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Iseli GC, Ulrich S, Schmidt A. Elucidating gut microbiota-hippocampus interactions in emerging psychosis: A new perspective for the development of early interventions for memory impairments. Front Psychiatry 2023; 14:1098019. [PMID: 37032923 PMCID: PMC10076719 DOI: 10.3389/fpsyt.2023.1098019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Hippocampal dysregulation might be a key pathophysiological factor for memory impairments in psychosis. Contemporary models particularly postulate that an imbalance of hippocampal glutamate and GABA leads to impaired memory and may thus serve as a therapeutic target to improve memory deficits. However, currently available interventions in early stages of psychosis do not explicitly target hippocampal pathology. A novel approach for manipulating hippocampus-dependent memory processes is provided via the gut microbiota. In this perspective article, we first recapitulate compelling evidence for emerging hippocampus pathology during the development of psychosis. The following sections emphasize the critical role of the gut microbiota in hippocampus plasticity and memory, and summarize existing evidence of gut microbiota alterations in different stages of psychosis. Finally, we propose a novel conceptual roadmap for future studies deciphering gut microbiota-hippocampus synergisms in emerging psychosis and argue that specific microbial supplementation might be promising for improving hippocampus-dependent memory deficits in early stages of psychosis.
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Guimond S, Mothi SS, Makowski C, Chakravarty MM, Keshavan MS. Altered amygdala shape trajectories and emotion recognition in youth at familial high risk of schizophrenia who develop psychosis. Transl Psychiatry 2022; 12:202. [PMID: 35562339 PMCID: PMC9106712 DOI: 10.1038/s41398-022-01957-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 01/04/2023] Open
Abstract
Relatives of individuals with schizophrenia have a higher risk of developing the illness compared to the general population. Thus, youth at familial high risk (FHR) offer a unique opportunity to identify neuroimaging-based endophenotypes of psychosis. Previous studies have identified lower amygdalo-hippocampal volume in FHR, as well as lower verbal memory and emotion recognition. However, whether these phenotypes increase the risk of transition to psychosis remains unclear. To determine if individuals who develop psychosis have abnormal neurodevelopmental trajectories of the amygdala and hippocampus, we investigated longitudinal changes of these structures in a unique cohort of 82 youth FHR and 56 healthy controls during a 3-year period. Ten individuals from the FHR group converted to psychosis. Longitudinal changes were compared using linear mixed-effects models. Group differences in verbal memory and emotion recognition performance at baseline were also analyzed. Surface-based morphometry measures revealed variation in amygdalar shape (concave shape of the right dorsomedial region) in those who converted to psychosis. Significantly lower emotion recognition performance at baseline was observed in converters. Percent trial-to-trial transfer on the verbal learning task was also significantly impaired in FHR, independently of the conversion status. Our results identify abnormal shape development trajectories in the dorsomedial amygdala and lower emotion recognition abilities as phenotypes of transition to psychosis. Our findings illustrate potential markers for early identification of psychosis, aiding prevention efforts in youth at risk of schizophrenia.
