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López-Caballero F, Curtis M, Coffman BA, Salisbury DF. Is source-resolved magnetoencephalographic mismatch negativity a viable biomarker for early psychosis? Eur J Neurosci 2024; 59:1889-1906. [PMID: 37537883 PMCID: PMC10837325 DOI: 10.1111/ejn.16107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/04/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Mismatch negativity (MMN) is an auditory event-related response reflecting the pre-attentive detection of novel stimuli and is a biomarker of cortical dysfunction in schizophrenia (SZ). MMN to pitch (pMMN) and to duration (dMMN) deviant stimuli are impaired in chronic SZ, but it is less clear if MMN is reduced in first-episode SZ, with inconsistent findings in scalp-level EEG studies. Here, we investigated the neural generators of pMMN and dMMN with MEG recordings in 26 first-episode schizophrenia spectrum (FEsz) and 26 matched healthy controls (C). We projected MEG inverse solutions into precise functionally meaningful auditory cortex areas. MEG-derived MMN sources were in bilateral primary auditory cortex (A1) and belt areas. In A1, pMMN FEsz reduction showed a trend towards statistical significance (F(1,50) = 3.31; p = .07), and dMMN was reduced in FEsz (F(1,50) = 4.11; p = .04). Hypothesis-driven comparisons at each hemisphere revealed dMMN reduction in FEsz occurred in the left (t(56) = 2.23; p = .03; d = .61) but not right (t(56) = 1.02; p = .31; d = .28) hemisphere, with a moderate effect size. The added precision of MEG source solution with high-resolution MRI and parcellation of A1 may be requisite to detect the emerging pathophysiology and indicates a critical role for left hemisphere pathology at psychosis onset. However, the moderate effect size in left A1, albeit larger than reported in scalp MMN meta-analyses, casts doubt on the clinical utility of MMN for differential diagnosis, as a majority of patients will overlap with the healthy individual's distribution.
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Affiliation(s)
- Fran López-Caballero
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mark Curtis
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Hua JPY, Roach BJ, Ford JM, Mathalon DH. Mismatch Negativity and Theta Oscillations Evoked by Auditory Deviance in Early Schizophrenia. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1186-1196. [PMID: 36931469 DOI: 10.1016/j.bpsc.2023.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 02/07/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Amplitude reduction of mismatch negativity (MMN), an event-related potential component indexing NMDA receptor-dependent auditory echoic memory and predictive coding, is widely replicated in schizophrenia. Time-frequency analyses of single-trial electroencephalography epochs suggest that theta oscillation abnormalities underlie MMN deficits in schizophrenia. However, this has received less attention in early schizophrenia (ESZ). METHODS Patients with ESZ (n = 89), within 5 years of illness onset, and healthy control subjects (n = 105) completed an electroencephalography MMN paradigm (duration-deviant, pitch-deviant, duration + pitch double-deviant). Repeated measures analyses of variance assessed group differences in MMN, theta intertrial phase coherence (ITC), and theta total power from frontocentral electrodes, after normal age adjustment. Group differences were retested after covarying MMN and theta measures. RESULTS Relative to healthy control subjects, patients with ESZ showed auditory deviance deficits. Patients with ESZ had MMN deficits for duration-deviants (p = .041), pitch-deviants (ps = .007), and double-deviants (ps < .047). Patients with ESZ had reduced theta ITC for standards (ps < .040) and duration-deviants (ps < .030). Furthermore, patients with ESZ had reduced theta power across deviants at central electrodes (p = .013). MMN group deficits were not fully accounted for by theta ITC and power, and neither were theta ITC group deficits fully accounted for by MMN. Group differences in theta total power were no longer significant after covarying for MMN. CONCLUSIONS Patients with ESZ showed reduced MMN and theta total power for all deviant types. Theta ITC showed a relatively specific reduction for duration-deviants. Although MMN and theta ITC were correlated in ESZ, covarying for one did not fully account for deficits in the other, raising the possibility of their sensitivity to dissociable pathophysiological processes.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco, California; San Francisco VA Medical Center, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Brian J Roach
- San Francisco VA Medical Center, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Judith M Ford
- San Francisco VA Medical Center, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Daniel H Mathalon
- San Francisco VA Medical Center, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California.
