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van der Weerd N, Mulders P, Vrijsen J, van Oort J, Collard R, van Eijndhoven P, Tendolkar I. Childhood adversity, stress reactivity, and structural brain measures in stress-related/neurodevelopmental disorders, and their comorbidity: A large transdiagnostic cross-sectional study. Hum Brain Mapp 2024; 45:e70025. [PMID: 39394915 PMCID: PMC11470373 DOI: 10.1002/hbm.70025] [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: 01/05/2024] [Revised: 08/08/2024] [Accepted: 08/29/2024] [Indexed: 10/14/2024] Open
Abstract
Childhood adversity (CA), including childhood adverse life events, increases the risk for development of psychiatric disorders later in life. Both CA and psychiatric disorders are associated with structural brain changes and dysfunctional hypothalamic-pituitary-adrenal-axis. However, many studies investigated single diagnostic and single regions of interest of the brain, and did not take stress reactivity into account. We investigated associations of CA and cortisol levels with gray matter volume and cortical thickness, in a whole-brain manner. Primary analysis constituted of a transdiagnostic approach, followed by a moderation analysis to investigate the influence of diagnosis. Patients with stress-related and/or neurodevelopmental disorders and matched healthy controls underwent an magnetic resonance imaging scan, next to assessing hair cortisol levels and CA/life events. CA was reported by 62-72% of the patients versus 33% of the controls. Primary transdiagnostic linear regression analyses revealed that CA was not associated with gray matter volume, while childhood life events were associated with lower right thalamic volume. Hair cortisol was not associated with any lobe volume. None of the associations were moderated by diagnosis. In conclusion, CA is a risk factor that needs to be taken into account when investigating psychiatric disorders. Yet the relationship with structural brain changes and stress reactivity is less clear than postulated on the basis of more seed-based studies.
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Affiliation(s)
| | - Peter Mulders
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourNijmegenThe Netherlands
| | - Janna Vrijsen
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourNijmegenThe Netherlands
- Pro Persona Mental Health Care, Depression Expertise CentreNijmegenThe Netherlands
| | - Jasper van Oort
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourNijmegenThe Netherlands
| | - Rose Collard
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourNijmegenThe Netherlands
| | - Philip van Eijndhoven
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourNijmegenThe Netherlands
| | - Indira Tendolkar
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and BehaviourNijmegenThe Netherlands
- Department of Psychiatry and PsychotherapyUniversity Hospital EssenGermany
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Armio RL, Laurikainen H, Ilonen T, Walta M, Sormunen E, Tolvanen A, Salokangas RKR, Koutsouleris N, Tuominen L, Hietala J. Longitudinal study on hippocampal subfields and glucose metabolism in early psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:66. [PMID: 39085221 PMCID: PMC11291638 DOI: 10.1038/s41537-024-00475-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/11/2024] [Indexed: 08/02/2024]
Abstract
Altered hippocampal morphology and metabolic pathology, but also hippocampal circuit dysfunction, are established phenomena seen in psychotic disorders. Thus, we tested whether hippocampal subfield volume deficits link with deviations in glucose metabolism commonly seen in early psychosis, and whether the glucose parameters or subfield volumes change during follow-up period using one-year longitudinal study design of 78 first-episode psychosis patients (FEP), 48 clinical high-risk patients (CHR) and 83 controls (CTR). We also tested whether hippocampal morphology and glucose metabolism relate to clinical outcome. Hippocampus subfields were segmented with Freesurfer from 3T MRI images and parameters of glucose metabolism were determined in fasting plasma samples. Hippocampal subfield volumes were consistently lower in FEPs, and findings were more robust in non-affective psychoses, with strongest decreases in CA1, molecular layer and hippocampal tail, and in hippocampal tail of CHRs, compared to CTRs. These morphometric differences remained stable at one-year follow-up. Both non-diabetic CHRs and FEPs had worse glucose parameters compared to CTRs at baseline. We found that, insulin levels and insulin resistance increased during the follow-up period only in CHR, effect being largest in the CHRs converting to psychosis, independent of exposure to antipsychotics. The worsening of insulin resistance was associated with deterioration of function and symptoms in CHR. The smaller volume of hippocampal tail was associated with higher plasma insulin and insulin resistance in FEPs, at the one-year follow-up. Our longitudinal study supports the view that temporospatial hippocampal subfield volume deficits are stable near the onset of first psychosis, being more robust in non-affective psychoses, but less prominent in the CHR group. Specific subfield defects were related to worsening glucose metabolism during the progression of psychosis, suggesting that hippocampus is part of the circuits regulating aberrant glucose metabolism in early psychosis. Worsening of glucose metabolism in CHR group was associated with worse clinical outcome measures indicating a need for heightened clinical attention to metabolic problems already in CHR.