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Affiliation(s)
- Synthia Guimond
- grid.38142.3c000000041936754XDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA ,grid.28046.380000 0001 2182 2255Department of Psychiatry, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON Canada ,grid.265705.30000 0001 2112 1125Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC Canada
| | - Suraj S. Mothi
- grid.32224.350000 0004 0386 9924Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
| | - Carolina Makowski
- grid.14709.3b0000 0004 1936 8649Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC Canada ,grid.416102.00000 0004 0646 3639McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, Montreal, QC Canada ,grid.266100.30000 0001 2107 4242Center for Multimodal Imaging and Genetics, Department of Radiology, University of California San Diego, San Diego, United States
| | - M. Mallar Chakravarty
- grid.14709.3b0000 0004 1936 8649Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Departments of Psychiatry and Biological and Biomedical Engineering, McGill University, Montreal, QC Canada
| | - Matcheri S. Keshavan
- grid.38142.3c000000041936754XDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
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Huang J, Ke P, Chen X, Li S, Zhou J, Xiong D, Huang Y, Li H, Ning Y, Duan X, Li X, Zhang W, Wu F, Wu K. Multimodal Magnetic Resonance Imaging Reveals Aberrant Brain Age Trajectory During Youth in Schizophrenia Patients. Front Aging Neurosci 2022; 14:823502. [PMID: 35309897 PMCID: PMC8929292 DOI: 10.3389/fnagi.2022.823502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Accelerated brain aging had been widely reported in patients with schizophrenia (SZ). However, brain aging trajectories in SZ patients have not been well-documented using three-modal magnetic resonance imaging (MRI) data. In this study, 138 schizophrenia patients and 205 normal controls aged 20–60 were included and multimodal MRI data were acquired for each individual, including structural MRI, resting state-functional MRI and diffusion tensor imaging. The brain age of each participant was estimated by features extracted from multimodal MRI data using linear multiple regression. The correlation between the brain age gap and chronological age in SZ patients was best fitted by a positive quadratic curve with a peak chronological age of 47.33 years. We used the peak to divide the subjects into a youth group and a middle age group. In the normal controls, brain age matched chronological age well for both the youth and middle age groups, but this was not the case for schizophrenia patients. More importantly, schizophrenia patients exhibited increased brain age in the youth group but not in the middle age group. In this study, we aimed to investigate brain aging trajectories in SZ patients using multimodal MRI data and revealed an aberrant brain age trajectory in young schizophrenia patients, providing new insights into the pathophysiological mechanisms of schizophrenia.
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Affiliation(s)
- Jiayuan Huang
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, China
| | - Pengfei Ke
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Xiaoyi Chen
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, China
| | - Shijia Li
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Jing Zhou
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Dongsheng Xiong
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Yuanyuan Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Hehua Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xujun Duan
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Wensheng Zhang
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
- *Correspondence: Fengchun Wu,
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, China
- Guangdong Province Key Laboratory of Biomedical Engineering, South China University of Technology, Guangzhou, China
- Guangdong Engineering Technology Research Center for Diagnosis and Rehabilitation of Dementia, Guangzhou, China
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Kai Wu,
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An N, Fu Y, Shi J, Guo HN, Yang ZW, Li YC, Li S, Wang Y, Yao ZJ, Hu B. Synergistic Effects of APOE and CLU May Increase the Risk of Alzheimer's Disease: Acceleration of Atrophy in the Volumes and Shapes of the Hippocampus and Amygdala. J Alzheimers Dis 2021; 80:1311-1327. [PMID: 33682707 DOI: 10.3233/jad-201162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The volume loss of the hippocampus and amygdala in non-demented individuals has been reported to increase the risk of developing Alzheimer's disease (AD). Many neuroimaging genetics studies mainly focused on the individual effects of APOE and CLU on neuroimaging to understand their neural mechanisms, whereas their synergistic effects have been rarely studied. OBJECTIVE To assess whether APOE and CLU have synergetic effects, we investigated the epistatic interaction and combined effects of the two genetic variants on morphological degeneration of hippocampus and amygdala in the non-demented elderly at baseline and 2-year follow-up. METHODS Besides the widely-used volume indicator, the surface-based morphometry method was also adopted in this study to evaluate shape alterations. RESULTS Our results showed a synergistic effect of homozygosity for the CLU risk allele C in rs11136000 and APOEɛ4 on the hippocampal and amygdalar volumes during a 2-year follow-up. Moreover, the combined effects of APOEɛ4 and CLU C were stronger than either of the individual effects in the atrophy progress of the amygdala. CONCLUSION These findings indicate that brain morphological changes are caused by more than one gene variant, which may help us to better understand the complex endogenous mechanism of AD.