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Selvaggi P, Fazio L, Toro VD, Mucci A, Rocca P, Martinotti G, Cascino G, Siracusano A, Zeppegno P, Pergola G, Bertolino A, Blasi G, Galderisi S. Effect of anticholinergic burden on brain activity during Working Memory and real-world functioning in patients with schizophrenia. Schizophr Res 2023; 260:76-84. [PMID: 37633126 DOI: 10.1016/j.schres.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/30/2023] [Accepted: 08/13/2023] [Indexed: 08/28/2023]
Abstract
Cognitive impairment has been associated with poor real-world functioning in patients with Schizophrenia. Previous studies have shown that pharmacological treatment with anticholinergic properties may contribute to cognitive impairment in Schizophrenia. We investigated the effect of the anticholinergic burden (ACB) on brain activity, cognition, and real-world functioning in Schizophrenia. We hypothesized that greater ACB would be associated with altered brain activity along with poorer cognitive performance and lower real-world functioning. A sample of 100 patients with a diagnosis of schizophrenia or schizoaffective disorder was recruited in the naturalistic multicenter study of the Italian Network for Research on Psychoses (NIRP) across 7 centres. For each participant, ACB was evaluated using the Anticholinergic Cognitive Burden scale. The association of ACB with brain function was assessed using BOLD fMRI during the N-Back Working Memory (WM) task in a nested cohort (N = 31). Real-world functioning was assessed using the Specific Level of Functioning (SLOF) scale. Patients with high ACB scores (≥3) showed lower brain activity in the WM frontoparietal network (TFCE corrected alpha <0.05) and poorer cognitive performance (p = 0.05) than patients with low ACB scores (<3). Both effects were unaffected by demographic characteristics, clinical severity, and antipsychotic dosage. Moreover, patients with high ACB showed poorer real-world functioning than patients with lower ACB (p = 0.03). Our results suggest that ACB in Schizophrenia is associated with impaired WM and abnormal underlying brain function along with reduced real-world functioning. Clinical practice should consider the potential adverse cognitive effects of ACB in the treatment decision-making process.
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Affiliation(s)
- Pierluigi Selvaggi
- Department of Translational Biomedicine and Neuroscience, University of Bari "Aldo Moro", Bari, Italy; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Leonardo Fazio
- Department of Translational Biomedicine and Neuroscience, University of Bari "Aldo Moro", Bari, Italy; Department of Medicine and Surgery, LUM University, Casamassima, Bari, Italy
| | - Veronica Debora Toro
- Department of Translational Biomedicine and Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, G. D'Annunzio University, Chieti, Italy
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy
| | - Giulio Pergola
- Department of Translational Biomedicine and Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Giuseppe Blasi
- Department of Translational Biomedicine and Neuroscience, University of Bari "Aldo Moro", Bari, Italy.
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Baker A, Suetani S, Cosgrove P, Siskind D, Murray GK, Scott JG, Kesby JP. Reversal learning in those with early psychosis features contingency-dependent changes in loss response and learning. Cogn Neuropsychiatry 2023; 28:342-360. [PMID: 37737715 DOI: 10.1080/13546805.2023.2259019] [Citation(s) in RCA: 1] [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: 01/19/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION People with psychotic disorders commonly feature broad decision-making impairments that impact their functional outcomes. Specific associative/reinforcement learning problems have been demonstrated in persistent psychosis. But these phenotypes may differ in early psychosis, suggesting that aspects of cognition decline over time. METHODS The present proof-of-concept study examined goal-directed action and reversal learning in controls and those with early psychosis. RESULTS Equivalent performance was observed between groups during outcome-specific devaluation, and reversal learning at an 80:20 contingency (reward probability for high:low targets). But when the low target reward probability was increased (80:40) those with early psychosis altered their response to loss, whereas controls did not. Computational modelling confirmed that in early psychosis there was a change in punishment learning that increased the chance of staying with the same stimulus after a loss, multiple trials into the future. In early psychosis, the magnitude of this response was greatest in those with higher IQ and lower clinical severity scores. CONCLUSIONS We show preliminary evidence that those with early psychosis present with a phenotype that includes altered responding to loss and hyper-adaptability in response to outcome changes. This may reflect a compensatory response to overcome the milieu of corticostriatal changes associated with psychotic disorders.
