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Damme KSF, Han YC, Han Z, Reber PJ, Mittal VA. Motor precision deficits in clinical high risk for psychosis. Eur Arch Psychiatry Clin Neurosci 2024; 274:1427-1435. [PMID: 37458819 PMCID: PMC10792107 DOI: 10.1007/s00406-023-01645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/25/2023] [Indexed: 08/02/2023]
Abstract
Motor deficits appear prior to psychosis onset, provide insight into vulnerability as well as mechanisms that give rise to emerging illness, and are predictive of conversion. However, to date, the extant literature has often targeted a complex abnormality (e.g., gesture dysfunction, dyskinesia), or a single fundamental domain (e.g., accuracy) but rarely provided critical information about several of the individual components that make up more complex behaviors (or deficits). This preliminary study applies a novel implicit motor task to assess domains of motor accuracy, speed, recognition, and precision in individuals at clinical high risk for psychosis (CHR-p). Sixty participants (29 CHR-p; 31 healthy volunteers) completed clinical symptom interviews and a novel Serial Interception Sequence Learning (SISL) task that assessed implicit motor sequence accuracy, speed, precision, and explicit sequence recognition. These metrics were examined in multilevel models that enabled the examination of overall effects and changes in motor domains over blocks of trials and by positive/negative symptom severity. Implicit motor sequence accuracy, speed, and explicit sequence recognition were not detected as impacted in CHR-p. When compared to healthy controls, individuals at CHR-p were less precise in motor responses both overall (d = 0.91) and particularly in early blocks which normalized over later blocks. Within the CHR-p group, these effects were related to positive symptom levels (t = - 2.22, p = 0.036), such that individuals with higher symptom levels did not improve in motor precision over time (r's = 0.01-0.05, p's > 0.54). CHR-p individuals showed preliminary evidence of motor precision deficits but no other motor domain deficits, particularly in early performance that normalized with practice.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, 2029 Sheridan Rd, Evanston, IL, 60208, USA.
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA.
| | - Y Catherine Han
- Department of Psychology, Northwestern University, 2029 Sheridan Rd, Evanston, IL, 60208, USA
| | - Ziyan Han
- Department of Psychology, Northwestern University, 2029 Sheridan Rd, Evanston, IL, 60208, USA
| | - Paul J Reber
- Department of Psychology, Northwestern University, 2029 Sheridan Rd, Evanston, IL, 60208, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, 2029 Sheridan Rd, Evanston, IL, 60208, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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Gupta T, Osborne KJ, Nadig A, Haase CM, Mittal VA. Alterations in facial expressions in individuals at risk for psychosis: a facial electromyography approach using emotionally evocative film clips. Psychol Med 2023; 53:5829-5838. [PMID: 36285533 PMCID: PMC10130238 DOI: 10.1017/s0033291722003087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Negative symptoms such as blunted facial expressivity are characteristic of schizophrenia. However, it is not well-understood if and what abnormalities are present in individuals at clinical high-risk (CHR) for psychosis. METHODS This experimental study employed facial electromyography (left zygomaticus major and left corrugator supercilia) in a sample of CHR individuals (N = 34) and healthy controls (N = 32) to detect alterations in facial expressions in response to emotionally evocative film clips and to determine links with symptoms. RESULTS Findings revealed that the CHR group showed facial blunting manifested in reduced zygomatic activity in response to an excitement (but not amusement, fear, or sadness) film clip compared to controls. Reductions in zygomatic activity in the CHR group emerged in response to the emotionally evocative peak period of the excitement film clip. Lower zygomaticus activity during the excitement clip was related to anxiety while lower rates of change in zygomatic activity during the excitement video clip were related to higher psychosis risk conversion scores. CONCLUSIONS Together, these findings inform vulnerability/disease driving mechanisms and biomarker and treatment development.
