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Alonso-Sanchez MF, Z-Rivera L, Otero M, Portal J, Cavieres Á, Alfaro-Faccio P. Aberrant brain language network in schizophrenia spectrum disorder: a systematic review of its relation to language signs beyond symptoms. Front Psychiatry 2024; 15:1244694. [PMID: 39026525 PMCID: PMC11254709 DOI: 10.3389/fpsyt.2024.1244694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/07/2024] [Indexed: 07/20/2024] Open
Abstract
Background Language disturbances are a core feature of schizophrenia, often studied as a formal thought disorder. The neurobiology of language in schizophrenia has been addressed within the same framework, that language and thought are equivalents considering symptoms and not signs. This review aims to systematically examine published peer-reviewed studies that employed neuroimaging techniques to investigate aberrant brain-language networks in individuals with schizophrenia in relation to linguistic signs. Methods We employed a language model for automatic data extraction. We selected our studies according to the PRISMA recommendations, and we conducted the quality assessment of the selected studies according to the STROBE guidance. Results We analyzed the findings from 37 studies, categorizing them based on patient characteristics, brain measures, and language task types. The inferior frontal gyrus (IFG) and superior temporal gyrus (STG) exhibited the most significant differences among these studies and paradigms. Conclusions We propose guidelines for future research in this field based on our analysis. It is crucial to investigate larger networks involved in language processing, and language models with brain metrics must be integrated to enhance our understanding of the relationship between language and brain abnormalities in schizophrenia.
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Affiliation(s)
- María F. Alonso-Sanchez
- Escuela de Fonoaudiología, Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Facultad de Medicina, Universidad de Valparaíso, Viña del Mar, Chile
| | - Lucía Z-Rivera
- Advanced Center for Electrical and Electronic Engineering (AC3E), Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Mónica Otero
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad San Sebastián, Santiago de Chile, Chile
- Centro BASAL Ciencia & Vida, Universidad San Sebastián, Santiago de Chile, Chile
| | - Jorge Portal
- Advanced Center for Electrical and Electronic Engineering (AC3E), Universidad Técnica Federico Santa María, Valparaíso, Chile
- Departamento de Electrónica, Univeridad Técnica Federico Santa María (USM), Valparaíso, Chile
| | - Álvaro Cavieres
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Pedro Alfaro-Faccio
- Instituto de Literatura y Ciencias del Lenguaje, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Zou T, Li L, Huang X, Deng C, Wang X, Gao Q, Chen H, Li R. Dynamic causal modeling analysis reveals the modulation of motor cortex and integration in superior temporal gyrus during multisensory speech perception. Cogn Neurodyn 2024; 18:931-946. [PMID: 38826672 PMCID: PMC11143173 DOI: 10.1007/s11571-023-09945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
The processing of speech information from various sensory modalities is crucial for human communication. Both left posterior superior temporal gyrus (pSTG) and motor cortex importantly involve in the multisensory speech perception. However, the dynamic integration of primary sensory regions to pSTG and the motor cortex remain unclear. Here, we implemented a behavioral experiment of classical McGurk effect paradigm and acquired the task functional magnetic resonance imaging (fMRI) data during synchronized audiovisual syllabic perception from 63 normal adults. We conducted dynamic causal modeling (DCM) analysis to explore the cross-modal interactions among the left pSTG, left precentral gyrus (PrG), left middle superior temporal gyrus (mSTG), and left fusiform gyrus (FuG). Bayesian model selection favored a winning model that included modulations of connections to PrG (mSTG → PrG, FuG → PrG), from PrG (PrG → mSTG, PrG → FuG), and to pSTG (mSTG → pSTG, FuG → pSTG). Moreover, the coupling strength of the above connections correlated with behavioral McGurk susceptibility. In addition, significant differences were found in the coupling strength of these connections between strong and weak McGurk perceivers. Strong perceivers modulated less inhibitory visual influence, allowed less excitatory auditory information flowing into PrG, but integrated more audiovisual information in pSTG. Taken together, our findings show that the PrG and pSTG interact dynamically with primary cortices during audiovisual speech, and support the motor cortex plays a specifically functional role in modulating the gain and salience between auditory and visual modalities. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-023-09945-z.