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Affiliation(s)
- Andrea Baker
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
- School of Medicine and Dentistry, Griffith University, Brisbane, Australia
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Peter Cosgrove
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Dan Siskind
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Metro South Addiction and Mental Health Services, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - James P Kesby
- Queensland Centre for Mental Health Research, Brisbane, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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Jalewa J, Todd J, Michie PT, Hodgson DM, Harms L. The effect of schizophrenia risk factors on mismatch responses in a rat model. Psychophysiology 2023; 60:e14175. [PMID: 36087044 PMCID: PMC10909418 DOI: 10.1111/psyp.14175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/28/2022] [Accepted: 08/04/2022] [Indexed: 01/06/2023]
Abstract
Reduced mismatch negativity (MMN), a robust finding in schizophrenia, has prompted interest in MMN as a preclinical biomarker of schizophrenia. The rat brain can generate human-like mismatch responses (MMRs) which therefore enables the exploration of the neurobiology of reduced MMRs. Given epidemiological evidence that two developmental factors, maternal infection and adolescent cannabis use, increase the risk of schizophrenia, we determined the effect of these two developmental risk factors on rat MMR amplitude in different auditory contexts. MMRs were assessed in awake adult male and female Wistar rats that were offspring of pregnant dams treated with either a viral infection mimetic (poly I:C) inducing maternal immune activation (MIA) or saline control. In adolescence, subgroups of the prenatal treatment groups were exposed to either a synthetic cannabinoid (adolescent cannabinoid exposure: ACE) or vehicle. The context under which MMRs were obtained was manipulated by employing two different oddball paradigms, one that manipulated the physical difference between rare and common auditory stimuli, and another that manipulated the probability of the rare stimulus. The design of the multiple stimulus sequences across the two paradigms also allowed an investigation of context on MMRs to two identical stimulus sequences. Male offspring exposed to each of the risk factors for schizophrenia (MIA, ACE or both) showed a reduction in MMR, which was evident only in the probability paradigm, with no effects seen in the physical difference. Our findings highlight the importance of contextual factors induced by paradigm manipulations and sex for modeling schizophrenia-like MMN impairments in rats.
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Affiliation(s)
- Jaishree Jalewa
- School of Psychological Sciences, College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Juanita Todd
- School of Psychological Sciences, College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Patricia T. Michie
- School of Psychological Sciences, College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Deborah M. Hodgson
- School of Psychological Sciences, College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
| | - Lauren Harms
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- School of Biomedical Science and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
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Veleva I, Stoychev K, Stoimenova-Popova M, Mineva-Dimitrova E. Impact of Cognitive Disturbances and Clinical Symptoms on Disability in Patients with Paranoid Schizophrenia: A Study of a Bulgarian Clinical Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2459. [PMID: 36767826 PMCID: PMC9916146 DOI: 10.3390/ijerph20032459] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/15/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The study aimed to assess the impact of clinical symptoms and cognitive impairment on disability in patients with paranoid schizophrenia (PS). METHODS 108 patients with schizophrenia were included (66 male and 42 female). Their average age was 38.86 ± 10.02 years and the disease duration was 12.80 ± 8.20 years, with mean disease onset of 24 years. Clinical symptoms were assessed with the PANSS, and cognitive performance was measured using a seven-item neurocognitive battery. The disability level of the subjects was assessed using the World Health Organization-Disability Assessment Schedule 2.0 (WHO-DAS 2.0). The relation between the variables studied was assessed using Spearman's rank correlation coefficient (rs) at a probability level of p < 0.05. RESULTS An increase in symptom severity resulted in worsening of the "participation in society" (r = 0.56, p < 0.01), "life activities-household" (r = 0.55, p < 0.01), and "getting along with people" (r = 0.59, p < 0.01) WHO-DAS 2.0 domains. Positive symptoms (13.89 ± 3.48) correlated strongly with "getting along with people" (r = 0.55, p < 0.01), "life activities-household" (r = 0.58, p < 0.01), and "participation in society" (r = 0.62, p < 0.01), and negative symptoms (14.25 ± 4.16) with "participation in society" (r = 0.53, p < 0.01) and "life activities-household" (r = 0.48, p < 0.01). Symptoms of disorganization (15.67 ± 4.16) had the highest impact on "life activities-household" (r = 0.81, p < 0.01), "getting along with people" (r = 0.56, p < 0.05), and "participation in society" (r = 0.65, p < 0.01). Episodic memory (r = -0.28, p < 0.01) was remotely related to comprehension and communication. The information processing speed (rs = 0.38, p < 0.01), visual memory (rs = -0.30, p < 0.01), and focused executive functions showed moderate correlations with all domains on the WHO-DAS 2.0 scale (rs = 0.38, p < 0.01). Attention (rs = -0.33, p < 0.01) was moderately related to community activities. Semantic (rs = -0.29, p < 0.01) and literal (rs = -0.27, p < 0.01) verbal fluency demonstrated weak correlations with "cognition-understanding", "getting along with people", and "participation in society". CONCLUSION Symptoms of disorganization and disturbed executive functions contribute most to disability in patients with schizophrenia through impairment of real-world functioning, especially in social interactions and communication. Severe clinical symptoms (negative and disorganization-related ones) as well as deficits in executive function, verbal memory, and verbal fluency cause the biggest problems in the functional domains of interaction with other people and participation in society.
