1
|
Lányi O, Koleszár B, Schulze Wenning A, Balogh D, Engh MA, Horváth AA, Fehérvari P, Hegyi P, Molnár Z, Unoka Z, Csukly G. Excitation/inhibition imbalance in schizophrenia: a meta-analysis of inhibitory and excitatory TMS-EMG paradigms. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:56. [PMID: 38879590 PMCID: PMC11180212 DOI: 10.1038/s41537-024-00476-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/16/2024] [Indexed: 06/19/2024]
Abstract
Cortical excitation-inhibition (E/I) imbalance is a potential model for the pathophysiology of schizophrenia. Previous research using transcranial magnetic stimulation (TMS) and electromyography (EMG) has suggested inhibitory deficits in schizophrenia. In this meta-analysis we assessed the reliability and clinical potential of TMS-EMG paradigms in schizophrenia following the methodological recommendations of the PRISMA guideline and the Cochrane Handbook. The search was conducted in three databases in November 2022. Included articles reported Short-Interval Intracortical Inhibition (SICI), Intracortical Facilitation (ICF), Long-Interval Intracortical Inhibition (LICI) and Cortical Silent Period (CSP) in patients with schizophrenia and healthy controls. Meta-analyses were conducted using a random-effects model. Subgroup analysis and meta-regressions were used to assess heterogeneity. Results of 36 studies revealed a robust inhibitory deficit in schizophrenia with a significant decrease in SICI (Cohen's d: 0.62). A trend-level association was found between SICI and antipsychotic medication. Our findings support the E/I imbalance hypothesis in schizophrenia and suggest that SICI may be a potential pathophysiological characteristic of the disorder.
Collapse
Affiliation(s)
- Orsolya Lányi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Boróka Koleszár
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - David Balogh
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - András Attila Horváth
- Neurocognitive Research Center, Nyírő Gyula National Institute of Psychiatry and Addictology, Budapest, Hungary
| | - Péter Fehérvari
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
2
|
Santoro V, Hou MD, Premoli I, Belardinelli P, Biondi A, Carobin A, Puledda F, Michalopoulou PG, Richardson MP, Rocchi L, Shergill SS. Investigating cortical excitability and inhibition in patients with schizophrenia: A TMS-EEG study. Brain Res Bull 2024; 212:110972. [PMID: 38710310 DOI: 10.1016/j.brainresbull.2024.110972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) combined with electromyography (EMG) has widely been used as a non-invasive brain stimulation tool to assess excitation/inhibition (E/I) balance. E/I imbalance is a putative mechanism underlying symptoms in patients with schizophrenia. Combined TMS-electroencephalography (TMS-EEG) provides a detailed examination of cortical excitability to assess the pathophysiology of schizophrenia. This study aimed to investigate differences in TMS-evoked potentials (TEPs), TMS-related spectral perturbations (TRSP) and intertrial coherence (ITC) between patients with schizophrenia and healthy controls. MATERIALS AND METHODS TMS was applied over the motor cortex during EEG recording. Differences in TEPs, TRSP and ITC between the patient and healthy subjects were analysed for all electrodes at each time point, by applying multiple independent sample t-tests with a cluster-based permutation analysis to correct for multiple comparisons. RESULTS Patients demonstrated significantly reduced amplitudes of early and late TEP components compared to healthy controls. Patients also showed a significant reduction of early delta (50-160 ms) and theta TRSP (30-250ms),followed by a reduction in alpha and beta suppression (220-560 ms; 190-420 ms). Patients showed a reduction of both early (50-110 ms) gamma increase and later (180-230 ms) gamma suppression. Finally, the ITC was significantly lower in patients in the alpha band, from 30 to 260 ms. CONCLUSION Our findings support the putative role of impaired GABA-receptor mediated inhibition in schizophrenia impacting excitatory neurotransmission. Further studies can usefully elucidate mechanisms underlying specific symptoms clusters using TMS-EEG biometrics.
Collapse
Affiliation(s)
- V Santoro
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; Headache Group, Wolfson SPaRC, Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom.
| | - M D Hou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - I Premoli
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - P Belardinelli
- Cimec, Center for Mind/Brain Sciences, University of Trento, Trento, Italy
| | - A Biondi
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - A Carobin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - F Puledda
- Headache Group, Wolfson SPaRC, Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - P G Michalopoulou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - M P Richardson
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - L Rocchi
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - S S Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; Kent and Medway Medical School, Canterbury CT2 7FS, United Kingdom; Kent and Medway NHS and Social Care Partnership Trust, Maidstone, ME7 4JL, United Kingdom
| |
Collapse
|
3
|
Perellón-Alfonso R, Oblak A, Kuclar M, Škrlj B, Pileckyte I, Škodlar B, Pregelj P, Abellaneda-Pérez K, Bartrés-Faz D, Repovš G, Bon J. Dense attention network identifies EEG abnormalities during working memory performance of patients with schizophrenia. Front Psychiatry 2023; 14:1205119. [PMID: 37817830 PMCID: PMC10560761 DOI: 10.3389/fpsyt.2023.1205119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Patients with schizophrenia typically exhibit deficits in working memory (WM) associated with abnormalities in brain activity. Alterations in the encoding, maintenance and retrieval phases of sequential WM tasks are well established. However, due to the heterogeneity of symptoms and complexity of its neurophysiological underpinnings, differential diagnosis remains a challenge. We conducted an electroencephalographic (EEG) study during a visual WM task in fifteen schizophrenia patients and fifteen healthy controls. We hypothesized that EEG abnormalities during the task could be identified, and patients successfully classified by an interpretable machine learning algorithm. Methods We tested a custom dense attention network (DAN) machine learning model to discriminate patients from control subjects and compared its performance with simpler and more commonly used machine learning models. Additionally, we analyzed behavioral performance, event-related EEG potentials, and time-frequency representations of the evoked responses to further characterize abnormalities in patients during WM. Results The DAN model was significantly accurate in discriminating patients from healthy controls, ACC = 0.69, SD = 0.05. There were no significant differences between groups, conditions, or their interaction in behavioral performance or event-related potentials. However, patients showed significantly lower alpha suppression in the task preparation, memory encoding, maintenance, and retrieval phases F(1,28) = 5.93, p = 0.022, η2 = 0.149. Further analysis revealed that the two highest peaks in the attention value vector of the DAN model overlapped in time with the preparation and memory retrieval phases, as well as with two of the four significant time-frequency ROIs. Discussion These results highlight the potential utility of interpretable machine learning algorithms as an aid in diagnosis of schizophrenia and other psychiatric disorders presenting oscillatory abnormalities.
