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Wang L, Liu R, Liao J, Xiong X, Xia L, Wang W, Liu J, Zhao F, Zhuo L, Li H. Meta-analysis of structural and functional brain abnormalities in early-onset schizophrenia. Front Psychiatry 2024; 15:1465758. [PMID: 39247615 PMCID: PMC11377232 DOI: 10.3389/fpsyt.2024.1465758] [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: 07/16/2024] [Accepted: 08/06/2024] [Indexed: 09/10/2024] Open
Abstract
Background Previous studies based on resting-state functional magnetic resonance imaging(rs-fMRI) and voxel-based morphometry (VBM) have demonstrated significant abnormalities in brain structure and resting-state functional brain activity in patients with early-onset schizophrenia (EOS), compared with healthy controls (HCs), and these alterations were closely related to the pathogenesis of EOS. However, previous studies suffer from the limitations of small sample sizes and high heterogeneity of results. Therefore, the present study aimed to effectively integrate previous studies to identify common and specific brain functional and structural abnormalities in patients with EOS. Methods The PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), and WanFang databases were systematically searched to identify publications on abnormalities in resting-state regional functional brain activity and gray matter volume (GMV) in patients with EOS. Then, we utilized the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software to conduct a whole-brain voxel meta-analysis of VBM and rs-fMRI studies, respectively, and followed by multimodal overlapping on this basis to comprehensively identify brain structural and functional abnormalities in patients with EOS. Results A total of 27 original studies (28 datasets) were included in the present meta-analysis, including 12 studies (13 datasets) related to resting-state functional brain activity (496 EOS patients, 395 HCs) and 15 studies (15 datasets) related to GMV (458 EOS patients, 531 HCs). Overall, in the functional meta-analysis, patients with EOS showed significantly increased resting-state functional brain activity in the left middle frontal gyrus (extending to the triangular part of the left inferior frontal gyrus) and the right caudate nucleus. On the other hand, in the structural meta-analysis, patients with EOS showed significantly decreased GMV in the right superior temporal gyrus (extending to the right rolandic operculum), the right middle temporal gyrus, and the temporal pole (superior temporal gyrus). Conclusion This meta-analysis revealed that some regions in the EOS exhibited significant structural or functional abnormalities, such as the temporal gyri, prefrontal cortex, and striatum. These findings may help deepen our understanding of the underlying pathophysiological mechanisms of EOS and provide potential biomarkers for the diagnosis or treatment of EOS.
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Affiliation(s)
- Lu Wang
- Medical Imaging College, North Sichuan Medical College, Nanchong, China
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Ruishan Liu
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Juan Liao
- Medical Imaging College, North Sichuan Medical College, Nanchong, China
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Xin Xiong
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Linfeng Xia
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Weiwei Wang
- Department of Psychiatry, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Junqi Liu
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Fulin Zhao
- Medical Imaging College, North Sichuan Medical College, Nanchong, China
| | - Lihua Zhuo
- Medical Imaging College, North Sichuan Medical College, Nanchong, China
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Hongwei Li
- Department of Radiology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
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Xie Y, Guan M, Wang Z, Ma Z, Fang P, Wang H. Cerebral blood flow changes in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment. Eur Arch Psychiatry Clin Neurosci 2023; 273:1851-1861. [PMID: 37280358 DOI: 10.1007/s00406-023-01624-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/22/2023] [Indexed: 06/08/2023]
Abstract
Auditory verbal hallucinations (AVH) are a prominent symptom of schizophrenia. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been evidenced to improve the treatment of AVH in schizophrenia. Although abnormalities in resting-state cerebral blood flow (CBF) have been reported in schizophrenia, the perfusion alterations specific to schizophrenia patients with AVH during rTMS require further investigation. In this study, we used arterial spin labeling (ASL) to investigate changes in brain perfusion in schizophrenia patients with AVH, and their associations with clinical improvement following low-frequency rTMS treatment applied to the left temporoparietal junction area. We observed improvements in clinical symptoms (e.g., positive symptoms and AVH) and certain neurocognitive functions (e.g., verbal learning and visual learning) following treatment. Furthermore, at baseline, the patients showed reductions in CBF in regions associated with language, sensory, and cognition compared to controls, primarily located in the prefrontal cortices (e.g., left inferior frontal gyrus and left middle frontal gyrus), occipital lobe (e.g., left calcarine cortex), and cingulate cortex (e.g., bilateral middle cingulate cortex), compared to controls. Conversely, we observed increased CBF in the left inferior temporal gyrus and bilateral putamen in patients relative to controls, regions known to be involved in AVH. However, the hypoperfusion or hyperperfusion patterns did not persist and instead were normalized, and were related to clinical response (e.g., AVH) in patients during low-frequency rTMS treatment. Importantly, the changes in brain perfusion were related to clinical response (e.g., AVH) in patients. Our findings suggest that low-frequency rTMS can regulate brain perfusion involving critical circuits by its remote effect in schizophrenia, and may play an important mechanistic role in the treatment of AVH.
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Affiliation(s)
- Yuanjun Xie
- Department of Military Medical Psychology, School of Psychology, Fourth Military Medical University, Xi'an, China.
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Muzhen Guan
- Department of Mental Health, Xi'an Medical University, Xi'an, China
| | - Zhongheng Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhujing Ma
- Department of Clinical Psychology, School of Psychology, Fourth Military Medical University, Xi'an, China
| | - Peng Fang
- Department of Military Medical Psychology, School of Psychology, Fourth Military Medical University, Xi'an, China.