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Affiliation(s)
- Ivanka Veleva
- Department of Psychiatry and Medical Psychology, Faculty of Public Health, Medical University, 5800 Pleven, Bulgaria
| | - Kaloyan Stoychev
- Department of Psychiatry and Medical Psychology, Faculty of Public Health, Medical University, 5800 Pleven, Bulgaria
| | - Maya Stoimenova-Popova
- Department of Psychiatry and Medical Psychology, Faculty of Public Health, Medical University, 5800 Pleven, Bulgaria
| | - Eleonora Mineva-Dimitrova
- Department of Social Medicine and Health Management, Faculty of Public Health, Medical University, 5800 Pleven, Bulgaria
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7
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Suetani S, Baker A, Garner K, Cosgrove P, Mackay-Sim M, Siskind D, Murray GK, Scott JG, Kesby JP. Impairments in goal-directed action and reversal learning in a proportion of individuals with psychosis. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:1390-1403. [PMID: 35915336 PMCID: PMC9622547 DOI: 10.3758/s13415-022-01026-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 01/27/2023]
Abstract
Cognitive impairment in psychosis is one of the strongest predictors of functional decline. Problems with decision-making processes, such as goal-directed action and reversal learning, can reflect cortico-striatal dysfunction. The heterogenous symptoms and neurobiology observed in those with psychosis suggests that specific cognitive phenotypes may reflect differing causative mechanisms. As such, decision-making performance could identify subgroups of individuals with more severe cortico-striatal dysfunction and help to predict their functional decline. The present work evaluated the relationship between goal-directed action, reversal learning, and symptom profiles in those with psychosis. We assessed decision-making processes in healthy controls (N = 34) and those with persistent psychosis (N = 45), subclassifying subjects based on intact/impaired goal-directed action. Compared with healthy controls (<20%), a large proportion (58%) of those with persistent psychosis displayed impaired goal-directed action, predicting poor serial reversal learning performance. Computational approaches indicated that those with impaired goal-directed action had a decreased capacity to rapidly update their prior beliefs in the face of changing contingencies. Impaired decision-making also was associated with reduced levels of grandiosity and increased problems with abstract thinking. These findings suggest that prominent decision-making deficits, indicative of cortico-striatal dysfunction, are present in a large proportion of people with persistent psychosis. Moreover, these impairments would have significant functional implications in terms of planning and abstract thinking.
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Affiliation(s)
- Shuichi Suetani
- Queensland Centre for Mental Health Research, Brisbane, QLD, 4076, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, 4072, Australia
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, 4111, Australia
- Institute for Urban Indigenous Health, Brisbane, QLD, 4030, Australia
| | - Andrea Baker
- Queensland Centre for Mental Health Research, Brisbane, QLD, 4076, Australia
| | - Kelly Garner
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, 4072, Australia
- Centre for Human Brain Health, School of Psychology, University of Birmingham, B0121, Birmingham, UK
| | - Peter Cosgrove
- Queensland Centre for Mental Health Research, Brisbane, QLD, 4076, Australia
| | - Matilda Mackay-Sim
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia
| | - Dan Siskind
- Queensland Centre for Mental Health Research, Brisbane, QLD, 4076, Australia
- Metro South Addiction and Mental Health Services, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, University of Queensland, QLD, 4072, Brisbane, Australia
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, Brisbane, QLD, 4076, Australia
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, 4029, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia
| | - James P Kesby
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, 4072, Australia.
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia.