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Affiliation(s)
- Ting Zou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Liyuan Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Xinju Huang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Chijun Deng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Xuyang Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Qing Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
| | - Rong Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 People’s Republic of China
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Schott BH, Soch J, Kizilirmak JM, Schütze H, Assmann A, Maass A, Ziegler G, Sauvage M, Richter A. Inhibitory temporo-parietal effective connectivity is associated with explicit memory performance in older adults. iScience 2023; 26:107765. [PMID: 37744028 PMCID: PMC10514462 DOI: 10.1016/j.isci.2023.107765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/30/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Successful explicit memory encoding is associated with inferior temporal activations and medial parietal deactivations, which are attenuated in aging. Here we used dynamic causal modeling (DCM) of functional magnetic resonance imaging data to elucidate effective connectivity patterns between hippocampus, parahippocampal place area (PPA), and precuneus during encoding of novel visual scenes. In 117 young adults, DCM revealed pronounced activating input from the PPA to the hippocampus and inhibitory connectivity from the PPA to the precuneus during novelty processing, with both being enhanced during successful encoding. This pattern could be replicated in two cohorts (N = 141 and 148) of young and older adults. In both cohorts, older adults selectively exhibited attenuated inhibitory PPA-precuneus connectivity, which correlated negatively with memory performance. Our results provide insight into the network dynamics underlying explicit memory encoding and suggest that age-related differences in memory-related network activity are, at least partly, attributable to altered temporo-parietal neocortical connectivity.
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Affiliation(s)
- Björn H. Schott
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Leibniz Institute for Neurobiology (LIN), Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Joram Soch
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Bernstein Center for Computational Neuroscience (BCCN), Berlin, Germany
| | - Jasmin M. Kizilirmak
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Neurodidactics and NeuroLab, Institute for Psychology, University of Hildesheim, Hildesheim, Germany
| | - Hartmut Schütze
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Otto von Guericke University, Medical Faculty, Magdeburg, Germany
| | - Anne Assmann
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Otto von Guericke University, Medical Faculty, Magdeburg, Germany
| | - Anne Maass
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Gabriel Ziegler
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Otto von Guericke University, Medical Faculty, Magdeburg, Germany
| | | | - Anni Richter
- Leibniz Institute for Neurobiology (LIN), Magdeburg, Germany
- German Center for Mental Health (DZPG), Magdeburg, Germany
- Center for Intervention and Research on adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C) Jena-Magdeburg-Halle, Magdeburg, Germany
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Cai XL, Pu CC, Zhou SZ, Wang Y, Huang J, Lui SSY, Møller A, Cheung EFC, Madsen KH, Xue R, Yu X, Chan RCK. Anterior cingulate glutamate levels associate with functional activation and connectivity during sensory integration in schizophrenia: a multimodal 1H-MRS and fMRI study. Psychol Med 2023; 53:4904-4914. [PMID: 35791929 DOI: 10.1017/s0033291722001817] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND Glutamatergic dysfunction has been implicated in sensory integration deficits in schizophrenia, yet how glutamatergic function contributes to behavioural impairments and neural activities of sensory integration remains unknown. METHODS Fifty schizophrenia patients and 43 healthy controls completed behavioural assessments for sensory integration and underwent magnetic resonance spectroscopy (MRS) for measuring the anterior cingulate cortex (ACC) glutamate levels. The correlation between glutamate levels and behavioural sensory integration deficits was examined in each group. A subsample of 20 pairs of patients and controls further completed an audiovisual sensory integration functional magnetic resonance imaging (fMRI) task. Blood Oxygenation Level Dependent (BOLD) activation and task-dependent functional connectivity (FC) were assessed based on fMRI data. Full factorial analyses were performed to examine the Group-by-Glutamate Level interaction effects on fMRI measurements (group differences in correlation between glutamate levels and fMRI measurements) and the correlation between glutamate levels and fMRI measurements within each group. RESULTS We found that schizophrenia patients exhibited impaired sensory integration which was positively correlated with ACC glutamate levels. Multimodal analyses showed significantly Group-by-Glutamate Level interaction effects on BOLD activation as well as task-dependent FC in a 'cortico-subcortical-cortical' network (including medial frontal gyrus, precuneus, ACC, middle cingulate gyrus, thalamus and caudate) with positive correlations in patients and negative in controls. CONCLUSIONS Our findings indicate that ACC glutamate influences neural activities in a large-scale network during sensory integration, but the effects have opposite directionality between schizophrenia patients and healthy people. This implicates the crucial role of glutamatergic system in sensory integration processing in schizophrenia.