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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DeLisi LE. Brain plasticity, language anomalies, genetic risk and the patient with schizophrenia: Trajectory of change over a lifetime. A commentary. Psychiatry Res 2023; 320:115034. [PMID: 36603384 DOI: 10.1016/j.psychres.2022.115034] [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] [Indexed: 01/01/2023]
Abstract
Research on schizophrenia has been pursued for over a century. While the ability to view the brain and also the entire human genome advanced dramatically during this time and particularly in recent years, it is still unclear whether these advances helped to understand the nature of schizophrenia. What appears, however, to be the case is that early detection and treatment of people who are at high risk for developing schizophrenia due to various clinical signs, lead to better outcomes and recovery in many cases. Medications have also dramatically improved and have not been associated with the side-effects of earlier treatments, although they still are not without new sets of adverse effects. Over the years it was shown that structural brain abnormalities were present in the brains of people with chronic schizophrenia and that these observations were present early in the onset of illness. It was then shown these were not static and changed over the years of illness. At the same time it was shown that the brain centers for perceiving and speaking language appeared particularly abnormal in patients with schizophrenia and that these abnormalities could underlie the misperceptions and experiences of auditory hallucinations so characteristic of this illness. In a separate set of investigations that began with family, then twin and adoption studies, it was shown that schizophrenia is inherited, but in a complex manner. At present many genetic studies now find that genes, whose variants can lead to a high risk for schizophrenia, are ones specifically involving brain development and functioning. At present, although still speculative, it can be concluded that the progressive changes in brain structure, particularly related to language processing, take place in genetically vulnerable people and put them ultimately at high risk for developing schizophrenia in a trajectory for a lifelong illness. It is hoped that in the future these brain changes can be prevented by intervening early on the processes of brain growth and plasticity, thus arresting the illness before it begins.
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Affiliation(s)
- Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts, United States.
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4
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Tonna M, Lucarini V, Borrelli DF, Parmigiani S, Marchesi C. Disembodiment and Language in Schizophrenia: An Integrated Psychopathological and Evolutionary Perspective. Schizophr Bull 2023; 49:161-171. [PMID: 36264669 PMCID: PMC9810023 DOI: 10.1093/schbul/sbac146] [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] [Indexed: 01/07/2023]
Abstract
Different hypotheses have flourished to explain the evolutionary paradox of schizophrenia. In this contribution, we sought to illustrate how, in the schizophrenia spectrum, the concept of embodiment may underpin the phylogenetic and developmental pathways linking sensorimotor processes, the origin of human language, and the construction of a basic sense of the self. In particular, according to an embodied model of language, we suggest that the reuse of basic sensorimotor loops for language, while enabling the development of fully symbolic thought, has pushed the human brain close to the threshold of a severe disruption of self-embodiment processes, which are at the core of schizophrenia psychopathology. We adopted an inter-disciplinary approach (psychopathology, neuroscience, developmental biology) within an evolutionary framework, to gain an integrated, multi-perspectival model on the origin of schizophrenia vulnerability. A maladaptive over-expression of evolutionary-developmental trajectories toward language at the expense of embodiment processes would have led to the evolutionary "trade-off" of a hyper-symbolic activity to the detriment of a disembodied self. Therefore, schizophrenia psychopathology might be the cost of long-term co-evolutive interactions between brain and language.
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Affiliation(s)
- Matteo Tonna
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Valeria Lucarini
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | | | - Stefano Parmigiani
- Department of Department of Chemistry, Life Sciences and Environmental Sustainability, Unit of Behavioral Biology, University of Parma, Parma, Italy
| | - Carlo Marchesi
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
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Historical pursuits of the language pathway hypothesis of schizophrenia. NPJ SCHIZOPHRENIA 2021; 7:53. [PMID: 34753947 PMCID: PMC8578658 DOI: 10.1038/s41537-021-00182-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022]
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Palaniyappan L, Du J, Zhang J, Feng J. Reply to: "Historical pursuits of the language pathway hypothesis of schizophrenia". NPJ SCHIZOPHRENIA 2021; 7:54. [PMID: 34753936 PMCID: PMC8578441 DOI: 10.1038/s41537-021-00183-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Lena Palaniyappan
- Department of Psychiatry and Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Jingnan Du
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 200030, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Jie Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, CV4 7AL, UK.
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7
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Del Re EC, Stone WS, Bouix S, Seitz J, Zeng V, Guliano A, Somes N, Zhang T, Reid B, Lyall A, Lyons M, Li H, Whitfield-Gabrieli S, Keshavan M, Seidman LJ, McCarley RW, Wang J, Tang Y, Shenton ME, Niznikiewicz MA. Baseline Cortical Thickness Reductions in Clinical High Risk for Psychosis: Brain Regions Associated with Conversion to Psychosis Versus Non-Conversion as Assessed at One-Year Follow-Up in the Shanghai-At-Risk-for-Psychosis (SHARP) Study. Schizophr Bull 2021; 47:562-574. [PMID: 32926141 PMCID: PMC8480195 DOI: 10.1093/schbul/sbaa127] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess cortical thickness (CT) and surface area (SA) of frontal, temporal, and parietal brain regions in a large clinical high risk for psychosis (CHR) sample, and to identify cortical brain abnormalities in CHR who convert to psychosis and in the whole CHR sample, compared with the healthy controls (HC). METHODS Magnetic resonance imaging, clinical, and cognitive data were acquired at baseline in 92 HC, 130 non-converters, and 22 converters (conversion assessed at 1-year follow-up). CT and SA at baseline were calculated for frontal, temporal, and parietal subregions. Correlations between regions showing group differences and clinical scores and age were also obtained. RESULTS CT but not SA was significantly reduced in CHR compared with HC. Two patterns of findings emerged: (1) In converters, CT was significantly reduced relative to non-converters and controls in the banks of superior temporal sulcus, Heschl's gyrus, and pars triangularis and (2) CT in the inferior parietal and supramarginal gyrus, and at trend level in the pars opercularis, fusiform, and middle temporal gyri was significantly reduced in all high-risk individuals compared with HC. Additionally, reduced CT correlated significantly with older age in HC and in non-converters but not in converters. CONCLUSIONS These results show for the first time that fronto-temporo-parietal abnormalities characterized all CHR, that is, both converters and non-converters, relative to HC, while CT abnormalities in converters relative to CHR-NC and HC were found in core auditory and language processing regions.
