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Guo J, He C, Song H, Gao H, Yao S, Dong SS, Yang TL. Unveiling Promising Neuroimaging Biomarkers for Schizophrenia Through Clinical and Genetic Perspectives. Neurosci Bull 2024:10.1007/s12264-024-01214-1. [PMID: 38703276 DOI: 10.1007/s12264-024-01214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/08/2024] [Indexed: 05/06/2024] Open
Abstract
Schizophrenia is a complex and serious brain disorder. Neuroscientists have become increasingly interested in using magnetic resonance-based brain imaging-derived phenotypes (IDPs) to investigate the etiology of psychiatric disorders. IDPs capture valuable clinical advantages and hold biological significance in identifying brain abnormalities. In this review, we aim to discuss current and prospective approaches to identify potential biomarkers for schizophrenia using clinical multimodal neuroimaging and imaging genetics. We first described IDPs through their phenotypic classification and neuroimaging genomics. Secondly, we discussed the applications of multimodal neuroimaging by clinical evidence in observational studies and randomized controlled trials. Thirdly, considering the genetic evidence of IDPs, we discussed how can utilize neuroimaging data as an intermediate phenotype to make association inferences by polygenic risk scores and Mendelian randomization. Finally, we discussed machine learning as an optimum approach for validating biomarkers. Together, future research efforts focused on neuroimaging biomarkers aim to enhance our understanding of schizophrenia.
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Affiliation(s)
- Jing Guo
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Changyi He
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Huimiao Song
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Huiwu Gao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Shi Yao
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524000, China
| | - Shan-Shan Dong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Tie-Lin Yang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China.
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2
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Xie Y, Guan M, He Y, Wang Z, Ma Z, Fang P, Wang H. The Static and dynamic functional connectivity characteristics of the left temporoparietal junction region in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment. Front Psychiatry 2023; 14:1071769. [PMID: 36761865 PMCID: PMC9907463 DOI: 10.3389/fpsyt.2023.1071769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are a core symptom of schizophrenia. Low-frequency (e.g., 1 Hz) repetitive transcranial magnetic stimulation (rTMS) targeting language processing regions (e.g., left TPJ) has been evident as a potential treatment for AVH. However, the underlying neural mechanisms of the rTMS treatment effect remain unclear. The present study aimed to investigate the effects of 1 Hz rTMS on functional connectivity (FC) of the temporoparietal junction area (TPJ) seed with the whole brain in schizophrenia patients with AVH. METHODS Using a single-blind placebo-controlled randomized clinical trial, 55 patients with AVH were randomly divided into active treatment group (n = 30) or placebo group (n = 25). The active treatment group receive 15-day 1 Hz rTMS stimulation to the left TPJ, whereas the placebo group received sham rTMS stimulation to the same site. Resting-state fMRI scans and clinical measures were acquired for all patients before and after treatment. The seed-based (left TPJ) static and DFC was used to assess the connectivity characteristics during rTMS treatment in patients with AVH. RESULTS Overall, symptom improvement following 1 Hz rTMS treatment was found in the active treatment group, whereas no change occurred in the placebo group. Moreover, decreased static FC (SFC) of the left TPJ with the right temporal lobes, as well as increased SFC with the prefrontal cortex and subcortical structure were observed in active rTMS group. Increased dynamic FC (DFC) of the left TPJ with frontoparietal areas was also found in the active rTMS group. However, seed-based SFC and DFC were reduced to a great extent in the placebo group. In addition, these changed FC (SFC) strengths in the active rTMS group were associated with reduced severity of clinical outcomes (e.g., positive symptoms). CONCLUSION The application of 1 Hz rTMS over the left TPJ may affect connectivity characteristics of the targeted region and contribute to clinical improvement, which shed light on the therapeutic effect of rTMS on schizophrenia with AVH.
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Affiliation(s)
- Yuanjun Xie
- School of Education, Xinyang College, Xinyang, China.,Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Muzhen Guan
- Department of Mental Health, Xi'an Medical University, Xi'an, China
| | - Ying He
- Department of Psychiatry, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Zhongheng Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhujing Ma
- Department of Clinical Psychology, Fourth Military Medical University, Xi'an, China
| | - Peng Fang
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Marschall TM, Koops S, Brederoo SG, Cabral J, Ćurčić-Blake B, Sommer IEC. Time varying dynamics of hallucinations in clinical and non-clinical voice-hearers. Neuroimage Clin 2023; 37:103351. [PMID: 36805417 PMCID: PMC9969260 DOI: 10.1016/j.nicl.2023.103351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/24/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
Auditory verbal hallucinations (AVH) are frequently associated with psychotic disorders, yet also occur in non-clinical voice-hearers. AVH in this group are similar to those within clinical voice-hearers in terms of several phenomenological aspects, but non-clinical voice-hearers report to have more control over their AVH and attribute less emotional valence to them. These dissimilarities may stem from differences on the neurobiological level, as it is still under debate whether the mechanisms involved in AVH are the same in clinical and non-clinical voice-hearers. In this study, 21 clinical and 21 non-clinical voice-hearers indicated the onset and offsets of AVH during an fMRI scan. Using a method called leading eigenvector dynamics analysis (LEiDA), we examined time-varying dynamics of functional connectivity involved in AVH with a sub-second temporal resolution. We assessed differences between groups, and between hallucination and rest periods in dwell time, switching frequency, probability of occurrence, and transition probabilities of nine recurrent states of functional connectivity with a permutation ANOVA. Deviations in dwell times, switching frequencies, and switch probabilities in the hallucination period indicated more erratic dynamics during this condition regardless of their clinical status. Post-hoc analyses of the dwell times exhibited the most distinct differences between the rest and hallucination condition for the non-clinical sample, suggesting stronger differences between the two conditions in this group. Overall, these findings suggest that the neurobiological mechanisms involved in AVH are similar in clinical and non-clinical individuals.
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Affiliation(s)
- Theresa M Marschall
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
| | - Sanne Koops
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne G Brederoo
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Joana Cabral
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK; Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - Branislava Ćurčić-Blake
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Iris E C Sommer
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
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Roell L, Maurus I, Keeser D, Karali T, Papazov B, Hasan A, Schmitt A, Papazova I, Lembeck M, Hirjak D, Sykorova E, Thieme CE, Muenz S, Seitz V, Greska D, Campana M, Wagner E, Loehrs L, Stoecklein S, Ertl-Wagner B, Poemsl J, Roeh A, Malchow B, Keller-Varady K, Meyer-Lindenberg A, Falkai P. Association between aerobic fitness and the functional connectome in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:1253-1272. [PMID: 35488054 PMCID: PMC9508005 DOI: 10.1007/s00406-022-01411-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/05/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Schizophrenia is accompanied by widespread alterations in static functional connectivity associated with symptom severity and cognitive deficits. Improvements in aerobic fitness have been demonstrated to ameliorate symptomatology and cognition in people with schizophrenia, but the intermediary role of macroscale connectivity patterns remains unknown. OBJECTIVE Therefore, we aim to explore the relation between aerobic fitness and the functional connectome in individuals with schizophrenia. Further, we investigate clinical and cognitive relevance of the identified fitness-connectivity links. METHODS Patients diagnosed with schizophrenia were included in this cross-sectional resting-state fMRI analysis. Multilevel Bayesian partial correlations between aerobic fitness and functional connections across the whole brain as well as between static functional connectivity patterns and clinical and cognitive outcome were performed. Preliminary causal inferences were enabled based on mediation analyses. RESULTS Static functional connectivity between the subcortical nuclei and the cerebellum as well as between temporal seeds mediated the attenuating relation between aerobic fitness and total symptom severity. Functional connections between cerebellar seeds affected the positive link between aerobic fitness and global cognition, while the functional interplay between central and limbic seeds drove the beneficial association between aerobic fitness and emotion recognition. CONCLUSION The current study provides first insights into the interactions between aerobic fitness, the functional connectome and clinical and cognitive outcome in people with schizophrenia, but causal interpretations are preliminary. Further interventional aerobic exercise studies are needed to replicate the current findings and to enable conclusive causal inferences. TRIAL REGISTRATION The study which the manuscript is based on is registered in the International Clinical Trials Database (ClinicalTrials.gov identifier [NCT number]: NCT03466112) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).
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Affiliation(s)
- Lukas Roell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany. .,NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany.
| | - Isabel Maurus
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Daniel Keeser
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany ,grid.411095.80000 0004 0477 2585NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
| | - Temmuz Karali
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany ,grid.411095.80000 0004 0477 2585NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
| | - Boris Papazov
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Alkomiet Hasan
- grid.7307.30000 0001 2108 9006Department of Psychiatry and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Andrea Schmitt
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,grid.11899.380000 0004 1937 0722Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Irina Papazova
- grid.7307.30000 0001 2108 9006Department of Psychiatry and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Moritz Lembeck
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Dusan Hirjak
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Eliska Sykorova
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Cristina E. Thieme
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Susanne Muenz
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Valentina Seitz
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - David Greska
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Mattia Campana
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Elias Wagner
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Lisa Loehrs
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Sophia Stoecklein
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany ,grid.42327.300000 0004 0473 9646Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Johannes Poemsl
- grid.15474.330000 0004 0477 2438Department of Psychiatry and Psychotherapy, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts Der Isar’, Munich, Germany
| | - Astrid Roeh
- grid.7307.30000 0001 2108 9006Department of Psychiatry and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Berend Malchow
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany
| | - Katriona Keller-Varady
- grid.492118.70000 0004 0619 212XHannover Medical School, Institute of Sports Medicine, Hannover, Germany
| | - Andreas Meyer-Lindenberg
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Peter Falkai
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
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Strawson WH, Wang HT, Quadt L, Sherman M, Larsson DEO, Davies G, Mckeown BLA, Silva M, Fielding-Smith S, Jones AM, Hayward M, Smallwood J, Critchley HD, Garfinkel SN. Voice Hearing in Borderline Personality Disorder Across Perceptual, Subjective, and Neural Dimensions. Int J Neuropsychopharmacol 2021; 25:375-386. [PMID: 34940826 PMCID: PMC9154289 DOI: 10.1093/ijnp/pyab093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/24/2021] [Accepted: 12/23/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) commonly occur in the context of borderline personality disorder (BPD) yet remain poorly understood. AVH are often perceived by patients with BPD as originating from inside the head and hence viewed clinically as "pseudohallucinations," but they nevertheless have a detrimental impact on well-being. METHODS The current study characterized perceptual, subjective, and neural expressions of AVH by using an auditory detection task, experience sampling and questionnaires, and functional neuroimaging, respectively. RESULTS Perceptually, reported AVH correlated with a bias for reporting the presence of a voice in white noise. Subjectively, questionnaire measures indicated that AVH were significantly distressing and persecutory. In addition, AVH intensity, but not perceived origin (i.e., inside vs outside the head), was associated with greater concurrent anxiety. Neurally, fMRI of BPD participants demonstrated that, relative to imagining or listening to voices, periods of reported AVH induced greater blood oxygenation level-dependent activity in anterior cingulate and bilateral temporal cortices (regional substrates for language processing). AVH symptom severity was associated with weaker functional connectivity between anterior cingulate and bilateral insular cortices. CONCLUSION In summary, our results indicate that AVH in participants with BPD are (1) underpinned by aberrant perceptual-cognitive mechanisms for signal detection, (2) experienced subjectively as persecutory and distressing, and (3) associated with distinct patterns of neural activity that inform proximal mechanistic understanding. Our findings are like analogous observations in patients with schizophrenia and validate the clinical significance of the AVH experience in BPD, often dismissed as "pseudohallucinations." These highlight a need to reconsider this experience as a treatment priority.
