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Chatterjee I, Hilal B. Investigating the association between symptoms and functional activity in brain regions in schizophrenia: A cross-sectional fmri-based neuroimaging study. Psychiatry Res Neuroimaging 2024; 344:111870. [PMID: 39142172 DOI: 10.1016/j.pscychresns.2024.111870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 02/20/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024]
Abstract
Schizophrenia is a persistent neurological disorder profoundly affecting cognitive, emotional, and behavioral functions, prominently characterized by delusions, hallucinations, disordered speech, and abnormal motor activity. These symptoms often present diagnostic challenges due to their overlap with other forms of psychosis. Therefore, the implementation of automated diagnostic methodologies is imperative. This research leverages Functional Magnetic Resonance Imaging (fMRI), a neuroimaging modality capable of delineating functional activations across diverse brain regions. Furthermore, the utilization of evolving machine learning techniques for fMRI data analysis has significantly progressive. Here, our study stands as a novel attempt, focusing on the comprehensive assessment of both classical and atypical symptoms of schizophrenia. We aim to uncover associated changes in brain functional activity. Our study encompasses two distinct fMRI datasets (1.5T and 3T), each comprising 34 schizophrenia patients for the 1.5T dataset and 25 schizophrenia patients for the 3T dataset, along with an equal number of healthy controls. Machine learning algorithms are applied to assess data subsets, enabling an in-depth evaluation of the current functional condition concerning symptom impact. The identified voxels contribute to determining the brain regions most influenced by each symptom, as quantified by symptom intensity. This rigorous approach has yielded various new findings while maintaining an impressive classification accuracy rate of 97 %. By elucidating variations in activation patterns across multiple brain regions in individuals with schizophrenia, this study contributes to the understanding of functional brain changes associated with the disorder. The insights gained may inform differential clinical interventions and provide a means of assessing symptom severity accurately, offering new avenues for the management of schizophrenia.
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Affiliation(s)
- Indranath Chatterjee
- Department of Computing and Mathematics, Manchester Metropolitan University, Manchester, United Kingdom; School of Technology, Woxsen University, Hyderabad, India.
| | - Bisma Hilal
- Department of Information Technology, Cluster University, Srinagar, India
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2
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Tsui HKH, Wong TY, Sum MY, Chu ST, Hui CLM, Chang WC, Lee EHM, Suen Y, Chen EYH, Chan SKW. Comparison of Negative Symptom Network Structures Between Patients With Early and Chronic Schizophrenia: A Network and Exploratory Graph Analysis. Schizophr Bull 2024:sbae135. [PMID: 39093707 DOI: 10.1093/schbul/sbae135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND AND HYPOTHESIS Despite the clinical relevance of negative symptoms in schizophrenia, our understanding of negative symptoms remains limited. Although various courses and stages of schizophrenia have been identified, variations in the negative symptom networks between distinct stages of schizophrenia remain unexplored. STUDY DESIGN We examined 405 patients with early schizophrenia (ES) and 330 patients with chronic schizophrenia (CS) using the Scale for the Assessment of Negative Symptoms. Network analysis and exploratory graph analysis were used to identify and compare the network structures and community memberships of negative symptoms between the two groups. Further, associations between communities and social functioning were evaluated. The potential influences of other symptom domains and confounding factors were also examined. STUDY RESULTS Multidimensional differences were found in the networks of negative symptoms between ES and CS. The global connectivity strength was higher in the network of ES than in the network of CS. In ES, central symptoms were mainly related to expressive deficits, whereas in CS they were distributed across negative symptom domains. A three-community structure was suggested across stages but with different memberships and associations with social functioning. Potential confounding factors and symptom domains, including mood, positive, disorganization, and excitement symptoms, did not affect the network structures. CONCLUSION Our findings revealed the presence of stage-specific network structures of negative symptoms in schizophrenia, with negative symptom communities having differential significance for social functioning. These findings provide implications for the future development of tailored interventions to alleviate negative symptoms and improve functionality across stages.
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Affiliation(s)
- Harry Kam Hung Tsui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Ting Yat Wong
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR
| | - Min Yi Sum
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Sin Ting Chu
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Yinam Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR
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3
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Jensen KM, Calhoun VD, Fu Z, Yang K, Faria AV, Ishizuka K, Sawa A, Andrés-Camazón P, Coffman BA, Seebold D, Turner JA, Salisbury DF, Iraji A. A whole-brain neuromark resting-state fMRI analysis of first-episode and early psychosis: Evidence of aberrant cortical-subcortical-cerebellar functional circuitry. Neuroimage Clin 2024; 41:103584. [PMID: 38422833 PMCID: PMC10944191 DOI: 10.1016/j.nicl.2024.103584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/31/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Psychosis (including symptoms of delusions, hallucinations, and disorganized conduct/speech) is a main feature of schizophrenia and is frequently present in other major psychiatric illnesses. Studies in individuals with first-episode (FEP) and early psychosis (EP) have the potential to interpret aberrant connectivity associated with psychosis during a period with minimal influence from medication and other confounds. The current study uses a data-driven whole-brain approach to examine patterns of aberrant functional network connectivity (FNC) in a multi-site dataset comprising resting-state functional magnetic resonance images (rs-fMRI) from 117 individuals with FEP or EP and 130 individuals without a psychiatric disorder, as controls. Accounting for age, sex, race, head motion, and multiple imaging sites, differences in FNC were identified between psychosis and control participants in cortical (namely the inferior frontal gyrus, superior medial frontal gyrus, postcentral gyrus, supplementary motor area, posterior cingulate cortex, and superior and middle temporal gyri), subcortical (the caudate, thalamus, subthalamus, and hippocampus), and cerebellar regions. The prominent pattern of reduced cerebellar connectivity in psychosis is especially noteworthy, as most studies focus on cortical and subcortical regions, neglecting the cerebellum. The dysconnectivity reported here may indicate disruptions in cortical-subcortical-cerebellar circuitry involved in rudimentary cognitive functions which may serve as reliable correlates of psychosis.
