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Szeszko PR, Gohel S, Vaccaro DH, Chu KW, Tang CY, Goldstein KE, New AS, Siever LJ, McClure M, Perez-Rodriguez MM, Haznedar MM, Byne W, Hazlett EA. Frontotemporal thalamic connectivity in schizophrenia and schizotypal personality disorder. Psychiatry Res Neuroimaging 2022; 322:111463. [PMID: 35240516 PMCID: PMC9018622 DOI: 10.1016/j.pscychresns.2022.111463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 11/22/2022]
Abstract
Schizotypal personality disorder (SPD) resembles schizophrenia, but with attenuated brain abnormalities and the absence of psychosis. The thalamus is integral for processing and transmitting information across cortical regions and widely implicated in the neurobiology of schizophrenia. Comparing thalamic connectivity in SPD and schizophrenia could reveal an intermediate schizophrenia-spectrum phenotype to elucidate neurobiological risk and protective factors in psychosis. We used rsfMRI to investigate functional connectivity between the mediodorsal nucleus (MDN) and pulvinar, and their connectivity with frontal and temporal cortical regions, respectively in 43 healthy controls (HCs), and individuals in the schizophrenia-spectrum including 45 psychotropic drug-free individuals with SPD, and 20 individuals with schizophrenia-related disorders [(schizophrenia (n = 10), schizoaffective disorder (n = 8), schizophreniform disorder (n = 1) and psychosis NOS (n = 1)]. Individuals with SPD had greater functional connectivity between the MDN and pulvinar compared to individuals with schizophrenia. Thalamo-frontal (i.e., between the MDN and rostral middle frontal cortex) connectivity was comparable in SPD and HCs; in SPD greater connectivity was associated with less symptom severity. Individuals with schizophrenia had less thalamo-frontal connectivity and thalamo-temporal (i.e., pulvinar to the transverse temporal cortex) connectivity compared with HCs. Thalamo-frontal functional connectivity may be comparable in SPD and HCs, but abnormal in schizophrenia, and that this may be protective against psychosis in SPD.
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Affiliation(s)
- Philip R Szeszko
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Mental Health Patient Care Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Suril Gohel
- Department of Health Informatics, Rutgers University, Newark, NJ, USA
| | - Daniel H Vaccaro
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - King-Wai Chu
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheuk Y Tang
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kim E Goldstein
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA
| | - Antonia S New
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Larry J Siever
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret McClure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychology, Fairfield University, Fairfield, CT, USA
| | | | - M Mehmet Haznedar
- Mental Health Patient Care Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William Byne
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Erin A Hazlett
- Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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2
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Solmi M, Dragioti E, Croatto G, Radua J, Borgwardt S, Carvalho AF, Demurtas J, Mosina A, Kurotschka P, Thompson T, Cortese S, Shin JI, Fusar-Poli P. Risk and Protective Factors for Personality Disorders: An Umbrella Review of Published Meta-Analyses of Case-Control and Cohort Studies. Front Psychiatry 2021; 12:679379. [PMID: 34552513 PMCID: PMC8450571 DOI: 10.3389/fpsyt.2021.679379] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/06/2021] [Indexed: 12/26/2022] Open
Abstract
The putative risk/protective factors for several personality disorders remain unclear. The vast majority of published studies has assessed personality characteristics/traits rather than disorders. Thus, the current umbrella review of meta-analyses (MAs) aims to systematically assess risk or protective factors associated with personality disorders. We searched PubMed-MEDLINE/PsycInfo databases, up to August 31, 2020. Quality of MAs was assessed with AMSTAR-2, while the credibility of evidence for each association was assessed through standard quantitative criteria. Out of 571 initial references, five meta-analyses met inclusion criteria, encompassing 56 associations of 26 potential environmental factors for antisocial, dependent, borderline personality disorder, with a median of five studies per association, and median 214 cases per association. Overall, 35 (62.5%) of the associations were nominally significant. Six associations met class II (i.e., highly suggestive) evidence for borderline personality disorder, with large effect sizes involving childhood emotional abuse (OR = 28.15, 95% CI 14.76-53.68), childhood emotional neglect (OR = 22.86, 95% CI 11.55-45.22), childhood any adversities (OR = 14.32, 95% CI 10.80-18.98), childhood physical abuse (OR = 9.30, 95% CI 6.57-13.17), childhood sexual abuse (OR = 7.95, 95% CI 6.21-10.17), and childhood physical neglect (OR = 5.73, 95% CI 3.21-10.21), plus 16 further associations supported by class IV evidence. No risk factor for antisocial or dependent personality disorder was supported by class I, II, and III, but six and seven met class IV evidence, respectively. Quality of included meta-analyses was rated as moderate in two, critically low in three. The large effect sizes found for a broad range of childhood adversities suggest that prevention of personality disorders should target childhood-related risk factors. However, larger cohort studies assessing multidimensional risk factors are needed in the field.
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Affiliation(s)
- Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, United Kingdom.,Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, United Kingdom.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, United Kingdom.,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain.,Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Solna, Sweden
| | - Stefan Borgwardt
- Department of Psychiatry, Medical Faculty, University of Basel, Basel, Switzerland.,Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Andre F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jacopo Demurtas
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Wetzikon, Switzerland
| | - Peter Kurotschka
- Department of General Practice, University Medical Center Würzburg, Würzburg, Germany
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Samuele Cortese
- Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, United Kingdom.,Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Solent NHS Trust, Southampton, United Kingdom.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, United States.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology, London, United Kingdom.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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3
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Sasabayashi D, Takayanagi Y, Takahashi T, Nemoto K, Furuichi A, Kido M, Nishikawa Y, Nakamura M, Noguchi K, Suzuki M. Increased brain gyrification in the schizophrenia spectrum. Psychiatry Clin Neurosci 2020; 74:70-76. [PMID: 31596011 DOI: 10.1111/pcn.12939] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/22/2022]
Abstract
AIM Increased brain gyrification in diverse cortical regions has been reported in patients with schizophrenia, possibly reflecting deviations in early neurodevelopment. However, it remains unknown whether patients with schizotypal disorder exhibit similar changes. METHODS This magnetic resonance imaging study investigated brain gyrification in 46 patients with schizotypal disorder (29 male, 17 female), 101 patients with schizophrenia (55 male, 46 female), and 77 healthy controls (44 male, 33 female). T1-weighted magnetic resonance images were obtained for each participant. Using FreeSurfer software, the local gyrification index (LGI) of the entire cortex was compared across the groups. RESULTS Both schizophrenia and schizotypal disorder patients showed a significantly higher LGI in diverse cortical regions, including the bilateral prefrontal and left parietal cortices, as compared with controls, but its extent was broader in schizophrenia especially for the right prefrontal and left occipital regions. No significant correlations were found between the LGI and clinical variables (e.g., symptom severity, medication) for either of the patient groups. CONCLUSION Increased LGI in the frontoparietal regions was common to both patient groups and might represent vulnerability to schizophrenia, while more diverse changes in schizophrenia patients might be associated with the manifestation of florid psychosis.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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Chan CC, Szeszko PR, Wong E, Tang CY, Kelliher C, Penner JD, Perez-Rodriguez MM, Rosell DR, McClure M, Roussos P, New AS, Siever LJ, Hazlett EA. Frontal and temporal cortical volume, white matter tract integrity, and hemispheric asymmetry in schizotypal personality disorder. Schizophr Res 2018; 197:226-232. [PMID: 29454512 PMCID: PMC8043048 DOI: 10.1016/j.schres.2018.01.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/29/2017] [Accepted: 01/21/2018] [Indexed: 12/29/2022]
Abstract
Abnormalities in temporal and frontal cortical volume, white matter tract integrity, and hemispheric asymmetry have been implicated in schizophrenia-spectrum disorders. Schizotypal personality disorder can provide insight into vulnerability and protective factors in these disorders without the confounds associated with chronic psychosis. However, multimodal imaging and asymmetry studies in SPD are sparse. Thirty-seven individuals with SPD and 29 healthy controls (HC) received clinical interviews and 3T magnetic resonance T1-weighted and diffusion tensor imaging scans. Mixed ANOVAs were performed on gray matter volumes of the lateral temporal regions involved in auditory and language processing and dorsolateral prefrontal cortex involved in executive functioning, as well as fractional anisotropy (FA) of prominent white matter tracts that connect frontal and temporal lobes. In the temporal lobe regions, there were no group differences in volume, but SPD had reduced right>left middle temporal gyrus volume asymmetry compared to HC and lacked the right>left asymmetry in the inferior temporal gyrus volume seen in HC. In the frontal regions, there were no differences between groups on volume or asymmetry. In the white matter tracts, SPD had reduced FA in the left sagittal stratum and superior longitudinal fasciculus, and increased right>left asymmetry in sagittal stratum FA compared to HC. In the SPD group, lower left superior longitudinal fasciculus FA was associated with greater severity of disorganization symptoms. Findings suggest that abnormities in structure and asymmetry of temporal regions and frontotemporal white matter tract integrity are implicated in SPD pathology.
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Affiliation(s)
- Chi C. Chan
- VISN 2 Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Corresponding author at: Mental Illness Research, Education, and Clinical Center, James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-41G, Bronx, NY 10468, USA, (C.C. Chan)
| | - Philip R. Szeszko
- VISN 2 Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edmund Wong
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheuk Y. Tang
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caitlin Kelliher
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Justin D. Penner
- VISN 2 Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Daniel R. Rosell
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret McClure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Panos Roussos
- VISN 2 Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Genetics and Genomic Sciences and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Antonia S. New
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Larry J. Siever
- VISN 2 Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Erin A. Hazlett
- VISN 2 Mental Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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5
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Sun Y, Zhang L, Ancharaz SS, Cheng S, Sun W, Wang H, Sun Y. Decreased fractional anisotropy values in two clusters of white matter in patients with schizotypal personality disorder: A DTI study. Behav Brain Res 2016; 310:68-75. [DOI: 10.1016/j.bbr.2016.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/16/2016] [Accepted: 05/09/2016] [Indexed: 11/24/2022]
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Matsui M, Sumiyoshi T, Kato K, Yoneyama E, Kurachi M. Neuropsychological Profile in Patients with Schizotypal Personality Disorder or Schizophrenia. Psychol Rep 2016; 94:387-97. [PMID: 15154161 DOI: 10.2466/pr0.94.2.387-397] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neuropsychological impairments have been consistently reported in patients with schizophrenia. As little is known whether subjects with schizotypal personality disorder exhibit neurocognitive dysfunction similar to that in schizophrenia, we assessed the neuropsychological profile of 15 subjects with schizotypal personality disorder and compared it with that for 15 patients with schizophrenia and for 15 psychiatrically normal volunteers. All participants were administered a standard neuropsychological battery assessing language ability, spatial ability, visuomotor function, verbal memory, visual memory, auditory attention, visual attention, and executive function. Performance on most of the cognitive domains was impaired in patients with schizotypal personality disorder but less than patients with schizophrenia. Specifically, impairment in verbal memory and visuomotor ability in patients with schizotypal personality disorder and patients with schizophrenia were comparable, while patients with schizophrenia performed worse on the test of executive function than did patients with schizotypal personality disorder. As a whole, cognitive deficits in patients with schizotypal personality disorder were qualitatively similar to, but quantitatively milder than, those for patients with schizophrenia. The results suggest that cognitive abilities related to frontotemporal lobe function are disturbed across these schizophrenia-spectrum disorders.