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Affiliation(s)
- Na An
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yu Fu
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Jie Shi
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Han-Ning Guo
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Zheng-Wu Yang
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yong-Chao Li
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Shan Li
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yin Wang
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Zhi-Jun Yao
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China
| | - Bin Hu
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China.,Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.,Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
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5
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Qi W, Blessing E, Li C, Ardekani BA, Hart KL, Marx J, Freudenreich O, Cather C, Holt D, Bello I, Diminich ED, Tang Y, Worthington M, Zeng B, Wu R, Fan X, Troxel A, Zhao J, Wang J, Goff DC. Effect of citalopram on hippocampal volume in first-episode schizophrenia: Structural MRI results from the DECIFER trial. Psychiatry Res Neuroimaging 2021; 312:111286. [PMID: 33857750 PMCID: PMC8231472 DOI: 10.1016/j.pscychresns.2021.111286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
Hippocampal volume loss is prominent in first episode schizophrenia (FES) and has been associated with poor clinical outcomes and with BDNF genotype; antidepressants are believed to reverse hippocampal volume loss via release of BDNF. In a 12-month, placebo-controlled add-on trial of the antidepressant, citalopram, during the maintenance phase of FES, negative symptoms were improved with citalopram. We now report results of structural brain imaging at baseline and 6 months in 63 FES patients (34 in citalopram group) from the trial to assess whether protection against hippocampal volume loss contributed to improved negative symptoms with citalopram. Hippocampal volumetric integrity (HVI) did not change significantly in the citalopram or placebo group and did not differ between treatment groups, whereas citalopram was associated with greater volume loss of the right CA1 subfield. Change in cortical thickness was associated with SANS change in 4 regions (left rostral anterior cingulate, right frontal pole, right cuneus, and right transverse temporal) but none differed between treatment groups. Our findings suggest that minimal hippocampal volume loss occurs after stabilization on antipsychotic treatment and that citalopram's potential benefit for negative symptoms is unlikely to result from protection against hippocampal volume loss or cortical thinning.
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Affiliation(s)
- Wei Qi
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Esther Blessing
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Chenxiang Li
- Division of Biostatistics, Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY 10016, United States of America
| | - Babak A Ardekani
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States of America
| | - Kamber L Hart
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Julia Marx
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Oliver Freudenreich
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Corinne Cather
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Daphne Holt
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Iruma Bello
- New York State Psychiatric Institute, Columbia University Medical Center, 601 West 168th St., New York, NY 10032, United States of America; Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, United States of America
| | - Erica D Diminich
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook School of Medicine, Health Sciences Center, Stony Brook, NY 11794, United States of America
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wanping S Road, Shanghai, China, 200030
| | - Michelle Worthington
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Botao Zeng
- Department of Psychiatry, Qingdao Mental Health Center, 9 Dongguan Road, Qingdao, Shandong, China, 266034
| | - Renrong Wu
- National Clinical Research Center for Mental Disorders, Mental Health Institute, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, China, 410005
| | - Xiaoduo Fan
- Department of Psychiatry, UMass Memorial Healthcare/University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA 01605, United States of America
| | - Andrea Troxel
- Division of Biostatistics, Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY 10016, United States of America
| | - Jingping Zhao
- National Clinical Research Center for Mental Disorders, Mental Health Institute, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, China, 410005
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wanping S Road, Shanghai, China, 200030
| | - Donald C Goff
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States of America.