Collapse
Affiliation(s)
- Ruben Perellón-Alfonso
- Faculty of Medicine and Health Sciences, and Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Aleš Oblak
- University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
| | - Matija Kuclar
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Blaž Škrlj
- Jožef Stefan Institute, Ljubljana, Slovenia
| | - Indre Pileckyte
- Center for Brain and Cognition, Pompeu Fabra University, Barcelona, Spain
| | - Borut Škodlar
- University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Peter Pregelj
- University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Kilian Abellaneda-Pérez
- Faculty of Medicine and Health Sciences, and Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació Adscrit a la UAB, Barcelona, Spain
| | - David Bartrés-Faz
- Faculty of Medicine and Health Sciences, and Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Grega Repovš
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Jurij Bon
- University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
4
|
Is cortical inhibition in primary motor cortex related to executive control? Cortex 2023; 160:100-114. [PMID: 36791591 DOI: 10.1016/j.cortex.2022.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/13/2022] [Accepted: 12/05/2022] [Indexed: 01/19/2023]
Abstract
Recent research using paired-pulse transcranial magnetic stimulation (TMS) has shown that the speed with which people can stop an action is linked to GABAergic inhibitory activity in the motor system. Specifically, a significant proportion of the variance in stop signal reaction time (SSRT; a widely used measure of inhibitory control) is accounted for by short-interval cortical inhibition (SICI). It is still unclear whether this relationship reflects a broader link between GABAergic processes and executive functions, or a specific link between GABAergic processes and motor stopping ability. The current study sought to replicate the correlation between SSRT and SICI while investigating whether this association generalises to other measures of inhibitory control and working memory, and to long-interval cortical inhibition (LICI). Participants completed a battery of inhibition (Stop-Signal, Stroop, Flanker) and working memory (n-back, Digit Span, and Operation Span) tasks. We replicated the correlation between SICI and SSRT but found no other correlations between behavioural measures of executive control and the two cortical measures of inhibition. These findings indicate that the relationship between SSRT and SICI is specific to a particular property of response inhibition and likely reflects the function of local inhibitory networks mediated by GABAA.
Collapse
|
5
|
Redondo-Camós M, Cattaneo G, Alviarez-Schulze V, Delgado-Gallén S, España-Irla G, Solana-Sanchez J, Perellón-Alfonso R, Albu S, Tormos JM, Pascual-Leone A, Bartres-Faz D. Long-interval intracortical inhibition in primary motor cortex related to working memory in middle-aged adults. Front Psychol 2022; 13:998062. [PMID: 36248602 PMCID: PMC9559215 DOI: 10.3389/fpsyg.2022.998062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Excitability of the primary motor cortex measured with TMS has been associated with cognitive dysfunctions in patient populations. However, only a few studies have explored this relationship in healthy adults, and even fewer have considered the role of biological sex. Methods Ninety-seven healthy middle-aged adults (53 male) completed a TMS protocol and a neuropsychological assessment. Resting Motor Threshold (RMT) and Long-Interval Intracortical Inhibition (LICI) were assessed in the left motor cortex and related to attention, episodic memory, working memory, reasoning, and global cognition composite scores to evaluate the relationship between cortical excitability and cognitive functioning. Results In the whole sample, there was a significant association between LICI and cognition; specifically, higher motor inhibition was related to better working memory performance. When the sample was broken down by biological sex, LICI was only associated with working memory, reasoning, and global cognition in men. No associations were found between RMT and cognitive functions. Conclusion Greater intracortical inhibition, measured by LICI, could be a possible marker of working memory in healthy middle-aged adults, and biological sex plays a critical role in this association.
Collapse
Affiliation(s)
- María Redondo-Camós
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Vanessa Alviarez-Schulze
- Departamento de Ciencias del Comportamiento, Escuela de Psicología, Universidad Metropolitana, Caracas, Venezuela
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Selma Delgado-Gallén
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Goretti España-Irla
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Javier Solana-Sanchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Ruben Perellón-Alfonso
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sergiu Albu
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - José M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
- *Correspondence: Alvaro Pascual-Leone,
| | - David Bartres-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- David Bartres-Faz,
| |
Collapse
|
6
|
di Hou M, Santoro V, Biondi A, Shergill SS, Premoli I. A systematic review of TMS and neurophysiological biometrics in patients with schizophrenia. J Psychiatry Neurosci 2021; 46:E675-E701. [PMID: 34933940 PMCID: PMC8695525 DOI: 10.1503/jpn.210006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation can be combined with electromyography (TMS-EMG) and electroencephalography (TMS-EEG) to evaluate the excitatory and inhibitory functions of the cerebral cortex in a standardized manner. It has been postulated that schizophrenia is a disorder of functional neural connectivity underpinned by a relative imbalance of excitation and inhibition. The aim of this review was to provide a comprehensive overview of TMS-EMG and TMS-EEG research in schizophrenia, focused on excitation or inhibition, connectivity, motor cortical plasticity and the effect of antipsychotic medications, symptom severity and illness duration on TMS-EMG and TMS-EEG indices. METHODS We searched PsycINFO, Embase and Medline, from database inception to April 2020, for studies that included TMS outcomes in patients with schizophrenia. We used the following combination of search terms: transcranial magnetic stimulation OR tms AND interneurons OR glutamic acid OR gamma aminobutyric acid OR neural inhibition OR pyramidal neurons OR excita* OR inhibit* OR GABA* OR glutam* OR E-I balance OR excitation-inhibition balance AND schizoaffective disorder* OR Schizophrenia OR schizophreni*. RESULTS TMS-EMG and TMS-EEG measurements revealed deficits in excitation or inhibition, functional connectivity and motor cortical plasticity in patients with schizophrenia. Increased duration of the cortical silent period (a TMS-EMG marker of γ-aminobutyric acid B receptor activity) with clozapine was a relatively consistent finding. LIMITATIONS Most of the studies used patients with chronic schizophrenia and medicated patients, employed cross-sectional group comparisons and had small sample sizes. CONCLUSION TMS-EMG and TMS-EEG offer an opportunity to develop a novel and improved understanding of the physiologic processes that underlie schizophrenia and to assess the therapeutic effect of antipsychotic medications. In the future, these techniques may also help predict disease progression and further our understanding of the excitatory/inhibitory balance and its implications for mechanisms that underlie treatment-resistant schizophrenia.