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Affiliation(s)
- Kyle M Jensen
- Georgia State University, Atlanta, GA, USA; Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, USA.
| | - Vince D Calhoun
- Georgia State University, Atlanta, GA, USA; Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, USA
| | - Zening Fu
- Georgia State University, Atlanta, GA, USA; Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, USA
| | - Kun Yang
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andreia V Faria
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Koko Ishizuka
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Akira Sawa
- Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pablo Andrés-Camazón
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, USA; Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Brian A Coffman
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dylan Seebold
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jessica A Turner
- Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Dean F Salisbury
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Armin Iraji
- Georgia State University, Atlanta, GA, USA; Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, USA
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4
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Voineskos AN, Hawco C, Neufeld NH, Turner JA, Ameis SH, Anticevic A, Buchanan RW, Cadenhead K, Dazzan P, Dickie EW, Gallucci J, Lahti AC, Malhotra AK, Öngür D, Lencz T, Sarpal DK, Oliver LD. Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions. World Psychiatry 2024; 23:26-51. [PMID: 38214624 PMCID: PMC10786022 DOI: 10.1002/wps.21159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicholas H Neufeld
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression and McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Alan Anticevic
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julia Gallucci
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anil K Malhotra
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Dost Öngür
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Todd Lencz
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Deepak K Sarpal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Tandon R, Nasrallah H, Akbarian S, Carpenter WT, DeLisi LE, Gaebel W, Green MF, Gur RE, Heckers S, Kane JM, Malaspina D, Meyer-Lindenberg A, Murray R, Owen M, Smoller JW, Yassin W, Keshavan M. The schizophrenia syndrome, circa 2024: What we know and how that informs its nature. Schizophr Res 2024; 264:1-28. [PMID: 38086109 DOI: 10.1016/j.schres.2023.11.015] [Citation(s) in RCA: 2] [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: 07/06/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024]
Abstract
With new data about different aspects of schizophrenia being continually generated, it becomes necessary to periodically revisit exactly what we know. Along with a need to review what we currently know about schizophrenia, there is an equal imperative to evaluate the construct itself. With these objectives, we undertook an iterative, multi-phase process involving fifty international experts in the field, with each step building on learnings from the prior one. This review assembles currently established findings about schizophrenia (construct, etiology, pathophysiology, clinical expression, treatment) and posits what they reveal about its nature. Schizophrenia is a heritable, complex, multi-dimensional syndrome with varying degrees of psychotic, negative, cognitive, mood, and motor manifestations. The illness exhibits a remitting and relapsing course, with varying degrees of recovery among affected individuals with most experiencing significant social and functional impairment. Genetic risk factors likely include thousands of common genetic variants that each have a small impact on an individual's risk and a plethora of rare gene variants that have a larger individual impact on risk. Their biological effects are concentrated in the brain and many of the same variants also increase the risk of other psychiatric disorders such as bipolar disorder, autism, and other neurodevelopmental conditions. Environmental risk factors include but are not limited to urban residence in childhood, migration, older paternal age at birth, cannabis use, childhood trauma, antenatal maternal infection, and perinatal hypoxia. Structural, functional, and neurochemical brain alterations implicate multiple regions and functional circuits. Dopamine D-2 receptor antagonists and partial agonists improve psychotic symptoms and reduce risk of relapse. Certain psychological and psychosocial interventions are beneficial. Early intervention can reduce treatment delay and improve outcomes. Schizophrenia is increasingly considered to be a heterogeneous syndrome and not a singular disease entity. There is no necessary or sufficient etiology, pathology, set of clinical features, or treatment that fully circumscribes this syndrome. A single, common pathophysiological pathway appears unlikely. The boundaries of schizophrenia remain fuzzy, suggesting the absence of a categorical fit and need to reconceptualize it as a broader, multi-dimensional and/or spectrum construct.
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Affiliation(s)
- Rajiv Tandon
- Department of Psychiatry, WMU Homer Stryker School of Medicine, Kalamazoo, MI 49008, United States of America.
| | - Henry Nasrallah
- Department of Psychiatry, University of Cincinnati College of Medicine Cincinnati, OH 45267, United States of America
| | - Schahram Akbarian
- Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - William T Carpenter
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America
| | - Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, United States of America
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Dusseldorf, Heinrich-Heine University, Dusseldorf, Germany
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute of Neuroscience and Human Behavior, UCLA, Los Angeles, CA 90024, United States of America; Greater Los Angeles Veterans' Administration Healthcare System, United States of America
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY 11004, United States of America
| | - Dolores Malaspina
- Department of Psychiatry, Neuroscience, Genetics, and Genomics, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannhein/Heidelberg University, Mannheim, Germany
| | - Robin Murray
- Institute of Psychiatry, Psychology, and Neuroscience, Kings College, London, UK
| | - Michael Owen
- Centre for Neuropsychiatric Genetics and Genomics, and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jordan W Smoller
- Center for Precision Psychiatry, Department of Psychiatry, Psychiatric and Neurodevelopmental Unit, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States of America
| | - Walid Yassin
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
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Chen LC, Tan WY, Xi JY, Xie XH, Lin HC, Wang SB, Wu GH, Liu Y, Gu J, Jia FJ, Du ZC, Hao YT. Violent behavior and the network properties of psychopathological symptoms and real-life functioning in patients with schizophrenia. Front Psychiatry 2024; 14:1324911. [PMID: 38274426 PMCID: PMC10808501 DOI: 10.3389/fpsyt.2023.1324911] [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: 10/20/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Objective To assess the interplay among psychopathological symptoms and real-life functioning, and to further detect their influence with violent behavior in patient with schizophrenia. Methods A sample of 1,664 patients with post-violence assessments and their propensity score-matched controls without violence from a disease registration report system of community mental health service in Guangdong, China, were studied by network analysis. Ising-Model was used to estimate networks of psychopathological symptoms and real-life functioning. Then, we tested whether network properties indicated the patterns of interaction were different between cases and controls, and calculated centrality indices of each node to identify the central nodes. Sensitivity analysis was conducted to examine the difference of interaction patterns between pre-violence and post-violence assessments in violence cases. Results Some nodes in the same domain were highly positive interrelations, while psychopathological symptoms were negatively related to real-life functioning in all networks. Many symptom-symptom connections and symptom-functioning connections were disconnected after the violence. The network density decreased from 23.53% to 12.42% without statistical significance (p = 0.338). The network structure, the global network strength, and the global clustering coefficient decreased significantly after the violence (p < 0.001, p = 0.019, and p = 0.045, respectively). Real-life functioning had a higher node strength. The strength of sleeping, lack of spontaneity and flow of conversation, and preoccupation were decreased in post-violence network of patients. Conclusion The decreasing connectivity may indicate an increased risk of violence and early warning for detecting violence. Interventions and improving health state based on nodes with high strength might prevent violence in schizophrenia patients.