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Czepielewski LS, Alliende LM, Castañeda CP, Castro M, Guinjoan SM, Massuda R, Berberian AA, Fonseca AO, Gadelha A, Bressan R, Crivelaro M, Louzã M, Undurraga J, González-Valderrama A, Nachar R, Nieto RR, Montes C, Silva H, Langer ÁI, Schmidt C, Mayol-Troncoso R, Díaz-Zuluaga AM, Valencia-Echeverry J, López-Jaramillo C, Solís-Vivanco R, Reyes-Madrigal F, de la Fuente-Sandoval C, Crossley NA, Gama CS. Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects. Psychol Med 2022; 52:2177-2188. [PMID: 34158132 DOI: 10.1017/s0033291721002403] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
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Affiliation(s)
- Letícia Sanguinetti Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Psicologia, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luz Maria Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | - Carmen Paz Castañeda
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | - Mariana Castro
- Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), FLENI-CONICET Neurosciences Institute, Buenos Aires, Argentina
- Department of Psychiatry and Mental Health (Fleni Teaching Unit) and Department of Physiology, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Salvador M Guinjoan
- Department of Psychiatry and Mental Health (Fleni Teaching Unit), University of Buenos Aires School of Medicine. CONICET, Buenos Aires, Argentina
| | - Raffael Massuda
- Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | | | | | - Ary Gadelha
- Programa de Esquizofrenia, da Escola Paulista de Medicina Universidade Federal de São Paulo (PROESQ-EPM/UNIFESP). Laboratory of Integrative Neuroscience (LINC), Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Marisa Crivelaro
- PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
| | - Mario Louzã
- PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Alfonso González-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Rubén Nachar
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Rodrigo R Nieto
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cristian Montes
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Hernan Silva
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Álvaro I Langer
- Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Carlos Schmidt
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
- Brain, Cognition and Behavior PhD Program, University of Barcelona, Barcelona, Spain
| | - Rocío Mayol-Troncoso
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Ana M Díaz-Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Johanna Valencia-Echeverry
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Carlos López-Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Rodolfo Solís-Vivanco
- Laboratory of Neuropsychology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
- Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Nicolás A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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9
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Raucher-Chéné D, Pochiet G, Lavigne KM, Heinrichs RW, Malla A, Joober R, Lepage M. Normal-range verbal memory in the first-episode of psychosis: Clinical and functional outcomes across 24 months and impact of estimated verbal memory decrement. Schizophr Res 2022; 246:75-84. [PMID: 35728419 DOI: 10.1016/j.schres.2022.06.007] [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: 02/03/2022] [Revised: 05/18/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022]
Abstract
Verbal memory (VM) dysfunction is prevalent in first-episode psychosis (FEP) and has major impacts on long-term functional and clinical outcomes. Nevertheless, a substantial proportion of FEP patients have VM performance in the norm, called normal-range (NR) VM, and only a few studies have explored its relation to outcomes. Moreover, probable decrements between estimated premorbid and current cognitive performance could confuse the relationship between VM and clinical or functional outcomes in FEP patients. These potential interactions have not yet been considered in FEP, thus, we examined 1) the longitudinal relationship between VM performance (NR vs. below NR (BNR)) in FEP and clinical and functional outcomes over 24 months following admission to treatment, and 2) compared the clinical and functional status of NR patients with and without cognitive decrement at baseline and 12 months. A total of 271 patients (BNR = 114, NR = 157; 81 out of 105 NR with decrement) completed measures of psychosocial functioning and clinical symptoms at baseline, month 12, and month 24. Generalized Estimating Equations and unpaired t-tests were used to address the first and second aim, respectively. NR demonstrated better functioning and fewer negative symptoms when compared to BNR. Interestingly, NR patients with decrement reported significantly more negative symptoms at baseline compared to their counterparts without decrement. These findings document that a large proportion (57.9 %) of FEP patients have NR VM that appear to be functionally advantageous but that NR VM is nuanced by the presence or absence of a potential decrement early in the developmental course of the disorder.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France; Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France
| | - Gabrielle Pochiet
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Canada
| | - Katie M Lavigne
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Ashok Malla
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychoses (PEPP - Montreal), Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychoses (PEPP - Montreal), Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychoses (PEPP - Montreal), Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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10
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Vita A, Gaebel W, Mucci A, Sachs G, Erfurth A, Barlati S, Zanca F, Giordano GM, Birkedal Glenthøj L, Nordentoft M, Galderisi S. European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia. Eur Psychiatry 2022; 65:e58. [PMID: 36059109 PMCID: PMC9532219 DOI: 10.1192/j.eurpsy.2022.2316] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Impairment in a wide range of cognitive abilities has been consistently reported in individuals with schizophrenia. Both neurocognitive and social cognitive deficits are thought to underlie severe functional disabilities associated with schizophrenia. Despite the key role in schizophrenia outcome, cognition is still poorly assessed in both research and clinical settings. Methods In this guidance paper, we provide a systematic review of the scientific literature and elaborate several recommendations for the assessment of cognitive functions in schizophrenia both in research settings and in real-world clinical practice. Results Expert consensus and systematic reviews provided guidance for the optimal assessment of cognitive functions in schizophrenia. Based on the reviewed evidence, we recommend a comprehensive and systematic assessment of neurocognitive and social cognitive domains in schizophrenia, in all phases of the disorder, as well as in subjects at risk to develop psychosis. This European Psychiatric Association guidance recommends not only the use of observer reports but also self-reports and interview-based cognitive assessment tools. The guidance also provides a systematic review of the state of the art of assessment in the first episode of psychosis patients and in individuals at risk for psychosis. Conclusion The comprehensive review of the evidence and the recommendations might contribute to advance the field, allowing a better cognitive assessment, and avoiding overlaps with other psychopathological dimensions. The dissemination of this guidance paper may promote the development of shared guidelines concerning the assessment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to obtain recovery.