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Grants
- Turun Yliopistollisen Keskussairaalan Koulutus- ja Tutkimussäätiö (TYKS-säätiö)
- Alfred Kordelinin Säätiö (Alfred Kordelin Foundation)
- Finnish Cultural Foundation | Varsinais-Suomen Rahasto (Varsinais-Suomi Regional Fund)
- Suomalainen Lääkäriseura Duodecim (Finnish Medical Society Duodecim)
- Turun Yliopisto (University of Turku)
- This work was supported by funding for the VAMI-project (Turku University Hospital, state research funding, no. P3848), partly supported by EU FP7 grants (PRONIA, grant a # 602152 and METSY grant #602478). Dr. Armio received personal funding from Doctoral Programme in Clinical Research at the University of Turku, grants from State Research Funding, Turunmaa Duodecim Society, Finnish Psychiatry Research Foundation, Finnish University Society of Turku (Valto Takala Foundation), Tyks-foundation, The Finnish Medical Foundation (Maija and Matti Vaskio fund), University of Turku, The Alfred Kordelin Foundation, Finnish Cultural Foundation (Terttu Enckell fund and Ritva Helminen fund) and The Alfred Kordelin foundation. Further, Dr. Tuominen received personal grant from Sigrid Juselius and Orion research foundation and NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation.
- This work was supported by funding for the VAMI-project (Turku University Hospital, state research funding, no. P3848), partly supported by EU FP7 grants (PRONIA, grant a # 602152 and METSY grant #602478). Dr. Tuominen received personal grant from Sigrid Juselius and Orion research foundation and NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation.
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Affiliation(s)
- Reetta-Liina Armio
- PET Centre, Turku University Hospital, 20520, Turku, Finland.
- Department of Psychiatry, University of Turku, 20700, Turku, Finland.
- Department of Psychiatry, Turku University Hospital, 20520, Turku, Finland.
| | - Heikki Laurikainen
- PET Centre, Turku University Hospital, 20520, Turku, Finland
- Department of Psychiatry, University of Turku, 20700, Turku, Finland
- Department of Psychiatry, Turku University Hospital, 20520, Turku, Finland
| | - Tuula Ilonen
- Department of Psychiatry, University of Turku, 20700, Turku, Finland
| | - Maija Walta
- PET Centre, Turku University Hospital, 20520, Turku, Finland
- Department of Psychiatry, University of Turku, 20700, Turku, Finland
- Department of Psychiatry, Turku University Hospital, 20520, Turku, Finland
| | - Elina Sormunen
- PET Centre, Turku University Hospital, 20520, Turku, Finland
- Department of Psychiatry, University of Turku, 20700, Turku, Finland
- Department of Psychiatry, Turku University Hospital, 20520, Turku, Finland
| | - Arvi Tolvanen
- Department of Psychiatry, University of Turku, 20700, Turku, Finland
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, D-80336, Munich, Germany
| | - Lauri Tuominen
- Department of Psychiatry, Turku University Hospital, 20520, Turku, Finland
- The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jarmo Hietala
- PET Centre, Turku University Hospital, 20520, Turku, Finland
- Department of Psychiatry, University of Turku, 20700, Turku, Finland
- Department of Psychiatry, Turku University Hospital, 20520, Turku, Finland
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3
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Thomas M, Rakesh D, Whittle S, Sheridan M, Upthegrove R, Cropley V. The neural, stress hormone and inflammatory correlates of childhood deprivation and threat in psychosis: A systematic review. Psychoneuroendocrinology 2023; 157:106371. [PMID: 37651860 DOI: 10.1016/j.psyneuen.2023.106371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
Childhood adversity increases the risk of developing psychosis, but the biological mechanisms involved are unknown. Disaggregating early adverse experiences into core dimensions of deprivation and threat may help to elucidate these mechanisms. We therefore systematically searched the literature investigating associations between deprivation and threat, and neural, immune and stress hormone systems in individuals on the psychosis spectrum. Our search yielded 74 articles, from which we extracted and synthesized relevant findings. While study designs were heterogeneous and findings inconsistent, some trends emerged. In psychosis, deprivation tended to correlate with lower global cortical volume, and some evidence supported threat-related variation in prefrontal cortex morphology. Greater threat exposure was also associated with higher C-reactive protein, and higher and lower cortisol measures. When examined, associations in controls were less evident. Overall, findings indicate that deprivation and threat may associate with partially distinct biological mechanisms in the psychosis spectrum, and that associations may be stronger than in controls. Dimensional approaches may help disentangle the biological correlates of childhood adversity in psychosis, but more studies are needed.
