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Ouellet J, Assaf R, Afzali MH, Nourbakhsh S, Potvin S, Conrod P. Neurocognitive consequences of adolescent sleep disruptions and their relationship to psychosis vulnerability: a longitudinal cohort study. NPJ MENTAL HEALTH RESEARCH 2024; 3:18. [PMID: 38714732 PMCID: PMC11076494 DOI: 10.1038/s44184-024-00058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/15/2024] [Indexed: 05/10/2024]
Abstract
Adolescence is a key period for neurocognitive maturation where deviation from normal developmental trajectories may be tied to adverse mental health outcomes. Cognitive disruptions have been noted in populations at risk for psychosis and are known to accompany periods of sleep deprivation. This study aims to assess the role of cognition as a mediator between sleep disruptions and psychosis risk. A cohort of 3801 high school students (51% female, mean age = 12.8, SD = 0.45 years) was recruited from 31 Montreal high schools. Measures of sleep, psychotic-like experiences, inhibition, working memory, perceptual reasoning, and delayed recall were collected from participants on a yearly basis over the five years of their high school education. A multi-level model mediation analysis was performed controlling for sex and time squared. Response inhibition was shown to be associated with, and to mediate (B = -0.005, SD = 0.003, p = 0.005*) the relationship between sleep disruptions (B = -0.011, SD = 0.004, p < 0.001*) and psychotic-like experiences (B = 0.411, SD = 0.170, p = 0.005*). Spatial working memory deficits on a given year were associated with a higher frequency of psychotic-like experiences that same year (B = -0.046, SD = 0.018, p = 0.005*) and the following year (B = -0.051, SD = 0.023, p = 0.010*), but were not associated with sleep disturbances. No significant associations were found between our variables of interest and either delayed recall or perceptual reasoning at the within person level. Findings from this large longitudinal study provide evidence that the association between sleep disruptions and psychosis risk is specifically mediated by inhibitory rather than general cognitive impairments. The association of spatial working memory, response inhibition, and sleep disruptions with psychotic-like experiences suggests that these factors may represent potential targets for preventative interventions.
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Affiliation(s)
- Julien Ouellet
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada.
| | - Roxane Assaf
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | | | - Sima Nourbakhsh
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
- Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
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Parker D, Trotti R, McDowell J, Keedy S, Keshavan M, Pearlson G, Gershon E, Ivleva E, Huang LY, Sauer K, Hill S, Sweeny J, Tamminga C, Clementz B. Differentiating Biomarker Features and Familial Characteristics of B-SNIP Psychosis Biotypes. RESEARCH SQUARE 2024:rs.3.rs-3702638. [PMID: 38260530 PMCID: PMC10802686 DOI: 10.21203/rs.3.rs-3702638/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Idiopathic psychosis shows considerable biological heterogeneity across cases. B-SNIP used psychosis-relevant biomarkers to identity psychosis Biotypes, which will aid etiological and targeted treatment investigations. Psychosis probands from the B-SNIP consortium (n = 1907), their first-degree biological relatives (n = 705), and healthy participants (n = 895) completed a biomarker battery composed of cognition, saccades, and auditory EEG measurements. ERP quantifications were substantially modified from previous iterations of this approach. Multivariate integration reduced multiple biomarker outcomes to 11 "bio-factors". Twenty-four different approaches indicated bio-factor data among probands were best distributed as three subgroups. Numerical taxonomy with k-means constructed psychosis Biotypes, and rand indices evaluated consistency of Biotype assignments. Psychosis subgroups, their non-psychotic first-degree relatives, and healthy individuals were compared across bio-factors. The three psychosis Biotypes differed significantly on all 11 bio-factors, especially prominent for general cognition, antisaccades, ERP magnitude, and intrinsic neural activity. Rand indices showed excellent consistency of clustering membership when samples included at least 1100 subjects. Canonical discriminant analysis described composite bio-factors that simplified group comparisons and captured neural dysregulation, neural vigor, and stimulus salience variates. Neural dysregulation captured Biotype-2, low neural vigor captured Biotype-1, and deviations of stimulus salience captured Biotype-3. First-degree relatives showed similar patterns as their Biotyped proband relatives on general cognition, antisaccades, ERP magnitudes, and intrinsic brain activity. Results extend previous efforts by the B-SNIP consortium to characterize biologically distinct psychosis Biotypes. They also show that at least 1100 observations are necessary to achieve consistent outcomes. First-degree relative data implicate specific bio-factor deviations to the subtype of their proband and may inform studies of genetic risk.
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Ramírez-Martín A, Sirignano L, Streit F, Foo JC, Forstner AJ, Frank J, Nöthen MM, Strohmaier J, Witt SH, Mayoral-Cleries F, Moreno-Küstner B, Rietschel M, Guzmán-Parra J. Impulsivity, decision-making, and risk behavior in bipolar disorder and major depression from bipolar multiplex families. Brain Behav 2023; 14:e3337. [PMID: 38111335 PMCID: PMC10897498 DOI: 10.1002/brb3.3337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVES Bipolar disorder (BD) and major depressive disorder (MDD) are characterized by specific alterations of mood. In both disorders, alterations in cognitive domains such as impulsivity, decision-making, and risk-taking have been reported. Identification of similarities and differences of these domains in BD and MDD could give further insight into their etiology. The present study assessed impulsivity, decision-making, and risk-taking behavior in BD and MDD patients from bipolar multiplex families. METHODS Eighty-two participants (BD type I, n = 25; MDD, n = 26; healthy relatives (HR), n = 17; and healthy controls (HC), n = 14) underwent diagnostic interviews and selected tests of a cognitive battery assessing neurocognitive performance across multiple subdomains including impulsivity (response inhibition and delay aversion), decision-making, and risk behavior. Generalized estimating equations (GEEs) were used to analyze whether the groups differed in the respective cognitive domains. RESULTS Participants with BD and MDD showed higher impulsivity levels compared to HC; this difference was more pronounced in BD participants. BD participants also showed lower inhibitory control than MDD participants. Overall, suboptimal decision-making was associated with both mood disorders (BD and MDD). In risk-taking behavior, no significant impairment was found in any group. LIMITATIONS As sample size was limited, it is possible that differences between BD and MDD may have escaped detection due to lack of statistical power. CONCLUSIONS Our findings show that alterations of cognitive domains-while present in both disorders-are differently associated with BD and MDD. This underscores the importance of assessing such domains in addition to mere diagnosis of mood disorders.
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Affiliation(s)
- Almudena Ramírez-Martín
- Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jerome C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas J Forstner
- School of Medicine & University Hospital Bonn, Institute of Human Genetics, University of Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus M Nöthen
- School of Medicine & University Hospital Bonn, Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fermin Mayoral-Cleries
- Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Málaga, Málaga, Spain
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jose Guzmán-Parra
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Clementz BA, Chattopadhyay I, Trotti RL, Parker DA, Gershon ES, Hill SK, Ivleva EI, Keedy SK, Keshavan MS, McDowell JE, Pearlson GD, Tamminga CA, Gibbons RD. Clinical characterization and differentiation of B-SNIP psychosis Biotypes: Algorithmic Diagnostics for Efficient Prescription of Treatments (ADEPT)-1. Schizophr Res 2023; 260:143-151. [PMID: 37657281 PMCID: PMC10712427 DOI: 10.1016/j.schres.2023.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/03/2023]
Abstract
Clinically defined psychosis diagnoses are neurobiologically heterogeneous. The B-SNIP consortium identified and validated more neurobiologically homogeneous psychosis Biotypes using an extensive battery of neurocognitive and psychophysiological laboratory measures. However, typically the first step in any diagnostic evaluation is the clinical interview. In this project, we evaluated if psychosis Biotypes have clinical characteristics that can support their differentiation in addition to obtaining laboratory testing. Clinical interview data from 1907 individuals with a psychosis Biotype were used to create a diagnostic algorithm. The features were 58 ratings from standard clinical scales. Extremely randomized tree algorithms were used to evaluate sensitivity, specificity, and overall classification success. Biotype classification accuracy peaked at 91 % with the use of 57 items on average. A reduced feature set of 28 items, though, also showed 81 % classification accuracy. Using this reduced item set, we found that only 10-11 items achieved a one-vs-all (Biotype-1 or not, Biotype-2 or not, Biotype-3 or not) area under the sensitivity-specificity curve of .78 to .81. The top clinical characteristics for differentiating psychosis Biotypes, in order of importance, were (i) difficulty in abstract thinking, (ii) multiple indicators of social functioning, (iii) conceptual disorganization, (iv) severity of hallucinations, (v) stereotyped thinking, (vi) suspiciousness, (vii) unusual thought content, (viii) lack of spontaneous speech, and (ix) severity of delusions. These features were remarkably different from those that differentiated DSM psychosis diagnoses. This low-burden adaptive algorithm achieved reasonable classification accuracy and will support Biotype-specific etiological and treatment investigations even in under-resourced clinical and research environments.
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Affiliation(s)
- Brett A Clementz
- Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA 30602, United States of America.
| | - Ishanu Chattopadhyay
- Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago, IL, United States of America
| | - Rebekah L Trotti
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - David A Parker
- Department of Human Genetics, Emory University School of Medicine, Atlanta VA Medical Center, Atlanta, GA, United States of America
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States of America
| | - Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Jennifer E McDowell
- Department of Psychology, Owens Institute for Behavioral Research, University of Georgia, Athens, GA 30602, United States of America
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University, School of Medicine, New Haven, CT, United States of America; Olin NeuroPsychiatry Research Center, Institute of Living, Hartford, CT, United States of America
| | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Robert D Gibbons
- Center for Health Statistics, Departments of Medicine and Public Health Sciences, University of Chicago, Chicago, IL, United States of America
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Trotti RL, Parker DA, Sabatinelli D, Keshavan MS, Keedy SK, Gershon ES, Pearlson GD, Hill SK, Tamminga CA, McDowell JE, Clementz BA. Emotional scene processing in biotypes of psychosis. Psychiatry Res 2023; 324:115227. [PMID: 37121219 PMCID: PMC10175237 DOI: 10.1016/j.psychres.2023.115227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/14/2023] [Accepted: 04/23/2023] [Indexed: 05/02/2023]
Abstract
Social-emotional deficits in psychosis may be indexed by deviations in emotional scene processing, but event-related potential (ERP) studies indicate such deviations may not map cleanly to diagnostic categories. Neurobiologically defined psychosis subgroups offer an alternative that may better capture neurophysiological correlates of social-emotional deficits. The current study investigates emotional scene-elicited ERPs in Biotypes of psychosis in a large (N = 622), well-characterized sample. Electroencephalography was recorded in healthy persons (N = 129), Biotype-1 (N = 195), Biotype-2 (N = 131), and Biotype-3 (N = 167) psychosis cases. ERPs were measured from posterior and centroparietal scalp locations. Neural responses to emotional scenes were compared between healthy and psychosis groups. Multivariate group discrimination analyses resulted in two composite variates that differentiated groups. The first variate displayed large differences between low-cognition (Biotype-1, Biotype-2) and intact-cognition groups (Biotype-3, healthy persons). The second indicated a small-to-moderate distinction of Biotypes-2 and -3 from Biotype-1 and healthy persons. Two multivariate correlations were identified indicating associations between 1) self-reported emotional experience and generalized cognition and 2) socio-occupational functioning and late-stage emotional processing. Psychosis Biotypes displayed emotional processing deficits not apparent in DSM psychosis subgroups. Future translational research may benefit from exploring emotional scene processing in such neurobiologically-defined psychosis groups.
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Affiliation(s)
- R L Trotti
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - D A Parker
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - D Sabatinelli
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - M S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - S K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - E S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - G D Pearlson
- Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - S K Hill
- Department of Psychology, Rosalind Franklin University, North Chicago, IL, USA
| | - C A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J E McDowell
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - B A Clementz
- Department of Psychology, University of Georgia, Athens, GA, USA
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Zhang L, Lizano P, Xu Y, Rubin LH, Lee AM, Lencer R, Reilly JL, Keefe RSE, Keedy SK, Pearlson GD, Clementz BA, Keshavan MS, Gershon ES, Tamminga CA, Sweeney JA, Hill SK, Bishop JR. Peripheral inflammation is associated with impairments of inhibitory behavioral control and visual sensorimotor function in psychotic disorders. Schizophr Res 2023; 255:69-78. [PMID: 36965362 PMCID: PMC10175233 DOI: 10.1016/j.schres.2023.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/08/2023] [Accepted: 03/13/2023] [Indexed: 03/27/2023]
Abstract
Elevated markers of peripheral inflammation are common in psychosis spectrum disorders and have been associated with brain anatomy, pathology, and physiology as well as clinical outcomes. Preliminary evidence suggests a link between inflammatory cytokines and C-reactive protein (CRP) with generalized cognitive impairments in a subgroup of individuals with psychosis. Whether these patients with elevated peripheral inflammation demonstrate deficits in specific cognitive domains remains unclear. To examine this, seventeen neuropsychological and sensorimotor tasks and thirteen peripheral inflammatory and microvascular markers were quantified in a subset of B-SNIP consortium participants (129 psychosis, 55 healthy controls). Principal component analysis was conducted across the inflammatory markers, resulting in five inflammation factors. Three discrete latent cognitive domains (Visual Sensorimotor, General Cognitive Ability, and Inhibitory Behavioral Control) were characterized based on the neurobehavioral battery and examined in association with inflammation factors. Hierarchical clustering analysis identified cognition-sensitive high/low inflammation subgroups. Among persons with psychotic disorders but not healthy controls, higher inflammation scores had significant associations with impairments of Inhibitory Control (R2 = 0.100, p-value = 2.69e-4, q-value = 0.004) and suggestive associations with Visual Sensorimotor function (R2 = 0.039, p-value = 0.024, q-value = 0.180), but not with General Cognitive Ability (R2 = 0.015, p-value = 0.162). Greater deficits in Inhibitory Control were observed in the high inflammation patient subgroup, which represented 30.2 % of persons with psychotic disorders, as compared to the low inflammation psychosis subgroup. These findings indicate that inflammation dysregulation may differentially impact specific neurobehavioral domains across psychotic disorders, particularly performance on tasks requiring ongoing behavioral monitoring and control.