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Affiliation(s)
- Will H Strawson
- Correspondence: Will H. Strawson, MSci, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, BN1 9RY, UK ()
| | - Hao-Ting Wang
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,Sackler Centre for Consciousness Science, Falmer, UK
| | - Lisa Quadt
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,Sackler Centre for Consciousness Science, Falmer, UK
| | - Maxine Sherman
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,Sackler Centre for Consciousness Science, Falmer, UK,Department of Informatics, University of Sussex, UK
| | - Dennis E O Larsson
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,Department of Psychology, Falmer, UK,Leverhulme Trust London, UK
| | - Geoff Davies
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,University of Sussex, Falmer, UK,Sussex Partnership NHS Foundation Trust, Brighton, UK
| | | | - Marta Silva
- Cognition and Brain Plasticity Unit, Barcelona, Catalunya, Spain,Institute of Neurosciences, University of Barcelona, Catalunya, Spain
| | - Sarah Fielding-Smith
- University of Sussex, Falmer, UK,Sussex Partnership NHS Foundation Trust, Brighton, UK,Oxford Health NHS Foundation Trust, Oxford, UK,Oxford Institute of Clinical Psychology Training and Research, Oxford, UK
| | - Anna-Marie Jones
- University of Sussex, Falmer, UK,Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Mark Hayward
- Department of Psychology, Falmer, UK,University of Sussex, Falmer, UK,Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Jonathan Smallwood
- Department of Psychology, University of York, York, UK,Department of Psychology, Queen’s University, Kingston, ON, Canada
| | - Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,Sackler Centre for Consciousness Science, Falmer, UK,University of Sussex, Falmer, UK,Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Sarah N Garfinkel
- Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK,University of Sussex, Falmer, UK,Sussex Partnership NHS Foundation Trust, Brighton, UK,Institute of Cognitive Neuroscience, University College London, London, UK
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Hwang M, Roh YS, Talero J, Cohen BM, Baker JT, Brady RO, Öngür D, Shinn AK. Auditory hallucinations across the psychosis spectrum: Evidence of dysconnectivity involving cerebellar and temporal lobe regions. Neuroimage Clin 2021; 32:102893. [PMID: 34911197 PMCID: PMC8636859 DOI: 10.1016/j.nicl.2021.102893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/29/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Auditory hallucinations (AH) are typically associated with schizophrenia (SZ), but they are also prevalent in bipolar disorder (BD). Despite the large body of research on the neural correlates of AH in SZ, the pathophysiology underlying AH remains unclear. Few studies have examined the neural substrates associated with propensity for AH in BD. Investigating AH across the psychosis spectrum has the potential to inform about the neural signature associated with the trait of AH, irrespective of psychiatric diagnosis. METHODS We compared resting state functional magnetic resonance imaging data in psychosis patients with (n = 90 AH; 68 SZ, 22 BD) and without (n = 55 NAH; 16 SZ, 39 BD) lifetime AH. We performed region of interest (ROI)-to-ROI functional connectivity (FC) analysis using 91 cortical, 15 subcortical, and 26 cerebellar atlas-defined regions. The primary aim was to identify FC differences between patients with and without lifetime AH. We secondarily examined differences between AH and NAH within each diagnosis. RESULTS Compared to the NAH group, patients with AH showed higher FC between cerebellum and frontal (left precentral gyrus), temporal [right middle temporal gyrus (MTG), left inferior temporal gyrus (ITG), left temporal fusiform gyrus)], parietal (bilateral superior parietal lobules), and subcortical (left accumbens, left palldium) brain areas. AH also showed lower FC between temporal lobe regions (between right ITG and right MTG and bilateral superior temporal gyri) relative to NAH. CONCLUSIONS Our findings suggest that dysconnectivity involving the cerebellum and temporal lobe regions may be common neurofunctional elements associated with AH propensity across the psychosis spectrum. We also found dysconnectivity patterns that were unique to lifetime AH within SZ or bipolar psychosis, suggesting both common and distinct mechanisms underlying AH pathophysiology in these disorders.
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Affiliation(s)
- Melissa Hwang
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Youkyung S Roh
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Jessica Talero
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Bruce M Cohen
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Justin T Baker
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Roscoe O Brady
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Ann K Shinn
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
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Lyu H, Jiao J, Feng G, Wang X, Sun B, Zhao Z, Shang D, Pan F, Xu W, Duan J, Zhou Q, Hu S, Xu Y, Xu D, Huang M. Abnormal causal connectivity of left superior temporal gyrus in drug-naïve first- episode adolescent-onset schizophrenia: A resting-state fMRI study. Psychiatry Res Neuroimaging 2021; 315:111330. [PMID: 34280873 DOI: 10.1016/j.pscychresns.2021.111330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/06/2021] [Accepted: 07/02/2021] [Indexed: 12/19/2022]
Abstract
This study aimed to investigate the alterations of causal connectivity between the brain regions in Adolescent-onset schizophrenia (AOS) patients. Thirty-two first-episode drug-naïve AOS patients and 27 healthy controls (HC) were recruited for resting-state functional MRI scanning. The brain region with the between-group difference in regional homogeneity (ReHo) values was chosen as a seed to perform the Granger causality analysis (GCA) and further detect the alterations of causal connectivity in AOS. AOS patients exhibited increased ReHo values in left superior temporal gyrus (STG) compared with HCs. Significantly decreased values of outgoing Granger causality from left STG to right superior frontal gyrus and right angular gyrus were observed in GC mapping for AOS. Significantly stronger causal outflow from left STG to right insula and stronger causal inflow from right middle occipital gyrus (MOG) to left STG were also observed in AOS patients. Based on assessments of the two strengthened causal connectivity of the left STG with insula and MOG, a discriminant model could identify all patients from controls with 94.9% accuracy. This study indicated that alterations of directional connections in left STG may play an important role in the pathogenesis of AOS and serve as potential biomarkers for the disease.
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Affiliation(s)
- Hailong Lyu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jianping Jiao
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Guoxun Feng
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Ningbo Mental Hospital, Ningbo, Zhejiang, China
| | - Xinxin Wang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bin Sun
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Ningbo Mental Hospital, Ningbo, Zhejiang, China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China; Columbia University & New York State Psychiatric Institute, New York, United States
| | - Desheng Shang
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Fen Pan
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Weijuan Xu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jinfeng Duan
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | | | - Shaohua Hu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yi Xu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Dongrong Xu
- Columbia University & New York State Psychiatric Institute, New York, United States.
| | - Manli Huang
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China.
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8
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Mohagheghian F, Khajehpour H, Samadzadehaghdam N, Eqlimi E, Jalilvand H, Makkiabadi B, Deevband MR. Altered effective brain network topology in tinnitus: An EEG source connectivity analysis. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Schutte MJL, Bohlken MM, Collin G, Abramovic L, Boks MPM, Cahn W, Dauwan M, van Dellen E, van Haren NEM, Hugdahl K, Koops S, Mandl RCW, Sommer IEC. Functional connectome differences in individuals with hallucinations across the psychosis continuum. Sci Rep 2021; 11:1108. [PMID: 33441965 PMCID: PMC7806763 DOI: 10.1038/s41598-020-80657-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/17/2020] [Indexed: 01/29/2023] Open
Abstract
Hallucinations may arise from an imbalance between sensory and higher cognitive brain regions, reflected by alterations in functional connectivity. It is unknown whether hallucinations across the psychosis continuum exhibit similar alterations in functional connectivity, suggesting a common neural mechanism, or whether different mechanisms link to hallucinations across phenotypes. We acquired resting-state functional MRI scans of 483 participants, including 40 non-clinical individuals with hallucinations, 99 schizophrenia patients with hallucinations, 74 bipolar-I disorder patients with hallucinations, 42 bipolar-I disorder patients without hallucinations, and 228 healthy controls. The weighted connectivity matrices were compared using network-based statistics. Non-clinical individuals with hallucinations and schizophrenia patients with hallucinations exhibited increased connectivity, mainly among fronto-temporal and fronto-insula/cingulate areas compared to controls (P < 0.001 adjusted). Differential effects were observed for bipolar-I disorder patients with hallucinations versus controls, mainly characterized by decreased connectivity between fronto-temporal and fronto-striatal areas (P = 0.012 adjusted). No connectivity alterations were found between bipolar-I disorder patients without hallucinations and controls. Our results support the notion that hallucinations in non-clinical individuals and schizophrenia patients are related to altered interactions between sensory and higher-order cognitive brain regions. However, a different dysconnectivity pattern was observed for bipolar-I disorder patients with hallucinations, which implies a different neural mechanism across the psychosis continuum.
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Affiliation(s)
- Maya J L Schutte
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands.
| | - Marc M Bohlken
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Guusje Collin
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA.,McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lucija Abramovic
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Marco P M Boks
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Meenakshi Dauwan
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Department of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway.,NORMENT Center for the Study of Mental Disorders, University of Oslo, Oslo, Norway
| | - Sanne Koops
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands
| | - René C W Mandl
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Iris E C Sommer
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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10
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Pinheiro AP, Schwartze M, Kotz SA. Cerebellar circuitry and auditory verbal hallucinations: An integrative synthesis and perspective. Neurosci Biobehav Rev 2020; 118:485-503. [DOI: 10.1016/j.neubiorev.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/30/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
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11
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van Dellen E, Börner C, Schutte M, van Montfort S, Abramovic L, Boks MP, Cahn W, van Haren N, Mandl R, Stam CJ, Sommer I. Functional brain networks in the schizophrenia spectrum and bipolar disorder with psychosis. NPJ SCHIZOPHRENIA 2020; 6:22. [PMID: 32879316 PMCID: PMC7468123 DOI: 10.1038/s41537-020-00111-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
Psychotic experiences have been proposed to lie on a spectrum, ranging from subclinical experiences to treatment-resistant schizophrenia. We aimed to characterize functional connectivity and brain network characteristics in relation to the schizophrenia spectrum and bipolar disorder with psychosis to disentangle neural correlates to psychosis. Additionally, we studied antipsychotic medication and lithium effects on network characteristics. We analyzed functional connectivity strength and network topology in 487 resting-state functional MRI scans of individuals with schizophrenia spectrum disorder (SCZ), bipolar disorder with a history of psychotic experiences (BD), treatment-naïve subclinical psychosis (SCP), and healthy controls (HC). Since differences in connectivity strength may confound group comparisons of brain network topology, we analyzed characteristics of the minimum spanning tree (MST), a relatively unbiased backbone of the network. SCZ and SCP subjects had a lower connectivity strength than BD and HC individuals but showed no differences in network topology. In contrast, BD patients showed a less integrated network topology but no disturbances in connectivity strength. No differences in outcome measures were found between SCP and SCZ, or between BD patients that used antipsychotic medication or lithium and those that did not. We conclude that functional networks in patients prone to psychosis have different signatures for chronic SCZ patients and SCP compared to euthymic BD patients, with a limited role for medication. Connectivity strength effects may have confounded previous studies, as no functional network alterations were found in SCZ after strict correction for connectivity strength.
