criteria has been limited. CONCLUSIONS AND RELEVANCE Over recent years, DSM-5-APS criteria have received substantial concurrent and prognostic validation, mostly driven by research into the clinical high-risk state for psychosis. Precipitating and predisposing factors, neurobiological correlates, and effective treatments are undetermined to date.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Institute of Psychiatry and Mental Health, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.,Mental Health Group, BioCruces Health Research Institute, Bizkaia, Spain.,Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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17
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Yoviene Sykes LA, Ferrara M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Perkins DO, Mathalon DH, Seidman LJ, Tsuang MT, Walker EF, McGlashan TH, Woodberry KA, Powers AR, Ponce AN, Cahill JD, Pollard JM, Srihari VH, Woods SW. Predictive validity of conversion from the clinical high risk syndrome to frank psychosis. Schizophr Res 2020; 216:184-191. [PMID: 31864837 PMCID: PMC7239715 DOI: 10.1016/j.schres.2019.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 02/08/2023]
Abstract
Although the clinical high risk for psychosis (CHR) paradigm has become well-established over the past two decades, one key component has received surprisingly little investigative attention: the predictive validity of the criteria for conversion or transition to frank psychosis. The current study evaluates the predictive validity of the transition to psychosis as measured by the Structured Interview for Psychosis-Risk Syndromes (SIPS) in CHR individuals. Participants included 33 SIPS converters and 399 CHR non-converters both from the North American Prodromal Longitudinal Study (NAPLS-2), as well as a sample of 67 separately ascertained first-episode psychosis (FEP) patients from the STEP program. Comparisons were made at baseline and one-year follow-up on demographic, diagnostic stability (SCID), and available measurement domains relating to severity of illness (psychotropic medication, psychosocial treatment, and resource utilization). Principal findings are: 1) a large majority of cases in both SIPS converters (n = 27/33, 81.8%) and FEP (n = 57/67, 85.1%) samples met criteria for continued psychosis at one-year follow-up; 2) follow-up prescription rates for current antipsychotic medication were higher in SIPS converters (n = 17/32, 53.1%) compared to SIPS non-converters (n = 81/397, 20.4%), and similar as compared to FEP cases (n = 39/65, 60%); and 3) at follow-up, SIPS converters had higher rates of resource utilization (psychiatric hospitalizations, day hospital admissions, and ER visits) than SIPS non-converters and were similar to FEP in most categories. The results suggest that the SIPS definition of psychosis onset carries substantial predictive validity. Limitations and future directions are discussed.
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Affiliation(s)
- Laura A Yoviene Sykes
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America.
| | - Maria Ferrara
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America; Dipartimento di Salute Mentale e Dipendenze Patologiche, AUSL Modena, Modena, Italy
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Departments of Psychology and Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, United States of America
| | | | - Tyrone D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, United States of America
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States of America
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, San Francisco, CA, United States of America
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, United States of America
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States of America
| | - Thomas H McGlashan
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
| | - Kristen A Woodberry
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America; Center for Psychiatric Research, Maine Medical Center, Portland, ME, United States of America
| | - Albert R Powers
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
| | - Allison N Ponce
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
| | - John D Cahill
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
| | - Jessica M Pollard
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
| | - Vinod H Srihari
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
| | - Scott W Woods
- Department of Psychiatry and Connecticut Mental Health Center, Yale University, New Haven, CT, United States of America
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18
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Fujioka M, Kirihara K, Koshiyama D, Tada M, Nagai T, Usui K, Morita S, Kawakami S, Morita K, Satomura Y, Koike S, Suga M, Araki T, Kasai K. Mismatch Negativity Predicts Remission and Neurocognitive Function in Individuals at Ultra-High Risk for Psychosis. Front Psychiatry 2020; 11:770. [PMID: 32848939 PMCID: PMC7416637 DOI: 10.3389/fpsyt.2020.00770] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/21/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the early intervention in psychosis, ultra-high risk (UHR) criteria have been used to identify individuals who are prone to develop psychosis. Although the transition rate to psychosis in individuals at UHR is 10% to 30% within several years, some individuals at UHR present with poor prognoses even without transition occurring. Therefore, it is important to identify biomarkers for predicting the prognosis of individuals at UHR, regardless of transition. We investigated whether mismatch negativity (MMN) in response to both duration deviant stimuli (dMMN) and frequency deviant stimuli (fMMN) could predict prognosis, including remission and neurocognitive function in individuals at UHR. MATERIALS AND METHODS Individuals at UHR (n = 24) and healthy controls (HC; n = 18) participated in this study. In an auditory oddball paradigm, both dMMN and fMMN were measured at baseline. Remission and neurocognitive function after > 180 days were examined in the UHR group. Remission from UHR was defined as functional and symptomatic improvement using the Global Assessment of Functioning (GAF) score and Scale of Prodromal Symptoms (SOPS) positive subscales. Neurocognitive function was measured using the Brief Assessment of Cognition in Schizophrenia (BACS). We examined differences in MMN amplitude at baseline between those who achieved remission (remitters) and those who did not (non-remitters). Multiple regression analyses were performed to identify predictors for functioning, positive symptoms, and neurocognitive function. RESULTS Compared with the HC group, the UHR group had a significantly attenuated dMMN amplitude (p = 0.003). In the UHR group, GAF scores significantly improved during the follow-up period (mean value 47.1 to 55.5, p = 0.004). The dMMN amplitude at baseline was significantly larger in the remitter (n = 6) than in the non-remitter group (n = 18) (p = 0.039). The total SOPS positive subscale scores and fMMN amplitude at baseline could predict BACS attention subscore at the follow-up point (SOPS positive subscales, p = 0.030; fMMN, p = 0.041). CONCLUSION Our findings indicate that dMMN and fMMN predicted remission and neurocognitive function, respectively, in individuals at UHR, which suggests that there are both promising biomarker candidates for predicting prognosis in individuals at UHR.
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Affiliation(s)
- Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Psychiatry, Kawamuro Memorial Hospital, Joetsu, Japan
| | - Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shintaro Kawakami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Morita
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate School of Clinical Psychology, Teikyo Heisei University, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
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19
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Zhao Z, Jinde S, Koike S, Tada M, Satomura Y, Yoshikawa A, Nishimura Y, Takizawa R, Kinoshita A, Sakakibara E, Sakurada H, Yamagishi M, Nishimura F, Inai A, Nishioka M, Eriguchi Y, Araki T, Takaya A, Kan C, Umeda M, Shimazu A, Hashimoto H, Bundo M, Iwamoto K, Kakiuchi C, Kasai K. Altered expression of microRNA-223 in the plasma of patients with first-episode schizophrenia and its possible relation to neuronal migration-related genes. Transl Psychiatry 2019; 9:289. [PMID: 31712567 PMCID: PMC6848172 DOI: 10.1038/s41398-019-0609-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 09/10/2019] [Accepted: 09/30/2019] [Indexed: 12/26/2022] Open
Abstract
Recent studies have shown that microRNAs (miRNAs) play a role as regulators of neurodevelopment by modulating gene expression. Altered miRNA expression has been reported in various psychiatric disorders, including schizophrenia. However, the changes in the miRNA expression profile that occur during the initial stage of schizophrenia have not been fully investigated. To explore the global alterations in miRNA expression profiles that may be associated with the onset of schizophrenia, we first profiled miRNA expression in plasma from 17 patients with first-episode schizophrenia and 17 healthy controls using microarray analysis. Among the miRNAs that showed robust changes, the elevated expression of has-miR-223-3p (miR-223) was validated via quantitative reverse transcription-polymerase chain reaction (qRT-PCR) using another independent sample set of 21 schizophrenia patients and 21 controls. To identify the putative targets of miR-223, we conducted a genome-wide gene expression analysis in neuronally differentiated SK-N-SH cells with stable miR-223 overexpression and an in silico analysis. We found that the mRNA expression levels of four genes related to the cytoskeleton or cell migration were significantly downregulated in miR-223-overexpressing cells, possibly due to interactions with miR-223. The in silico analysis suggested the presence of miR-223 target sites in these four genes. Lastly, a luciferase assay confirmed that miR-223 directly interacted with the 3' untranslated regions (UTRs) of all four genes. Our results reveal an increase in miR-223 in plasma during both the first episode and the later stage of schizophrenia, which may affect the expression of cell migration-related genes targeted by miR-223.