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6
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Hoang D, Lizano P, Lutz O, Zeng V, Raymond N, Miewald J, Montrose D, Keshavan M. Thalamic, Amygdalar, and hippocampal nuclei morphology and their trajectories in first episode psychosis: A preliminary longitudinal study ✰. Psychiatry Res Neuroimaging 2021; 309:111249. [PMID: 33484937 PMCID: PMC7904670 DOI: 10.1016/j.pscychresns.2021.111249] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/20/2020] [Accepted: 01/06/2021] [Indexed: 11/19/2022]
Abstract
The thalamus, amygdala, and hippocampus play important pathophysiologic roles in psychosis. Few studies have prospectively examined subcortical nuclei in relation to predicting clinical outcomes after a first-episode of psychosis (FEP). Here, we examined volumetric differences and trajectories among subcortical nuclei in FEP patients and their associations with illness severity. Clinical and brain volume measures were collected using a 1.5T MRI scanner and processed using FreeSurfer 6.0 from a prospective study of antipsychotic-naïve FEP patients of FEP-schizophrenia (FEP-SZ) (baseline, n = 38; follow-up, n = 17), FEP non-schizophrenia (FEP-NSZ) (baseline, n = 23; follow-up, n = 13), and healthy controls (HCs) (baseline, n = 47; follow-up, n = 29). Compared to FEP-NSZ and HCs, FEP-SZ had significantly smaller thalamic anterior nuclei volume at baseline. Longitudinally, FEP-SZ showed a positive rate of change in the amygdala compared to controls or FEP-NSZ, as well as in the basal, central and accessory basal nuclei compared to FEP-NSZ. Enlargement in the thalamic anterior nuclei predicted a worsening in overall psychosis symptoms. Baseline thalamic anterior nuclei alterations further specify key subcortical regions associated with FEP-SZ pathophysiology. Longitudinally, anterior nuclei volume enlargement may signal symptomatic worsening. The amygdala and thalamus structures may show diagnostic differences between schizophrenia and non-schizophrenia psychoses, while the thalamus changes may reflect disease or treatment related changes in clinical outcome.
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Affiliation(s)
- Dung Hoang
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, 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.
| | - Olivia Lutz
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Victor Zeng
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Nicolas Raymond
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Jean Miewald
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, United States
| | - Deborah Montrose
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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7
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Merritt K, Luque Laguna P, Irfan A, David AS. Longitudinal Structural MRI Findings in Individuals at Genetic and Clinical High Risk for Psychosis: A Systematic Review. Front Psychiatry 2021; 12:620401. [PMID: 33603688 PMCID: PMC7884337 DOI: 10.3389/fpsyt.2021.620401] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/08/2021] [Indexed: 01/18/2023] Open
Abstract
Background: Several cross-sectional studies report brain structure differences between healthy volunteers and subjects at genetic or clinical high risk of developing schizophrenia. However, longitudinal studies are important to determine whether altered trajectories of brain development precede psychosis onset. Methods: We conducted a systematic review to determine if brain trajectories differ between (i) those with psychotic experiences (PE), genetic (GHR) or clinical high risk (CHR), compared to healthy volunteers, and (ii) those who transition to psychosis compared to those who do not. Results: Thirty-eight studies measured gray matter and 18 studies measured white matter in 2,473 high risk subjects and 990 healthy volunteers. GHR, CHR, and PE subjects show an accelerated decline in gray matter primarily in temporal, and also frontal, cingulate and parietal cortex. In those who remain symptomatic or transition to psychosis, gray matter loss is more pronounced in these brain regions. White matter volume and fractional anisotropy, which typically increase until early adulthood, did not change or reduced in high risk subjects in the cingulum, thalamic radiation, cerebellum, retrolenticular part of internal capsule, and hippocampal-thalamic tracts. In those who transitioned, white matter volume and fractional anisotropy reduced over time in the inferior and superior fronto-occipital fasciculus, corpus callosum, anterior limb of the internal capsule, superior corona radiate, and calcarine cortex. Conclusion: High risk subjects show deficits in white matter maturation and an accelerated decline in gray matter. Gray matter loss is more pronounced in those who transition to psychosis, but may normalize by early adulthood in remitters.