Collapse
Affiliation(s)
- Meng di Hou
- From the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK (Hou, Shergill); the Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK (Santoro, Biondi, Premoli); and the Kent and Medway Medical School, Canterbury, UK (Shergill)
| | | | | | | | | |
Collapse
|
7
|
Percelay S, Freret T, Turnbull N, Bouet V, Boulouard M. Combination of MAP6 deficit, maternal separation and MK801 in female mice: A 3-hit animal model of neurodevelopmental disorder with cognitive deficits. Behav Brain Res 2021; 413:113473. [PMID: 34280461 DOI: 10.1016/j.bbr.2021.113473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
Schizophrenia is a major psychiatric disease still lacking efficient treatment, particularly for cognitive deficits. To go further in research of new treatments that would encompass all the symptoms associated with this pathology, preclinical animal models need to be improved. To date, the aetiology of schizophrenia is unknown, but there is increasing evidence to highlight its multifactorial nature. We built a new neurodevelopmental mouse model gathering a triple factor combination (3-M): a genetic factor (partial deletion of MAP6 gene), an early stress (maternal separation) and a late pharmacological factor (MK801 administration, 0.05 mg/kg, i.p., daily for 5 days). The effects of each factor and of their combination were investigated on several behaviours including cognitive functions. While each individual factor induced slight deficits in one or another behavioural test, 3-M conditioning induces a wider phenotype with hyperlocomotion and cognitive deficits (working memory and social recognition). This study confirms the hypothesis that genetic, environmental and pharmacological factors, even if not deleterious by themselves, could act synergistically to induce a deleterious behavioural phenotype. It moreover encourages the use of such combined models to improve translational research on neurodevelopmental disorders.
Collapse
Affiliation(s)
- Solenn Percelay
- Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France.
| | - Thomas Freret
- Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France
| | - Nicole Turnbull
- Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France
| | - Valentine Bouet
- Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France
| | - Michel Boulouard
- Normandie Université, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, 14000, Caen, France
| |
Collapse
|
8
|
Cao KX, Ma ML, Wang CZ, Iqbal J, Si JJ, Xue YX, Yang JL. TMS-EEG: An emerging tool to study the neurophysiologic biomarkers of psychiatric disorders. Neuropharmacology 2021; 197:108574. [PMID: 33894219 DOI: 10.1016/j.neuropharm.2021.108574] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/08/2021] [Accepted: 04/15/2021] [Indexed: 01/02/2023]
Abstract
The etiology of psychiatric disorders remains largely unknown. The exploration of the neurobiological mechanisms of mental illness helps improve diagnostic efficacy and develop new therapies. This review focuses on the application of concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) in various mental diseases, including major depressive disorder, bipolar disorder, schizophrenia, autism spectrum disorder, attention-deficit/hyperactivity disorder, substance use disorder, and insomnia. First, we summarize the commonly used protocols and output measures of TMS-EEG; then, we review the literature exploring the alterations in neural patterns, particularly cortical excitability, plasticity, and connectivity alterations, and studies that predict treatment responses and clinical states in mental disorders using TMS-EEG. Finally, we discuss the potential mechanisms underlying TMS-EEG in establishing biomarkers for psychiatric disorders and future research directions.
Collapse
Affiliation(s)
- Ke-Xin Cao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Mao-Liang Ma
- Department of Clinical Psychology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Cheng-Zhan Wang
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Javed Iqbal
- School of Psychology, Shaanxi Normal University and Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, Xi'an, China
| | - Ji-Jian Si
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; Key Laboratory for Neuroscience of Ministry of Education and Neuroscience, National Health and Family Planning Commission, Peking University, Beijing, China.
| | - Jian-Li Yang
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China.
| |
Collapse
|
9
|
Single-Pulse Transcranial Magnetic Stimulation-Evoked Potential Amplitudes and Latencies in the Motor and Dorsolateral Prefrontal Cortex among Young, Older Healthy Participants, and Schizophrenia Patients. J Pers Med 2021; 11:jpm11010054. [PMID: 33477346 PMCID: PMC7830964 DOI: 10.3390/jpm11010054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/14/2023] Open
Abstract
Background: The combination of transcranial magnetic stimulation (TMS) with electroencephalography (EEG) allows for non-invasive investigation of cortical response and connectivity in human cortex. This study aimed to examine the amplitudes and latencies of each TMS-evoked potential (TEP) component induced by single-pulse TMS (spTMS) to the left motor (M1) and dorsolateral prefrontal cortex (DLPFC) among healthy young participants (YNG), older participants (OLD), and patients with schizophrenia (SCZ). Methods: We compared the spatiotemporal characteristics of TEPs induced by spTMS among the groups. Results: Compared to YNG, M1-spTMS induced lower amplitudes of N45 and P180 in OLD and a lower amplitude of P180 in SCZ, whereas the DLPFC-spTMS induced a lower N45 in OLD. Further, OLD demonstrated latency delays in P60 after M1-spTMS and in N45-P60 over the right central region after left DLPFC-spTMS, whereas SCZ demonstrated latency delays in N45-P60 over the midline and right central regions after DLPFC-spTMS. Conclusions: These findings suggest that inhibitory and excitatory mechanisms mediating TEPs may be altered in OLD and SCZ. The amplitude and latency changes of TEPs with spTMS may reflect underlying neurophysiological changes in OLD and SCZ, respectively. The spTMS administered to M1 and the DLPFC can probe cortical functions by examining TEPs. Thus, TMS-EEG can be used to study changes in cortical connectivity and signal propagation from healthy to pathological brains.