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Affiliation(s)
- Edwin van Dellen
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Corinna Börner
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maya Schutte
- University of Groningen, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
| | - Simone van Montfort
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marco P Boks
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neeltje van Haren
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - René Mandl
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Iris Sommer
- University of Groningen, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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12
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Falkenberg LE, Westerhausen R, Johnsen E, Kroken R, Løberg EM, Beresniewicz J, Kazimierczak K, Kompus K, Ersland L, Sandøy LB, Hugdahl K. Hallucinating schizophrenia patients have longer left arcuate fasciculus fiber tracks: a DTI tractography study. Psychiatry Res Neuroimaging 2020; 302:111088. [PMID: 32480045 DOI: 10.1016/j.pscychresns.2020.111088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023]
Abstract
The arcuate fasciculus (AF) has been implicated in the pathology behind schizophrenia and auditory verbal hallucinations (AVHs). White matter tracts forming the arcuate fasciculus can be quantified and visualized using diffusion tensor imaging (DTI) tractography. Although there have been a number of studies on this topic, the results have been conflicting. Studying the underlying white matter structure of the AF could shed light on the constrains for interaction between temporal and frontal language areas in AVHs. The participants were 66 patients with a schizophrenia diagnosis, where AVHs were defined from the Positive and Negative Syndrome Scale (PANSS), and compared with a healthy control group. DTI was performed on a 3T MR scanner, and tensor estimation was done using deterministic streamline tractography. Statistical analysis of the data showed significantly longer reconstructed tracks along the AF in patients with severe and frequent AVHs, as well as an overall significant asymmetry with longer tracks in the left compared to the right side. In addition, there were significant positive correlations between PANSS scores and track length, track volume, and number of track streamlines for the posterior AF segment on the left side. It is concluded that the present DTI results may have implications for interpretations of functional imaging results.
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Affiliation(s)
- Liv E Falkenberg
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Erik Johnsen
- Division of Psychiatry and NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - Rune Kroken
- Division of Psychiatry and NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Else-Marie Løberg
- Division of Psychiatry and NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway; Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Norway
| | | | | | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Lars Ersland
- Department of Biological and Medical Psychology, University of Bergen, Norway; Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | | | - Kenneth Hugdahl
- Division of Psychiatry and NORMENT Center of Excellence, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway.
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13
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Humpston C, Garrison J, Orlov N, Aleman A, Jardri R, Fernyhough C, Allen P. Real-Time Functional Magnetic Resonance Imaging Neurofeedback for the Relief of Distressing Auditory-Verbal Hallucinations: Methodological and Empirical Advances. Schizophr Bull 2020; 46:1409-1417. [PMID: 32740661 PMCID: PMC7707074 DOI: 10.1093/schbul/sbaa103] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Auditory-verbal hallucinations (AVH) are often associated with high levels of distress and disability in individuals with schizophrenia-spectrum disorders. In around 30% of individuals with distressing AVH and diagnosed with schizophrenia, traditional antipsychotic drugs have little or no effect. Thus, it is important to develop mechanistic models of AVH to inform new treatments. Recently a small number of studies have begun to explore the use of real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) for the treatment of AVH in individuals with schizophrenia. rtfMRI-NF protocols have been developed to provide feedback about brain activation in real time to enable participants to progressively achieve voluntary control over their brain activity. We offer a conceptual review of the background and general features of neurofeedback procedures before summarizing and evaluating existing mechanistic models of AVH to identify feasible neural targets for the application of rtfMRI-NF as a potential treatment. We consider methodological issues, including the choice of localizers and practicalities in logistics when setting up neurofeedback procedures in a clinical setting. We discuss clinical considerations relating to the use of rtfMRI-NF for AVH in individuals distressed by their experiences and put forward a number of questions and recommendations about best practice. Lastly, we conclude by offering suggestions for new avenues for neurofeedback methodology and mechanistic targets in relation to the research and treatment of AVH.
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Affiliation(s)
- Clara Humpston
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK,Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,To whom correspondence should be addressed; tel: +44 (0)121 414 2942, fax: +44 (0)121 414 3971, e-mail:
| | - Jane Garrison
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Natasza Orlov
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA,Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China,Precision Brain Imaging Lab, Medical University of South Carolina, Charleston, SC
| | - André Aleman
- Faculty of Medical Sciences, University of Groningen, AB Groningen, The Netherlands
| | - Renaud Jardri
- University of Lille, INSERM, CHU Lille, Lille Neuroscience and Cognition Centre (U-1172), Plasticity and Subjectivity (PSY) Team, CURE Platform, Lille, France
| | | | - Paul Allen
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Department of Psychology, University of Roehampton, London, UK
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14
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Alloza C, Blesa-Cábez M, Bastin ME, Madole JW, Buchanan CR, Janssen J, Gibson J, Deary IJ, Tucker-Drob EM, Whalley HC, Arango C, McIntosh AM, Cox SR, Lawrie SM. Psychotic-like experiences, polygenic risk scores for schizophrenia, and structural properties of the salience, default mode, and central-executive networks in healthy participants from UK Biobank. Transl Psychiatry 2020; 10:122. [PMID: 32341335 PMCID: PMC7186224 DOI: 10.1038/s41398-020-0794-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/11/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia is a highly heritable disorder with considerable phenotypic heterogeneity. Hallmark psychotic symptoms can be considered as existing on a continuum from non-clinical to clinical populations. Assessing genetic risk and psychotic-like experiences (PLEs) in non-clinical populations and their associated neurobiological underpinnings can offer valuable insights into symptom-associated brain mechanisms without the potential confounds of the effects of schizophrenia and its treatment. We leveraged a large population-based cohort (UKBiobank, N = 3875) including information on PLEs (obtained from the Mental Health Questionnaire (MHQ); UKBiobank Category: 144; N auditory hallucinations = 55, N visual hallucinations = 79, N persecutory delusions = 16, N delusions of reference = 13), polygenic risk scores for schizophrenia (PRSSZ) and multi-modal brain imaging in combination with network neuroscience. Morphometric (cortical thickness, volume) and water diffusion (fractional anisotropy) properties of the regions and pathways belonging to the salience, default-mode, and central-executive networks were computed. We hypothesized that these anatomical concomitants of functional dysconnectivity would be negatively associated with PRSSZ and PLEs. PRSSZ was significantly associated with a latent measure of cortical thickness across the salience network (r = -0.069, p = 0.010) and PLEs showed a number of significant associations, both negative and positive, with properties of the salience and default mode networks (involving the insular cortex, supramarginal gyrus, and pars orbitalis, pFDR < 0.050); with the cortical thickness of the insula largely mediating the relationship between PRSSZ and auditory hallucinations. Generally, these results are consistent with the hypothesis that higher genetic liability for schizophrenia is related to subtle disruptions in brain structure and may predispose to PLEs even among healthy participants. In addition, our study suggests that networks engaged during auditory hallucinations show structural associations with PLEs in the general population.
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Affiliation(s)
- C Alloza
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK.
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
- Ciber del Area de Salud Mental (CIBERSAM), Madrid, Spain.
| | - M Blesa-Cábez
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - M E Bastin
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - J W Madole
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - C R Buchanan
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, The University of Edinburgh, Edinburgh, UK
- Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE), Edinburgh, UK
| | - J Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Ciber del Area de Salud Mental (CIBERSAM), Madrid, Spain
| | - J Gibson
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - I J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - E M Tucker-Drob
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - H C Whalley
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - C Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Ciber del Area de Salud Mental (CIBERSAM), Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - A M McIntosh
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - S R Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, The University of Edinburgh, Edinburgh, UK
- Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE), Edinburgh, UK
| | - S M Lawrie
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
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15
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Gao J, Zhang D, Wang L, Wang W, Fan Y, Tang M, Zhang X, Lei X, Wang Y, Yang J, Zhang X. Altered Effective Connectivity in Schizophrenic Patients With Auditory Verbal Hallucinations: A Resting-State fMRI Study With Granger Causality Analysis. Front Psychiatry 2020; 11:575. [PMID: 32670108 PMCID: PMC7327618 DOI: 10.3389/fpsyt.2020.00575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/05/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Auditory verbal hallucinations (AVH) are among the most common and prominent symptoms of schizophrenia. Although abnormal functional connectivity associated with AVH has been reported in multiple regions, the changes in information flow remain unclear. In this study, we aimed to elucidate causal influences related to AVH in key regions of auditory, language, and memory networks, by using Granger causality analysis (GCA). PATIENTS AND METHODS Eighteen patients with schizophrenia with AVH and eighteen matched patients without AVH who received resting-state fMRI scans were enrolled in the study. The bilateral superior temporal gyrus (STG), Broca's area, Wernicke's area, putamen, and hippocampus were selected as regions of interest. RESULTS Granger causality (GC) increased from Broca's area to the left STG, and decreased from the right homolog of Wernicke's area to the right homolog of Broca's area, and from the right STG to the right hippocampus in the AVH group compared with the non-AVH group. Correlation analysis showed that the normalized GC ratios from the left STG to Broca's area, from the left STG to the right homolog of Broca's area, and from the right STG to the right homolog of Broca's area were negatively correlated with severity of AVH, and the normalized GC ratios from Broca's area to the left hippocampus and from Broca's area to the right STG were positively correlated with severity of AVH. CONCLUSION Our findings indicate a causal influence of pivotal regions involving the auditory, language, and memory networks in schizophrenia with AVH, which provide a deeper understanding of the neural mechanisms underlying AVH.