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Affiliation(s)
- Xin-Lu Cai
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
- Sino-Danish Centre for Education and Research, Beijing, China
| | - Cheng-Cheng Pu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shu-Zhe Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Arne Møller
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
- Sino-Danish Centre for Education and Research, Beijing, China
- Centre of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Kristoffer H Madsen
- Sino-Danish Centre for Education and Research, Beijing, China
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Rong Xue
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
- Sino-Danish Centre for Education and Research, Beijing, China
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Brain Disorders, Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
- Sino-Danish Centre for Education and Research, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Department of Diagnostic Radiology, the University of Hong Kong, Hong Kong Special Administrative Region, China
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Ghaneirad E, Saenger E, Szycik GR, Čuš A, Möde L, Sinke C, Wiswede D, Bleich S, Borgolte A. Deficient Audiovisual Speech Perception in Schizophrenia: An ERP Study. Brain Sci 2023; 13:970. [PMID: 37371448 DOI: 10.3390/brainsci13060970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
In everyday verbal communication, auditory speech perception is often disturbed by background noise. Especially in disadvantageous hearing conditions, additional visual articulatory information (e.g., lip movement) can positively contribute to speech comprehension. Patients with schizophrenia (SZs) demonstrate an aberrant ability to integrate visual and auditory sensory input during speech perception. Current findings about underlying neural mechanisms of this deficit are inconsistent. Particularly and despite the importance of early sensory processing in speech perception, very few studies have addressed these processes in SZs. Thus, in the present study, we examined 20 adult subjects with SZ and 21 healthy controls (HCs) while presenting audiovisual spoken words (disyllabic nouns) either superimposed by white noise (-12 dB signal-to-noise ratio) or not. In addition to behavioral data, event-related brain potentials (ERPs) were recorded. Our results demonstrate reduced speech comprehension for SZs compared to HCs under noisy conditions. Moreover, we found altered N1 amplitudes in SZ during speech perception, while P2 amplitudes and the N1-P2 complex were similar to HCs, indicating that there may be disturbances in multimodal speech perception at an early stage of processing, which may be due to deficits in auditory speech perception. Moreover, a positive relationship between fronto-central N1 amplitudes and the positive subscale of the Positive and Negative Syndrome Scale (PANSS) has been observed.
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Affiliation(s)
- Erfan Ghaneirad
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
| | - Ellyn Saenger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
| | - Gregor R Szycik
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
| | - Anja Čuš
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
| | - Laura Möde
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
| | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
| | - Daniel Wiswede
- Department of Neurology, University of Lübeck, 23562 Lübeck, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
- Center for Systems Neuroscience, University of Veterinary Medicine, 30559 Hanover, Germany
| | - Anna Borgolte
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hanover, Germany
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Lozano-Goupil J, Raffard S, Capdevielle D, Aigoin E, Marin L. Gesture-speech synchrony in schizophrenia: A pilot study using a kinematic-acoustic analysis. Neuropsychologia 2022; 174:108347. [PMID: 35970254 DOI: 10.1016/j.neuropsychologia.2022.108347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/30/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
Severe impairment of social functioning is the core feature of schizophrenia that persists despite treatment, and contributes to chronic functional disability. Abnormal non-verbal behaviors have been reported during interpersonal interactions but the temporal coordination of co-speech gestures with language abilities have been poorly studied to date in this pathology. Using the dynamical systems framework, the goal of the current study was to investigate whether gestures and speech synchrony is impaired in schizophrenia, exploring a new approach to report communicational skill disorders. Performing the first continuous kinematic-acoustic analysis in individuals with schizophrenia, we examined gesture-speech synchrony in solo spontaneous speech and in sensorimotor synchronization task. The experimental group consisted of twenty-eight participants with a diagnosis of schizophrenia and the control group consisted of twenty-four healthy participants age-gender-education matched. The results showed that spontaneous gesture-speech synchrony was preserved while intentional finger tapping-speech synchrony was impaired. In sensorimotor synchronization task, the schizophrenia group displayed greater asynchronies between finger tapping and syllable uttering and lower stability of coordination patterns. These findings suggest a specific deficit in time delay of information circulation and processing, especially in explicit functions. Thus, investigating intrapersonal coordination in schizophrenia may constitute a promising window into brain/behavior dynamic relationship.
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Affiliation(s)
- Juliette Lozano-Goupil
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France.
| | - Stéphane Raffard
- Univ Paul Valéry Montpellier 3, EPSYLON EA, 4556, Montpellier, France; University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France
| | | | - Emilie Aigoin
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Ludovic Marin
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
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Morese R, Brasso C, Stanziano M, Parola A, Valentini MC, Bosco FM, Rocca P. Efforts for the Correct Comprehension of Deceitful and Ironic Communicative Intentions in Schizophrenia: A Functional Magnetic Resonance Imaging Study on the Role of the Left Middle Temporal Gyrus. Front Psychol 2022; 13:866160. [PMID: 35774960 PMCID: PMC9237627 DOI: 10.3389/fpsyg.2022.866160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Deficits in social cognition and more specifically in communication have an important impact on the real-life functioning of people with schizophrenia (SZ). In particular, patients have severe problems in communicative-pragmatics, for example, in correctly inferring the speaker's communicative intention in everyday conversational interactions. This limit is associated with morphological and functional alteration of the left middle temporal gyrus (L-MTG), a cerebral area involved in various communicative processes, in particular in the distinction of ironic communicative intention from sincere and deceitful ones. We performed an fMRI study on 20 patients with SZ and 20 matched healthy controls (HCs) while performing a pragmatic task testing the comprehension of sincere, deceitful, and ironic communicative intentions. We considered the L-MTG as the region of interest. SZ patients showed difficulties in the correct comprehension of all types of communicative intentions and, when correctly answering to the task, they exhibited a higher activation of the L-MTG, as compared to HC, under all experimental conditions. This greater involvement of the L-MTG in the group of patients could depend on different factors, such as the increasing inferential effort required in correctly understanding the speaker's communicative intentions, and the higher integrative semantic processes involved in sentence processing. Future studies with a larger sample size and functional connectivity analysis are needed to study deeper the specific role of the L-MTG in pragmatic processes in SZ, also in relation to other brain areas.