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11
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Mitelman SA, Buchsbaum MS, Vyas NS, Christian BT, Merrill BM, Buchsbaum BR, Mitelman AM, Mukherjee J, Lehrer DS. Reading abilities and dopamine D 2/D 3 receptor availability: An inverted U-shaped association in subjects with schizophrenia. BRAIN AND LANGUAGE 2021; 223:105046. [PMID: 34763166 DOI: 10.1016/j.bandl.2021.105046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
Reading impairments are prominent trait-like features of cognitive deficits in schizophrenia, predictive of overall cognitive functioning and presumably linked to dopaminergic abnormalities. To evaluate this, we used 18F-fallypride PET in 19 healthy and 21 antipsychotic-naïve schizophrenia subjects and correlated dopamine receptor binding potentials in relevant AFNI-derived regions and voxelwise with group performance on WRAT4 single-word reading subtest. Healthy subjects' scores were positively and linearly associated with D2/D3 receptor availability in the rectus, orbital and superior frontal gyri, fusiform and middle temporal gyri, as well as middle occipital gyrus and precuneus, all predominantly in the left hemisphere and previously implicated in reading, hence suggesting that higher dopamine receptor density is cognitively advantageous. This relationship was weakened in schizophrenia subjects and in contrast to healthy participants followed an inverted U-shaped curve both in the cortex and dorsal striatum, indicating restricted optimal range of dopamine D2/D3 receptor availability for cognitive performance in schizophrenia.
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Affiliation(s)
- Serge A Mitelman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Division of Child and Adolescent Psychiatry, Elmhurst Hospital Center, Elmhurst, NY, USA.
| | - Monte S Buchsbaum
- Departments of Psychiatry and Radiology, University of California San Diego, San Diego, USA; Department of Psychiatry and Human Behavior, University of California Irvine School of Medicine, Orange, CA, USA
| | - Nora S Vyas
- Kingston University London, Department of Psychology, Kingston upon Thames, Surrey, UK; Imperial College Healthcare NHS Trust, Charing Cross Hospital, Department of Nuclear Medicine, London, UK
| | - Bradley T Christian
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, USA
| | - Brian M Merrill
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Bradley R Buchsbaum
- The Rotman Research Institute, Baycrest Centre for Geriatric Care and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Jogeshwar Mukherjee
- Department of Radiological Sciences, Preclinical Imaging, University of California, Irvine School of Medicine, USA
| | - Douglas S Lehrer
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
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12
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Bonotis K, Anargyros K, Liaskopoulos N, Barlogianni AM. Evaluation of memory performance in patients with brain disorders following rTMS treatment. A systematic review. Clin Neurophysiol 2021; 135:126-153. [DOI: 10.1016/j.clinph.2021.11.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/24/2021] [Accepted: 11/29/2021] [Indexed: 12/01/2022]
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13
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Mi L, Wang L, Li X, She S, Li H, Huang H, Zhang J, Liu Y, Zhao J, Ning Y, Zheng Y. Reduction of phonetic mismatch negativity may depict illness course and predict functional outcomes in schizophrenia. J Psychiatr Res 2021; 137:290-297. [PMID: 33735719 DOI: 10.1016/j.jpsychires.2021.02.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/05/2021] [Accepted: 02/26/2021] [Indexed: 01/16/2023]
Abstract
Schizophrenia (SZ) is characterized by a series of cognitive impairments, including automatic processing impairment of basic auditory information, indexed by mismatch negativity (MMN). Existing studies mainly focus on MMN induced by deviant of single acoustic features, and relatively few studies have focused on complex acoustic stimuli, especially speech-induced MMN. Many cognitive impairments in SZ are related to speech function. Thus, the present study aimed to examine the reduction of phonetic MMN in SZ as a potential biomarker and its relationship with illness course and functional outcomes. Electroencephalogram (EEG) signals were recorded from 32 SZ and 32 healthy controls (HC) in a double oddball paradigm, with /da/ as the standard stimulus and /ba/ and /du/ as the deviant stimuli. MMN was computed for vowel and consonant deviants separately. Clinical symptoms were assessed using the Positive and Negative Symptom Rating Scale (PANSS). Illness duration and illness relapse were acquired by combining clinical interviews and electronic medical records. Functional outcomes were assessed using the Global Assessment of Functioning scale (GAF). Compared with HC, SZ showed lower amplitudes of phonetic MMN, especially for vowel deviants. In addition, the MMN amplitude of the vowel deviant was significantly correlated with illness duration, illness relapse, and functional outcomes among patients with SZ. These findings indicate that the pre-attentive automatic phonetic processing of SZ was impaired for both consonants and vowels, while the vowel processing deficit may be the key speech processing deficit in SZ, which could depict the illness course and predict the functional outcomes.