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Affiliation(s)
- Lusi Zhang
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Yanxun Xu
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, United States
| | - Leah H Rubin
- Department of Neurology, Psychiatry, and Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Adam M Lee
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States
| | - Richard S E Keefe
- Departments of Psychiatry, Neuroscience, and Psychology, Duke University, Durham, NC, United States
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, School of Medicine, Yale University, New Haven, CT, United States
| | - Brett A Clementz
- Department of Psychology and Neuroscience, University of Georgia, Athens, GA, United States
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center Dallas, TX, United States
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States.
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Shamanna V, Mehta UM, Naik SS, Basavaraju R, Thirthalli J. Transdiagnostic investigation into the relationship between mirror neuron system activity, echo-phenomena, and theory of mind in major psychoses. Asian J Psychiatr 2023; 82:103504. [PMID: 36801552 DOI: 10.1016/j.ajp.2023.103504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
The association between social cognition and putative mirror neuron system (MNS)-activity in major psychoses might be contingent upon frontal dysregulation. We used a transdiagnostic ecological approach to enrich a specific behavioral phenotype (echophenomena or hyper-imitative states) across clinical diagnoses (mania and schizophrenia) to compare behavioral and physiological markers of social cognition and frontal disinhibition. We examined 114 participants with schizophrenia (N = 53) and mania (N = 61) for the presence and severity of echo-phenomena (echopraxia, incidental, and induced echolalia) using an ecological paradigm to simulate real-life social communication. Symptom severity, frontal release reflexes, and theory of mind performance were also assessed. In a proportion of these participants with (N = 20) and without (N = 20) echo-phenomena, we compared motor resonance (motor evoked potential facilitation during action observation compared to static image viewing) and cortical silent period (CSP) as putative markers of MNS-activity and frontal disinhibition, respectively, using Transcranial Magnetic Stimulation. While the prevalence of echo-phenomena was similar between mania and schizophrenia, incidental echolalia was more severe in mania. Participants with echo-phenomena (compared to those without) had significantly greater motor resonance with singlepulse (not with paired-pulse) stimuli, poorer theory of mind scores, higher frontal release reflexes but similar CSP, and greater symptom severity. None of these parameters significantly differed between participants with mania and schizophrenia. We observed relatively better phenotypic and neurophysiological characterization of major psychoses by categorizing participants based on the presence of echophenomena than clinical diagnoses. Higher putative MNS-activity was associated with poorer theory of mind in a hyper-imitative behavioral state.
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Affiliation(s)
- Varsha Shamanna
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India.
| | - Shalini S Naik
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Rakshathi Basavaraju
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
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Qin K, Sweeney JA, DelBello MP. The inferior frontal gyrus and familial risk for bipolar disorder. PSYCHORADIOLOGY 2022; 2:171-179. [PMID: 38665274 PMCID: PMC10917220 DOI: 10.1093/psyrad/kkac022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 04/28/2024]
Abstract
Bipolar disorder (BD) is a familial disorder with high heritability. Genetic factors have been linked to the pathogenesis of BD. Relatives of probands with BD who are at familial risk can exhibit brain abnormalities prior to illness onset. Given its involvement in prefrontal cognitive control and in frontolimbic circuitry that regulates emotional reactivity, the inferior frontal gyrus (IFG) has been a focus of research in studies of BD-related pathology and BD-risk mechanism. In this review, we discuss multimodal neuroimaging findings of the IFG based on studies comparing at-risk relatives and low-risk controls. Review of these studies in at-risk cases suggests the presence of both risk and resilience markers related to the IFG. At-risk individuals exhibited larger gray matter volume and increased functional activities in IFG compared with low-risk controls, which might result from an adaptive brain compensation to support emotion regulation as an aspect of psychological resilience. Functional connectivity between IFG and downstream limbic or striatal areas was typically decreased in at-risk individuals relative to controls, which could contribute to risk-related problems of cognitive and emotional control. Large-scale and longitudinal investigations on at-risk individuals will further elucidate the role of IFG and other brain regions in relation to familial risk for BD, and together guide identification of at-risk individuals for primary prevention.
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Affiliation(s)
- Kun Qin
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
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Huang LY, Jackson BS, Rodrigue AL, Tamminga CA, Gershon ES, Pearlson GD, Keshavan MS, Keedy SS, Hill SK, Sweeney JA, Clementz BA, McDowell JE. Antisaccade error rates and gap effects in psychosis syndromes from bipolar-schizophrenia network for intermediate phenotypes 2 (B-SNIP2). Psychol Med 2022; 52:2692-2701. [PMID: 33622437 DOI: 10.1017/s003329172000478x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Antisaccade tasks can be used to index cognitive control processes, e.g. attention, behavioral inhibition, working memory, and goal maintenance in people with brain disorders. Though diagnoses of schizophrenia (SZ), schizoaffective (SAD), and bipolar I with psychosis (BDP) are typically considered to be distinct entities, previous work shows patterns of cognitive deficits differing in degree, rather than in kind, across these syndromes. METHODS Large samples of individuals with psychotic disorders were recruited through the Bipolar-Schizophrenia Network on Intermediate Phenotypes 2 (B-SNIP2) study. Anti- and pro-saccade task performances were evaluated in 189 people with SZ, 185 people with SAD, 96 people with BDP, and 279 healthy comparison participants. Logistic functions were fitted to each group's antisaccade speed-performance tradeoff patterns. RESULTS Psychosis groups had higher antisaccade error rates than the healthy group, with SZ and SAD participants committing 2 times as many errors, and BDP participants committing 1.5 times as many errors. Latencies on correctly performed antisaccade trials in SZ and SAD were longer than in healthy participants, although error trial latencies were preserved. Parameters of speed-performance tradeoff functions indicated that compared to the healthy group, SZ and SAD groups had optimal performance characterized by more errors, as well as less benefit from prolonged response latencies. Prosaccade metrics did not differ between groups. CONCLUSIONS With basic prosaccade mechanisms intact, the higher speed-performance tradeoff cost for antisaccade performance in psychosis cases indicates a deficit that is specific to the higher-order cognitive aspects of saccade generation.
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Affiliation(s)
- Ling-Yu Huang
- Departments of Psychology & Neuroscience, University of Georgia, Athens, GA, USA
| | - Brooke S Jackson
- Departments of Psychology & Neuroscience, University of Georgia, Athens, GA, USA
| | - Amanda L Rodrigue
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | | | - Sarah S Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Departments of Psychology & Neuroscience, University of Georgia, Athens, GA, USA
| | - Jennifer E McDowell
- Departments of Psychology & Neuroscience, University of Georgia, Athens, GA, USA
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10
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Karpouzian-Rogers T, Sweeney JA, Rubin LH, McDowell J, Clementz BA, Gershon E, Keshavan MS, Pearlson GD, Tamminga CA, Reilly JL. Reduced task-evoked pupillary response in preparation for an executive cognitive control response among individuals across the psychosis spectrum. Schizophr Res 2022; 248:79-88. [PMID: 35963057 DOI: 10.1016/j.schres.2022.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 04/29/2022] [Accepted: 07/25/2022] [Indexed: 11/19/2022]
Abstract
Task-evoked pupillary response (TEPR) is a measure of physiological arousal modulated by cognitive demand. Healthy individuals demonstrate greater TEPR prior to correct versus error antisaccade trials and correct antisaccade versus visually guided saccade (VGS) trials. The relationship between TEPR and antisaccade performance in individuals with psychotic disorders and their relatives has not been investigated. Probands with schizophrenia, schizoaffective disorder, psychotic bipolar disorder, their first-degree relatives, and controls from the B-SNIP study completed antisaccade and VGS tasks. TEPR prior to execution of responses on these tasks was evaluated among controls compared to probands and relatives according to diagnostic groups and neurobiologically defined subgroups (biotypes). Controls demonstrated greater TEPR on antisaccade correct versus error versus VGS trials. TEPR was not differentiated between antisaccade correct versus error trials in bipolar or schizophrenia probands, though was greater on antisaccade compared to prosaccade trials. There was no modulation of TEPR in schizoaffective probands. Relatives of schizophrenia and schizoaffective probands and those with elevated psychosis spectrum traits failed to demonstrate differential TEPR on antisaccade correct versus error trials. No proband or relative biotypes demonstrated differential TEPR on antisaccade correct versus error trials, and only proband biotype 3 and relative biotypes 3 and 2 demonstrated greater TEPR on antisaccade versus VGS trials. Our findings suggest that aberrant modulation of preparatory activity prior to saccade execution contributes to impaired executive cognitive control across the psychosis spectrum, including nonpsychotic relatives with elevated clinical risk. Reduced pupillary modulation under cognitive challenge may thus be a biomarker for the psychosis phenotype.
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Affiliation(s)
- Tatiana Karpouzian-Rogers
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - John A Sweeney
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
| | - Leah H Rubin
- Departments of Neurology and Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Jennifer McDowell
- Department of Psychology, University of Georgia, Athens, GA, United States of America
| | - Brett A Clementz
- Department of Psychology, University of Georgia, Athens, GA, United States of America
| | - Elliot Gershon
- Psychiatry, University of Chicago, Chicago, IL, United States of America
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University and Olin Neuropsychiatric Research Center, Hartford, CT, United States of America
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
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11
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Menkes MW, Andrews CM, Suzuki T, Chun J, Donnell LO, Grove T, Deng W, McInnis MG, Deldin PJ, Tso IF. Event-related potential correlates of affective response inhibition in bipolar I disorder: Comparison with schizophrenia. J Affect Disord 2022; 309:131-140. [PMID: 35472478 PMCID: PMC9844970 DOI: 10.1016/j.jad.2022.04.118] [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: 02/15/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Individuals with bipolar I disorder (BD) have difficulty inhibiting context-inappropriate responses. The neural mechanisms contributing to these difficulties, especially in emotional contexts, are little understood. This study aimed to inform mechanisms of impaired impulsivity control in response to emotion in BD, and whether response inhibition indices are altered to a similar degree in schizophrenia spectrum disorders (SZ). We examined alterations to behavioral performance and event-related potentials (ERPs) during inhibition to affective stimuli in BD, relative to healthy control participants (HC) and SZ. METHODS Sixty-six participants with BD, 32 participants with SZ, and 48 HC completed a Go/No-Go task with emotional face stimuli while electroencephalography was recorded. Behavioral signal detection metrics (perceptual sensitivity, response bias) and ERPs (N200, P300) were compared across groups. RESULTS Relative to HC, participants with BD showed reduced (1) discrimination of Go vs. No-Go stimuli (i.e., emotional vs. neutral faces), and (2) P300 amplitudes elicited by emotional faces. Results similarly extended to SZ: BD and SZ groups did not differ on behavioral performance nor ERP amplitudes. LIMITATIONS Aspects of the Go/No-Go task design may have limited findings, and medication effects on ERP amplitudes in patient samples cannot be fully ruled out. CONCLUSIONS Findings suggest the difficulty participants with BD and SZ experienced on the current affective response inhibition task lied largely in discriminating between facial expressions. Difficulties with discriminating emotional from neutral expressions may contribute to difficulties with appropriate behavioral responding in social-affective contexts for individuals with BD and SZ.