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Affiliation(s)
- Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Lei Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yajuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xin Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yarong Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
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16
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Kubera KM, Rashidi M, Schmitgen MM, Barth A, Hirjak D, Sambataro F, Calhoun VD, Wolf RC. Structure/function interrelationships in patients with schizophrenia who have persistent auditory verbal hallucinations: A multimodal MRI study using parallel ICA. Prog Neuropsychopharmacol Biol Psychiatry 2019; 93:114-121. [PMID: 30890460 DOI: 10.1016/j.pnpbp.2019.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 02/28/2019] [Accepted: 03/13/2019] [Indexed: 12/22/2022]
Abstract
There is accumulating neuroimaging evidence for both structural and functional abnormalities in schizophrenia patients with persistent auditory verbal hallucinations (AVH). So far, the direct interrelationships between altered structural and functional changes underlying AVH are unknown. Recently, it has become possible to reveal hidden patterns of neural dysfunction not sufficiently captured by separate analysis of these two modalities. A data-driven fusion method called parallel independent component analysis (p-ICA) is able to identify maximally independent components of each imaging modality as well as the link between them. In the present study, we utilized p-ICA to study covarying components among gray matter volume maps computed from structural MRI (sMRI) and fractional amplitude of low-frequency fluctuations (fALFF) maps computed from resting-state functional MRI (rs-fMRI) data of 15 schizophrenia patients with AVH, 16 non-hallucinating schizophrenia patients (nAVH), and 19 healthy controls (HC). We found a significant correlation (r = 0.548, n = 50, p < .001) between a sMRI component and a rs-fMRI component, which was significantly different between the AVH and non AVH group (nAVH). The rs-fMRI component comprised temporal cortex and cortical midline regions, the sMRI component included predominantly fronto-temporo-parietal regions. Distinct clinical features, as measured by the Psychotic Symptoms Rating Scale (PSYRATS), were associated with two different modality specific rs-fMRI components. There was a significant correlation between a predominantly parietal resting-state network and the physical dimension of PSYRATS and the posterior cingulate/temporal cortex network and the emotional dimension of PSYRATS. These data suggest AVH-specific interrelationships between intrinsic network activity and GMV, together with modality-specific associations with distinct symptom dimensions of AVH.
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Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Mahmoud Rashidi
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Anja Barth
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Vince D Calhoun
- Department of Electrical and Computer Engineering, The University of New Mexico and the Mind Research Network, Albuquerque, NM, USA
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.
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17
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Aldaz T, Nigro P, Sánchez-Gómez A, Painous C, Planellas L, Santacruz P, Cámara A, Compta Y, Valldeoriola F, Martí MJ, Muñoz E. Non-motor symptoms in Huntington's disease: a comparative study with Parkinson's disease. J Neurol 2019; 266:1340-1350. [PMID: 30834978 DOI: 10.1007/s00415-019-09263-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIMS The presence of non-motor symptoms in Huntington's disease (HD) has not been systematically assessed so far. Our objective was to know their prevalence and to compare it with a cohort of patients with Parkinson's disease (PD). MATERIALS AND METHODS Participants were consecutively recruited from our outpatient clinic. They were assessed through the motor part of the Unified Huntington's Disease Rating Scale, the motor part of the Unified Parkinson's Disease Rating Scale, the total functional capacity scale and the PD non-motor symptoms questionnaire. RESULTS We enrolled 123 participants: 53 HD, 45 PD and 25 healthy controls (HC). Non-motor symptoms were significantly more prevalent in HD patients than in HC. The most frequent non-motor symptoms in HD, involving more than 50% of patients, were attentional deficits, apathy, dysphagia, memory complaints, depression falls, insomnia and urinary urgency. The total score of non-motor symptoms correlated with disease duration, total functional capacity and disease stage. HD scored significantly higher than PD in 11 items (dysphagia, constipation, bowel incontinence, faecal tenesmus, weight loss, memory, apathy, attention, falls, nightmares, delusions) and in four domains (cognitive, hallucinations and delusions, digestive and cardiovascular). PD did not score significantly higher than HD in any domain. CONCLUSIONS HD patients have a high prevalence of non-motor symptoms, which is even higher than in PD, and correlates with disease progression.
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Affiliation(s)
- Tatiana Aldaz
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Pasquale Nigro
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Almudena Sánchez-Gómez
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Celia Painous
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Lluís Planellas
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Pilar Santacruz
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,European Huntington's Disease Network (EHDN), Barcelona, Spain
| | - Ana Cámara
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Yaroslau Compta
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Francesc Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria J Martí
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Esteban Muñoz
- Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain. .,Institut de Neurociències, University of Barcelona, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,European Huntington's Disease Network (EHDN), Barcelona, Spain.
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18
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Chen X, Ji GJ, Zhu C, Bai X, Wang L, He K, Gao Y, Tao L, Yu F, Tian Y, Wang K. Neural Correlates of Auditory Verbal Hallucinations in Schizophrenia and the Therapeutic Response to Theta-Burst Transcranial Magnetic Stimulation. Schizophr Bull 2019; 45:474-483. [PMID: 29733409 PMCID: PMC6403092 DOI: 10.1093/schbul/sby054] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Auditory verbal hallucinations (AVHs) are a core symptom of schizophrenia, and resistant to antipsychotic medication in a substantial proportion of patients. This study aimed to investigate the neural correlates of AVHs in schizophrenia patients and its response to a modified continuous theta-burst stimulation (cTBS) by transcranial magnetic stimulation. In a cross-sectional experiment, resting-state functional magnetic resonance images were collected from 31 AVH schizophrenia patients, 26 non-AVH schizophrenia patients, and 33 sex-/age-matched healthy controls (HCs). Functional connectivity strength (FCS) maps were compared among groups by 1-way analysis of variance (ANOVA). In a longitudinal experiment, 16 and 11 AVH patients received real and sham cTBS treatment for 15 days, respectively. Notably, this was not a randomized control trail. Changes in AVH and FCS were analyzed by 2-way ANOVA and 2-sample t-test, respectively. In the cross-sectional experiment, comparison of FCS maps identified 8 clusters among groups, but only one cluster (in left cerebellum) differed significantly in AVH patients compared to both HCs and non-AVH patients. In the longitudinal experiment, the real cTBS group showed a greater improvement in symptoms and a larger FCS decrease in left cerebellum than the sham group. Pearson's correlation analysis indicated that baseline FCS of the overlapping cerebellum cluster (between the cross-sectional and longitudinal findings) was negatively correlated with symptom improvement in the real treatment group. These findings emphasize the role of the left cerebellum in both the pathophysiology and clinical treatment of AVHs in schizophrenia patients.
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Affiliation(s)
- Xingui Chen
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China,Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Anhui Province, China,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Gong-Jun Ji
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Chunyan Zhu
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Anhui Province, China,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China,Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Xiaomeng Bai
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Lu Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | | | - Yaxiang Gao
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Anhui Province, China
| | - Longxiang Tao
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Anhui Province, China,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China,Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China,Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Anhui Province, China,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China,Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China,Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Anhui Province, China,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China,Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China,To whom correspondence should be addressed; Laboratory of Cognitive Neuropsychology, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China; tel: +86-551-62923704, fax: +86-551-62922418, e-mail:
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19
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Scheinost D, Tokoglu F, Hampson M, Hoffman R, Constable RT. Data-Driven Analysis of Functional Connectivity Reveals a Potential Auditory Verbal Hallucination Network. Schizophr Bull 2019; 45:415-424. [PMID: 29660081 PMCID: PMC6403094 DOI: 10.1093/schbul/sby039] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Schizophrenia is a severe global health problem, with over half of such patients experiencing auditory verbal hallucinations (AVHs). A better understanding of the neural correlates differentiating patients experiencing AVHs from patients not experiencing AVHs and healthy controls may identify targets that lead to better treatment strategies for AVHs. Employing 2 data-driven, voxel-based measure of functional connectivity, we studied 46 patients with schizophrenia or schizoaffective disorder (28 experiencing AVHs and 18 not experiencing AVHs). Twenty healthy controls matched for age, gender, ethnicity, education level, handedness, and estimated verbal intelligence were included for comparison. The intrinsic connectivity distribution (ICD) was used to model each voxel's connectivity to the rest of the brain using a Weibull distribution. To investigate lateralization of connectivity, we used cross-hemisphere ICD, a method that separates the contribution of each hemisphere to interrogate connectivity laterality. Patients with AVHs compared with patients without AVHs exhibited significantly decreased whole-brain connectivity in the medial prefrontal cortex and posterior cingulate cortex, less lateralized connectivity in left putamen, and more lateralized connectivity in left interior frontal gyrus. Correlations with Auditory Hallucination Rating Scale (AHRS) and post hoc seed connectivity analyses revealed significantly altered network connectivity. Using the results from all analyses comparing the patient groups and correlations with AHRS, we identified a potential AVH network, consisting of 25 nodes, showing substantial overlap with the default mode network and language processing networks. This network as a whole, instead of individual nodes, may represent actionable targets for interventions.
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Affiliation(s)
- Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT,To whom correspondence should be addressed; Magnetic Resonance Research Center, 300 Cedar St, PO Box 208043, New Haven, CT 06520-8043, USA; tel: 203-785-6148, fax: 203-737-1124, e-mail:
| | - Fuyuze Tokoglu
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Michelle Hampson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Ralph Hoffman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT,Department of Neurosurgery, Yale School of Medicine, New Haven, CT
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20
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Fonville L, Drakesmith M, Zammit S, Lewis G, Jones DK, David AS. MRI Indices of Cortical Development in Young People With Psychotic Experiences: Influence of Genetic Risk and Persistence of Symptoms. Schizophr Bull 2019; 45:169-179. [PMID: 29385604 PMCID: PMC6293214 DOI: 10.1093/schbul/sbx195] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Psychotic experiences (PEs) are considered part of an extended psychosis phenotype and are associated with an elevated risk of developing a psychotic disorder. Risk of transition increases with persistence of PEs, and this is thought to be modulated by genetic and environmental factors. However, it is unclear if persistence is associated with progressive schizophrenia-like changes in neuroanatomy. Methods We examined cortical morphometry using MRI in 247 young adults, from a population-based cohort, assessed for the presence of PEs at ages 18 and 20. We then incorporated a polygenic risk score for schizophrenia (PRS) to elucidate the effects of high genetic risk. Finally, we used atlas-based tractography data to examine the underlying white matter. Results Individuals with persisting PEs showed reductions in gyrification (local gyrification index: lGI) in the left temporal gyrus as well as atypical associations with brain volume (TBV) in the left occipital and right prefrontal gyri. No main effect was found for the PRS, but interaction effects with PEs were identified in the orbitofrontal, parietal, and temporal regions. Examination of underlying white matter did not provide strong evidence of further disturbances. Conclusions Disturbances in lGI were similar to schizophrenia but findings were mostly limited to those with persistent PEs. These could reflect subtle changes that worsen with impending psychosis or reflect an early vulnerability associated with the persistence of PEs. The lack of clear differences in underlying white matter suggests our findings reflect early disturbances in cortical expansion rather than progressive changes in brain structure.
