1
|
Shah R, Ghosh A, Avasthi A, Ahuja CK, Khandelwal N, Nehra R. White Matter Microstructure and Gray Matter Volume in Cannabis-Induced Psychosis and Schizophrenia With Cannabis Use. J Neuropsychiatry Clin Neurosci 2022; 34:406-413. [PMID: 35872614 DOI: 10.1176/appi.neuropsych.21070172] [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: 11/30/2022]
Abstract
OBJECTIVE This study explored the differences in white matter (WM) microstructural integrity and gray matter (GM) volume between cannabis-induced psychosis (CIP) and schizophrenia with cannabis use (SZC). METHODS This cross-sectional study with convenience sampling involved three groups of 20 participants each (CIP, SZC, and a control group without substance use), matched on age, handedness, and education. CIP and SZC were diagnosed with the Psychiatric Research Interview for Substance and Mental Disorders. Diffusion tensor and kurtosis imaging were done, and fractional anisotropy (FA), mean diffusivity, and mean kurtosis were estimated. GM volume was measured with voxel-based morphometry. RESULTS Group comparisons revealed comparable age at initiation and duration and frequency of cannabis use between participants in the SZC and CIP groups. Participants with SZC had lower FA than controls in the anterior and retrolenticular internal capsule limbs, cingulate gyrus hippocampal formation, fornix, and superior fronto-occipital fasciculus (all p<0.05). Participants with CIP had lower FA than controls in the left fornix and right superior fronto-occipital fasciculus but higher FA than those with SZC in the left corticospinal tract (all p<0.05). On morphometry, participants with CIP had greater cerebellar GM volume than those with SZC and greater inferior frontal gyrus volumes than controls (all p<0.05). CONCLUSIONS Widespread WM microstructural abnormalities were observed in participants with SZC, and fewer but significant WM disruptions were observed in those with CIP. Better WM integrity in some WM fiber tracts and greater GM volumes in crucial brain areas among those with CIP may have prevented the transition to schizophrenia.
Collapse
Affiliation(s)
- Raghav Shah
- Department of Psychiatry (Shah, Ghosh, Avasthi, Nehra) and Department of Radiodiagnosis and Imaging (Ahuja, Khandelwal), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Abhishek Ghosh
- Department of Psychiatry (Shah, Ghosh, Avasthi, Nehra) and Department of Radiodiagnosis and Imaging (Ahuja, Khandelwal), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry (Shah, Ghosh, Avasthi, Nehra) and Department of Radiodiagnosis and Imaging (Ahuja, Khandelwal), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Chirag K Ahuja
- Department of Psychiatry (Shah, Ghosh, Avasthi, Nehra) and Department of Radiodiagnosis and Imaging (Ahuja, Khandelwal), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Niranjan Khandelwal
- Department of Psychiatry (Shah, Ghosh, Avasthi, Nehra) and Department of Radiodiagnosis and Imaging (Ahuja, Khandelwal), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry (Shah, Ghosh, Avasthi, Nehra) and Department of Radiodiagnosis and Imaging (Ahuja, Khandelwal), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| |
Collapse
|
2
|
Tural U, Irvin MK, Iosifescu DV. Correlation between S100B and severity of depression in MDD: A meta-analysis. World J Biol Psychiatry 2022; 23:456-463. [PMID: 34854356 DOI: 10.1080/15622975.2021.2013042] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Previous studies have demonstrated elevated levels of the S100B protein (located in glial cells) in major depressive disorder (MDD) as compared to healthy controls. However, studies reporting correlation between S100B levels and depression severity have been conflicting. METHODS We investigated, through systematic review and meta-analysis, whether the correlation between S100B levels and depression severity is significant in patients with MDD. Pearson correlation coefficients reported in the individual studies were converted to Fisher's Z scores, then pooled using the random effects model. Meta-regression was used to test modifiers of the effect size. RESULTS Sixteen studies including 658 patients with MDD met eligibility criteria. No publication bias was observed. There was a significant and positive correlation between serum S100B level and depression severity (r = 0.204, z = 2.297, p = 0.022). A meta-regression determined that onset age of MDD and percentage of female participants are significant modifiers of this correlation. A moderate, but non-significant heterogeneity was observed in serum studies (44%). CONCLUSION As many studies have reported significantly increased levels of S100B in MDD compared to controls, this meta-analysis supports the assumption that the increase in S100B correlates with the severity of MDD. Additional studies investigating the precise biological connection between S100B and MDD are indicated.
Collapse
Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Molly Kennedy Irvin
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Dan Vlad Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Psychiatry Department, New York University School of Medicine, New York, NY, USA
| |
Collapse
|
3
|
Hu M, Qian X, Liu S, Koh AJ, Sim K, Jiang X, Guan C, Zhou JH. Structural and diffusion MRI based schizophrenia classification using 2D pretrained and 3D naive Convolutional Neural Networks. Schizophr Res 2022; 243:330-341. [PMID: 34210562 DOI: 10.1016/j.schres.2021.06.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/11/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023]
Abstract
The ability of automatic feature learning makes Convolutional Neural Network (CNN) potentially suitable to uncover the complex and widespread brain changes in schizophrenia. Despite that, limited studies have been done on schizophrenia identification using interpretable deep learning approaches on multimodal neuroimaging data. Here, we developed a deep feature approach based on pre-trained 2D CNN and naive 3D CNN models trained from scratch for schizophrenia classification by integrating 3D structural and diffusion magnetic resonance imaging (MRI) data. We found that the naive 3D CNN models outperformed the pretrained 2D CNN models and the handcrafted feature-based machine learning approach using support vector machine during both cross-validation and testing on an independent dataset. Multimodal neuroimaging-based models accomplished performance superior to models based on a single modality. Furthermore, we identified brain grey matter and white matter regions critical for illness classification at the individual- and group-level which supported the salience network and striatal dysfunction hypotheses in schizophrenia. Our findings underscore the potential of CNN not only to automatically uncover and integrate multimodal 3D brain imaging features for schizophrenia identification, but also to provide relevant neurobiological interpretations which are crucial for developing objective and interpretable imaging-based probes for prognosis and diagnosis in psychiatric disorders.
Collapse
Affiliation(s)
- Mengjiao Hu
- NTU Institute for Health Technologies, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore, Singapore; Center for Sleep and Cognition, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xing Qian
- Center for Sleep and Cognition, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siwei Liu
- Center for Sleep and Cognition, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amelia Jialing Koh
- Center for Sleep and Cognition, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health (IMH), Singapore, Singapore; Department of Research, Institute of Mental Health (IMH), Singapore, Singapore
| | - Xudong Jiang
- School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Cuntai Guan
- School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | - Juan Helen Zhou
- Center for Sleep and Cognition, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Neuroscience and Behavioural Disorders Program, Duke-NUS Medical School, Singapore, Singapore; NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
4
|
Chen S, Tang Y, Fan X, Qiao Y, Wang J, Wen H, Wang W, Wang H, Yang F, Sheng J. The role of white matter abnormality in the left anterior corona radiata: In relation to formal thought disorder in patients with schizophrenia. Psychiatry Res 2022; 307:114302. [PMID: 34890908 DOI: 10.1016/j.psychres.2021.114302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/27/2022]
Abstract
White matter abnormality has been widely reported in patients with schizophrenia (Sz). However, few studies have focused on the relationship between the white matter deficit and formal thought disorder (FTD). Moreover, the role of genetic high risk in FTD-related white matter deficit remains unclear. The present study recruited 46 Sz patients, 18 unaffected first-degree relatives of Sz patients, and 29 healthy controls. There was a widespread fractional anisotropy (FA) reduction in Sz. In addition, reduced FA in the left anterior corona radiata was related to more severe FTD symptoms in Sz. However, the genetic high-risk group only showed lower mean FA in the left anterior limb of the internal capsule than healthy controls. Our findings suggest that abnormality in the left anterior corona radiata may only occur in Sz but not in the genetic high-risk group. Such an abnormality might be associated with the severity of FTD symptoms. Meanwhile, genetic vulnerability may contribute to the abnormality in the left anterior limb of the internal capsule. Better analytical methods are needed to validate our results.