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Affiliation(s)
- Li-Chang Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Jun-Yan Xi
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xin-Hui Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hai-Cheng Lin
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Gong-Hua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yu Liu
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Cheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuan-Tao Hao
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
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7
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Banaj N, Vecchio D, Piras F, De Rossi P, Bustillo J, Ciufolini S, Dazzan P, Di Forti M, Dickie EW, Ford JM, Fuentes-Claramonte P, Gruber O, Guerrero-Pedraza A, Hamilton HK, Howells FM, Kraemer B, Lawrie SM, Mathalon DH, Murray R, Pomarol-Clotet E, Potkin SG, Preda A, Radua J, Richter A, Salvador R, Sawa A, Scheffler F, Sim K, Spaniel F, Stein DJ, Temmingh HS, Thomopoulos SI, Tomecek D, Uhlmann A, Voineskos A, Yang K, Jahanshad N, Thompson PM, Van Erp TGM, Turner JA, Spalletta G, Piras F. Cortical morphology in patients with the deficit and non-deficit syndrome of schizophrenia: a worldwide meta- and mega-analyses. Mol Psychiatry 2023; 28:4363-4373. [PMID: 37644174 PMCID: PMC10827665 DOI: 10.1038/s41380-023-02221-w] [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: 01/20/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
Converging evidence suggests that schizophrenia (SZ) with primary, enduring negative symptoms (i.e., Deficit SZ (DSZ)) represents a distinct entity within the SZ spectrum while the neurobiological underpinnings remain undetermined. In the largest dataset of DSZ and Non-Deficit (NDSZ), we conducted a meta-analysis of data from 1560 individuals (168 DSZ, 373 NDSZ, 1019 Healthy Controls (HC)) and a mega-analysis of a subsampled data from 944 individuals (115 DSZ, 254 NDSZ, 575 HC) collected across 9 worldwide research centers of the ENIGMA SZ Working Group (8 in the mega-analysis), to clarify whether they differ in terms of cortical morphology. In the meta-analysis, sites computed effect sizes for differences in cortical thickness and surface area between SZ and control groups using a harmonized pipeline. In the mega-analysis, cortical values of individuals with schizophrenia and control participants were analyzed across sites using mixed-model ANCOVAs. The meta-analysis of cortical thickness showed a converging pattern of widespread thinner cortex in fronto-parietal regions of the left hemisphere in both DSZ and NDSZ, when compared to HC. However, DSZ have more pronounced thickness abnormalities than NDSZ, mostly involving the right fronto-parietal cortices. As for surface area, NDSZ showed differences in fronto-parietal-temporo-occipital cortices as compared to HC, and in temporo-occipital cortices as compared to DSZ. Although DSZ and NDSZ show widespread overlapping regions of thinner cortex as compared to HC, cortical thinning seems to better typify DSZ, being more extensive and bilateral, while surface area alterations are more evident in NDSZ. Our findings demonstrate for the first time that DSZ and NDSZ are characterized by different neuroimaging phenotypes, supporting a nosological distinction between DSZ and NDSZ and point toward the separate disease hypothesis.
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Affiliation(s)
- Nerisa Banaj
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy.