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Affiliation(s)
- Elisabetta C Del Re
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston
Healthcare System, Brockton Division, and Harvard Medical School,
Boston, MA
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Johanna Seitz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Victor Zeng
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Anthony Guliano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Nathaniel Somes
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Tianhong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of
Medicine, Shanghai Key Laboratory of Psychotic Disorders, SHARP
Program, Shanghai China
| | - Benjamin Reid
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
| | - Amanda Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
| | - Monica Lyons
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
| | - Huijun Li
- Florida A&M University, Department of Psychology,
Tallahassee, FL
| | | | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
| | - Robert W McCarley
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston
Healthcare System, Brockton Division, and Harvard Medical School,
Boston, MA
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of
Medicine, Shanghai Key Laboratory of Psychotic Disorders, SHARP
Program, Shanghai China
| | - Yingying Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of
Medicine, Shanghai Key Laboratory of Psychotic Disorders, SHARP
Program, Shanghai China
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham
and Women’s Hospital, and Harvard Medical School, Boston,
MA
- Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Boston, MA
- Department of Radiology, Brigham and Women’s Hospital, and
Harvard Medical School, Boston, MA
- Research and Development, VA Boston Healthcare System,
Boston, MA
| | - Margaret A Niznikiewicz
- Laboratory of Neuroscience, Department of Psychiatry, VA Boston
Healthcare System, Brockton Division, and Harvard Medical School,
Boston, MA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
- To whom correspondence should be addressed; e-mail:
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Abstract
PURPOSE OF REVIEW After more than a century of neuroscience research, reproducible, clinically relevant biomarkers for schizophrenia have not yet been established. This article reviews current advances in evaluating the use of language as a diagnostic or prognostic tool in schizophrenia. RECENT FINDINGS The development of computational linguistic tools to quantify language disturbances is rapidly gaining ground in the field of schizophrenia research. Current applications are the use of semantic space models and acoustic analyses focused on phonetic markers. These features are used in machine learning models to distinguish patients with schizophrenia from healthy controls or to predict conversion to psychosis in high-risk groups, reaching accuracy scores (generally ranging from 80 to 90%) that exceed clinical raters. Other potential applications for a language biomarker in schizophrenia are monitoring of side effects, differential diagnostics and relapse prevention. SUMMARY Language disturbances are a key feature of schizophrenia. Although in its early stages, the emerging field of research focused on computational linguistics suggests an important role for language analyses in the diagnosis and prognosis of schizophrenia. Spoken language as a biomarker for schizophrenia has important advantages because it can be objectively and reproducibly quantified. Furthermore, language analyses are low-cost, time efficient and noninvasive in nature.
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Anteraper SA, Collin G, Guell X, Scheinert T, Molokotos E, Henriksen MT, Mesholam-Gately R, Thermenos HW, Seidman LJ, Keshavan MS, Gabrieli JDE, Whitfield-Gabrieli S. Altered resting-state functional connectivity in young children at familial high risk for psychotic illness: A preliminary study. Schizophr Res 2020; 216:496-503. [PMID: 31801673 PMCID: PMC7239744 DOI: 10.1016/j.schres.2019.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 01/05/2023]
Abstract
Multiple lines of evidence suggest that illness development in schizophrenia and other psychotic disorders predates the first psychotic episode by many years. In this study, we examined a sample of 15 pre-adolescent children, ages 7 through 12 years, who are at familial high-risk (FHR) because they have a parent or sibling with a history of schizophrenia or related psychotic disorder. Using multi-voxel pattern analysis (MVPA), a data-driven fMRI analysis, we assessed whole-brain differences in functional connectivity in the FHR sample as compared to an age- and sex-matched control (CON) group of 15 children without a family history of psychosis. MVPA analysis yielded a single cluster in right posterior superior temporal gyrus (pSTG/BA 22) showing significant group-differences in functional connectivity. Post-hoc characterization of this cluster through seed-to-voxel analysis revealed mostly reduced functional connectivity of the pSTG seed to a set of language and default mode network (DMN) associated brain regions including Heschl's gyrus, inferior temporal gyrus extending into fusiform gyrus, (para)hippocampus, thalamus, and a cerebellar cluster encompassing mainly Crus I/II. A height-threshold of whole-brain p < .001 (two-sided), and FDR-corrected cluster-threshold of p < .05 (non-parametric statistics) was used for post-hoc characterization. These findings suggest that abnormalities in functional communication in a network encompassing right STG and associated brain regions are present before adolescence in at-risk children and may be a risk marker for psychosis. Subsequent changes in this functional network across development may contribute to either disease manifestation or resilience in children with a familial vulnerability for psychosis.
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Affiliation(s)
- Sheeba Arnold Anteraper
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychology, Northeastern University, Boston, MA, USA; Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, MA, USA.
| | - Guusje Collin
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Corresponding author
| | - Xavier Guell
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Timothy Scheinert
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Elena Molokotos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Maria Toft Henriksen
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Raquelle Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Heidi W. Thermenos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - John D. E. Gabrieli
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Susan Whitfield-Gabrieli
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Department of Psychology, Northeastern University, Boston, MA, USA
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Collin G, Nieto-Castanon A, Shenton ME, Pasternak O, Kelly S, Keshavan MS, Seidman LJ, McCarley RW, Niznikiewicz MA, Li H, Zhang T, Tang Y, Stone WS, Wang J, Whitfield-Gabrieli S. Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis. NEUROIMAGE-CLINICAL 2019; 26:102108. [PMID: 31791912 PMCID: PMC7229353 DOI: 10.1016/j.nicl.2019.102108] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 02/08/2023]
Abstract
The first episode of psychosis is typically preceded by a prodromal phase with subthreshold symptoms and functional decline. Improved outcome prediction in this stage is needed to allow targeted early intervention. This study assesses a combined clinical and resting-state fMRI prediction model in 137 adolescents and young adults at Clinical High Risk (CHR) for psychosis from the Shanghai At Risk for Psychosis (SHARP) program. Based on outcome at one-year follow-up, participants were separated into three outcome categories including good outcome (symptom remission, N = 71), intermediate outcome (ongoing CHR symptoms, N = 30), and poor outcome (conversion to psychosis or treatment-refractory, N = 36). Validated clinical predictors from the psychosis-risk calculator were combined with measures of resting-state functional connectivity. Using multinomial logistic regression analysis and leave-one-out cross-validation, a clinical-only prediction model did not achieve a significant level of outcome prediction (F1 = 0.32, p = .154). An imaging-only model yielded a significant prediction model (F1 = 0.41, p = .016), but a combined model including both clinical and connectivity measures showed the best performance (F1 = 0.46, p < .001). Influential predictors in this model included functional decline, verbal learning performance, a family history of psychosis, default-mode and frontoparietal within-network connectivity, and between-network connectivity among language, salience, dorsal attention, sensorimotor, and cerebellar networks. These findings suggest that brain changes reflected by alterations in functional connectivity may be useful for outcome prediction in the prodromal stage.