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Affiliation(s)
- Mié Matsui
- Department of Psychology, School of Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
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7
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Wang Y, Yan C, Yin DZ, Fan MX, Cheung EFC, Pantelis C, Chan RCK. Neurobiological changes of schizotypy: evidence from both volume-based morphometric analysis and resting-state functional connectivity. Schizophr Bull 2015; 41 Suppl 2:S444-54. [PMID: 25533270 PMCID: PMC4373629 DOI: 10.1093/schbul/sbu178] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The current study sought to examine the underlying brain changes in individuals with high schizotypy by integrating networks derived from brain structural and functional imaging. Individuals with high schizotypy (n = 35) and low schizotypy (n = 34) controls were screened using the Schizotypal Personality Questionnaire and underwent brain structural and resting-state functional magnetic resonance imaging on a 3T scanner. Voxel-based morphometric analysis and graph theory-based functional network analysis were conducted. Individuals with high schizotypy showed reduced gray matter (GM) density in the insula and the dorsolateral prefrontal gyrus. The graph theoretical analysis showed that individuals with high schizotypy showed similar global properties in their functional networks as low schizotypy individuals. Several hubs of the functional network were identified in both groups, including the insula, the lingual gyrus, the postcentral gyrus, and the rolandic operculum. More hubs in the frontal lobe and fewer hubs in the occipital lobe were identified in individuals with high schizotypy. By comparing the functional connectivity between clusters with abnormal GM density and the whole brain, individuals with high schizotypy showed weaker functional connectivity between the left insula and the putamen, but stronger connectivity between the cerebellum and the medial frontal gyrus. Taken together, our findings suggest that individuals with high schizotypy present changes in terms of GM and resting-state functional connectivity, especially in the frontal lobe.
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Affiliation(s)
- Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China;,These authors contributed equally to the study
| | - Chao Yan
- Shanghai Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China;,These authors contributed equally to the study
| | - Da-zhi Yin
- Shanghai Key Laboratory of MRI, East China Normal University, Shanghai, China
| | - Ming-xia Fan
- Shanghai Key Laboratory of MRI, East China Normal University, Shanghai, China
| | - Eric F. C. Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China;,Magnetic Resonance Imaging Centre, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,*To whom correspondence should be addressed; Raymond Chan, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China; tel/fax: (86)-10-64877349; e-mail:
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8
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Hazlett EA, Rothstein EG, Ferreira R, Silverman JM, Siever LJ, Olincy A. Sensory gating disturbances in the spectrum: similarities and differences in schizotypal personality disorder and schizophrenia. Schizophr Res 2015; 161:283-90. [PMID: 25482574 PMCID: PMC4308515 DOI: 10.1016/j.schres.2014.11.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND DSM-5 places schizophrenia on a continuum from severe, chronic schizophrenia to the attenuated schizophrenia-like traits of schizotypal personality disorder (SPD), the prototypic schizophrenia-related personality disorder. SPD shares common genetic and neurobiological substrates with schizophrenia, including information processing abnormalities, although they are less marked. This is the first study to directly compare the P50 evoked electroencephalographic response-a measure of sensory gating and a neurophysiological endophenotype-between schizophrenia-spectrum groups. Two hypotheses were tested: (1) Compared with healthy controls (HCs), schizophrenia patients show reduced P50 suppression and SPD patients resemble schizophrenia but exhibit less marked deficits; and (2) Deficient P50 suppression in SPD is associated with greater clinical symptom severity. METHODS P50 was assessed in 32 schizophrenia-spectrum disorder patients (12 SPD, 20 schizophrenia patients) and 25 demographically-matched HCs. The standard conditioning (C)-testing (T) paradigm was used and P50 suppression was quantified using the T-C difference and the T/C ratio. RESULTS All P50 measures showed a linear, stepwise pattern with the SPD group intermediate between the HC and schizophrenia groups. Compared with HCs, both patient groups had lower conditioning and T-C difference values. Among the SPD group, greater clinical symptom severity was associated with greater conditioning-response amplitude deficits. CONCLUSION These findings: (1) are novel in showing that P50 deficits in SPD resemble those observed in schizophrenia, albeit less marked; (2) support the concept that the phenomenological link between SPD and schizophrenia lies in shared neurocognitive/neurophysiological pathologies; and (3) provide evidence that P50 is a neurophysiological endophenotype for schizophrenia-spectrum disorders.
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Affiliation(s)
- Erin A. Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY,Research and Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY,Mental Illness Research, Education, and Clinical Center (VISN3), James J. Peters Veterans Affairs Medical Center, Bronx, NY,Corresponding Author: Mental Illness Research, Education, and Clinical Center (VISN3), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, 10468, United States, Phone: 718-584-9000 x3701; Fax: 718-364-3576,
| | - Ethan G. Rothstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rui Ferreira
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jeremy M. Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY,Research and Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Larry J. Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY,Research and Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY,Mental Illness Research, Education, and Clinical Center (VISN3), James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Ann Olincy
- Department of Psychiatry, University of Colorado, Denver, CO
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Mittal VA, Gupta T, Orr JM, Pelletier-Baldelli A, Dean DJ, Lunsford-Avery JR, Smith AK, Robustelli BL, Leopold DR, Millman ZB. Physical activity level and medial temporal health in youth at ultra high-risk for psychosis. JOURNAL OF ABNORMAL PSYCHOLOGY 2014; 122:1101-10. [PMID: 24364613 DOI: 10.1037/a0034085] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A growing body of evidence suggests that moderate to vigorous activity levels can affect quality of life, cognition, and brain structure in patients diagnosed with schizophrenia. However, physical activity has not been systematically studied during the period immediately preceding the onset of psychosis. Given reports of exercise-based neurogenesis in schizophrenia, understanding naturalistic physical activity levels in the prodrome may provide valuable information for early intervention efforts. The present study examined 29 ultra high-risk (UHR) and 27 matched controls to determine relationships between physical activity level, brain structure (hippocampus and parahippocampal gyrus), and symptoms. Participants were assessed with actigraphy for a 5-day period, MRI, and structured clinical interviews. UHR participants showed a greater percentage of time in sedentary behavior while healthy controls spent more time engaged in light to vigorous activity. There was a strong trend to suggest the UHR group showed less total physical activity. The UHR group exhibited smaller medial temporal volumes when compared with healthy controls. Total level of physical activity in the UHR group was moderately correlated with parahippocampal gyri bilaterally (right: r = .44, left: r = .55) and with occupational functioning (r = -.36; of negative symptom domain), but not positive symptomatology. Results suggest that inactivity is associated with medial temporal lobe health. Future studies are needed to determine if symptoms are driving inactivity, which in turn may be affecting the health of the parahippocampal structure and progression of illness. Although causality cannot be determined from the present design, these findings hold important implications for etiological conceptions and suggest promise for an experimental trial.
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Affiliation(s)
| | - Tina Gupta
- Department of Psychology and Neuroscience
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10
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Hazlett EA, Lamade RV, Graff FS, McClure MM, Kolaitis JC, Goldstein KE, Siever LJ, Godbold JH, Moshier E. Visual-spatial working memory performance and temporal gray matter volume predict schizotypal personality disorder group membership. Schizophr Res 2014; 152:350-7. [PMID: 24398009 DOI: 10.1016/j.schres.2013.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/27/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prior work shows individuals with schizotypal personality disorder (SPD) evince temporal lobe volume abnormalities similar to schizophrenia but sparing of prefrontal cortex, which may mitigate psychosis and the severe neurocognitive impairments observed in schizophrenia. This study examined the extent to which frontal-temporal gray matter volume and neurocognitive performance predict: (1) SPD group membership in a demographically-balanced sample of 51 patients and 37 healthy controls; and (2) symptom severity in SPD. METHODS Dimensional gray-matter volume (left frontal-temporal regions (Brodmann area (BA) 10, 21, 22)) and neurocognitive performance on key memory tasks (California Verbal Learning Test (CVLT), Dot Test, Paced Auditory Serial Addition Test (PASAT)), all salient to schizophrenia-spectrum disorders were examined in a multi-variable model. RESULTS Middle temporal gyrus (BA21) volume and spatial-working memory (Dot Test) performance were significant predictors of SPD group membership likelihood, with poorer working-memory performance indicating increased probability of SPD membership. Combining across regional volumes or cognitive measures resulted in fair-to-good discrimination of group membership, but including neurocognitive and non-collinear regional volume measures together resulted in a receiver-operating-characteristic (ROC) curve with improved diagnostic discrimination. Larger BA10 volume in dorsolateral prefrontal cortex (DLPFC) significantly predicted less symptom severity in SPD. CONCLUSIONS These findings suggest that temporal lobe volume and spatial-working memory performance are promising biological/phenotype markers for likelihood of SPD classification, while greater DLPFC volume may serve as a protective factor.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States.
| | - Raina V Lamade
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Fiona S Graff
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Margaret M McClure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Jeanine C Kolaitis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States
| | - Kim E Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - James H Godbold
- Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Erin Moshier
- Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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11
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Cluster B personality symptoms in persons at genetic risk for schizophrenia are associated with social competence and activation of the right temporo-parietal junction during emotion processing. Psychiatry Res 2014; 221:30-6. [PMID: 24262801 DOI: 10.1016/j.pscychresns.2013.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 09/24/2013] [Accepted: 10/25/2013] [Indexed: 11/21/2022]
Abstract
Personality disorders are common in nonpsychotic siblings of patients with schizophrenia, and some personality traits in this group may be associated with an increased risk for full-blown psychosis. We sought to establish if faulty right-hemisphere activation induced by social cognitive tasks, as previously described in patients with schizophrenia, is associated with specific personality symptoms in their unaffected siblings. We observed that cluster B personality symptoms in this group were inversely related to activation in the right temporo parietal junction (rTPJ, a structure critical in social cognitive processing) in response to a basic emotion processing task and also to social competence, whereas in contrast to our initial hypothesis, cluster A traits were not associated with right hemisphere activation during emotion processing or with social competence. These findings suggest the existence of clinical traits in at-risk individuals which share a common neurobiological substrate with schizophrenia, in regards to social performance.
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Smiley JF, Hackett TA, Preuss TM, Bleiwas C, Figarsky K, Mann JJ, Rosoklija G, Javitt DC, Dwork AJ. Hemispheric asymmetry of primary auditory cortex and Heschl's gyrus in schizophrenia and nonpsychiatric brains. Psychiatry Res 2013; 214:435-43. [PMID: 24148910 PMCID: PMC3851973 DOI: 10.1016/j.pscychresns.2013.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 07/09/2013] [Accepted: 08/13/2013] [Indexed: 01/06/2023]
Abstract
Heschl's gyrus (HG) is reported to have a normal left>right hemispheric volume asymmetry, and reduced asymmetry in schizophrenia. Primary auditory cortex (A1) occupies the caudal-medial surface of HG, but it is unclear if A1 has normal asymmetry, or whether its asymmetry is altered in schizophrenia. To address these issues, we compared bilateral gray matter volumes of HG and A1, and neuron density and number in A1, in autopsy brains from male subjects with or without schizophrenia. Comparison of diagnostic groups did not reveal altered gray matter volumes, neuron density, neuron number or hemispheric asymmetries in schizophrenia. With respect to hemispheric differences, HG displayed a clear left>right asymmetry of gray matter volume. Area A1 occupied nearly half of HG, but had less consistent volume asymmetry, that was clearly present only in a subgroup of archival brains from elderly subjects. Neuron counts, in layers IIIb-c and V-VI, showed that the A1 volume asymmetry reflected differences in neuron number, and was not caused simply by changes in neuron density. Our findings confirm previous reports of striking hemispheric asymmetry of HG, and additionally show evidence that A1 has a corresponding asymmetry, although less consistent than that of HG.