Collapse
Affiliation(s)
- Shan Chen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai 200030, China
| | - Xiaoduo Fan
- UMass Memorial Health Care & University of Massachusetts Medical School, Worcester, MA 01605, United States
| | - Yi Qiao
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders,Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai 200030, China
| | - Hun Wen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Wenzheng Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Hongyan Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Fuzhong Yang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
| | - Jianhua Sheng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
| |
Collapse
|
5
|
Maximo JO, Kraguljac NV, Rountree BG, Lahti AC. Structural and Functional Default Mode Network Connectivity and Antipsychotic Treatment Response in Medication-Naïve First Episode Psychosis Patients. ACTA ACUST UNITED AC 2021; 2:sgab032. [PMID: 34414373 PMCID: PMC8364918 DOI: 10.1093/schizbullopen/sgab032] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Only a few studies have comprehensively characterized default mode network (DMN) pathology on a structural and functional level, and definite conclusions cannot be drawn due to antipsychotic medication exposure and illness chronicity. The objective of this study was to characterize DMN pathology in medication-naïve first episode psychosis (FEP) patients, and determine if DMN structural and functional connectivity (FC) have potential utility as a predictor for subsequent antipsychotic treatment response. Methods Diffusion imaging and resting state FC data from 42 controls and 52 FEP were analyzed. Patients then received 16 weeks of antipsychotic treatment. Using region of interest analyses, we quantified FC of the DMN and structural integrity of the white matter tracts supporting DMN function. We then did linear regressions between DMN structural and FC indices and antipsychotic treatment response. Results We detected reduced DMN fractional anisotropy and axial diffusivity in FEP compared to controls. No DMN FC abnormalities nor correlations between DMN structural and FC were found. Finally, DMN fractional anisotropy and radial diffusivity were associated with response to treatment. Conclusion Our study highlights the critical role of the DMN in the pathophysiology suggesting that axonal damage may already be present in FEP patients. We also demonstrated that DMN pathology is clinically relevant, as greater structural DMN alterations were associated with a less favorable clinical response to antipsychotic medications.
Collapse
Affiliation(s)
- Jose O Maximo
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Nina V Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Boone G Rountree
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| |
Collapse
|
6
|
Wang C, Oughourlian T, Tishler TA, Anwar F, Raymond C, Pham AD, Perschon A, Villablanca JP, Ventura J, Subotnik KL, Nuechterlein KH, Ellingson BM. Cortical morphometric correlational networks associated with cognitive deficits in first episode schizophrenia. Schizophr Res 2021; 231:179-188. [PMID: 33872855 DOI: 10.1016/j.schres.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/09/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022]
Abstract
Schizophrenia (SCZ) is a chronic cognitive and behavioral disorder associated with abnormal cortical activity during information processing. Several brain structures associated with the seven performance domains evaluated using the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery (MCCB) have shown cortical volume loss in first episode schizophrenia (FES) patients. However, the relationship between morphological organization and MCCB performance remains unclear. Therefore, in the current observational study, high-resolution structural MRI scans were collected from 50 FES patients, and the morphometric correlation network (MCN) using cortical volume was established to characterize the cortical pattern associated with poorer MCCB performance. We also investigated topological properties, such as the modularity, the degree and the betweenness centrality. Our findings show structural volume was directly and strongly associated with the cognitive deficits of FES patients in the precuneus, anterior cingulate, and fusiform gyrus, as well as the prefrontal, parietal, and sensorimotor cortices. The medial orbitofrontal, fusiform, and superior frontal gyri were not only identified as the predominant nodes with high degree and betweenness centrality in the MCN, but they were also found to be critical in performance in several of the MCCB domains. Together, these results suggest a widespread cortical network is altered in FES patients and that performance on the MCCB domains is associated with the core pathophysiology of SCZ.
Collapse
Affiliation(s)
- Chencai Wang
- Dept. of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Talia Oughourlian
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Todd A Tishler
- Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Faizan Anwar
- Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Catalina Raymond
- Dept. of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Alex D Pham
- Dept. of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Abby Perschon
- Dept. of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - J Pablo Villablanca
- Dept. of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Joseph Ventura
- Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Kenneth L Subotnik
- Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Keith H Nuechterlein
- Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Benjamin M Ellingson
- Dept. of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Neuroscience Interdisciplinary Graduate Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
| |
Collapse
|
7
|
Multimodal assessment of white matter microstructure in antipsychotic-naïve schizophrenia patients and confounding effects of recreational drug use. Brain Imaging Behav 2021; 15:36-48. [PMID: 31909444 DOI: 10.1007/s11682-019-00230-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cerebral white matter (WM) aberrations in schizophrenia have been linked to multiple neurobiological substrates but the underlying mechanisms remain unknown. Moreover, antipsychotic treatment and substance use constitute potential confounders. Multimodal studies using diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI) may provide deeper insight into the whole brain WM pathophysiology in schizophrenia. We combined DTI and MTI to investigate WM integrity in 51 antipsychotic-naïve, first-episode schizophrenia patients and 55 matched healthy controls, using 3 T magnetic resonance imaging (MRI). Psychopathology was assessed with the positive and negative syndrome scale (PANSS). A whole brain partial least squares correlation (PLSC) method was used to conjointly analyze DTI-derived measures (fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), mode of anisotropy (MO)) and the magnetization transfer ratio (MTR) to identify group differences, and associations with psychopathology. In secondary analyses, we excluded recreational substance users from both groups resulting in 34 patients and 51 healthy controls. The primary PLSC group difference analysis identified a significant pattern of lower FA, AD, MO and higher RD in patients (p = 0.04). This pattern suggests disorganized WM microstructure in patients. The secondary PLSC group difference analysis without recreational substance users revealed a significant pattern of lower FA and higher AD, RD, MO, MTR in patients (p = 0.04). This pattern in the substance free patients is consistent with higher extracellular free-water concentrations, which may reflect neuroinflammation. No significant associations with psychopathology were observed. Recreational substance use appears to be a confounding issue, which calls for attention in future WM studies.
Collapse
|
8
|
Kraguljac NV, Monroe WS, Anthony T, Jindal RD, Hill H, Lahti AC. Neurite Orientation Dispersion and Density Imaging (NODDI) and Duration of Untreated Psychosis in Antipsychotic Medication-Naïve First Episode Psychosis Patients. NEUROIMAGE. REPORTS 2021; 1:100005. [PMID: 36969709 PMCID: PMC10038586 DOI: 10.1016/j.ynirp.2021.100005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Diffusion tensor imaging suggests that white matter alterations are already evident in first episode psychosis patients (FEP) and may become more prominent as the duration of untreated psychosis (DUP) increases. But because the tensor model lacks specificity, it remains unclear how to interpret findings on a biological level. Here, we used a biophysical diffusion model, Neurite Orientation Dispersion and Density Imaging (NODDI), to map microarchitecture in FEP, and to investigate associations between DUP and microarchitectural integrity. Methods We scanned 78 antipsychotic medication-naïve FEP and 64 healthy controls using a multi-shell diffusion weighted sequence and used the NODDI toolbox to compute neurite density (ND), orientation dispersion index (ODI) and extracellular free water (FW) maps. AFNI's 3dttest++ was used to compare diffusion maps between groups and to perform regression analyses with DUP. Results We found that ND was decreased in commissural and association fibers but increased in projection fibers in FEP. ODI was largely increased regardless of fiber type, and FW showed a mix of increase in decrease across fiber tracts. We also demonstrated associations between DUP and microarchitecture for all NODDI indices. Conclusions We demonstrated that complex microarchitecture abnormalities are already evident in antipsychotic-naïve FEP. ND alterations are differentially expressed depending on fiber type, while decreased fiber complexity appears to be a uniform marker of white matter deficit in the illness. Importantly, we identified an empirical link between longer DUP and greater white matter pathology across NODDI indices, underscoring the critical importance of early intervention in this devastating illness.
Collapse
Affiliation(s)
- Nina Vanessa Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - William Stonewall Monroe
- Department of Electrical and Computer Engineering/ IT Research Computing, University of Alabama at Birmingham
| | - Thomas Anthony
- Department of Electrical and Computer Engineering/ IT Research Computing, University of Alabama at Birmingham
| | | | - Harrison Hill
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| |
Collapse
|
9
|
Lee MY, Lin BF, Chan MH, Chen HH. Increased behavioral and neuronal responses to a hallucinogenic drug after adolescent toluene exposure in mice: Effects of antipsychotic treatment. Toxicology 2020; 445:152602. [PMID: 32980479 DOI: 10.1016/j.tox.2020.152602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 01/23/2023]
Abstract
Toluene has been characterized as a non-classical hallucinogen drug through activation of 5-HT2A receptors and antagonism of NMDA receptors. It remains unclear whether psychotic symptoms after long-term and intense toluene exposure are associated with abnormalities in 5-HT2A receptor function. The present study examined whether the responses to a hallucinogenic 5-HT2A receptor agonist 2,5-dimethoxy-4-iodoamphetamine (DOI) were altered in a mouse model of toluene psychosis. Male NMRI mice were subchronically treated with toluene during adolescence. Reciprocal social interaction test and novel object recognition test were conducted to confirm the persistent behavioral deficits in adulthood. Subsequently, DOI-induced head twitch, c-Fos and Egr-2 expression, field potentials in the medial prefrontal cortex (mPFC), and the levels of 5-HT2A, 5-HT1A and mGlu2 receptors in the mPFC were monitored. Toluene exposure during adolescence produced social and memory impairments and enhanced DOI-induced behavioral, molecular and electrophysiological responses, but did not change the levels of 5-HT2A, 5-HT1A or mGlu2 receptors in the mPFC. Moreover, the effects of haloperidol and risperidone on the behavioral deficits and hyper-responsiveness to DOI after adolescent toluene exposure were compared. When administered after adolescent toluene exposure, risperidone could reverse social withdrawal, cognitive impairment and hypersensitivity to DOI, whereas haloperidol was only beneficial for social withdrawal. These findings suggest that increased functionality of 5-HT2A receptors may play a critical role in solvent-induced psychosis and recommend the antipsychotics with more selective 5-HT2A receptor antagonism as the first-line treatment for solvent-induced psychosis.