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Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia.
| | - Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia; Neuroimaging Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
| | - Margaret Sheridan
- Department of Psychology & Neuroscience, University of North Carolina, United States
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, United Kingdom; Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, United Kingdom
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
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Vahermaa V, Aydogan DB, Raij T, Armio RL, Laurikainen H, Saramäki J, Suvisaari J. FreeSurfer 7 quality control: Key problem areas and importance of manual corrections. Neuroimage 2023; 279:120306. [PMID: 37541458 DOI: 10.1016/j.neuroimage.2023.120306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023] Open
Abstract
We have studied the effects of manual quality control of brain Magnetic Resonance Imaging (MRI) images processed with Freesurfer. T1 images of first episode psychosis patients (N = 60) and healthy controls (N = 41) were inspected for gray matter boundary errors. The errors were fixed, and the effects of error correction on brain volume, thickness, and surface area were measured. It is commonplace to apply quality control to Freesurfer MRI recordings to ensure that the edges of gray and white matter are detected properly, as incorrect edge detection leads to changes in variables such as volume, cortical thickness, and cortical surface area. We find that while Freesurfer v7.1.1. does regularly make mistakes in identifying the edges of cortical gray matter, correcting these errors yields limited changes in the commonly measured variables listed above. We further find that the software makes fewer gray matter boundary errors when processing female brains. The results suggest that manually correcting gray matter boundary errors may not be worthwhile due to its small effect on the measurements, with potential exceptions for studies that focus on the areas that are more commonly affected by errors: the areas around the cerebellar tentorium, paracentral lobule, and the optic nerves, specifically the horizontal segment of the middle cerebral artery.
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Affiliation(s)
- Vesa Vahermaa
- Department of Computer Science, Aalto School of Science, Aalto University, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Finland.
| | - Dogu Baran Aydogan
- A.I. Virtanen Institute for Molecular Science, University of Eastern Finland, Kuopio, Finland; Department of Neuroscience and Biomedical Engineering, Aalto School of Science, Espoo, Finland
| | - Tuukka Raij
- Department of Neuroscience and Biomedical Engineering, Aalto School of Science, Espoo, Finland; University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Jari Saramäki
- Department of Computer Science, Aalto School of Science, Aalto University, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare, Finland
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Prasad KM, Muldoon B, Theis N, Iyengar S, Keshavan MS. Multipronged investigation of morphometry and connectivity of hippocampal network in relation to risk for psychosis using ultrahigh field MRI. Schizophr Res 2023; 256:88-97. [PMID: 37196534 PMCID: PMC10363272 DOI: 10.1016/j.schres.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/10/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Abstract
Hippocampal abnormalities are associated with psychosis-risk states. Given the complexity of hippocampal anatomy, we conducted a multipronged examination of morphometry of regions connected with hippocampus, and structural covariance network (SCN) and diffusion-weighted circuitry among 27 familial high-risk (FHR) individuals who were past the highest risk for conversion to psychoses and 41 healthy controls using ultrahigh-field high-resolution 7 Tesla (7T) structural and diffusion MRI data. We obtained fractional anisotropy and diffusion streams of white matter connections and examined correspondence of diffusion streams with SCN edges. Nearly 89 % of the FHR group had an axis-I disorder including 5 with schizophrenia. Therefore, we compared the entire FHR group regardless of the diagnosis (All_FHR = 27) and FHR-without-schizophrenia (n = 22) with 41 controls in this integrative multimodal analysis. We found striking volume loss in bilateral hippocampus, particularly the head, bilateral thalamus, caudate, and prefrontal regions. All_FHR and FHR-without-SZ SCNs showed significantly lower assortativity and transitivity but higher diameter compared to controls, but FHR-without-SZ SCN differed on every graph metric compared to All_FHR suggesting disarrayed network with no hippocampal hubs. Fractional anisotropy and diffusion streams were lower in FHR suggesting white matter network impairment. White matter edges showed significantly higher correspondence with SCN edges in FHR compared to controls. These differences correlated with psychopathology and cognitive measures. Our data suggest that hippocampus may be a "neural hub" contributing to psychosis risk. Higher correspondence of white matter tracts with SCN edges suggest that shared volume loss may be more coordinated among regions within the hippocampal white matter circuitry.
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Affiliation(s)
- Konasale M Prasad
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, United States of America; VA Pittsburgh Healthcare System, Pittsburgh, PA, United States of America.