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Affiliation(s)
- Margo W. Menkes
- Department of Psychiatry, University of Michigan, Ann
Arbor, MI,Department of Psychology, University of Michigan, Ann
Arbor, MI
| | | | - Takakuni Suzuki
- Department of Psychiatry, University of Michigan, Ann
Arbor, MI
| | - Jinsoo Chun
- Department of Psychiatry, Beth Israel Deaconess Medical
Center, Boston, MA
| | | | - Tyler Grove
- Department of Psychiatry, University of Michigan, Ann
Arbor, MI
| | - Wisteria Deng
- Department of Psychology, Yale University, New Haven,
CT
| | | | - Patricia J. Deldin
- Department of Psychiatry, University of Michigan, Ann
Arbor, MI,Department of Psychology, University of Michigan, Ann
Arbor, MI
| | - Ivy F. Tso
- Department of Psychiatry, University of Michigan, Ann
Arbor, MI,Department of Psychology, University of Michigan, Ann
Arbor, MI
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12
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Clementz BA, Parker DA, Trotti RL, McDowell JE, Keedy SK, Keshavan MS, Pearlson GD, Gershon ES, Ivleva EI, Huang LY, Hill SK, Sweeney JA, Thomas O, Hudgens-Haney M, Gibbons RD, Tamminga CA. Psychosis Biotypes: Replication and Validation from the B-SNIP Consortium. Schizophr Bull 2022; 48:56-68. [PMID: 34409449 PMCID: PMC8781330 DOI: 10.1093/schbul/sbab090] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Current clinical phenomenological diagnosis in psychiatry neither captures biologically homologous disease entities nor allows for individualized treatment prescriptions based on neurobiology. In this report, we studied two large samples of cases with schizophrenia, schizoaffective, and bipolar I disorder with psychosis, presentations with clinical features of hallucinations, delusions, thought disorder, affective, or negative symptoms. A biomarker approach to subtyping psychosis cases (called psychosis Biotypes) captured neurobiological homology that was missed by conventional clinical diagnoses. Two samples (called "B-SNIP1" with 711 psychosis and 274 healthy persons, and the "replication sample" with 717 psychosis and 198 healthy persons) showed that 44 individual biomarkers, drawn from general cognition (BACS), motor inhibitory (stop signal), saccadic system (pro- and anti-saccades), and auditory EEG/ERP (paired-stimuli and oddball) tasks of psychosis-relevant brain functions were replicable (r's from .96-.99) and temporally stable (r's from .76-.95). Using numerical taxonomy (k-means clustering) with nine groups of integrated biomarker characteristics (called bio-factors) yielded three Biotypes that were virtually identical between the two samples and showed highly similar case assignments to subgroups based on cross-validations (88.5%-89%). Biotypes-1 and -2 shared poor cognition. Biotype-1 was further characterized by low neural response magnitudes, while Biotype-2 was further characterized by overactive neural responses and poor sensory motor inhibition. Biotype-3 was nearly normal on all bio-factors. Construct validation of Biotype EEG/ERP neurophysiology using measures of intrinsic neural activity and auditory steady state stimulation highlighted the robustness of these outcomes. Psychosis Biotypes may yield meaningful neurobiological targets for treatments and etiological investigations.
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Affiliation(s)
- Brett A Clementz
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - David A Parker
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Rebekah L Trotti
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
- Institute of Living, Hartford Healthcare Corp, Hartford, CT, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ling-Yu Huang
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Olivia Thomas
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | | | - Robert D Gibbons
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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13
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Eskridge CLM, Hochberger WC, Kaseda ET, Lencer R, Reilly JL, Keedy SK, Keefe RSE, Pearlson GD, Keshavan MS, Tamminga CA, Sweeney JA, Hill SK. Deficits in generalized cognitive ability, visual sensorimotor function, and inhibitory control represent discrete domains of neurobehavioral deficit in psychotic disorders. Schizophr Res 2021; 236:54-60. [PMID: 34392106 PMCID: PMC8464494 DOI: 10.1016/j.schres.2021.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/06/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Psychotic disorders are characterized by impaired cognition, yet some reports indicate specific deficits extend beyond reduced general cognitive ability. This study utilized exploratory and confirmatory factor analytic methods to evaluate the latent structure of a broad neurocognitive battery used in the Bipolar-Schizophrenia Network of Intermediate Phenotypes (B-SNIP) study, which included neuropsychological and neurophysiological measures in psychotic disorder probands and their unaffected first-degree relatives. Findings indicate that the factor structure of data from this set of assessments is more complex than the unitary factor of global cognitive ability underlying the Brief Assessment of Cognition in Schizophrenia (BACS). In addition to assessing generalized cognitive ability, two other factors were identified: visual sensorimotor function and inhibitory behavioral control. This complex cognitive architecture, derived in controls, generalized to patients across the psychosis spectrum and to their unaffected relatives. These findings highlight the need for a more differentiated assessment of neurobehavioral functions in studies designed to test for diagnostically specific biomarkers, endophenotypes for gene discovery and beneficial effects of therapeutics on cognitive function.
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Affiliation(s)
- Courtney L M Eskridge
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, United States.
| | - William C Hochberger
- Advanced Neurobehavioral Health of Southern California, San Diego, CA, United States
| | - Erin T Kaseda
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, United States
| | - Rebekka Lencer
- University of Muenster, Department of Psychiatry and Psychotherapy, Munster, Germany
| | - James L Reilly
- Northwestern University, Department of Psychiatry and Behavioral Sciences, Chicago, IL, United States
| | - Sarah K Keedy
- University of Chicago, Department of Psychiatry, Chicago, IL, United States
| | - Richard S E Keefe
- Duke University, Departments of Psychiatry, Neuroscience, and Psychology, Durham, NC, United States
| | - Godfrey D Pearlson
- Yale University School of Medicine, Departments of Psychiatry and Neurobiology, New Haven, CT, United States
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Psychiatry, Boston, MA, United States
| | - Carol A Tamminga
- University of Texas-Southwestern University Hospital, Department of Psychiatry, Dallas, TX, United States
| | - John A Sweeney
- University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience, Cincinnati, OH, United States
| | - S Kristian Hill
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, United States
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14
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Battaglia S, Serio G, Scarpazza C, D'Ausilio A, Borgomaneri S. Frozen in (e)motion: How reactive motor inhibition is influenced by the emotional content of stimuli in healthy and psychiatric populations. Behav Res Ther 2021; 146:103963. [PMID: 34530318 DOI: 10.1016/j.brat.2021.103963] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/06/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022]
Abstract
Efficient inhibitory control is vital. However, environmental cues can influence motor control especially in an emotional context. One common task to measure inhibitory control is the stop-signal task (SST), which asks participants to respond to go stimuli knowing that on some trials a stop signal will be presented, requiring them to inhibit their response. This paradigm estimates the ability to inhibit already-initiated responses by calculating participants' stop-signal reaction times (SSRT), an index of inhibitory control. Here, we aim to review the existing, often contradictory, evidence on the influence of emotional stimuli on the inhibitory process. We aim to discuss which factors may reveal an interference as well as an advantage of emotional stimuli on action inhibition performance. Finally, we review the existing evidence that has investigated the effect of such stimuli on action inhibition in the psychiatric population. Important factors are the relevance, the intensity and the valence of the emotional stimulus, as well as the affected component of the motor control. From all this evidence, it is clear that understand precisely how emotion is integrated into core executive functions, such as inhibitory control, is essential not only for cognitive neuroscience, but also for refining neurocognitive models of psychopathology.
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Affiliation(s)
- Simone Battaglia
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Università di Bologna, Campus di Cesena, 47521, Cesena, Italy.
| | - Gianluigi Serio
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Università di Bologna, Campus di Cesena, 47521, Cesena, Italy
| | - Cristina Scarpazza
- Department of General Psychology, University of Padova, 35131, Padova, Italy; Padova Neuroscience Centre (PNC), 35131, Padova, Italy
| | - Alessandro D'Ausilio
- Università di Ferrara, Dipartimento di Neuroscienze e Riabilitazione, Ferrara, Italy; Italian Institute of Technology, Center for Translational Neurophysiology, Ferrara, Italy
| | - Sara Borgomaneri
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Università di Bologna, Campus di Cesena, 47521, Cesena, Italy; IRCCS Fondazione Santa Lucia, 00179, Rome, Italy.
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15
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Altered Effective Connectivity within an Oculomotor Control Network in Unaffected Relatives of Individuals with Schizophrenia. Brain Sci 2021; 11:brainsci11091228. [PMID: 34573248 PMCID: PMC8467791 DOI: 10.3390/brainsci11091228] [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] [Received: 07/28/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/17/2022] Open
Abstract
The ability to rapidly stop or change a planned action is a critical cognitive process that is impaired in schizophrenia. The current study aimed to examine whether this impairment reflects familial vulnerability to schizophrenia across two experiments comparing unaffected first-degree relatives to healthy controls. First, we examined performance on a saccadic stop-signal task that required rapid inhibition of an eye movement. Then, in a different sample, we investigated behavioral and neural responses (using fMRI) during a stop-signal task variant that required rapid modification of a prepared eye movement. Here, we examined differences between relatives and healthy controls in terms of activation and effective connectivity within an oculomotor control network during task performance. Like individuals with schizophrenia, the unaffected relatives showed behavioral evidence for more inefficient inhibitory processes. Unlike previous findings in individuals with schizophrenia, however, the relatives showed evidence for a compensatory waiting strategy. Behavioral differences were accompanied by more activation among the relatives in task-relevant regions across conditions and group differences in effective connectivity across the task that were modulated differently by the instruction to exert control over a planned saccade. Effective connectivity parameters were related to behavioral measures of inhibition efficiency. The results suggest that individuals at familial risk for schizophrenia were engaging an oculomotor control network differently than controls and in a way that compromises inhibition efficiency.
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16
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Zhou Z, Wang K, Tang J, Wei D, Song L, Peng Y, Fu Y, Qiu J. Cortical thickness distinguishes between major depression and schizophrenia in adolescents. BMC Psychiatry 2021; 21:361. [PMID: 34284747 PMCID: PMC8293570 DOI: 10.1186/s12888-021-03373-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early diagnosis of adolescent psychiatric disorder is crucial for early intervention. However, there is extensive comorbidity between affective and psychotic disorders, which increases the difficulty of precise diagnoses among adolescents. METHODS We obtained structural magnetic resonance imaging scans from 150 adolescents, including 67 and 47 patients with major depressive disorder (MDD) and schizophrenia (SCZ), as well as 34 healthy controls (HC) to explore whether psychiatric disorders could be identified using a machine learning technique. Specifically, we used the support vector machine and the leave-one-out cross-validation method to distinguish among adolescents with MDD and SCZ and healthy controls. RESULTS We found that cortical thickness was a classification feature of a) MDD and HC with 79.21% accuracy where the temporal pole had the highest weight; b) SCZ and HC with 69.88% accuracy where the left superior temporal sulcus had the highest weight. Notably, adolescents with MDD and SCZ could be classified with 62.93% accuracy where the right pars triangularis had the highest weight. CONCLUSIONS Our findings suggest that cortical thickness may be a critical biological feature in the diagnosis of adolescent psychiatric disorders. These findings might be helpful to establish an early prediction model for adolescents to better diagnose psychiatric disorders.
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Affiliation(s)
- Zheyi Zhou
- grid.419897.a0000 0004 0369 313XKey Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715 China ,grid.263906.8Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715 China
| | - Kangcheng Wang
- grid.410585.d0000 0001 0495 1805Faculty of Psychology, Shandong Normal University, Jinan, 250014 Shandong China
| | - Jinxiang Tang
- grid.452206.7Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Sleep and Psychology Center, The Bishan Hospital of Chongqing, Chongqing, 402760 China
| | - Dongtao Wei
- grid.419897.a0000 0004 0369 313XKey Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715 China ,grid.263906.8Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715 China
| | - Li Song
- grid.419897.a0000 0004 0369 313XKey Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715 China ,grid.263906.8Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715 China
| | - Yadong Peng
- grid.452206.7Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Department of Psychology, Chongqing Health Center for Women and Children, Chongqing, 401147 China
| | - Yixiao Fu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1, Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China. .,Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715, China. .,Collaborative Innovation Center of Assessment Toward Basic Education Quality, Southwest University Branch, Beijing Normal University, Beijing, 100875, China.
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17
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Türközer HB, Ivleva EI, Palka J, Clementz BA, Shafee R, Pearlson GD, Sweeney JA, Keshavan MS, Gershon ES, Tamminga CA. Biomarker Profiles in Psychosis Risk Groups Within Unaffected Relatives Based on Familiality and Age. Schizophr Bull 2021; 47:1058-1067. [PMID: 33693883 PMCID: PMC8266584 DOI: 10.1093/schbul/sbab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Investigating biomarkers in unaffected relatives (UR) of individuals with psychotic disorders has already proven productive in research on psychosis neurobiology. However, there is considerable heterogeneity among UR based on features linked to psychosis vulnerability. Here, using the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) dataset, we examined cognitive and neurophysiologic biomarkers in first-degree UR of psychosis probands, stratified by 2 widely used risk factors: familiality status of the respective proband (the presence or absence of a first- or second-degree relative with a history of psychotic disorder) and age (within or older than the common age range for developing psychosis). We investigated biomarkers that best differentiate the above specific risk subgroups. Additionally, we examined the relationship of biomarkers with Polygenic Risk Scores for Schizophrenia (PRSSCZ) in a subsample of Caucasian probands and healthy controls (HC). Our results demonstrate that the Brief Assessment of Cognition in Schizophrenia (BACS) score, antisaccade error (ASE) factor, and stop-signal task (SST) factor best differentiate UR (n = 169) from HC (n = 137) (P = .013). Biomarker profiles of UR of familial (n = 82) and non-familial (n = 83) probands were not significantly different. Furthermore, ASE and SST factors best differentiated younger UR (age ≤ 30) (n = 59) from older UR (n = 110) and HC from both age groups (age ≤ 30 years, n=49; age > 30 years, n = 88) (P < .001). In addition, BACS (r = -0.175, P = .006) and ASE factor (r = 0.188, P = .006) showed associations with PRSSCZ. Taken together, our findings indicate that cognitive biomarkers-"top-down inhibition" impairments in particular-may be of critical importance as indicators of psychosis vulnerability.