Collapse
Affiliation(s)
- Mei-Yi Lee
- Center for Neuropsychiatric Research, National Health Research Institutes, 35 Keyan Rd. Zhunan, Miaoli, 35053, Taiwan
| | - Bih-Fen Lin
- Department of Laboratory Medicine and Biotechnology School of Medicine, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien, 97004, Taiwan
| | - Ming-Huan Chan
- Institute of Neuroscience, National Chengchi University, NO. 64, Sec. 2, Zhinan Rd., Taipei, 11605, Taiwan; Research Center for Mind, Brain, and Learning, National Chengchi University, NO. 64, Sec. 2, Zhinan Rd., Taipei, 11605, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 40402, Taiwan.
| | - Hwei-Hsien Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, 35 Keyan Rd. Zhunan, Miaoli, 35053, Taiwan; Institute of Neuroscience, National Chengchi University, NO. 64, Sec. 2, Zhinan Rd., Taipei, 11605, Taiwan; Ph.D. Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, No. 145, Xingda Rd., Taichung, 40227, Taiwan.
| |
Collapse
|
10
|
Bergé D, Mané A, Lesh TA, Bioque M, Barcones F, Gonzalez-Pinto AM, Parellada M, Vieta E, Castro-Fornieles J, Rodriguez-Jimenez R, García-Portilla MP, Usall J, Carter CS, Cabrera B, Bernardo M, Janssen J. Elevated Extracellular Free-Water in a Multicentric First-Episode Psychosis Sample, Decrease During the First 2 Years of Illness. Schizophr Bull 2020; 46:846-856. [PMID: 31915835 PMCID: PMC7342177 DOI: 10.1093/schbul/sbz132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Recent diffusion imaging studies using free-water (FW) elimination have shown increased FW in gray matter (GM) and white matter (WM) in first-episode psychosis (FEP) and lower corrected fractional anisotropy (FAt) in WM in chronic schizophrenia. However, little is known about the longitudinal stability and clinical significance of these findings. To determine tissue-specific FW and FAt abnormalities in FEP, as part of a multicenter Spanish study, 132 FEP and 108 healthy controls (HC) were clinically characterized and underwent structural and diffusion-weighted MRI scanning. FEP subjects were classified as schizophrenia spectrum disorder (SSD) or non-SSD. Of these subjects, 45 FEP and 41 HC were longitudinally assessed and rescanned after 2 years. FA and FW tissue-specific measurements were cross-sectional and longitudinally compared between groups using voxel-wise analyses in the skeletonized WM and vertex-wise analyses in the GM surface. SSD and non-SSD subjects showed (a) higher baseline FW in temporal regions and in whole GM average (P.adj(SSD vs HC) = .003, P.adj(Non-SSD vs HC) = .040) and (b) lower baseline FAt in several WM tracts. SSD, but not non-SSD, showed (a) higher FW in several WM tracts and in whole WM (P.adj(SSD vs HC)= .049) and (b) a significant FW decrease over time in temporal cortical regions and in whole GM average (P.adj = .011). Increased extracellular FW in the brain is a reliable finding in FEP, and in SSD appears to decrease over the early course of the illness. FAt abnormalities are stable during the first years of psychosis.
Collapse
Affiliation(s)
- Daniel Bergé
- Neuroscience Department, Neuroimaging Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, Spain,CIBERSAM, Madrid, Spain,To whom correspondence should be addressed; IMIM, Neuroimaging group. c/ Doctor Aiguader 88, 08003, Barcelona, Spain; tel: +34-932483175, fax: 0034 93 248 3445, e-mail:
| | - Anna Mané
- Neuroscience Department, Neuroimaging Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Bellaterra, Spain,CIBERSAM, Madrid, Spain
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California at Davis (UCDAVIS), Sacramento, CA
| | - Miquel Bioque
- Schizophrenia Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - Fe Barcones
- Department of Psychiatry, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain,Department of Family Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain,Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
| | - Ana Maria Gonzalez-Pinto
- CIBERSAM, Madrid, Spain,BioAraba Health Research Institute, Vitoria-Gasteiz, Spain,Department of Neuroscience, University of the Basque Country, Leioa, Spain
| | - Mara Parellada
- CIBERSAM, Madrid, Spain,Child and Adolescent Psychiatry, Hospital Gregorio Marañon, Madrid, Spain
| | - Eduard Vieta
- CIBERSAM, Madrid, Spain,Bipolar and Depressive Disorders Unit, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- CIBERSAM, Madrid, Spain,Department of Child and Adolescent Psychiatry and Psychology, IDIBAPS, Hospital Clínic Barcelona, Barcelona, Spain
| | - Roberto Rodriguez-Jimenez
- CIBERSAM, Madrid, Spain,Department of Cognition and Psychosis, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | | | - Judith Usall
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California at Davis (UCDAVIS), Sacramento, CA
| | - Bibiana Cabrera
- CIBERSAM, Madrid, Spain,Schizophrenia Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - Miguel Bernardo
- CIBERSAM, Madrid, Spain,Schizophrenia Unit, Hospital Clínic Barcelona, Barcelona, Spain
| | - Joost Janssen
- CIBERSAM, Madrid, Spain,Child and Adolescent Psychiatry, Hospital Universitario Gregorio Marañon, Madrid, Spain,Brain Center Rudolf Magnus, UMC Ultrecht, Ultrecht, The Netherlands
| | | |
Collapse
|
11
|
Cannabis use and psychosis: a review of reviews. Eur Arch Psychiatry Clin Neurosci 2020; 270:403-412. [PMID: 31563981 DOI: 10.1007/s00406-019-01068-z] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 09/18/2019] [Indexed: 12/22/2022]
Abstract
We conducted a systematic review of meta-analyses and systematic reviews to evaluate the impact of cannabis use on the onset and course of psychoses. Following a systematic literature search of five data bases (2005-2016) and consecutive structured evaluation, we were able to include 26 systematic reviews and meta-analyses. The methodological quality of the included publications were in the range of high and poor. The scientific literature indicates that psychotic illness arises more frequently in cannabis users compared to non-users, cannabis use is associated with a dose-dependent risk of developing psychotic illness, and cannabis users have an earlier onset of psychotic illness compared to non-users. Cannabis use was also associated with increased relapse rates, more hospitalizations and pronounced positive symptoms in psychotic patients. We make recommendations about the type of research that is required to better characterize the relationship between cannabis use and the development and outcomes of psychosis.
Collapse
|
12
|
Michielse S, Lange I, Bakker J, Goossens L, Verhagen S, Wichers M, Lieverse R, Schruers K, van Amelsvoort T, van Os J, Marcelis M. White matter microstructure and network-connectivity in emerging adults with subclinical psychotic experiences. Brain Imaging Behav 2019; 14:1876-1888. [PMID: 31183775 PMCID: PMC7572337 DOI: 10.1007/s11682-019-00129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Group comparisons of individuals with psychotic disorder and controls have shown alterations in white matter microstructure. Whether white matter microstructure and network connectivity is altered in adolescents with subclinical psychotic experiences (PE) at the lowest end of the psychosis severity spectrum is less clear. DWI scan were acquired in 48 individuals with PE and 43 healthy controls (HC). Traditional tensor-derived indices: Fractional Anisotropy, Axial Diffusivity, Mean Diffusivity and Radial Diffusivity, as well as network connectivity measures (global/local efficiency and clustering coefficient) were compared between the groups. Subclinical psychopathology was assessed with the Community Assessment of Psychic Experiences (CAPE) and Montgomery-Åsberg Depression Rating Scale (MADRS) questionnaires and, in order to capture momentary subclinical expression of psychosis, the Experience Sampling Method (ESM) questionnaires. Within the PE-group, interactions between subclinical (momentary) symptoms and brain regions in the model of tensor-derived indices and network connectivity measures were investigated in a hypothesis-generating fashion. Whole brain analyses showed no group differences in tensor-derived indices and network connectivity measures. In the PE-group, a higher positive symptom distress score was associated with both higher local efficiency and clustering coefficient in the right middle temporal pole. The findings indicate absence of microstructural white matter differences between emerging adults with subclinical PE and controls. In the PE-group, attenuated symptoms were positively associated with network efficiency/cohesion, which requires replication and may indicate network alterations in emerging mild psychopathology.