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Affiliation(s)
- John F. Smiley
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA,Corresponding author: John F. Smiley, Ph.D., Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd., Orangeburg, NY 10962, Phone: 845-398-6601, Fax: 845-398-5531,
| | - Troy A. Hackett
- Department of Psychology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Todd M. Preuss
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Center, Emory University, Atlanta, GA, USA
| | - Cynthia Bleiwas
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Khadija Figarsky
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - J. John Mann
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Neuroscience, New York State Psychiatric Institute, New York, NY, USA
| | - Gorazd Rosoklija
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Neuroscience, New York State Psychiatric Institute, New York, NY, USA,Macedonian Academy of Sciences and Arts, Skopje, Macedonia
| | - Daniel C. Javitt
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Andrew J. Dwork
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Neuroscience, New York State Psychiatric Institute, New York, NY, USA
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13
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Vu MAT, Thermenos HW, Terry DP, Wolfe DJ, Voglmaier MM, Niznikiewicz MA, McCarley RW, Seidman LJ, Dickey CC. Working memory in schizotypal personality disorder: fMRI activation and deactivation differences. Schizophr Res 2013; 151:113-23. [PMID: 24161536 DOI: 10.1016/j.schres.2013.09.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/19/2013] [Accepted: 09/16/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Schizotypal personality disorder (SPD) is considered a schizophrenia spectrum disorder, sharing with schizophrenia cognitive, neuropsychological, epidemiological, and biological characteristics. Working memory may be one area of shared deficit, although to date, this is only the second study to investigate working memory in SPD using fMRI. METHODS In a block-design fMRI study, fifteen antipsychotic-naïve SPD and sixteen healthy control subjects performed blocks of a 2back visual working memory task and 0back continuous performance task while undergoing whole-brain fMRI at 3T. Whole-brain analyses were performed for the 0back>rest (fixation baseline) and the 2back>0back contrasts (isolating the working memory component from the visual perception and attention component). Parameter estimates were extracted to determine whether observed differences were due to task-induced activation and/or deactivation. RESULTS Activation differences emerged between the two groups, without differences in task performance. In the 0back task, SPD showed decreased task-induced activation of the left postcentral gyrus. In the 2back>0back contrast, HC showed greater task-induced activation of the left posterior cingulate gyrus, superior temporal gyrus, insula, and middle frontal gyrus. These differences were due to SPD subjects' decreased task-induced activation in the left posterior cingulate gyrus, and task-induced deactivation in the remaining regions. CONCLUSIONS These findings suggest that compared to HC subjects, individuals with SPD may achieve comparable working memory performance. However, differences emerge at the level of functional neural activation, attributable to different task-induced activation and deactivation patterns. Such differential recruitment of neural resources may be beneficial, contributing to SPD subjects' ability to perform these tasks comparably to HC subjects.
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Affiliation(s)
- Mai-Anh T Vu
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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14
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Pantazatos SP. Prediction of individual season of birth using MRI. Neuroimage 2013; 88:61-8. [PMID: 24246490 DOI: 10.1016/j.neuroimage.2013.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 11/03/2013] [Accepted: 11/05/2013] [Indexed: 11/19/2022] Open
Abstract
Previous research suggests statistical associations between season of birth (SOB) with prevalence of neurobehavioral disorders such as schizophrenia and bipolar disorder, personality traits such as novelty and sensation seeking, and suicidal behavior. These effects are thought to be mediated by seasonal differences in perinatal photoperiod, which was recently shown to imprint circadian clock neurons and behavior in rodents. However, it is unknown whether SOB is associated with any measurable differences in the normal human adult brain, and whether individual SOB can be deduced based on phenotype. Here I show that SOB predicts morphological differences in brain structure, and that MRI scans carry spatially distributed information allowing significantly above chance prediction of an individual's SOB. Using an open source database of over 550 structural brain scans, Voxel-Based Morphometry (VBM) analysis showed a significant SOB effect in the left superior temporal gyrus (STG) in males (p=0.009, FWE whole-brain corrected), with greater gray matter volumes in fall and winter births. A cosinor analysis revealed a significant annual periodicity in the left STG gray matter volume (Zero Amplitude Test: p<5×10(-7)), with a peak towards the end of December and a nadir towards the end of June, suggesting that perinatal photoperiod accounts for this SOB effect. Whole-brain VBM maps were used as input features to multivariate machine-learning based analyses to classify SOB. Significantly greater than chance prediction was achieved in females (overall accuracy 35%, p<0.001), but not in males (overall accuracy 26%, p=0.45). Pairwise binary classification in females revealed that the highest discrimination was obtained for winter vs. summer classification (peak area under the ROC curve=0.71, p<0.0005). Discriminating regions included fusiform and middle temporal gyrus, inferior and superior parietal lobe, cerebellum, and dorsolateral and dorsomedial prefrontal cortex. Results indicate that SOB is detectable with MRI, imply that SOB exerts effects on the developing human brain that persist through adulthood, and suggest that neuroimaging may be a valuable intermediate phenotype in bridging the gap between SOB and personality and neurobehavioral disorders.
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Affiliation(s)
- Spiro P Pantazatos
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
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15
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Ivleva EI, Bidesi AS, Keshavan MS, Pearlson GD, Meda SA, Dodig D, Moates AF, Lu H, Francis AN, Tandon N, Schretlen DJ, Sweeney JA, Clementz BA, Tamminga CA. Gray matter volume as an intermediate phenotype for psychosis: Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). Am J Psychiatry 2013; 170:1285-96. [PMID: 24185241 PMCID: PMC6487663 DOI: 10.1176/appi.ajp.2013.13010126] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The study examined gray matter volume across psychosis diagnoses organized by dimensional and DSM-IV categories from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) sample. METHOD In total, 351 probands with psychosis (146 with schizophrenia, 90 with schizoaffective disorder, and 115 with psychotic bipolar I disorder), 369 of their first-degree relatives (134 were relatives of individuals with schizophrenia, 106 of individuals with schizoaffective disorder, and 129 of individuals with psychotic bipolar I disorder), and 200 healthy comparison subjects were assessed. Gray matter volumes from 3-T T1-weighted images were analyzed using the VBM8 toolbox for SPM8, and outcomes were determined at a false discovery rate-corrected threshold of p<0.005. RESULTS Across the psychosis dimension, probands (N=351) and relatives with psychosis spectrum disorders (N=34) showed substantial overlapping gray matter reductions throughout the neocortex, whereas relatives without psychosis spectrum (N=332) had normal gray matter volumes relative to comparison subjects. Across DSM-IV diagnoses, schizophrenia and schizoaffective probands showed overlapping gray matter reductions in numerous cortical and subcortical regions, whereas psychotic bipolar probands showed limited gray matter reductions localized to the frontotemporal cortex relative to comparison subjects. All relative groups had gray matter volumes that did not differ from comparison subjects. CONCLUSIONS Across the dimensional psychosis categories, these findings indicate extensive neocortical gray matter reductions in psychosis probands and relatives with psychosis spectrum disorders, possibly reflecting lifetime psychosis burden, but normal gray matter in nonpsychotic relatives. Traditional DSM-IV psychosis grouping revealed partially divergent gray matter phenotypes for probands with schizophrenia or schizoaffective disorder (extensive neocortical or subcortical gray matter reductions) relative to those with psychotic bipolar disorder (smaller reductions were limited to frontotemporal regions). The dimensional conceptualization of psychosis appears useful in defining more homogenous disease categories that may help identify underlying psychosis biomarkers and develop a biologically driven diagnostic system and targeted treatments.
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16
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Fervaha G, Remington G. Neuroimaging findings in schizotypal personality disorder: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:96-107. [PMID: 23220094 DOI: 10.1016/j.pnpbp.2012.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/10/2012] [Accepted: 11/28/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizotypal personality disorder is the prototypical schizophrenia-spectrum condition, sharing similar phenomenological, cognitive, genetic, physiological, neurochemical, neuroanatomical and neurofunctional abnormalities with schizophrenia. Investigations into SPD circumvent many confounds inherent to schizophrenia such as medication and institutionalization. Hence, SPD offers a unique vantage point from which to study schizophrenia-spectrum conditions. METHODS We systematically reviewed the neuroimaging literature in SPD to establish: (1) whether there are concordant findings in SPD and schizophrenia, possibly reflective of core pathology between the two conditions and (2) whether there are discordant findings in SPD and schizophrenia, possibly reflecting protective factors in the former. The findings are synthesized across structural and functional neuroimaging domains. RESULTS A total of 54 studies were identified. Medial temporal lobe structures seem to be compromised in both SPD and schizophrenia. In schizophrenia prefrontal structures are further compromised, whereas in SPD these seem to be larger-than-normal, possibly reflecting a compensatory mechanism. Additional pathology is discussed, including evidence of aberrant subcortical dopaminergic functioning. CONCLUSIONS SPD is a schizophrenia-spectrum condition that shares pathology with schizophrenia, but is distinct in showing unique neural findings. Future studies are needed to confirm and localize regions of common and disparate pathology between SPD and schizophrenia.
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Affiliation(s)
- Gagan Fervaha
- Schizophrenia Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
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17
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Hovington CL, McGirr A, Lepage M, Berlim MT. Repetitive transcranial magnetic stimulation (rTMS) for treating major depression and schizophrenia: a systematic review of recent meta-analyses. Ann Med 2013; 45:308-21. [PMID: 23687987 DOI: 10.3109/07853890.2013.783993] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In recent years, repetitive transcranial magnetic stimulation (rTMS) has been developed for the treatment of major depression (MD) and schizophrenia. Although rTMS has shown some promising findings, the lack of standardization in the methodology employed has resulted in discordant findings. OBJECTIVES The objective of this systematic review was to summarize several meta-analytical studies exploring the efficacy of rTMS in either MD or schizophrenia in order to examine the methodologies that increase the efficacy of rTMS and to provide some recommendations for future studies. METHODS We searched the MEDLINE database for potentially relevant meta-analytic studies on the use of rTMS for treating major depression and schizophrenia published from January 2000 to October 2011. RESULTS Fifteen rTMS meta-analytical studies were reviewed (11 on MD and 5 on schizophrenia). Several variables were reviewed including outcome measures, side-effects of rTMS, site of stimulation, frequency and intensity of stimulation, and number of treatment sessions. CONCLUSIONS Overall, rTMS appears to be an effective and promising therapeutic for both MD and schizophrenia.
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Affiliation(s)
- Cindy L Hovington
- Neuromodulation Program, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada
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18
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Pituitary volume in schizophrenia spectrum disorders. Schizophr Res 2013; 146:301-7. [PMID: 23522905 PMCID: PMC3760333 DOI: 10.1016/j.schres.2013.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 02/14/2013] [Accepted: 02/20/2013] [Indexed: 11/22/2022]
Abstract
INTRODUCTION There is converging evidence supporting hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in schizophrenia spectrum disorders (SSD), such as schizotypal personality disorder (SPD), first-episode schizophrenia (FESZ) and chronic schizophrenia (CHSZ). Such an aberrant HPA activity might have volumetric consequences on the pituitary gland. However, previous magnetic resonance imaging (MRI) studies assessing pituitary volume (PV) in SSD are conflicting. The main objective of this study was to examine further PV in SSD. METHODS PV were manually traced on structural MRIs in 137 subjects, including subjects with SPD (n = 40), FESZ (n = 15), CHSZ (n = 15), and HC (n = 67). We used an ANCOVA to test PV between groups and gender while controlling for inter-subject variability in age, years of education, socioeconomic status, and whole brain volume. RESULTS Overall, women had larger PV than men, and within the male sample all SSD subjects had smaller PV than HC, statistically significant only for the SPD group. In addition, dose of medication, illness duration and age of onset were not associated with PV. CONCLUSION Chronic untreated HPA hyperactivity might account for smaller PV in SPD subjects, whereas the absence of PV changes in FESZ and CHSZ patients might be related to the normalizing effects of antipsychotics on PV. SPD studies offer a way to examine HPA related alterations in SSD without the potential confounds of medication effects.