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Affiliation(s)
- R. Morese
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - C. Brasso
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
- Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
| | - M. Stanziano
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A. Parola
- Research Group on Inferential Processes in Social Interaction (GIPSI), Department of Psychology, University of Turin, Turin, Italy
| | - M. C. Valentini
- Struttura Complessa di Neuroradiologia, Dipartimento Diagnostica per Immagini e Radiologia interventistica, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
| | - F. M. Bosco
- Research Group on Inferential Processes in Social Interaction (GIPSI), Department of Psychology, University of Turin, Turin, Italy
| | - P. Rocca
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
- Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
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Bambini V, Agostoni G, Buonocore M, Tonini E, Bechi M, Ferri I, Sapienza J, Martini F, Cuoco F, Cocchi F, Bischetti L, Cavallaro R, Bosia M. It is time to address language disorders in schizophrenia: A RCT on the efficacy of a novel training targeting the pragmatics of communication (PragmaCom). JOURNAL OF COMMUNICATION DISORDERS 2022; 97:106196. [PMID: 35526293 DOI: 10.1016/j.jcomdis.2022.106196] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Language and communication disruptions in schizophrenia are at the center of a large body of investigation. Yet, the remediation of such disruptions is still in its infancy. Here we targeted what is known to be one of the most damaged language domains in schizophrenia, namely pragmatics, by conducting a pragmatics-centered intervention with a randomized controlled trial design and assessing also durability and generalization. To the best of our knowledge, this is the first study with these characteristics. METHODS Inspired by the Gricean account of natural language use, we tailored a novel treatment addressing the pragmatics of communication (PragmaCom) and we tested its efficacy in a sample of individuals with schizophrenia randomized to the experimental group or to an active control group. The primary outcome with respect to the efficacy of the PragmaCom was measured by changes in pragmatic abilities (as evaluated with the global score of the Assessment of Pragmatic Abilities and Cognitive Substrates test) from baseline to 12 weeks and at 3-month follow-up. The secondary outcome was measured by changes in metaphor comprehension, abstract thinking, and global functioning from baseline to 12 weeks and at 3-month follow-up. RESULTS Relative to the control group, at post-test the PragmaCom group showed greater and enduring improvement in global pragmatic skills and in metaphor comprehension. At follow-up, these improvements persisted and the PragmaCom exerted beneficial effects also on functioning. CONCLUSIONS Despite the limited sample size, we believe that these findings offer initial yet encouraging evidence of the possibility to improve pragmatic skills with a theoretically grounded approach and to obtain durable and clinically relevant benefits. We argue that it is time that therapeutic efforts embrace communicative dysfunctions in order to improve illness outcome.
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Affiliation(s)
- Valentina Bambini
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS Pavia, Italy.
| | - Giulia Agostoni
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Tonini
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS Pavia, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ilaria Ferri
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jacopo Sapienza
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Martini
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cuoco
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Bischetti
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS Pavia, Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Bosia
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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Cuevas P, He Y, Steines M, Straube B. The Processing of Semantic Complexity and Cospeech Gestures in Schizophrenia: A Naturalistic, Multimodal fMRI Study. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac026. [PMID: 39144758 PMCID: PMC11205911 DOI: 10.1093/schizbullopen/sgac026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Schizophrenia is marked by aberrant processing of complex speech and gesture, which may contribute functionally to its impaired social communication. To date, extant neuroscientific studies of schizophrenia have largely investigated dysfunctional speech and gesture in isolation, and no prior research has examined how the two communicative channels may interact in more natural contexts. Here, we tested if patients with schizophrenia show aberrant neural processing of semantically complex story segments, and if speech-associated gestures (co-speech gestures) might modulate this effect. In a functional MRI study, we presented to 34 participants (16 patients and 18 matched-controls) an ecologically-valid retelling of a continuous story, performed via speech and spontaneous gestures. We split the entire story into ten-word segments, and measured the semantic complexity for each segment with idea density, a linguistic measure that is commonly used clinically to evaluate aberrant language dysfunction at the semantic level. Per segment, the presence of numbers of gestures varied (n = 0, 1, +2). Our results suggest that, in comparison to controls, patients showed reduced activation for more complex segments in the bilateral middle frontal and inferior parietal regions. Importantly, this neural aberrance was normalized in segments presented with gestures. Thus, for the first time with a naturalistic multimodal stimulation paradigm, we show that gestures reduced group differences when processing a natural story, probably by facilitating the processing of semantically complex segments of the story in schizophrenia.