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Affiliation(s)
- Zhilei Zhao
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan ,0000 0001 2151 536Xgrid.26999.3dInternational Research Center for Neurointelligence, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Seiichiro Jinde
- Department of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Shinsuke Koike
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Mariko Tada
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Yoshihiro Satomura
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Akane Yoshikawa
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Yukika Nishimura
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Ryu Takizawa
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Akihide Kinoshita
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Eisuke Sakakibara
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Hanako Sakurada
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Mika Yamagishi
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Fumichika Nishimura
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Aya Inai
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Child Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Masaki Nishioka
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Yosuke Eriguchi
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Child Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Tsuyoshi Araki
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Atsuhiko Takaya
- Department of Psychiatry, Fukui Kinen Hospital, Miura City, Kanagawa 238-0115 Japan
| | - Chiemi Kan
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Maki Umeda
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-0033 Japan ,0000 0001 0318 6320grid.419588.9Department of Public Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo, 104-0044 Japan
| | - Akihito Shimazu
- 0000 0000 9206 2938grid.410786.cCenter for Human and Social Sciences, College of Liberal Arts and Sciences, Kitasato University, Sagamihara City, Kanagawa 252-0373 Japan
| | - Hideki Hashimoto
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Health Economics and Epidemiology Research, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Miki Bundo
- 0000 0001 0660 6749grid.274841.cDepartment of Molecular Brain Science, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto, 860-8556 Japan
| | - Kazuya Iwamoto
- 0000 0001 0660 6749grid.274841.cDepartment of Molecular Brain Science, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto, 860-8556 Japan
| | - Chihiro Kakiuchi
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Kiyoto Kasai
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Neuropsychiatry, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, 113-8655 Japan ,0000 0001 2151 536Xgrid.26999.3dInternational Research Center for Neurointelligence, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033 Japan
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20
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Nakamura M, Takahashi T, Takayanagi Y, Sasabayashi D, Katagiri N, Sakuma A, Obara C, Koike S, Yamasue H, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Surface morphology of the orbitofrontal cortex in individuals at risk of psychosis: a multicenter study. Eur Arch Psychiatry Clin Neurosci 2019; 269:397-406. [PMID: 29572660 DOI: 10.1007/s00406-018-0890-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 03/16/2018] [Indexed: 11/28/2022]
Abstract
Changes in the surface morphology of the orbitofrontal cortex (OFC), such as a fewer orbital sulci and altered sulcogyral pattern of the 'H-shaped' orbital sulcus, have been reported in schizophrenia, possibly reflecting abnormal neurodevelopment during gestation. However, whether high-risk subjects for developing psychosis also exhibit these gross morphologic anomalies is not well documented. This multicenter MRI study from four scanning sites in Japan investigated the distribution of the number of intermediate and posterior orbital sulci, as well as the OFC sulcogyral pattern, in 125 individuals with an at-risk mental state (ARMS) [of whom 22 later developed psychosis (ARMS-P) and 89 did not (ARMS-NP)] and 110 healthy controls. The ARMS group as a whole had a significantly lower number of intermediate and posterior orbital sulci compared with the controls, which was associated with prodromal symptomatology. However, there was no group difference in OFC pattern distribution. The ARMS-P and -NP groups did not differ in OFC surface morphology. These results suggest that gross morphology of the OFC in high-risk subjects may at least partly reflect neurodevelopmental pathology related to vulnerability to psychosis.
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Affiliation(s)
- Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan.
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Japan
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21
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Malda A, Boonstra N, Barf H, de Jong S, Aleman A, Addington J, Pruessner M, Nieman D, de Haan L, Morrison A, Riecher-Rössler A, Studerus E, Ruhrmann S, Schultze-Lutter F, An SK, Koike S, Kasai K, Nelson B, McGorry P, Wood S, Lin A, Yung AY, Kotlicka-Antczak M, Armando M, Vicari S, Katsura M, Matsumoto K, Durston S, Ziermans T, Wunderink L, Ising H, van der Gaag M, Fusar-Poli P, Pijnenborg GHM. Individualized Prediction of Transition to Psychosis in 1,676 Individuals at Clinical High Risk: Development and Validation of a Multivariable Prediction Model Based on Individual Patient Data Meta-Analysis. Front Psychiatry 2019; 10:345. [PMID: 31178767 PMCID: PMC6537857 DOI: 10.3389/fpsyt.2019.00345] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/01/2019] [Indexed: 12/26/2022] Open
Abstract
Background: The Clinical High Risk state for Psychosis (CHR-P) has become the cornerstone of modern preventive psychiatry. The next stage of clinical advancements rests on the ability to formulate a more accurate prognostic estimate at the individual subject level. Individual Participant Data Meta-Analyses (IPD-MA) are robust evidence synthesis methods that can also offer powerful approaches to the development and validation of personalized prognostic models. The aim of the study was to develop and validate an individualized, clinically based prognostic model for forecasting transition to psychosis from a CHR-P stage. Methods: A literature search was performed between January 30, 2016, and February 6, 2016, consulting PubMed, Psychinfo, Picarta, Embase, and ISI Web of Science, using search terms ("ultra high risk" OR "clinical high risk" OR "at risk mental state") AND [(conver* OR transition* OR onset OR emerg* OR develop*) AND psychosis] for both longitudinal and intervention CHR-P studies. Clinical knowledge was used to a priori select predictors: age, gender, CHR-P subgroup, the severity of attenuated positive psychotic symptoms, the severity of attenuated negative psychotic symptoms, and level of functioning at baseline. The model, thus, developed was validated with an extended form of internal validation. Results: Fifteen of the 43 studies identified agreed to share IPD, for a total sample size of 1,676. There was a high level of heterogeneity between the CHR-P studies with regard to inclusion criteria, type of assessment instruments, transition criteria, preventive treatment offered. The internally validated prognostic performance of the model was higher than chance but only moderate [Harrell's C-statistic 0.655, 95% confidence interval (CIs), 0.627-0.682]. Conclusion: This is the first IPD-MA conducted in the largest samples of CHR-P ever collected to date. An individualized prognostic model based on clinical predictors available in clinical routine was developed and internally validated, reaching only moderate prognostic performance. Although personalized risk prediction is of great value in the clinical practice, future developments are essential, including the refinement of the prognostic model and its external validation. However, because of the current high diagnostic, prognostic, and therapeutic heterogeneity of CHR-P studies, IPD-MAs in this population may have an limited intrinsic power to deliver robust prognostic models.
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Affiliation(s)
- Aaltsje Malda
- GGZ Friesland Mental Health Institute, Leeuwarden, Netherlands
- University of Groningen, Groningen, Netherlands
| | - Nynke Boonstra
- GGZ Friesland Mental Health Institute, Leeuwarden, Netherlands
- NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
| | - Hans Barf
- NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
| | | | - Andre Aleman
- University of Groningen, Groningen, Netherlands
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Marita Pruessner
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Dorien Nieman
- Amsterdam University Medical Centers, Location AMC, Department of Psychiatry, Amsterdam, Netherlands
| | - Lieuwe de Haan
- Amsterdam University Medical Centers, Location AMC, Department of Psychiatry, Amsterdam, Netherlands
| | - Anthony Morrison
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | | | - Erich Studerus
- University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Suk Kyoon An
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Shinsuke Koike
- University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Stephen Wood
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Alison Y. Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | | | - Marco Armando
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
- Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva, School of Medicine, Geneva, Switzerland
| | - Stefano Vicari
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center, Utrecht, Netherlands
| | - Tim Ziermans
- Amsterdam University Medical Centers, Location AMC, Department of Psychiatry, Amsterdam, Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Lex Wunderink
- GGZ Friesland Mental Health Institute, Leeuwarden, Netherlands
- University Medical Center Groningen, Groningen, Netherlands
| | - Helga Ising
- Department of Clinical Psychology, VU University, Amsterdam, Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, Department of Psychosis Research, Den Haag, Netherlands
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- National Institute for Health Research, Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Gerdina Hendrika Maria Pijnenborg
- University of Groningen, Groningen, Netherlands
- GGZ Drenthe Mental Health Care Center, Department of Psychotic Disorders, Assen, Netherlands
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22
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Hirt V, Schubring D, Schalinski I, Rockstroh B. Mismatch negativity and cognitive performance in the course of schizophrenia. Int J Psychophysiol 2019; 145:30-39. [PMID: 30684515 DOI: 10.1016/j.ijpsycho.2019.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 01/06/2019] [Accepted: 01/21/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cognitive deficits and abnormal event-related brain potentials (ERP) have been proposed as risk markers for the development of schizophrenia. Evidence is inconclusive whether these markers indicate a risk for the development of psychosis or illness progression. METHODS The present study aimed at further clarification by comparing symptom expression (Brief Psychiatric Rating Scale, BRPS), the ERP Mismatch Negativity (MMN), and neuropsychological performance on the MATRICS Consensus Cognitive Battery between healthy controls (HC, n = 38) and individuals at different stages of illness: individuals at risk for psychosis (ARP, n = 33), patients at first admission, thus, early stage (ES, n = 35), chronic schizophrenia patients (CS, n = 25). Moreover, symptom expression was reassessed for ARP and ES at a 6 months follow-up. RESULTS MMN was smaller in individuals with manifest psychosis (ES, CS) than in HC, but did not differ between ARP and HC. In contrast, ARP showed similar cognitive deficits as ES and CS, all three groups differing from HC. Lower cognitive performance predicted higher symptom severity at index assessments and 6 months follow-up in ARP and ES, while MMN did not explain additional variance. CONCLUSION MMN seems to mark manifest psychosis, independent of early or chronic stage, while cognitive deficits mark early present psychopathology in individuals at risk for and with diagnosed psychosis rather than illness progression.