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Affiliation(s)
- Tina Gupta
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - K. Juston Osborne
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Ajay Nadig
- Harvard/MIT MD-PhD Program, Harvard Medical School, Boston, MA, 02115
| | - Claudia M. Haase
- Department of Psychology, Northwestern University, Evanston, IL, USA
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
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Mamah D. A Review of Potential Neuroimaging Biomarkers of Schizophrenia-Risk. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2023; 8:e230005. [PMID: 37427077 PMCID: PMC10327607 DOI: 10.20900/jpbs.20230005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The risk for developing schizophrenia is increased among first-degree relatives of those with psychotic disorders, but the risk is even higher in those meeting established criteria for clinical high risk (CHR), a clinical construct most often comprising of attenuated psychotic experiences. Conversion to psychosis among CHR youth has been reported to be about 15-35% over three years. Accurately identifying individuals whose psychotic symptoms will worsen would facilitate earlier intervention, but this has been difficult to do using behavior measures alone. Brain-based risk markers have the potential to improve the accuracy of predicting outcomes in CHR youth. This narrative review provides an overview of neuroimaging studies used to investigate psychosis risk, including studies involving structural, functional, and diffusion imaging, functional connectivity, positron emission tomography, arterial spin labeling, magnetic resonance spectroscopy, and multi-modality approaches. We present findings separately in those observed in the CHR state and those associated with psychosis progression or resilience. Finally, we discuss future research directions that could improve clinical care for those at high risk for developing psychotic disorders.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, 63110, USA
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Frosch IR, Damme KSF, Bernard JA, Mittal VA. Cerebellar correlates of social dysfunction among individuals at clinical high risk for psychosis. Front Psychiatry 2022; 13:1027470. [PMID: 36532176 PMCID: PMC9752902 DOI: 10.3389/fpsyt.2022.1027470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/01/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Social deficits are a significant feature among both individuals with psychosis and those at clinical high-risk (CHR) for developing psychosis. Critically, the psychosis risk syndrome emerges in adolescence and young adulthood, when social skill development is being fine-tuned. Yet, the underlying pathophysiology of social deficits in individuals at CHR for psychosis remains unclear. Literature suggests the cerebellum plays a critical role in social functioning. Cerebellar dysfunction in psychosis and CHR individuals is well-established, yet limited research has examined links between the cerebellum and social functioning deficits in this critical population. Method In the current study, 68 individuals at CHR for developing psychosis and 66 healthy controls (HCs) completed social processing measures (examining social interaction, social cognition, and global social functioning) and resting-state MRI scans. Seed-to-voxel resting-state connectivity analyses were employed to examine the relationship between social deficits and lobular cerebellar network connectivity. Results Analyses indicated that within the CHR group, each social domain variable was linked to reduced connectivity between social cerebellar subregions (e.g., Crus II, lobules VIIIa and VIIIb) and cortical regions (e.g., frontal pole and frontal gyrus), but a control cerebellar subregion (e.g., lobule X) and was unrelated to these social variables. Discussion These results indicate an association between several cerebellar lobules and specific deficits in social processing. The cerebellum, therefore, may be particularly salient to the social domain and future research is need to examine the role of the cerebellum in psychosis.
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Affiliation(s)
- Isabelle R. Frosch
- Department of Psychology, Northwestern University, Evanston, IL, United States
| | - Katherine S. F. Damme
- Department of Psychology, Northwestern University, Evanston, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
| | - Jessica A. Bernard
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
- Department of Psychiatry, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, United States
- Institute for Policy Research, Northwestern University, Chicago, IL, United States
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Osborne KJ, Mittal VA. Postural sway and neurocognition in individuals meeting criteria for a clinical high-risk syndrome. Eur Arch Psychiatry Clin Neurosci 2022; 272:155-160. [PMID: 33606092 PMCID: PMC8373991 DOI: 10.1007/s00406-021-01234-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/23/2021] [Indexed: 02/03/2023]
Abstract
Neurocognitive deficits are implicated in individuals that meet criteria for a clinical high-risk (CHR) syndrome. Evidence in patients with schizophrenia suggests that cerebellar dysfunction may underlie neurocognitive deficits. However, little research has examined if similar associations are present in those meeting CHR criteria. This study examined associations between the MATRICS cognitive battery, postural sway (an index of cerebellar functioning), and SIPS-RC psychosis risk scores in a CHR sample (N = 66). Poorer working memory and processing speed were associated with less postural control. Consistent with the cognitive dysmetria theory of schizophrenia, neurocognitive deficits are associated with cerebellar dysfunction in this critical population.