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Affiliation(s)
- Halide Bilge Türközer
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Elena I Ivleva
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Jayme Palka
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Rebecca Shafee
- Department of Genetics, Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT
- Departments of Psychiatry and Neuroscience, Yale University, New Haven, CT
| | - John A Sweeney
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Matcheri S Keshavan
- Department of Psychiatry and Cognitive Neurology, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Carol A Tamminga
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
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18
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Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
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19
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Morales-Muñoz I, Upthegrove R, Mallikarjun PK, Broome MR, Marwaha S. Longitudinal Associations Between Cognitive Deficits in Childhood and Psychopathological Symptoms in Adolescence and Young Adulthood. JAMA Netw Open 2021; 4:e214724. [PMID: 33825839 PMCID: PMC8027911 DOI: 10.1001/jamanetworkopen.2021.4724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPORTANCE Cognitive deficits are core features of mental disorders and are important in predicting long-term prognosis. However, it is still unknown whether individual patterns of cognitive deficits predate specific mental disorders. OBJECTIVE To investigate the specificity of the associations of attention, working memory, and inhibition in childhood with borderline personality disorder (BPD), psychosis, depression, and hypomania in adolescence and young adulthood. DESIGN, SETTING, AND PARTICIPANTS This cohort study obtained data from the Avon Longitudinal Study of Parents and Children in the United Kingdom. All pregnant women resident in Avon, United Kingdom, with an expected date of delivery from April 1, 1991, and December 31, 1992, were eligible. Data analysis was conducted from April 1 to September 30, 2020. The sample initially comprised 13 988 participants who were alive at 1 year of age. For this study, data were available for 6333 individuals reporting on any psychopathological measure at ages 11 to 12 years, 4903 individuals at ages 17 to 18 years, and 2963 individuals at 22 to 23 years. EXPOSURES Sustained attention, selective attention, and attentional control were assessed with the Test of Everyday Attention for Children at age 8 years, and working memory and inhibition were assessed at age 10 years with the Counting Span Task and the stop-signal paradigm, respectively. MAIN OUTCOMES AND MEASURES Symptoms of BPD were assessed at ages 11 to 12 years, psychotic experiences and depression were examined at ages 17 to 18 years, and hypomania was examined at ages 22 to 23 years. RESULTS Among 5315 individuals included in the statistical analysis, 2551 (48.0%) were male and 2764 (52.0) were female. Higher sustained attention at 8 years was associated with decreased risk of BPD symptoms at ages 11 to 12 years (adjusted odds ratio [aOR], 0.964; 95% CI, 0.933-0.996; P = .03), better performance on inhibition at age 10 years with decreased risk of psychotic experiences at ages 17 to 18 years (aOR, 0.938; 95% CI, 0.890-0.989; P = .02), higher sustained attention at age 8 years with decreased risk of depressive symptoms at ages 17 to 18 years (aOR, 0.969; 95% CI 0.938-0.9997; P = .048), and better performance in working memory at age 10 years with decreased risk of hypomania symptoms at ages 22 to 23 years (aOR, 0.694; 95% CI, 0.529-0.911; P = .008). After controlling for potential psychopathological overlay, all the associations remained, except for working memory and hypomania. Higher sustained attention at age 8 years was associated with decreased risk of BPD symptoms at ages 11 to 12 years (β = -0.05; P < .001) and of depression at ages 17 to 18 years (β = -0.03; P = .04), and better performance in inhibition at age 10 years was associated with decreased risk of psychotic experiences at ages 17 to 18 years (β = -0.03; P = .04). CONCLUSIONS AND RELEVANCE These findings suggest that specific cognitive deficits in childhood are distinctively associated with different psychopathological symptoms in young people. Furthermore, these results suggest the potential of early cognitive interventions in childhood as a way of modifying or attenuating risk for subsequent psychopathological symptoms.
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Affiliation(s)
- Isabel Morales-Muñoz
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Pavan K. Mallikarjun
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Matthew R. Broome
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Specialist Mood Disorders Clinic, Zinnia Centre, Birmingham, United Kingdom
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20
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Schutte MJL, Bohlken MM, Collin G, Abramovic L, Boks MPM, Cahn W, Dauwan M, van Dellen E, van Haren NEM, Hugdahl K, Koops S, Mandl RCW, Sommer IEC. Functional connectome differences in individuals with hallucinations across the psychosis continuum. Sci Rep 2021; 11:1108. [PMID: 33441965 PMCID: PMC7806763 DOI: 10.1038/s41598-020-80657-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/17/2020] [Indexed: 01/29/2023] Open
Abstract
Hallucinations may arise from an imbalance between sensory and higher cognitive brain regions, reflected by alterations in functional connectivity. It is unknown whether hallucinations across the psychosis continuum exhibit similar alterations in functional connectivity, suggesting a common neural mechanism, or whether different mechanisms link to hallucinations across phenotypes. We acquired resting-state functional MRI scans of 483 participants, including 40 non-clinical individuals with hallucinations, 99 schizophrenia patients with hallucinations, 74 bipolar-I disorder patients with hallucinations, 42 bipolar-I disorder patients without hallucinations, and 228 healthy controls. The weighted connectivity matrices were compared using network-based statistics. Non-clinical individuals with hallucinations and schizophrenia patients with hallucinations exhibited increased connectivity, mainly among fronto-temporal and fronto-insula/cingulate areas compared to controls (P < 0.001 adjusted). Differential effects were observed for bipolar-I disorder patients with hallucinations versus controls, mainly characterized by decreased connectivity between fronto-temporal and fronto-striatal areas (P = 0.012 adjusted). No connectivity alterations were found between bipolar-I disorder patients without hallucinations and controls. Our results support the notion that hallucinations in non-clinical individuals and schizophrenia patients are related to altered interactions between sensory and higher-order cognitive brain regions. However, a different dysconnectivity pattern was observed for bipolar-I disorder patients with hallucinations, which implies a different neural mechanism across the psychosis continuum.
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Affiliation(s)
- Maya J L Schutte
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands.
| | - Marc M Bohlken
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Guusje Collin
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA.,McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lucija Abramovic
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Marco P M Boks
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Meenakshi Dauwan
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Department of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway.,NORMENT Center for the Study of Mental Disorders, University of Oslo, Oslo, Norway
| | - Sanne Koops
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands
| | - René C W Mandl
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Iris E C Sommer
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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21
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Hudgens-Haney ME, Clementz BA, Ivleva EI, Keshavan MS, Pearlson GD, Gershon ES, Keedy SK, Sweeney JA, Gaudoux F, Bunouf P, Canolle B, Tonner F, Gatti-McArthur S, Tamminga CA. Cognitive Impairment and Diminished Neural Responses Constitute a Biomarker Signature of Negative Symptoms in Psychosis. Schizophr Bull 2020; 46:1269-1281. [PMID: 32043133 PMCID: PMC7505197 DOI: 10.1093/schbul/sbaa001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The treatment of negative symptoms (NS) in psychosis represents an urgent unmet medical need given the significant functional impairment it contributes to psychosis syndromes. The lack of progress in treating NS is impacted by the lack of known pathophysiology or associated quantitative biomarkers, which could provide tools for research. This current analysis investigated potential associations between NS and an extensive battery of behavioral and brain-based biomarkers in 932 psychosis probands from the B-SNIP database. The current analyses examined associations between PANSS-defined NS and (1) cognition, (2) pro-/anti-saccades, (3) evoked and resting-state electroencephalography (EEG), (4) resting-state fMRI, and (5) tractography. Canonical correlation analyses yielded symptom-biomarker constructs separately for each biomarker modality. Biomarker modalities were integrated using canonical discriminant analysis to summarize the symptom-biomarker relationships into a "biomarker signature" for NS. Finally, distinct biomarker profiles for 2 NS domains ("diminished expression" vs "avolition/apathy") were computed using step-wise linear regression. NS were associated with cognitive impairment, diminished EEG response amplitudes, deviant resting-state activity, and oculomotor abnormalities. While a connection between NS and poor cognition has been established, association to neurophysiology is novel, suggesting directions for future mechanistic studies. Each biomarker modality was related to NS in distinct and complex ways, giving NS a rich, interconnected fingerprint and suggesting that any one biomarker modality may not adequately capture the full spectrum of symptomology.
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Affiliation(s)
| | - Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT
- Institute of Living, Hartford Hospital, Hartford, CT
| | | | - Sarah K Keedy
- Department of Psychiatry, University of Chicago, Chicago, IL
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | | | | | | | | | | | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
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22
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Gotra MY, Hill SK, Gershon ES, Tamminga CA, Ivleva EI, Pearlson GD, Keshavan MS, Clementz BA, McDowell JE, Buckley PF, Sweeney JA, Keedy SK. Distinguishing patterns of impairment on inhibitory control and general cognitive ability among bipolar with and without psychosis, schizophrenia, and schizoaffective disorder. Schizophr Res 2020; 223:148-157. [PMID: 32674921 PMCID: PMC7704797 DOI: 10.1016/j.schres.2020.06.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Deficits in inhibitory control on a Stop Signal Task (SST) were previously observed to be of similar magnitude across schizophrenia, schizoaffective, and bipolar disorder with psychosis, despite variation in general cognitive ability. Understanding different patterns of performance on the SST may elucidate different pathways to the impaired inhibitory control each group displayed. Comparing nonpsychotic bipolar disorder to the psychosis groups on SST may also expand our understanding of the shared neurobiology of this illness spectrum. METHODS We tested schizophrenia (n = 220), schizoaffective (n = 216), bipolar disorder with (n = 192) and without psychosis (n = 67), and 280 healthy comparison participants with a SST and the Brief Assessment of Cognition in Schizophrenia (BACS), a measure of general cognitive ability. RESULTS All patient groups had a similar degree of impaired inhibitory control over prepotent responses. However, bipolar groups differed from schizophrenia and schizoaffective groups in showing speeded responses and inhibition errors that were not accounted for by general cognitive ability. Schizophrenia and schizoaffective groups had a broader set of deficits on inhibition and greater general cognitive deficit, which fully accounted for the inhibition deficits. No differences were found between the clinically well-matched bipolar with and without psychosis groups, including for inhibitory control or general cognitive ability. CONCLUSIONS We conclude that 1) while impaired inhibitory control on a SST is of similar magnitude across the schizo-bipolar spectrum, including nonpsychotic bipolar, different mechanisms may underlie the impairments, and 2) history of psychosis in bipolar disorder does not differentially impact inhibitory behavioral control or general cognitive abilities.
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Affiliation(s)
- Milena Y Gotra
- Department of Psychology, Rosalind Franklin University, North Chicago, IL, United States
| | - Scot K Hill
- Department of Psychology, Rosalind Franklin University, North Chicago, IL, United States
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Carol A Tamminga
- Department of Psychiatry, UT-Southwestern Medical Center, Dallas, TX, United States
| | - Elena I Ivleva
- Department of Psychiatry, UT-Southwestern Medical Center, Dallas, TX, United States
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT, United States; Institute of Living, Hartford Hospital, Hartford, CT, United States
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconness Medical Center and Harvard Medical School, Boston, MA, United States
| | - Brett A Clementz
- Department of Psychology and Neuroscience, University of Georgia, Athens, GA, United States
| | - Jennifer E McDowell
- Department of Psychology and Neuroscience, University of Georgia, Athens, GA, United States
| | - Peter F Buckley
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States.
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23
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Yang H, Di X, Gong Q, Sweeney J, Biswal B. Investigating inhibition deficit in schizophrenia using task-modulated brain networks. Brain Struct Funct 2020; 225:1601-1613. [DOI: 10.1007/s00429-020-02078-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/18/2020] [Indexed: 12/28/2022]
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24
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Mistry S, Escott-Price V, Florio AD, Smith DJ, Zammit S. Investigating associations between genetic risk for bipolar disorder and cognitive functioning in childhood. J Affect Disord 2019; 259:112-120. [PMID: 31445336 DOI: 10.1016/j.jad.2019.08.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/01/2019] [Accepted: 08/17/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Identifying phenotypic manifestations of genetic risk for bipolar disorder (BD) in childhood could increase our understanding of aetiological mechanisms. AIMS To examine whether BD genetic risk is associated with childhood (age 8 years) cognitive function. METHODS Using data from the Avon Longitudinal Study of Parents and Children, we examined associations between polygenic risk scores for BD (BD-PRS) derived using Psychiatric Genomics Consortium summary data at p-thresholds (PT) ≤0.01 (primary) and ≤0.5 (secondary) and several cognitive domains (sample sizes 5,613 to 5,936). We also examined whether associations were due to SNPs that have shared risk effects on schizophrenia (SZ). RESULTS At PT≤0.01, the BD-PRS was associated with poorer executive functioning (ß= -0.03, 95%CI -0.06, -0.01; p = 0.013), and, more weakly with poorer processing speed (ß = -0.02, 95%CI -0.05, 0.02; p = 0.075). Evidence of association with both poorer processing speed (p = 0.016) and performance IQ (p = 0.018) was stronger at PT≤0.5. Associations with performance IQ and processing speed were primarily driven by genetic effects that are shared with SZ risk, but there was some evidence of bipolar-specific genetic effects on childhood executive functioning. LIMITATIONS The BD-PRS still explains only a small proportion of the variance for BD which will have reduced power to detect associations. CONCLUSIONS Genetic risk for BD manifests as impaired cognition in childhood, and this is driven by risk SNPs that are also shared with SZ genetic risk. Further elucidation of which cognitive domains are most affected by genetic risk for BD could help understanding of aetiology and improve prediction of BD.