Collapse
|
10
|
Carment L, Dupin L, Guedj L, Térémetz M, Cuenca M, Krebs MO, Amado I, Maier MA, Lindberg PG. Neural noise and cortical inhibition in schizophrenia. Brain Stimul 2020; 13:1298-1304. [PMID: 32585356 DOI: 10.1016/j.brs.2020.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/25/2020] [Accepted: 06/14/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Neural information processing is subject to noise and this leads to variability in neural firing and behavior. Schizophrenia has been associated with both more variable motor control and impaired cortical inhibition, which is crucial for excitatory/inhibitory balance in neural commands. HYPOTHESIS In this study, we hypothesized that impaired intracortical inhibition in motor cortex would contribute to task-related motor noise in schizophrenia. METHODS We measured variability of force and of electromyographic (EMG) activity in upper limb and hand muscles during a visuomotor grip force-tracking paradigm in patients with schizophrenia (N = 25), in unaffected siblings (N = 17) and in healthy control participants (N = 25). Task-dependent primary motor cortex (M1) excitability and inhibition were assessed using transcranial magnetic stimulation (TMS). RESULTS During force maintenance patients with schizophrenia showed increased variability in force and EMG, despite similar mean force and EMG magnitudes. Compared to healthy controls, patients with schizophrenia also showed increased M1 excitability and reduced cortical inhibition during grip-force tracking. EMG variability and force variability correlated negatively to cortical inhibition in patients with schizophrenia. EMG variability also correlated positively to negative symptoms. Siblings had similar variability and cortical inhibition compared to controls. Increased EMG and force variability indicate enhanced motor noise in schizophrenia, which relates to reduced motor cortex inhibition. CONCLUSION The findings suggest that excessive motor noise in schizophrenia may arise from an imbalance of M1 excitation/inhibition of GABAergic origin. Thus, higher motor noise may provide a useful marker of impaired cortical inhibition in schizophrenia.
Collapse
Affiliation(s)
- Loïc Carment
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France.
| | - Lucile Dupin
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France
| | - Laura Guedj
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, C3RP, Université de Paris, GHU Psychiatrie et Neurosciences Sainte-Anne, Paris, France
| | - Maxime Térémetz
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France
| | - Macarena Cuenca
- Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Centre de Recherche Clinique, Hôpital Sainte-Anne, Paris, France
| | - Marie-Odile Krebs
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, C3RP, Université de Paris, GHU Psychiatrie et Neurosciences Sainte-Anne, Paris, France
| | - Isabelle Amado
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, C3RP, Université de Paris, GHU Psychiatrie et Neurosciences Sainte-Anne, Paris, France
| | - Marc A Maier
- Institut de Psychiatrie, CNRS, GDR3557, Paris, France; Université de Paris, CNRS UMR, 8002, Paris, France
| | - Påvel G Lindberg
- Institute of Psychiatry and Neuroscience of Paris, INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut de Psychiatrie, CNRS, GDR3557, Paris, France
| |
Collapse
|
11
|
Vittala A, Murphy N, Maheshwari A, Krishnan V. Understanding Cortical Dysfunction in Schizophrenia With TMS/EEG. Front Neurosci 2020; 14:554. [PMID: 32547362 PMCID: PMC7270174 DOI: 10.3389/fnins.2020.00554] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/05/2020] [Indexed: 12/16/2022] Open
Abstract
In schizophrenia and related disorders, a deeper mechanistic understanding of neocortical dysfunction will be essential to developing new diagnostic and therapeutic techniques. To this end, combined transcranial magnetic stimulation and electroencephalography (TMS/EEG) provides a non-invasive tool to simultaneously perturb and measure neurophysiological correlates of cortical function, including oscillatory activity, cortical inhibition, connectivity, and synchronization. In this review, we summarize the findings from a variety of studies that apply TMS/EEG to understand the fundamental features of cortical dysfunction in schizophrenia. These results lend to future applications of TMS/EEG in understanding the pathophysiological mechanisms underlying cognitive deficits in schizophrenia.
Collapse
Affiliation(s)
- Aadith Vittala
- Department of Biosciences, Rice University, Houston, TX, United States
| | - Nicholas Murphy
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, United States
| | - Atul Maheshwari
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States.,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Vaishnav Krishnan
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, United States.,Department of Neurology, Baylor College of Medicine, Houston, TX, United States.,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
12
|
Yamada S, Takahashi S, Ohoshi Y, Ishida T, Tsuji T, Shinosaki K, Terada M, Ukai S. Widespread white matter microstructural abnormalities and cognitive impairment in schizophrenia, bipolar disorder, and major depressive disorder: Tract-based spatial statistics study. Psychiatry Res Neuroimaging 2020; 298:111045. [PMID: 32087457 DOI: 10.1016/j.pscychresns.2020.111045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/01/2020] [Accepted: 02/06/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Shinichi Yamada
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan.