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Affiliation(s)
- Paulina Cuevas
- Translational Neuroimaging Lab Marburg, Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University, Giessen, Marburg, Germany
| | - Yifei He
- Translational Neuroimaging Lab Marburg, Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University, Giessen, Marburg, Germany
| | - Miriam Steines
- Translational Neuroimaging Lab Marburg, Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University, Giessen, Marburg, Germany
| | - Benjamin Straube
- Translational Neuroimaging Lab Marburg, Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University, Giessen, Marburg, Germany
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10
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Wang D, Liang S. Dynamic Causal Modeling on the Identification of Interacting Networks in the Brain: A Systematic Review. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2299-2311. [PMID: 34714747 DOI: 10.1109/tnsre.2021.3123964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dynamic causal modeling (DCM) has long been used to characterize effective connectivity within networks of distributed neuronal responses. Previous reviews have highlighted the understanding of the conceptual basis behind DCM and its variants from different aspects. However, no detailed summary or classification research on the task-related effective connectivity of various brain regions has been made formally available so far, and there is also a lack of application analysis of DCM for hemodynamic and electrophysiological measurements. This review aims to analyze the effective connectivity of different brain regions using DCM for different measurement data. We found that, in general, most studies focused on the networks between different cortical regions, and the research on the networks between other deep subcortical nuclei or between them and the cerebral cortex are receiving increasing attention, but far from the same scale. Our analysis also reveals a clear bias towards some task types. Based on these results, we identify and discuss several promising research directions that may help the community to attain a clear understanding of the brain network interactions under different tasks.
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11
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Gröhn C, Norgren E, Eriksson L. A systematic review of the neural correlates of multisensory integration in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 27:100219. [PMID: 34660211 PMCID: PMC8502765 DOI: 10.1016/j.scog.2021.100219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 01/01/2023]
Abstract
Multisensory integration (MSI), in which sensory signals from different modalities are unified, is necessary for our comprehensive perception of and effective adaptation to the objects and events around us. However, individuals with schizophrenia suffer from impairments in MSI, which could explain typical symptoms like hallucination and reality distortion. Because the neural correlates of aberrant MSI in schizophrenia help us understand the physiognomy of this psychiatric disorder, we performed a systematic review of the current research on this subject. The literature search concerned investigated MSI in diagnosed schizophrenia patients compared to healthy controls using brain imaging. Seventeen of 317 identified studies were finally included. To assess risk of bias, the Newcastle-Ottawa quality assessment was used, and the review was written according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The results indicated that multisensory processes in schizophrenia are associated with aberrant, mainly reduced, neural activity in several brain regions, as measured by event-related potentials, oscillations, activity and connectivity. The conclusion is that a fronto-temporal region, comprising the frontal inferior gyrus, middle temporal gyrus and superior temporal gyrus/sulcus, along with the fusiform gyrus and dorsal visual stream in the occipital-parietal lobe are possible key regions of deficient MSI in schizophrenia.
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Affiliation(s)
| | | | - Lars Eriksson
- Corresponding author at: Department of Social and Psychological Studies, Karlstad University, SE-651 88 Karlstad, Sweden.
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Wei W, Yin Y, Zhang Y, Li X, Li M, Guo W, Wang Q, Deng W, Ma X, Zhao L, Palaniyappan L, Li T. Structural Covariance of Depth-Dependent Intracortical Myelination in the Human Brain and Its Application to Drug-Naïve Schizophrenia: A T1w/T2w MRI Study. Cereb Cortex 2021; 32:2373-2384. [PMID: 34581399 DOI: 10.1093/cercor/bhab337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 02/05/2023] Open
Abstract
Aberrations in intracortical myelination are increasingly being considered as a cardinal feature in the pathophysiology of schizophrenia. We investigated the network-level distribution of intracortical myelination across various cortex depths. We enrolled 126 healthy subjects and 106 first-episode drug-naïve schizophrenia patients. We used T1w/T2w ratio as a proxy of intracortical myelination, parcellated cortex into several equivolumetric surfaces based on cortical depths and mapped T1w/T2w ratios to each surface. Non-negative matrix factorization was used to generate depth-dependent structural covariance networks (dSCNs) of intracortical myelination from 2 healthy controls datasets-one from our study and another from 100-unrelated dataset of the Human Connectome Project. For patient versus control comparisons, partial least squares approach was used; we also related myelination to clinical features of schizophrenia. We found that dSCNs were highly reproducible in 2 independent samples. Network-level myelination was reduced in prefrontal and cingulate cortex and increased in perisylvian cortex in schizophrenia. The abnormal network-level myelination had a canonical correlation with symptom burden in schizophrenia. Moreover, myelination of prefrontal cortex correlated with duration of untreated psychosis. In conclusion, we offer a feasible and sensitive framework to study depth-dependent myelination and its relationship with clinical features.