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Williams MR, Chaudhry R, Perera S, Pearce RKB, Hirsch SR, Ansorge O, Thom M, Maier M. Changes in cortical thickness in the frontal lobes in schizophrenia are a result of thinning of pyramidal cell layers. Eur Arch Psychiatry Clin Neurosci 2013; 263:25-39. [PMID: 22610045 DOI: 10.1007/s00406-012-0325-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 04/30/2012] [Indexed: 12/23/2022]
Abstract
Decreased cortical thickness and reduced activity as measured by fMRI in the grey matter of the subgenual cingulate cortex have been reported in schizophrenia and bipolar disorder, and cortical grey matter loss has been reliably reported in the frontal and temporal lobes in schizophrenia. The aim of this study was to examine the thickness of each of the six cortical layers in the subgenual cingulate cortex, five frontal lobe and four temporal lobe gyri. We examined two separate cohorts. Cohort 1 examines the subgenual cingulate cortex (SCC) in schizophrenia (n = 10), bipolar disorder (n = 15) and major depressive disorder (n = 20) against control subjects (n = 19). Cohort two examines frontal and temporal gyri in schizophrenia (n = 16), major depressive disorder (n = 6) against matched controls (n = 32). The cohorts were selected with identical clinical criteria, but underwent different tissue processing to contrast the effect of chemical treatment on tissue shrinkage. Measurements of layer I-VI thickness were taken from cresyl-violet- and haematoxylin-stained sections in cohort one and from cresyl-violet- and H&E-stained sections in cohort two. SCC cortical thickness decreased in male subjects with bipolar disorder (p = 0.048), and male schizophrenia cases showed a specific decrease in the absolute thickness of layer V (p = 0.003). Compared to controls, the relative thickness of layer V in the crown of the SCC decreased in schizophrenia (p < 0.001). A significant decrease in total cortical thickness was observed across the frontal lobe in schizophrenia (p < 0.0001), with specific pyramidal layer thinning in layers III (p = 0.0001) and V (p = 0.005). There was no effect of lateralization. No changes were noted in temporal lobe cortical thickness. This study demonstrates diminished pyramidal layer thickness resulting in decreased frontal lobe thickness in schizophrenia.
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Affiliation(s)
- M R Williams
- Neuropathology Unit, Department of Experimental Medicine, Imperial College London, Charing Cross Hospital, UK.
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Dickey CC, Vu MAT, Voglmaier MM, Niznikiewicz MA, McCarley RW, Panych LP. Prosodic abnormalities in schizotypal personality disorder. Schizophr Res 2012; 142:20-30. [PMID: 23068317 PMCID: PMC3502641 DOI: 10.1016/j.schres.2012.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/31/2012] [Accepted: 09/05/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Patients with schizophrenia speak with blunted vocal affect but little is known regarding the prosody of persons with schizotypal personality disorder (SPD). This work examined expressive prosody in SPD, its relationship to brain structure, and outlined a framework for measuring elements of prosody in clinical populations. METHODS Twenty-eight antipsychotic-naïve SPD subjects were matched with 27 healthy comparison (HC) subjects. Subjects read aloud short sentences and responded to probes to record both predetermined and self-generated speech samples. Samples were analyzed acoustically (pause proportion, duration, attack, and pitch variability) and subjectively by raters (amount of pauses, degree of emotion portrayed, and how much they wanted to hear more from the subjects) on paragraph, sentence, word, word-fragment, and syllable levels. Alexithymia and ability to self-monitor behavior were compared between groups. The pars opercularis was manually traced on structural MRI data. RESULTS SPD subjects' speech had significantly more pauses, was slower, had less pitch variability, and expressed less emotion than HC subjects. Pitch variability correlated with socio-economic status achievement. There was no difference between groups in left or right pars opercularis volumes. A statistically significant correlation suggested that smaller left pars opercularis volumes in SPD subjects correlated with more pauses and less emotion. SPD subjects reported more alexithymia and difficulty self-monitoring their behavior compared with controls. In SPD subjects the high alexithymia correlated with raters not wanting to hear more from them and SPD subjects' inability to modulate their social behavior correlated with their having fewer friends. Thus, the SPD subjects exhibited insight. CONCLUSIONS SPD subjects displayed significant prosodic deficits that were measurable in speech samples as brief as a word-fragment. The determinants of these deficits are not known although these may include a dysfunctional pars opercularis. These data add to the nascent literature describing social cognition deficits in SPD.
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Affiliation(s)
- Chandlee C. Dickey
- VA Boston Healthcare System, Harvard Medical School Psychiatry 116A-7, 940 Belmont St., Brockton, MA 02301,Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301,Corresponding Author: Chandlee Dickey, M.D. VA Boston Healthcare System, Psychiatry 116A-7, 940 Belmont St., Brockton, MA 02301 Phone: (774) 826-2457 Fax: (774) 826-1859
| | - Mai-Anh T Vu
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School 1249 Boylston St, Boston, MA 02215
| | - Martina M. Voglmaier
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301
| | - Margaret A. Niznikiewicz
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301,Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School 1249 Boylston St, Boston, MA 02215
| | - Robert W. McCarley
- Laboratory of Neuroscience, VA Boston Healthcare System, Harvard Medical School 940 Belmont St., Brockton, MA 02301
| | - Lawrence P. Panych
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School 75 Francis St., Boston, MA 02216
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Kühn S, Schubert F, Gallinat J. Higher prefrontal cortical thickness in high schizotypal personality trait. J Psychiatr Res 2012; 46:960-5. [PMID: 22551659 DOI: 10.1016/j.jpsychires.2012.04.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/07/2012] [Accepted: 04/05/2012] [Indexed: 10/28/2022]
Abstract
A model of schizophrenia-spectrum disorders hypothesized that schizotypy shares biomarkers with schizophrenia but due to protective factors such as a greater prefrontal cortex those individuals have a reduced vulnerability to schizophrenia. In contrast to previous studies exploring volumetric brain correlates of schizotypy focussing on clinical samples or relying on between-group comparisons we measured cortical thickness and correlated it with the expression of schizotypal personality traits in a mentally healthy sample. We acquired high-resolution MRI scans from 34 subjects and used FreeSurfer to model the grey-white and pial surfaces for each individual cortex in order to compute the distance between these surfaces to obtain a measure of cortical thickness. Differences in cortical thickness were correlated with positive and negative factors of schizotypy as assessed by means of the schizotypal personality questionnaire. We found a significant positive correlation between right dorso-lateral prefrontal cortex (DLPFC) and right dorsal premotor cortex/frontal eye fields (dPMC/FEF) and the total schizotypy score, between right DLPFC and the positive factor, and between right temporo-parietal junction and the negative factor of schizotypy. The volume of thalamus was negatively correlated with schizotypy. A significant negative correlation between thalamus volume and dPMC/FEF cortical thickness was observed. One may speculate that this finding is in line with the hypothesis of a compensatory role of greater prefrontal cortex in schizotypy in healthy populations.
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Affiliation(s)
- Simone Kühn
- Charité University Medicine, St. Hedwig Krankenhaus, Clinic for Psychiatry and Psychotherapy, Große Hamburger Straße 5-11, 10115 Berlin, Germany.
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A developmental increase in allostatic load from ages 3 to 11 years is associated with increased schizotypal personality at age 23 years. Dev Psychopathol 2012; 23:1059-68. [PMID: 22018081 DOI: 10.1017/s0954579411000496] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Although allostatic load has been investigated in mood and anxiety disorders, no prior study has investigated developmental change in allostatic load as a precursor to schizotypal personality. This study employed a multilevel developmental framework to examine whether the development of increased allostatic load, as indicated by impaired sympathetic nervous system habituation from ages 3 to 11 years, predisposes to schizotypal personality at age 23 years. Electrodermal activity to six aversive tones was recorded in 995 subjects at age 3 years and again at 11 years. Habituation slopes at both ages were used to create groups who showed a developmental increase in habituation (decreased allostatic load), and those who showed a developmental decrease in habituation (increased allostatic load). Children who showed a developmental increase in allostatic load from ages 3 to 11 years had higher levels of schizotypal personality at 23 years. A breakdown of total schizotypy scores demonstrated specificity of findings to cognitive-perceptual features of schizotypy. Findings are the first to document a developmental abnormality in allostasis in relation to adult schizotypal personality. The relative failure to develop normal habituation to repeated stressors throughout childhood is hypothesized to result in an accumulation of allostatic load and consequently increased positive symptom schizotypy in adulthood.
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Abstract
Individuals with schizotypal personality disorder (SPD) share genetic, phenomenologic, and cognitive abnormalities with people diagnosed with schizophrenia. To date, 15 structural MRI studies of the brain have examined size, and 3 diffusion tensor imaging studies have examined white matter connectivity in SPD. Overall, both types of structural neuroimaging modalities have shown temporal lobe abnormalities similar to those observed in schizophrenia, while frontal lobe regions appear to show more sparing. This intriguing pattern suggests that frontal lobe sparing may suppress psychosis, which is consistent with the idea of a possible neuroprotective factor. In this paper, we review these 18 studies and discuss whether individuals with SPD who both resemble and differ from schizophrenia patients in their phenomenology, share some or all of the structural brain imaging characteristics of schizophrenia. We attempt to group the MRI abnormalities in SPD into three patterns: 1) a spectrum of severity-abnormalities are similar to those observed in schizophrenia but not so severe; 2) a spectrum of region-abnormalities affecting some, but not all, brain regions affected in schizophrenia; and 3) a spectrum of compensation-abnormalities reflecting greater-than-normal white matter volume, possibly serving as a buffer or compensatory mechanism protecting the individual with SPD from the frank psychosis observed in schizophrenia.
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Discovery and development of integrative biological markers for schizophrenia. Prog Neurobiol 2011; 95:686-702. [DOI: 10.1016/j.pneurobio.2011.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 05/25/2011] [Accepted: 05/27/2011] [Indexed: 12/30/2022]
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Interhemispheric hypoconnectivity in schizophrenia: fiber integrity and volume differences of the corpus callosum in patients and unaffected relatives. Neuroimage 2011; 59:926-34. [PMID: 21964509 DOI: 10.1016/j.neuroimage.2011.07.088] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 07/13/2011] [Accepted: 07/27/2011] [Indexed: 11/21/2022] Open
Abstract
Changes in hemispheric asymmetry and inter-hemispheric connectivity have been reported in schizophrenia. However, the genetic contribution to these alterations is still unclear. In the current study, we applied an automatic segmentation method to structural MRI and diffusion tensor imaging (DTI) data and examined volume and fiber integrity of the corpus callosum (CC), the main interhemispheric fiber tract, in 16 chronic schizophrenia (SZ) patients, matched first degree relatives and controls. SZ patients and relatives had smaller CC volumes than controls, particularly in the posterior genu, isthmus and splenium. Fractional anisotropy (FA), an indicator of fiber integrity, was reduced in patients and relatives in the whole CC, the inferior genu, the superior genu and the isthmus. Correspondingly, the mean diffusivity (MD) values of the whole CC and the isthmus were higher in patients and their unaffected relatives, indicating decreased compactness and increased intercellular space. Relatives had intermediate values in the volumetric and fiber integrity measurements between patients and controls. Lower CC volume and fiber integrity in SZ patients were associated with more severe auditory hallucinations. These results support the connectivity hypothesis of SZ (Friston, 1998) and particularly highlight the altered interhemispheric connectivity, which appears to be a genetic feature of SZ risk.