Collapse
Affiliation(s)
- Stijn Michielse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Iris Lange
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Jindra Bakker
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,Department of Neuroscience, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Simone Verhagen
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Marieke Wichers
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, England.,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
| |
Collapse
|
13
|
Sabioni P, Le Foll B. Psychosocial and Pharmacological Interventions for the Treatment of Cannabis Use Disorder. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2019; 17:163-168. [PMID: 32021586 DOI: 10.1176/appi.focus.17202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(Reprinted with permission from Sabioni P and Le Foll B. Psychosocial and pharmacological interventions for the treatment of cannabis use disorder [version 1; referees: 3 approved]. F1000Research 2018, 7(F1000 Faculty Rev):173 (https://doi.org/10.12688/f1000research.11191.1)).
Collapse
|
14
|
Domen P, Michielse S, Peeters S, Viechtbauer W, van Os J, Marcelis M. Childhood trauma- and cannabis-associated microstructural white matter changes in patients with psychotic disorder: a longitudinal family-based diffusion imaging study. Psychol Med 2019; 49:628-638. [PMID: 29807550 DOI: 10.1017/s0033291718001320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Decreased white matter (WM) integrity in patients with psychotic disorder has been a consistent finding in diffusion tensor imaging (DTI) studies. However, the contribution of environmental risk factors to these WM alterations is rarely investigated. The current study examines whether individuals with (increased risk for) psychotic disorder will show increased WM integrity change over time with increasing levels of childhood trauma and cannabis exposure. METHODS DTI scans were obtained from 85 patients with a psychotic disorder, 93 non-psychotic siblings and 80 healthy controls, of which 60% were rescanned 3 years later. In a whole-brain voxel-based analysis, associations between change in fractional anisotropy (ΔFA) and environmental exposures as well as interactions between group and environmental exposure in the model of FA and ΔFA were investigated. Analyses were adjusted for a priori hypothesized confounding variables: age, sex, and level of education. RESULTS At baseline, no significant associations were found between FA and both environmental risk factors. At follow-up as well as over a 3-year interval, significant interactions between group and, respectively, cannabis exposure and childhood trauma exposure in the model of FA and ΔFA were found. Patients showed more FA decrease over time compared with both controls and siblings when exposed to higher levels of cannabis or childhood trauma. CONCLUSIONS Higher levels of cannabis or childhood trauma may compromise connectivity over the course of the illness in patients, but not in individuals at low or higher than average genetic risk for psychotic disorder, suggesting interactions between the environment and illness-related factors.
Collapse
Affiliation(s)
- Patrick Domen
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University, Maastricht,The Netherlands
| |
Collapse
|
15
|
Cannabis use during pregnancy: Are we at the verge of defining a "fetal cannabis spectrum disorder"? Med Hypotheses 2019; 124:53-55. [PMID: 30798916 DOI: 10.1016/j.mehy.2019.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/19/2018] [Accepted: 02/02/2019] [Indexed: 01/19/2023]
Abstract
Cannabis is probably the drug most commonly used globally since ancient times. Following the trend of legalization of access to cannabis in several Western countries, its use has increased in North America over the past few years. In spite of warnings of the potential hazards associated with in-utero exposure to cannabis, approximately 10% of pregnant women in an American study reported using cannabis in recent years, and most of them on a daily basis. Significant effects of prenatal cannabis exposure have been found on children's sleep, cognitive functions (memory and scholastic skills), as well as on executive (frontal lobe) functions (reasoning, attention, impulsivity, and motivation), and affective (depression) and anxiety symptoms throughout the stages of development. Following the presentation of two case vignettes, we integrate the published information on outcomes of maternal use of cannabis during pregnancy on the developing fetus and the "soft" neurological deficits and neuro-behavioral disturbances manifested by them from early childhood and evolving to peaks in adolescence. Taken together, these data serve to define what we call a heretofore unspecified "fetal cannabis spectrum disorder".
Collapse
|
16
|
McNabb CB, Kydd R, Sundram F, Soosay I, Russell BR. Differences in white matter connectivity between treatment-resistant and treatment-responsive subtypes of schizophrenia. Psychiatry Res Neuroimaging 2018; 282:47-54. [PMID: 30412902 DOI: 10.1016/j.pscychresns.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/23/2018] [Accepted: 11/02/2018] [Indexed: 12/24/2022]
Abstract
Schizophrenia is a heterogeneous disorder exhibiting variable responsiveness to treatment between individuals. Previous work demonstrated that white matter abnormalities may relate to antipsychotic response but no study to date has examined differences between first-line treatment responders (FLR) and clozapine-eligible individuals receiving first-line antipsychotics. The current study aimed to establish whether differences in white matter structure exist between these two cohorts. Diffusion-weighted images were acquired for 15 clozapine-eligible and 10 FLR participants. Measures of fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) were obtained and between-group t-tests interrogating differences in FA were conducted. To investigate the neural basis of a decrease in FA, the significant cluster from FA analysis was masked and used to obtain mean RD and AD measures for that region. Those who were clozapine-eligible had significantly lower FA in the body of the corpus callosum (p < 0.05), associated with a significant increase in mean RD compared with FLR (p < 0.001). No difference in mean AD was observed for this region. These data reveal differences in diffusion measures between FLR and those eligible for clozapine and suggest that lower FA and greater RD in the corpus callosum could exist as a biomarker of treatment resistance in people with schizophrenia.
Collapse
Affiliation(s)
| | - Rob Kydd
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Ian Soosay
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | | |
Collapse
|
17
|
Cookey J, Crocker CE, Bernier D, Newman AJ, Stewart S, McAllindon D, Tibbo PG. Microstructural Findings in White Matter Associated with Cannabis and Alcohol Use in Early-Phase Psychosis: A Diffusion Tensor Imaging and Relaxometry Study. Brain Connect 2018; 8:567-576. [PMID: 30417651 DOI: 10.1089/brain.2018.0611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Accumulating evidence suggests that brain white matter (WM) abnormalities may be central to the pathophysiology of psychotic disorders. In addition, there is evidence that cannabis use and alcohol use each is associated with WM abnormalities. However, there are very limited data on the effects of these substances on WM microstructure in patients with psychosis, especially for those at the early phase of illness. This project aimed to examine the impact of cannabis use and alcohol use on WM tissue in early-phase psychosis (EPP). WM was investigated in 21 patients with EPP using diffusion tensor imaging (DTI) and transverse relaxation time of tissue water (T2), with the primary outcomes being mean fractional anisotropy (FA) and T2. DTI analyses were performed at the full-brain level using tract-based spatial statistics with both DTI and T2 analysis done within a WM volume of interest (VOI) implicated in psychosis (containing the left superior longitudinal fasciculus). Our findings revealed that younger age of onset of regular alcohol use (more than one drink per week) was associated with lower FA values in the left thalamic radiation and left parahippocampal and left amygdalar WM. More frequent lifetime cannabis use was correlated with increased mean full-brain FA. There was no significant relationship found between FA and alcohol or cannabis use within the VOI. Relaxometry analysis revealed trend-level evidence of shortened T2 with later onset of regular alcohol use and with more frequent cannabis use. This study provides novel data demonstrating cortical and subcortical WM findings related to alcohol use in EPP and is the first to combine DTI and relaxometry, relating to this patient population.
Collapse
Affiliation(s)
- Jacob Cookey
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada
| | - Candice E Crocker
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada .,3 Department of Diagnostic Radiology, Nova Scotia Health Authority , Halifax, Canada
| | - Denise Bernier
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada
| | - Aaron J Newman
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,4 Department of Psychology and Neuroscience, Dalhousie University , Halifax, Canada
| | - Sherry Stewart
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,4 Department of Psychology and Neuroscience, Dalhousie University , Halifax, Canada
| | - David McAllindon
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,5 Biomedical Translational Imaging Center , IWK Health Centre, Halifax, Canada
| | - Philip G Tibbo
- 1 Department of Psychiatry, Dalhousie University , Halifax, Canada .,2 Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone) , Halifax, Canada
| |
Collapse
|
18
|
Memedovich KA, Dowsett LE, Spackman E, Noseworthy T, Clement F. The adverse health effects and harms related to marijuana use: an overview review. CMAJ Open 2018; 6:E339-E346. [PMID: 30115639 PMCID: PMC6182105 DOI: 10.9778/cmajo.20180023] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND With impending marijuana legislation in Canada, a broad understanding of the harms associated with marijuana use is needed to inform the clinical community and public, and to support evidence-informed public policy development. The purpose of the review was to synthesize the evidence on adverse health effects and harms of marijuana use. METHODS We searched MEDLINE, The Cochrane Database of Systematic Reviews, Embase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Health Technology Assessment Database from the inception of each database to May 2018. Given that systematic reviews evaluating one or other specific harm have been published, this is an overview review with the primary objective of assessing a health effect or harm. Data on author, country and year of publication, search strategy and results, and outcomes were extracted. Quality was assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist. RESULTS The final analysis included 68 reviews. Evidence of harm was reported in 62 reviews for several mental health disorders, brain changes, cognitive outcomes, pregnancy outcomes and testicular cancer. Inconclusive evidence was found for 20 outcomes (some mental health outcomes, other types of cancers and all-cause mortality). No evidence of harm was reported for 6 outcomes. INTERPRETATION Harm was associated with most outcomes assessed. These results should be viewed with concern by physicians and policy-makers given the prevalence of use, the persistent reporting of a lack of recognition of marijuana as a possibly harmful substance and the emerging context of legalization for recreational use.