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Affiliation(s)
- Vanessa Hirt
- Department of Psychology, PO Box 905, University of Konstanz, 78457 Konstanz, Germany.
| | - David Schubring
- Department of Psychology, PO Box 905, University of Konstanz, 78457 Konstanz, Germany.
| | - Inga Schalinski
- Department of Psychology, PO Box 905, University of Konstanz, 78457 Konstanz, Germany.
| | - Brigitte Rockstroh
- Department of Psychology, PO Box 905, University of Konstanz, 78457 Konstanz, Germany.
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23
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Koshiyama D, Kirihara K, Tada M, Nagai T, Fujioka M, Ichikawa E, Ohta K, Tani M, Tsuchiya M, Kanehara A, Morita K, Sawada K, Matsuoka J, Satomura Y, Koike S, Suga M, Araki T, Kasai K. Auditory gamma oscillations predict global symptomatic outcome in the early stages of psychosis: A longitudinal investigation. Clin Neurophysiol 2018; 129:2268-2275. [DOI: 10.1016/j.clinph.2018.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/25/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
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24
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Electrophysiological evidence for abnormal glutamate-GABA association following psychosis onset. Transl Psychiatry 2018; 8:211. [PMID: 30297786 PMCID: PMC6175929 DOI: 10.1038/s41398-018-0261-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/26/2018] [Accepted: 09/07/2018] [Indexed: 12/16/2022] Open
Abstract
Previous studies have shown glutamatergic dysfunction and γ-aminobutyric acid (GABA)-ergic dysfunction in schizophrenia. Animal studies suggest that N-methyl-D-aspartate receptor (NMDAR) dysfunction and GABA-ergic dysfunction interact with each other and lead to alterations in excitatory/inhibitory balance. The NMDAR and GABAergic-interneuron functions may be indexed by mismatch negativity (MMN) and auditory steady-state gamma-band response (ASSR), respectively. However, no previous studies have tested the hypothesis of an abnormal association between MMN and gamma-band ASSR in the same patients to identify the in vivo evidence of NMDAR-GABA association during the early stages of psychosis. Participants were individuals with recent-onset schizophrenia (ROSZ; N = 21), ultra-high risk (UHR; N = 27), and healthy controls (HCs; N = 24). The MMN amplitude was significantly impaired in ROSZ (p = 0.001, d = 1.20) and UHR (p = 0.003, d = 1.01) compared with HCs. The intertrial phase coherence (ITC) index of gamma-band ASSR was significantly reduced in ROSZ compared with HCs (p < 0.001, d = -1.27) and UHR (p = 0.032, d = -0.75). The event-related spectral perturbation (ERSP) index of gamma-band ASSR was significantly smaller in ROSZ compared with HCs (p < 0.001, d = -1.21). The MMN amplitude was significantly correlated with the ITC in ROSZ (r = -0.69, p < 0.001). These findings provide the first in vivo evidence that an abnormal association of the electrophysiological indices of NMDAR and GABA dysfunctions may be present in recent-onset schizophrenia.
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25
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Du Y, Fu Z, Calhoun VD. Classification and Prediction of Brain Disorders Using Functional Connectivity: Promising but Challenging. Front Neurosci 2018; 12:525. [PMID: 30127711 PMCID: PMC6088208 DOI: 10.3389/fnins.2018.00525] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/12/2018] [Indexed: 12/13/2022] Open
Abstract
Brain functional imaging data, especially functional magnetic resonance imaging (fMRI) data, have been employed to reflect functional integration of the brain. Alteration in brain functional connectivity (FC) is expected to provide potential biomarkers for classifying or predicting brain disorders. In this paper, we present a comprehensive review in order to provide guidance about the available brain FC measures and typical classification strategies. We survey the state-of-the-art FC analysis methods including widely used static functional connectivity (SFC) and more recently proposed dynamic functional connectivity (DFC). Temporal correlations among regions of interest (ROIs), data-driven spatial network and functional network connectivity (FNC) are often computed to reflect SFC from different angles. SFC can be extended to DFC using a sliding-window framework, and intrinsic connectivity states along the time-varying connectivity patterns are typically extracted using clustering or decomposition approaches. We also briefly summarize window-less DFC approaches. Subsequently, we highlight various strategies for feature selection including the filter, wrapper and embedded methods. In terms of model building, we include traditional classifiers as well as more recently applied deep learning methods. Moreover, we review representative applications with remarkable classification accuracy for psychosis and mood disorders, neurodevelopmental disorder, and neurological disorders using fMRI data. Schizophrenia, bipolar disorder, autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), Alzheimer's disease and mild cognitive impairment (MCI) are discussed. Finally, challenges in the field are pointed out with respect to the inaccurate diagnosis labeling, the abundant number of possible features and the difficulty in validation. Some suggestions for future work are also provided.
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Affiliation(s)
- Yuhui Du
- The Mind Research Network, Albuquerque, NM, United States
- School of Computer & Information Technology, Shanxi University, Taiyuan, China
| | - Zening Fu
- The Mind Research Network, Albuquerque, NM, United States
| | - Vince D. Calhoun
- The Mind Research Network, Albuquerque, NM, United States
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, United States
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26
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Polari A, Lavoie S, Yuen HP, Amminger P, Berger G, Chen E, deHaan L, Hartmann J, Markulev C, Melville F, Nieman D, Nordentoft M, Riecher-Rössler A, Smesny S, Stratford J, Verma S, Yung A, McGorry P, Nelson B. Clinical trajectories in the ultra-high risk for psychosis population. Schizophr Res 2018; 197:550-556. [PMID: 29463457 DOI: 10.1016/j.schres.2018.01.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 10/19/2017] [Accepted: 01/21/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Traditionally, research in the ultra-high risk (UHR) for psychosis population has focused on the treatment of existing symptomatology and prevention of transition to psychosis. Recently, there has been an increase in focus on outcomes in individuals who do not transition to psychosis. However, there is a lack of standardised definitions of remission, recovery, recurrence and relapse in UHR, resulting in the inability to generalise and replicate outcomes. METHOD The aims of the current study were to develop definitions for remission, recovery, recurrence and relapse, and apply them to a UHR cohort allowing the identification of longitudinal clinical trajectories. Further stratification in broader categories of favourable and unfavourable outcomes was applied. The predictive value of various baseline factors on specific clinical trajectories was also assessed. RESULTS 17 different trajectories were identified in a cohort of 202 individuals within a 12-month period and classified according to the suggested definitions for recovery (35.7%), remission (7.5%), any recurrence (20%), no remission (17.3%), relapse (4.0%) and transition to psychosis (15.8%). Favourable and unfavourable trajectories represented 43.2% and 57.1% respectively. Long duration of untreated symptoms and high depression scores were associated with unfavourable outcomes. DISCUSSION It is possible to apply clear definitions of remission, recovery, recurrence, relapse and transition to psychosis to a UHR cohort to evaluate longitudinal clinical trajectories. Acceptance and use of these definitions will help to facilitate comparisons between trials and to improve clinical clarity across the range of available therapeutic options in UHR individuals.