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Affiliation(s)
- Kate Merritt
- Division of Psychiatry, Institute of Mental Health, University College London, London, United Kingdom
| | - Pedro Luque Laguna
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | - Ayela Irfan
- Division of Psychiatry, Institute of Mental Health, University College London, London, United Kingdom
| | - Anthony S David
- Division of Psychiatry, Institute of Mental Health, University College London, London, United Kingdom
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8
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Hippocampal volume in early psychosis: a 2-year longitudinal study. Transl Psychiatry 2020; 10:306. [PMID: 32873788 PMCID: PMC7463254 DOI: 10.1038/s41398-020-00985-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/13/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022] Open
Abstract
Cross-sectional studies suggest that hippocampal volume declines across stages of psychosis. In contrast, longitudinal studies indicate that hippocampal volume is stable in the critical period following illness onset. How can these seemingly disparate sets of findings be resolved? In the present study, we examine two previously unexplored reasons for this discrepancy. First, only specific subregions of the hippocampus may change during the early stage of psychosis. Second, there is diagnostic heterogeneity in the early stage of psychosis and cross-sectional analysis does not permit examination of illness trajectory. Some early stage individuals will have persistent illness leading to a diagnosis of schizophrenia, whereas in others, psychosis will remit. Hippocampal volume may be reduced only in individuals who will ultimately be diagnosed with schizophrenia. We acquired longitudinal structural MRI data from 63 early psychosis and 63 healthy control participants, with up to 4 time points per participant collected over 2 years. Subfield volumes were measured in the anterior and posterior hippocampus using automated segmentation specialized for longitudinal analysis. We observed a volume deficit in early psychosis participants compared to healthy controls that was most pronounced in the anterior hippocampus, but this deficit did not change over 2 years. Importantly, we found that anterior cornu ammonis volume is smaller at baseline in individuals who were diagnosed with schizophrenia at follow-up, but normal in those who maintained a diagnosis of schizophreniform disorder over 2 years. Smaller hippocampal volume is not diagnostic of psychosis, but is instead prognostic of clinical outcome.
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9
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Derome M, Zöller D, Modinos G, Schaer M, Eliez S, Debbané M. Developmental trajectories of subcortical structures in relation to dimensional schizotypy expression along adolescence. Schizophr Res 2020; 218:76-84. [PMID: 32081537 DOI: 10.1016/j.schres.2020.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 12/31/2022]
Abstract
Morphological abnormalities of subcortical structures have been consistently reported along the schizophrenia clinical spectrum, and they may play an important role in the pathophysiology of psychosis. However, the question arises whether these subcortical features are consequences of medication and illness chronicity, or if they contribute to the vulnerability to develop schizophrenia spectrum disorders. If some of the subcortical abnormalities could be evidenced in community adolescents expressing higher schizotypal traits (psychometric schizotypy), they could potentially shed light on vulnerability markers. To date, very few studies have examined the link between psychometric schizotypy and volumes of subcortical regions, and none of them have used a longitudinal design. This study sets out to investigate developmental trajectories of subcortical volumes in 110 community adolescents (12 to 20 years old), for whom MRI-scans were acquired over a period of 5 years, reaching a total of 297 scans. Analyses were conducted using Freesurfer, and schizotypal traits were measured with the Schizotypal Personality Questionnaire (SPQ). Using mixed model regression analyses following a region-of-interest approach, we observed differential linear developmental trajectories in four subcortical structures when comparing higher versus lower scorers on the disorganized schizotypy dimension (bilateral hippocampus, left-lateral ventricle and left-pallidum) and the negative schizotypy dimension (bilateral pallidum, and right-thalamus). All results survived a threshold of p < .05 (FDR-corrected) while covarying for the effect of other psychological problems (externalized and internalized psychopathology). These results indicate that expression of higher levels of negative and disorganized schizotypy during adolescence was associated with neural markers linking schizotypy personality features to schizophrenia spectrum disorders.
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Affiliation(s)
- Mélodie Derome
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland.
| | - Daniela Zöller
- Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Medical Image Processing Lab, Institute of Bioengineering, EPFL, Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland.
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Marie Schaer
- Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland.
| | - Stephan Eliez
- Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Switzerland.
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Research Department of Clinical, Educational & Health Psychology, University College London, United Kingdom.