| | - Brendan Muldoon
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Nicholas Theis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
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Delavari F, Rafi H, Sandini C, Murray RJ, Latrèche C, Van De Ville D, Eliez S. Amygdala subdivisions exhibit aberrant whole-brain functional connectivity in relation to stress intolerance and psychotic symptoms in 22q11.2DS. Transl Psychiatry 2023; 13:145. [PMID: 37142582 PMCID: PMC10160125 DOI: 10.1038/s41398-023-02458-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
The amygdala is a key region in emotional regulation, which is often impaired in psychosis. However, it is unclear if amygdala dysfunction directly contributes to psychosis, or whether it contributes to psychosis through symptoms of emotional dysregulation. We studied the functional connectivity of amygdala subdivisions in patients with 22q11.2DS, a known genetic model for psychosis susceptibility. We investigated how dysmaturation of each subdivision's connectivity contributes to positive psychotic symptoms and impaired tolerance to stress in deletion carriers. Longitudinally-repeated MRI scans from 105 patients with 22q11.2DS (64 at high-risk for psychosis and 37 with impaired tolerance to stress) and 120 healthy controls between the ages of 5 to 30 years were included. We calculated seed-based whole-brain functional connectivity for amygdalar subdivisions and employed a longitudinal multivariate approach to evaluate the developmental trajectory of functional connectivity across groups. Patients with 22q11.2DS presented a multivariate pattern of decreased basolateral amygdala (BLA)-frontal connectivity alongside increased BLA-hippocampal connectivity. Moreover, associations between developmental drops in centro-medial amygdala (CMA)-frontal connectivity to both impaired tolerance to stress and positive psychotic symptoms in deletion carriers were detected. Superficial amygdala hyperconnectivity to the striatum was revealed as a specific pattern arising in patients who develop mild to moderate positive psychotic symptoms. Overall, CMA-frontal dysconnectivity was found as a mutual neurobiological substrate in both impaired tolerance to stress and psychosis, suggesting a role in prodromal dysregulation of emotions in psychosis. While BLA dysconnectivity was found to be an early finding in patients with 22q11.2DS, which contributes to impaired tolerance to stress.
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Affiliation(s)
- Farnaz Delavari
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
- Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland.
| | - Halima Rafi
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Ryan J Murray
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Caren Latrèche
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Dimitri Van De Ville
- Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva (UNIGE), Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
- Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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Charbonneau JA, Bennett JL, Chau K, Bliss-Moreau E. Reorganization in the macaque interoceptive-allostatic network following anterior cingulate cortex damage. Cereb Cortex 2023; 33:4334-4349. [PMID: 36066407 PMCID: PMC10110454 DOI: 10.1093/cercor/bhac346] [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: 06/08/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/14/2022] Open
Abstract
Accumulating evidence indicates that the adult brain is capable of significant structural change following damage-a capacity once thought to be largely limited to developing brains. To date, most existing research on adult plasticity has focused on how exteroceptive sensorimotor networks compensate for damage to preserve function. Interoceptive networks-those that represent and process sensory information about the body's internal state-are now recognized to be critical for a wide range of physiological and psychological functions from basic energy regulation to maintaining a sense of self, but the extent to which these networks remain plastic in adulthood has not been established. In this report, we used detailed histological analyses to pinpoint precise changes to gray matter volume in the interoceptive-allostatic network in adult rhesus monkeys (Macaca mulatta) who received neurotoxic lesions of the anterior cingulate cortex (ACC) and neurologically intact control monkeys. Relative to controls, monkeys with ACC lesions had significant and selective unilateral expansion of the ventral anterior insula and significant relative bilateral expansion of the lateral nucleus of the amygdala. This work demonstrates the capacity for neuroplasticity in the interoceptive-allostatic network which, given that changes included expansion rather than atrophy, is likely to represent an adaptive response following damage.
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Affiliation(s)
- Joey A Charbonneau
- Neuroscience Graduate Program, University of California Davis, 1544 Newton Court, Davis, CA 95618, United States
- California National Primate Research Center, University of California Davis, One Shields Avenue, Davis, CA 95616, United States
| | - Jeffrey L Bennett
- California National Primate Research Center, University of California Davis, One Shields Avenue, Davis, CA 95616, United States
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, 2230 Stockton Blvd, Sacramento, CA 95817, United States
- The MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA 95817, United States
| | - Kevin Chau
- California National Primate Research Center, University of California Davis, One Shields Avenue, Davis, CA 95616, United States
| | - Eliza Bliss-Moreau
- California National Primate Research Center, University of California Davis, One Shields Avenue, Davis, CA 95616, United States
- Department of Psychology, University of California Davis, 135 Young Hall One Shields Avenue, Davis, CA 95616, United States