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Affiliation(s)
- Andrea Polari
- Orygen Youth Health, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Suzie Lavoie
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Hok-Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
| | - Eric Chen
- Department of Psychiatry, the University of Hong Kong, Hong Kong, China
| | - Lieuwe deHaan
- Academic Medical Centre, University of Amsterdam and Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Jessica Hartmann
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Connie Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | | | - Dorien Nieman
- Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
| | | | - Anita Riecher-Rössler
- University of Basel, Psychiatric University Clinics, Centre for Gender Research and Early Detection, Basel, Switzerland
| | - Stefan Smesny
- Universitätsklinikum Jena, Department of Psychiatry, Jena, Germany
| | | | - Swapna Verma
- Early Psychosis Intervention Programme (EPIP), Institute of Mental Health, Singapore
| | - Alison Yung
- Division of Psychology and Mental Health, School of Health Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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27
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Koshiyama D, Kirihara K, Tada M, Nagai T, Fujioka M, Koike S, Suga M, Araki T, Kasai K. Association between mismatch negativity and global functioning is specific to duration deviance in early stages of psychosis. Schizophr Res 2018; 195:378-384. [PMID: 28986006 DOI: 10.1016/j.schres.2017.09.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/11/2017] [Accepted: 09/24/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Mismatch negativity (MMN) is a candidate biomarker for early stages of psychosis. Although an association among duration MMN (dMMN), cognitive deficits, and functional outcome in chronic schizophrenia has been shown by a large-scale study, the effects of deviant type and clinical stages have not been investigated. METHODS We investigated the relationships among dMMN, frequency MMN (fMMN), global functioning, and cognitive function in early stages of psychosis. The participants included 26 individuals with recent-onset schizophrenia (ROSZ), 30 individuals with ultra-high risk (UHR), and 20 healthy controls. RESULTS The correlational analyses revealed that dMMN amplitude, which was impaired in the ROSZ group compared to the healthy controls, correlated with global functioning (Global Assessment of Functioning-Functioning scale) in the ROSZ (r=-0.45) and UHR (r=-0.37) groups. The amplitude of fMMN, which did not differ among the groups, correlated with working memory (r=-0.57) only in the ROSZ group. The path analyses indicated that dMMN had a direct effect on global functioning in the ROSZ and UHR groups while fMMN had a direct effect on working memory only in the ROSZ group. CONCLUSIONS Our findings suggested that the association between MMN and global functioning was specific to the duration deviant and was already present in early stages of psychosis. These findings confirm the usefulness of dMMN as a biological marker of early psychosis to guide treatment interventions.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Psychiatry, Kawamuro Memorial Hospital, Niigata, Japan
| | - Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan; Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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28
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Koshiyama D, Kirihara K, Tada M, Nagai T, Koike S, Suga M, Araki T, Kasai K. Duration and frequency mismatch negativity shows no progressive reduction in early stages of psychosis. Schizophr Res 2017; 190:32-38. [PMID: 28314681 DOI: 10.1016/j.schres.2017.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 10/20/2022]
Abstract
The auditory mismatch negativity (MMN) is a component of event-related potentials, which is being increasingly recognized as a candidate biomarker for early stages of psychosis. Although previous cross-sectional studies have demonstrated small MMN amplitude in early stages of psychosis, it remains unknown whether small MMN amplitude is due to progressive reduction during the early course. In this study, we investigated longitudinal changes of MMN in early stages of psychosis. Participant included 14 patients with first-episode psychosis (FEP), 16 individuals with ultra-high risk (UHR), and 16 healthy control subjects (HC). We measured MMN in response to duration deviants (dMMN) and that in response to frequency deviants (fMMN), respectively. The amplitudes of dMMN in FEP and UHR were significantly smaller in comparison to those in HC, which did not show a progressive decrease over time. The amplitude of fMMN did not differ among groups, which again did not show progression. There was no significant correlation between the length of the follow-up period and the longitudinal change of either deviant-type MMN in the FEP or UHR. These results suggest that dMMN is a trait marker in the early stages of psychosis, and that small dMMN amplitude in early stages of psychosis may reflect altered developmental process rather than progressive brain pathology. The amplitude of fMMN may not alter in early stages of psychosis. These findings may contribute to the future establishment of MMN as a biomarker in early stages of psychosis.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Psychiatry, Kawamuro Memorial Hospital, Niigata, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan; Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Koike S, Satomura Y, Kawasaki S, Nishimura Y, Kinoshita A, Sakurada H, Yamagishi M, Ichikawa E, Matsuoka J, Okada N, Takizawa R, Kasai K. Application of functional near infrared spectroscopy as supplementary examination for diagnosis of clinical stages of psychosis spectrum. Psychiatry Clin Neurosci 2017; 71:794-806. [PMID: 28692185 DOI: 10.1111/pcn.12551] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/28/2017] [Accepted: 07/05/2017] [Indexed: 12/18/2022]
Abstract
AIM Research efforts aiming at neuroimaging-aided differential diagnosis for psychiatric disorders have been progressing rapidly. A previous multisite study has developed a supplementary diagnostic system using functional near-infrared spectroscopy (fNIRS) that can be easily applied to clinical settings. However, few neuroimaging biomarkers have been developed for the psychosis spectrum with various clinical stages. METHODS We employed the fNIRS as a clinical examination device for 143 participants, comprising 47 ultra-high risk for psychosis (UHR) individuals, 30 patients with first-episode psychosis (FEP), 34 patients with chronic schizophrenia (ChSZ), and 33 healthy controls, who were independent of the previous study. A 12-month follow-up measurement was also carried out on 34 UHR individuals (72%), 21 patients with FEP (70%), and 33 controls. The fNIRS algorithm variables used for classification were the intensity and timing of prefrontal activation following the start of the cognitive task as used in the previous multisite study. RESULTS The discrimination rate by timing of activation was modest but it became acceptable after adjusting confounding factors. Discrimination by intensity of activation was not improved by similar adjustment. A total of 63.8%, 86.7%, and 81.3% patients were classified as UHR, FEP, and ChSZ, respectively; and 85.1%, 86.7%, and 71.9% of patients in these groups, respectively, were classified as being on the psychosis spectrum. In the follow-up measurement, 88.2% of individuals with UHR and 95.0% of patients with FEP were successfully classified into the psychosis spectrum group. CONCLUSION The fNIRS for supplementary clinical examination could be validly applied to differentiating people with the psychosis spectrum in various clinical stages. The fNIRS is a candidate biological marker for aiding diagnosis of psychosis spectrum in routine clinical settings.
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Affiliation(s)
- Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM).,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Shingo Kawasaki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo.,Application Development Office, Hitachi Medical Corporation, Chiba, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Akihide Kinoshita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Hanako Sakurada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Mika Yamagishi
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Eriko Ichikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Jun Matsuoka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Ryu Takizawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo
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30
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Sasabayashi D, Takayanagi Y, Takahashi T, Koike S, Yamasue H, Katagiri N, Sakuma A, Obara C, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Increased Occipital Gyrification and Development of Psychotic Disorders in Individuals With an At-Risk Mental State: A Multicenter Study. Biol Psychiatry 2017; 82:737-745. [PMID: 28709499 DOI: 10.1016/j.biopsych.2017.05.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anomalies of brain gyrification have been reported in schizophrenia, possibly reflecting its neurodevelopmental pathology. However, it remains elusive whether individuals at risk for psychotic disorders exhibit deviated gyrification patterns, and whether such findings, if present, are predictive of transition to psychotic disorders. METHODS This multicenter magnetic resonance imaging study investigated brain gyrification and its relationship to later transition to psychotic disorders in a large sample of at-risk mental state (ARMS) individuals. T1-weighted magnetic resonance imaging scans were obtained from 104 ARMS individuals, of whom 21 (20.2%) exhibited the transition to psychotic disorders during clinical follow-up (mean = 4.9 years, SD = 2.6 years), and 104 healthy control subjects at 4 different sites. The local gyrification index (LGI) of the entire cortex was compared across the groups using FreeSurfer software. RESULTS Compared with the control subjects, ARMS individuals showed a significantly higher LGI in widespread cortical areas, including the bilateral frontal, temporal, parietal, and occipital regions, which was partly associated with prodromal symptomatology. ARMS individuals who exhibited the transition to psychotic disorders showed a significantly higher LGI in the left occipital region compared with individuals without transition. CONCLUSIONS These findings suggested that increased LGI in diverse cortical regions might represent vulnerability to psychopathology, while increased LGI in the left occipital cortex might be related to subsequent manifestation of florid psychotic disorders as a possible surrogate marker.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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31
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Nagai T, Kirihara K, Tada M, Koshiyama D, Koike S, Suga M, Araki T, Hashimoto K, Kasai K. Reduced Mismatch Negativity is Associated with Increased Plasma Level of Glutamate in First-episode Psychosis. Sci Rep 2017; 7:2258. [PMID: 28536477 PMCID: PMC5442101 DOI: 10.1038/s41598-017-02267-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 04/10/2017] [Indexed: 01/17/2023] Open
Abstract
Reduced amplitude of mismatch negativity (MMN) is one of the more promising biological markers of schizophrenia. This finding holds true in both early and chronic phases of the disorder, and is compatible with the glutamatergic dysfunction hypothesis. To further establish MMN as a biomarker of aberrant glutamatergic neurotransmission, an exploration for an association with blood levels of glutamatergic amino acids is an important next step. Despite a large body of work investigating MMN in schizophrenia, no previous studies have undertaken this endeavor. Nineteen patients with first-episode psychosis (FEP), 21 ultra-high risk individuals (UHR), and 16 healthy controls (HC) participated in the study. The MMNs in response to duration change (dMMN) and frequency change (fMMN) were measured. The fasting plasma levels of glutamate, glutamine, glycine, D-serine, and L-serine were measured. dMMN amplitudes were significantly reduced in FEP and UHR, compared to HC. The plasma levels of glutamate of FEP were significantly higher than those of HC. Higher plasma levels of glutamate were associated with smaller dMMN amplitudes in the FEP and HC groups. These findings are compatible with the hypothesis that MMN is a useful biological marker of aberrant glutamatergic neurotransmission in the early stages of schizophrenia.