| | - Daniela Vecchio
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Pietro De Rossi
- Child and Adolescence Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Juan Bustillo
- Psichiatry and Neuroscience, University of New Mexico, Albuquerque, NM, USA
| | - Simone Ciufolini
- Psychosis Studies, Institute of Psychiatry, Psychology and Neurology, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurology, King's College London, London, UK
| | - Marta Di Forti
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurology, King's College London, London, UK
| | - Erin W Dickie
- Center for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Kimel Family Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Judith M Ford
- San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Paola Fuentes-Claramonte
- FIMDAG Sisters Hospitallers Research Foundation, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Baden-Wuerttemberg, Germany
| | | | - Holly K Hamilton
- San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Fleur M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Bernd Kraemer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Baden-Wuerttemberg, Germany
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburg, EH10 5HF, UK
| | - Daniel H Mathalon
- San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Robin Murray
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurology, King's College London, London, UK
| | - Edith Pomarol-Clotet
- FIMDAG Sisters Hospitallers Research Foundation, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Steven G Potkin
- Department of Psychiatry, University of California Irvine, Newfoundland, NJ, NJ 07435, USA
| | - Adrian Preda
- Psychiatry and Human Behavior, University of California Irvine, Orange, CA, 92868, USA
| | - Joaquim Radua
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Imaging of mood- and anxiety-related disorders (IMARD), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Medicina, University of Barcelona, Barcelona, 08036, Spain
| | - Anja Richter
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Baden-Wuerttemberg, Germany
| | - Raymond Salvador
- FIMDAG Sisters Hospitallers Research Foundation, Barcelona, Spain
| | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Genetic Medicine, Johns Hopkins University School of Medicine Baltimore, Baltimore, MD, USA
- Department of Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Freda Scheffler
- Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Brain Behavior Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kang Sim
- West Region, Institute of Mental Health, National Healthcare Group, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Filip Spaniel
- CARE, National Institute of Mental Health, Klecany, Czech Republic
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Henk S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa
- Department of Psychiatry and Mental Health, Valkenberg Psychiatric Hospital, Cape Town, Western Cape, South Africa
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - David Tomecek
- CARE, National Institute of Mental Health, Klecany, Czech Republic
| | - Anne Uhlmann
- Department of child and adolescent psychiatry, TU Dresden, Dresden, Saxony, Germany
| | - Aristotle Voineskos
- Center for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Temerty Faculty of Medicine, Toronto, ON, Canada
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Theo G M Van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, USA
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Federica Piras
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
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8
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Vöckel J, Thiemann U, Weisbrod M, Schröder J, Resch F, Klein C, Bender S. Movement initiation and preparation in subjects with schizophrenia - The amplitude of the readiness potential as a biological marker for negative symptom severity. Schizophr Res 2023; 260:3-11. [PMID: 37543008 DOI: 10.1016/j.schres.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 04/24/2023] [Accepted: 07/10/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Despite extensive research, the etiology of negative symptoms is not well understood. Preliminary findings are linking motor disturbances to negative symptom severity. We aimed to further the understanding to what extent motor movement preparation influences negative symptom severity. METHODS In a cohort of 31 subjects with schizophrenia and 20 control subjects we recorded the readiness potential amplitude over Cz during spontaneous movements of the right and left thumb. We further assessed negative and positive symptom severity (scale for the assessment of negative and positive symptoms) as well as neurological soft signs (NSS). RESULTS In subjects with schizophrenia the severity of negative symptoms was best predicted by the readiness potential amplitude and the NSS subdomain motor coordination. The correlation between deficits in motor coordination and negative symptom severity was partially mediated by the readiness potential amplitude in subjects with schizophrenia. CONCLUSIONS Deficits in motor processing are linked to negative symptom severity in schizophrenia. The readiness potential may represent a biological marker of these basal deficits. In combination with the assessment of NSS, the readiness potential may be a marker of the course of negative symptom severity and help clarifying interdependencies between (pre)frontal networks for action initiation and coordination, as well as negative symptoms.
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Affiliation(s)
- Jasper Vöckel
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Ulf Thiemann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR Hospital, Bonn, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Germany; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Voßstr. 4, 69115 Heidelberg, Germany
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany
| | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine and University of Freiburg, Hauptstr. 8, 79104 Freiburg, Germany; 2(nd) Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, University General Hospital "Attikon", Athens, Greece
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany
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9
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Gangl N, Conring F, Federspiel A, Wiest R, Walther S, Stegmayer K. Resting-state perfusion in motor and fronto-limbic areas is linked to diminished expression of emotion and speech in schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:51. [PMID: 37573445 PMCID: PMC10423240 DOI: 10.1038/s41537-023-00384-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/25/2023] [Indexed: 08/14/2023]
Abstract
Negative symptoms (NS) are a core component of schizophrenia affecting community functioning and quality of life. We tested neural correlates of NS considering NS factors and consensus subdomains. We assessed NS using the Clinical Assessment Interview for Negative Symptoms and the Scale for Assessment of Negative Symptoms. Arterial spin labeling was applied to measure resting-state cerebral blood flow (rCBF) in 47 schizophrenia patients and 44 healthy controls. Multiple regression analyses calculated the relationship between rCBF and NS severity. We found an association between diminished expression (DE) and brain perfusion within the cerebellar anterior lobe and vermis, and the pre-, and supplementary motor area. Blunted affect was linked to fusiform gyrus and alogia to fronto-striatal rCBF. In contrast, motivation and pleasure was not associated with rCBF. These results highlight the key role of motor areas for DE. Considering NS factors and consensus subdomains may help identifying specific pathophysiological pathways of NS.
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Affiliation(s)
- Nicole Gangl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Frauke Conring
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
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10
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Wang C, Zhang Y, Lim LG, Cao W, Zhang W, Wan X, Fan L, Liu Y, Zhang X, Tian Z, Liu X, Pan X, Zheng Y, Pan R, Tan Y, Zhang Z, McIntyre RS, Li Z, Ho RCM, Tang TB. An fNIRS investigation of novel expressed emotion stimulations in schizophrenia. Sci Rep 2023; 13:11141. [PMID: 37429942 DOI: 10.1038/s41598-023-38057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 07/02/2023] [Indexed: 07/12/2023] Open
Abstract
Living in high expressed emotion (EE) environments tends to increase the relapse rate in schizophrenia (SZ). At present, the neural substrates responsible for high EE in SZ remain poorly understood. Functional near-infrared spectroscopy (fNIRS) may be of great use to quantitatively assess cortical hemodynamics and elucidate the pathophysiology of psychiatric disorders. In this study, we designed novel low- (positivity and warmth) and high-EE (criticism, negative emotion, and hostility) stimulations, in the form of audio, to investigate cortical hemodynamics. We used fNIRS to measure hemodynamic signals while participants listened to the recorded audio. Healthy controls (HCs, [Formula: see text]) showed increased hemodynamic activation in the major language centers across EE stimulations, with stronger activation in Wernicke's area during the processing of negative emotional language. Compared to HCs, people with SZ ([Formula: see text]) exhibited smaller hemodynamic activation in the major language centers across EE stimulations. In addition, people with SZ showed weaker or insignificant hemodynamic deactivation in the medial prefrontal cortex. Notably, hemodynamic activation in SZ was found to be negatively correlated with the negative syndrome scale score at high EE. Our findings suggest that the neural mechanisms in SZ are altered and disrupted, especially during negative emotional language processing. This supports the feasibility of using the designed EE stimulations to assess people who are vulnerable to high-EE environments, such as SZ. Furthermore, our findings provide preliminary evidence for future research on functional neuroimaging biomarkers for people with psychiatric disorders.