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Affiliation(s)
- Lin Mi
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Le Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Xuanzi Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Shenglin She
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Haijing Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Huiyan Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Jinfang Zhang
- School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Yi Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Jingping Zhao
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
| | - Yingjun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
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14
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Koshiyama D, Miyakoshi M, Joshi YB, Nakanishi M, Tanaka-Koshiyama K, Sprock J, Light GA. Source decomposition of the frontocentral auditory steady-state gamma band response in schizophrenia patients and healthy subjects. Psychiatry Clin Neurosci 2021; 75:172-179. [PMID: 33470494 DOI: 10.1111/pcn.13201] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 12/27/2022]
Abstract
AIM Gamma-band auditory steady-state response (ASSR) is a neurophysiologic index that is increasingly used as a translational biomarker in the development of treatments of neuropsychiatric disorders. While gamma-band ASSR is generated by distributed networks of highly interactive temporal and frontal cortical sources, the majority of human gamma-band ASSR studies using electroencephalography (EEG) highlight activity from only a single frontocentral scalp site, Fz, where responses tend to be largest and reductions in schizophrenia patients are most evident. However, no previous study has characterized the relative source contributions to Fz, which is a necessary step to improve the concordance of preclinical and clinical EEG studies. METHODS A novel method to back-project the contributions of independent cortical source components was applied to assess the independent sources and their proportional contributions to Fz as well as source-resolved responses in 432 schizophrenia patients and 294 healthy subjects. RESULTS Independent contributions of gamma-band ASSR to Fz were detected from orbitofrontal, bilateral superior/middle/inferior temporal, bilateral middle frontal, and posterior cingulate gyri in both groups. In contrast to expectations, the groups showed comparable source contribution weight to gamma-band ASSR at Fz. While gamma-band ASSR reductions at Fz were present in schizophrenia patients consistent with previous studies, no group differences in individual source-level responses to Fz were detected. CONCLUSION Small differences in multiple independent sources summate to produce scalp-level differences at Fz. The identification of independent source contributions to a single scalp sensor represents a promising methodology for measuring dissociable and homologous biomarker targets in future translational studies.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Makoto Miyakoshi
- Swartz Center for Neural Computation, University of California San Diego, La Jolla, USA
| | - Yash B Joshi
- Department of Psychiatry, University of California San Diego, La Jolla, USA.,VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, USA
| | - Masaki Nakanishi
- Swartz Center for Neural Computation, University of California San Diego, La Jolla, USA
| | | | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La Jolla, USA.,VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, USA
| | - Gregory A Light
- Department of Psychiatry, University of California San Diego, La Jolla, USA.,VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, USA
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15
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Sources of the frontocentral mismatch negativity and P3a responses in schizophrenia patients and healthy comparison subjects. Int J Psychophysiol 2021; 161:76-85. [PMID: 33453303 DOI: 10.1016/j.ijpsycho.2021.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mismatch negativity (MMN) and P3a are event-related potential measures of early auditory information processing that are increasingly used as translational biomarkers in the development of treatments for neuropsychiatric disorders. These responses are reduced in schizophrenia patients over the frontocentral scalp electrodes and are associated with important domains of cognitive and psychosocial functioning. While MMN and P3a responses are generated by a dynamic network of cortical sources distributed across the temporal and frontal brain regions, it is not clear how these sources independently contribute to MMN and P3a at the primary frontocentral scalp electrode or to abnormalities observed in schizophrenia. This study aimed to determine the independent source contributions and characterize the magnitude of impairment in source-level MMN and P3a responses in schizophrenia patients. METHODS A novel method was applied to back-project the contributions of 11 independent cortical source components to Fz, the primary scalp sensor that is used in clinical studies, in n = 589 schizophrenia patients and n = 449 healthy comparison subjects. RESULTS The groups showed comparable individual source contributions underlying both MMN and P3a responses at Fz. Source-level responses revealed an increasing magnitude of impairment in schizophrenia patients from the temporal to more frontal sources. CONCLUSIONS Schizophrenia patients have a normal architecture of source contributions that are accompanied by widespread abnormalities in source resolved mismatch and P3a responses, with more prominent deficits detected from the frontal sources. Quantification of source contributions and source-level responses accelerates clarification of the neural networks underlying MMN reduction at Fz in schizophrenia patients.