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Affiliation(s)
- Tatsuya Nagai
- Department of Psychiatry, Kawamuro Memorial Hospital 71-Ko, Ohaza, Kitashinpo, Joetsu-shi, Niigata-ken, 943-0109, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shinsuke Koike
- Office for Counseling and Support, Division for Mental Health Support, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Motomu Suga
- Department of Rehabilitation, Graduate School of Medicine, University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tsuyoshi Araki
- Department of Youth Mental Health, Graduate School of Medicine, University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health 1-8-1, Inohana, Chuuoku-ku, Chiba-shi, Chiba-ken, 260-8670, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Sawada K, Kanehara A, Sakakibara E, Eguchi S, Tada M, Satomura Y, Suga M, Koike S, Kasai K. Identifying neurocognitive markers for outcome prediction of global functioning in individuals with first-episode and ultra-high-risk for psychosis. Psychiatry Clin Neurosci 2017; 71:318-327. [PMID: 28294477 DOI: 10.1111/pcn.12522] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/05/2017] [Accepted: 03/07/2017] [Indexed: 02/04/2023]
Abstract
AIM There is an increasing need for identifying neurocognitive predictors of global functional outcome in early psychosis toward optimizing an early intervention strategy. METHODS We conducted a longitudinal observational study to investigate an association between neurocognitive assessments at baseline and global functional outcome at an average of 1-year follow up. Participants included ultra-high-risk for psychosis (UHR) individuals who had not converted to psychosis during the follow-up period (UHR-NP) and those with first-episode psychosis (FEP). We evaluated neurocognition at baseline using the Brief Assessment of Cognition in Schizophrenia Japanese version, including Verbal Memory, Working Memory, Motor Speed, Verbal Fluency, Attention/Processing Speed, and Executive Function. We also assessed global functional outcome using the modified Global Assessment of Functioning (mGAF) scale both at baseline and after the follow-up period. RESULTS Thirty-four UHR-NP individuals (34/47, 72%) and 29 FEP individuals (29/36, 81%) completed assessment of neurocognitive function at baseline and functional outcome at follow up. In the UHR-NP group, Attention/Processing Speed was significantly associated with the mGAF score at follow up. In the FEP group, Executive Function was significantly associated with the average mGAF score during follow up. CONCLUSION Attention/Processing Speed and Executive Function at baseline may predict global functional outcome of early psychosis. These neurocognitive tests are easy to incorporate in clinical settings and, if replicated in independent samples, may be included in routine clinical assessments for prediction of functional outcome in early psychosis.
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Affiliation(s)
- Kingo Sawada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Kanehara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eisuke Sakakibara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Eguchi
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Takano Y, Aoki Y, Yahata N, Kawakubo Y, Inoue H, Iwashiro N, Natsubori T, Koike S, Gonoi W, Sasaki H, Takao H, Kasai K, Yamasue H. Neural basis for inferring false beliefs and social emotions in others among individuals with schizophrenia and those at ultra-high risk for psychosis. Psychiatry Res Neuroimaging 2017; 259:34-41. [PMID: 27960147 DOI: 10.1016/j.pscychresns.2016.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 11/12/2016] [Accepted: 11/20/2016] [Indexed: 01/14/2023]
Abstract
Inferring beliefs and social emotions of others has different neural substrates and possibly different roles in the pathophysiology of different clinical phases of schizophrenia. The current study investigated the neural basis for inferring others' beliefs and social emotions, as individual concepts, in 17 subjects at ultra-high risk for psychosis (UHR), 16 patients with schizophrenia and 20 healthy controls. Brain activity significantly differed from normal in both the left superior temporal sulcus (STS) and the inferior frontal gyrus (IFG) in the schizophrenia group while inferring others' beliefs, whereas those of UHR group were in the middle of those in the schizophrenia and healthy-control groups. Brain activity during inferring others' social emotions significantly differed in both the left STS and right IFG among individuals at UHR; however, there was no significant difference in the schizophrenia group. In contrast, brain activity differed in the left IFG of those in both the schizophrenia and UHR groups while inferring social emotion. Regarding the difference in direction of the abnormality, both the UHR and schizophrenia groups were characterized by hyper-STS and hypo-IFG activations when inferring others' beliefs and emotions. These findings might reflect different aspects of the same pathophysiological process at different clinical phases of psychosis.
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Affiliation(s)
- Yosuke Takano
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yuta Aoki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; The Child Study Center at NYU Langone Medical Center, One Park Avenue, New York, NY 10016, USA
| | - Noriaki Yahata
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yuki Kawakubo
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideyuki Inoue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Norichika Iwashiro
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Tatsunobu Natsubori
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hiroki Sasaki
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hidemasa Takao
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu City 431-3192, Japan.
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34
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Kim SW, Lee BJ, Kim JJ, Yu JC, Lee KY, Won SH, Lee SH, Kim SH, Kang SH, Chung YC. Design and Methodology of the Korean Early Psychosis Cohort Study. Psychiatry Investig 2017; 14:93-99. [PMID: 28096881 PMCID: PMC5240457 DOI: 10.4306/pi.2017.14.1.93] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/21/2016] [Accepted: 03/28/2016] [Indexed: 11/19/2022] Open
Abstract
The present study details the rationale and methodology of the Korean Early Psychosis Cohort Study (KEPS), which is a clinical cohort investigation of first episode psychosis patients from a Korean population. The KEPS is a prospective naturalistic observational cohort study that follows the participants for at least 2 years. This study includes patients between 18 and 45 years of age who fulfill the criteria for one of schizophrenia spectrum and other psychotic disorders according to the diagnostic criteria of DSM-5. Early psychosis is defined as first episode patients who received antipsychotic treatment for fewer than 4 consecutive weeks after the onset of illness or stabilized patients in the early stages of the disorder whose duration of illness was less than 2 years from the initiation of antipsychotic treatment. The primary outcome measures are treatment response, remission, recovery, and relapse. Additionally, several laboratory tests are conducted and a variety of objective and subjective psychiatric measures assessing early life trauma, lifestyle pattern, and social and cognitive functioning are administered. This long-term prospective cohort study may contribute to the development of early intervention strategies and the improvement of long-term outcomes in patients with schizophrenia.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Jung Jin Kim
- Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Je-Chun Yu
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - Kyu Young Lee
- Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea
| | - Shi Hyun Kang
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
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Association between impaired brain activity and volume at the sub-region of Broca's area in ultra-high risk and first-episode schizophrenia: A multi-modal neuroimaging study. Schizophr Res 2016; 172:9-15. [PMID: 26873807 DOI: 10.1016/j.schres.2016.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/31/2016] [Accepted: 02/03/2016] [Indexed: 11/24/2022]
Abstract
Recent studies have suggested that functional abnormalities in Broca's area, which is important in language production (speech and thoughts before speech), play an important role in the pathophysiology of schizophrenia. While multi-modal approaches have proved useful in revealing the specific pathophysiology of psychosis, the association of functional abnormalities with gray matter volume (GMV) here in subjects with an ultra-high risk (UHR) of schizophrenia, those with first-episode schizophrenia (FES), and healthy controls has yet to be clarified. Therefore, the relationship between cortical activity measured using functional near-infrared spectroscopy (fNIRS) during a verbal fluency task, and GMV in the Broca's area assessed using a manual tracing in magnetic resonance imaging (MRI), which considers individual structural variation, was examined for 57 subjects (23 UHR/18 FES/16 controls). The UHR and FES group showed significantly reduced brain activity compared to control group in the left pars triangularis (PT) (P=.036, .003, respectively). Furthermore in the FES group, the reduced brain activity significantly positively correlated with the volume in the left PT (B=0.29, P=.027), while significant negative association was evident for all subjects (B=-0.18, P=.010). This correlation remained significant after adjusting for antipsychotics dosage, and voxel-wise analysis could not detect any significant correlation between impaired cortical activity and volume. The significant relationship between neural activity and GMV in the left PT may reflect a specific pathophysiology related to the onset of schizophrenia.