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Affiliation(s)
- Guusje Collin
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Alfonso Nieto-Castanon
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychology, Northeastern University, Boston, MA, USA; Department of Speech, Language & Hearing Sciences, Boston University, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Research and Development, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sinead Kelly
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Robert W McCarley
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | | | - Huijun Li
- Florida A&M University, Department of Psychology, Tallahassee, FL, USA
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Adamczyk P, Wyczesany M, Domagalik A, Daren A, Cepuch K, Błądziński P, Cechnicki A, Marek T. Neural circuit of verbal humor comprehension in schizophrenia - an fMRI study. Neuroimage Clin 2017; 15:525-540. [PMID: 28652967 PMCID: PMC5473647 DOI: 10.1016/j.nicl.2017.06.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/03/2017] [Accepted: 06/01/2017] [Indexed: 11/17/2022]
Abstract
Individuals with schizophrenia exhibit problems with understanding the figurative meaning of language. This study evaluates neural correlates of diminished humor comprehension observed in schizophrenia. The study included chronic schizophrenia (SCH) outpatients (n = 20), and sex, age and education level matched healthy controls (n = 20). The fMRI punchline based humor comprehension task consisted of 60 stories of which 20 had funny, 20 nonsensical and 20 neutral (not funny) punchlines. After the punchlines were presented, the participants were asked to indicate whether the story was comprehensible and how funny it was. Three contrasts were analyzed in both groups reflecting stages of humor processing: abstract vs neutral stories - incongruity detection; funny vs abstract - incongruity resolution and elaboration; and funny vs neutral - complete humor processing. Additionally, parametric modulation analysis was performed using both subjective ratings separately. Between-group comparisons revealed that the SCH subjects had attenuated activation in the right posterior superior temporal gyrus (BA 41) in case of irresolvable incongruity processing of nonsensical puns; in the left dorsomedial middle and superior frontal gyri (BA 8/9) in case of incongruity resolution and elaboration processing of funny puns; and in the interhemispheric dorsal anterior cingulate cortex (BA 24) in case of complete processing of funny puns. Additionally, during comprehensibility ratings the SCH group showed a suppressed activity in the left dorsomedial middle and superior frontal gyri (BA 8/9) and revealed weaker activation during funniness ratings in the left dorsal anterior cingulate cortex (BA 24). Interestingly, these differences in the SCH group were accompanied behaviorally by a protraction of time in both types of rating responses and by indicating funny punchlines less comprehensible. Summarizing, our results indicate neural substrates of humor comprehension processing impairments in schizophrenia, which is accompanied by fronto-temporal hypoactivation.
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Key Words
- ABS, absurd/nonsensical punchline
- ACC, anterior cingulate cortex
- BA, Brodmann's area
- CON, healthy controls/control group
- Communication skills
- EEG, electroencephalography
- ERPs, EEG event-related potentials
- FDR, False Discovery Rate
- FUN, funny punchline
- FWHM, full-width-at-half-maximum
- Figurative meaning
- Functional magnetic resonance imaging
- GLM, general linear model
- Humor
- IFG, inferior frontal gyrus
- IPL, Inferior Parietal Lobule
- ISI, interstimulus-interval
- L, left hemisphere
- MFG, medial frontal gyrus
- MNI, Montreal Neurological Institute coordinates
- MOG, middle occipital gyrus
- MRI, magnetic resonance imaging
- MTG, middle temporal gyrus
- MoCA, Montreal Cognitive Assessment
- NEU, neutral/unfunny punchline
- PANSS, Positive and Negative Syndrome Scale
- PFC, prefrontal cortex
- R, right hemisphere
- RHLB, Right Hemisphere Language Battery
- RT, reaction time
- SCH, schizophrenia outpatients/clinical group
- SD, standard deviations
- SEM, standard error of the mean
- SFG, Superior Frontal Gyrus
- SOA, stimulus onset asynchrony
- STG, superior temporal gyrus
- Schizophrenia
- TP, temporal pole
- TPJ, temporoparietal junction
- ToM, theory of mind.
- dACC, dorsal anterior cingulate cortex
- dlPFC, dorsolateral prefrontal cortex
- dmMFG, dorsomedial Middle Frontal Gyrus
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- k, number of voxels in analyzed cluster size
- ns, non-significant group difference
- pSTG, posterior Superior Temporal Gyrus
- sLORETA, standardized low resolution brain electromagnetic tomography analysis
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Affiliation(s)
- Przemysław Adamczyk
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland; Psychosis Research and Psychotherapy Unit, Association for the Development of Psychiatry and Community Care, Krakow, Poland.