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Yasuda Y, Hashimoto R, Ohi K, Fukumoto M, Umeda-Yano S, Yamamori H, Okochi T, Iwase M, Kazui H, Iwata N, Takeda M. Impact on schizotypal personality trait of a genome-wide supported psychosis variant of the ZNF804A gene. Neurosci Lett 2011; 495:216-20. [PMID: 21457757 DOI: 10.1016/j.neulet.2011.03.069] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 03/23/2011] [Indexed: 01/09/2023]
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Kostova M, de Loye C, Blanchet A. Left but not right hemisphere semantic processing abnormalities in language comprehension in subjects with schizotypy traits. Psychiatry Res 2011; 185:84-91. [PMID: 20627324 DOI: 10.1016/j.psychres.2010.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Revised: 04/30/2010] [Accepted: 05/05/2010] [Indexed: 11/24/2022]
Abstract
Thought and language disorders in schizophrenia and schizotypy are thought to result from hemispheric dysfunction during semantic processing. Left hemisphere (LH) abnormalities are well established, but little is known about right hemisphere (RH) semantic processes. We explored hemispheric processing in 50 healthy volunteers assigned to high (h-SZT) or low schizotypy (l-SZT) group using the Schizotypal Personality Questionnaire (SPQ). Subjects were asked to make semantic judgments on sentence pair ending with a target that was either expected word (EW) or an unexpected word from the same (related violation, RV) or a different category (unrelated violation, URV). Targets were presented in a dichotic manner to the left or right ear. Analyses of reaction times in the l-SZT group showed semantic compatibility effect (URV-EW) in the LH and semantic memory activation effect (RV-URV) as well as semantic compatibility effect in the RH. The h-SZT group showed semantic memory activation but no semantic compatibility effect in the LH, the RH pattern resembling that of the l-SZT group. The magnitude of the LH semantic compatibility effect was inversely correlated with SPQ total scores and SPQ Cognitive-perceptual factor. Thus, RH semantic processes are effective and there is a deficit in LH focused activation in schizotypy.
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Affiliation(s)
- Milena Kostova
- Laboratoire de Psychopathologie et Neuropsychologie (EA 2027), Université Paris 8, Saint-Denis, France.
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Hazlett EA, Goldstein KE, Tajima-Pozo K, Speidel ER, Zelmanova Y, Entis JJ, Silverman JM, New AS, Koenigsberg HW, Haznedar MM, Byne W, Siever LJ. Cingulate and temporal lobe fractional anisotropy in schizotypal personality disorder. Neuroimage 2011; 55:900-8. [PMID: 21223999 DOI: 10.1016/j.neuroimage.2010.12.082] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 12/14/2010] [Accepted: 12/30/2010] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Consistent with the clinical picture of milder symptomatology in schizotypal personality disorder (SPD) than schizophrenia, morphological studies indicate SPD abnormalities in temporal lobe regions but to a much lesser extent in prefrontal regions implicated in schizophrenia. Lower fractional anisotropy (FA), a measure of white-matter integrity within prefrontal, temporal, and cingulate regions has been reported in schizophrenia but has been little studied in SPD. AIMS The study aim was to examine temporal and prefrontal white matter FA in 30 neuroleptic-naïve SPD patients and 35 matched healthy controls (HCs). We hypothesized that compared with HCs, SPD patients would exhibit lower FA in temporal lobe and anterior cingulum regions but relative sparing in prefrontal regions. METHOD We acquired diffusion tensor imaging (DTI) in all participants and examined FA in the white matter underlying Brodmann areas (BAs) in dorsolateral prefrontal (BAs 44, 45, and 46), temporal lobe (BAs 22, 21, and 20), and cingulum (BAs 25, 24, 31, 23, and 29) regions with a series of analyses using multivariate analysis of variance. RESULTS Compared with HCs, the SPD group had significantly lower FA in the left temporal lobe but not prefrontal regions. In the cingulum, FA was lower in the SPD group in the posterior regions (BAs 31 and 23), higher in the anterior (BA 25) regions and lower overall in the right but not the left cingulum. Among the SPD group, lower FA in the cingulum was associated with more severe negative symptoms (e.g., odd speech). CONCLUSIONS Similar to schizophrenia, our results indicate cingulum-temporal lobe FA abnormalities in SPD and suggest that cingulum abnormalities are associated with negative symptoms.
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Affiliation(s)
- Erin A Hazlett
- Mental Illness Research, Education and Clinical Center VISN 3, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA.
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Modinos G, Mechelli A, Ormel J, Groenewold NA, Aleman A, McGuire PK. Schizotypy and brain structure: a voxel-based morphometry study. Psychol Med 2010; 40:1423-1431. [PMID: 19917146 DOI: 10.1017/s0033291709991875] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizotypy is conceptualized as a subclinical manifestation of the same underlying biological factors that give rise to schizophrenia and other schizophrenia spectrum disorders. Individuals with psychometric schizotypy (PS) experience subthreshold psychotic signs and can be psychometrically identified among the general population. Previous research using magnetic resonance imaging (MRI) has shown gray-matter volume (GMV) abnormalities in chronic schizophrenia, in subjects with an at-risk mental state (ARMS) and in individuals with schizotypal personality disorder (SPD). However, to date, no studies have investigated the neuroanatomical correlates of PS. METHOD Six hundred first- and second-year university students completed the Community Assessment of Psychic Experiences (CAPE), a self-report instrument on psychosis proneness measuring attenuated positive psychotic experiences. A total of 38 subjects with high and low PS were identified and subsequently scanned with MRI. Voxel-based morphometry (VBM) was applied to examine GMV differences between subjects with high and low positive PS. RESULTS Subjects with high positive PS showed larger global volumes compared to subjects with low PS, and larger regional volumes in the medial posterior cingulate cortex (PCC) and the precuneus. There were no regions where GMV was greater in low than in high positive PS subjects. CONCLUSIONS These regions, the PCC and precuneus, have also been sites of volumetric differences in MRI studies of ARMS subjects and schizophrenia, suggesting that psychotic or psychotic-like experiences may have common neuroanatomical correlates across schizophrenia spectrum disorders.
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Affiliation(s)
- G Modinos
- Department of Neuroscience, University Medical Center Groningen, and BCN Neuroimaging Center, University of Groningen, Groningen, The Netherlands.
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Factors in sensory processing of prosody in schizotypal personality disorder: an fMRI experiment. Schizophr Res 2010; 121:75-89. [PMID: 20362418 PMCID: PMC2905482 DOI: 10.1016/j.schres.2010.03.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 03/04/2010] [Accepted: 03/09/2010] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Persons diagnosed with schizophrenia demonstrate deficits in prosody recognition. To examine prosody along the schizophrenia spectrum, antipsychotic-naïve schizotypal personality disorder (SPD) subjects and healthy control subjects were compared. It was hypothesized that SPD subjects would perform more poorly; with cognitive and demographic factors contributing to the poor performance. The superior temporal gyrus (STG) was selected as the region-of-interest (ROI) given its known abnormalities in SPD and its important role in the processing of prosody. METHODS SPD and healthy comparison (HC) subjects were matched on age, IQ, and parental social-economic status (PSES). Cognitive measures included the Speech Sound Perception Test (SSPT) to examine phonological processing (SPD=68, HC=74) and the Verbal Fluency task to examine executive functioning (SPD=129, HC=138). The main experiment was a novel fMRI task of prosody identification using semantically neutral sentences spoken with emotional prosody (SPD=16, HC=13). Finally, volumetric measurement of the superior temporal sulcus (STS), a key region for processing prosody, and partially overlapping with the STG, was performed (SPD=30, HC=30). RESULTS Phonological processing and executive functioning were both impaired in SPD subjects compared with HC subjects. Contrary to the prediction, SPD subjects, as a group, were similar to HC subjects in terms of correctly indentifying the emotion conveyed and reaction time. Within the SPD group, prosody identification accuracy was influenced by executive functioning, IQ and perhaps PSES, relationships not found with HC subjects. Phonological perception aided prosody identification in both diagnostic groups. As expected, both groups activated the STG while performing the prosody identification task. However, SPD subjects may have been less "efficient" in their recruitment of STG neurons. Finally, SPD subjects demonstrated a trend toward smaller STS volumes on the left, particularly the lower bank. CONCLUSIONS These data suggest that subtle differences between SPD and controls in phonological processing, executive functioning, IQ, and possibly PSES, contributed to difficulty in processing prosody for some SPD subjects.
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Takahashi T, Suzuki M, Zhou SY, Tanino R, Nakamura K, Kawasaki Y, Seto H, Kurachi M. A follow-up MRI study of the superior temporal subregions in schizotypal disorder and first-episode schizophrenia. Schizophr Res 2010; 119:65-74. [PMID: 20051316 DOI: 10.1016/j.schres.2009.12.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 10/30/2009] [Accepted: 12/03/2009] [Indexed: 01/19/2023]
Abstract
While longitudinal magnetic resonance imaging (MRI) studies have demonstrated progressive gray matter reduction of the superior temporal gyrus (STG) during the early phases of schizophrenia, it remains unknown whether patients with schizotypal features exhibit similar STG changes. In this study, longitudinal MRI data were obtained from 18 patients with first-episode schizophrenia, 13 patients with schizotypal disorder, and 20 healthy controls. The volumes of the STG and its subregions [planum polare (PP), Heschl gyrus (HG), planum temporale (PT), rostral STG, and caudal STG] were measured on baseline and follow-up (mean: 2.7 years) scans and were compared across groups. At the baseline, both the schizophrenia and schizotypal patients had smaller left PT and left caudal STG than the controls. In a longitudinal comparison, the schizophrenia patients showed significant gray matter reduction of the STG over time (left: -2.8%/year; right: -1.5%/year) compared with the schizotypal patients (left: -0.6%/year; right: -0.3%/year) and controls (left: 0.0%/year; right: -0.1%/year) without a prominent effect of subregion or type of antipsychotic (typical/atypical). In the schizophrenia patients, greater annual volume reductions of the left PP and right PT were correlated with less improvement of positive psychotic symptoms. A higher cumulative dose of antipsychotics during follow-up in schizophrenia was significantly correlated with less severe gray matter reductions in the left PT and bilateral caudal STG. Our findings suggest that the left posterior STG subregions are commonly reduced in diseases of the schizophrenia spectrum; whereas, schizophrenia patients exhibit further progressive STG changes associated with overt psychosis in the early years of the illness.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
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Visual information processing deficits as biomarkers of vulnerability to schizophrenia: an event-related potential study in schizotypy. Neuropsychologia 2010; 48:2205-14. [PMID: 20412812 DOI: 10.1016/j.neuropsychologia.2010.04.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 04/12/2010] [Accepted: 04/13/2010] [Indexed: 11/23/2022]
Abstract
We aimed to clarify the importance of early visual processing deficits for the formation of cognitive deficits in the schizophrenia spectrum. We carried out an event-related potential (ERP) study using a computerised delayed matching to sample working memory (WM) task on a sample of volunteers with high and low scores on the Schizotypal Personality Questionnaire (SPQ). The amplitudes of the visual ERPs to the encoding and retrieval stimuli in the task were measured using the BESA software. The hypothesis was that the high schizotypes would have deficits in early visual processing (reduced P1 amplitude) and working memory similar to those observed in schizophrenia. The high schizotypy group identified fewer previously encoded target cues than the low schizotypy group in the WM task and their mean cue-evoked P1 amplitudes were significantly reduced, both in the encoding and the retrieval phases of the task. Accuracy on the WM task correlated with the P1 amplitude. None of the later components (N1 and P2) were significantly different between the groups, nor were there differences in performance on the CANTAB tests. The results are compatible with the hypothesis that trait vulnerability to schizophrenia is associated with impaired early visual processing which may contribute to impaired cognitive memory performance. However, the high schizotypes are apparently able to compensate for the visual processing deficits and perform normally when stimuli are presented for longer as in the CANTAB tasks. This study adds to growing evidence that the schizophrenia spectrum is characterized by early sensory abnormalities.