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10
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Niznikiewicz MA. Neurobiological approaches to the study of clinical and genetic high risk for developing psychosis. Psychiatry Res 2019; 277:17-22. [PMID: 30926150 DOI: 10.1016/j.psychres.2019.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/12/2023]
Abstract
Research on neurobiological impairments in clinical and genetic high risk for developing psychosis individuals (CHR) has identified several brain abnormalities that impact both brain structure and function. The current review will discuss research examining brain abnormalities in clinical and genetic high risk for psychosis using magnetic resonance imaging (MRI) focusing on structural brain abnormalities, diffusion tensor imaging (DTI) focusing on the integrity of white matter tracks, functional MRI focusing on functional brain abnormalities, and EEG and event related potential (ERP) methodologies focusing on indices of cognitive dysfunction in CHR. Studies conducted across these different methodologies sought to identify brain regions and brain processes that would distinguish between those high risk individuals who converted to psychosis versus those who did not. In addition, in some of the studies, the distinction was made between individuals who converted to psychosis, those who did not, and those individuals who remained clinically symptomatic while not converting to psychosis. The brain regions most often identified as abnormal in this subject group were the brain areas often found abnormal in schizophrenia, including frontal and temporal regions. Similarly, several cognitive processes often found to be abnormal in schizophrenia have been also found impaired in CHR.
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Affiliation(s)
- Margaret A Niznikiewicz
- Harvard Medical School and Veterans Administration Boston, Healthcare System, United States.
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Abstract
Hippocampal abnormalities have been heavily implicated in the pathophysiology of schizophrenia. The dentate gyrus of the hippocampus was shown to manifest an immature molecular profile in schizophrenia subjects, as well as in various animal models of the disorder. In this position paper, we advance a hypothesis that this immature molecular profile is accompanied by an identifiable immature morphology of the dentate gyrus granule cell layer. We adduce evidence for arrested maturation of the dentate gyrus in the human schizophrenia-affected brain, as well as multiple rodent models of the disease. Implications of this neurohistopathological signature for current theory regarding the development of schizophrenia are discussed.
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Affiliation(s)
- Ayda Tavitian
- Department of Neurology & Neurosurgery, Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Wei Song
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Hyman M. Schipper
- Department of Neurology & Neurosurgery, Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
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12
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Omega-3 fatty acid supplementation may prevent loss of gray matter thickness in the left parieto-occipital cortex in first episode schizophrenia: A secondary outcome analysis of the OFFER randomized controlled study. Schizophr Res 2018; 195:168-175. [PMID: 29079060 DOI: 10.1016/j.schres.2017.10.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/28/2017] [Accepted: 10/08/2017] [Indexed: 11/22/2022]
Abstract
The aim of the study was to assess changes in cortical thickness related to the use of n-3 polyunsaturated fatty acids (PUFA) as add-on therapy in patients with first episode schizophrenia. A double-blind randomized controlled study was conducted using a 26-week intervention composed of concentrated fish oil containing 2.2g/d of eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) or placebo (olive oil). Participants underwent MRI scanning twice to assess changes in cortical thickness: at the beginning and at the end of intervention. Data of suitable quality was obtained from 29 participants. The T1-weighted images for each participant were analyzed using FreeSurfer methodology for longitudinal pipeline. Significant differences in cortical thickness loss were observed between the groups in the parieto-occipital regions of Brodmann areas 7 and 19 of the left hemisphere, dysfunctions in which may be involved in schizophrenia symptomatology. The results of the study support the previous observations carried out in older individuals and patients with mild cognitive impairment, indicating that n-3 PUFA may have neuroprotective properties, especially at early stages of neurodegenerative diseases, such as schizophrenia. If replicated, the results of the present study may encourage clinicians to consider n-3 PUFA as a promising addition to antipsychotics for long-term treatment of schizophrenia.
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Hill K, Bolo N, Sarvode Mothi S, Lizano P, Guimond S, Tandon N, Molokotos E, Keshavan M. Subcortical surface shape in youth at familial high risk for schizophrenia. Psychiatry Res Neuroimaging 2017; 267:36-44. [PMID: 28734178 DOI: 10.1016/j.pscychresns.2017.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/29/2017] [Accepted: 07/14/2017] [Indexed: 01/11/2023]
Abstract
Abnormalities in the subcortical brain regions that support cognitive functions have been reported in schizophrenia. Relatives of those with schizophrenia often present with psychosis-like traits (schizotypy) and similar cognition as those with schizophrenia. To evaluate the relationships between subcortical structure, schizotypy, and cognitive function, we assessed shape and volume of the hippocampus, amygdala and thalamus in untreated youth at familial high risk for schizophrenia (HRSZ). The sample consisted of 66 HRSZ and 69 age-matched healthy controls (HC). Subjects' cognitive functions and schizotypy were assessed, and T1-weighted brain MRI were analyzed using the FSL software FIRST. The right hippocampus and right amygdala showed significantly increased concavity (inward displacement) in HRSZ compared to HC. While regional subcortical shape displacements were significantly correlated with sustained attention and executive function scores in HC, fewer correlations were seen in HRSZ. This suggests a possible alteration of the local structure-function relationship in subcortical brain regions of HRSZ for these cognitive domains, which could be related to anomalous plasticity.