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Affiliation(s)
| | | | - Lam Ghai Lim
- Department of Electrical and Robotics Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Weiqi Cao
- Huaibei Normal University, Huaibei, China
| | - Wei Zhang
- Huaibei Mental Health Center, Huaibei, China
| | | | - Lijun Fan
- Huaibei Normal University, Huaibei, China
| | - Ying Liu
- Huaibei Normal University, Huaibei, China
| | - Xi Zhang
- Huaibei Mental Health Center, Huaibei, China
| | | | | | - Xiuzhi Pan
- Huaibei Normal University, Huaibei, China
| | - Yuan Zheng
- Huaibei Normal University, Huaibei, China
| | - Riyu Pan
- Anqing Normal University, Anqing, China
| | - Yilin Tan
- Huaibei Normal University, Huaibei, China
| | | | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Zhifei Li
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 117599, Singapore
| | - Roger C M Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 117599, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Tong Boon Tang
- Centre for Intelligent Signal and Imaging Research (CISIR), Universiti Teknologi PETRONAS, 32610, Seri Iskandar, Perak, Malaysia
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11
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Zarghami TS, Zeidman P, Razi A, Bahrami F, Hossein‐Zadeh G. Dysconnection and cognition in schizophrenia: A spectral dynamic causal modeling study. Hum Brain Mapp 2023; 44:2873-2896. [PMID: 36852654 PMCID: PMC10089110 DOI: 10.1002/hbm.26251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/28/2023] [Accepted: 02/13/2023] [Indexed: 03/01/2023] Open
Abstract
Schizophrenia (SZ) is a severe mental disorder characterized by failure of functional integration (aka dysconnection) across the brain. Recent functional connectivity (FC) studies have adopted functional parcellations to define subnetworks of large-scale networks, and to characterize the (dys)connection between them, in normal and clinical populations. While FC examines statistical dependencies between observations, model-based effective connectivity (EC) can disclose the causal influences that underwrite the observed dependencies. In this study, we investigated resting state EC within seven large-scale networks, in 66 SZ and 74 healthy subjects from a public dataset. The results showed that a remarkable 33% of the effective connections (among subnetworks) of the cognitive control network had been pathologically modulated in SZ. Further dysconnection was identified within the visual, default mode and sensorimotor networks of SZ subjects, with 24%, 20%, and 11% aberrant couplings. Overall, the proportion of discriminative connections was remarkably larger in EC (24%) than FC (1%) analysis. Subsequently, to study the neural correlates of impaired cognition in SZ, we conducted a canonical correlation analysis between the EC parameters and the cognitive scores of the patients. As such, the self-inhibitions of supplementary motor area and paracentral lobule (in the sensorimotor network) and the excitatory connection from parahippocampal gyrus to inferior temporal gyrus (in the cognitive control network) were significantly correlated with the social cognition, reasoning/problem solving and working memory capabilities of the patients. Future research can investigate the potential of whole-brain EC as a biomarker for diagnosis of brain disorders and for neuroimaging-based cognitive assessment.
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Affiliation(s)
- Tahereh S. Zarghami
- Bio‐Electric Department, School of Electrical and Computer Engineering, College of EngineeringUniversity of TeranTehranIran
- Human Motor Control and Computational Neuroscience Laboratory, School of Electrical and Computer Engineering, College of EngineeringUniversity of TehranTehranIran
| | - Peter Zeidman
- The Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
| | - Adeel Razi
- The Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
- Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
- Monash Biomedical ImagingMonash UniversityClaytonVictoriaAustralia
- CIFAR Azrieli Global Scholars Program, CIFARTorontoCanada
| | - Fariba Bahrami
- Bio‐Electric Department, School of Electrical and Computer Engineering, College of EngineeringUniversity of TeranTehranIran
- Human Motor Control and Computational Neuroscience Laboratory, School of Electrical and Computer Engineering, College of EngineeringUniversity of TehranTehranIran
| | - Gholam‐Ali Hossein‐Zadeh
- Bio‐Electric Department, School of Electrical and Computer Engineering, College of EngineeringUniversity of TeranTehranIran
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12
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Hancock F, Rosas FE, McCutcheon RA, Cabral J, Dipasquale O, Turkheimer FE. Metastability as a candidate neuromechanistic biomarker of schizophrenia pathology. PLoS One 2023; 18:e0282707. [PMID: 36952467 PMCID: PMC10035891 DOI: 10.1371/journal.pone.0282707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/21/2023] [Indexed: 03/25/2023] Open
Abstract
The disconnection hypothesis of schizophrenia proposes that symptoms of the disorder arise as a result of aberrant functional integration between segregated areas of the brain. The concept of metastability characterizes the coexistence of competing tendencies for functional integration and functional segregation in the brain, and is therefore well suited for the study of schizophrenia. In this study, we investigate metastability as a candidate neuromechanistic biomarker of schizophrenia pathology, including a demonstration of reliability and face validity. Group-level discrimination, individual-level classification, pathophysiological relevance, and explanatory power were assessed using two independent case-control studies of schizophrenia, the Human Connectome Project Early Psychosis (HCPEP) study (controls n = 53, non-affective psychosis n = 82) and the Cobre study (controls n = 71, cases n = 59). In this work we extend Leading Eigenvector Dynamic Analysis (LEiDA) to capture specific features of dynamic functional connectivity and then implement a novel approach to estimate metastability. We used non-parametric testing to evaluate group-level differences and a naïve Bayes classifier to discriminate cases from controls. Our results show that our new approach is capable of discriminating cases from controls with elevated effect sizes relative to published literature, reflected in an up to 76% area under the curve (AUC) in out-of-sample classification analyses. Additionally, our new metric showed explanatory power of between 81-92% for measures of integration and segregation. Furthermore, our analyses demonstrated that patients with early psychosis exhibit intermittent disconnectivity of subcortical regions with frontal cortex and cerebellar regions, introducing new insights about the mechanistic bases of these conditions. Overall, these findings demonstrate reliability and face validity of metastability as a candidate neuromechanistic biomarker of schizophrenia pathology.