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Goldstein KE, Hazlett EA, New AS, Haznedar MM, Newmark RE, Zelmanova Y, Passarelli V, Weinstein SR, Canfield EL, Meyerson DA, Tang CY, Buchsbaum MS, Siever LJ. Smaller superior temporal gyrus volume specificity in schizotypal personality disorder. Schizophr Res 2009; 112:14-23. [PMID: 19473820 PMCID: PMC2782902 DOI: 10.1016/j.schres.2009.04.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 04/21/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Superior temporal gyrus (STG/BA22) volume is reduced in schizophrenia and to a milder degree in schizotypal personality disorder (SPD), representing a less severe disorder in the schizophrenia spectrum. SPD and Borderline personality disorder (BPD) are severe personality disorders characterized by social and cognitive dysfunction. However, while SPD is characterized by social withdrawal/anhedonia, BPD is marked by hyper-reactivity to interpersonal stimuli and hyper-emotionality. This is the first morphometric study to directly compare SPD and BPD patients in temporal lobe volume. METHODS We compared three age-, sex-, and education-matched groups: 27 unmedicated SPD individuals with no BPD traits, 52 unmedicated BPD individuals with no SPD traits, and 45 healthy controls. We examined gray matter volume of frontal and temporal lobe Brodmann areas (BAs), and dorsal/ventral amygdala from 3-T magnetic resonance imaging. RESULTS In the STG, an auditory association area reported to be dysfunctional in SPD and BPD, the SPD patients had significantly smaller volume than healthy controls and BPD patients. No group differences were found between BPD patients and controls. Smaller BA22 volume was associated with greater symptom severity in SPD patients. Reduced STG volume may be an important endophenotype for schizophrenia-spectrum disorders. SPD is distinct from BPD in terms of STG volume abnormalities which may reflect different underlying pathophysiological mechanisms and could help discriminate between them.
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Affiliation(s)
- Kim E. Goldstein
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Erin A. Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA,Erin A. Hazlett, Ph.D., Department of Psychiatry, Box 1505, Mount Sinal School of Medicine, NY, NY 10029.
| | - Antonia S. New
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC)
| | - M. Mehmet Haznedar
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Randall E. Newmark
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Yuliya Zelmanova
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Vincent Passarelli
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Shauna R. Weinstein
- Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC)
| | - Emily L. Canfield
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - David A. Meyerson
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Cheuk Y. Tang
- Department of Radiology, Mount Sinai School of Medicine, New York, NY, USA
| | - Monte S. Buchsbaum
- Departments of Psychiatry and Neurology, University of California, San Diego
| | - Larry J. Siever
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC)
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Allen AJ, Griss ME, Folley BS, Hawkins KA, Pearlson GD. Endophenotypes in schizophrenia: a selective review. Schizophr Res 2009; 109:24-37. [PMID: 19223268 PMCID: PMC2665704 DOI: 10.1016/j.schres.2009.01.016] [Citation(s) in RCA: 156] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 01/11/2009] [Accepted: 01/14/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND Given the wealth of data in the literature on schizophrenia endophenotypes, it is useful to have one source to reference their frequency data. We reviewed the literature on disease-liability associated variants in structural and functional magnetic resonance images (MRI), sensory processing measures, neuromotor abilities, neuropsychological measures, and physical characteristics in schizophrenia patients (SCZ), their first-degree relatives (REL), and healthy controls (HC). The purpose of this review was to provide a summary of the existing data on the most extensively published endophenotypes for schizophrenia. METHODS We searched PubMed and MedLine for all studies on schizophrenia endophenotypes comparing SCZ to HC and/or REL to HC groups. Percent abnormal values, generally defined as >2 SD from the mean (in the direction of abnormality) and/or associated effect sizes (Cohen's d) were calculated for each study. RESULTS Combined, the articles reported an average 39.4% (SD=20.7%; range=2.2-100%) of abnormal values in SCZ, 28.1% (SD=16.6%; range=1.6-67.0%) abnormal values in REL, and 10.2% (SD=6.7%; range=0.0-34.6%) in HC groups. CONCLUSIONS These findings are reviewed in the context of emerging hypotheses on schizophrenia endophenotypes, as well as a discussion of clustering trends among the various intermediate phenotypes. In addition, programs for future research are discussed, as instantiated in a few recent large-scale studies on multiple endophenotypes across patients, relatives, and healthy controls.
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Affiliation(s)
- Allyssa J. Allen
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106,Corresponding Author: Allyssa J. Allen, Olin Neuropsychiatry Research Center, Whitehall Building, 200 Retreat Avenue, Hartford, CT 06106, Tel: 860-459-7806, Fax: 860-545-7797,
| | - Mélina E. Griss
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106
| | - Bradley S. Folley
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106
| | - Keith A. Hawkins
- Dept. of Psychiatry, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06511
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106,Dept. of Psychiatry, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06511
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The transliminal brain at rest: baseline EEG, unusual experiences, and access to unconscious mental activity. Cortex 2008; 44:1353-63. [PMID: 18814870 DOI: 10.1016/j.cortex.2007.08.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Revised: 08/02/2007] [Accepted: 08/07/2007] [Indexed: 11/30/2022]
Abstract
Transliminality reflects individual differences in the threshold at which unconscious processes or external stimuli enter into consciousness. Individuals high in transliminality possess characteristics such as magical ideation, belief in the paranormal, and creative personality traits, and also report the occurrence of manic/mystic experiences. The goal of the present research was to determine if resting brain activity differs for individuals high versus low in transliminality. We compared baseline EEG recordings (eyes-closed) between individuals high versus low in transliminality, assessed using The Revised Transliminality Scale of Lange et al. (2000). Identifying reliable differences at rest between high- and low-transliminality individuals would support a predisposition for transliminality-related traits. Individuals high in transliminality exhibited lower alpha, beta, and gamma power than individuals low in transliminality over left posterior association cortex and lower high alpha, low beta, and gamma power over the right superior temporal region. In contrast, when compared to individuals low in transliminality, individuals high in transliminality exhibited greater gamma power over the frontal-midline region. These results are consistent with prior research reporting reductions in left temporal/parietal activity, as well as the desynchronization of right temporal activity in schizotypy and related schizophrenia spectrum disorders. Further, differences between high- and low-transliminality groups extend existing theories linking altered hemispheric asymmetries in brain activity to a predisposition toward schizophrenia, paranormal beliefs, and unusual experiences.
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Auditory processing abnormalities in schizotypal personality disorder: an fMRI experiment using tones of deviant pitch and duration. Schizophr Res 2008; 103:26-39. [PMID: 18555666 PMCID: PMC3188851 DOI: 10.1016/j.schres.2008.04.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 04/18/2008] [Accepted: 04/24/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND One of the cardinal features of schizotypal personality disorder (SPD) is language abnormalities. The focus of this study was to determine whether or not there are also processing abnormalities of pure tones differing in pitch and duration in SPD. METHODS Thirteen neuroleptic-naïve male subjects met full criteria for SPD and were group-matched on age and parental socio-economic status to 13 comparison subjects. Verbal learning was measured with the California Verbal Learning Test. Heschl's gyrus volumes were measured using structural MRI. Whole-brain fMRI activation patterns in an auditory task of listening to tones including pitch and duration deviants were compared between SPD and control subjects. In a second and separate ROI analysis we found that peak activation in superior temporal gyrus (STG), Brodmann Areas 41 and 42, was correlated with verbal learning and clinical measures derived from the SCID-II interview. RESULTS In the region of the STG, SPD subjects demonstrated more activation to pitch deviants bilaterally (p<0.001); and to duration deviants in the left hemisphere (p=0.005) (two-sample t). SPD subjects also showed more bilateral parietal cortex activation to duration deviants. In no region did comparison subjects activate more than SPD subjects in either experiment. Exploratory correlations for SPD subjects suggest a relationship between peak activation on the right for deviant tones in the pitch experiment with odd speech and impaired verbal learning. There was no difference between groups on Heschl's gyrus volume. CONCLUSIONS These data suggest that SPD subjects have inefficient or hyper-responsive processing of pure tones both in terms of pitch and duration deviance that is not attributable to smaller Heschl's gyrus volumes. Finally, these auditory processing abnormalities may have significance for the odd speech heard in some SPD subjects and downstream language and verbal learning deficits.
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Hazlett EA, Buchsbaum MS, Haznedar MM, Newmark R, Goldstein KE, Zelmanova Y, Glanton CF, Torosjan Y, New AS, Lo JN, Mitropoulou V, Siever LJ. Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients. Schizophr Res 2008; 101:111-23. [PMID: 18272348 PMCID: PMC2672563 DOI: 10.1016/j.schres.2007.12.472] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 12/05/2007] [Accepted: 12/13/2007] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging (MRI) studies have revealed fronto-temporal cortical gray matter volume reductions in schizophrenia. However, to date studies have not examined whether age- and sex-matched unmedicated schizotypal personality disorder (SPD) patients share some or all of the structural brain-imaging characteristics of schizophrenia patients. We examined cortical gray/white matter volumes in a large sample of unmedicated schizophrenia-spectrum patients (n=79 SPD, n=57 schizophrenia) and 148 healthy controls. MRI images were reoriented to standard position parallel to the anterior-posterior commissure line, segmented into gray and white matter tissue types, and assigned to Brodmann areas (BAs) using a postmortem-histological atlas. Group differences in regional volume of gray and white matter in the BAs were examined with MANOVA. Schizophrenia patients had significantly reduced gray matter volume widely across the cortex but more marked in frontal and temporal lobes. SPD patients had reductions in the same regions but only about half that observed in schizophrenia and sparing in key regions including BA10. In schizophrenia, greater fronto-temporal volume loss was associated with greater negative symptom severity and in SPD, greater interpersonal and cognitive impairment. Overall, our findings suggest that increased prefrontal volume in BA10 and sparing of volume loss in temporal cortex (BAs 22 and 20) may be a protective factor in SPD which reduces vulnerability to psychosis.