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Affiliation(s)
- Sumit Mistry
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK.
| | - Valentina Escott-Price
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Arianna D Florio
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, UK
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
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Mothi SS, Sudarshan M, Tandon N, Tamminga C, Pearlson G, Sweeney J, Clementz B, Keshavan MS. Machine learning improved classification of psychoses using clinical and biological stratification: Update from the bipolar-schizophrenia network for intermediate phenotypes (B-SNIP). Schizophr Res 2019; 214:60-69. [PMID: 29807804 DOI: 10.1016/j.schres.2018.04.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Suraj Sarvode Mothi
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA; Department of Psychiatry, Massachusetts General Hospital Boston, MA 02114, USA.
| | | | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA; Baylor College of Medicine, Houston, TX, USA
| | | | - Godfrey Pearlson
- Olin Neuropsychiatry Research Center, Hartford, CT, USA; Department of Psychiatry and Neurobiology, Yale University, New Haven, CT, USA
| | - John Sweeney
- Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Brett Clementz
- Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA; Department of Psychology, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA.
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Yu F, Chen X, Zhang L, Bai T, Gao Y, Dong Y, Luo Y, Zhu C, Wang K. Shared Response Inhibition Deficits but Distinct Error Processing Capacities Between Schizophrenia and Obsessive-Compulsive Disorder Patients Revealed by Event-Related Potentials and Oscillations During a Stop Signal Task. Front Psychiatry 2019; 10:853. [PMID: 31798483 PMCID: PMC6878724 DOI: 10.3389/fpsyt.2019.00853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Schizophrenia (SCH) patients are at high risk for obsessive-compulsive syndrome, which can lead to difficulty in differential diagnosis between SCH and obsessive-compulsive disorder (OCD). It would be of great clinical value to identify objective markers for these diseases based on behavioral or neurological manifestations. Deficient response inhibition has been reported in both SCH and OCD; however, it is unclear if common or distinct neural abnormalities underlie this impairment. Methods: To address this question, we compared Stop signal task performance and associated event-related potentials (ERPs) and event-related oscillation (ERO) among 24 SCH patients, 25 OCD patients, and 27 healthy controls (HCs). Results: In successful Stop trials, both SCH and OCD patients showed prolonged Stop signal response time, reduced ERP-P3 component amplitude, and weaker theta-band synchronization compared to HCs, while there were no significant differences between patient groups. In unsuccessful Stop trials, however, SCH patients demonstrated significantly lower P3 amplitudes and weaker theta-band activity than OCD patients. In addition, Stop accuracy rate in SCH patients was negatively correlated with Positive subscale score of the Positive and Negative Syndrome Scale. Conclusions: These results provide evidence that impaired response inhibition in SCH and OCD arises from common underlying neural processing abnormalities. However, the lower P3 amplitude and weaker theta-band activity in SCH patients in unsuccessful Stop trials suggest distinct neural activity patterns related to error processing. These differences in ERPs and ERO may provide clues to unique neurological abnormalities in SCH and provide objective measures for differential diagnosis.
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Affiliation(s)
- Fengqiong Yu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xingui Chen
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Zhang
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Tongjian Bai
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yaxiang Gao
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
| | - Yi Dong
- Anhui Mental Health Center, Hefei, China
| | - Yuejia Luo
- College of Psychology and Sociology of Shenzhen University, Shenzhen, China
| | - Chunyan Zhu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Kai Wang
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
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27
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Rodrigue AL, McDowell JE, Tandon N, Keshavan MS, Tamminga CA, Pearlson GD, Sweeney JA, Gibbons RD, Clementz BA. Multivariate Relationships Between Cognition and Brain Anatomy Across the Psychosis Spectrum. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:992-1002. [PMID: 29759822 PMCID: PMC6167203 DOI: 10.1016/j.bpsc.2018.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cognitive and structural brain abnormalities range from mild to severe in psychosis. The relationships of specific cognitive functions to specific brain structures across the psychosis spectrum is less certain. METHODS Participants (n = 678) with bipolar, schizoaffective, or schizophrenia psychoses and healthy control subjects were recruited via the Bipolar-Schizophrenia Network for Intermediate Phenotypes. The Schizo-Bipolar Scale was used to create a psychosis continuum (from purely affective to purely nonaffective). Canonical correlation between 14 cognitive measures and structural brain measures (gray matter volume, cortical thickness, cortical surface area, and local gyrification indices) for 68 neocortical regions yielded constructs that defined shared cognition-brain structure relationships. Canonical discriminant analysis was used to integrate these constructs and efficiently summarize cognition-brain structure relationships across the psychosis continuum. RESULTS General cognition was associated with larger gray matter volumes and thicker cortices but smaller cortical surface area in frontoparietal regions. Working memory was associated with larger volume and surface area in frontotemporal regions. Faster response speed was associated with thicker frontal cortices. Constructs that captured general cognitive ability and working memory and their relationship to cortical volumes primarily defined an ordered psychosis spectrum (purely affective, least abnormal through purely nonaffective, and most abnormal). A construct that captured general cognitive ability and its relationship to cortical surface area differentiated purely affective cases from other groups. CONCLUSIONS General cognition and working memory with cortical volume deviations characterized more nonaffective psychoses. Alternatively, affective psychosis cases with general cognitive deficits had deviations in cortical surface area, perhaps accounting for heterogeneous findings across previous studies.
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Affiliation(s)
- Amanda L Rodrigue
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, Connecticut
| | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Robert D Gibbons
- Department of Medicine and Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia.
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28
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Hudgens-Haney ME, Ethridge LE, McDowell JE, Keedy SK, Pearlson GD, Tamminga CA, Keshavan MS, Sweeney JA, Clementz BA. Psychosis subgroups differ in intrinsic neural activity but not task-specific processing. Schizophr Res 2018; 195:222-230. [PMID: 28844436 PMCID: PMC5826774 DOI: 10.1016/j.schres.2017.08.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 08/11/2017] [Accepted: 08/16/2017] [Indexed: 12/12/2022]
Abstract
Individuals with psychosis often show high levels of intrinsic, or nonspecific, neural activity, but attenuated stimulus-specific activity. Clementz et al. (2016) proposed that one subgroup of psychosis cases has accentuated intrinsic activity (Biotype-2's) and a different subgroup (Biotype-1's) has diminished intrinsic activity, with both groups exhibiting varying degrees of cognitive deficits. This model was studied by assessing neural activity in psychosis probands (N=105) during baseline and a 5second period in preparation for a pro-/anti-saccade task. Steady-state stimuli allowed real-time assessment of modulation of visuocortical investment to different target locations. Psychosis probands as a whole showed poor antisaccade performance. As expected, Biotype-1 showed diminished intrinsic neural activity and the worst behavior, and Biotype-2 showed accentuated intrinsic activity and less deviant behavior. Both of these groups also exhibited less dynamic oscillatory phase synchrony. Biotype-3 showed no neurophysiological differences from healthy individuals, despite a history of psychosis. Interestingly, all psychosis subgroups showed normal (i.e., not different from healthy) preparatory modulation of visuocortical investment as a function of cognitive demands, despite varying levels of task performance. Similar analyses conducted subgrouping cases by psychotic symptomatology revealed fewer and less consistent differences, including no intrinsic activity differences between any clinical subgroup and healthy individuals. This study illustrates that (i) differences in intrinsic neural activity may be a fundamental characteristic of psychosis and need to be evaluated separately from stimulus-specific responses, and (ii) grouping patients based on multidimensional classification using neurobiological data may have advantages for resolving heterogeneity and clarifying illness mechanisms relative to traditional psychiatric diagnoses.
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Affiliation(s)
- Matthew E. Hudgens-Haney
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Lauren E. Ethridge
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,Department of Psychology, University of Oklahoma, Norman, Oklahoma
| | - Jennifer E. McDowell
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Sarah K. Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Godfrey D. Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Connecticut,Institute of Living, Hartford Hospital, Hartford, Connecticut
| | | | | | - John A. Sweeney
- Department of Psychiatry, UT-Southwestern, Dallas, Texas,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Ohio
| | - Brett A. Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia,To whom correspondence should be addressed: Brett A. Clementz, Ph.D. Psychology Department, Psychology Building, University of Georgia, Athens, GA 30602. , 706-542-2174
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29
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Schmitt LM, White SP, Cook EH, Sweeney JA, Mosconi MW. Cognitive mechanisms of inhibitory control deficits in autism spectrum disorder. J Child Psychol Psychiatry 2018; 59:586-595. [PMID: 29052841 PMCID: PMC5906199 DOI: 10.1111/jcpp.12837] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Inhibitory control deficits are common in autism spectrum disorder (ASD) and associated with more severe repetitive behaviors. Inhibitory control deficits may reflect slower execution of stopping processes, or a reduced ability to delay the onset of behavioral responses in contexts of uncertainty. Previous studies have documented relatively spared stopping processes in ASD, but whether inhibitory control deficits in ASD reflect failures to delay response onset has not been systematically assessed. Further, while improvements in stopping abilities and response slowing are seen through adolescence/early adulthood in health, their development in ASD is less clear. METHODS A stop-signal test (SST) was administered to 121 individuals with ASD and 76 age and IQ-matched healthy controls (ages 5-28). This test included 'GO trials' in which participants pressed a button when a peripheral target appeared and interleaved 'STOP trials' in which they were cued to inhibit button-presses when a stop-signal appeared at variable times following the GO cue. STOP trial accuracy, RT of the stopping process (SSRT), and reaction time (RT) slowing during GO trials were examined. RESULTS Relative to controls, individuals with ASD had reduced accuracy on STOP trials. SSRTs were similar across control and ASD participants, but RT slowing was reduced in patients compared to controls. Age-related increases in stopping ability and RT slowing were attenuated in ASD. Reduced stopping accuracy and RT slowing were associated with more severe repetitive behaviors in ASD. DISCUSSION Our findings show that inhibitory control deficits in ASD involve failures to strategically delay behavioral response onset. These results suggest that reduced preparatory behavioral control may underpin inhibitory control deficits as well as repetitive behaviors in ASD. Typical age-related improvements in inhibitory control during late childhood/early adolescence are reduced in ASD, highlighting an important developmental window during which treatments may mitigate cognitive alterations contributing to repetitive behaviors.
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Affiliation(s)
- Lauren M. Schmitt
- Schiefelbusch Institute for Life Span Studies and Clinical Child Psychology Program, University of Kansas,Kansas Center for Autism Research and Training (KCART), University of Kansas Medical School,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati
| | - Stormi P. White
- Center for Autism and Developmental Disabilities, University of Texas Southwestern Medical Center
| | - Edwin H. Cook
- Institute for Juvenile Research, University of Illinois at Chicago
| | - John A. Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati
| | - Matthew W. Mosconi
- Schiefelbusch Institute for Life Span Studies and Clinical Child Psychology Program, University of Kansas,Kansas Center for Autism Research and Training (KCART), University of Kansas Medical School
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30
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Reduced pupil dilation during action preparation in schizophrenia. Int J Psychophysiol 2018; 128:111-118. [PMID: 29574231 DOI: 10.1016/j.ijpsycho.2018.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/30/2018] [Accepted: 03/19/2018] [Indexed: 11/22/2022]
Abstract
Impairments in cognitive control-the ability to exert control over thoughts and actions and respond flexibly to the environment-are well-documented in schizophrenia. However, the degree to which experimental task performance reflects true cognitive control impairments or more general alterations in effort, arousal and/or task preparedness is unclear. Pupillary responses can provide insight into these latter factors, as the pupil dilates with degree of cognitive effort and response preparation. In the current study, 16 medicated outpatients with schizophrenia (SZP) and 18 healthy controls performed a task that measures the ability to reactively inhibit and modify a planned action-the double-step task. In this task, participants were required to make a saccade to a visual target. Infrequently, the target jumped to a new location and participants were instructed to rapidly inhibit and change their eye movement plan. Applying a race model of performance, we have previously shown that SZP require more time to inhibit a planned action. In the current analysis, we measured pupil dilation associated with task preparation and found that SZP had a shallower increase in pupil size prior to the onset of the trial. Additionally, reduced magnitude of the pupil response was associated with negative symptom severity in patients. Based on primate neurophysiology and cognitive neuroscience work, we suggest that this blunted pupillary response may reflect abnormalities in a general orienting response or reduced motivational significance of a cue signifying the onset of a preparatory period and that these abnormalities might share an autonomic basis with negative symptoms.
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31
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Shared and differential cortical functional abnormalities associated with inhibitory control in patients with schizophrenia and bipolar disorder. Sci Rep 2018; 8:4686. [PMID: 29549335 PMCID: PMC5856811 DOI: 10.1038/s41598-018-22929-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 03/05/2018] [Indexed: 01/06/2023] Open
Abstract
Schizophrenia (SZ) and bipolar I disorder (BD-I) share genetic risk factors and cognitive impairments, but these conditions may exhibit differences in cortical functioning associated with inhibitory control. We measured hemodynamic responses during a stop-signal task using near-infrared spectroscopy (NIRS) in 20 patients with SZ, 21 patients with BD-I and 18 healthy controls (HCs). We used stop-signal reaction time (SSRT) to estimate behavioural inhibition. Compared with HCs, patients with either SZ or BD-I exhibited significantly reduced activation in the bilateral inferior, middle and superior frontal gyri. Furthermore, patients with BD-I showed inactivation of the right superior temporal gyri compared with patients with SZ or HCs. Patients with SZ or BD-I demonstrated significant negative correlations between SSRT and hemodynamic responses of the right inferior frontal gyrus. Moreover, patients with SZ exhibited correlations in the middle and superior frontal gyri. Our findings suggest that right inferior frontal abnormalities mediate behavioural inhibition impairments in individuals with SZ or BD-I. Differential patterns of orbitofrontal or superior temporal functional abnormalities may reflect important differences in psychopathological features between these disorders.