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Affiliation(s)
- Fran Hancock
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, United Kingdom
| | - Fernando E. Rosas
- Department of Informatics, University of Sussex, Brighton, United Kingdom
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
- Centre for Complexity Science, Imperial College London, London, United Kingdom
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, United Kingdom
| | - Robert A. McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Joana Cabral
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Life and Health Sciences Research Institute School of Medicine, University of Minho, Braga, Portugal
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, United Kingdom
| | - Federico E. Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, United Kingdom
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13
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Wang X, Chang Z, Wang R. Opposite effects of positive and negative symptoms on resting-state brain networks in schizophrenia. Commun Biol 2023; 6:279. [PMID: 36932140 PMCID: PMC10023794 DOI: 10.1038/s42003-023-04637-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
Schizophrenia is a severe psychotic disorder characterized by positive and negative symptoms, but their neural bases remain poorly understood. Here, we utilized a nested-spectral partition (NSP) approach to detect hierarchical modules in resting-state brain functional networks in schizophrenia patients and healthy controls, and we studied dynamic transitions of segregation and integration as well as their relationships with clinical symptoms. Schizophrenia brains showed a more stable integrating process and a more variable segregating process, thus maintaining higher segregation, especially in the limbic system. Hallucinations were associated with higher integration in attention systems, and avolition was related to a more variable segregating process in default-mode network (DMN) and control systems. In a machine-learning model, NSP-based features outperformed graph measures at predicting positive and negative symptoms. Multivariate analysis confirmed that positive and negative symptoms had opposite effects on dynamic segregation and integration of brain networks. Gene ontology analysis revealed that the effect of negative symptoms was related to autistic, aggressive and violent behavior; the effect of positive symptoms was associated with hyperammonemia and acidosis; and the interaction effect was correlated with abnormal motor function. Our findings could contribute to the development of more accurate diagnostic criteria for positive and negative symptoms in schizophrenia.
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Affiliation(s)
- Xinrui Wang
- College of Science, Xi'an University of Science and Technology, Xi'an, Shaanxi, China
| | - Zhao Chang
- College of Science, Xi'an University of Science and Technology, Xi'an, Shaanxi, China
| | - Rong Wang
- College of Science, Xi'an University of Science and Technology, Xi'an, Shaanxi, China.
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14
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Percie du Sert O, Unrau J, Gauthier CJ, Chakravarty M, Malla A, Lepage M, Raucher-Chéné D. Cerebral blood flow in schizophrenia: A systematic review and meta-analysis of MRI-based studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110669. [PMID: 36341843 DOI: 10.1016/j.pnpbp.2022.110669] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/19/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Schizophrenia-spectrum disorders (SSD) represent one of the leading causes of disability worldwide and are usually underpinned by neurodevelopmental brain abnormalities observed on a structural and functional level. Nuclear medicine imaging studies of cerebral blood flow (CBF) have already provided insights into the pathophysiology of these disorders. Recent developments in non-invasive MRI techniques such as arterial spin labeling (ASL) have allowed broader examination of CBF across SSD prompting us to conduct an updated literature review of MRI-based perfusion studies. In addition, we conducted a focused meta-analysis of whole brain studies to provide a complete picture of the literature on the topic. METHODS A systematic OVID search was performed in Embase, MEDLINEOvid, and PsycINFO. Studies eligible for inclusion in the review involved: 1) individuals with SSD, first-episode psychosis or clinical-high risk for psychosis, or; 2) had healthy controls for comparison; 3) involved MRI-based perfusion imaging methods; and 4) reported CBF findings. No time span was specified for the database queries (last search: 08/2022). Information related to participants, MRI techniques, CBF analyses, and results were systematically extracted. Whole-brain studies were then selected for the meta-analysis procedure. The methodological quality of each included studies was assessed. RESULTS For the systematic review, the initial Ovid search yielded 648 publications of which 42 articles were included, representing 3480 SSD patients and controls. The most consistent finding was that negative symptoms were linked to cortical fronto-limbic hypoperfusion while positive symptoms seemed to be associated with hyperperfusion, notably in subcortical structures. The meta-analysis integrated results from 13 whole-brain studies, across 426 patients and 401 controls, and confirmed the robustness of the hypoperfusion in the left superior and middle frontal gyri and right middle occipital gyrus while hyperperfusion was found in the left putamen. CONCLUSION This updated review of the literature supports the implication of hemodynamic correlates in the pathophysiology of psychosis symptoms and disorders. A more systematic exploration of brain perfusion could complete the search of a multimodal biomarker of SSD.
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Affiliation(s)
- Olivier Percie du Sert
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Joshua Unrau
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Claudine J Gauthier
- Concordia University, Montreal, QC, Canada; Montreal Heart Institute, Montreal, QC, Canada
| | - Mallar Chakravarty
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Ashok Malla
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Martin Lepage
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Delphine Raucher-Chéné
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada; University of Reims Champagne-Ardenne, Cognition, Health, and Society Laboratory (EA 6291), Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
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15
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Gao Z, Xiao Y, Zhang Y, Zhu F, Tao B, Tang X, Lui S. Comparisons of resting-state brain activity between insomnia and schizophrenia: a coordinate-based meta-analysis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:80. [PMID: 36207333 PMCID: PMC9547062 DOI: 10.1038/s41537-022-00291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/19/2022] [Indexed: 11/05/2022]
Abstract
Growing evidence shows that insomnia is closely associated with schizophrenia (SCZ), but the neural mechanism under the association remains unclear. A direct comparison of the patterns of resting-state brain activities would help understand the above question. Using meta-analytic approach, 11 studies of insomnia vs. healthy controls (HC) and 39 studies of SCZ vs. HC were included to illuminate the common and distinct patterns between insomnia and SCZ. Results showed that SCZ and insomnia shared increased resting-state brain activities in frontolimbic structures including the right medial prefrontal gyrus (mPFC) and left parahippocampal gyrus. SCZ additionally revealed greater increased activities in subcortical areas including bilateral putamen, caudate and right insula and greater decreased activities in precentral gyrus and orbitofrontal gyrus. Our study reveals both shared and distinct activation patterns in SCZ and insomnia, which may provide novel insights for understanding the neural basis of the two disorders and enlighten the possibility of the development of treatment strategies for insomnia in SCZ in the future.