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Ballerini A, Tondelli M, Talami F, Molinari MA, Micalizzi E, Giovannini G, Turchi G, Malagoli M, Genovese M, Meletti S, Vaudano AE. Amygdala subnuclear volumes in temporal lobe epilepsy with hippocampal sclerosis and in non-lesional patients. Brain Commun 2022; 4:fcac225. [PMID: 36213310 PMCID: PMC9536297 DOI: 10.1093/braincomms/fcac225] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/12/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Together with hippocampus, the amygdala is important in the epileptogenic network of patients with temporal lobe epilepsy. Recently, an increase in amygdala volumes (i.e. amygdala enlargement) has been proposed as morphological biomarker of a subtype of temporal lobe epilepsy patients without MRI abnormalities, although other data suggest that this finding might be unspecific and not exclusive to temporal lobe epilepsy. In these studies, the amygdala is treated as a single entity, while instead it is composed of different nuclei, each with peculiar function and connection. By adopting a recently developed methodology of amygdala's subnuclei parcellation based of high-resolution T1-weighted image, this study aims to map specific amygdalar subnuclei participation in temporal lobe epilepsy due to hippocampal sclerosis (n = 24) and non-lesional temporal lobe epilepsy (n = 24) with respect to patients with focal extratemporal lobe epilepsies (n = 20) and healthy controls (n = 30). The volumes of amygdala subnuclei were compared between groups adopting multivariate analyses of covariance and correlated with clinical variables. Additionally, a logistic regression analysis on the nuclei resulting statistically different across groups was performed. Compared with other populations, temporal lobe epilepsy with hippocampal sclerosis showed a significant atrophy of the whole amygdala (p Bonferroni = 0.040), particularly the basolateral complex (p Bonferroni = 0.033), while the non-lesional temporal lobe epilepsy group demonstrated an isolated hypertrophy of the medial nucleus (p Bonferroni = 0.012). In both scenarios, the involved amygdala was ipsilateral to the epileptic focus. The medial nucleus demonstrated a volume increase even in extratemporal lobe epilepsies although contralateral to the seizure onset hemisphere (p Bonferroni = 0.037). Non-lesional patients with psychiatric comorbidities showed a larger ipsilateral lateral nucleus compared with those without psychiatric disorders. This exploratory study corroborates the involvement of the amygdala in temporal lobe epilepsy, particularly in mesial temporal lobe epilepsy and suggests a different amygdala subnuclei engagement depending on the aetiology and lateralization of epilepsy. Furthermore, the logistic regression analysis indicated that the basolateral complex and the medial nucleus of amygdala can be helpful to differentiate temporal lobe epilepsy with hippocampal sclerosis and with MRI negative, respectively, versus controls with a consequent potential clinical yield. Finally, the present results contribute to the literature about the amygdala enlargement in temporal lobe epilepsy, suggesting that the increased volume of amygdala can be regarded as epilepsy-related structural changes common across different syndromes whose meaning should be clarified.
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Affiliation(s)
- Alice Ballerini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | | | - Francesca Talami
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
| | | | - Elisa Micalizzi
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Giada Giovannini
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Giulia Turchi
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
| | | | | | - Stefano Meletti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy
- Neurology Unit, OCB Hospital, AOU Modena, Modena 41126, Italy
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9
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Walta M, Laurikainen H, Armio RL, From T, Tolvanen A, Salokangas RKR, Hietala J. Selection bias in clinical studies of first-episode psychosis: A follow-up study. Schizophr Res 2022; 246:235-240. [PMID: 35839535 DOI: 10.1016/j.schres.2022.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 05/18/2022] [Accepted: 06/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Selection bias is a concern in studies on psychotic disorders due to high dropout rates and many eligibility criteria for inclusion. We studied how representative the first-episode psychosis study sample in the Turku Early Psychosis Study (TEPS) was. METHODS We screened 3772 consecutive admissions to the clinical psychiatric services of Turku Psychiatry, Finland, between October 2011 and June 2016. A total of 193 subjects had first-episode psychosis and were suitable for TEPS. Out of 193 subjects, 101 participated (PA) and 92 did not participate (NPA) in TEPS due to refusal or contact problems. We retrospectively used patient register data to study whether NPA and PA groups differed in terms of clinical outcomes during 1-year follow-up. RESULTS In overall sample, the NPA group had a significantly higher rate of discontinuation of clinical treatment than the PA group (48.9 % vs 29.7 %, p = 0.01). In the hospital-treated subsample chi-square tests did not indicate statistically significant differences between the NPA and PA groups in the rate of involuntary care (69.7 % vs 62.7 %, p = 0.34), coercive measures (36.0 % vs 22.7 %, p = 0.06), and readmissions during the follow-up (41.5 % vs 33.8 %, p = 0.31), respectively. CONCLUSION The differences in clinical outcomes and treatment characteristics in the non-participating and participating groups were relatively modest. The results do not support a major sample selection bias that would complicate the interpretation of results in this first-episode psychosis study.