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32
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Hoptman MJ, Parker EM, Nair-Collins S, Dias EC, Ross ME, DiCostanzo JN, Sehatpour P, Javitt DC. Sensory and cross-network contributions to response inhibition in patients with schizophrenia. NEUROIMAGE-CLINICAL 2018; 18:31-39. [PMID: 29868440 PMCID: PMC5984577 DOI: 10.1016/j.nicl.2018.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/12/2017] [Accepted: 01/05/2018] [Indexed: 02/07/2023]
Abstract
Patients with schizophrenia show response inhibition deficits equal to or greater than those seen in impulse-control disorders, and these deficits contribute to poor outcome. However, little is known about the circuit abnormalities underlying this impairment. To address this, we examined stop signal task performance in 21 patients with schizophrenia and 21 healthy controls using event related potential (ERP) and resting state functional connectivity. Patients showed prolonged stop signal reaction time (SSRT) and reduced N1, N2, and P3 amplitudes compared to controls. Across groups, P3 amplitudes were maximal after SSRT (i.e., after the time associated with the decision to stop occurred), suggesting that this component indexed response monitoring. Multiple regression analyses showed that longer SSRTs were independently related to 1) patient status, 2) reduced N1 amplitude on successful stop trials and 3) reduced anticorrelated resting state functional connectivity between visual and frontoparietal cortical networks. This study used a combined multimodal imaging approach to better understand the network abnormalities that underlie response inhibition in schizophrenia. It is the first of its kind to specifically assess the brain's resting state functional architecture in combination with behavioral and ERP methods to investigate response inhibition in schizophrenia. People with schizophrenia show deficits in response inhibition measured using behavioral and ERP methods. Behavioral and ERP measures of response inhibition are correlated. Patient status, reduced N1, and higher resting state functional connectivity separately predicted poorer response inhibition. This study underscores the value of using multimodal imaging to understand response inhibition deficits in schizophrenia.
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Affiliation(s)
- Matthew J Hoptman
- Nathan Kline Institute, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA; City University of New York, New York, NY, USA.
| | | | - Sangeeta Nair-Collins
- Nathan Kline Institute, Orangeburg, NY, USA; City University of New York, New York, NY, USA
| | - Elisa C Dias
- Nathan Kline Institute, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | | | | | - Pejman Sehatpour
- Nathan Kline Institute, Orangeburg, NY, USA; Department of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Daniel C Javitt
- Nathan Kline Institute, Orangeburg, NY, USA; Department of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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33
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Bauer IE, Diniz BS, Meyer TD, Teixeira AL, Sanches M, Spiker D, Zunta-Soares G, Soares JC. Increased reward-oriented impulsivity in older bipolar patients: A preliminary study. J Affect Disord 2018; 225:585-592. [PMID: 28886499 PMCID: PMC5626658 DOI: 10.1016/j.jad.2017.08.067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/02/2017] [Accepted: 08/20/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Impulsivity is a well-established trait of bipolar disorder (BD) that persists across mood phases. It is, however, still unknown whether, in BD, impulsivity remains stable or varies in intensity over the lifespan. This cross-sectional study compared impulsive behavior in older euthymic BD patients and healthy individuals using a range of self-rating and behavioral measures of impulsivity. METHODS 28 BD patients (56.07 ± 4.08 years, 16 women) and 15 healthy controls (HC; 55.1 ± 3.95 years, 6 women) were administered the Barratt Impulsivity Scale (BIS) and selected tasks of the Cambridge Neuropsychological Test Automated Batter (CANTAB) reflecting impulsivity. Multivariate analysis of variance controlled for age compared impulsivity measures across BD and HC. RESULTS BD patients displayed poor decision making, risk taking, and increased delay aversion. Other measures of impulsivity such as response inhibition, sustained cognitive control, and BIS scores were, overall, comparable between BD and HC. CONCLUSIONS These preliminary findings suggest that, in BD, aspects of impulsivity related to reward-based decision making persist into late adulthood. Large scale, longitudinal studies are needed to evaluate the relationship of age to impulsivity over time, and explore the link between impulsivity and illness progression in elderly individuals with BD.
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Affiliation(s)
- Isabelle E. Bauer
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
| | - Breno Satler Diniz
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
| | - Thomas D. Meyer
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
| | - Antonio Lucio Teixeira
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
| | - Marsal Sanches
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States,Archway Mental Health Services, 58502 Bismarck, ND, United States
| | - Danielle Spiker
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
| | - Giovana Zunta-Soares
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
| | - Jair C. Soares
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, 77054 Houston, TX, United States
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34
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Basavaraju R, Sanjay TN, Mehta UM, Muralidharan K, Thirthalli J. Cortical inhibition in symptomatic and remitted mania compared to healthy subjects: A cross-sectional study. Bipolar Disord 2017; 19:698-703. [PMID: 28833861 PMCID: PMC7610506 DOI: 10.1111/bdi.12546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/05/2017] [Accepted: 08/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Transcranial magnetic stimulation (TMS)-derived cortical reactivity studies provide a unique opportunity to non-invasively study gamma amino butyric acid (GABA)-mediated inhibitory neurotransmission in bipolar disorder (BD). Earlier studies were conducted in smaller samples and on patients who were on medications that can potentially confound the results. We aimed to study short-interval (SICI) and long-interval intracortical inhibition (LICI) in medication-naïve/free symptomatic (manic) BD patients (n=39), first episode mania (FEM) patients who had recently (≤6 months) remitted with treatment (remitted FEM; n = 28) and healthy subjects (HSs; n = 45). METHODS Resting motor threshold (RMT), stimulation intensity to elicit a 1-mV motor evoked potential (MEP) (SI1 mV ), SICI and LICI were measured in three groups using single- and paired-pulse TMS. RESULTS Motor thresholds were higher in the manic BD and HS groups compared to the remitted FEM group (P < .001). SICI was lower (P = .026) but LICI was higher (P = .044) in the manic BD and remitted FEM groups compared to the HS group. CONCLUSIONS Lower motor thresholds in remitted FEM perhaps reflect the effect of treatment, and could be studied as potential prognostic neuromarkers. Inverse findings for SICI (reduced) and LICI (increased) in BD indicate a possible differential involvement of the GABAA and GABAB subreceptor systems. These could be trait markers as they are impaired in both mania and euthymia.
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Affiliation(s)
- Rakshathi Basavaraju
- Department of Psychiatry; National Institute of Mental Health & Neurosciences (NIMHANS); Bengaluru Karnataka India
| | - Tarasingh N Sanjay
- Department of Psychiatry; National Institute of Mental Health & Neurosciences (NIMHANS); Bengaluru Karnataka India
| | - Urvakhsh M Mehta
- Department of Psychiatry; National Institute of Mental Health & Neurosciences (NIMHANS); Bengaluru Karnataka India
| | - Keshavan Muralidharan
- Department of Psychiatry; National Institute of Mental Health & Neurosciences (NIMHANS); Bengaluru Karnataka India
| | - Jagadisha Thirthalli
- Department of Psychiatry; National Institute of Mental Health & Neurosciences (NIMHANS); Bengaluru Karnataka India
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35
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Newman E, Jernigan TL, Lisdahl KM, Tamm L, Tapert SF, Potkin SG, Mathalon D, Molina B, Bjork J, Castellanos FX, Swanson J, Kuperman JM, Bartsch H, Chen CH, Dale AM, Epstein JN. Go/No Go task performance predicts cortical thickness in the caudal inferior frontal gyrus in young adults with and without ADHD. Brain Imaging Behav 2017; 10:880-92. [PMID: 26404018 DOI: 10.1007/s11682-015-9453-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Response inhibition deficits are widely believed to be at the core of Attention-Deficit Hyperactivity Disorder (ADHD). Several studies have examined neural architectural correlates of ADHD, but research directly examining structural correlates of response inhibition is lacking. Here we examine the relationship between response inhibition as measured by a Go/No Go task, and cortical surface area and thickness of the caudal inferior frontal gyrus (cIFG), a region implicated in functional imaging studies of response inhibition, in a sample of 114 young adults with and without ADHD diagnosed initially during childhood. We used multiple linear regression models to test the hypothesis that Go/No Go performance would be associated with cIFG surface area or thickness. Results showed that poorer Go/No Go performance was associated with thicker cIFG cortex, and this effect was not mediated by ADHD status or history of substance use. However, independent of Go/No Go performance, persistence of ADHD symptoms and more frequent cannabis use were associated with thinner cIFG. Go/No Go performance was not associated with cortical surface area. The association between poor inhibitory functioning and thicker cIFG suggests that maturation of this region may differ in low performing participants. An independent association of persistent ADHD symptoms and frequent cannabis use with thinner cIFG cortex suggests that distinct neural mechanisms within this region may play a role in inhibitory function, broader ADHD symptomatology, and cannabis use. These results contribute to Research Domain Criteria (RDoC) by revealing novel associations between neural architectural phenotypes and basic neurobehavioral processes measured dimensionally.
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Affiliation(s)
- Erik Newman
- Center for Human Development, University of California, 9500 Gilman Drive, MC 0115, La Jolla, CA, 92093, USA.
| | - Terry L Jernigan
- Center for Human Development, University of California, 9500 Gilman Drive, MC 0115, La Jolla, CA, 92093, USA.,Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - Leanne Tamm
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Steven G Potkin
- Department of Psychiatry, University of California, Irvine, Irvine, CA, USA
| | - Daniel Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Brooke Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - James Bjork
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - F Xavier Castellanos
- Department of Child and Adolescent Psychiatry, Child Study Center at NYU Langone Medical Center, New York, NY, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - James Swanson
- The Child Development Center, University of California, Irvine, Irvine, CA, USA
| | - Joshua M Kuperman
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA
| | - Hauke Bartsch
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA
| | - Chi-Hua Chen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA.,Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Jeffery N Epstein
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Angry but not neutral faces facilitate response inhibition in schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 2017; 267:621-627. [PMID: 27866272 DOI: 10.1007/s00406-016-0748-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Abstract
Schizophrenia is a very heterogeneous disorder with extensive impairments in cognitive as well as emotional abilities. One critical domain is response inhibition, and previous studies in schizophrenia patients have mostly observed impairments, i.e., slower inhibition. Moreover, response inhibition to socially salient stimuli has not been investigated in schizophrenia so far. Therefore, to elucidate emotion-cognition interactions by examining potential emotional effects on inhibition processes and further investigate the association of cognition with inhibition we used an emotional stop signal task in 27 schizophrenia patients and 27 gender- and age-matched controls. Task irrelevant emotional faces (angry and neutral) were used as stimuli in a stop signal reaction time task. Regarding accuracy, patients showed significantly worse performance in neutral trials, while their performance in anger trials (stop and go) was similar to controls. Angry faces elicited faster response inhibition in both groups, underlining an emotional facilitation effect. Neurocognitive functions significantly correlated with accuracy in the stop signal task in schizophrenia patients, thus further strengthening the notion of the strong link between cognitive abilities and inhibition processes. Inhibitory control impairments are of high clinical interest due to their association with substance abuse, impulsive behavior and suicide. Based on our data, neutral faces significantly affect response inhibition in schizophrenia while an emotional facilitation effect was apparent for angry faces even in schizophrenia patients. Thus, our data further support the notion that neutral face processing is critically impaired in schizophrenia.
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Curley LB, Newman E, Thompson WK, Brown TT, Hagler DJ, Akshoomoff N, Reuter C, Dale AM, Jernigan TL. Cortical morphology of the pars opercularis and its relationship to motor-inhibitory performance in a longitudinal, developing cohort. Brain Struct Funct 2017; 223:211-220. [PMID: 28756486 PMCID: PMC5772141 DOI: 10.1007/s00429-017-1480-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/18/2017] [Indexed: 10/29/2022]
Abstract
This study investigates the relationship between variability in cortical surface area and thickness of the pars opercularis of the inferior frontal gyrus and motor-inhibitory performance on a stop-signal task in a longitudinal, typically developing cohort of children and adolescents. Linear mixed-effects models were used to investigate the hypotheses that (1) cortical thinning and (2) a relatively larger cortical surface area of the bilateral pars opercularis of the inferior frontal gyrus would predict better performance on the stop-signal task in a cohort of 110 children and adolescents 4-13 years of age, with one to four observations (totaling 232 observations). Cortical thickness of the bilateral opercular region was not related to inhibitory performance. However, independent of age, gender, and total cortical surface area, relatively larger cortical surface area of the bilateral opercular region of the inferior frontal gyrus was associated with better motor-inhibitory performance. Follow-up analyses showed a significant effect of surface area of the right pars opercularis, but no evidence for an effect of area of left pars opercularis, on motor-inhibitory performance. These findings are consistent with the previous work in adults showing that cortical morphology of the pars opercularis is related to inhibitory functioning. It also expands upon this literature by showing that, in contrast to earlier work highlighting the importance of cortical thickness of this region in adults, relative cortical surface area of the pars opercularis may be related to developing motor-inhibitory functions during childhood and adolescence. Relationships between cortical phenotypes and individual differences in behavioral measures may vary across the lifespan.