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Affiliation(s)
- Kathryn Hill
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA
| | - Nicolas Bolo
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA.
| | - Suraj Sarvode Mothi
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA; Department of Psychiatry, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA
| | - Synthia Guimond
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA
| | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA; Baylor College of Medicine, Houston, TX, USA
| | - Elena Molokotos
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, 75 Fenwood Rd, Boston, MA 02115, USA
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Progressive Decline in Hippocampal CA1 Volume in Individuals at Ultra-High-Risk for Psychosis Who Do Not Remit: Findings from the Longitudinal Youth at Risk Study. Neuropsychopharmacology 2017; 42:1361-1370. [PMID: 28079061 PMCID: PMC5437892 DOI: 10.1038/npp.2017.5] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/05/2016] [Accepted: 01/04/2017] [Indexed: 01/08/2023]
Abstract
Most individuals identified as ultra-high-risk (UHR) for psychosis do not develop frank psychosis. They continue to exhibit subthreshold symptoms, or go on to fully remit. Prior work has shown that the volume of CA1, a subfield of the hippocampus, is selectively reduced in the early stages of schizophrenia. Here we aimed to determine whether patterns of volume change of CA1 are different in UHR individuals who do or do not achieve symptomatic remission. Structural MRI scans were acquired at baseline and at 1-2 follow-up time points (at 12-month intervals) from 147 UHR and healthy control subjects. An automated method (based on an ex vivo atlas of ultra-high-resolution hippocampal tissue) was used to delineate the hippocampal subfields. Over time, a greater decline in bilateral CA1 subfield volumes was found in the subgroup of UHR subjects whose subthreshold symptoms persisted (n=40) and also those who developed clinical psychosis (n=12), compared with UHR subjects who remitted (n=41) and healthy controls (n=54). No baseline differences in volumes of the overall hippocampus or its subfields were found among the groups. Moreover, the rate of volume decline of CA1, but not of other hippocampal subfields, in the non-remitters was associated with increasing symptom severity over time. Thus, these findings indicate that there is deterioration of CA1 volume in persistently symptomatic UHR individuals in proportion to symptomatic progression.
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Bartholomeusz CF, Cropley VL, Wannan C, Di Biase M, McGorry PD, Pantelis C. Structural neuroimaging across early-stage psychosis: Aberrations in neurobiological trajectories and implications for the staging model. Aust N Z J Psychiatry 2017; 51:455-476. [PMID: 27733710 DOI: 10.1177/0004867416670522] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model. RESULTS In general, grey matter (and, to a lesser extent, white matter) declines across multiple frontal, temporal (especially superior regions), insular and parietal regions during the first episode of psychosis, which has a steeper trajectory than that of age-matched healthy counterparts. Although the ultra-high-risk of psychosis literature is considerably mixed, evidence indicates that certain volumetric structural aberrations predate psychotic illness onset (e.g. prefrontal cortex thinning), while other abnormalities present in ultra-high-risk of psychosis populations are potentially non-psychosis-specific (e.g. hippocampal volume reductions). CONCLUSION We highlight the advantages of longitudinal designs, discuss the implications such studies have on clinical staging and provide directions for future research.