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Affiliation(s)
- Leon Fonville
- Section of Cognitive Neuropsychiatry (Box 68), Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King ’s College London, UK
| | - Mark Drakesmith
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Stanley Zammit
- Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Anthony S David
- Section of Cognitive Neuropsychiatry (Box 68), Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King ’s College London, UK
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21
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Mallikarjun PK, Lalousis PA, Dunne TF, Heinze K, Reniers RLEP, Broome MR, Farmah B, Oyebode F, Wood SJ, Upthegrove R. Aberrant salience network functional connectivity in auditory verbal hallucinations: a first episode psychosis sample. Transl Psychiatry 2018; 8:69. [PMID: 29581420 PMCID: PMC5913255 DOI: 10.1038/s41398-018-0118-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/20/2017] [Accepted: 01/15/2018] [Indexed: 01/15/2023] Open
Abstract
Auditory verbal hallucinations (AVH) often lead to distress and functional disability, and are frequently associated with psychotic illness. Previously both state and trait magnetic resonance imaging (MRI) studies of AVH have identified activity in brain regions involving auditory processing, language, memory and areas of default mode network (DMN) and salience network (SN). Current evidence is clouded by research mainly in participants on long-term medication, with chronic illness and by choice of seed regions made 'a priori'. Thus, the aim of this study was to elucidate the intrinsic functional connectivity in patients presenting with first episode psychosis (FEP). Resting state functional MRI data were available from 18 FEP patients, 9 of whom also experienced AVH of sufficient duration in the scanner and had symptom capture functional MRI (sc fMRI), together with 18 healthy controls. Symptom capture results were used to accurately identify specific brain regions active during AVH; including the superior temporal cortex, insula, precuneus, posterior cingulate and parahippocampal complex. Using these as seed regions, patients with FEP and AVH showed increased resting sb-FC between parts of the SN and the DMN and between the SN and the cerebellum, but reduced sb-FC between the claustrum and the insula, compared to healthy controls.It is possible that aberrant activity within the DMN and SN complex may be directly linked to impaired salience appraisal of internal activity and AVH generation. Furthermore, decreased intrinsic functional connectivity between the claustrum and the insula may lead to compensatory over activity in parts of the auditory network including areas involved in DMN, auditory processing, language and memory, potentially related to the complex and individual content of AVH when they occur.
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Affiliation(s)
- Pavan Kumar Mallikarjun
- 0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK ,Forward Thinking Birmingham, Birmingham, UK
| | | | - Thomas Frederick Dunne
- 0000 0004 1936 7486grid.6572.6College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Kareen Heinze
- 0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Renate LEP Reniers
- 0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Matthew R. Broome
- 0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Birmingham, UK ,Forward Thinking Birmingham, Birmingham, UK ,0000 0004 1936 8948grid.4991.5University of Oxford, Oxford, UK
| | | | - Femi Oyebode
- 0000 0004 1936 7486grid.6572.6College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK ,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Stephen J Wood
- 0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Birmingham, UK ,grid.488501.0Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia ,0000 0001 2179 088Xgrid.1008.9Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK. .,College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. .,Forward Thinking Birmingham, Birmingham, UK.
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22
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Kerepesi C, Varga B, Szalkai B, Grolmusz V. The dorsal striatum and the dynamics of the consensus connectomes in the frontal lobe of the human brain. Neurosci Lett 2018; 673:51-55. [PMID: 29496609 DOI: 10.1016/j.neulet.2018.02.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/07/2018] [Accepted: 02/23/2018] [Indexed: 11/15/2022]
Abstract
In the applications of the graph theory, it is unusual that one considers numerous, pairwise different graphs on the very same set of vertices. In the case of human braingraphs or connectomes, however, this is the standard situation: the nodes correspond to anatomically identified cerebral regions, and two vertices are connected by an edge if a diffusion MRI-based workflow identifies a fiber of axons, running between the two regions, corresponding to the two vertices. Therefore, if we examine the braingraphs of n subjects, then we have n graphs on the very same, anatomically identified vertex set. It is a natural idea to describe the k-frequently appearing edges in these graphs: the edges that are present between the same two vertices in at least k out of the n graphs. Based on the NIH-funded large Human Connectome Project's public data release, we have reported the construction of the Budapest Reference Connectome Server http://www.connectome.pitgroup.org that generates and visualizes these k-frequently appearing edges. We call the graphs of the k-frequently appearing edges "k-consensus connectomes" since an edge could be included only if it is present in at least k graphs out of n. Considering the whole human brain, we have reported a surprising property of these consensus connectomes earlier. In the present work we are focusing on the frontal lobe of the brain, and we report here a similarly surprising dynamical property of the consensus connectomes when k is gradually changed from k = n to k = 1: the connections between the nodes of the frontal lobe are seemingly emanating from those nodes that were connected to sub-cortical structures of the dorsal striatum: the caudate nucleus, and the putamen. We hypothesize that this dynamic behavior copies the axonal fiber development of the frontal lobe. An animation of the phenomenon is presented at https://youtu.be/wBciB2eW6_8.
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Affiliation(s)
- Csaba Kerepesi
- PIT Bioinformatics Group, Eötvös University, H-1117 Budapest, Hungary; Institute for Computer Science and Control (MTA SZTAKI), Hungarian Academy of Sciences.
| | - Bálint Varga
- PIT Bioinformatics Group, Eötvös University, H-1117 Budapest, Hungary.
| | - Balázs Szalkai
- PIT Bioinformatics Group, Eötvös University, H-1117 Budapest, Hungary.
| | - Vince Grolmusz
- PIT Bioinformatics Group, Eötvös University, H-1117 Budapest, Hungary; Uratim Ltd., H-1118 Budapest, Hungary.
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23
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Orlov ND, Giampietro V, O’Daly O, Lam SL, Barker GJ, Rubia K, McGuire P, Shergill SS, Allen P. Real-time fMRI neurofeedback to down-regulate superior temporal gyrus activity in patients with schizophrenia and auditory hallucinations: a proof-of-concept study. Transl Psychiatry 2018; 8:46. [PMID: 29430009 PMCID: PMC5865171 DOI: 10.1038/s41398-017-0067-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/18/2017] [Accepted: 10/26/2017] [Indexed: 02/07/2023] Open
Abstract
Neurocognitive models and previous neuroimaging work posit that auditory verbal hallucinations (AVH) arise due to increased activity in speech-sensitive regions of the left posterior superior temporal gyrus (STG). Here, we examined if patients with schizophrenia (SCZ) and AVH could be trained to down-regulate STG activity using real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF). We also examined the effects of rtfMRI-NF training on functional connectivity between the STG and other speech and language regions. Twelve patients with SCZ and treatment-refractory AVH were recruited to participate in the study and were trained to down-regulate STG activity using rtfMRI-NF, over four MRI scanner visits during a 2-week training period. STG activity and functional connectivity were compared pre- and post-training. Patients successfully learnt to down-regulate activity in their left STG over the rtfMRI-NF training. Post- training, patients showed increased functional connectivity between the left STG, the left inferior prefrontal gyrus (IFG) and the inferior parietal gyrus. The post-training increase in functional connectivity between the left STG and IFG was associated with a reduction in AVH symptoms over the training period. The speech-sensitive region of the left STG is a suitable target region for rtfMRI-NF in patients with SCZ and treatment-refractory AVH. Successful down-regulation of left STG activity can increase functional connectivity between speech motor and perception regions. These findings suggest that patients with AVH have the ability to alter activity and connectivity in speech and language regions, and raise the possibility that rtfMRI-NF training could present a novel therapeutic intervention in SCZ.
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Affiliation(s)
- Natasza D. Orlov
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 0468 7274grid.35349.38Department of Psychology, University of Roehampton, London, UK
| | - Vincent Giampietro
- 0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Owen O’Daly
- 0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sheut-Ling Lam
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gareth J. Barker
- 0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Katya Rubia
- 0000 0001 2322 6764grid.13097.3cDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Philip McGuire
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sukhwinder S. Shergill
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paul Allen
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 0468 7274grid.35349.38Department of Psychology, University of Roehampton, London, UK ,Combined Universities Brain Imaging Centre (CUBIC), London, UK
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24
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Cortical folding abnormalities in patients with schizophrenia who have persistent auditory verbal hallucinations. Eur Neuropsychopharmacol 2018; 28:297-306. [PMID: 29305294 DOI: 10.1016/j.euroneuro.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/28/2017] [Accepted: 12/06/2017] [Indexed: 01/28/2023]
Abstract
In schizophrenia temporal cortical volume loss differs between patients presenting with persistent auditory verbal hallucinations (pAVH) in contrast to those without hallucinatory symptoms (nAVH). However, it is unknown whether this deficit reflects a neural signature of neurodevelopmental origin or if abnormal temporal cortical volume is reflective of factors which may be relevant at later stages of the disorder. Here, we tested the hypothesis that local gyrification index (LGI) in regions of the temporal cortex differs between patients with pAVH (n=10) and healthy controls (n=14), and that abnormal temporal LGI discriminates between pAVH and nAVH (n=10). Structural magnetic resonance imaging at 3T along with surface-based data analysis methods was used. Contrary to our expectations, patients with pAVH showed lower LGI in Broca´s region compared to both healthy persons and nAVH. Compared to nAVH, those individuals presenting with pAVH also showed lower LGI in right Broca's homologue and right superior middle frontal cortex, together with increased LGI in the precuneus and superior parietal cortex. Regions with abnormal LGI common to both patient samples were found in anterior cingulate and superior frontal areas. Inferior cortical regions exhibiting abnormal LGI in pAVH patients were associated with overall symptom load (BPRS), but not with measures of AVH symptom severity. The pattern of abnormal cortical folding in this sample suggests a neurodevelopmental signature in Broca's region, consistent with current AVH models emphasizing the pivotal role of language circuits and inner speech. Temporal cortical deficits may characterize patients with pAVH during later stages of the disorder.
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25
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Steinmann S, Leicht G, Andreou C, Polomac N, Mulert C. Auditory verbal hallucinations related to altered long-range synchrony of gamma-band oscillations. Sci Rep 2017; 7:8401. [PMID: 28827744 PMCID: PMC5566404 DOI: 10.1038/s41598-017-09253-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 07/25/2017] [Indexed: 11/09/2022] Open
Abstract
Our understanding of the neural correlates of auditory-verbal-hallucinations (AVH) has substantially increased during the last few years, but is far from sufficient. One current hypothesis, the interhemispheric miscommunication theory, is based on findings from fMRI, DTI and EEG, but there is only limited evidence so far concerning underlying functional coupling mechanisms. Here we report a 64-channel EEG study using lagged phase synchronization analysis and eLORETA source estimation to examine the functional connectivity between bilateral auditory cortices in the gamma-band in 26 schizophrenia patients (13 with and 13 without AVH) and 26 matched healthy controls (HC) while performing a dichotic listening task. We found a significantly reduced right-ear-advantage (REA) in AVH but not in non-AVH patients compared to HC. The major finding was significantly stronger gamma-band connectivity between bilateral auditory cortices during conscious perception of left (versus right) ear syllables in patients with AVH compared to HC and patients without AVH. A significant positive correlation was found between this connectivity alteration and the AVH symptom score in schizophrenia patients. These findings provide further support for the interhemispheric miscommunication hypothesis of AVH pathophysiology by indicating that aberrant gamma-band coupling between auditory cortices is related to the emergence of AVH in schizophrenia.
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Affiliation(s)
- Saskia Steinmann
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Andreou
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nenad Polomac
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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26
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Abstract
Auditory verbal hallucinations (AVH) are a frequently occurring phenomenon in the general population and are considered a psychotic symptom when presented in the context of a psychiatric disorder. Neuroimaging literature has shown that AVH are subserved by a variety of alterations in brain structure and function, which primarily concentrate around brain regions associated with the processing of auditory verbal stimuli and with executive control functions. However, the direction of association between AVH and brain function remains equivocal in certain research areas and needs to be carefully reviewed and interpreted. When AVH have significant impact on daily functioning, several efficacious treatments can be attempted such as antipsychotic medication, brain stimulation and cognitive-behavioural therapy. Interestingly, the neural correlates of these treatments largely overlap with brain regions involved in AVH. This suggests that the efficacy of treatment corresponds to a normalization of AVH-related brain activity. In this selected review, we give a compact yet comprehensive overview of the structural and functional neuroimaging literature on AVH, with a special focus on the neural correlates of efficacious treatment.