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Affiliation(s)
- Lauren B Curley
- Department of Cognitive Science, University of California, San Diego, La Jolla, USA
| | - Erik Newman
- Center for Human Development, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0115, USA
| | - Wesley K Thompson
- Center for Human Development, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0115, USA.,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, USA
| | - Timothy T Brown
- Center for Human Development, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0115, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego School of Medicine, La Jolla, USA.,Department of Neurosciences, University of California, San Diego School of Medicine, La Jolla, USA
| | - Donald J Hagler
- Center for Multimodal Imaging and Genetics, University of California, San Diego School of Medicine, La Jolla, USA.,Department of Radiology, University of California, San Diego School of Medicine, La Jolla, USA
| | - Natacha Akshoomoff
- Center for Human Development, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0115, USA.,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, USA
| | - Chase Reuter
- Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, USA
| | - Anders M Dale
- Department of Cognitive Science, University of California, San Diego, La Jolla, USA.,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego School of Medicine, La Jolla, USA.,Department of Neurosciences, University of California, San Diego School of Medicine, La Jolla, USA.,Department of Radiology, University of California, San Diego School of Medicine, La Jolla, USA
| | - Terry L Jernigan
- Department of Cognitive Science, University of California, San Diego, La Jolla, USA. .,Center for Human Development, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0115, USA. .,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, USA. .,Department of Radiology, University of California, San Diego School of Medicine, La Jolla, USA.
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38
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Bauer IE, Meyer TD, Sanches M, Spiker D, Zunta-Soares G, Soares JC. Are self-rated and behavioural measures of impulsivity in bipolar disorder mainly related to comorbid substance use problems? Cogn Neuropsychiatry 2017; 22:298-314. [PMID: 28490234 DOI: 10.1080/13546805.2017.1324951] [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] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Impulsivity is a multidimensional feature observed in bipolar disorder (BD) and substance use disorder (SUD). We previously found a relationship between SUD and risk taking in BD. It is still unclear whether self-rated and behavioral impulsivity measures differ between BD with and without comorbid SUD, or are specific to BD. METHODS 93 adults with BD with comorbid SUD, 91 BD without SUD, and 93 healthy controls (HC) were administered the Barratt Impulsivity Scale (BIS), the Behavioral Inhibition/Behavioral Activation System Scale (BIS/BAS), and the Cambridge Neuropsychological Test Automated Battery. Analyses compared impulsivity measures across groups controlling for age. Discriminant function analyses (DFA) assessed the combination of variables effectively predicting group membership. RESULTS BD displayed increased BIS, BIS/BAS scores, reduced performance on the Cambridge Gambling and Rapid Visual Processing, and Affective Go/No-Go tasks compared to HC. Comparisons between BD with and without SUD showed increased BIS Motor impulsiveness. The overall predictive power of DFA was weak. CONCLUSIONS Some facets of impulsivity are a core trait of BD and are partially independent from the presence of SUD. Motor impulsiveness may be distinctive of BD+SUD. More research is needed to understand the role of impulsive behaviors as risk factors for relapse in SUD.
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Affiliation(s)
- Isabelle E Bauer
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Thomas D Meyer
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Marsal Sanches
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA.,b Archway Mental Health Services , Bismarck , ND , USA
| | - Danielle Spiker
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Giovana Zunta-Soares
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Jair C Soares
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
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Ettinger U, Aichert DS, Wöstmann N, Dehning S, Riedel M, Kumari V. Response inhibition and interference control: Effects of schizophrenia, genetic risk, and schizotypy. J Neuropsychol 2017; 12:484-510. [DOI: 10.1111/jnp.12126] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/06/2017] [Indexed: 01/18/2023]
Affiliation(s)
| | | | | | - Sandra Dehning
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy; University of Munich; Germany
| | | | - Veena Kumari
- Research and Development; Sovereign Health Group; San Clemente California USA
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Hudgens-Haney ME, Ethridge LE, Knight JB, McDowell JE, Keedy SK, Pearlson GD, Tamminga CA, Keshavan MS, Sweeney JA, Clementz BA. Intrinsic neural activity differences among psychotic illnesses. Psychophysiology 2017; 54:1223-1238. [PMID: 28419491 DOI: 10.1111/psyp.12875] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/03/2017] [Accepted: 03/11/2017] [Indexed: 12/13/2022]
Abstract
Individuals with psychosis have been reported to show either reduced or augmented brain responses under seemingly similar conditions. It is likely that inconsistent baseline-adjustment methods are partly responsible for this discrepancy. Using steady-state stimuli during a pro/antisaccade task, this study addressed the relationship between nonspecific and stimulus-related neural activity, and how these activities are modulated as a function of cognitive demands. In 98 psychosis probands (schizophrenia, schizoaffective disorder, and bipolar disorder with psychosis), neural activity was assessed during baseline and during a 5-s period in preparation for the pro/antisaccade task. To maximize the ability to identify meaningful differences between psychosis subtypes, analyses were conducted as a function of subgrouping probands by standard clinical diagnoses and neurobiological features. These psychosis "biotypes" were created using brain-based biomarkers, independent of symptomatology (Clementz et al., ). Psychosis probands as a whole showed poor antisaccade performance and diminished baseline oscillatory phase synchrony. Psychosis biotypes differed on both behavioral and brain measures, in ways predicted from Clementz et al. (). Two biotype groups showed similarly deficient behavior and baseline synchrony, despite diametrically opposed neural activity amplitudes. Another biotype subgroup was more similar to healthy individuals on behavioral and brain measures, despite the presence of psychosis. This study provides evidence that (a) consideration of baseline levels of activation and synchrony will be essential for a comprehensive understanding of neural response differences in psychosis, and (b) distinct psychosis subgroups exhibit reduced versus augmented intrinsic neural activity, despite cognitive performance and clinical similarities.
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Affiliation(s)
- Matthew E Hudgens-Haney
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Lauren E Ethridge
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.,Department of Psychology, University of Oklahoma, Norman, Oklahoma
| | - Justin B Knight
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Connecticut.,Institute of Living, Hartford Hospital, Hartford, Connecticut
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern, Dallas, Texas
| | | | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern, Dallas, Texas.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
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Reilly JL, Hill SK, Gold JM, Keefe RSE, Clementz BA, Gershon E, Keshavan MS, Pearlson G, Tamminga CA, Sweeney JA. Impaired Context Processing is Attributable to Global Neuropsychological Impairment in Schizophrenia and Psychotic Bipolar Disorder. Schizophr Bull 2017; 43:397-406. [PMID: 27306316 PMCID: PMC5605273 DOI: 10.1093/schbul/sbw081] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Context processing may reflect a specific cognitive impairment in schizophrenia. Whether impaired context processing is observed across psychotic disorders or among relatives of affected individuals, and whether it is a deficit that is independent from the generalized neuropsychological deficits seen in psychotic disorders, are less established. METHODS Schizophrenia, schizoaffective, and psychotic bipolar probands (n = 660), their first-degree relatives (n = 741), and healthy individuals (n = 308) studied by the Bipolar-Schizophrenia Network on Intermediate Phenotypes consortium performed an expectancy task requiring use of contextual information to overcome a pre-potent response. Sensitivity for target detection and false alarm rates on trials requiring inhibition or goal maintenance were measured. RESULTS Proband groups and relatives with psychosis spectrum personality traits demonstrated reduced target sensitivity and elevated false alarm rates. False alarm rate was higher under inhibition vs goal maintenance conditions although this difference was attenuated in schizophrenia and schizoaffective proband groups. After accounting for global neuropsychological impairment, as reflected by the composite score from the Brief Assessment of Cognition in Schizophrenia neuropsychological battery, deficits in schizophrenia and bipolar proband groups were no longer significant. Performance measures were moderately familial. CONCLUSION Reduced target detection, but not a specific deficit in context processing, is observed across psychotic disorders. Impairments in both goal maintenance and response inhibition appear to contribute comparably to deficits in schizophrenia and schizoaffective disorder, whereas greater difficulty with response inhibition underlies deficits in bipolar disorder. Yet, these deficits are not independent from the generalized neurocognitive impairment observed in schizophrenia and psychotic bipolar disorder.
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Affiliation(s)
- James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - James M Gold
- Department of Psychiatry, University of Maryland School of Medicine, Maryland Psychiatric Research Center, Baltimore, MD, USA
| | | | - Brett A Clementz
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Elliot Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | - Godfrey Pearlson
- Department of Psychiatry, Institute of Living/Hartford Hospital, Yale School of Medicine, New Haven, CT, USA
| | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical School, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
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Gkintoni E, Pallis EG, Bitsios P, Giakoumaki SG. Neurocognitive performance, psychopathology and social functioning in individuals at high risk for schizophrenia or psychotic bipolar disorder. J Affect Disord 2017; 208:512-520. [PMID: 27810272 DOI: 10.1016/j.jad.2016.10.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/05/2016] [Accepted: 10/22/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Although cognitive deficits are consistent endophenotypes of schizophrenia and bipolar disorder, findings in psychotic bipolar disorder (BDP) are inconsistent. In this study we compared adult unaffected first-degree relatives of schizophrenia and BDP patients on cognition, psychopathology, social functioning and quality of life. METHODS Sixty-six unaffected first-degree relatives of schizophrenia patients (SUnR), 36 unaffected first-degree relatives of BDP patients (BDPUnR) and 102 controls participated in the study. Between-group differences were examined and Discriminant Function Analysis (DFA) predicted group membership. RESULTS Visual memory, control inhibition, working memory, cognitive flexibility and abstract reasoning were linearly impaired in the relatives' groups. Poorer verbal fluency and processing speed were evident only in the SUnR group. The SUnR group had higher depressive and somatization symptoms while the BDPUnR group had higher anxiety and lower social functioning compared with the controls. Individuals with superior cognition were more likely to be classified as controls; those with higher social functioning, prolonged processing speed and lower anxiety were more likely to be classified as SUnR. LIMITATIONS The relatives' sample is quite heterogeneous; the effects of genetic or environmental risk-factors were not examined. CONCLUSIONS Cognitive functions mediated by a fronto-parietal network, show linear impairments in unaffected relatives of BDP and schizophrenia patients; processing speed and verbal fluency impairments were evident only in schizophrenia relatives. Self-perceived symptomatology and social functioning also differ between schizophrenia and BDP relatives. The continuum seen in patients in several indices was also seen in the cognitive impairments in unaffected relatives of schizophrenia and BDP patients.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychology, Gallos University campus, University of Crete, Rethymno, Crete, Greece
| | - Eleftherios G Pallis
- Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Panos Bitsios
- Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Stella G Giakoumaki
- Department of Psychology, Gallos University campus, University of Crete, Rethymno, Crete, Greece.
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Schmitt LM, Ankeny LD, Sweeney JA, Mosconi MW. Inhibitory Control Processes and the Strategies That Support Them during Hand and Eye Movements. Front Psychol 2016; 7:1927. [PMID: 28018266 PMCID: PMC5145855 DOI: 10.3389/fpsyg.2016.01927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/24/2016] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: Adaptive behavior depends on the ability to voluntarily suppress context-inappropriate behaviors, a process referred to as response inhibition. Stop Signal tests (SSTs) are the most frequently studied paradigm used to assess response inhibition. Previous studies of SSTs have indicated that inhibitory control behavior can be explained using a common model in which GO and STOP processes are initiated independent from one and another, and the process that is completed first determines whether the behavior is elicited (GO process) or terminated (STOP process). Consistent with this model, studies have indicated that individuals strategically delay their behaviors during SSTs in order to increase their stopping abilities. Despite being controlled by distinct neural systems, prior studies have largely documented similar inhibitory control performance across eye and hand movements. Though, no existing studies have compared the extent to which individuals strategically delay behavior across different effectors is not yet clear. Here, we compared the extent to which inhibitory control processes and the cognitive strategies that support them during oculomotor and manual motor behaviors. Methods: We examined 29 healthy individuals who performed parallel oculomotor and manual motor SSTs. Participants also completed a separate block of GO trials administered prior to the Stop Signal tests to assess baseline reaction times for each effector and reaction time increases during interleaved GO trials of the SST. Results: Our results showed that stopping errors increased for both effectors as the interval between GO and STOP cues was increased (i.e., stop signal delay), but performance deteriorated more rapidly for eye compared to hand movements with increases in stop signal delay. During GO trials, participants delayed the initiation of their responses for each effector, and greater slowing of reaction times on GO trials was associated with increased accuracy on STOP trials for both effectors. However, participants delayed their eye movements to a lesser degree than their hand movements, and strategic reaction time slowing was a stronger determinant of stopping accuracy for hand compared to eye movements. Overall, stopping accuracies for eye and hand movements were only modestly correlated, and the time it took individuals to cancel a response was not related for eye and hand movements. Discussion and Conclusion: Our findings that GO and STOP processes are independent and that individuals strategically delay their behavioral responses to increase stopping accuracy regardless of effector indicate that inhibitory control of oculomotor and manual motor behaviors both follow common guiding principles. Yet, our findings document that eye movements are more difficult to inhibit than hand movements, and the timing, magnitude, and impact of cognitive control strategies used to support voluntary response inhibition are less robust for eye compared to hand movements. This suggests that inhibitory control systems also show unique characteristics that are behavior-dependent. This conclusion is consistent with neurophysiological evidence showing important differences in the architecture and functional properties of the neural systems involved in inhibitory control of eye and hand movements. It also suggests that characterizing inhibitory control processes in health and disease requires effector-specific analysis.