Collapse
Affiliation(s)
- K Ally Memedovich
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Laura E Dowsett
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Eldon Spackman
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Tom Noseworthy
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta
| | - Fiona Clement
- The Department of Community Health Sciences (Memedovich, Dowsett, Spackman, Clement) and O'Brien Institute for Public Health (Memedovich, Dowsett, Spackman, Noseworthy, Clement), University of Calgary, Calgary, Alta.
| |
Collapse
|
19
|
Sabioni P, Le Foll B. Psychosocial and pharmacological interventions for the treatment of cannabis use disorder. F1000Res 2018; 7:173. [PMID: 29497498 PMCID: PMC5811668 DOI: 10.12688/f1000research.11191.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 11/24/2022] Open
Abstract
Cannabis use has been continuously increasing, and cannabis use disorder (CUD) has become a public health issue. Some psychosocial interventions have demonstrated the ability to reduce cannabis use; however, there are no pharmacotherapies approved for the treatment of CUD. Some drugs have shown limited positive effects on use and withdrawal symptoms, but no controlled studies have been able to show strong and persistent effects on clinically meaningful outcomes. The aim of this review is to synthesize the evidence from the available literature regarding the effectiveness of psychosocial and pharmacological treatments for CUD among adults (that is, 18 years old or older). An analysis of the evidence shows that the current best psychosocial intervention to reduce cannabis use is the combination of motivational enhancement therapy and cognitive-behavioral therapy, preferably accompanied by a contingency management approach. In regard to pharmacological interventions, there are mostly unclear findings. Some drugs, such as CB1 agonists, gabapentin, and N-acetylcysteine, have been shown to produce improvements in some symptoms of CUD in single studies, but these have not been replicated. Other classes of medications, including antidepressants and antipsychotics, have been unsuccessful in producing such effects. There is an imminent need for more clinical trials to develop more effective treatments for CUD.
Collapse
Affiliation(s)
- Pamela Sabioni
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health , Toronto, Ontario , M5S 2S1, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health , Toronto, Ontario , M5S 2S1, Canada.,Addiction Medicine Service, Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry, Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| |
Collapse
|
20
|
Wu F, Zhang Y, Yang Y, Lu X, Fang Z, Huang J, Kong L, Chen J, Ning Y, Li X, Wu K. Structural and functional brain abnormalities in drug-naive, first-episode, and chronic patients with schizophrenia: a multimodal MRI study. Neuropsychiatr Dis Treat 2018; 14:2889-2904. [PMID: 30464473 PMCID: PMC6214581 DOI: 10.2147/ndt.s174356] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Structural and functional brain abnormalities in schizophrenia (SZ) have been widely reported. However, a few studies have investigated both structural and functional characteristics in SZ patients at different stages to understand the neuropathology of SZ. METHODS In this study, we recruited 44 first-episode drug-naive SZ (FESZ) patients, 44 medicated chronic SZ (CSZ) patients, and 56 normal controls (NCs) and acquired their structural and resting-state functional magnetic resonance imaging (MRI). We then made group comparisons on structural and functional characteristics, including regional gray matter volume (GMV), regional homogeneity, amplitude of low-frequency fluctuation, and degree centrality. A linear support vector machine (SVM) combined with a recursive feature elimination (RFE) algorithm was implemented to discriminate three groups. RESULTS Our results indicated that the regional GMV was significantly decreased in patients compared with that in NCs; CSZ patients have more diffused GMV decreases primarily involved in the frontal and temporal lobes when compared with FESZ patients. Both FESZ and CSZ patients showed significant functional alterations compared with NCs; when compared with FESZ patients, CSZ patients showed significant reductions in functional characteristics in several brain regions associated with auditory, visual processing, and sensorimotor functions. Moreover, a linear SVM combined with a RFE algorithm was implemented to discriminate three groups. The accuracies of the three classifiers were 79.80%, 83.16%, and 81.71%, respectively. The performance of classifiers in this study with multimodal MRI was better than that of previous discriminative analyses of SZ patients with single-modal MRI. CONCLUSION Our findings bring new insights into the understanding of the neuropathology of SZ and contribute to stage-specific biomarkers in diagnosis and interventions of SZ.
Collapse
Affiliation(s)
- Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China, .,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China, ,
| | - Yue Zhang
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China, , .,Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology (SCUT), Guangzhou, China,
| | - Yongzhe Yang
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China, , .,Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology (SCUT), Guangzhou, China, .,School of Medicine, South China University of Technology (SCUT), Guangzhou, China
| | - Xiaobing Lu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China, .,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China, ,
| | - Ziyan Fang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Jianwei Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Lingyin Kong
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology (SCUT), Guangzhou, China,
| | - Jun Chen
- Guangdong Engineering Technology Research Center for Diagnosis and Rehabilitation of Dementia, Guangzhou, China, .,National Engineering Research Center for Healthcare Devices, Guangzhou, China,
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China, .,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China, ,
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA.,Department of Electric and Computer Engineering, New Jersey Institute of Technology, NJ, USA
| | - Kai Wu
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China, , .,Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology (SCUT), Guangzhou, China, .,Guangdong Engineering Technology Research Center for Diagnosis and Rehabilitation of Dementia, Guangzhou, China, .,National Engineering Research Center for Healthcare Devices, Guangzhou, China, .,Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan,
| |
Collapse
|
21
|
Sun Z, Jiang T, Wu Y, Ma C, He Y, Yang J. Low Field Magnetic Stimulation Ameliorates Schizophrenia-Like Behavior and Up-Regulates Neuregulin-1 Expression in a Mouse Model of Cuprizone-Induced Demyelination. Front Psychiatry 2018; 9:675. [PMID: 30574102 PMCID: PMC6291499 DOI: 10.3389/fpsyt.2018.00675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 11/22/2018] [Indexed: 11/13/2022] Open
Abstract
White matter and myelin sheath integrity are disrupted in schizophrenia, and non-invasive magnetic brain stimulation targeting these tracts is a promising new therapeutic approach. In particular, deep-brain reachable low field magnetic stimulation (DMS) could alleviate cognitive impairment and depressive-like behaviors in animal models. In this study, we sought to assess the effects of DMS on myelin sheath damage and schizophrenia-like behaviors in the cuprizone-induced demyelination mouse model. Mice were fed cuprizone (copper ion chelating agent, 0.2% w/w mixed with food) for 6 weeks to induce demyelination. During these 6 weeks, mice were stimulated with either sham, low-frequency (LFS, delta frequency) DMS or high-frequency (HFS, gamma Hz) DMS for 20 min each day. Behavioral tests were conducted 24 h after the final DMS session. The myelin sheath was examined by immunohistochemistry and the expression of neuregulin-1 (NRG1)/ErbB4 in the prefrontal cortex was measured with Western blotting. Six weeks of HFS significantly alleviated schizophrenia-like behaviors in cuprizone mice, including improved nesting, social interaction and sensorimotor gating, while LFS improved sensorimotor gating only. HFS and LFS both repaired the myelin sheath and increased the expression of neuregulin-1 and its receptor ErbB4, in the prefrontal cortex of demyelinated mice. Our findings show that DMS is a potential effective neuromodulation technique for the treatment of schizophrenia. One possible mechanism underlying these therapeutic effects could involve the up-regulation of NRG1/ErbB4 signaling in the prefrontal cortex.
Collapse
Affiliation(s)
- Zuoli Sun
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Tianhe Jiang
- Key Laboratory for Neurodegenerative Disorders of the Ministry of Education, Capital Medical University, Beijing, China
| | - Yan Wu
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chao Ma
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi He
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jian Yang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| |
Collapse
|
22
|
Tamnes CK, Roalf DR, Goddings AL, Lebel C. Diffusion MRI of white matter microstructure development in childhood and adolescence: Methods, challenges and progress. Dev Cogn Neurosci 2017; 33:161-175. [PMID: 29229299 PMCID: PMC6969268 DOI: 10.1016/j.dcn.2017.12.002] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/18/2017] [Accepted: 12/04/2017] [Indexed: 12/13/2022] Open
Abstract
Diffusion magnetic resonance imaging (dMRI) continues to grow in popularity as a useful neuroimaging method to study brain development, and longitudinal studies that track the same individuals over time are emerging. Over the last decade, seminal work using dMRI has provided new insights into the development of brain white matter (WM) microstructure, connections and networks throughout childhood and adolescence. This review provides an introduction to dMRI, both diffusion tensor imaging (DTI) and other dMRI models, as well as common acquisition and analysis approaches. We highlight the difficulties associated with ascribing these imaging measurements and their changes over time to specific underlying cellular and molecular events. We also discuss selected methodological challenges that are of particular relevance for studies of development, including critical choices related to image acquisition, image analysis, quality control assessment, and the within-subject and longitudinal reliability of dMRI measurements. Next, we review the exciting progress in the characterization and understanding of brain development that has resulted from dMRI studies in childhood and adolescence, including brief overviews and discussions of studies focusing on sex and individual differences. Finally, we outline future directions that will be beneficial to the field.