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Affiliation(s)
- M M Bohlken
- Department of Psychiatry,Brain Center Rudolf Magnus,University Medical Center Utrecht,3584CX Utrecht,The Netherlands
| | - K Hugdahl
- Department of Biological and Medical Psychology,University of Bergen,Bergen,Norway
| | - I E C Sommer
- Department of Psychiatry,Brain Center Rudolf Magnus,University Medical Center Utrecht,3584CX Utrecht,The Netherlands
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27
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Chahine G, Richter A, Wolter S, Goya-Maldonado R, Gruber O. Disruptions in the left frontoparietal network underlie resting state endophenotypic markers in schizophrenia. Hum Brain Mapp 2016; 38:1741-1750. [PMID: 28009080 DOI: 10.1002/hbm.23477] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 11/12/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
Advances in functional brain imaging have improved the search for potential endophenotypic markers in schizophrenia. Here, we employed independent component analysis (ICA) and dynamic causal modeling (DCM) in resting state fMRI on a sample of 35 schizophrenia patients, 20 first-degree relatives and 35 control subjects. Analysis on ICA-derived networks revealed increased functional connectivity between the left frontoparietal network (FPN) and left temporal and parietal regions in schizophrenia patients (P < 0.001). First-degree relatives shared this hyperconnectivity, in particular in the supramarginal gyrus (SMG; P = 0.008). DCM analysis was employed to further explore underlying effective connectivity. Results showed increased inhibitory connections to the left angular gyrus (AG) in schizophrenia patients from all other nodes of the left FPN (P < 0.001), and in particular from the left SMG (P = 0.001). Relatives also showed a pattern of increased inhibitory connections to the left AG (P = 0.008). Furthermore, the patient group showed increased excitatory connectivity between the left fusiform gyrus and the left SMG (P = 0.002). This connection was negatively correlated to inhibitory afferents to the left AG (P = 0.005) and to the negative symptom score on the PANSS scale (P = 0.001, r = -0.51). Left frontoparietotemporal dysfunction in schizophrenia has been previously associated with a range of abnormalities, including formal thought disorder, working memory dysfunction and sensory hallucinations. Our analysis uncovered new potential endophenotypic markers of schizophrenia and shed light on the organization of the left FPN in patients and their first-degree relatives. Hum Brain Mapp 38:1741-1750, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- George Chahine
- Department of Psychiatry and Psychotherapy, Centre for Translational Research in Systems, Neuroscience and Clinical Psychiatry, George August University, Göttingen, Germany.,Department of Psychiatry, Maimonides Medical Center, Brooklyn, New York
| | - Anja Richter
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Sarah Wolter
- Department of Psychiatry and Psychotherapy, Centre for Translational Research in Systems, Neuroscience and Clinical Psychiatry, George August University, Göttingen, Germany
| | - Roberto Goya-Maldonado
- Department of Psychiatry and Psychotherapy, Centre for Translational Research in Systems, Neuroscience and Clinical Psychiatry, George August University, Göttingen, Germany
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
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Ćurčić-Blake B, Ford JM, Hubl D, Orlov ND, Sommer IE, Waters F, Allen P, Jardri R, Woodruff PW, David O, Mulert C, Woodward TS, Aleman A. Interaction of language, auditory and memory brain networks in auditory verbal hallucinations. Prog Neurobiol 2016; 148:1-20. [PMID: 27890810 PMCID: PMC5240789 DOI: 10.1016/j.pneurobio.2016.11.002] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 10/04/2016] [Accepted: 11/20/2016] [Indexed: 12/22/2022]
Abstract
The language, auditory and memory/limbic networks are of particular relevance for auditory verbal hallucinations. An increased interaction among the auditory-language and striatal brain regions occurs while patients hallucinate. Fronto-temporal connections are often altered in AVH individuals, but there is no consensus regarding increase or decrease. Connections of the interhemispheric auditory pathway are stronger for first episode patients, but they are weaker in chronic patients. The majority of studies support hybrid AVH hypotheses in which all three networks and the striatal network are involved.
Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses.
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Affiliation(s)
- Branislava Ćurčić-Blake
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Judith M Ford
- University of California and Veterans Affairs Medical Center, San Francisco, United States
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Switzerland
| | - Natasza D Orlov
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Iris E Sommer
- Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Flavie Waters
- Graylands Hospital, North Metro Health Service Mental Health, The University of Western Australia, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia Graylands Hospital, Australia
| | - Paul Allen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Psychology, University of Roehampton, London, United Kingdom
| | - Renaud Jardri
- University of Lille, CNRS UMR9193, SCA-Lab & CHU Lille, Fontan Hospital (CURE), Lille, France
| | - Peter W Woodruff
- Department of Neuroscience, The University of Sheffield, United Kingdom
| | - Olivier David
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institute of Neuroscience, Grenoble, France
| | - Christoph Mulert
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, Hamburg, Germany
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, Canada; BC Mental Health and Addiction Research Institute, Vancouver, Canada
| | - André Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Baumeister D, Sedgwick O, Howes O, Peters E. Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature. Clin Psychol Rev 2016; 51:125-141. [PMID: 27866082 PMCID: PMC5240854 DOI: 10.1016/j.cpr.2016.10.010] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/05/2016] [Accepted: 10/29/2016] [Indexed: 12/22/2022]
Abstract
Recent decades have seen a surge of research interest in the phenomenon of healthy individuals who experience auditory verbal hallucinations, yet do not exhibit distress or need for care. The aims of the present systematic review are to provide a comprehensive overview of this research and examine how healthy voice-hearers may best be conceptualised in relation to the diagnostic versus ‘quasi-‘ and ‘fully-dimensional’ continuum models of psychosis. A systematic literature search was conducted, resulting in a total of 398 article titles and abstracts that were scrutinised for appropriateness to the present objective. Seventy articles were identified for full-text analysis, of which 36 met criteria for inclusion. Subjective perceptual experience of voices, such as loudness or location (i.e., inside/outside head), is similar in clinical and non-clinical groups, although clinical voice-hearers have more frequent voices, more negative voice content, and an older age of onset. Groups differ significantly in beliefs about voices, control over voices, voice-related distress, and affective difficulties. Cognitive biases, reduced global functioning, and psychiatric symptoms such as delusions, appear more prevalent in healthy voice-hearers than in healthy controls, yet less than in clinical samples. Transition to mental health difficulties is increased in HVHs, yet only occurs in a minority and is predicted by previous mood problems and voice distress. Whilst healthy voice-hearers show similar brain activity during hallucinatory experiences to clinical voice-hearers, other neuroimaging measures, such as mismatch negativity, have been inconclusive. Risk factors such as familial and childhood trauma appear similar between clinical and non-clinical voice-hearers. Overall the results of the present systematic review support a continuum view rather than a diagnostic model, but cannot distinguish between ‘quasi’ and ‘fully’ dimensional models. Healthy voice-hearers may be a key resource in informing transdiagnostic approaches to research of auditory hallucinations. Subjective perceptual experiences of voices appear similar in clinical and non-clinical groups. Healthy voice-hearers hear voices less frequently, with less negative content, more perceived control and from an earlier age. Healthy and clinical voice-hearers differ in beliefs about voices, voice-related distress, and affective difficulties. Healthy voice-hearers show more cognitive biases, psychiatric symptoms and functional impairments than healthy controls. Risk factors such as familial and childhood trauma appear similar between clinical and non-clinical voice-hearers.
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Affiliation(s)
- David Baumeister
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK.
| | - Ottilie Sedgwick
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Oliver Howes
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychosis Studies, London, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
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Houck JM, Çetin MS, Mayer AR, Bustillo JR, Stephen J, Aine C, Cañive J, Perrone-Bizzozero N, Thoma RJ, Brookes MJ, Calhoun VD. Magnetoencephalographic and functional MRI connectomics in schizophrenia via intra- and inter-network connectivity. Neuroimage 2016; 145:96-106. [PMID: 27725313 DOI: 10.1016/j.neuroimage.2016.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 10/05/2016] [Accepted: 10/07/2016] [Indexed: 12/11/2022] Open
Abstract
Examination of intrinsic functional connectivity using functional MRI (fMRI) has provided important findings regarding dysconnectivity in schizophrenia. Extending these results using a complementary neuroimaging modality, magnetoencephalography (MEG), we present the first direct comparison of functional connectivity between schizophrenia patients and controls, using these two modalities combined. We developed a novel MEG approach for estimation of networks using MEG that incorporates spatial independent component analysis (ICA) and pairwise correlations between independent component timecourses, to estimate intra- and intern-network connectivity. This analysis enables group-level inference and testing of between-group differences. Resting state MEG and fMRI data were acquired from a large sample of healthy controls (n=45) and schizophrenia patients (n=46). Group spatial ICA was performed on fMRI and MEG data to extract intrinsic fMRI and MEG networks and to compensate for signal leakage in MEG. Similar, but not identical spatial independent components were detected for MEG and fMRI. Analysis of functional network connectivity (FNC; i.e., pairwise correlations in network (ICA component) timecourses) revealed a differential between-modalities pattern, with greater connectivity among occipital networks in fMRI and among frontal networks in MEG. Most importantly, significant differences between controls and patients were observed in both modalities. MEG FNC results in particular indicated dysfunctional hyperconnectivity within frontal and temporal networks in patients, while in fMRI FNC was always greater for controls than for patients. This is the first study to apply group spatial ICA as an approach to leakage correction, and as such our results may be biased by spatial leakage effects. Results suggest that combining these two neuroimaging modalities reveals additional disease-relevant patterns of connectivity that were not detectable with fMRI or MEG alone.