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Affiliation(s)
- Cali F Bartholomeusz
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Vanessa L Cropley
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Cassandra Wannan
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Maria Di Biase
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Patrick D McGorry
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christos Pantelis
- 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- 4 Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia
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Pruessner M, Bechard-Evans L, Pira S, Joober R, Collins DL, Pruessner JC, Malla AK. Interplay of hippocampal volume and hypothalamus-pituitary-adrenal axis function as markers of stress vulnerability in men at ultra-high risk for psychosis. Psychol Med 2017; 47:471-483. [PMID: 27774914 DOI: 10.1017/s0033291716002658] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Altered hypothalamus-pituitary-adrenal (HPA) axis function and reduced hippocampal volume (HV) are established correlates of stress vulnerability. We have previously shown an attenuated cortisol awakening response (CAR) and associations with HV specifically in male first-episode psychosis patients. Findings in individuals at ultra-high risk (UHR) for psychosis regarding these neurobiological markers are inconsistent, and assessment of their interplay, accounting for sex differences, could explain incongruent results. METHOD Study participants were 42 antipsychotic-naive UHR subjects (24 men) and 46 healthy community controls (23 men). Saliva samples for the assessment of CAR were collected at 0, 30 and 60 min after awakening. HV was determined from high-resolution structural magnetic resonance imaging scans using a semi-automatic segmentation protocol. RESULTS Cortisol measures and HV were not significantly different between UHR subjects and controls in total, but repeated-measures multivariate regression analyses revealed reduced cortisol levels 60 min after awakening and smaller left HV in male UHR individuals. In UHR participants only, smaller left and right HV was significantly correlated with a smaller total CAR (ρ = 0.42, p = 0.036 and ρ = 0.44, p = 0.029, respectively), corresponding to 18% and 19% of shared variance (medium effect size). CONCLUSIONS Our findings suggest that HV reduction in individuals at UHR for psychosis is specific to men and linked to reduced post-awakening cortisol concentrations. Abnormalities in the neuroendocrine circuitry modulating stress vulnerability specifically in male UHR subjects might explain increased psychosis risk and disadvantageous illness outcomes in men compared to women.
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Affiliation(s)
- M Pruessner
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - L Bechard-Evans
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - S Pira
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - R Joober
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - D L Collins
- Departments of Neurology & Neurosurgery, and Biomedical Engineering,Brain Imaging Centre,Montreal Neurological Institute,McGill University,Montréal,Québec,Canada
| | - J C Pruessner
- Departments of Psychiatry, and Psychology,McGill Centre for Studies in Aging,Douglas Mental Health University Institute,McGill University,Montréal,Québec,Canada
| | - A K Malla
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
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Archer T, Kostrzewa RM. Physical Exercise Alleviates Health Defects, Symptoms, and Biomarkers in Schizophrenia Spectrum Disorder. Neurotox Res 2015; 28:268-80. [PMID: 26174041 DOI: 10.1007/s12640-015-9543-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/08/2015] [Accepted: 07/06/2015] [Indexed: 02/07/2023]
Abstract
Schizophrenia spectrum disorders are characterized by symptom profiles consisting of positive and negative symptoms, cognitive impairment, and a plethora of genetic, epigenetic, and phenotypic biomarkers. Assorted animal models of these disorders and clinical neurodevelopmental indicators have implicated neurodegeneration as an element in the underlying pathophysiology. Physical exercise or activity regimes--whether aerobic, resistance, or endurance--ameliorate regional brain and functional deficits not only in affected individuals but also in animal models of the disorder. Cognitive deficits, often linked to regional deficits, were alleviated by exercise, as were quality-of-life, independent of disorder staging and risk level. Apoptotic processes intricate to the etiopathogenesis of schizophrenia were likewise attenuated by physical exercise. There is also evidence of manifest benefits endowed by physical exercise in preserving telomere length and integrity. Not least, exercise improves overall health and quality-of-life. The notion of scaffolding as the outcome of physical exercise implies the "buttressing" of regional network circuits, neurocognitive domains, anti-inflammatory defenses, maintenance of telomeric integrity, and neuro-reparative and regenerative processes.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, 405 30, Gothenburg, Sweden,
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