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Association between rostral prefrontal cortical activity and functional outcome in first-episode psychosis: a longitudinal functional near-infrared spectroscopy study. Schizophr Res 2016; 170:304-10. [PMID: 26792296 DOI: 10.1016/j.schres.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/24/2015] [Accepted: 01/01/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Few biomarkers can be used easily and noninvasively to measure clinical condition and future outcome in patients with first-episode psychosis (FEP). To develop such biomarker using multichannel functional near-infrared spectroscopy (fNIRS), cortical function in the prefrontal cortex was longitudinally measured during a verbal fluency task. METHODS Sixty-nine fNIRS measurements and 77 clinical assessments were obtained from 31 patients with FEP at baseline, 6-month, and 12-month follow-ups. Sixty measurements were obtained from 30 healthy controls matched for age, sex, and premorbid IQ. We initially tested signal changes for 12 months, and then investigated the relationship between fNIRS signals and clinical assessments. RESULTS Signal changes from baseline to 12-month follow-up were not evident in any group. Patients with FEP had significant positive correlation coefficients between 6-month fNIRS signals and the 12-month Global Assessment of Functioning (GAF) score in the left middle frontal gyrus (FDR-corrected p=.0016-.0052, r=.65-.59). fNIRS signals at the 12-month follow-up were associated with 12-month GAF score in the bilateral superior and middle frontal gyri (FDR-corrected p=.00085-.018, r=.72-.55), and with the difference between baseline and 12-month GAF scores in the right superior frontal gyrus (FDR-corrected p=.000067-.00012, r=.80-.78). These associations were significant even after controlling for demographic variables. No association between baseline fNIRS signals and later GAF scores was found. DISCUSSION fNIRS measurement can potentially be used as a biomarker to aid sequential assessment of neuro-clinical conditions through the early stage of psychosis.
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Rocchetti M, Sardella A, Avila A, Brandizzi M, Caverzasi E, Politi P, Ruhrmann S, McGuire P, Fusar-Poli P. Authors' reply. Br J Psychiatry 2016; 208:197-8. [PMID: 26834172 DOI: 10.1192/bjp.208.2.197a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Matteo Rocchetti
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Alberto Sardella
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Alessia Avila
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Martina Brandizzi
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Edgardo Caverzasi
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Pierluigi Politi
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Stephan Ruhrmann
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Philip McGuire
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Paolo Fusar-Poli
- Matteo Rocchetti, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK, and Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy. ; Alberto Sardella, Alessia Avila, Department of Psychosis Studies, IoPPN, King's College London, UK; Martina Brandizzi, Department of Psychosis Studies, IoPPN, King's College London, UK, and Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Rome, Italy; Edgardo Caverzasi, Pierluigi Politi, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Stephan Ruhrmann, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; Philip McGuire, Paolo Fusar-Poli, Department of Psychosis Studies, IoPPN, King's College London, and OASIS Prodromal Team, South London and the Maudsley NHS Foundation Trust, London, UK
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Balda M, Calvó M, Padilla E, Guerrero G, Molina J, Florenzano NV, Kamis D, Escobar JI, Cloninger CR, de Erausquin G. Detection, Assessment, and Management of Schizophrenia in an Andean Population of South America: Parkinsonism Testing and Transcranial Ultrasound as Preventive Tools. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2015; 13:432-440. [PMID: 26516317 DOI: 10.1176/appi.focus.20150018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Schizophrenia is a debilitating psychiatric illness that is among the world's top 10 causes of long-term disability, affecting people who are just entering the peak of social, economic, and intellectual productivity. Such functional loss is particularly relevant in indigenous communities, which rely on change in functional status (rather than on the presence of symptoms) to identify mental illness. Particularly among the indigenous communities of Latin America, the gap between mental health need and availability of resources to reduce the burden has been judged "a case of outrageous exclusion." For more than a decade, as part of the Investigation of Movement Abnormalities and Genetic of Schizophrenia study, the authors have been studying vulnerability markers (genetic, motor, imaging, and neuropsychological differences) for schizophrenia in a remote, indigenous population in rural northern Argentina. In this article, the authors discuss the implementation of a task-shifting paradigm resulting in more proficient identification and referral of individuals with untreated psychosis and a severalfold reduction in the duration of untreated psychosis, with very high retention rates (70%) and treatment adherence during a decade in a rural environment. The authors also propose to use transcranial ultrasound screening and testing for parkinsonism at illness onset before introduction of neuroleptics as potentially useful markers in determining illness severity, negative symptomatology, and tolerance to antipsychotic treatment/refractoriness.
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Affiliation(s)
- Mara Balda
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, and Roskamp Laboratory for Brain Development, Modulation and Repair, Morsani College of Medicine, University of South Florida, Tampa
| | - Maria Calvó
- Fundación de Lucha contra los Trastornos Neurológicos y Psiquiátricos en Minorías (FULTRA), Buenos Aires, Argentina
| | - Eduardo Padilla
- Ministerio de Salud, Hospital Neuropsiquiátrico Néstor Sequeiros, Provinicia de Jujuy, Argentina
| | - Gonzalo Guerrero
- FULTRA, Buenos Aires, Argentina; and Hospital Neuropsiquiátrico Néstor Sequeiros, Provinicia de Jujuy, Argentina
| | - Juan Molina
- Roskamp Laboratory for Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa
| | | | - Danielle Kamis
- Roskamp Laboratory for Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa
| | - Javier I Escobar
- Department of Global Health and Department of Psychiatry and Family Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - C Robert Cloninger
- Sansone Family Center for Well-Being and Center for Psychobiology of Personality, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Gabriel de Erausquin
- Roskamp Laboratory for Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa
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Schultze-Lutter F, Michel C, Schmidt SJ, Schimmelmann BG, Maric NP, Salokangas RKR, Riecher-Rössler A, van der Gaag M, Nordentoft M, Raballo A, Meneghelli A, Marshall M, Morrison A, Ruhrmann S, Klosterkötter J. EPA guidance on the early detection of clinical high risk states of psychoses. Eur Psychiatry 2015; 30:405-16. [PMID: 25735810 DOI: 10.1016/j.eurpsy.2015.01.010] [Citation(s) in RCA: 256] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 01/15/2023] Open
Abstract
The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion 'cognitive disturbances' (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The 'genetic risk and functional decline' UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states.
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Affiliation(s)
- F Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - C Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - S J Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - B G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - N P Maric
- School of Medicine, University of Belgrade and Clinic of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia
| | | | - A Riecher-Rössler
- Center for Gender Research and Early Detection, Psychiatric University Clinics Basel, Basel, Switzerland
| | - M van der Gaag
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - M Nordentoft
- Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - A Raballo
- Department of Mental Health, Reggio Emilia Public Health Centre, Reggio Emilia, Italy; Regional Working Group on Early Detection of Psychosis, Emilia Romagna Regional Health Service, Bologna, Italy
| | - A Meneghelli
- Dipartimento di Salute Mentale, Centro per l'Individuazione e l'Intervento Precoce nelle Psicosi-Programma 2000, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - M Marshall
- School of Medicine, University of Manchester, Manchester, UK; LANTERN Centre, Lancashire Care NHS Foundation Trust, Preston, UK
| | - A Morrison
- School of Psychological Sciences, University of Manchester, Manchester, UK; Psychosis Research Unit, Greater Manchester West NHS Mental Health Trust, Manchester, UK
| | - S Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - J Klosterkötter
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
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Schubert KO, Clark SR, Baune BT. The use of clinical and biological characteristics to predict outcome following First Episode Psychosis. Aust N Z J Psychiatry 2015; 49:24-35. [PMID: 25430911 DOI: 10.1177/0004867414560650] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Psychotic illnesses such as schizophrenia and other non-affective psychoses are heterogeneous in disease course and functional outcomes. We review evidence from investigations in clinical psychiatry, neuroimaging, neurocognition, and blood biomarker research suggesting that distinct bio-psycho-social patterns exist at the onset and during the early phase of a First Episode Psychosis (FEP), which can describe the risk of individual illness progression and functional trajectories. METHOD A selective literature review was performed on articles drawn from Medline searches for relevant key words. A simulation model was constructed from data derived from two recent publications, selected as examples of studies that investigated multivariate predictors of long-term outcome following FEP. RESULTS We illustrate how illness trajectories following FEP could be described based on multimodal sociodemographic, clinical, psychological, and neurobiological information. A clinical modeling simulation shows thatrisk trajectories for achieving long-term favorable or unfavorable outcomes can differ significantly depending on baseline characteristics in combination with MRI and functional measurements within 6 months of disease onset. CONCLUSIONS Multimodal trajectory modeling may be useful to describe longitudinal outcomes following FEP. Richlongitudinal data on predictors and outcomes, and better integration of multimodal (sociodemographic, clinical, psychological, biological) data, are required to operationalize this approach. This technique may improve our understanding of course of illness and help to provide a more personalized approach to the assessment and treatment of people presenting with FEP.