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Affiliation(s)
- Wei Wei
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Yubing Yin
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Yamin Zhang
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Xiaojing Li
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Mingli Li
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Wanjun Guo
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Qiang Wang
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Wei Deng
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Liansheng Zhao
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Lena Palaniyappan
- Department of Psychiatry, University of Western Ontario, London, Ontario N6A 3K7, Canada.,Robarts Research Institute, University of Western Ontario, London, Ontario N6A 3K7, Canada.,Lawson Health Research Institute, London, Ontario N6C 2R5, Canada
| | - Tao Li
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China.,Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China
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Steines M, Nagels A, Kircher T, Straube B. The role of the left and right inferior frontal gyrus in processing metaphoric and unrelated co-speech gestures. Neuroimage 2021; 237:118182. [PMID: 34020020 DOI: 10.1016/j.neuroimage.2021.118182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 11/30/2022] Open
Abstract
Gestures are an integral part of in-person conversations and complement the meaning of the speech they accompany. The neural processing of co-speech gestures is supported by a mostly left-lateralized network of fronto-temporal regions. However, in contrast to iconic gestures, metaphoric as well as unrelated gestures have been found to more strongly engage the left and right inferior frontal gyrus (IFG), respectively. With this study, we conducted the first systematic comparison of all three types of gestures and resulting potential laterality effects. During collection of functional imaging data, 74 subjects were presented with 5 s videos of abstract speech with related metaphoric gestures, concrete speech with related iconic gestures and concrete speech with unrelated gestures. They were asked to judge whether the content of the speech and gesture matched or not. Differential contrasts revealed that both abstract related and concrete unrelated compared to concrete related stimuli elicited stronger activation of the bilateral IFG. Analyses of lateralization indices for IFG activation further showed a left hemispheric dominance for metaphoric gestures and a right hemispheric dominance for unrelated gestures. Our results give support to the hypothesis that the bilateral IFG is activated specifically when processing load for speech-gesture combinations is high. In addition, laterality effects indicate a stronger involvement of the right IFG in mismatch detection and conflict processing, whereas the left IFG performs the actual integration of information from speech and gesture.
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Affiliation(s)
- Miriam Steines
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Straße 8, Marburg 35039, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, Marburg 35032, Germany.
| | - Arne Nagels
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Straße 8, Marburg 35039, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Straße 8, Marburg 35039, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, Marburg 35032, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Straße 8, Marburg 35039, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, Marburg 35032, Germany
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14
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Bitsch F, Berger P, Nagels A, Falkenberg I, Straube B. Characterizing the theory of mind network in schizophrenia reveals a sparser network structure. Schizophr Res 2021; 228:581-589. [PMID: 33229225 DOI: 10.1016/j.schres.2020.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/06/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023]
Abstract
Impaired social functioning is a hallmark of schizophrenia and altered functional integration between distant brain regions are expected to account for signs and symptoms of the disorder. The functional neuroarchitecture of a network relevant for social functioning, the mentalizing network, is however poorly understood. In this study we examined dysfunctions of the mentalizing network in patients with schizophrenia compared to healthy controls via dynamic causal modelling and an interactive social decision-making game. Network characteristics were analyzed on a single subject basis whereas graph theoretic metrics such as in-degree, out-degree and edge-connectivity per network node were compared between the groups. The results point to a sparser network structure in patients with schizophrenia and highlight the dorsomedial prefrontal cortex as a disconnected network hub receiving significantly less input from other brain regions in the network. Further analyses suggest that integrating pathways from the right and the left temporo-parietal junction into the dorsomedial prefrontal cortex were less frequently found in patients with schizophrenia. Brain and behavior analyses further suggest that the connectivity-intactness within the entire network is associated with functional interpersonal behavior during the task. Thus, the neurobiological alterations within the mentalizing network in patients with schizophrenia point to a specific integration deficit between core brain regions underlying the generation of higher-order representations and thereby provide a potential treatment target.