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Affiliation(s)
- Lauren M. Schmitt
- Clinical Child Psychology Program, Shiefelbusch Institute for Life Span Studies, University of Kansas, LawrenceKS, USA
| | - Lisa D. Ankeny
- Department of Psychology, University of Denver, DenverCO, USA
| | - John A. Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, CincinnatiOH, USA
| | - Matthew W. Mosconi
- Clinical Child Psychology Program, Shiefelbusch Institute for Life Span Studies, University of Kansas, LawrenceKS, USA
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Özerdem A, Ceylan D, Can G. Neurobiology of Risk for Bipolar Disorder. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2016; 3:315-329. [PMID: 27867834 PMCID: PMC5093194 DOI: 10.1007/s40501-016-0093-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Bipolar disorder (BD) is a chronic mental illness which follows a relapsing and remitting course and requires lifetime treatment. The lack of biological markers for BD is a major difficulty in clinical practice. Exploring multiple endophenotypes to fit in multivariate genetic models for BD is an important element in the process of finding tools to facilitate early diagnosis, early intervention, prevention of new episodes, and follow-up of treatment response in BD. Reviewing of studies on neuroimaging, neurocognition, and biochemical parameters in populations with high genetic risk for the illness can yield an integrative perspective on the neurobiology of risk for BD. The most up-to-date data reveals consistent deficits in executive function, response inhibition, verbal memory/learning, verbal fluency, and processing speed in risk groups for BD. Functional magnetic resonance imaging (fMRI) studies report alterations in the activity of the inferior frontal gyrus, medial prefrontal cortex, and limbic areas, particularly in the amygdala in unaffected first-degree relatives (FDR) of BD compared to healthy controls. Risk groups for BD also present altered immune and neurochemical modulation. Despite inconsistencies, accumulating data reveals cognitive and imaging markers for risk and to a less extent resilience of BD. Findings on neural modulation markers are preliminary and require further studies. Although the knowledge on the neurobiology of risk for BD has been inadequate to provide benefits for clinical practice, further studies on structural and functional changes in the brain, neurocognitive functioning, and neurochemical modulation have a potential to reveal biomarkers for risk and resilience for BD. Multimodal, multicenter, population-based studies with large sample size allowing for homogeneous subgroup analyses will immensely contribute to the elucidation of biological markers for risk for BD in an integrative model.
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Affiliation(s)
- Ayşegül Özerdem
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Deniz Ceylan
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
- Department of Psychiatry, Gümüşhane State Hospital, Gümüşhane, Turkey
| | - Güneş Can
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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Loos M, Schetters D, Hoogeland M, Spijker S, de Vries TJ, Pattij T. Prefrontal cortical neuregulin-ErbB modulation of inhibitory control in rats. Eur J Pharmacol 2016; 781:157-63. [DOI: 10.1016/j.ejphar.2016.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/07/2016] [Accepted: 04/11/2016] [Indexed: 12/13/2022]
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Fortgang RG, Hultman CM, van Erp TG, Cannon TD. Multidimensional assessment of impulsivity in schizophrenia, bipolar disorder, and major depressive disorder: testing for shared endophenotypes. Psychol Med 2016; 46:1497-1507. [PMID: 26899136 PMCID: PMC7039317 DOI: 10.1017/s0033291716000131] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Impulsivity is associated with bipolar disorder as a clinical feature during and between manic episodes and is considered a potential endophenotype for the disorder. Schizophrenia and major depressive disorder share substantial genetic overlap with bipolar disorder, and these two disorders have also been associated with elevations in impulsivity. However, little is known about the degree of overlap among these disorders in discrete subfacets of impulsivity and whether any overlap is purely phenotypic or due to shared genetic diathesis. METHOD We focused on five subfacets of impulsivity: self-reported attentional, motor, and non-planning impulsivity, self-reported sensation seeking, and a behavioral measure of motor inhibition (stop signal reaction time; SSRT). We examined these facets within and across disorder proband and co-twin groups, modeled heritability, and tested for endophenotypic patterning in a sample of twin pairs recruited from the Swedish Twin Registry (N = 420). RESULTS We found evidence of moderate to high levels of heritability for all five subfacets. All three proband groups and their unaffected co-twins showed elevations on attentional, motor, and non-planning impulsivity. Schizophrenia probands (but not their co-twins) showed significantly lower sensation seeking, and schizophrenia and bipolar disorder probands (but not in their co-twins) had significantly longer SSRTs, compared with healthy controls and the other groups. CONCLUSIONS Attentional, motor, and non-planning impulsivity emerged as potential shared endophenotypes for the three disorders, whereas sensation seeking and SSRT were associated with phenotypic affection but not genetic loading for these disorders.
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Affiliation(s)
| | - Christina M. Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Theo G.M. van Erp
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, CA, USA
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Flowers SA, Ryan KA, Lai Z, McInnis MG, Ellingrod VL. Interaction between COMT rs5993883 and second generation antipsychotics is linked to decreases in verbal cognition and cognitive control in bipolar disorder. BMC Psychol 2016; 4:14. [PMID: 27039372 PMCID: PMC4818866 DOI: 10.1186/s40359-016-0118-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 03/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Second generation antipsychotics (SGAs) are increasingly utilized in Bipolar Disorder (BD) but are potentially associated with cognitive side effects. Also linked to cognitive deficits associated with SGA-treatment are catechol-O-methyltransferase (COMT) gene variants. In this study, we examine the relationship between cognition in SGA use and COMT rs5993883 in cohort sample of subjects with BD. METHODS Interactions between SGA-treatment and COMT rs5993883 genotype on cognition was tested using a battery of neuropsychological tests performed in cross-sectional study of 246 bipolar subjects. RESULTS The mean age of our sample was 40.15 years and was comprised of 70 % female subjects. Significant demographic differences included gender, hospitalizations, benzodiazepine/antidepressant use and BD-type diagnosis. Linear regressions showed that the COMT rs5993883 GG genotype predicted lower verbal learning (p = 0.0006) and memory (p = 0.0026) scores, and lower scores on a cognitive control task (p = 0.004) in SGA-treated subjects. Interestingly, COMT GT- or TT-variants showed no intergroup cognitive differences. Further analysis revealed an interaction between SGA-COMT GG-genotype for verbal learning (p = 0.028), verbal memory (p = 0.026) and cognitive control (p = 0.0005). CONCLUSIONS This investigation contributes to previous work demonstrating links between cognition, SGA-treatment and COMT rs5993883 in BD subjects. Our analysis shows significant associations between cognitive domains such as verbal-cognition and cognitive control in SGA-treated subjects carrying the COMT rs5993883 GG-genotype. Prospective studies are needed to evaluate the clinical significance of these findings.
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Affiliation(s)
- Stephanie A Flowers
- Clinical Pharmacy Department, College of Pharmacy, University of Michigan, 428 Church St, Ann Arbor, MI, 48109-106, USA
| | - Kelly A Ryan
- Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Zongshan Lai
- Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA.,Center for Clinical Management Research (CCMR) Veterans Affairs, Ann Arbor, USA
| | - Melvin G McInnis
- Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Vicki L Ellingrod
- Clinical Pharmacy Department, College of Pharmacy, University of Michigan, 428 Church St, Ann Arbor, MI, 48109-106, USA. .,Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA.
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Clementz BA, Sweeney JA, Hamm JP, Ivleva EI, Ethridge LE, Pearlson GD, Keshavan MS, Tamminga CA. Identification of Distinct Psychosis Biotypes Using Brain-Based Biomarkers. Am J Psychiatry 2016; 173:373-84. [PMID: 26651391 PMCID: PMC5314432 DOI: 10.1176/appi.ajp.2015.14091200] [Citation(s) in RCA: 466] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Clinical phenomenology remains the primary means for classifying psychoses despite considerable evidence that this method incompletely captures biologically meaningful differentiations. Rather than relying on clinical diagnoses as the gold standard, this project drew on neurobiological heterogeneity among psychosis cases to delineate subgroups independent of their phenomenological manifestations. METHOD A large biomarker panel (neuropsychological, stop signal, saccadic control, and auditory stimulation paradigms) characterizing diverse aspects of brain function was collected on individuals with schizophrenia, schizoaffective disorder, and bipolar disorder with psychosis (N=711), their first-degree relatives (N=883), and demographically comparable healthy subjects (N=278). Biomarker variance across paradigms was exploited to create nine integrated variables that were used to capture neurobiological variance among the psychosis cases. Data on external validating measures (social functioning, structural magnetic resonance imaging, family biomarkers, and clinical information) were collected. RESULTS Multivariate taxometric analyses identified three neurobiologically distinct psychosis biotypes that did not respect clinical diagnosis boundaries. The same analysis procedure using clinical DSM diagnoses as the criteria was best described by a single severity continuum (schizophrenia worse than schizoaffective disorder worse than bipolar psychosis); this was not the case for biotypes. The external validating measures supported the distinctiveness of these subgroups compared with clinical diagnosis, highlighting a possible advantage of neurobiological versus clinical categorization schemes for differentiating psychotic disorders. CONCLUSIONS These data illustrate how multiple pathways may lead to clinically similar psychosis manifestations, and they provide explanations for the marked heterogeneity observed across laboratories on the same biomarker variables when DSM diagnoses are used as the gold standard.
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Affiliation(s)
- Brett A Clementz
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - John A Sweeney
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - Jordan P Hamm
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - Elena I Ivleva
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - Lauren E Ethridge
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - Godfrey D Pearlson
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - Matcheri S Keshavan
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
| | - Carol A Tamminga
- From the Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Conn., and the Institute of Living, Hartford Hospital, Hartford, Conn.; and the Department of Psychiatry, Harvard Medical School, Boston
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Abstract
Endophenotypes are quantitative, heritable traits that may help to elucidate the pathophysiologic mechanisms underlying complex disease syndromes, such as schizophrenia. They can be assessed at numerous levels of analysis; here, we review electrophysiological endophenotypes that have shown promise in helping us understand schizophrenia from a more mechanistic point of view. For each endophenotype, we describe typical experimental procedures, reliability, heritability, and reported gene and neurobiological associations. We discuss recent findings regarding the genetic architecture of specific electrophysiological endophenotypes, as well as converging evidence from EEG studies implicating disrupted balance of glutamatergic signaling and GABAergic inhibition in the pathophysiology of schizophrenia. We conclude that refining the measurement of electrophysiological endophenotypes, expanding genetic association studies, and integrating data sets are important next steps for understanding the mechanisms that connect identified genetic risk loci for schizophrenia to the disease phenotype.
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Affiliation(s)
- Emily Owens
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA
| | - Peter Bachman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - David C Glahn
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT,Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA
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Hıdıroğlu C, Torres IJ, Er A, Işık G, Yalın N, Yatham LN, Ceylan D, Özerdem A. Response inhibition and interference control in patients with bipolar I disorder and first-degree relatives. Bipolar Disord 2015; 17:781-94. [PMID: 26415581 DOI: 10.1111/bdi.12335] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 08/01/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The current study aimed to assess both response inhibition (RI) and interference control (IC) in euthymic patients with bipolar disorder (BD-Ps) as well as asymptomatic first-degree relatives (BD-Rs) and healthy controls (HCs) in order to evaluate trait-as opposed to illness-associated features of these components. METHODS BD-Ps (n = 35) who had been in the euthymic state for at least six months, BD-Rs (n = 30), and HCs (n = 33) completed a Stop-Signal Task (SST) and Stroop Task to assess RI and IC, respectively. Groups were compared on the stop-signal reaction time (SSRT), stop-signal delay (SSD), mean reaction time on go trials (go-RT), Stroop interference score (S-interference), and number of errors on the color-word-naming trial (S-error). Associations between the patient's clinical features and RI and IC, between the patient's treatment and RI and IC, and between RI and IC in each group were investigated. RESULTS BD-Ps and BD-Rs had significantly shorter go-RT and SSD, and longer SSRT compared to HCs, with these scores being similar between the BD-Ps and BD-Rs. Also, both BD-Ps and BD-Rs made significantly more S-errors than HCs, whereas, the S-interference score was not significantly different between groups. There were no significant correlations between Stroop Task and SST scores within each group, nor between clinical features or treatment variables and RI and IC in BD-Ps. CONCLUSIONS Overall, impairment in RI and IC (only on S-error score) was present in both patients and relatives. The persistence of these deficits in the absence of mood symptoms suggests that these features may represent candidate endophenotypes for bipolar disorder.
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Affiliation(s)
- Ceren Hıdıroğlu
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey.,Department of Psychology, Faculty of Arts, Dokuz Eylul University, Izmir, Turkey
| | - Ivan J Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ayşe Er
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Gizem Işık
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Nefize Yalın
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey.,Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Deniz Ceylan
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ayşegül Özerdem
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey.,Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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