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Affiliation(s)
- Jon M Houck
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Mind Research Network, Albuquerque, New Mexico, United States.
| | - Mustafa S Çetin
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Mind Research Network, Albuquerque, New Mexico, United States; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico, United States
| | - Andrew R Mayer
- Mind Research Network, Albuquerque, New Mexico, United States
| | - Juan R Bustillo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico, United States
| | - Julia Stephen
- Mind Research Network, Albuquerque, New Mexico, United States
| | - Cheryl Aine
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Mind Research Network, Albuquerque, New Mexico, United States; Department of Radiology, University of New Mexico, Albuquerque, New Mexico, United States
| | - Jose Cañive
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico, United States
| | - Nora Perrone-Bizzozero
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Department of Neurosciences, University of New Mexico, Albuquerque, New Mexico, United States
| | - Robert J Thoma
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States; Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico, United States
| | - Matthew J Brookes
- Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico, United States; University of Nottingham, United Kingdom
| | - Vince D Calhoun
- Mind Research Network, Albuquerque, New Mexico, United States; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico, United States
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Alderson-Day B, Diederen K, Fernyhough C, Ford JM, Horga G, Margulies DS, McCarthy-Jones S, Northoff G, Shine JM, Turner J, van de Ven V, van Lutterveld R, Waters F, Jardri R. Auditory Hallucinations and the Brain's Resting-State Networks: Findings and Methodological Observations. Schizophr Bull 2016; 42:1110-23. [PMID: 27280452 PMCID: PMC4988751 DOI: 10.1093/schbul/sbw078] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In recent years, there has been increasing interest in the potential for alterations to the brain's resting-state networks (RSNs) to explain various kinds of psychopathology. RSNs provide an intriguing new explanatory framework for hallucinations, which can occur in different modalities and population groups, but which remain poorly understood. This collaboration from the International Consortium on Hallucination Research (ICHR) reports on the evidence linking resting-state alterations to auditory hallucinations (AH) and provides a critical appraisal of the methodological approaches used in this area. In the report, we describe findings from resting connectivity fMRI in AH (in schizophrenia and nonclinical individuals) and compare them with findings from neurophysiological research, structural MRI, and research on visual hallucinations (VH). In AH, various studies show resting connectivity differences in left-hemisphere auditory and language regions, as well as atypical interaction of the default mode network and RSNs linked to cognitive control and salience. As the latter are also evident in studies of VH, this points to a domain-general mechanism for hallucinations alongside modality-specific changes to RSNs in different sensory regions. However, we also observed high methodological heterogeneity in the current literature, affecting the ability to make clear comparisons between studies. To address this, we provide some methodological recommendations and options for future research on the resting state and hallucinations.
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Affiliation(s)
| | - Kelly Diederen
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | | | - Judith M. Ford
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Guillermo Horga
- New York State Psychiatric Institute, Columbia University Medical Center, New York, NY
| | - Daniel S. Margulies
- Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, ON, Canada
| | - James M. Shine
- Department of Psychology, Stanford University, Stanford, CA
| | - Jessica Turner
- Department of Psychology, Neuroscience Institute, Georgia State University, Atlanta, GA
| | - Vincent van de Ven
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Remko van Lutterveld
- Center for Mindfulness, University of Massachusetts Medical School, Worcester, MA
| | - Flavie Waters
- North Metro Health Service Mental Health, Graylands Health Campus, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - Renaud Jardri
- Univ Lille, CNRS (UMR 9193), SCALab & CHU Lille, Psychiatry dept. (CURE), Lille, France
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Daalman K, Diederen KMJ, Hoekema L, van Lutterveld R, Sommer IEC. Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy? Psychol Med 2016; 46:1897-1907. [PMID: 26961499 DOI: 10.1017/s0033291716000386] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15-35 years). It is unclear if these older individuals with AVH are still at increased risk for psychosis or other psychopathology. To address this question, we conducted a 5-year follow-up of previously included individuals (103 with AVH, 60 controls). METHOD Eighty-one adults with AVH (78.6%) and forty-nine controls (81.7%) could be contacted and were willing to participate. Participants were screened for psychosis and a need for mental healthcare at follow-up using the Comprehensive Assessment of Symptoms and History interview (CASH). Need for mental healthcare was defined as a clinical diagnosis as identified using the CASH and/or treatment by a mental healthcare specialist. Phenomenology of AVH was assessed with the PSYRATS Auditory Hallucinations Rating Scale. RESULTS Five individuals with AVH (6.2%) had developed psychosis and 32 (39.5%) had developed a need for mental healthcare. Voice-related distress at baseline significantly predicted need for mental healthcare. AVH persisted in most individuals (86.4%), without significant changes in phenomenology. None of the controls had developed psychotic symptoms, and need for mental healthcare (n = 6, 12.2%) was significantly lower in this group. CONCLUSIONS These findings suggest that frequent AVH in non-psychotic adults past the peak incidence age for psychosis constitute a rather static symptom and that individuals with AVH may be best viewed as situated on a need for care continuum.
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Affiliation(s)
- K Daalman
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - K M J Diederen
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - L Hoekema
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - R van Lutterveld
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - I E C Sommer
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
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Psomiades M, Fonteneau C, Mondino M, Luck D, Haesebaert F, Suaud-Chagny MF, Brunelin J. Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study. NEUROIMAGE-CLINICAL 2016; 12:970-975. [PMID: 27995063 PMCID: PMC5153606 DOI: 10.1016/j.nicl.2016.04.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
Auditory verbal hallucinations (AVH) of schizophrenia are associated with a disrupted connectivity between frontal and temporoparietal language areas. We hypothesized that this dysconnectivity is underpinned by white matter abnormalities in the left arcuate fasciculus, the main fiber bundle connecting speech production and perception areas. We therefore investigated the relationship between AVH severity and the integrity of the arcuate fasciculus measured by diffusion tensor imaging (DTI) tractography in patients with schizophrenia. Thirty-eight patients with treatment-resistant schizophrenia were included: 26 presented with daily severe treatment-resistant AVH, 12 reported prominent negative symptoms and no AVH. Fractional anisotropy (FA) was measured along the length of the left and right anterior arcuate fasciculi and severity of AVH was assessed using P3 PANSS item. FA values were significantly higher in the left arcuate fasciculus in patients with AVH than in no AVH patients (F(1,35) = 3.86; p = 0.05). No difference was observed in the right arcuate fasciculus. There was a significant positive correlation between FA value in the left arcuate fasciculus and the severity of AVH (r = 0.36; p = 0.02). No correlation was observed between FA values and PANSS total score suggesting a specific relationship between AVH severity and the left arcuate fasciculus integrity. These results support the hypothesis of a relationship between left frontotemporal connectivity and AVH in patients with schizophrenia and suggest that whilst a disruption of frontotemporal connectivity might be present to ensure the emergence of AVH, more severe anatomical alterations may prevent the occurrence of AVH in patients with schizophrenia. Fractional anisotropy (FA) in the left arcuate fasciculus (AF) correlated with severity of hallucinations. Hallucinating patients had greater FA in the left AF than non-hallucinating patients. We did not find any association between hallucinations and FA in the right AF.
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Affiliation(s)
- Marion Psomiades
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Clara Fonteneau
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marine Mondino
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
| | - David Luck
- Institut Universitaire en Santé Mentale de Montréal Research Center, Québec, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada
| | - Frederic Haesebaert
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marie-Françoise Suaud-Chagny
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France; Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
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Upthegrove R, Broome MR, Caldwell K, Ives J, Oyebode F, Wood SJ. Understanding auditory verbal hallucinations: a systematic review of current evidence. Acta Psychiatr Scand 2016; 133:352-67. [PMID: 26661730 DOI: 10.1111/acps.12531] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) are core features of psychotic illness and remain significant in predicting poor outcome and risk. There has been a wide range of approaches to understanding these experiences. METHOD A systematic literature review summarizing different methods of investigation and their results; phenomenology, descriptive psychopathology, psychological, cognitive neurobiology, and neuroimaging. RESULTS A number of 764 papers and texts were screened and 113 reviewed. Phenomenological studies are comparably few in number, and psychopathology remains based on concepts defined in the early 20th century. Psychological models focus on voice content and emotional reaction, and suggest a continuum of AVHs from normal experience. Neuropsychological models include AVHs as misattribution of inner speech, whilst functional neuroimaging studies focus on the spontaneous activity and connectivity of auditory networks. CONCLUSION There has been a large growth in research on AVHs in recent decades dominated by neurobiological and neuroimaging studies. Future research should include focus on phenomenological aspects and AVHs change over the course of developing illness. Integration between branches of enquiry is needed, and the risk is that without this, models are proposed and investigated that bear scant relevance to the symptom itself.
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Affiliation(s)
- R Upthegrove
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - M R Broome
- Department of Psychiatry, University of Oxford, Oxford, UK.,Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK
| | - K Caldwell
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - J Ives
- Medicine, Ethics, Society and History, The University of Birmingham, Birmingham, UK
| | - F Oyebode
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - S J Wood
- School of Psychology, University of Birmingham, Birmingham, UK.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Vic., Australia
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Kubera KM, Barth A, Hirjak D, Thomann PA, Wolf RC. Noninvasive brain stimulation for the treatment of auditory verbal hallucinations in schizophrenia: methods, effects and challenges. Front Syst Neurosci 2015; 9:131. [PMID: 26528145 PMCID: PMC4601083 DOI: 10.3389/fnsys.2015.00131] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/07/2015] [Indexed: 12/12/2022] Open
Abstract
This mini-review focuses on noninvasive brain stimulation techniques as an augmentation method for the treatment of persistent auditory verbal hallucinations (AVH) in patients with schizophrenia. Paradigmatically, we place emphasis on transcranial magnetic stimulation (TMS). We specifically discuss rationales of stimulation and consider methodological questions together with issues of phenotypic diversity in individuals with drug-refractory and persistent AVH. Eventually, we provide a brief outlook for future investigations and treatment directions. Taken together, current evidence suggests TMS as a promising method in the treatment of AVH. Low-frequency stimulation of the superior temporal cortex (STC) may reduce symptom severity and frequency. Yet clinical effects are of relatively short duration and effect sizes appear to decrease over time along with publication of larger trials. Apart from considering other innovative stimulation techniques, such as transcranial Direct Current Stimulation (tDCS), and optimizing stimulation protocols, treatment of AVH using noninvasive brain stimulation will essentially rely on accurate identification of potential responders and non-responders for these treatment modalities. In this regard, future studies will need to consider distinct phenotypic presentations of AVH in patients with schizophrenia, together with the putative functional neurocircuitry underlying these phenotypes.
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Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Anja Barth
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Dusan Hirjak
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University Homburg, Germany
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Fonville L, Cohen Kadosh K, Drakesmith M, Dutt A, Zammit S, Mollon J, Reichenberg A, Lewis G, Jones DK, David AS. Psychotic Experiences, Working Memory, and the Developing Brain: A Multimodal Neuroimaging Study. Cereb Cortex 2015; 25:4828-38. [PMID: 26286920 PMCID: PMC4635922 DOI: 10.1093/cercor/bhv181] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Psychotic experiences (PEs) occur in the general population, especially in children and adolescents, and are associated with poor psychosocial outcomes, impaired cognition, and increased risk of transition to psychosis. It is unknown how the presence and persistence of PEs during early adulthood affects cognition and brain function. The current study assessed working memory as well as brain function and structure in 149 individuals, with and without PEs, drawn from a population cohort. Observer-rated PEs were classified as persistent or transient on the basis of longitudinal assessments. Working memory was assessed using the n-back task during fMRI. Dynamic causal modeling (DCM) was used to characterize frontoparietal network configuration and voxel-based morphometry was utilized to examine gray matter. Those with persistent, but not transient, PEs performed worse on the n-back task, compared with controls, yet showed no significant differences in regional brain activation or brain structure. DCM analyses revealed greater emphasis on frontal connectivity within a frontoparietal network in those with PEs compared with controls. We propose that these findings portray an altered configuration of working memory function in the brain, potentially indicative of an adaptive response to atypical development associated with the manifestation of PEs.