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | - Yuji Ohoshi
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | - Takuya Ishida
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | - Tomikimi Tsuji
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | | | | | - Satoshi Ukai
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| |
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW This current review summarizes the investigational and therapeutic applications of transcranial magnetic stimulation (TMS) in schizophrenia. RECENT FINDINGS Fairly consistent findings of an impaired cortical excitation-inhibition balance, cortical plasticity, and motor resonance have been reported in schizophrenia. Cortical connectivity impairments have also been demonstrated in motor and prefrontal brain regions. In terms of treatment, the best support is for 1-Hz TMS to the left temporoparietal cortex for the short-term treatment of persistent auditory hallucinations. High-frequency TMS to the left prefrontal cortex improves negative and cognitive symptoms, but with inconsistent and small effects. TMS combined with diverse brain mapping techniques and clinical evaluation can unravel critical brain-behavior relationships relevant to schizophrenia. These provide critical support to the conceptualization of schizophrenia as a connectopathy with anomalous cortical plasticity. Adaptive modulation of these aberrant brain networks in a neuroscience-informed manner drives short-term therapeutic gains in difficult-to-treat symptoms of schizophrenia.
Collapse
|
14
|
Ohoshi Y, Takahashi S, Yamada S, Ishida T, Tsuda K, Tsuji T, Terada M, Shinosaki K, Ukai S. Microstructural abnormalities in callosal fibers and their relationship with cognitive function in schizophrenia: A tract-specific analysis study. Brain Behav 2019; 9:e01357. [PMID: 31283112 PMCID: PMC6710197 DOI: 10.1002/brb3.1357] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/14/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The corpus callosum serves the essential role of relaying cognitive information between the homologous regions in the left and the right hemispheres of the brain. Cognitive impairment is a core dysfunction of schizophrenia, but much of its pathophysiology is unknown. The aim of this study was to elucidate the association between microstructural abnormalities of the corpus callosum and cognitive dysfunction in schizophrenia. METHODS We examined stepwise multiple regression analysis to investigate the relationship of the fractional anisotropy (FA) of callosal fibers in each segment with z-scores of each brief assessment of cognition in schizophrenia subtest and cognitive composite score in all subjects (19 patients with schizophrenia [SZ group] and 19 healthy controls [HC group]). Callosal fibers were separated into seven segments based on their cortical projection using tract-specific analysis of diffusion tensor imaging. RESULTS The FA of callosal fibers in the temporal segment was significantly associated with z-scores of token motor test, Tower of London test, and the composite score. In the SZ group, the FA of callosal fibers in the temporal segment was significantly associated with the z-score of the Tower of London test. In addition, the FA of callosal fibers in temporal segment showed significant negative association with the positive and negative syndrome scale negative score in the SZ group. Compared to the HC group, the FA in temporal segment was significantly decreased in the SZ group. CONCLUSION Our results suggest that microstructural abnormalities in the callosal white matter fibers connecting bilateral temporal lobe cortices contribute to poor executive function and severe negative symptom in patients with schizophrenia.
Collapse
Affiliation(s)
- Yuji Ohoshi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shinichi Yamada
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Takuya Ishida
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Kumi Tsuda
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Tomikimi Tsuji
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | | | - Kazuhiro Shinosaki
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan.,Asakayama General Hospital, Osaka, Japan
| | - Satoshi Ukai
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| |
Collapse
|
15
|
Newton R, Rouleau A, Nylander AG, Loze JY, Resemann HK, Steeves S, Crespo-Facorro B. Diverse definitions of the early course of schizophrenia-a targeted literature review. NPJ SCHIZOPHRENIA 2018; 4:21. [PMID: 30323274 PMCID: PMC6189105 DOI: 10.1038/s41537-018-0063-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder and patients experience significant comorbidity, especially cognitive and psychosocial deficits, already at the onset of disease. Previous research suggests that treatment during the earlier stages of disease reduces disease burden, and that a longer time of untreated psychosis has a negative impact on treatment outcomes. A targeted literature review was conducted to gain insight into the definitions currently used to describe patients with a recent diagnosis of schizophrenia in the early course of disease ('early' schizophrenia). A total of 483 relevant English-language publications of clinical guidelines and studies were identified for inclusion after searches of MEDLINE, MEDLINE In-Process, relevant clinical trial databases and Google for records published between January 2005 and October 2015. The extracted data revealed a wide variety of terminology and definitions used to describe patients with 'early' or 'recent-onset' schizophrenia, with no apparent consensus. The most commonly used criteria to define patients with early schizophrenia included experience of their first episode of schizophrenia or disease duration of less than 1, 2 or 5 years. These varied definitions likely result in substantial disparities of patient populations between studies and variable population heterogeneity. Better agreement on the definition of early schizophrenia could aid interpretation and comparison of studies in this patient population and consensus on definitions should allow for better identification and management of schizophrenia patients in the early course of their disease.
Collapse
Affiliation(s)
- Richard Newton
- Austin Health, University of Melbourne, Melbourne, VIC, Australia.,Peninsula Health, Frankston, VIC, Australia
| | | | | | | | | | | | - Benedicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| |
Collapse
|
16
|
Test-retest reliability of short-interval intracortical inhibition and intracortical facilitation in patients with schizophrenia. Psychiatry Res 2018; 267:575-581. [PMID: 30032068 PMCID: PMC6131061 DOI: 10.1016/j.psychres.2018.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/29/2018] [Accepted: 06/07/2018] [Indexed: 12/31/2022]
Abstract
Impaired short-interval intracortical inhibition (SICI) elicited by paired-pulse TMS (ppTMS) has emerged as one of the most consistent TMS findings in patients with schizophrenia. Reduction of SICI has been reproducibly found, suggesting that SICI may be a new biomarker indexing the inhibitory dysfunction in schizophrenia. This study evaluated whether SICI has the test-retest reliability suitable for clinical trial and research applications. SICIs, intracortical facilitation (ICF), and other ppTMS effects were obtained using inter-stimulus intervals (ISIs) from 1 to 500 ms, on 2 occasions about 3-4 weeks apart in patients with schizophrenia and healthy individuals. Acceptable test-retest reliabilities were found for SICI (at 1 and 3 ms ISIs) in both patients and controls (all intraclass correlation coefficients r > 0.6). However, test-retest reliability in longer ISIs and in ICF were modest or poor. To our knowledge, this is the first study demonstrated the acceptable reliability of SICI measure in patients with schizophrenia. The data support SICI as a reliable biomarker for schizophrenia.