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Affiliation(s)
- Erin A. Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY,Corresponding author: Erin A. Hazlett, Ph.D, Department of Psychiatry, Box 1505, Mount Sinai School of Medicine, New York, NY 10029, , Phone: (212) 241-2779
| | | | | | - Randall Newmark
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Kim E. Goldstein
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Yuliya Zelmanova
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | | | - Yuliya Torosjan
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Antonia S. New
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC) and VISN 3
| | - Jennifer N. Lo
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | | | - Larry J. Siever
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC) and VISN 3
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Razafimandimby A, Maïza O, Hervé PY, Lecardeur L, Delamillieure P, Brazo P, Mazoyer B, Tzourio-Mazoyer N, Dollfus S. Stability of functional language lateralization over time in schizophrenia patients. Schizophr Res 2007; 94:197-206. [PMID: 17570644 DOI: 10.1016/j.schres.2007.04.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 04/10/2007] [Accepted: 04/14/2007] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cross-sectional functional imaging studies have shown a reduced leftward language lateralization in schizophrenic patients. An unanswered question is whether this reduced leftward lateralization is stable over time or is modified over the course of the illness. METHODS Ten right-handed (RH) patients (DSM-IV) and 10 RH controls were matched one-to-one for sex, age, and level of education. The subjects underwent two separate fMRI sessions while engaged in a story listening task, 21 months apart. After each session, story comprehension (task performance) was assessed through a 12-item questionnaire. The stability of the decreased asymmetry indices in the semantic region of interest (LANG) was investigated with an ANOVA to compare groups and sessions. In order to test the evolution of functional asymmetry indices at an individual level, a linear correlation between both fMRI session asymmetry indices was calculated in all subjects. Correlations between asymmetry indices and the severity of psychotic symptoms or task performances were computed. RESULTS The asymmetry indices of the LANG were significantly reduced in patients as compared to controls and strongly correlated between sessions. Values of asymmetry indices were unrelated to either psychotic symptoms or task performances. CONCLUSIONS This reduced leftward lateralization for language did not vary over time and was not influenced by the psychosis severity or the task performances. This result reinforces the hypothesis that schizophrenia is characterized by a particular organization of language.
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Affiliation(s)
- Annick Razafimandimby
- Groupe d'Imagerie Neurofonctionnelle, UMR 6194 CNRS/CEA/Universités de Caen et Paris 5, GIP Cyceron, Bld Henri Becquerel, 14074 Caen Cedex, France
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Abstract
It is well known that environmental factors, such as early life events, perinatal damage, and urbanicity, which interact with multiple genes, induces persistent sensitization to stress possibly through an imbalance in interactions between dopaminergic and glutamatergic systems. This stress sensitization may be critical in the development or relapse of schizophrenia. The neural correlates of a negative mood might be impaired, resulting in stress sensitization and difficulties in social adjustment (Dr. Habel). Urbanicity is associated with later schizophrenia. Metabolic stress induces stress sensitization via dysregulation of dopaminergic and/or noradrenergic systems in activated HVA and cortical response (Dr. Marcelis). The glutamatergic regulation activates HPA axis in stress response (Dr. Zelena). Ameloblast activity in human molar's enamel slowed by exposure to stress, and the segment of enamel rods is smaller, making a particular dark line. Stress sensitization may be induced at the age of 10.5 to 11.5 years resulting from severe emotional stress at the age of 10.5 to 11.5 years (Dr. Yui). It has been reported that volume reductions in the amygdala, hippocampus, superior temporal gyrus, and anterior parietal cortex common to both patient groups may represent the vulnerability to schizophrenia, while volume loss of the prefrontal cortex, posterior parietal cortex, cingulate, insula, and fusiform cortex preferentially observed in schizophrenia may be critical for overt manifestation of psychosis (Dr. Suzuki).
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Affiliation(s)
- Kunio Yuii
- Research Institute of Asperger Disorder, Ahiya University Graduate School of Education. Rokurokuso-Machi 13-22, Ashiya, 659-8511 Hyogo, Japan
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Borgwardt SJ, Riecher-Rössler A, Dazzan P, Chitnis X, Aston J, Drewe M, Gschwandtner U, Haller S, Pflüger M, Rechsteiner E, D'Souza M, Stieglitz RD, Radü EW, McGuire PK. Regional gray matter volume abnormalities in the at risk mental state. Biol Psychiatry 2007; 61:1148-56. [PMID: 17098213 DOI: 10.1016/j.biopsych.2006.08.009] [Citation(s) in RCA: 238] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 07/11/2006] [Accepted: 08/04/2006] [Indexed: 11/22/2022]
Abstract
BACKGROUND Individuals with an At Risk Mental State (ARMS) have a very high risk of developing a psychotic disorder but the basis of this risk is unclear. We addressed this issue by studying gray matter volume in this group with magnetic resonance imaging (MRI). METHODS Thirty-five individuals with an ARMS, 25 patients with first episode schizophrenia, and 22 healthy volunteers were studied using a 1.5T MRI scanner. Twelve (34%) of the ARMS group developed schizophrenia in the 2 years subsequent to scanning. RESULTS There were significant volumetric differences between the three groups in the left insula, superior temporal gyrus, cingulate gyrus and precuneus. In these regions, the volume in the ARMS group was smaller than in volunteers but not significantly different from that in the first episode (FE) group. Direct comparison of the ARMS and control groups revealed additional areas of reduced volume in the left medial temporal cortex. Within the ARMS group, those subjects who later developed psychosis had less gray matter than subjects who did not in the right insula, inferior frontal and superior temporal gyrus. CONCLUSIONS The ARMS was associated with reductions in gray matter volume in areas that are also reduced in schizophrenia, suggesting that these are a correlate of an increased vulnerability to psychosis. Volumetric differences within the ARMS group may be related to the subsequent onset of schizophrenia in a subset of those at high risk.
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Affiliation(s)
- Stefan J Borgwardt
- Psychiatric Outpatient Department, University Hospital Basel, Switzerland.
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Abstract
The idea that some phenotypes bear a closer relationship to the biological processes that give rise to psychiatric illness than diagnostic categories has attracted considerable interest. Much effort has been devoted to finding such endophenotypes, partly because it is believed that the genetic basis of endophenotypes will be easier to analyse than that of psychiatric disease. This belief depends in part on the assumption that the effect sizes of genetic loci contributing to endophenotypes are larger than those contributing to disease susceptibility, hence increasing the chance that genetic linkage and association tests will detect them. We examine this assumption by applying meta-analytical techniques to genetic association studies of endophenotypes. We find that the genetic effect sizes of the loci examined to date are no larger than those reported for other phenotypes. A review of the genetic architecture of traits in model organisms also provides no support for the view that the effect sizes of loci contributing to phenotypes closer to the biological basis of disease is any larger than those contributing to disease itself. While endophenotype measures may afford greater reliability, it should not be assumed that they will also demonstrate simpler genetic architecture.
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Affiliation(s)
- JONATHAN FLINT
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford, UK
| | - MARCUS R. MUNAFÒ
- Department of Experimental Psychology, University of
Bristol, Bristol, UK
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The Pharmacological and Psychological Treatment of Personality Disorders—From Neurobiology to Treatment Strategies. ACTA ACUST UNITED AC 2007. [DOI: 10.1300/j085v17n03_04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bell V, Reddy V, Halligan P, Kirov G, Ellis H. Relative Suppression of Magical Thinking: A Transcranial Magnetic Stimulation Study. Cortex 2007; 43:551-7. [PMID: 17624001 DOI: 10.1016/s0010-9452(08)70249-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The tendency to perceive meaning in noise (apophenia) has been linked to "magical thinking" (MT), a distinctive form of thinking associated with a range of normal cognitive styles, anomalous perceptual experiences and frank psychosis. Important aspects of MT include the propensity to imbue meaning or causality to events that might otherwise be considered coincidental. Structures in the lateral temporal lobes have been hypothesised to be involved in both the clinical and nonclinical aspects of MT. Accordingly, in this study we used single-pulse transcranial magnetic stimulation (TMS) to stimulate either the left or right lateral temporal areas, or the vertex, of 12 healthy participants (balanced for similar levels of MT, delusional ideation and temporal lobe disturbance) while they were required to indicate if they had "detected" pictures, claimed to be present by the experimenters, in visual noise. Relative to the vertex, TMS inhibition of the left lateral temporal area produced significant reduced tendency to report meaningful information, suggesting that left lateral temporal activation may be more important in MT and therefore producing and supporting anomalous beliefs and experiences. The effect cannot simply be explained by TMS induced cognitive slowing as reaction times were not affected.
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Affiliation(s)
- Vaughan Bell
- School of Psychology, Cardiff University, Cardiff, UK.
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44
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Dickey CC, McCarley RW, Xu ML, Seidman LJ, Voglmaier MM, Niznikiewicz MA, Connor E, Shenton ME. MRI abnormalities of the hippocampus and cavum septi pellucidi in females with schizotypal personality disorder. Schizophr Res 2007; 89:49-58. [PMID: 17027236 PMCID: PMC2777663 DOI: 10.1016/j.schres.2006.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 08/14/2006] [Accepted: 08/16/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study examined MRI hippocampal volume and cavum septi pellucidi (CSP) in female subjects with schizotypal personality disorder (SPD) and comparison subjects. METHOD MRI was performed on 20 SPD and 29 comparison subjects with delineation of left and right hippocampi. Number of slices containing the CSP was counted. Subjects were given a working memory task, the Delayed Alternation task and other measures of working memory including the Wechsler Memory Test-Revised and the California Verbal Learning Test. Clinical measures were derived from the SCID-II. RESULTS SPD females evinced bilaterally smaller hippocampal volumes compared with non-psychiatric female subjects (15.1% on left, 15.7% on right). Additionally, SPD subjects showed statistically significantly more slices containing CSP, and a trend level difference when large CSP was defined as four or more slices (20% vs. 6.9%). SPD subjects demonstrated more errors, more perseverations, and a trend toward more failure to maintain set on the Delayed Alternating task, which were associated with smaller left hippocampal volumes. There was no difference between groups in logical memory, verbal learning or semantic clustering nor a significant correlation between these measures and hippocampal volumes. Clinically, in SPD subjects, right hippocampal volumes correlated negatively with odd appearance/behavior and positively with suspiciousness/paranoia, and odd speech was positively correlated with the number of slices containing a CSP in exploratory analyses. CONCLUSIONS Female SPD subjects showed bilaterally smaller hippocampal volumes and larger CSP than comparison subjects, similar to what has been shown in schizophrenia. Moreover, these abnormalities have clinically significant associations which may help to explain some of the manifestations of the disorder.
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Affiliation(s)
- Chandlee C Dickey
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA.