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Affiliation(s)
- K Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
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Tada M, Nagai T, Kirihara K, Koike S, Suga M, Araki T, Kobayashi T, Kasai K. Differential Alterations of Auditory Gamma Oscillatory Responses Between Pre-Onset High-Risk Individuals and First-Episode Schizophrenia. Cereb Cortex 2014; 26:1027-1035. [PMID: 25452567 DOI: 10.1093/cercor/bhu278] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Alterations in gamma-band auditory steady-state response (ASSR) are the most robust finding of abnormal neural oscillations in patients with first-episode (FES) and chronic schizophrenia. Gamma-band ASSRs may indicate GABAergic interneuron dysfunction. Nevertheless, it is unknown whether abnormal gamma-band ASSRs are present before the onset of psychosis. Subjects were 15 ultra-high-risk (UHR) individuals, 13 FES patients, and 21 healthy control (HC) subjects. We performed electroencephalogram recordings and measured ASSRs in each group as they were presented with click trains at 20, 30, and 40 Hz. We then conducted time-frequency analyses and calculated intertrial phase coherence and event-related spectral perturbation. The time course of gamma-band ASSRs showed significantly different features among groups. Compared with the HC group, the UHR group was characterized by intact early-latency (0-100 ms) and reduced late-latency (300-500 ms) ASSRs. In contrast, both early- and late-latency ASSRs were significantly reduced in the FES group. Gamma-band ASSRs were correlated with clinical symptoms and attentional functioning in FES (|rs| > 0.70). These results suggest differential alterations of gamma-band ASSRs between UHR and FES groups. The late-latency ASSR alteration may represent a biomarker for early detection of psychosis, while the early-latency ASSR abnormality may develop through the onset of psychosis.
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Affiliation(s)
- Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine
| | - Tatsuya Nagai
- Department of Neuropsychiatry, Graduate School of Medicine
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine.,Office for Mental Health Support, Division for Counseling and Support
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine
| | - Tsuyoshi Araki
- Department of Youth Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Tetsuo Kobayashi
- Department of Electrical Engineering, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto 615-8530, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine.,Japan Science and Technology Agency (JST), National Bioscience Database Center (NBDC), Kawaguchi-shi, Saitama 332-0012, Japan
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Clark SR, Schubert KO, Baune BT. Towards indicated prevention of psychosis: using probabilistic assessments of transition risk in psychosis prodrome. J Neural Transm (Vienna) 2014; 122:155-69. [PMID: 25319445 DOI: 10.1007/s00702-014-1325-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 10/08/2014] [Indexed: 12/11/2022]
Abstract
The concept of indicated prevention has proliferated in psychiatry, and accumulating evidence suggests that it may indeed be possible to prevent or delay the onset of a first episode of psychosis though adequate interventions in individuals deemed at clinical high risk (CHR) for such an event. One challenge undermining these efforts is the relatively poor predictive accuracy of clinical assessments used in practice for CHR individuals, often leading to diagnostic and therapeutic uncertainty reflected in clinical guidelines promoting a 'watch and wait' approach to CHR patients. Using data from published studies, and employing predictive models based on the odds-ratio form of Bayes' rule, we simulated scenarios where clinical interview, neurocognitive testing, structural magnetic resonance imaging and electrophysiology are part of the initial assessment process of a CHR individual (extended diagnostic approach). Our findings indicate that for most at-risk patients, at least three of these assessments are necessary to arrive at a clinically meaningful differentiation into high- intermediate-, and low-risk groups. In particular, patients with equivocal results in the initial assessments require additional diagnostic testing to produce an accurate risk profile forming part of the comprehensive initial assessment. The findings may inform future research into reliable identification and personalized therapeutic targeting of CHR patients, to prevent transition to full-blown psychosis.
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Affiliation(s)
- Scott Richard Clark
- School of Medicine, Discipline of Psychiatry, Royal Adelaide Hospital, University of Adelaide, 4th Floor, Eleanor Harrald Building, 5005, Adelaide, SA, Australia
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Natsubori T, Inoue H, Abe O, Takano Y, Iwashiro N, Aoki Y, Koike S, Yahata N, Katsura M, Gonoi W, Sasaki H, Takao H, Kasai K, Yamasue H. Reduced frontal glutamate + glutamine and N-acetylaspartate levels in patients with chronic schizophrenia but not in those at clinical high risk for psychosis or with first-episode schizophrenia. Schizophr Bull 2014; 40:1128-39. [PMID: 24023251 PMCID: PMC4133658 DOI: 10.1093/schbul/sbt124] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Changes in brain pathology as schizophrenia progresses have been repeatedly suggested by previous studies. Meta-analyses of previous proton magnetic resonance spectroscopy ((1)H MRS) studies at each clinical stage of schizophrenia indicate that the abnormalities of N-acetylaspartate (NAA) and glutamatergic metabolites change progressively. However, to our knowledge, no single study has addressed the possible differences in (1)H MRS abnormalities in subjects at 3 different stages of disease, including those at ultrahigh risk for psychosis (UHR), with first-episode schizophrenia (FES), and with chronic schizophrenia (ChSz). In the current study, 24 patients with UHR, 19 FES, 25 ChSz, and their demographically matched 3 independent control groups (n = 26/19/28 for the UHR, FES, and ChSz control groups, respectively) underwent (1)H MRS in a 3-Tesla scanner to examine metabolites in medial prefrontal cortex. The analysis revealed significant decreases in the medial prefrontal NAA and glutamate + glutamine (Glx) levels, specifically in the ChSz group as indexed by a significant interaction between stage (UHR/FES/ChSz) and clinical status (patients/controls) (P = .008). Furthermore, the specificity of NAA and Glx reductions compared with the other metabolites in the patients with ChSz was also supported by a significant interaction between the clinical status and types of metabolites that only occurred at the ChSz stage (P = .001 for NAA, P = .004 for Glx). The present study demonstrates significant differences in (1)H MRS abnormalities at different stages of schizophrenia, which potentially correspond to changes in glutamatergic neurotransmission, plasticity, and/or excitotoxicity and regional neuronal integrity with relevance for the progression of schizophrenia.
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Affiliation(s)
- Tatsunobu Natsubori
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideyuki Inoue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Radiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yosuke Takano
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norichika Iwashiro
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuta Aoki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriaki Yahata
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaki Katsura
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Sasaki
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidemasa Takao
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;
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A snapshot of plasma metabolites in first-episode schizophrenia: a capillary electrophoresis time-of-flight mass spectrometry study. Transl Psychiatry 2014; 4:e379. [PMID: 24713860 PMCID: PMC4012283 DOI: 10.1038/tp.2014.19] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/20/2014] [Accepted: 02/23/2014] [Indexed: 02/04/2023] Open
Abstract
Few biomarkers have been known that can easily measure clinical conditions in mental illnesses such as schizophrenia. Capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS) is a new method that can measure ionized and low-molecular-weight metabolites. To explore global metabolomic alterations that characterize the onset of schizophrenia and identify biomarkers, we profiled the relative and absolute concentrations of the plasma metabolites from 30 patients with first-episode schizophrenia (FESZ, four drug-naïve samples), 38 healthy controls and 15 individuals with autism spectrum disorders using CE-TOFMS. Five metabolites had robust changes (increased creatine and decreased betaine, nonanoic acid, benzoic acid and perillic acid) in two independent sample sets. Altered levels of these metabolites are consistent with well-known hypotheses regarding abnormalities of the homocysteine metabolism, creatine kinase-emia and oxidative stress. Although it should be considered that most patients with FESZ received medication, these metabolites are candidate biomarkers to improve the determination of diagnosis, severity and clinical stages, especially for FESZ.