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Affiliation(s)
- Ziyang Gao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Xiao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ye Zhang
- grid.412901.f0000 0004 1770 1022Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Fei Zhu
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Tao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiangdong Tang
- grid.412901.f0000 0004 1770 1022Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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16
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Damiani S, Tarchi L, La-Torraca-Vittori P, Scalabrini A, Castellini G, Ricca V, Fusar-Poli P, Politi P. State-dependent reductions of local brain connectivity in schizophrenia and their relation to performance and symptoms: A functional magnetic resonance imaging study. Psychiatry Res Neuroimaging 2022; 326:111541. [PMID: 36122541 DOI: 10.1016/j.pscychresns.2022.111541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 08/01/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022]
Abstract
State-dependent reallocation of cognitive resources is impaired in schizophrenia and may be underlined by alterations in brain local-connectivity. Increasing evidence suggests local connectivity reductions from rest to task in healthy individuals, while insufficient information is available for schizophrenia spectrum. Resting-state and stop-signal task fMRI scans of 107 healthy controls and 32 patients with DSM-IV-TR schizophrenia or schizoaffective disorder were analyzed. As primary aim we measured within-group shifts in local-connectivity from rest to task as voxel-wise Regional Homogeneity (ReHo-shift). Secondary aims were to test: i) Between-groups differences in ReHo-rest, ReHo-task and ReHo-shift; ii) ReHo covariations with task performance (=shorter reaction times) and severity of symptoms (SAPS/SANS scores). Age, sex, and education were accounted for as covariates. Motion, global-signal-regression, antipsychotic dosage and smoothing associations with ReHo were evaluated. Rest-to-task ReHo reductions occurred in both groups on a whole-brain level (False-Discovery-Rate p=0.05). Trends of greater ReHo reductions in patients versus controls were observed. Controls performed better than patients (p<0.001). ReHo negatively correlated with performance in both groups. ReHo-shift predicted worse performance in controls, but better performance in patients (uncorrected p=0.05). ReHo reductions correlated with severity of symptoms. State-dependent reconfigurations in local-connectivity provide new links between neurobiology and behavioral/clinical features of the schizophrenia spectrum.
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Affiliation(s)
- Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy.
| | - Livio Tarchi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy; Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, FI, Italy
| | | | - Andrea Scalabrini
- Department of Human and Social Sciences, University of Bergamo, Bergamo, BG, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, FI, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, FI, Italy
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy; Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, London, UK
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
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17
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Buizza C, Strozza C, Sbravati G, de Girolamo G, Ferrari C, Iozzino L, Macis A, Kennedy HG, Candini V. Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis. Ann Gen Psychiatry 2022; 21:36. [PMID: 36088451 PMCID: PMC9463849 DOI: 10.1186/s12991-022-00413-2] [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: 01/12/2022] [Accepted: 06/19/2022] [Indexed: 01/10/2023] Open
Abstract
Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: "forensic" AND "Positive and Negative Syndrome Scale" OR "PANSS". A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed.Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021).
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Affiliation(s)
- Chiara Buizza
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Cosmo Strozza
- Interdisciplinary Centre On Population Dynamics, University of Southern Denmark, 5000, Odense, Denmark
| | - Giulio Sbravati
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Laura Iozzino
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Harry G Kennedy
- The National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.,Academic Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Valentina Candini
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.
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18
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Bègue I, Brakowski J, Seifritz E, Dagher A, Tobler PN, Kirschner M, Kaiser S. Cerebellar and cortico-striatal-midbrain contributions to reward-cognition processes and apathy within the psychosis continuum. Schizophr Res 2022; 246:85-94. [PMID: 35728420 DOI: 10.1016/j.schres.2022.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/30/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022]
Abstract
Negative symptoms in the psychosis continuum are linked to impairments in reward processing and cognitive function. Processes at the interface of reward processing and cognition and their relation to negative symptoms remain little studied, despite evidence suggestive of integration in mechanisms and neural circuitry. Here, we investigated brain activation during reward-dependent modulation of working memory (WM) and their relationship to negative symptoms in subclinical and early stages of the psychosis continuum. We included 27 persons with high schizotypal personality traits and 23 patients with first episode psychosis as well as 27 healthy controls. Participants underwent functional magnetic resonance imaging while performing an established 2-back WM task with two reward levels (5 CHF vs. no reward), which allowed us to assess common reward-cognition regions through whole-brain conjunction analyses and to investigate relations with clinical scores of negative symptoms. As expected for behavior, reward facilitated performance while cognitive load diminished it. At the neural level, the conjunction of high reward and high cognitive load contrasts across the psychosis continuum showed increased hemodynamic activity in the thalamus and the cerebellar vermis. During high cognitive load, more severe apathy but not diminished expression in the psychosis continuum was associated with reduced activity in right lateral orbitofrontal cortex, midbrain, posterior vermal cerebellum, caudate and lateral parietal cortex. Our results suggest that hypoactivity in the cerebellar vermis and the cortical-striatal-midbrain-circuitry in the psychosis continuum relates to apathy possibly via impaired flexible cognitive resource allocation for effective goal pursuit.