| | - Miroslaw Wyczesany
- Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Aleksandra Domagalik
- Neurobiology Department, The Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Artur Daren
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland; Psychosis Research and Psychotherapy Unit, Association for the Development of Psychiatry and Community Care, Krakow, Poland
| | - Kamil Cepuch
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Piotr Błądziński
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland; Psychosis Research and Psychotherapy Unit, Association for the Development of Psychiatry and Community Care, Krakow, Poland
| | - Tadeusz Marek
- Neurobiology Department, The Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland; Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
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Li P, Jing RX, Zhao RJ, Ding ZB, Shi L, Sun HQ, Lin X, Fan TT, Dong WT, Fan Y, Lu L. Electroconvulsive therapy-induced brain functional connectivity predicts therapeutic efficacy in patients with schizophrenia: a multivariate pattern recognition study. NPJ SCHIZOPHRENIA 2017; 3:21. [PMID: 28560267 PMCID: PMC5441568 DOI: 10.1038/s41537-017-0023-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 04/01/2017] [Accepted: 04/21/2017] [Indexed: 01/08/2023]
Abstract
Previous studies suggested that electroconvulsive therapy can influence regional metabolism and dopamine signaling, thereby alleviating symptoms of schizophrenia. It remains unclear what patients may benefit more from the treatment. The present study sought to identify biomarkers that predict the electroconvulsive therapy response in individual patients. Thirty-four schizophrenia patients and 34 controls were included in this study. Patients were scanned prior to treatment and after 6 weeks of treatment with antipsychotics only (n = 16) or a combination of antipsychotics and electroconvulsive therapy (n = 13). Subject-specific intrinsic connectivity networks were computed for each subject using a group information-guided independent component analysis technique. Classifiers were built to distinguish patients from controls and quantify brain states based on intrinsic connectivity networks. A general linear model was built on the classification scores of first scan (referred to as baseline classification scores) to predict treatment response. Classifiers built on the default mode network, the temporal lobe network, the language network, the corticostriatal network, the frontal-parietal network, and the cerebellum achieved a cross-validated classification accuracy of 83.82%, with specificity of 91.18% and sensitivity of 76.47%. After the electroconvulsive therapy, psychosis symptoms of the patients were relieved and classification scores of the patients were decreased. Moreover, the baseline classification scores were predictive for the treatment outcome. Schizophrenia patients exhibited functional deviations in multiple intrinsic connectivity networks which were able to distinguish patients from healthy controls at an individual level. Patients with lower classification scores prior to treatment had better treatment outcome, indicating that the baseline classification scores before treatment is a good predictor for treatment outcome.
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Affiliation(s)
- Peng Li
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191 China
| | - Ri-xing Jing
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Rong-jiang Zhao
- Department of Alcohol and Drug Dependence, Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096 China
| | - Zeng-bo Ding
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191 China
| | - Le Shi
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191 China
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191 China
| | - Hong-qiang Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191 China
| | - Xiao Lin
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871 China
| | - Teng-teng Fan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191 China
| | - Wen-tian Dong
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191 China
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191 China
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191 China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871 China
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Li T, Wang Q, Zhang J, Rolls ET, Yang W, Palaniyappan L, Zhang L, Cheng W, Yao Y, Liu Z, Gong X, Luo Q, Tang Y, Crow TJ, Broome MR, Xu K, Li C, Wang J, Liu Z, Lu G, Wang F, Feng J. Brain-Wide Analysis of Functional Connectivity in First-Episode and Chronic Stages of Schizophrenia. Schizophr Bull 2017; 43:436-448. [PMID: 27445261 PMCID: PMC5605268 DOI: 10.1093/schbul/sbw099] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Published reports of functional abnormalities in schizophrenia remain divergent due to lack of staging point-of-view and whole-brain analysis. To identify key functional-connectivity differences of first-episode (FE) and chronic patients from controls using resting-state functional MRI, and determine changes that are specifically associated with disease onset, a clinical staging model is adopted. We analyze functional-connectivity differences in prodromal, FE (mostly drug naïve), and chronic patients from their matched controls from 6 independent datasets involving a total of 789 participants (343 patients). Brain-wide functional-connectivity analysis was performed in different datasets and the results from the datasets of the same stage were then integrated by meta-analysis, with Bonferroni correction for multiple comparisons. Prodromal patients differed from controls in their pattern of functional-connectivity involving the inferior frontal gyri (Broca's area). In FE patients, 90% of the functional-connectivity changes involved the frontal lobes, mostly the inferior frontal gyrus including Broca's area, and these changes were correlated with delusions/blunted affect. For chronic patients, functional-connectivity differences extended to wider areas of the brain, including reduced thalamo-frontal connectivity, and increased thalamo-temporal and thalamo-sensorimoter connectivity that were correlated with the positive, negative, and general symptoms, respectively. Thalamic changes became prominent at the chronic stage. These results provide evidence for distinct patterns of functional-dysconnectivity across FE and chronic stages of schizophrenia. Importantly, abnormalities in the frontal language networks appear early, at the time of disease onset. The identification of stage-specific pathological processes may help to understand the disease course of schizophrenia and identify neurobiological markers crucial for early diagnosis.