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Takahashi T, Suzuki M, Zhou SY, Tanino R, Hagino H, Niu L, Kawasaki Y, Seto H, Kurachi M. Temporal lobe gray matter in schizophrenia spectrum: a volumetric MRI study of the fusiform gyrus, parahippocampal gyrus, and middle and inferior temporal gyri. Schizophr Res 2006; 87:116-26. [PMID: 16750349 DOI: 10.1016/j.schres.2006.04.023] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2006] [Revised: 04/25/2006] [Accepted: 04/25/2006] [Indexed: 11/29/2022]
Abstract
Although several brain morphologic studies have suggested abnormalities in the temporal regions to be a common indicator of vulnerability for the schizophrenia spectrum, less attention has been paid to temporal lobe structures other than the superior temporal gyrus or the medial temporal region. In this study, we investigated the volume of gray matter in the fusiform gyrus, the parahippocampal gyrus, the middle temporal gyrus, and the inferior temporal gyrus using magnetic resonance imaging in 39 schizotypal disorder patients, 65 schizophrenia patients, and 72 age and gender matched healthy control subjects. The anterior fusiform gyrus was significantly smaller in the schizophrenia patients than the control subjects but not in the schizotypal disorder patients, while the volume reduction of the posterior fusiform gyrus was common to both disorders. Volumes for the middle and inferior temporal gyri or the parahippocampal gyrus did not differ between groups. These findings suggest that abnormalities in the posterior region of the fusiform gyrus are, as have been suggested for the superior temporal gyrus or the amygdala/hippocampus, prominent among the temporal lobe structures as a common morphologic substrate for the schizophrenia spectrum, whereas more widespread alterations involving the anterior region might be associated with the development of full-blown schizophrenia.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
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46
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Takahashi T, Suzuki M, Zhou SY, Tanino R, Hagino H, Kawasaki Y, Matsui M, Seto H, Kurachi M. Morphologic alterations of the parcellated superior temporal gyrus in schizophrenia spectrum. Schizophr Res 2006; 83:131-43. [PMID: 16503399 DOI: 10.1016/j.schres.2006.01.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2005] [Revised: 01/10/2006] [Accepted: 01/10/2006] [Indexed: 11/20/2022]
Abstract
Morphologic abnormalities of the superior temporal gyrus (STG) as well as its sub-regions such as Heschl's gyrus (HG) or planum temporale (PT) have been reported in schizophrenia patients, but have not been extensively studied in schizotypal subjects. In the present study, magnetic resonance images were acquired from 65 schizophrenia patients, 39 schizotypal disorder patients, and 72 healthy controls. Volumetric analyses were performed using consecutive 1-mm coronal slices on the temporal pole (TP) and superior temporal sub-regions [planum polare (PP), HG, PT, rostral STG, and caudal STG]. The HG was significantly smaller in schizophrenia patients compared with controls but not in schizotypal patients, while volume reductions of the left PT and bilateral caudal STG were common to both disorders. The TP gray matter was larger in female schizotypal patients compared with female schizophrenia patients. There were no significant group differences in the PP and rostral STG volume. In the subgroup of early phase schizophrenia patients (illness duration <1.0 year), smaller volumes for the left PP and rostral STG were correlated with hallucinations and delusions. Our findings suggest that morphologic changes in the posterior regions of the STG are common to the schizophrenia spectrum, whereas less involvement of the HG, and possibly the PP and rostral STG might be related to the sparing of schizotypal patients from developing overt psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
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Dickey CC, McCarley RW, Niznikiewicz MA, Voglmaier MM, Seidman LJ, Kim S, Shenton ME. Clinical, cognitive, and social characteristics of a sample of neuroleptic-naive persons with schizotypal personality disorder. Schizophr Res 2005; 78:297-308. [PMID: 15985362 PMCID: PMC2766931 DOI: 10.1016/j.schres.2005.05.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2005] [Revised: 05/12/2005] [Accepted: 05/18/2005] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Schizotypal personality disorder (SPD) shares with schizophrenia many biological features, yet little is known about the clinical characteristics of persons diagnosed with this disorder. This report describes the clinical, cognitive and socio-occupational characteristics of a community sample of subjects diagnosed with SPD. METHOD Sixty-four male and 40 female neuroleptic-naive DSM-IV SPD subjects and 59 male and 51 female comparison subjects were recruited from the community for a total sample of 214 subjects. Demographic and cognitive differences between groups and, within the SPD group, the effect of gender on clinical features, such as the SPD criteria, SAPS, SANS, Schizotypal Personality Questionnaire, and co-morbidity, were examined using ANOVA and Chi-square distributions. RESULTS SPD subjects, in contrast to comparison subjects, had significantly lower socio-economic status, poorer social relationships and skills, and lower vocabulary scores. Furthermore, SPD subjects demonstrated more impairment on Vocabulary scores than on Block Design, as measured by the WAIS-R, a pattern not seen in comparison subjects. In the SPD cohort, positive symptoms predominated and nearly half were co-morbid for major depression. With respect to gender, male SPD subjects, compared with female SPD subjects, evinced significantly more negative symptoms, fewer friends, had more odd speech, and were more likely to also suffer from paranoid and narcissistic personality disorders. In contrast to male SPD subjects, female SPD subjects perceived themselves to be more disorganized. CONCLUSIONS SPD subjects, similar to schizophrenics, are impaired socially, occupationally, and cognitively, particularly in the area of verbal measures. Moreover, male SPD subjects may be more severely affected than female SPD subjects across multiple domains of functioning.
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Affiliation(s)
- Chandlee C Dickey
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Psychiatry 116A, 940 Belmont St., Brockton, MA 02401, USA.
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Nakamura M, McCarley RW, Kubicki M, Dickey CC, Niznikiewicz MA, Voglmaier MM, Seidman LJ, Maier SE, Westin CF, Kikinis R, Shenton ME. Fronto-temporal disconnectivity in schizotypal personality disorder: a diffusion tensor imaging study. Biol Psychiatry 2005; 58:468-78. [PMID: 15978550 PMCID: PMC2768055 DOI: 10.1016/j.biopsych.2005.04.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2004] [Revised: 02/14/2005] [Accepted: 04/13/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND Using diffusion tensor imaging (DTI), we previously reported abnormalities in two critical white matter tracts in schizophrenia, the uncinate fasciculus (UF) and the cingulum bundle (CB), both related to fronto-temporal connectivity. Here, we investigate these two bundles in unmedicated subjects with schizotypal personality disorder (SPD). METHODS Fifteen male SPD subjects and 15 male control subjects were scanned with line-scan DTI. Fractional anisotropy (FA) and mean diffusivity (D(m)) were used to quantify water diffusion, and cross-sectional area was defined with a directional threshold method. Exploratory correlation analyses were evaluated with Spearman's rho, followed by post hoc hierarchical regression analyses. RESULTS We found bilaterally reduced FA in the UF of SPD subjects. For CB, there was no significant group difference for FA or D(m) measures. Additionally, in SPD, reduced FA in the right UF was correlated with clinical symptoms, including ideas of reference, suspiciousness, restricted affect, and social anxiety. In contrast, left UF area was correlated with measures of cognitive function, including general intelligence, verbal and visual memory, and executive performance. CONCLUSIONS These findings in SPD suggest altered fronto-temporal connectivity through the UF, similar to findings in schizophrenia, and intact neocortical-limbic connectivity through the CB, in marked contrast with what has been reported in schizophrenia.
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Affiliation(s)
- Motoaki Nakamura
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
| | - Robert W. McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
| | - Marek Kubicki
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Chandlee C. Dickey
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
- Departments of Psychiatry and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Margaret A. Niznikiewicz
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
| | - Martina M. Voglmaier
- Department of Psychiatry, Harvard Medical School at Cambridge Hospital, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School at Massachusetts Mental Health Center and Massachusetts General Hospital, Boston
| | - Stephan E. Maier
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Carl-Fredrik Westin
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Ron Kikinis
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Martha E. Shenton
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
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Plailly J, d'Amato T, Saoud M, Royet JP. Left temporo-limbic and orbital dysfunction in schizophrenia during odor familiarity and hedonicity judgments. Neuroimage 2005; 29:302-13. [PMID: 16099179 DOI: 10.1016/j.neuroimage.2005.06.056] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2005] [Revised: 06/27/2005] [Accepted: 06/28/2005] [Indexed: 11/17/2022] Open
Abstract
Impairments of olfactory processing in patients with schizophrenia (SZ) have been reported in various olfactory tasks such as detection, discrimination, recognition memory, identification, and naming. The purpose of our study was to determine whether impairments in odor familiarity and hedonicity judgments observed in SZ patients during a previous behavioral study are associated with modifications of the activation patterns in olfactory areas. Twelve SZ patients, and 12 healthy comparison (HC) subjects, were tested using the H2(15)O-PET technique and 48 different odorants delivered during 8 scans. In addition to an odorless baseline condition, they had either to detect odor, or to judge odor familiarity or hedonicity, giving their responses by pressing a button. Regional cerebral blood flows during olfactory conditions were compared with those for baseline condition. Between-group analyses were then performed, and completed by regions of interest analyses. Both groups had equivalent ability for the detection of suprathreshold odorants, but patients found odors less familiar, and pleasant odors less pleasant than HC subjects. These behavioral results were related to functional abnormalities in temporo-limbic and orbital olfactory regions lateralized in the left hemisphere: the posterior part of the piriform cortex and orbital regions for familiarity judgments, the insular gyrus for hedonicity judgments, and the left inferior frontal gyrus and anterior piriform cortex/putamen region for the three olfactory tasks. They mainly resulted from a lack of activation during task conditions in the SZ patients. These data could explain olfactory disturbances and other clinical features of schizophrenia such as anhedonia.
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Affiliation(s)
- Jane Plailly
- Laboratoire Neurosciences & Systèmes Sensoriels, Université Claude Bernard Lyon1, UMR CNRS 5020, IFR 19, Institut Fédératif des Neurosciences de Lyon, 50 avenue Tony Garnier, 69366 Lyon cedex 07, France.
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50
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Suzuki M, Zhou SY, Takahashi T, Hagino H, Kawasaki Y, Niu L, Matsui M, Seto H, Kurachi M. Differential contributions of prefrontal and temporolimbic pathology to mechanisms of psychosis. ACTA ACUST UNITED AC 2005; 128:2109-22. [PMID: 15930048 DOI: 10.1093/brain/awh554] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Common abnormalities within the schizophrenia spectrum may be essential for the pathogenesis of schizophrenia, but additional pathological changes may be required for the development of full-blown schizophrenia. Clarifying the neurobiological similarities and differences between established schizophrenia and a milder form of schizophrenia spectrum disorder would potentially discriminate the pathophysiological mechanisms underlying the core features of the schizophrenia spectrum from those associated with overt psychosis. High-resolution MRIs were acquired from 25 patients with schizotypal disorder, 53 patients with schizophrenia and 59 healthy volunteers matched for age, gender, handedness and parental education. Volumetric measurements of the medial temporal structures and the prefrontal cortex subcomponents were performed using consecutive 1-mm thick coronal slices. Parcellation of the prefrontal cortex into subcomponents was performed according to the intrinsic anatomical landmarks of the frontal sulci/gyri. Compared with the controls, the bilateral volumes of the amygdala and the hippocampus were reduced comparably in the schizotypal and schizophrenia patients. The parahippocampal gyrus volume did not differ significantly between diagnostic groups. Total prefrontal grey matter volumes were smaller bilaterally in the schizophrenia patients than in the controls and the schizotypal patients, whereas the schizotypal patients had larger prefrontal grey matter than the controls in the right hemisphere. In the schizophrenia patients, grey matter volumes of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral inferior frontal gyrus and bilateral straight gyrus were smaller than those in the controls. The schizophrenia patients also had reduced grey matter volumes in the right superior frontal gyrus, bilateral middle frontal gyrus and right inferior frontal gyrus relative to the schizotypal patients. Compared with the controls, the schizotypal patients had larger volumes of the bilateral middle frontal gyrus and smaller volumes of the right straight gyrus. There were no significant between-group differences in volumes of the ventral medial prefrontal cortex or the orbitofrontal cortex. These findings suggest that volume reductions in the amygdala and hippocampus are the common morphological substrates for the schizophrenia spectrum, which presumably represent the vulnerability. Additional widespread involvement of the prefrontal cortex in schizophrenia may lead to the loss of inhibitory control in other brain regions and suggests (although it is not specifically be related to) its critical role in the manifestation of overt psychosis.
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Affiliation(s)
- Michio Suzuki
- Department of Neuropsychiatry, Toyama Medical and Pharmaceutical University, Toyama 930-0194, Japan.
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