Collapse
Affiliation(s)
| | - David R Roalf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Catherine Lebel
- Department of Radiology, Cumming School of Medicine, and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
23
|
Sun ZY, Gu HS, Chen X, Zhang L, Li XM, Zhang JW, Li L. A novel flavanone derivative ameliorates cuprizone-induced behavioral changes and white matter pathology in the brain of mice. Psychiatry Res 2017; 257:249-259. [PMID: 28783571 DOI: 10.1016/j.psychres.2017.07.075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/04/2017] [Accepted: 07/30/2017] [Indexed: 11/24/2022]
Abstract
Recent studies have shown that white matter lesions play an important role in the pathogenesis of schizophrenia. DHF-6 is a novel flavanone derivative synthesized in our laboratory. The purpose of the present study was to investigate the effects of DHF-6 on behavioral changes and white matter pathology in a 0.2% cuprizone-fed C57BL/6 mice model. The results showed that cuprizone induced a decrease in spontaneous alternations in the Y-maze test, an increase in locomotor activity in the open field test, demyelination determined by electron microscopy, a decline in the expression of myelin basic protein (MBP), a decrease in the differentiation of oligodendrocyte precursor cells (OPCs) into mature oligodendrocytes (OLs), and an activation of microglia and astrocytes in the corpus callosum measured by western blot and/or immunocytochemical analyses. Intragastric administration of DHF-6 (25 and 50mg/kg) for 5-weeks increased the spontaneous alternations, reduced locomotor activity, reversed demyelination and MBP decrease, promoted OPCs differentiation into mature OLs, and inhibited the activation of microglia and astrocytes. These results suggest that DHF-6 may improve cognitive impairment and the positive symptoms of schizophrenia by alleviating white matter lesions via facilitating remyelination and inhibiting neuroinflammation, thus may be beneficial in the treatment of schizophrenia.
Collapse
Affiliation(s)
- Zheng-Yu Sun
- Department of Pharmacology, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing Engineering Research Center for Nerve System Drugs, Key Laboratory for Neurodegenerative Diseases of Ministry of Education, Beijing 100053, China
| | - Hong-Shun Gu
- Department of Pharmacology, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing Engineering Research Center for Nerve System Drugs, Key Laboratory for Neurodegenerative Diseases of Ministry of Education, Beijing 100053, China
| | - Xi Chen
- Department of Pharmacology, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing Engineering Research Center for Nerve System Drugs, Key Laboratory for Neurodegenerative Diseases of Ministry of Education, Beijing 100053, China
| | - Lan Zhang
- Department of Pharmacology, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing Engineering Research Center for Nerve System Drugs, Key Laboratory for Neurodegenerative Diseases of Ministry of Education, Beijing 100053, China
| | - Xin-Min Li
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
| | - Jian-Wei Zhang
- School of Chemical Biology and Pharmaceutical Sciences, Capital Medical University, Beijing 100069, China.
| | - Lin Li
- Department of Pharmacology, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing Engineering Research Center for Nerve System Drugs, Key Laboratory for Neurodegenerative Diseases of Ministry of Education, Beijing 100053, China.
| |
Collapse
|
24
|
Serpa MH, Doshi J, Erus G, Chaim-Avancini TM, Cavallet M, van de Bilt MT, Sallet PC, Gattaz WF, Davatzikos C, Busatto GF, Zanetti MV. State-dependent microstructural white matter changes in drug-naïve patients with first-episode psychosis. Psychol Med 2017; 47:2613-2627. [PMID: 28826419 DOI: 10.1017/s0033291717001015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies have consistently shown white matter (WM) microstructural abnormalities in schizophrenia. Whether or not such alterations could vary depending on clinical status (i.e. acute psychosis v. remission) remains to be investigated. METHODS Twenty-five treatment-naïve first-episode psychosis (FEP) patients and 51 healthy-controls (HC) underwent MRI scanning at baseline. Twenty-one patients were re-scanned as soon as they achieved sustained remission of symptoms; 36 HC were also scanned twice. Rate-of-change maps of longitudinal DTI changes were calculated for in order to examine WM alterations associated with changes in clinical status. We conducted voxelwise analyses of fractional anisotropy (FA) and trace (TR) maps. RESULTS At baseline, FEP presented reductions of FA in comparison with HC [p < 0.05, false-discovery rate (FDR)-corrected] affecting fronto-limbic WM and associative, projective and commissural fasciculi. After symptom remission, patients showed FA increase over time (p < 0.001, uncorrected) in some of the above WM tracts, namely the right anterior thalamic radiation, right uncinate fasciculus/inferior fronto-occipital fasciculus, and left inferior fronto-occipital fasciculus/inferior longitudinal fasciculus. We also found significant correlations between reductions in PANSS scores and FA increases over time (p < 0.05, FDR-corrected). CONCLUSIONS WM changes affecting brain tracts critical to the integration of perceptual information, cognition and emotions are detectable soon after the onset of FEP and may partially reverse in direct relation to the remission of acute psychotic symptoms. Our findings reinforce the view that WM abnormalities in brain tracts are a key neurobiological feature of acute psychotic disorders, and recovery from such WM pathology can lead to amelioration of symptoms.
Collapse
Affiliation(s)
- M H Serpa
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - J Doshi
- Section of Biomedical Image Analysis (SBIA), Department of Radiology,University of Pennsylvania,3600 Market St,Suite 380, Philadelphia, PA,USA
| | - G Erus
- Section of Biomedical Image Analysis (SBIA), Department of Radiology,University of Pennsylvania,3600 Market St,Suite 380, Philadelphia, PA,USA
| | - T M Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - M Cavallet
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - M T van de Bilt
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - P C Sallet
- Laboratory of Neuroscience, LIM-27,Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Instituto de Psiquiatria,3o andar, LIM-27,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - W F Gattaz
- Laboratory of Neuroscience, LIM-27,Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Instituto de Psiquiatria,3o andar, LIM-27,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - C Davatzikos
- Section of Biomedical Image Analysis (SBIA), Department of Radiology,University of Pennsylvania,3600 Market St,Suite 380, Philadelphia, PA,USA
| | - G F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| | - M V Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21),Department and Institute of Psychiatry,Faculty of Medicine,University of São Paulo, Centro de Medicina Nuclear,3o andar, LIM-21,Rua Dr. Ovídio Pires de Campos,s/n, São Paulo, SP,Brazil
| |
Collapse
|
25
|
Michielse S, Gronenschild E, Domen P, van Os J, Marcelis M. The details of structural disconnectivity in psychotic disorder: A family-based study of non-FA diffusion weighted imaging measures. Brain Res 2017; 1671:121-130. [PMID: 28709907 DOI: 10.1016/j.brainres.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/01/2017] [Accepted: 07/04/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies in psychotic disorder have shown reduced FA, often interpreted as disturbed white matter integrity. The observed 'dysintegrity' may be of multifactorial origin, as changes in FA are thought to reflect a combination of changes in myelination, fiber organization and number of axons. Examining the structural substrate of the diffusion tensor in individuals with (risk for) psychotic disorder may provide better understanding of the underlying structural changes. METHODS DTI scans were acquired from 85 patients with psychotic disorder, 93 siblings of patients with psychotic disorder and 80 controls. Cross-sectional group comparisons were performed using Tract-Based Spatial Statistics (TBSS) on six DTI measures: axial diffusivity (AXD), radial diffusivity (RD), mean diffusivity (MD), and the case linear (CL), case planar (CP) and case spherical (CS) tensor shape measures. RESULTS AXD did not differ between the groups. RD and CS values were significantly increased in patients compared to controls and siblings, with no significant differences between the latter two groups. MD was higher in patients compared to controls (but not siblings), with no difference between siblings and controls. CL was smaller in patients than in siblings and controls, and CP was smaller in both patients and siblings as compared to controls. CONCLUSION The differences between individuals with psychotic disorder and healthy controls, derived from detailed diffusion data analyses, suggest less fiber orientation and increased free water movement in the patients. There was some evidence for association with familial risk expressed by decreased fiber orientation.