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Affiliation(s)
- Tao Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, PR China
- West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Qiang Wang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, PR China
- West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jie Zhang
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, PR China
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Edmund T Rolls
- Oxford Centre for Computational Neuroscience, Oxford, UK
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Wei Yang
- Shanghai Center for Mathematical Sciences, Shanghai, PR China
| | - Lena Palaniyappan
- Division of Psychiatry and Applied Psychology, University of Nottingham, Centre for Translational Neuroimaging, Institute of Mental Health, Nottingham, UK
- Institute of Mental Health, Nottingham, UK and Penticton Regional Hospital, Penticton, British Columbia, Canada
| | - Lu Zhang
- Shanghai Center for Mathematical Sciences, Shanghai, PR China
| | - Wei Cheng
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, PR China
| | - Ye Yao
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, PR China
| | - Zhaowen Liu
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, PR China
- School of Computer Science and Technology, Xidian University, Xi'an, Shannxi, PR China
| | - Xiaohong Gong
- School of life science department, Fudan University, Shanghai, PR China
| | - Qiang Luo
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, PR China
- School of life science department, Fudan University, Shanghai, PR China
| | - Yanqing Tang
- Psychiatry department, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Timothy J Crow
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Matthew R Broome
- Department of Psychiatry, Medical Science Division, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ke Xu
- Psychiatry department, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders (No. 13dz2260500), Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders (No. 13dz2260500), Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhening Liu
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, PR China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Fei Wang
- Psychiatry department, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, PR China
- Department of Computer Science, University of Warwick, Coventry, UK
- Shanghai Center for Mathematical Sciences, Shanghai, PR China
- Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, PR China
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14
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Li X, Thermenos HW, Wu Z, Momura Y, Wu K, Keshavan M, Seidman L, DeLisi LE. Abnormal interactions of verbal- and spatial-memory networks in young people at familial high-risk for schizophrenia. Schizophr Res 2016; 176:100-105. [PMID: 27481817 DOI: 10.1016/j.schres.2016.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/19/2016] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Working memory impairment (especially in verbal and spatial domains) is the core neurocognitive impairment in schizophrenia and the familial high-risk (FHR) population. Inconsistent results have been reported in clinical and neuroimaging studies examining the verbal- and spatial-memory deficits in the FHR subjects, due to sample differences and lack of understanding on interactions of the brain regions for processing verbal- and spatial-working memory. METHODS Functional MRI data acquired during a verbal- vs. spatial-memory task were included from 51 young adults [26 FHR and 25 controls]. Group comparisons were conducted in brain activation patterns responding to 1) verbal-memory condition (A), 2) spatial-memory condition (B), 3) verbal higher than spatial (A-B), 4) spatial higher than verbal (B-A), 5) conjunction of brain regions that were activated during both A and B (A∧B). Group difference of the laterality index (LI) in inferior frontal lobe for condition A was also assessed. RESULTS Compared to controls, the FHR group exhibited significantly decreased brain activity in left inferior frontal during A, and significantly stronger involvement of ACC, PCC, paracentral gyrus for the contrast of A-B. The LI showed a trend of reduced left-higher-than-right pattern for verbal-memory processing in the HR group. CONCLUSIONS Our findings suggest that in the entire functional brain network for working-memory processing, verbal information processing associated brain pathways are significantly altered in people at familial high risk for developing schizophrenia. Future studies will need to examine whether these alterations may indicate vulnerability for predicting the onset of Schizophrenia.
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Affiliation(s)
- Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA; Department of Electric and Computer Engineering, , New Jersey Institute of Technology, Newark, NJ, USA.
| | | | - Ziyan Wu
- Department of Electric and Computer Engineering, , New Jersey Institute of Technology, Newark, NJ, USA
| | - Yoko Momura
- Department of Psychology, Queens College, City University of New York, NY, USA
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Matcheri Keshavan
- Harvard Medical School, Boston, MA, USA; Beth Israel-Deakoness Hospital, MA, USA
| | - Lawrence Seidman
- Harvard Medical School, Boston, MA, USA; Beth Israel-Deakoness Hospital, MA, USA
| | - Lynn E DeLisi
- VA Boston Healthcare System, Brockton, MA, USA; Harvard Medical School, Boston, MA, USA
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15
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Elvevåg B, Cohen AS, Wolters MK, Whalley HC, Gountouna V, Kuznetsova KA, Watson AR, Nicodemus KK. An examination of the language construct in NIMH's research domain criteria: Time for reconceptualization! Am J Med Genet B Neuropsychiatr Genet 2016; 171:904-19. [PMID: 26968151 PMCID: PMC5025728 DOI: 10.1002/ajmg.b.32438] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/11/2016] [Indexed: 12/25/2022]
Abstract
The National Institute of Mental Health's Research Domain Criteria (RDoC) Initiative "calls for the development of new ways of classifying psychopathology based on dimensions of observable behavior." As a result of this ambitious initiative, language has been identified as an independent construct in the RDoC matrix. In this article, we frame language within an evolutionary and neuropsychological context and discuss some of the limitations to the current measurements of language. Findings from genomics and the neuroimaging of performance during language tasks are discussed in relation to serious mental illness and within the context of caveats regarding measuring language. Indeed, the data collection and analysis methods employed to assay language have been both aided and constrained by the available technologies, methodologies, and conceptual definitions. Consequently, different fields of language research show inconsistent definitions of language that have become increasingly broad over time. Individually, they have also shown significant improvements in conceptual resolution, as well as in experimental and analytic techniques. More recently, language research has embraced collaborations across disciplines, notably neuroscience, cognitive science, and computational linguistics and has ultimately re-defined classical ideas of language. As we move forward, the new models of language with their remarkably multifaceted constructs force a re-examination of the NIMH RDoC conceptualization of language and thus the neuroscience and genetics underlying this concept. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Brita Elvevåg
- Department of Clinical MedicineUniversity of Tromsø−The Arctic University of NorwayTromsøNorway
- Norwegian Centre for eHealth ResearchUniversity Hospital of North NorwayTromsøNorway
| | - Alex S. Cohen
- Department of PsychologyLouisiana State UniversityBaton RougeLouisiana
| | - Maria K. Wolters
- School of InformaticsUniversity of EdinburghEdinburghUnited Kingdom
| | | | - Viktoria‐Eleni Gountouna
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUnited Kingdom
| | - Ksenia A. Kuznetsova
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUnited Kingdom
| | - Andrew R. Watson
- Division of PsychiatryUniversity of EdinburghEdinburghUnited Kingdom
| | - Kristin K. Nicodemus
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUnited Kingdom
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Brown M, Kuperberg GR. A Hierarchical Generative Framework of Language Processing: Linking Language Perception, Interpretation, and Production Abnormalities in Schizophrenia. Front Hum Neurosci 2015; 9:643. [PMID: 26640435 PMCID: PMC4661240 DOI: 10.3389/fnhum.2015.00643] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 11/12/2015] [Indexed: 12/27/2022] Open
Abstract
Language and thought dysfunction are central to the schizophrenia syndrome. They are evident in the major symptoms of psychosis itself, particularly as disorganized language output (positive thought disorder) and auditory verbal hallucinations (AVHs), and they also manifest as abnormalities in both high-level semantic and contextual processing and low-level perception. However, the literatures characterizing these abnormalities have largely been separate and have sometimes provided mutually exclusive accounts of aberrant language in schizophrenia. In this review, we propose that recent generative probabilistic frameworks of language processing can provide crucial insights that link these four lines of research. We first outline neural and cognitive evidence that real-time language comprehension and production normally involve internal generative circuits that propagate probabilistic predictions to perceptual cortices - predictions that are incrementally updated based on prediction error signals as new inputs are encountered. We then explain how disruptions to these circuits may compromise communicative abilities in schizophrenia by reducing the efficiency and robustness of both high-level language processing and low-level speech perception. We also argue that such disruptions may contribute to the phenomenology of thought-disordered speech and false perceptual inferences in the language system (i.e., AVHs). This perspective suggests a number of productive avenues for future research that may elucidate not only the mechanisms of language abnormalities in schizophrenia, but also promising directions for cognitive rehabilitation.