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Affiliation(s)
- Maija Walta
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland; Psychiatry Services, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Psychiatric Services, Turku City, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland.
| | - Heikki Laurikainen
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland; Psychiatry Services, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Reetta-Liina Armio
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland; Psychiatry Services, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Tiina From
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland
| | - Arvi Tolvanen
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland
| | - Raimo K R Salokangas
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland; Psychiatry Services, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Psychiatric Services, Turku City, Kunnallissairaalantie 20, Building 9, 20700 Turku, Finland
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10
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Ohi K, Ishibashi M, Torii K, Hashimoto M, Yano Y, Shioiri T. Differences in subcortical brain volumes among patients with schizophrenia and bipolar disorder and healthy controls. J Psychiatry Neurosci 2022; 47:E77-E85. [PMID: 35232800 PMCID: PMC8896343 DOI: 10.1503/jpn.210144] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/09/2021] [Accepted: 10/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Patients with schizophrenia and bipolar disorder have an overlapping polygenic architecture and clinical similarities, although the 2 disorders are distinct diagnoses with clinical dissimilarities. It remains unclear whether there are specific differences in subcortical volumes between schizophrenia and bipolar disorder, and whether the subcortical differences are affected by any clinical characteristics. We investigated differences in subcortical volumes bilaterally among patients with schizophrenia, patients with bipolar disorder and healthy controls. We also investigated the influences of clinical characteristics on specific subcortical volumes in these patient groups. METHODS We collected 3 T T 1-weighted MRI brain scans from 413 participants (157 with schizophrenia, 51 with bipolar disorder and 205 controls) with a single scanner at a single institute. We used FreeSurfer version 6.0 for processing the T 1-weighted images to segment the following subcortical brain volumes: thalamus, caudate, putamen, globus pallidus, hippocampus, amygdala and nucleus accumbens. Differences in the 7 subcortical volumes were investigated among the groups. We also evaluated correlations between subcortical volumes and clinical variables in these patient groups. RESULTS Of 7 subcortical regions, patients with schizophrenia had significantly smaller volumes in the left thalamus (Cohen d = -0.29, p = 5.83 × 10-3), bilateral hippocampi (left, d = -0.36, p = 8.85 × 10-4; right, d = -0.41, p = 1.15 × 10-4) and left amygdala (d = -0.31, p = 4.02 × 10-3) than controls. Compared with controls, patients with bipolar disorder had bilateral reductions only in the hippocampal volumes (left, d = -0.52, p = 1.12 × 10-3; right, d = -0.58, p = 0.30 × 10-4). We also found that patients with schizophrenia had significantly smaller volumes in the bilateral amygdalae (left, d = -0.43, p = 4.22 × 10-3; right, d = -0.45, p = 4.56 × 10-3) than patients with bipolar disorder. We did not find any significant volumetric differences in the other 6 subcortical structures between patient groups (p > 0.05). Smaller left amygdalar volumes were significantly correlated with younger onset age only in patients with schizophrenia (r = 0.22, p = 5.78 × 10-3). LIMITATIONS We did not evaluate the differences in subcortical volumes between patients stratified based on clinical bipolar disorder subtype and a history of psychotic episodes because our sample size of patients with bipolar disorder was limited. CONCLUSION Our findings suggest that volumetric differences in the amygdala between patients with schizophrenia and those with bipolar disorder may be a putative biomarker for distinguishing 2 clinically similar diagnoses.
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Affiliation(s)
- Kazutaka Ohi
- From the Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan (Ohi, Shioiri); the Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan (Ohi); and the School of Medicine, Gifu University, Gifu, Japan (Ishibashi, Torii, Hashimoto, Yano)
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11
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Impairment in acquisition of conditioned fear in schizophrenia. Neuropsychopharmacology 2022; 47:681-686. [PMID: 34588608 PMCID: PMC8782847 DOI: 10.1038/s41386-021-01193-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 02/08/2023]
Abstract
Individuals with schizophrenia show impairments in associative learning. One well-studied, quantifiable form of associative learning is Pavlovian fear conditioning. However, to date, studies of fear conditioning in schizophrenia have been inconclusive, possibly because they lacked sufficient power. To address this issue, we pooled data from four independent fear conditioning studies that included a total of 77 individuals with schizophrenia and 74 control subjects. Skin conductance responses (SCRs) to stimuli that were paired (the CS + ) or not paired (CS-) with an aversive, unconditioned stimulus were measured, and the success of acquisition of differential conditioning (the magnitude of CS + vs. CS- SCRs) and responses to CS + and CS- separately were assessed. We found that acquisition of differential conditioned fear responses was significantly lower in individuals with schizophrenia than in healthy controls (Cohen's d = 0.53). This effect was primarily related to a significantly higher response to the CS- stimulus in the schizophrenia compared to the control group. Moreover, the magnitude of this response to the CS- in the schizophrenia group was correlated with the severity of delusional ideation (p = 0.006). Other symptoms or antipsychotic dose were not associated with fear conditioning measures. In conclusion, individuals with schizophrenia who endorse delusional beliefs may be over-responsive to neutral stimuli during fear conditioning. This finding is consistent with prior models of abnormal associative learning in psychosis.