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Chou PH, Koike S, Nishimura Y, Kawasaki S, Satomura Y, Kinoshita A, Takizawa R, Kasai K. Distinct effects of duration of untreated psychosis on brain cortical activities in different treatment phases of schizophrenia: a multi-channel near-infrared spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2014; 49:63-9. [PMID: 24275075 DOI: 10.1016/j.pnpbp.2013.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/28/2013] [Accepted: 11/14/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Duration of untreated psychosis (DUP) has been shown to be associated with both poor short-term and long-term outcomes in schizophrenia. Even so, few studies have used functional neuroimaging to investigate DUP in schizophrenia. In the present study, we used near-infrared spectroscopy (NIRS) to investigate the influence of DUP on brain functions during a verbal fluency test (VFT) in patients with schizophrenia. METHODS A total of 62 patients with schizophrenia were included. They were categorized into either short treatment (≤6months, n=33) or long treatment (>6months, n=29) groups based on their duration of treatment. Hemodynamic changes over the frontotemporal regions during a VFT were measured using multi-channel NIRS. We examined the associations between DUP and hemodynamic changes in each group to explore if there were different effects of DUP on brain cortical activity at different treatment durations. RESULTS In the long treatment group, we found significant associations between a longer DUP and decreased cortical activity approximately at the left inferior frontal gyrus, left middle frontal gyrus, left postcentral gyrus, right precentral gyrus, bilateral superior temporal gyrus, and bilateral middle temporal gyrus, whereas no associations between DUP and brain cortical activity were observed in the short treatment group. CONCLUSIONS Our results indicated that longer DUP may be associated with decreased level of cortical activities over the frontotemporal regions in the long-term. Early detection and intervention of psychosis that shortens DUP might help to improve the long-term outcomes in patients with schizophrenia.
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Affiliation(s)
- Po-Han Chou
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan; Department of Psychiatry, Taichung Veterans General Hospital, Taichung City, 40705, Taiwan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan; Office for Mental Health Support, Division for Counseling and Support, the University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shingo Kawasaki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan; Application Development Office, Hitachi Medical Corporation, Kashiwa City, Chiba 277-0804, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akihide Kinoshita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryu Takizawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Penadés R, Catalán R, López-Vílchez I, Arias B, González-Rodríguez A, Galán AM, Gastó C. Brain-derived neurotrophic factor as a potential biomarker of cognitive recovery in schizophrenia. World J Psychiatry 2013; 3:93-102. [DOI: 10.5498/wjp.v3.i4.93] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/10/2013] [Accepted: 11/03/2013] [Indexed: 02/05/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) has been proposed as a biomarker of schizophrenia and, more specifically, as a biomarker of cognitive recovery. Evidence collected in this review indicates that BDNF is relevant in the pathophysiology of schizophrenia and could play a role as a marker of clinical response. BDNF has been shown to play a positive role as a marker in antipsychotic treatment, and it has been demonstrated that typical antipsychotics decrease BDNF levels while atypical antipsychotics maintain or increase serum BDNF levels. Furthermore, BDNF levels have been associated with severe cognitive impairments in patients with schizophrenia. Consequently, BDNF has been proposed as a candidate target of strategies to aid the cognitive recovery process. There is some evidence suggesting that BDNF could be mediating neurobiological processes underlying cognitive recovery. Thus, serum BDNF levels seem to be involved in some synaptic plasticity and neurotransmission processes. Additionally, serum BDNF levels significantly increased in schizophrenia subjects after neuroplasticity-based cognitive training. If positive replications of those findings are published in the future then serum BDNF levels could be definitely postulated as a peripheral biomarker for the effects of intensive cognitive training or any sort of cognitive recovery in schizophrenia. All in all, the current consideration of BDNF as a biomarker of cognitive recovery in schizophrenia is promising but still premature.
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Abstract
Although translational medicine has become a priority for medical science, advances in neuroscience have failed to be translated for the benefit of patients. In populations at high risk of psychosis, neuroimaging could stratify those mostly likely to develop psychosis. This is an example of potentially translatable psychiatry.
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Affiliation(s)
- Thomas J Reilly
- Thomas J. Reilly, BSc, MBChB, Academic Foundation Programme, University of Glasgow, UK; Philip K. McGuire, PhD, FRCPsych, Institute of Psychiatry, King's College London, UK
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Auditory mismatch negativity and P3a in response to duration and frequency changes in the early stages of psychosis. Schizophr Res 2013; 150:547-54. [PMID: 24012461 DOI: 10.1016/j.schres.2013.08.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/12/2013] [Accepted: 08/10/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND A shorter duration of untreated psychosis in patients with schizophrenia results in better symptomatic and functional outcomes. Therefore, identifying biological markers in the early stages of psychosis is an important step toward early detection and intervention. Mismatch negativity (MMN) and P3a are leading candidate biomarkers. MMN measures differ in their sensitivity to varying deviants. However, this has not been fully addressed in assessing the early stages of psychosis. In the current study, we examined MMN/P3a to duration deviant (dMMN/dP3a) and frequency deviant (fMMN/fP3a) in the early stages of psychosis. To our knowledge, this is the first study that examined both MMN/P3a to duration deviant (dMMN/dP3a) and frequency deviant (fMMN/fP3a) in the early stages of psychosis. METHODS Participants consisted of 20 patients with first episode schizophrenia (FES), 21 ultra-high risk (UHR) individuals, and 22 healthy controls (HC). We measured dMMN/dP3a and fMMN/fP3a ERP components by means of a 64 electrodes-cap for EEG recording, and we used two-tone auditory oddball paradigms with 2000 stimuli. RESULTS The amplitude of dMMN was significantly reduced in FES and UHR compared to HC. The amplitude of fMMN showed no significant difference among the three groups. The amplitudes of dP3a and fP3a were significantly reduced in FES and UHR compared to HC. CONCLUSION These findings suggest that dMMN may have higher sensitivity than fMMN whereas dP3a and fP3a may have similar sensitivity in the early stages of psychosis.
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Koike S, Nishimura Y, Takizawa R, Yahata N, Kasai K. Near-infrared spectroscopy in schizophrenia: a possible biomarker for predicting clinical outcome and treatment response. Front Psychiatry 2013; 4:145. [PMID: 24294205 PMCID: PMC3827961 DOI: 10.3389/fpsyt.2013.00145] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 10/25/2013] [Indexed: 12/14/2022] Open
Abstract
Functional near-infrared spectroscopy (fNIRS) is a relatively new technique that can measure hemoglobin changes in brain tissues, and its use in psychiatry has been progressing rapidly. Although it has several disadvantages (e.g., relatively low spatial resolution and the possibility of shallow coverage in the depth of brain regions) compared with other functional neuroimaging techniques (e.g., functional magnetic resonance imaging and positron emission tomography), fNIRS may be a candidate instrument for clinical use in psychiatry, as it can measure brain activity in naturalistic position easily and non-invasively. fNIRS instruments are also small and work silently, and can be moved almost everywhere including schools and care units. Previous fNIRS studies have shown that patients with schizophrenia have impaired activity and characteristic waveform patterns in the prefrontal cortex during the letter version of the verbal fluency task, and part of these results have been approved as one of the Advanced Medical Technologies as an aid for the differential diagnosis of depressive symptoms by the Ministry of Health, Labor and Welfare of Japan in 2009, which was the first such approval in the field of psychiatry. Moreover, previous studies suggest that the activity in the frontopolar prefrontal cortex is associated with their functions in chronic schizophrenia and is its next candidate biomarker. Future studies aimed at exploring fNIRS differences in various clinical stages, longitudinal changes, drug effects, and variations during different task paradigms will be needed to develop more accurate biomarkers that can be used to aid differential diagnosis, the comprehension of the present condition, the prediction of outcome, and the decision regarding treatment options in schizophrenia. Future fNIRS researches will require standardized measurement procedures, probe settings, analytical methods and tools, manuscript description, and database systems in an fNIRS community.
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Affiliation(s)
- Shinsuke Koike
- Office for Mental Health Support, Division for Counseling and Support, The University of Tokyo , Tokyo , Japan ; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
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