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Affiliation(s)
- Meredith Brown
- Department of Psychiatry–Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, CharlestownMA, USA
- Department of Psychology, Tufts University, MedfordMA, USA
| | - Gina R. Kuperberg
- Department of Psychiatry–Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, CharlestownMA, USA
- Department of Psychology, Tufts University, MedfordMA, USA
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Duffy FH, D'Angelo E, Rotenberg A, Gonzalez-Heydrich J. Neurophysiological differences between patients clinically at high risk for schizophrenia and neurotypical controls--first steps in development of a biomarker. BMC Med 2015; 13:276. [PMID: 26525736 PMCID: PMC4630963 DOI: 10.1186/s12916-015-0516-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schizophrenia is a severe, disabling and prevalent mental disorder without cure and with a variable, incomplete pharmacotherapeutic response. Prior to onset in adolescence or young adulthood a prodromal period of abnormal symptoms lasting weeks to years has been identified and operationalized as clinically high risk (CHR) for schizophrenia. However, only a minority of subjects prospectively identified with CHR convert to schizophrenia, thereby limiting enthusiasm for early intervention(s). This study utilized objective resting electroencephalogram (EEG) quantification to determine whether CHR constitutes a cohesive entity and an evoked potential to assess CHR cortical auditory processing. METHODS This study constitutes an EEG-based quantitative neurophysiological comparison between two unmedicated subject groups: 35 neurotypical controls (CON) and 22 CHR patients. After artifact management, principal component analysis (PCA) identified EEG spectral and spectral coherence factors described by associated loading patterns. Discriminant function analysis (DFA) determined factors' discrimination success between subjects in the CON and CHR groups. Loading patterns on DFA-selected factors described CHR-specific spectral and coherence differences when compared to controls. The frequency modulated auditory evoked response (FMAER) explored functional CON-CHR differences within the superior temporal gyri. RESULTS Variable reduction by PCA identified 40 coherence-based factors explaining 77.8% of the total variance and 40 spectral factors explaining 95.9% of the variance. DFA demonstrated significant CON-CHR group difference (P <0.00001) and successful jackknifed subject classification (CON, 85.7%; CHR, 86.4% correct). The population distribution plotted along the canonical discriminant variable was clearly bimodal. Coherence factors delineated loading patterns of altered connectivity primarily involving the bilateral posterior temporal electrodes. However, FMAER analysis showed no CON-CHR group differences. CONCLUSIONS CHR subjects form a cohesive group, significantly separable from CON subjects by EEG-derived indices. Symptoms of CHR may relate to altered connectivity with the posterior temporal regions but not to primary auditory processing abnormalities within these regions.
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Affiliation(s)
- Frank H Duffy
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, Massachusetts, 02115, USA.
| | - Eugene D'Angelo
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, Massachusetts, 02115, USA.
| | - Alexander Rotenberg
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, Massachusetts, 02115, USA.
| | - Joseph Gonzalez-Heydrich
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, Massachusetts, 02115, USA.
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Spironelli C, Angrilli A. Language-related gamma EEG frontal reduction is associated with positive symptoms in schizophrenia patients. Schizophr Res 2015; 165:22-9. [PMID: 25913900 DOI: 10.1016/j.schres.2015.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/27/2015] [Accepted: 04/05/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Frontal hypoactivation has been consistently found in schizophrenia. We hypothesized that patients' deficit is asymmetrical, i.e., centred over the left frontal locations, associated with loss of language-related asymmetry, and correlated with positive symptoms. METHOD The amplitude of EEG gamma band (36-48Hz) was measured during the processing of three linguistic (Phonological vs. Semantic vs. Visuo-perceptual) tasks and used as index of activation/connectivity in 18 schizophrenia patients and 18 healthy participants. RESULTS Healthy controls showed higher gamma in frontal sites, revealing a significantly greater left vs. right asymmetry in all linguistic tasks, whereas patients exhibited decreased and bilateral gamma amplitude (i.e., reduced activation/connectivity) in frontal regions. The patients' left hypofrontality during phonological processing was positively correlated with higher levels of Delusions (P1) and Hallucination (P3) PANSS subscales. A significantly greater left posterior gamma amplitude was found in patients compared with controls. CONCLUSION Results suggest, in schizophrenia patients, a functional deficit of left frontal regions including Broca's area, a key site playing a fundamental hierarchical role between and within hemispheres which integrates many basic processes in linguistic and conceptual organization. The significant correlation between lack of the left anterior asymmetry and increased positive symptoms is in line with Crow's hypothesis postulating the aetiological role of disrupted linguistic frontal asymmetry on the onset of the key symptoms of schizophrenia.