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Affiliation(s)
- Leon Fonville
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Mark Drakesmith
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Anirban Dutt
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stanley Zammit
- Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Josephine Mollon
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Abraham Reichenberg
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Department of Psychiatry, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology Institute of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Anthony S David
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Yoon YB, Yun JY, Jung WH, Cho KIK, Kim SN, Lee TY, Park HY, Kwon JS. Altered Fronto-Temporal Functional Connectivity in Individuals at Ultra-High-Risk of Developing Psychosis. PLoS One 2015; 10:e0135347. [PMID: 26267069 PMCID: PMC4534425 DOI: 10.1371/journal.pone.0135347] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/21/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The superior temporal gyrus (STG) is one of the key regions implicated in psychosis, given that abnormalities in this region are associated with an increased risk of conversion from an at-risk mental state to psychosis. However, inconsistent results regarding the functional connectivity strength of the STG have been reported, and the regional heterogeneous characteristics of the STG should be considered. METHODS To investigate the distinctive functional connection of each subregion in the STG, we parcellated the STG of each hemisphere into three regions: the planum temporale, Heschl's gyrus, and planum polare. Resting-state functional magnetic resonance imaging was obtained from 22 first-episode psychosis (FEP) patients, 41 individuals at ultra-high-risk for psychosis (UHR), and 47 demographically matched healthy controls. RESULTS Significant group differences (in seed-based connectivity) were demonstrated in the left planum temporale and from both the right and left Heschl's gyrus seeds. From the left planum temporale seed, the FEP and UHR groups exhibited increased connectivity to the bilateral dorsolateral prefrontal cortex. In contrast, the FEP and UHR groups demonstrated decreased connectivity from the bilateral Heschl's gyrus seeds to the dorsal anterior cingulate cortex. The enhanced connectivity between the left planum temporale and right dorsolateral prefrontal cortex was positively correlated with positive symptom severity in individuals at UHR (r = .34, p = .03). CONCLUSIONS These findings corroborate the fronto-temporal connectivity disruption hypothesis in schizophrenia by providing evidence supporting the altered fronto-temporal intrinsic functional connection at earlier stages of psychosis. Our data indicate that subregion-specific aberrant fronto-temporal interactions exist in the STG at the early stage of psychosis, thus suggesting that these aberrancies are the neural underpinning of proneness to psychosis.
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Affiliation(s)
- Youngwoo Bryan Yoon
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wi Hoon Jung
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Institute of Human Behavioral Medicine, Seoul National University-Medical Research Center, Seoul, Republic of Korea
| | - Kang Ik K. Cho
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- Institute of Human Behavioral Medicine, Seoul National University-Medical Research Center, Seoul, Republic of Korea
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University-Medical Research Center, Seoul, Republic of Korea
- * E-mail:
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38
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Alderson-Day B, McCarthy-Jones S, Fernyhough C. Hearing voices in the resting brain: A review of intrinsic functional connectivity research on auditory verbal hallucinations. Neurosci Biobehav Rev 2015; 55:78-87. [PMID: 25956256 PMCID: PMC5901708 DOI: 10.1016/j.neubiorev.2015.04.016] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 04/16/2015] [Accepted: 04/25/2015] [Indexed: 12/26/2022]
Abstract
Resting state networks (RSNs) are thought to reflect the intrinsic functional connectivity of brain regions. Alterations to RSNs have been proposed to underpin various kinds of psychopathology, including the occurrence of auditory verbal hallucinations (AVH). This review outlines the main hypotheses linking AVH and the resting state, and assesses the evidence for alterations to intrinsic connectivity provided by studies of resting fMRI in AVH. The influence of hallucinations during data acquisition, medication confounds, and movement are also considered. Despite a large variety of analytic methods and designs being deployed, it is possible to conclude that resting connectivity in the left temporal lobe in general and left superior temporal gyrus in particular are disrupted in AVH. There is also preliminary evidence of atypical connectivity in the default mode network and its interaction with other RSNs. Recommendations for future research include the adoption of a common analysis protocol to allow for more overlapping datasets and replication of intrinsic functional connectivity alterations.
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Affiliation(s)
- Ben Alderson-Day
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham DH1 3LE, United Kingdom.
| | - Simon McCarthy-Jones
- Department of Cognitive Science, Australian Hearing Hub, Macquarie University, 16 University Avenue, NSW 2109, Australia
| | - Charles Fernyhough
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham DH1 3LE, United Kingdom
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Schmidt A, Diwadkar VA, Smieskova R, Harrisberger F, Lang UE, McGuire P, Fusar-Poli P, Borgwardt S. Approaching a network connectivity-driven classification of the psychosis continuum: a selective review and suggestions for future research. Front Hum Neurosci 2015; 8:1047. [PMID: 25628553 PMCID: PMC4292722 DOI: 10.3389/fnhum.2014.01047] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/15/2014] [Indexed: 01/07/2023] Open
Abstract
Brain changes in schizophrenia evolve along a dynamic trajectory, emerging before disease onset and proceeding with ongoing illness. Recent investigations have focused attention on functional brain interactions, with experimental imaging studies supporting the disconnection hypothesis of schizophrenia. These studies have revealed a broad spectrum of abnormalities in brain connectivity in patients, particularly for connections integrating the frontal cortex. A critical point is that brain connectivity abnormalities, including altered resting state connectivity within the fronto-parietal (FP) network, are already observed in non-help-seeking individuals with psychotic-like experiences. If we consider psychosis as a continuum, with individuals with psychotic-like experiences at the lower and psychotic patients at the upper ends, individuals with psychotic-like experiences represent a key population for investigating the validity of putative biomarkers underlying the onset of psychosis. This paper selectively addresses the role played by FP connectivity in the psychosis continuum, which includes patients with chronic psychosis, early psychosis, clinical high risk, genetic high risk, as well as the general population with psychotic experiences. We first discuss structural connectivity changes among the FP pathway in each domain in the psychosis continuum. This may provide a basis for us to gain an understanding of the subsequent changes in functional FP connectivity. We further indicate that abnormal FP connectivity may arise from glutamatergic disturbances of this pathway, in particular from abnormal NMDA receptor-mediated plasticity. In the second part of this paper we propose some concepts for further research on the use of network connectivity in the classification of the psychosis continuum. These concepts are consistent with recent efforts to enhance the role of data in driving the diagnosis of psychiatric spectrum diseases.
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Affiliation(s)
- André Schmidt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University Detroit, Michigan, USA
| | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | | | - Undine E Lang
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel Basel, Switzerland ; Department of Psychosis Studies, Institute of Psychiatry, King's College London London, UK
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Northoff G. Are Auditory Hallucinations Related to the Brain's Resting State Activity? A 'Neurophenomenal Resting State Hypothesis'. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:189-95. [PMID: 25598821 PMCID: PMC4293163 DOI: 10.9758/cpn.2014.12.3.189] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/19/2014] [Accepted: 06/23/2014] [Indexed: 11/23/2022]
Abstract
While several hypotheses about the neural mechanisms underlying auditory verbal hallucinations (AVH) have been suggested, the exact role of the recently highlighted intrinsic resting state activity of the brain remains unclear. Based on recent findings, we therefore developed what we call the 'resting state hypotheses' of AVH. Our hypothesis suggest that AVH may be traced back to abnormally elevated resting state activity in auditory cortex itself, abnormal modulation of the auditory cortex by anterior cortical midline regions as part of the default-mode network, and neural confusion between auditory cortical resting state changes and stimulus-induced activity. We discuss evidence in favour of our 'resting state hypothesis' and show its correspondence with phenomenal, i.e., subjective-experiential features as explored in phenomenological accounts. Therefore I speak of a 'neurophenomenal resting state hypothesis' of auditory hallucinations in schizophrenia.
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Affiliation(s)
- Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada. ; Taipei Medical University, Graduate Institute of Humanities in Medicine, Taipei, Taiwan. ; Taipei Medical University-Shuang Ho Hospital, Brain and Consciousness Research Center, New Taipei City, Taiwan. ; National Chengchi University, Research Center for Mind, Brain and Learning, Taipei, Taiwan. ; National Chengchi University, Department of Psychology, Taipei, Taiwan. ; Centre for Cognition and Brain Disorders (CBBD), Normal University Hangzhou, Hangzhou, China
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Tracy DK, Shergill SS. Mechanisms Underlying Auditory Hallucinations-Understanding Perception without Stimulus. Brain Sci 2013; 3:642-69. [PMID: 24961419 PMCID: PMC4061847 DOI: 10.3390/brainsci3020642] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 04/07/2013] [Accepted: 04/18/2013] [Indexed: 12/17/2022] Open
Abstract
Auditory verbal hallucinations (AVH) are a common phenomenon, occurring in the “healthy” population as well as in several mental illnesses, most notably schizophrenia. Current thinking supports a spectrum conceptualisation of AVH: several neurocognitive hypotheses of AVH have been proposed, including the “feed-forward” model of failure to provide appropriate information to somatosensory cortices so that stimuli appear unbidden, and an “aberrant memory model” implicating deficient memory processes. Neuroimaging and connectivity studies are in broad agreement with these with a general dysconnectivity between frontotemporal regions involved in language, memory and salience properties. Disappointingly many AVH remain resistant to standard treatments and persist for many years. There is a need to develop novel therapies to augment existing pharmacological and psychological therapies: transcranial magnetic stimulation has emerged as a potential treatment, though more recent clinical data has been less encouraging. Our understanding of AVH remains incomplete though much progress has been made in recent years. We herein provide a broad overview and review of this.
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Affiliation(s)
- Derek K Tracy
- Cognition, Schizophrenia & Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF, UK.
| | - Sukhwinder S Shergill
- Cognition, Schizophrenia & Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF, UK
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Caspers S, Eickhoff SB, Zilles K, Amunts K. Microstructural grey matter parcellation and its relevance for connectome analyses. Neuroimage 2013; 80:18-26. [PMID: 23571419 DOI: 10.1016/j.neuroimage.2013.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 03/27/2013] [Accepted: 04/01/2013] [Indexed: 12/12/2022] Open
Abstract
The human brain connectome is closely linked to the anatomical framework provided by the structural segregation of the cortex into distinct cortical areas. Therefore, a thorough anatomical reference for the analysis and interpretation of connectome data is indispensable to understand the structure and function of different regions of the cortex, the white matter fibre architecture connecting them, and the interplay between these different entities. This article focuses on parcellation schemes of the cerebral grey matter and their relevance for connectome analyses. In particular, benefits and limitations of using different available atlases and parcellation schemes are reviewed. It is furthermore discussed how atlas information is currently used in connectivity analyses with major focus on seed-based and seed-target analyses, connectivity-based parcellation results, and the robust anatomical interpretation of connectivity data. Particularly this last aspect opens the possibility of integrating connectivity information into given anatomical frameworks, paving the way to multi-modal atlases of the human brain for a thorough understanding of structure-function relationships.
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Affiliation(s)
- Svenja Caspers
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany.
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