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Affiliation(s)
- Florian Bitsch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann Str. 8, 35039 Marburg, Germany.
| | - Philipp Berger
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann Str. 8, 35039 Marburg, Germany
| | - Arne Nagels
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann Str. 8, 35039 Marburg, Germany; Department of English and Linguistics, Johannes Gutenberg-University Mainz, Jakob-Welder-Weg 18, 55128 Mainz, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann Str. 8, 35039 Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann Str. 8, 35039 Marburg, Germany
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He Y, Steines M, Sammer G, Nagels A, Kircher T, Straube B. Modality-specific dysfunctional neural processing of social-abstract and non-social-concrete information in schizophrenia. Neuroimage Clin 2021; 29:102568. [PMID: 33524805 PMCID: PMC7851842 DOI: 10.1016/j.nicl.2021.102568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 11/09/2022]
Abstract
Schizophrenia is characterized by marked communication dysfunctions encompassing potential impairments in the processing of social-abstract and non-social-concrete information, especially in everyday situations where multiple modalities are present in the form of speech and gesture. To date, the neurobiological basis of these deficits remains elusive. In a functional magnetic resonance imaging (fMRI) study, 17 patients with schizophrenia or schizoaffective disorder, and 18 matched controls watched videos of an actor speaking, gesturing (unimodal), and both speaking and gesturing (bimodal) about social or non-social events in a naturalistic way. Participants were asked to judge whether each video contains person-related (social) or object-related (non-social) information. When processing social-abstract content, patients showed reduced activation in the medial prefrontal cortex (mPFC) only in the gesture but not in the speech condition. For non-social-concrete content, remarkably, reduced neural activation for patients in the left postcentral gyrus and the right insula was observed only in the speech condition. Moreover, in the bimodal conditions, patients displayed improved task performance and comparable activation to controls in both social and non-social content. To conclude, patients with schizophrenia displayed modality-specific aberrant neural processing of social and non-social information, which is not present for the bimodal conditions. This finding provides novel insights into dysfunctional multimodal communication in schizophrenia, and may have potential therapeutic implications.
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Affiliation(s)
- Yifei He
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032 Marburg, Germany.
| | - Miriam Steines
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032 Marburg, Germany
| | - Gebhard Sammer
- Cognitive Neuroscience at Centre for Psychiatry, Justus-Liebig University Giessen, Giessen, Germany
| | - Arne Nagels
- Department of General Linguistics, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032 Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Hans-Meerwein-Straße 6, 35032 Marburg, Germany
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Straube B, van Kemenade BM, Kircher T, Schülke R. Transcranial direct current stimulation improves action-outcome monitoring in schizophrenia spectrum disorder. Brain Commun 2020; 2:fcaa151. [PMID: 33543133 PMCID: PMC7850031 DOI: 10.1093/braincomms/fcaa151] [Citation(s) in RCA: 14] [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: 06/12/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022] Open
Abstract
Patients with schizophrenia spectrum disorder often demonstrate impairments in action-outcome monitoring. Passivity phenomena and hallucinations, in particular, have been related to impairments of efference copy-based predictions which are relevant for the monitoring of outcomes produced by voluntary action. Frontal transcranial direct current stimulation has been shown to improve action-outcome monitoring in healthy subjects. However, whether transcranial direct current stimulation can improve action monitoring in patients with schizophrenia spectrum disorder remains unknown. We investigated whether transcranial direct current stimulation can improve the detection of temporal action-outcome discrepancies in patients with schizophrenia spectrum disorder. On 4 separate days, we applied sham or left cathodal/right anodal transcranial direct current stimulation in a randomized order to frontal (F3/F4), parietal (CP3/CP4) and frontoparietal (F3/CP4) areas of 19 patients with schizophrenia spectrum disorder and 26 healthy control subjects. Action-outcome monitoring was assessed subsequent to 10 min of sham/transcranial direct current stimulation (1.5 mA). After a self-generated (active) or externally generated (passive) key press, subjects were presented with a visual outcome (a dot on the screen), which was presented after various delays (0-417 ms). Participants had to detect delays between the key press and the visual consequence. Symptom subgroups were explored based on the presence or absence of symptoms related to a paranoid-hallucinatory syndrome. In general, delay-detection performance was impaired in the schizophrenia spectrum disorder compared to the healthy control group. Interaction analyses showed group-specific (schizophrenia spectrum disorder versus healthy control group) and symptom-specific (with/without relevant paranoid-hallucinatory symptoms) transcranial direct current stimulation effects. Post hoc tests revealed that frontal transcranial direct current stimulation improved the detection of long delays in active conditions and reduced the proportion of false alarms in undelayed trials of the passive condition in patients. The patients with no or few paranoid-hallucinatory symptoms benefited especially from frontal transcranial direct current stimulation in active conditions, while improvement in the patients with paranoid-hallucinatory symptoms was predominantly reflected in reduced false alarm rates in passive conditions. These data provide some first evidence for the potential utility of transcranial direct current stimulation in improving efference copy mechanisms and action-outcome monitoring in schizophrenia spectrum disorder. Current data indicate that improving efference copy-related processes can be especially effective in patients with no or few positive symptoms, while intersensory matching (i.e. task-relevant in passive conditions) could be more susceptible to improvement in patients with paranoid-hallucinatory symptoms.