Collapse
|
17
|
Fond G, Berna F, Boyer L, Godin O, Brunel L, Andrianarisoa M, Aouizerate B, Capdevielle D, Chereau I, Danion JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Le Gloahec T, Llorca PM, Mallet J, Misdrahi D, Rey R, Richieri R, Passerieux C, Portalier C, Roux P, Vehier A, Yazbek H, Schürhoff F, Bulzacka E. Benzodiazepine long-term administration is associated with impaired attention/working memory in schizophrenia: results from the national multicentre FACE-SZ data set. Eur Arch Psychiatry Clin Neurosci 2018; 268:17-26. [PMID: 28349247 DOI: 10.1007/s00406-017-0787-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The effect of benzodiazepine long-term administration (BLTA) in cognitive functioning of subjects with schizophrenia (SZ) has been partially explored to date. The objective was to assess BLTA-associated cognitive impairment with a comprehensive cognitive battery in a non-selected multicentric/national community-dwelling sample of stabilized SZ subjects. METHOD 407 community-dwelling stabilized SZ subjects were consecutively included in the FondaMental Academic Centers of Expertise for Schizophrenia Cohort (FACE-SZ). Patients taking daily benzodiazepine were defined as BLTA+ as all patients examined by the Expert Center were clinically stabilized and under stable dose of treatment for at least 3 months. Each patient has been administered a 1-day long comprehensive cognitive battery (including The National Adult Reading Test, the Wechsler Adult Intelligence Scale, the Trail Making Test, the California Verbal Learning Test, the Doors test, and The Continuous Performance Test-Identical Pairs). RESULTS In the multivariate analyses, results showed that BLTA was associated with impaired attention/working memory (OR 0.60, 95% confidence interval 0.42-0.86; p = 0.005) independently of socio-demographic variables and illness characteristics. Verbal and performance current IQ-[respectively, OR 0.98, 95% CI (0.96;0.99), p = 0.016 and 0.98, 95% CI(0.97;0.99), p = 0.034] but not premorbid IQ-(p > 0.05) have been associated with BLTA in a multivariate model including the same confounding variables. CONCLUSION BLTA is associated with impaired attention/working memory in schizophrenia. The BLTA benefit/risk ratio should be regularly reevaluated. Alternative pharmacological and non-pharmacological strategies for comorbid anxiety disorders and sleep disorders should be preferred when possible. It seems reasonable to withdraw BLTA before the start of cognitive remediation therapy, as soon as possible, to improve the effectiveness of this therapy. Limits: the delay between the last benzodiazepine intake and testing, as well as the specific class of benzodiazepines (long half-life vs. short half-life), and the number of benzodiazepine daily intakes have not been recorded in the present study. The precise motive for BLTA prescription and sleep disturbances have not been reported, which is a limit for the interpretation of the present results.
Collapse
Affiliation(s)
- Guillaume Fond
- Fondation FondaMental, Créteil, France. .,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France. .,Clinique Jeanne d'arc-Hôpital Privé Parisien, 55 rue du commandant Mouchotte, 94160, Saint-Mandé, France. .,CHU Carémeau, 30000, Nîmes, France.
| | - F Berna
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - L Boyer
- Fondation FondaMental, Créteil, France.,Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, 13274, Marseille cedex 09, France
| | - O Godin
- Fondation FondaMental, Créteil, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - L Brunel
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, 33000, Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - J M Danion
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Inserm U894, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - T Le Gloahec
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - J Mallet
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Inserm U894, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,CNRS UMR 5287-INCIA, Bordeaux, France
| | - R Rey
- Fondation FondaMental, Créteil, France.,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, 95 bd Pinel, BP 300 39, 69678, BRON Cedex, France
| | - R Richieri
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - C Portalier
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Inserm U894, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes, France
| | - P Roux
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Vehier
- Fondation FondaMental, Créteil, France.,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, 95 bd Pinel, BP 300 39, 69678, BRON Cedex, France
| | - H Yazbek
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - E Bulzacka
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | | |
Collapse
|
18
|
The dysfunction of inhibition control in pituitary patients: evidence from the Go/Nogo event-related potential study. Neuroreport 2018; 28:272-278. [PMID: 28225481 DOI: 10.1097/wnr.0000000000000757] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Pituitary tumor is an intracranial tumor; because of the development of neuroimaging technology in recent years, morbidity is likely to increase. Evidence showed impaired cognitive ability of patients with pituitary adenoma. There is evidence that neurobehavioral disorders are common in pituitary adenoma patients. This disorder is because of the cognitive and emotional function of the important functional areas of the brain oppressed and hormone imbalance. Individuals' mental activity is controlled by the brain and the abnormal mental activity is caused by both the structural abnormalities of the brain and neurochemical dysfunction. Event-related potentials have been used widely in the early assessment of cognitive functions associated with disease, taking advantage of the high temporal resolution, and then analyzing the characteristics of emotional competence from the perspective of cognitive processing. A visual Go/Nogo task was used. A larger Nogo-N2 and Nogo-P3 was found in the control group compared with the pituitary group. This reflects the nonphysiological process of conflict monitoring and inhibitory control in pituitary patients. The results also showed that the difference waves between Go and Nogo conditions (N2d and P3d) over the frontal electrode sites were more robust and earlier in the control group compared with the pituitary group, which reflects frontal dysfunction in the pituitary group. These data suggest reduced earlier and later stages of inhibitory processes in pituitary individuals, implicating the dysfunction of conflict detection and inhibitory control.