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16
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Clementz BA, Trotti RL, Pearlson GD, Keshavan MS, Gershon ES, Keedy SK, Ivleva EI, McDowell JE, Tamminga CA. Testing Psychosis Phenotypes From Bipolar-Schizophrenia Network for Intermediate Phenotypes for Clinical Application: Biotype Characteristics and Targets. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:808-818. [PMID: 32600898 DOI: 10.1016/j.bpsc.2020.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Psychiatry aspires to the molecular understanding of its disorders and, with that knowledge, to precision medicine. Research supporting such goals in the dimension of psychosis has been compromised, in part, by using phenomenology alone to estimate disease entities. To this end, we are proponents of a deep phenotyping approach in psychosis, using computational strategies to discover the most informative phenotypic fingerprint as a promising strategy to uncover mechanisms in psychosis. METHODS Doing this, the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) has used biomarkers to identify distinct subtypes of psychosis with replicable biomarker characteristics. While we have presented these entities as relevant, their potential utility in clinical practice has not yet been demonstrated. RESULTS Here we carried out an analysis of clinical features that characterize biotypes. We found that biotypes have unique and defining clinical characteristics that could be used as initial screens in the clinical and research settings. Differences in these clinical features appear to be consistent with biotype biomarker profiles, indicating a link between biological features and clinical presentation. Clinical features associated with biotypes differ from those associated with DSM diagnoses, indicating that biotypes and DSM syndromes are not redundant and are likely to yield different treatment predictions. We highlight 3 predictions based on biotype that are derived from individual biomarker features and cannot be obtained from DSM psychosis syndromes. CONCLUSIONS In the future, biotypes may prove to be useful for targeting distinct molecular, circuit, cognitive, and psychosocial therapies for improved functional outcomes.
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Affiliation(s)
- Brett A Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Rebekah L Trotti
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts
| | - Elliot S Gershon
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - Sarah K Keedy
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - Elena I Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jennifer E McDowell
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.
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17
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Abnormal Effective Connectivity Underlying Auditory Mismatch Negativity Impairments in Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:1028-1039. [PMID: 32830097 DOI: 10.1016/j.bpsc.2020.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Auditory mismatch negativity (MMN) is a translatable event-related potential biomarker, and its reduction in schizophrenia is associated with the severity of clinical symptoms. While MMN recorded at the scalp is generated by a distributed network of temporofrontal neural sources, the primary contributing sources and the dynamic interactions among sources underlying MMN impairments in schizophrenia have not been previously characterized. METHODS A novel data-driven analytic framework was applied to large cohorts of healthy comparison subjects (n = 449) and patients with schizophrenia (n = 589) to identify the independent contributing sources of MMN, characterize the patterns of effective connectivity underlying reduced MMN in patients, and explore the clinical significance of these abnormal source dynamics in schizophrenia. RESULTS A network of 11 independent contributing sources underlying MMN distributed across temporofrontal cortices was identified. Orderly shifts in peak source activity were detected in a steplike manner, starting at temporal structures and progressing across frontal brain regions. MMN reduction in patients was predominantly associated with reduced contributions from 3 frontal midline sources: orbitofrontal, anterior cingulate, and middle cingulate cortices. Patients showed increased connectivity from temporal to prefrontal regions in conjunction with decreased cross-hemispheric connectivity to prefrontal regions. The decreased connectivity strength of precentral to prefrontal regions in patients with schizophrenia was associated with greater severity of negative symptoms. CONCLUSIONS Alterations in the dynamic interactions among temporofrontal sources underlie MMN abnormalities in schizophrenia. These results advance our understanding of the neural substrates and temporal dynamics of normal and impaired information processing with novel applications for translatable biomarkers of neuropsychiatric disorders.
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