Collapse
Affiliation(s)
- Stijn Michielse
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | - Ed Gronenschild
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Patrick Domen
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | | |
Collapse
|
26
|
Fischer B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, Rehm J, Room R. Lower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and Recommendations. Am J Public Health 2017. [PMID: 28644037 DOI: 10.2105/ajph.2017.303818] [Citation(s) in RCA: 251] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cannabis use is common in North America, especially among young people, and is associated with a risk of various acute and chronic adverse health outcomes. Cannabis control regimes are evolving, for example toward a national legalization policy in Canada, with the aim to improve public health, and thus require evidence-based interventions. As cannabis-related health outcomes may be influenced by behaviors that are modifiable by the user, evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG)-akin to similar guidelines in other health fields-offer a valuable, targeted prevention tool to improve public health outcomes. OBJECTIVES To systematically review, update, and quality-grade evidence on behavioral factors determining adverse health outcomes from cannabis that may be modifiable by the user, and translate this evidence into revised LRCUG as a public health intervention tool based on an expert consensus process. SEARCH METHODS We used pertinent medical search terms and structured search strategies, to search MEDLINE, EMBASE, PsycINFO, Cochrane Library databases, and reference lists primarily for systematic reviews and meta-analyses, and additional evidence on modifiable risk factors for adverse health outcomes from cannabis use. SELECTION CRITERIA We included studies if they focused on potentially modifiable behavior-based factors for risks or harms for health from cannabis use, and excluded studies if cannabis use was assessed for therapeutic purposes. DATA COLLECTION AND ANALYSIS We screened the titles and abstracts of all studies identified by the search strategy and assessed the full texts of all potentially eligible studies for inclusion; 2 of the authors independently extracted the data of all studies included in this review. We created Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow-charts for each of the topical searches. Subsequently, we summarized the evidence by behavioral factor topic, quality-graded it by following standard (Grading of Recommendations Assessment, Development, and Evaluation; GRADE) criteria, and translated it into the LRCUG recommendations by the author expert collective on the basis of an iterative consensus process. MAIN RESULTS For most recommendations, there was at least "substantial" (i.e., good-quality) evidence. We developed 10 major recommendations for lower-risk use: (1) the most effective way to avoid cannabis use-related health risks is abstinence, (2) avoid early age initiation of cannabis use (i.e., definitively before the age of 16 years), (3) choose low-potency tetrahydrocannabinol (THC) or balanced THC-to-cannabidiol (CBD)-ratio cannabis products, (4) abstain from using synthetic cannabinoids, (5) avoid combusted cannabis inhalation and give preference to nonsmoking use methods, (6) avoid deep or other risky inhalation practices, (7) avoid high-frequency (e.g., daily or near-daily) cannabis use, (8) abstain from cannabis-impaired driving, (9) populations at higher risk for cannabis use-related health problems should avoid use altogether, and (10) avoid combining previously mentioned risk behaviors (e.g., early initiation and high-frequency use). AUTHORS' CONCLUSIONS Evidence indicates that a substantial extent of the risk of adverse health outcomes from cannabis use may be reduced by informed behavioral choices among users. The evidence-based LRCUG serve as a population-level education and intervention tool to inform such user choices toward improved public health outcomes. However, the LRCUG ought to be systematically communicated and supported by key regulation measures (e.g., cannabis product labeling, content regulation) to be effective. All of these measures are concretely possible under emerging legalization regimes, and should be actively implemented by regulatory authorities. The population-level impact of the LRCUG toward reducing cannabis use-related health risks should be evaluated. Public health implications. Cannabis control regimes are evolving, including legalization in North America, with uncertain impacts on public health. Evidence-based LRCUG offer a potentially valuable population-level tool to reduce the risk of adverse health outcomes from cannabis use among (especially young) users in legalization contexts, and hence to contribute to improved public health outcomes.
Collapse
Affiliation(s)
- Benedikt Fischer
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Cayley Russell
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Pamela Sabioni
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Wim van den Brink
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Bernard Le Foll
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Wayne Hall
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Jürgen Rehm
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Robin Room
- Benedikt Fischer, Cayley Russell, Pamela Sabioni, and Jürgen Rehm are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario. Wim van den Brink is with the Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Bernard Le Foll is with the Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto. Wayne Hall is with the Centre for Youth Substance Abuse Research, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia. Robin Room is with the Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| |
Collapse
|
27
|
Schizophrenia symptomatic associations with diffusion tensor imaging measured fractional anisotropy of brain: a meta-analysis. Neuroradiology 2017; 59:699-708. [PMID: 28550466 DOI: 10.1007/s00234-017-1844-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 05/02/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE Several studies have examined the relationships between diffusion tensor imaging (DTI)-measured fractional anisotropy (FA) and the symptoms of schizophrenia, but results vary across the studies. The aim of this study was to carry out a meta-analysis of correlation coefficients reported by relevant studies to evaluate the correlative relationships between FA of various parts of the brain and schizophrenia symptomatic assessments. METHODS Literature was searched in several electronic databases, and study selection was based on précised eligibility criteria. Correlation coefficients between FA of a part of the brain and schizophrenia symptom were first converted into Fisher's z-scores for meta-analyses, and then overall effect sizes were back transformed to correlation coefficients. RESULTS Thirty-three studies (1121 schizophrenia patients; age 32.66 years [95% confidence interval (CI) 30.19, 35.13]; 65.95 % [57.63, 74.28] males) were included in this meta-analysis. Age was inversely associated with brain FA (z-scores [95% CI] -0.23 [-0.14, -0.32]; p ˂ 0.00001). Brain FA of various areas was inversely associated with negative symptoms of schizophrenia (z-score -0.30 [-0.23, -0.36]; p ˂ 0.00001) but was positively associated with positive symptoms of schizophrenia (z-score 0.16 [0.04, 0.27]; p = 0.007) and general psychopathology of schizophrenia (z-score 0.26 [0.15, 0.37]; p = 0.00001). CONCLUSION Although, DTI-measured brain FA is found to be inversely associated with negative symptoms and positively associated with positive symptoms and general psychopathology of schizophrenia, the effect sizes of these correlations are low and may not be clinically significant. Moreover, brain FA was also negatively associated with age of patients.
Collapse
|
28
|
Adan A, Arredondo AY, Capella MDM, Prat G, Forero DA, Navarro JF. Neurobiological underpinnings and modulating factors in schizophrenia spectrum disorders with a comorbid substance use disorder: A systematic review. Neurosci Biobehav Rev 2017; 75:361-377. [PMID: 28188887 DOI: 10.1016/j.neubiorev.2017.01.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/01/2017] [Accepted: 01/27/2017] [Indexed: 12/13/2022]
Abstract
Recently there is a growing interest in the interaction of schizophrenia spectrum disorders (SSD) and substance use disorders (SUD), a condition named dual schizophrenia spectrum disorders (SSD+). While previous research has focused on clinical and cognitive aspects, little is known about the impact of comorbidity in the brain structure and functions. Evidence suggests that dual diagnosis patients, including SSD+, show a better neurocognitive functioning during the first years of illness, followed by a serious long-term decline. The initial search retrieved 94 articles, 12 were excluded for being redundant and 49 for not fulfilling the selection criteria. Thirty-three structural and functional neuroimaging studies that compare SSD and SSD+ patients were included. Both groups exhibited more brain alterations, in comparison to only SUD patients and healthy controls. SSD+ patients are less cognitively and emotionally impaired than non-dual SSD, but worse than healthy controls. The neurobiological alterations are prominent in SSD+ after five years of illness or longer. Moreover, SUD characteristics are important modulating factors, contrary to clinical severity or specific SSD diagnosis.
Collapse
Affiliation(s)
- Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain.
| | - Arantxa Y Arredondo
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Maria Del Mar Capella
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Diego A Forero
- Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Sede Circunvalar, Universidad Antonio Nariño, 110231 Bogotá, Colombia
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus Teatinos s/n, 29071 Málaga, Spain
| |
Collapse
|
29
|
Bernier D, Bartha R, McAllindon D, Hanstock CC, Marchand Y, Dillen KNH, Gallant M, Good KP, Tibbo PG. Illness versus substance use effects on the frontal white matter in early phase schizophrenia: A 4Tesla (1)H-MRS study. Schizophr Res 2016; 175:4-11. [PMID: 27161760 DOI: 10.1016/j.schres.2016.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Young adults with early phase schizophrenia often report a past or current pattern of illicit substance use and/or alcohol misuse. Still, little is known about the cumulative and separate effects of each stressor on white matter tissue, at this vulnerable period of brain development. METHODS Participants involved 24 healthy controls with a past or current history of sustained illicit drug use and/or alcohol misuse (users), 23 healthy controls without such history (normative data), and 27 users with early phase schizophrenia. (1)H-MRS data were acquired from a large frontal volume encompassing 95% of white matter, using a 4Tesla scanner (LASER sequence, TR/TE 3200/46ms). RESULTS Reduced levels of choline-containing compounds (Cho) were specific to the effect of illness (Cohen's d=0.68), with 22% of the variance in Cho levels accounted for by duration of illness. Reduced levels of myoInositol (d=1.10) and creatine plus phosphocreatine (d=1.07) were specific to the effects of illness plus substance use. Effect of substance use on its own was revealed by reductions in levels of glutamate plus glutamine (d=0.83) in control users relative to normative data. CONCLUSIONS The specific effect of illness on white matter might indicate a decreased synthesis of membrane phospholipids or alternatively, reduced membrane cellular density. In terms of limitations, this study did not include patients without a lifetime history of substance use (non-users), and the specific effect of each substance used could not be studied separately.