Collapse
|
19
|
Lindberg PG, Térémetz M, Charron S, Kebir O, Saby A, Bendjemaa N, Lion S, Crépon B, Gaillard R, Oppenheim C, Krebs MO, Amado I. Altered cortical processing of motor inhibition in schizophrenia. Cortex 2016; 85:1-12. [DOI: 10.1016/j.cortex.2016.09.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/20/2016] [Accepted: 09/23/2016] [Indexed: 12/30/2022]
|
20
|
Goodman MS, Bridgman AC, Rabin RA, Blumberger DM, Rajji TK, Daskalakis ZJ, George TP, Barr MS. Differential effects of cannabis dependence on cortical inhibition in patients with schizophrenia and non-psychiatric controls. Brain Stimul 2016; 10:275-282. [PMID: 27964871 DOI: 10.1016/j.brs.2016.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/04/2016] [Accepted: 11/10/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cannabis is the most commonly used illicit substance among patients with schizophrenia. Cannabis exacerbates psychotic symptoms and leads to poor functional outcomes. Dysfunctional cortical inhibition has been implicated in the pathophysiology of schizophrenia; however, the effects of cannabis on this mechanism have been relatively unexamined. The goal of this study was to index cortical inhibition from the motor cortex among 4 groups: schizophrenia patients and non-psychiatric controls dependent on cannabis as well as cannabis-free schizophrenia patients and non-psychiatric controls. METHODS In this cross-sectional study, GABA-mediated cortical inhibition was index with single- and paired-pulse transcranial magnetic stimulation (TMS) paradigms to the left motor cortex in 12 cannabis dependent and 11 cannabis-free schizophrenia patients, and in 10 cannabis dependent and 13 cannabis-free controls. RESULTS Cannabis-dependent patients with schizophrenia displayed greater short-interval cortical inhibition (SICI) compared to cannabis-free schizophrenia patients (p = 0.029), while cannabis-dependent controls displayed reduced SICI compared to cannabis-free controls (p = 0.004). SICI did not differ between cannabis dependent patients and cannabis-free controls, or between dependent schizophrenia patients compared to dependent controls. No significant differences were found for long-interval cortical inhibition (LICI) or intra-cortical facilitation (ICF) receptor function, suggesting a selective effect on SICI. CONCLUSION These findings suggest that cannabis dependence may have selective and differing effects on SICI in schizophrenia patients compared to controls, which may provide insight into the pathophysiology of co-morbid cannabis dependence in schizophrenia.
Collapse
Affiliation(s)
- Michelle S Goodman
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Alanna C Bridgman
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Rachel A Rabin
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Daniel M Blumberger
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada; Division of Geriatric Psychiatry, CAMH and Department of Psychiatry, University of Toronto, 80 Workman Way, Toronto M6J 1H4, ON, Canada
| | - Tarek K Rajji
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada; Division of Geriatric Psychiatry, CAMH and Department of Psychiatry, University of Toronto, 80 Workman Way, Toronto M6J 1H4, ON, Canada
| | - Zafiris J Daskalakis
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Tony P George
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada
| | - Mera S Barr
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, Toronto M5T 1R8, ON, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, CAMH, 1001 Queen Street West, Toronto M6J 1H4 ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle Room 2374, Toronto M5S 1A8, ON, Canada.
| |
Collapse
|
21
|
Du X, Kochunov P, Summerfelt A, Chiappelli J, Choa FS, Hong LE. The role of white matter microstructure in inhibitory deficits in patients with schizophrenia. Brain Stimul 2016; 10:283-290. [PMID: 27867023 DOI: 10.1016/j.brs.2016.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/01/2016] [Accepted: 11/10/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Inhibitory-excitatory (I-E) imbalance has increasingly been proposed as a fundamental mechanism giving rise to many schizophrenia-related pathophysiology. The integrity of I-E functions should require precise and rapid electrical signal transmission. OBJECTIVE/HYPOTHESIS We hypothesized that part of the I-E abnormality in schizophrenia may originate from their known abnormal white matter connectivity that may interfere the I-E functions. METHODS We test this using short-interval intracortical inhibition (SICI) vs. intracortical facilitation (ICF) which is a non-invasive measurement of I-E signaling. SICI-ICF from left motor cortex and white matter microstructure were assessed in schizophrenia patients and healthy controls. RESULTS Schizophrenia patients showed significantly reduced SICI but not ICF. White matter microstructure as measured by fraction anisotropy (FA) in diffusion tensor imaging had a significant effect on SICI in patients, such that weaker SICI was associated with lower FA in several white matter tracts, most strongly with left corona radiata (r = -0.68, p = 0.0002) that contains the fibers connecting with left motor cortex. Left corticospinal tract, which carries the motor fibers to peripheral muscular output, also showed significant correlation with SICI (r = -0.54, p = 0.005). Mediation analysis revealed that much of the schizophrenia disease effect on SICI can be accounted for by mediation through left corona radiata. SICI was also significantly associated with the performance of processing speed in patients. CONCLUSION This study demonstrated the importance of structural circuitry integrity in inhibitory signaling in schizophrenia, and encouraged modeling the I-E dysfunction in schizophrenia from a circuitry perspective.
Collapse
Affiliation(s)
- Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ann Summerfelt
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Fow-Sen Choa
- The Department of Computer Science and Electrical Engineering, University of Maryland Baltimore County, Baltimore, MD, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
22
|
Bridgman AC, Barr MS, Goodman MS, Chen R, Rajji TK, Daskalakis ZJ, George TP. Deficits in GABAA receptor function and working memory in non-smokers with schizophrenia. Schizophr Res 2016; 171:125-30. [PMID: 26796540 DOI: 10.1016/j.schres.2016.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/31/2015] [Accepted: 01/03/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although altered gamma-aminobutyric acid (GABA) neurotransmission has been implicated in the pathophysiology of schizophrenia, it is unclear whether the influence of GABA on working memory processes is confounded by nicotine use in this population. It is therefore crucial to evaluate working memory and its underlying mechanisms in non-smokers with schizophrenia to eliminate the confounding effects of nicotine on behavior and neurophysiology. METHODS In this cross-sectional study, working memory was assessed using the verbal N-back task, while GABAergic function was assessed through motor cortical inhibition using single and paired-pulse transcranial magnetic stimulation (TMS) to the left primary motor cortex in 11 non-smokers with schizophrenia and 13 non-smoker healthy subjects. RESULTS Similar to previously published studies, working memory performance was significantly impaired in the 3-back condition in patients with schizophrenia compared to healthy subjects (p=0.036). In addition, GABAA receptor function was significantly reduced in schizophrenia as assessed by short interval cortical inhibition (SICI) (p=0.005). A positive correlation was found between GABAA inhibition and working memory performance on the 3-back task (r(23)=0.55, p=0.006), suggesting that greater GABAA inhibition is associated with better performance on tasks of working memory. CONCLUSIONS Our findings highlight the role of GABAA receptor dysfunction in working memory and the pathophysiology of schizophrenia, and may represent a selective characteristic of schizophrenia. Moreover, these findings suggest a potential therapeutic role for targeting GABA receptor activity to improve cognition and quality of life in patients with schizophrenia.