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Affiliation(s)
- Chiara Spironelli
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy; CCN, Center for Cognitive Neuroscience, via Venezia 8, 35131 Padova, Italy.
| | - Alessandro Angrilli
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy; CCN, Center for Cognitive Neuroscience, via Venezia 8, 35131 Padova, Italy; CNR Neuroscience Institute, Padova Section, via G. Colombo 3, 35121 Padova, Italy
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Scognamiglio C, Houenou J. A meta-analysis of fMRI studies in healthy relatives of patients with schizophrenia. Aust N Z J Psychiatry 2014; 48:907-16. [PMID: 24972603 DOI: 10.1177/0004867414540753] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Genetically at-risk yet healthy relatives of patients with schizophrenia, sharing an important part of the genetic susceptibility to the disease, allow the study of neuroimaging endophenotypes. The aim of our study was to perform a meta-analysis of whole-brain functional magnetic resonance imaging (fMRI) studies that compared adult healthy relatives of patients with schizophrenia and controls. METHODS Twenty-one whole-brain fMRI studies were included (17 using cognitive tasks and four using emotional tasks), published between 2003 and 2013. These studies included 467 healthy relatives of patients with schizophrenia and 768 controls. To conduct the statistical analysis, we used the effect-size signed differential mapping software, a voxel-based meta-analytic approach. RESULTS In healthy relatives of patients with schizophrenia, we observed a general pattern of overactivation across the 21 fMRI studies in right-sided frontal, parietal and temporal regions compared to controls. This pattern was accompanied by an underactivation in the cingulate gyrus. Our analyses showed a very similar pattern during purely cognitive tasks; during emotional tasks, healthy relatives additionally overactivated the left parahippocampal gyrus. CONCLUSIONS This fMRI pattern of prefrontal overactivation and hypoactivation of the cingulate gyrus may represent a candidate endophenotype for schizophrenia.
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Affiliation(s)
- Claire Scognamiglio
- Paris Ile de France Ouest Medical School, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Josselin Houenou
- UNIACT, NeuroSpin, I2BM, CEA Saclay, Gif-Sur-Yvette, France INSERM U955, Equipe 15 'Psychiatrie Génétique', Créteil, France Fondation Fondamental, Créteil, France AP-HP, Hôpitaux Universitaires Mondor, Pôle de Psychiatrie, Créteil, France
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Natsubori T, Hashimoto RI, Yahata N, Inoue H, Takano Y, Iwashiro N, Koike S, Gonoi W, Sasaki H, Takao H, Abe O, Kasai K, Yamasue H. An fMRI study of visual lexical decision in patients with schizophrenia and clinical high-risk individuals. Schizophr Res 2014; 157:218-24. [PMID: 24893907 DOI: 10.1016/j.schres.2014.05.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 11/26/2022]
Abstract
Disturbances in semantic and phonological aspects of language processing are indicated in patients with schizophrenia, and in high-risk individuals for schizophrenia. To uncover neural correlates of the disturbances, a previous functional magnetic resonance imaging (fMRI) study using a visual lexical decision task in block design reported less leftward lateralization in the inferior frontal cortices, in patients with schizophrenia and individuals with high genetic risk for psychosis compared with normal control subjects. However, to our knowledge, no previous study has investigated contrasts between word and non-word processing that allow dissociation between semantic and phonological processing using event-related design visual lexical decision fMRI tasks in subjects with ultra-high-risk for psychosis (UHR) and patients with schizophrenia. In the current study, 20 patients with schizophrenia, 11 UHR, and 20 demographically matched controls underwent lexical decision fMRI tasks. Compared with controls, both schizophrenia and UHR groups showed significantly decreased activity in response to non-words compared with words in the inferior frontal regions. Additionally, decreased leftward lateralization in the non-word compared with word activity contrast was found in subjects with UHR compared with controls, which was not evident in patients with schizophrenia. The present findings suggest neural correlates of difficulty in phonological aspects of language processing during non-word processing in contrast to word, which at least partially commonly underlies the pathophysiology of schizophrenia and UHR. Together with a previous study in genetic high-risk subjects, the current results also suggest that reduced functional lateralization in the language-related frontal cortex may be a vulnerability marker for schizophrenia. Furthermore, the current result may suggest that the genetic basis of psychosis is presumed to be related to the evolution of the language capacity characteristic of humans.
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Affiliation(s)
- Tatsunobu Natsubori
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Ryu-Ichiro Hashimoto
- Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0364, Japan
| | - Noriaki Yahata
- Department of 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
| | - Yosuke Takano
- 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
| | - Shinsuke Koike
- 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, Division for Counseling and Support, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, 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
| | - Osamu Abe
- Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi kami-cho, Itabashi-ku, Tokyo 173-8610, 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.
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Dodell-Feder D, DeLisi LE, Hooker CI. The relationship between default mode network connectivity and social functioning in individuals at familial high-risk for schizophrenia. Schizophr Res 2014; 156:87-95. [PMID: 24768131 PMCID: PMC4082024 DOI: 10.1016/j.schres.2014.03.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/24/2014] [Accepted: 03/27/2014] [Indexed: 10/25/2022]
Abstract
Unaffected first-degree relatives of individuals with schizophrenia (i.e., those at familial high-risk [FHR]), demonstrate social dysfunction qualitatively similar though less severe than that of their affected relatives. These social difficulties may be the consequence of genetically conferred disruption to aspects of the default mode network (DMN), such as the dMPFC subsystem, which overlaps with the network of brain regions recruited during social cognitive processes. In the present study, we investigate this possibility, testing DMN connectivity and its relationship to social functioning in FHR using resting-state fMRI. Twenty FHR individuals and 17 controls underwent fMRI during a resting-state scan. Hypothesis-driven functional connectivity analyses examined ROI-to-ROI correlations between the DMN's hubs, and regions of the dMPFC subsystem and MTL subsystem. Connectivity values were examined in relationship to a measure of social functioning and empathy/perspective-taking. Results demonstrate that FHR exhibit reduced connectivity specifically within the dMPFC subsystem of the DMN. Certain ROI-to-ROI correlations predicted aspects of social functioning and empathy/perspective-taking across all participants. Together, the data indicate that disruption to the dMPFC subsystem of the DMN may be associated with familial risk for schizophrenia, and that these intrinsic connections may carry measurable consequences for social functioning.
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Affiliation(s)
| | - Lynn E. DeLisi
- Boston VA Medical Center, Brockton, MA 02301 USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215 USA
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