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12
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Moreau I, Hébert M, Maziade M, Painchaud A, Mérette C. The Electroretinogram as a Potential Biomarker of Psychosis in Children at Familial Risk. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac016. [PMID: 39144760 PMCID: PMC11206048 DOI: 10.1093/schizbullopen/sgac016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
We previously proposed the electroretinogram (ERG) as a promising biomarker of major psychiatric disorders such as schizophrenia (SZ) and bipolar disorder (BP), given that we found anomalies in the ERG parameters of patients with these diagnoses as well as in their children who are at high risk (HR) of developing such disorders. The aim of the present study is to investigate the usefulness of the ERG for individual detection, among HR children, of an ERG profile resembling that of a SZ patient, as this may indicate a stronger likelihood of transition to psychosis. Using a logistic regression model previously derived from the ERG assessments of SZ patients and control (CT) subjects, individual risk scores were obtained for 61 HR and 80 CT youth. Those with a very high individual risk score were classified as "schizophrenia-like" (SZ-like). We found that the HR subjects were 3.5 times more likely to be classified as SZ-like than the CT subjects (95% CI [1.1-11.8]). Furthermore, among the HR subjects, we studied the relationship between the SZ-like classification and psychotic-like experiences and found that HR subjects classified as SZ-like were 2.7 times more likely than all remaining HR subjects to have experienced psychotic-like symptoms (95% CI [1.3-4.6]), and 6.8 times more likely than those with a very low individual risk score (95% CI [1.4-40.4]). Our results suggest that a model previously derived from ERG data on SZ patients could be a potential tool for early detection of the susceptibility to a psychotic-like disorder among familial HR children.
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Affiliation(s)
- Isabel Moreau
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département d’informatique et de génie logiciel, Université Laval, Québec, QC, Canada
| | - Marc Hébert
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département d’ophtalmologie et oto-rhino-laryngologie – chirurgie cervico-faciale, Université Laval, Québec, QC, Canada
| | - Michel Maziade
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Québec, QC, Canada
| | - Alexandra Painchaud
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Québec, QC, Canada
| | - Chantal Mérette
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Québec, QC, Canada
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13
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Evermann U, Gaser C, Meller T, Pfarr J, Grezellschak S, Nenadić I. Nonclinical psychotic-like experiences and schizotypy dimensions: Associations with hippocampal subfield and amygdala volumes. Hum Brain Mapp 2021; 42:5075-5088. [PMID: 34302409 PMCID: PMC8449098 DOI: 10.1002/hbm.25601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022] Open
Abstract
Schizotypy and psychotic-like experiences (PLE) form part of the wider psychosis continuum and may have brain structural correlates in nonclinical cohorts. This study aimed to compare the effects of differential schizotypy dimensions, PLE, and their interaction on hippocampal subfields and amygdala volumes in the absence of clinical psychopathology. In a cohort of 367 psychiatrically healthy individuals, we assessed schizotypal traits using the Oxford-Liverpool Inventory of Life Experiences (O-LIFE) and PLE using the short form of the Prodromal Questionnaire (PQ-16). Based on high-resolution structural MRI scans, we used automated segmentation to estimate volumes of limbic structures. Sex and total intracranial volume (Step 1), PLE and schizotypy dimensions (Step 2), and their interaction terms (Step 3) were entered as regressors for bilateral amygdala and hippocampal subfield volumes in hierarchical multiple linear regression models. Positive schizotypy, but not PLE, was negatively associated with left amygdala and subiculum volumes. O-LIFE Impulsive Nonconformity, as well as the two-way interaction between positive schizotypy and PLE, were associated with larger left subiculum volumes. None of the estimators for right hemispheric hippocampal subfield volumes survived correction for multiple comparisons. Our findings support differential associations of hippocampus subfield volumes with trait dimensions rather than PLE, and support overlap and interactions between psychometric positive schizotypy and PLE. In a healthy cohort without current psychosis risk syndromes, the positive association between PLE and hippocampal subfield volume occurred at a high expression of positive schizotypy. Further studies combining stable, transient, and genetic parameters are required.