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Affiliation(s)
- K. Juston Osborne
- Northwestern University, Department of Psychology, Evanston, IL, USA
| | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Evanston, Chicago, IL, USA
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Cerebellar-thalamic circuits play a critical role in psychomotor function. Mol Psychiatry 2021; 26:3666-3668. [PMID: 33203993 PMCID: PMC8126567 DOI: 10.1038/s41380-020-00935-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/28/2020] [Accepted: 10/22/2020] [Indexed: 01/13/2023]
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Why is there symptom coupling of psychological and motor changes in psychomotor mechanisms? Insights from the brain's topography. Mol Psychiatry 2021; 26:3669-3671. [PMID: 33203994 DOI: 10.1038/s41380-020-00945-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/26/2020] [Indexed: 01/22/2023]
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Damme KSF, Schiffman J, Ellman LM, Mittal VA. Sensorimotor and Activity Psychosis-Risk (SMAP-R) Scale: An Exploration of Scale Structure With Replication and Validation. Schizophr Bull 2021; 47:332-343. [PMID: 33047134 PMCID: PMC7965079 DOI: 10.1093/schbul/sbaa138] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Sensorimotor abnormalities precede and predict the onset of psychosis. Despite the practical utility of sensorimotor abnormalities for early identification, prediction, and individualized medicine applications, there is currently no dedicated self-report instrument designed to capture these important behaviors. The current study assessed and validated a questionnaire designed for use in individuals at clinical high-risk for psychosis (CHR). METHODS The current study included both exploratory (n = 3009) and validation (n = 439) analytic datasets-that included individuals identified as meeting criteria for a CHR syndrome (n = 84)-who completed the novel Sensorimotor Abnormalities and Psychosis-Risk (SMAP-R) Scale, clinical interviews and a finger-tapping task. The structure of the scale and reliability of items were consistent across 2 analytic datasets. The resulting scales were assessed for discriminant validity across CHR, community sample non-psychiatric volunteer, and clinical groups. RESULTS The scale showed a consistent structure across 2 analytic datasets subscale structure. The resultant subscale structure was consistent with conceptual models of sensorimotor pathology in psychosis (coordination and dyskinesia) in both the exploratory and the validation analytic dataset. Further, these subscales showed discriminant, predictive, and convergent validity. The sensorimotor abnormality scales discriminated CHR from community sample non-psychiatric controls and clinical samples. Finally, these subscales predicted to risk calculator scores and showed convergent validity with sensorimotor performance on a finger-tapping task. CONCLUSION The SMAP-R scale demonstrated good internal, discriminant, predictive, and convergent validity, and subscales mapped on to conceptually relevant sensorimotor circuits. Features of the scale may facilitate widespread incorporation of sensorimotor screening into psychosis-risk research and practice.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, Evanston, IL
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL
| | | | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL
- Department of Psychiatry, Northwestern University, Chicago, IL
- Medical Social Sciences, Northwestern University, Chicago, IL
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL
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Osborne KJ, Walther S, Shankman SA, Mittal VA. Psychomotor Slowing in Schizophrenia: Implications for Endophenotype and Biomarker Development. Biomark Neuropsychiatry 2020; 2:100016. [PMID: 33738459 PMCID: PMC7963400 DOI: 10.1016/j.bionps.2020.100016] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Motor abnormalities (e.g., dyskinesia, psychomotor slowing, neurological soft signs) are core features of schizophrenia that occur independent of drug treatment and are associated with the genetic vulnerability and pathophysiology for the illness. Among this list, psychomotor slowing in particular is one of the most consistently observed and robust findings in the field. Critically, psychomotor slowing may serve as a uniquely promising endophenotype and/or biomarker for schizophrenia considering it is frequently observed in those with genetic vulnerability for the illness, predicts transition in subjects at high-risk for the disorder, and is associated with symptoms and recovery in patients. The purpose of the present review is to provide an overview of the history of psychomotor slowing in psychosis, discuss its possible neural underpinnings, and review the current literature supporting slowing as a putative endophenotype and/or biomarker for the illness. This review summarizes substantial evidence from a diverse array of methodologies and research designs that supports the notion that psychomotor slowing not only reflects genetic vulnerability, but is also sensitive to disease processes and the pathophysiology of the illness. Furthermore, there are unique deficits across the cognitive (prefix "psycho") and motor execution (root word "motor") aspects of slowing, with cognitive processes such as planning and response selection being particularly affected. These findings suggest that psychomotor slowing may serve as a promising endophenotype and biomarker for schizophrenia that may prove useful for identifying individuals at greatest risk and tracking the course of the illness and recovery.
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Affiliation(s)
- K. Juston Osborne
- Northwestern University, Department of Psychology, Evanston, IL, USA
| | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Translational Research Center, Bern, Switzerland
| | - Stewart A. Shankman
- Northwestern University, Department of Psychology, Evanston, IL, USA
- Northwestern University, Department of Psychiatry, Chicago, IL, USA
| | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Evanston, IL, USA
- Northwestern University, Department of Psychiatry, Chicago, IL, USA
- Northwestern University, Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Evanston, Chicago, IL, USA
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