Collapse
Affiliation(s)
- Alanna C Bridgman
- Schizophrenia Division, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON M6J 1H4, Canada
| | - Mera S Barr
- Schizophrenia Division, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON M6J 1H4, Canada.
| | - Michelle S Goodman
- Schizophrenia Division, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON M6J 1H4, Canada
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON M6J 1H4, Canada; Division of Geriatric Psychiatry, Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Zafiris J Daskalakis
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON M6J 1H4, Canada
| | - Tony P George
- Schizophrenia Division, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
| |
Collapse
|
23
|
GABA abnormalities in schizophrenia: a methodological review of in vivo studies. Schizophr Res 2015; 167:84-90. [PMID: 25458856 PMCID: PMC4409914 DOI: 10.1016/j.schres.2014.10.011] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 10/04/2014] [Accepted: 10/07/2014] [Indexed: 12/31/2022]
Abstract
Abnormalities of GABAergic interneurons are some of the most consistent findings from post-mortem studies of schizophrenia. However, linking these molecular deficits with in vivo observations in patients - a critical goal in order to evaluate interventions that would target GABAergic deficits - presents a challenge. Explanatory models have been developed based on animal work and the emerging experimental literature in schizophrenia patients. This literature includes: neuroimaging ligands to GABA receptors, magnetic resonance spectroscopy (MRS) of GABA concentration, transcranial magnetic stimulation of cortical inhibitory circuits and pharmacologic probes of GABA receptors to dynamically challenge the GABA system, usually in combination with neuroimaging studies. Pharmacologic challenges have elicited behavioral changes, and preliminary studies of therapeutic GABAergic interventions have been conducted. This article critically reviews the evidence for GABAergic dysfunction from each of these areas. These methods remain indirect measures of GABAergic function, and a broad array of dysfunction is linked with the putative GABAergic measures, including positive symptoms, cognition, emotion, motor processing and sensory processing, covering diverse brain areas. Measures of receptor binding have not shown replicable group differences in binding, and MRS assays of GABA concentration have yielded equivocal evidence of large-scale alteration in GABA concentration. Overall, the experimental base remains sparse, and much remains to be learned about the role of GABAergic interneurons in healthy brains. Challenges with pharmacologic and functional probes show promise, and may yet enable a better characterization of GABAergic deficits in schizophrenia.
Collapse
|
24
|
Nakajima M, Görlich A, Heintz N. Oxytocin modulates female sociosexual behavior through a specific class of prefrontal cortical interneurons. Cell 2015; 159:295-305. [PMID: 25303526 DOI: 10.1016/j.cell.2014.09.020] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/03/2014] [Accepted: 09/10/2014] [Indexed: 12/27/2022]
Abstract
Human imaging studies have revealed that intranasal administration of the "prosocial" hormone oxytocin (OT) activates the frontal cortex, and this action of OT correlates with enhanced brain function in autism. Here, we report the discovery of a population of somatostatin (Sst)-positive, regular spiking interneurons that express the oxytocin receptor (OxtrINs). Silencing of OxtrINs in the medial prefrontal cortex (mPFC) of female mice resulted in loss of social interest in male mice specifically during the sexually receptive phase of the estrous cycle. This sociosexual deficit was also present in mice in which the Oxtr gene was conditionally deleted from the mPFC and in control mice infused with an Oxtr antagonist. Our data demonstrate a gender-, cell type-, and state-specific role for OT/Oxtr signaling in the mPFC and identify a latent cortical circuit element that may modulate other complex social behaviors in response to OT.
Collapse
Affiliation(s)
- Miho Nakajima
- Laboratory of Molecular Biology, Howard Hughes Medical Institute, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA
| | - Andreas Görlich
- Laboratory of Molecular Biology, Howard Hughes Medical Institute, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA
| | - Nathaniel Heintz
- Laboratory of Molecular Biology, Howard Hughes Medical Institute, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA.
| |
Collapse
|
25
|
Takahashi S, Ukai S, Tsuji T, Ueyama T, Kono M, Yamanaka N, Shinosaki K. Reduction of cortical excitability and increase of thalamic activity in a low-frequency rTMS treatment for chronic tinnitus. Neurocase 2015; 21:339-44. [PMID: 24606019 DOI: 10.1080/13554794.2014.893000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Low-frequency repetitive transcranial magnetic stimulation (rTMS) has received increasing attention for the treatment of tinnitus, but its therapeutic mechanisms are unclear. We performed low-frequency rTMS treatment for a patient with chronic tinnitus and examined changes of cortical excitability and cerebral blood flow using paired-pulse TMS and single-photon emission computed tomography. After the rTMS treatment, tinnitus loudness was decreased, cortical excitability was reduced, and blood flow in the thalamus was increased. Our results suggest that low-frequency rTMS treatment reduces tinnitus loudness by an inhibitory effect on the cortical excitability and a remote activation effect on the thalamus through the corticothalamic networks.
Collapse
Affiliation(s)
- Shun Takahashi
- a Department of Neuropsychiatry , Wakayama Medical University , Wakayama , Japan
| | | | | | | | | | | | | |
Collapse
|