Collapse
Affiliation(s)
- Denise Bernier
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Robert Bartha
- Robarts Research Institute, University of Western Ontario, Ontario, Canada
| | - David McAllindon
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada; Biomedical Translational Imaging Centre, Halifax, Nova Scotia, Canada
| | | | - Yannick Marchand
- Faculty of Computer Science, Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canada
| | - Kim N H Dillen
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Michelle Gallant
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Kimberly P Good
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada.
| |
Collapse
|
30
|
Ebdrup BH, Raghava JM, Nielsen MØ, Rostrup E, Glenthøj B. Frontal fasciculi and psychotic symptoms in antipsychotic-naive patients with schizophrenia before and after 6 weeks of selective dopamine D2/3 receptor blockade. J Psychiatry Neurosci 2016; 41:133-41. [PMID: 26599135 PMCID: PMC4764482 DOI: 10.1503/jpn.150030] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Psychotic symptoms are core clinical features of schizophrenia. We tested recent hypotheses proposing that psychotic, or positive, symptoms stem from irregularities in long-range white matter tracts projecting into the frontal cortex, and we predicted that selective dopamine D2/3 receptor blockade would restore white matter. METHODS Between December 2008 and July 2011, antipsychotic-naive patients with first-episode schizophrenia and matched healthy controls underwent baseline examination with 3 T MRI diffusion tensor imaging and clinical assessments. We assessed group differences of fractional anisotropy (FA) using voxelwise tract-based spatial statistics (TBSS) and anatomic region of interest (ROI)-based analyses. Subsequently, patients underwent 6 weeks of antipsychotic monotherapy with amisulpride. We repeated the examinations after 6 weeks. RESULTS We included 38 patients with first-episode schizophrenia and 38 controls in our analysis, and 28 individuals in each group completed the study. At baseline, whole brain TBSS analyses revealed lower FA in patients in the right anterior thalamic radiation (ATR), right cingulum, right inferior longitudinal fasciculus and right corticospinal tract (CT). Fractional anisotropy in the right ATR correlated with positive symptoms (z = 2.64, p= 0.008). The ROI analyses showed significant associations between positive symptoms and FA of the frontal fasciculi, specifically the right arcuate fasciculus (z = 2.83, p= 0.005) and right superior longitudinal fasciculus (z = -3.31, p= 0.001). At re-examination, all correlations between positive symptoms and frontal fasciculi had resolved. Fractional anisotropy in the ATR increased more in patients than in controls (z = -4.92, p< 0.001). The amisulpride dose correlated positively with FA changes in the right CT (t= 2.52, p= 0.019). LIMITATIONS Smoking and a previous diagnosis of substance abuse were potential confounders. Long-term effects of amisulpride on white matter were not evaluated. CONCLUSION Antipsychotic-naive patients with schizophrenia displayed subtle deficits in white matter, and psychotic symptoms appeared specifically associated with frontal fasciculi integrity. Six weeks of amisulpride treatment normalized white matter. Potential remyelinating effects of dopamine D2/3 receptor antagonism warrant further clarification.
Collapse
Affiliation(s)
- Bjørn H. Ebdrup
- Correspondence to: B.H. Ebdrup, Centre for Neuropsychiatric Schizophrenia Research, CNSR & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Copenhagen University Hospital, Mental Health Centre, Glostrup, Nordre Ringvej 29-67, DK-2600 Glostrup, Denmark;
| | | | | | | | | |
Collapse
|
31
|
Decomposition of brain diffusion imaging data uncovers latent schizophrenias with distinct patterns of white matter anisotropy. Neuroimage 2015; 120:43-54. [PMID: 26151103 DOI: 10.1016/j.neuroimage.2015.06.083] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/01/2015] [Accepted: 06/28/2015] [Indexed: 11/24/2022] Open
Abstract
Fractional anisotropy (FA) analysis of diffusion tensor-images (DTI) has yielded inconsistent abnormalities in schizophrenia (SZ). Inconsistencies may arise from averaging heterogeneous groups of patients. Here we investigate whether SZ is a heterogeneous group of disorders distinguished by distinct patterns of FA reductions. We developed a Generalized Factorization Method (GFM) to identify biclusters (i.e., subsets of subjects associated with a subset of particular characteristics, such as low FA in specific regions). GFM appropriately assembles a collection of unsupervised techniques with Non-negative Matrix Factorization to generate biclusters, rather than averaging across all subjects and all their characteristics. DTI tract-based spatial statistics images, which output is the locally maximal FA projected onto the group white matter skeleton, were analyzed in 47 SZ and 36 healthy subjects, identifying 8 biclusters. The mean FA of the voxels of each bicluster was significantly different from those of other SZ subjects or 36 healthy controls. The eight biclusters were organized into four more general patterns of low FA in specific regions: 1) genu of corpus callosum (GCC), 2) fornix (FX)+external capsule (EC), 3) splenium of CC (SCC)+retrolenticular limb (RLIC)+posterior limb (PLIC) of the internal capsule, and 4) anterior limb of the internal capsule. These patterns were significantly associated with particular clinical features: Pattern 1 (GCC) with bizarre behavior, pattern 2 (FX+EC) with prominent delusions, and pattern 3 (SCC+RLIC+PLIC) with negative symptoms including disorganized speech. The uncovered patterns suggest that SZ is a heterogeneous group of disorders that can be distinguished by different patterns of FA reductions associated with distinct clinical features.
Collapse
|
32
|
Lubman DI, Cheetham A, Yücel M. Cannabis and adolescent brain development. Pharmacol Ther 2014; 148:1-16. [PMID: 25460036 DOI: 10.1016/j.pharmthera.2014.11.009] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/03/2014] [Indexed: 12/14/2022]
Abstract
Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
Collapse
Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia; Monash Clinical & Imaging Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
33
|
Chuang JY, Murray GK, Metastasio A, Segarra N, Tait R, Spencer J, Ziauddeen H, Dudas RB, Fletcher PC, Suckling J. Brain structural signatures of negative symptoms in depression and schizophrenia. Front Psychiatry 2014; 5:116. [PMID: 25221526 PMCID: PMC4145726 DOI: 10.3389/fpsyt.2014.00116] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/12/2014] [Indexed: 02/02/2023] Open
Abstract
Negative symptoms occur in several major mental health disorders with undetermined mechanisms and unsatisfactory treatments; identification of their neural correlates might unveil the underlying pathophysiological basis and pinpoint the therapeutic targets. In this study, participants with major depressive disorder (n = 24), schizophrenia (n = 22), and healthy controls (n = 20) were assessed with 10 frequently used negative symptom scales followed by principal component analysis (PCA) of the scores. A linear model with the prominent components identified by PCA was then regressed on gray and white-matter volumes estimated from T1-weighted magnetic resonance imaging. In depressed patients, negative symptoms such as blunted affect, alogia, withdrawal, and cognitive impairment, assessed mostly via clinician-rated scales were inversely associated with gray matter volume in the bilateral cerebellum. In patients with schizophrenia, anhedonia, and avolition evaluated via self-rated scales inversely related to white-matter volume in the left anterior limb of internal capsule/anterior thalamic radiation and positively in the left superior longitudinal fasiculus. The pathophysiological mechanisms underlying negative symptoms might differ between depression and schizophrenia. These results also point to future negative symptom scale development primarily focused on detecting and monitoring the corresponding changes to brain structure or function.
Collapse
Affiliation(s)
- Jie-Yu Chuang
- Department of Psychiatry, University of Cambridge , Cambridge , UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| | | | - Nuria Segarra
- Department of Psychiatry, University of Cambridge , Cambridge , UK
| | - Roger Tait
- Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK
| | - Jenny Spencer
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK ; Wellcome Trust MRC, Institute of Metabolic Science, University of Cambridge , Cambridge , UK
| | - Robert B Dudas
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK ; Norfolk and Suffolk NHS Foundation Trust , Norfolk , UK
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge , Cambridge , UK ; Behavioural and Clinical Neuroscience Institute, University of Cambridge , Cambridge , UK ; Cambridgeshire and Peterborough NHS Foundation Trust , Cambridge , UK
| |
Collapse
|