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Affiliation(s)
- Ulrika Evermann
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and PsychotherapyPhilipps‐Universität MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)MarburgGermany
| | - Christian Gaser
- Department of Psychiatry and PsychotherapyJena University HospitalJenaGermany
- Department of NeurologyJena University HospitalJenaGermany
| | - Tina Meller
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and PsychotherapyPhilipps‐Universität MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)MarburgGermany
| | - Julia‐Katharina Pfarr
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and PsychotherapyPhilipps‐Universität MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)MarburgGermany
| | - Sarah Grezellschak
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and PsychotherapyPhilipps‐Universität MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)MarburgGermany
- Marburg University HospitalUKGMMarburgGermany
| | - Igor Nenadić
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and PsychotherapyPhilipps‐Universität MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)MarburgGermany
- Marburg University HospitalUKGMMarburgGermany
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14
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Schmitz-Koep B, Zimmermann J, Menegaux A, Nuttall R, Bäuml JG, Schneider SC, Daamen M, Boecker H, Zimmer C, Wolke D, Bartmann P, Hedderich DM, Sorg C. Within amygdala: Basolateral parts are selectively impaired in premature-born adults. Neuroimage Clin 2021; 31:102780. [PMID: 34391140 PMCID: PMC8374486 DOI: 10.1016/j.nicl.2021.102780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/14/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022]
Abstract
While it is known that whole amygdala volume is lastingly reduced after premature birth, it is unknown whether different amygdala nuclei are distinctively affected by prematurity. This question is motivated by two points: First, the observation that developmental trajectories of superficial, centromedial and basolateral amygdala nuclei are different. And second, the expectation that these different developmental pathways are distinctively affected by prematurity. Furthermore, we stated the question whether alterations in amygdala nuclei are associated with increased adults' anxiety traits after premature birth. We investigated 101 very premature-born adults (<32 weeks of gestation and/or birth weight below 1500 g) and 108 full-term controls of a prospectively and longitudinally collected cohort at 26 years of age using automated amygdala nuclei segmentation based on structural MRI. We found selectively reduced volumes of bilateral accessory basal nuclei (pertaining to the basolateral amygdala of claustral developmental trajectory) adjusted for whole amygdala volume. Volumes of bilateral accessory basal nuclei were positively associated with gestational age and negatively associated with duration of ventilation. Furthermore, structural covariance within the basolateral amygdala was increased in premature-born adults. We did not find an association between reduced volumes of basolateral amygdala and increased social anxiety in the prematurity group. These results demonstrate specifically altered basolateral amygdala structure in premature-born adults. Data suggest that prematurity has distinct effects on amygdala nuclei.
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Affiliation(s)
- Benita Schmitz-Koep
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany.
| | - Juliana Zimmermann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Aurore Menegaux
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Rachel Nuttall
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Josef G Bäuml
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Sebastian C Schneider
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Marcel Daamen
- Functional Neuroimaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany; Department of Neonatology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, United Kingdom; Warwick Medical School, University of Warwick, University Road, Coventry CV4 7AL, United Kingdom
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany
| | - Dennis M Hedderich
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Christian Sorg
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; TUM-NIC Neuroimaging Center, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany; Department of Psychiatry, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
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15
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Barth C, Nerland S, de Lange AMG, Wortinger LA, Hilland E, Andreassen OA, Jørgensen KN, Agartz I. In Vivo Amygdala Nuclei Volumes in Schizophrenia and Bipolar Disorders. Schizophr Bull 2021; 47:1431-1441. [PMID: 33479754 PMCID: PMC8379533 DOI: 10.1093/schbul/sbaa192] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abnormalities in amygdala volume are well-established in schizophrenia and commonly reported in bipolar disorders. However, the specificity of volumetric differences in individual amygdala nuclei is largely unknown. Patients with schizophrenia disorders (SCZ, N = 452, mean age 30.7 ± 9.2 [SD] years, females 44.4%), bipolar disorders (BP, N = 316, 33.7 ± 11.4, 58.5%), and healthy controls (N = 753, 34.1 ± 9.1, 40.9%) underwent T1-weighted magnetic resonance imaging. Total amygdala, nuclei, and intracranial volume (ICV) were estimated with Freesurfer (v6.0.0). Analysis of covariance and multiple linear regression models, adjusting for age, age2, ICV, and sex, were fitted to examine diagnostic group and subgroup differences in volume, respectively. Bilateral total amygdala and all nuclei volumes, except the medial and central nuclei, were significantly smaller in patients relative to controls. The largest effect sizes were found for the basal nucleus, accessory basal nucleus, and cortico-amygdaloid transition area (partial η2 > 0.02). The diagnostic subgroup analysis showed that reductions in amygdala nuclei volume were most widespread in schizophrenia, with the lateral, cortical, paralaminar, and central nuclei being solely reduced in this disorder. The right accessory basal nucleus was marginally smaller in SCZ relative to BP (t = 2.32, P = .05). Our study is the first to demonstrate distinct patterns of amygdala nuclei volume reductions in a well-powered sample of patients with schizophrenia and bipolar disorders. Volume differences in the basolateral complex (lateral, basal, and accessory basal nuclei), an integral part of the threat processing circuitry, were most prominent in schizophrenia.
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Affiliation(s)
- Claudia Barth
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway,To whom correspondence should be addressed; tel: +47 22 02 99 67, fax: +47 22 02 99 01, e-mail:
| | - Stener Nerland
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ann-Marie G de Lange
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatry, University of Oxford, Oxford, UK,Department of Psychology, University of Oslo, Oslo, Norway
| | - Laura A Wortinger
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Eva Hilland
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kjetil N Jørgensen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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