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Affiliation(s)
- Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Bianca M van Kemenade
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Rasmus Schülke
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Wüthrich F, Pavlidou A, Stegmayer K, Eisenhardt S, Moor J, Schäppi L, Vanbellingen T, Bohlhalter S, Walther S. Nonverbal communication remains untouched: No beneficial effect of symptomatic improvement on poor gesture performance in schizophrenia. Schizophr Res 2020; 223:258-264. [PMID: 32883557 PMCID: PMC7952214 DOI: 10.1016/j.schres.2020.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/06/2020] [Accepted: 08/15/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gestures are an important part of communication. Patients with schizophrenia present gesture deficits that tend to deteriorate in the course of the disease and hamper functional outcome. This gesture deficit has been associated with motor abnormalities, cognitive impairment, and psychotic symptoms. Unaffected, first-degree relatives of schizophrenia patients share some subclinical motor and cognitive abnormalities. We aimed to investigate, whether gesture performance changes with symptomatic improvement in patients, and to test the longitudinal performance in unaffected, first-degree relatives. METHODS In this study, we measured gesture performance using a validated test in 33 patients, 29 first-degree relatives and 38 healthy controls. Measurements were completed shortly after admission and before discharge in patients. Performance was rated blindly by experts using video recordings of the gesture task. Additionally, we evaluated cognitive function and psychotic symptoms at both visits. RESULTS Gesture performance was poorer in relatives compared to controls and poorer in patients compared to both relatives and controls. Patients showed an improvement in psychopathology but a significant decrease in gesture performance at follow-up, while performance in the other groups remained stable. Proportional change of gesture performance correlated with change of cognitive function in patients, whereas there were no correlations with change of cognitive function in the other groups. CONCLUSION While symptom severity was reduced, the gesture deficit further deteriorated in schizophrenia. The finding argues for distinct processes contributing to poor nonverbal communication skills in patients, requiring novel alternative treatment efforts.
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Affiliation(s)
- Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
| | - Anastasia Pavlidou
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Sarah Eisenhardt
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jeanne Moor
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland,Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland
| | - Lea Schäppi
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Tim Vanbellingen
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Switzerland,Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
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Wüthrich F, Viher PV, Stegmayer K, Federspiel A, Bohlhalter S, Vanbellingen T, Wiest R, Walther S. Dysbalanced Resting-State Functional Connectivity Within the Praxis Network Is Linked to Gesture Deficits in Schizophrenia. Schizophr Bull 2020; 46:905-915. [PMID: 32052844 PMCID: PMC7342100 DOI: 10.1093/schbul/sbaa008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patients with schizophrenia frequently present deficits in gesture production and interpretation, greatly affecting their communication skills. As these gesture deficits can be found early in the course of illness and as they can predict later outcomes, exploring their neural basis may lead to a better understanding of schizophrenia. While gesturing has been reported to rely on a left lateralized network of brain regions, termed praxis network, in healthy subjects and lesioned patients, studies in patients with schizophrenia are sparse. It is currently unclear whether within-network connectivity at rest is linked to gesture deficit. Here, we compared the functional connectivity between regions of the praxis network at rest between 46 patients and 44 healthy controls. All participants completed a validated test of hand gesture performance before resting-state functional magnetic resonance imaging (fMRI) was acquired. Patients performed gestures poorer than controls in all categories and domains. In patients, we also found significantly higher resting-state functional connectivity between left precentral gyrus and bilateral superior and inferior parietal lobule. Likewise, patients had higher connectivity from right precentral gyrus to left inferior and bilateral superior parietal lobule (SPL). In contrast, they exhibited lower connectivity between bilateral superior temporal gyrus (STG). Connectivity between right precentral gyrus and left SPL, as well as connectivity between bilateral STG, correlated with gesture performance in healthy controls. We failed to detect similar correlations in patients. We suggest that altered resting-state functional connectivity within the praxis network perturbs correct gesture planning in patients, reflecting the gesture deficit often seen in schizophrenia.
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Affiliation(s)
- Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,To whom correspondence should be addressed; University Hospital of Psychiatry, Translational Research Center, Bolligenstrasse 111, 3000 Bern 60, Switzerland; tel: +41-31-932-87-13, fax: +41 31 930 99 61, e-mail:
| | - Petra V Viher
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland,Department of Clinical Research, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Tim Vanbellingen
- Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland,Department of Clinical Research, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Roland Wiest
- Institute of Neuroradiology, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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