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Affiliation(s)
- Indrit Bègue
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland.
| | - Janis Brakowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Philippe N Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Switzerland
| | - Matthias Kirschner
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland
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19
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Horne CM, Sahni A, Pang SW, Vanes LD, Szentgyorgyi T, Averbeck B, Moran RJ, Shergill SS. The role of cognitive control in the positive symptoms of psychosis. Neuroimage Clin 2022; 34:103004. [PMID: 35468567 PMCID: PMC9059151 DOI: 10.1016/j.nicl.2022.103004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022]
Abstract
Mechanisms underlying positive symptoms in psychosis are unclear. Differential fMRI activity present in left amygdala, pallidum and thalamus in high positive symptom patients compared to low. Lower activity in SMA/pre-SMA also present in high symptom patients. We suggest poor integration of social-emotional information with reward feedback. Results may be important for guiding treatment strategies to prevent chronic illness.
Background Positive symptoms of psychosis (e.g., hallucinations) often limit everyday functioning and can persist despite adequate antipsychotic treatment. We investigated whether poor cognitive control is a mechanism underlying these symptoms. Methods 97 patients with early psychosis (30 with high positive symptoms (HS) and 67 with low positive symptoms (LS)) and 40 healthy controls (HC) underwent fMRI whilst performing a reward learning task with two conditions; low cognitive demand (choosing between neutral faces) and high cognitive demand (choosing between angry and happy faces – shown to induce an emotional bias). Decision and feedback phases were examined. Results Both patient groups showed suboptimal learning behaviour compared to HC and altered activity within a core reward network including occipital/lingual gyrus (decision), rostral Anterior Cingulate Cortex, left pre-central gyrus and Supplementary Motor Cortex (feedback). In the low cognitive demand condition, HS group showed significantly reduced activity in Supplementary Motor Area (SMA)/pre-SMA during the decision phase whilst activity was increased in LS group compared to HC. Recruitment of this region suggests a top-down compensatory mechanism important for control of positive symptoms. With additional cognitive demand (emotional vs. neutral contrast), HS patients showed further alterations within a subcortical network (increased left amygdala activity during decisions and reduced left pallidum and thalamus activity during feedback) compared to LS patients. Conclusions The findings suggest a core reward system deficit may be present in both patient groups, but persistent positive symptoms are associated with a specific dysfunction within a network needed to integrate social-emotional information with reward feedback.
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Affiliation(s)
- Charlotte M Horne
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Angad Sahni
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Sze W Pang
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Lucy D Vanes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Timea Szentgyorgyi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Bruno Averbeck
- Laboratory of Neuropsychology, National Institute for Mental Health, Bethesda, BETHESDA, MD 20814, USA
| | - Rosalyn J Moran
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Sukhwinder S Shergill
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Kent and Medway Medical School, Cantebury Christ Church University and University of Kent, Kent CT2 7FS, UK
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20
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Association of reduced local activities in the default mode and sensorimotor networks with clinical characteristics in first-diagnosed of schizophrenia. Neuroscience 2022; 495:47-57. [DOI: 10.1016/j.neuroscience.2022.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 01/10/2023]
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21
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Zhang Y, Peng Y, Song Y, Zhou Y, Zhang S, Yang G, Yang Y, Li W, Yue W, Lv L, Zhang D. Abnormal functional connectivity of the striatum in first-episode drug-naive early-onset Schizophrenia. Brain Behav 2022; 12:e2535. [PMID: 35384392 PMCID: PMC9120884 DOI: 10.1002/brb3.2535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/03/2021] [Accepted: 01/27/2022] [Indexed: 11/17/2022] Open
Abstract
Abnormal brain network connectivity is strongly implicated in the pathogenesis of schizophrenia. The striatum, consisting of the caudate and putamen, is the major treatment target for antipsychotics, the primary treatments for schizophrenia; however, there are few studies on the functional connectivity (FC) of striatum in drug-naive early-onset schizophrenia (EOS) patients. We examined the FC values of the caudate nucleus and putamen with whole brain by resting-state functional magnetic resonance imaging (RS-fMRI) and the associations with indices of clinical severity. Patients demonstrated abnormal FC between subregions of the putamen and both the visual network (left middle occipital gyrus) and default mode network (bilateral anterior cingulate, left superior frontal, and right middle frontal gyri). Furthermore, FC between dorsorostral putamen and left superior frontal gyrus correlated with both positive symptom subscore and total score on the Positive and Negative Syndrome Scale (PANSS). These findings demonstrate abnormal FC between the striatum and other brain areas even in the early stages of schizophrenia, supporting neurodevelopmental disruption in disease etiology and expression.
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Affiliation(s)
- Yan Zhang
- Psychiatry Institute of Mental Health/Peking University Sixth Hospital, Peking University, Beijing, China.,Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China.,International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Yue Peng
- Department of Pediatric Rehabilitation Medicine, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yichen Song
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.,International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Youqi Zhou
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Sen Zhang
- Child and Adolescent Psychiatry Department, Mental Health Center of Shantou University, Shantou, Guangdong, China
| | - Ge Yang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yongfeng Yang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.,International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Wenqiang Li
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Weihua Yue
- Psychiatry Institute of Mental Health/Peking University Sixth Hospital, Peking University, Beijing, China
| | - Luxian Lv
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China.,International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Dai Zhang
- Psychiatry Institute of Mental Health/Peking University Sixth Hospital, Peking University, Beijing, China
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22
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Pham TV, Sasabayashi D, Takahashi T, Takayanagi Y, Kubota M, Furuichi A, Kido M, Noguchi K, Suzuki M. Longitudinal Changes in Brain Gyrification in Schizophrenia Spectrum Disorders. Front Aging Neurosci 2022; 13:752575. [PMID: 35002674 PMCID: PMC8739892 DOI: 10.3389/fnagi.2021.752575] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/25/2021] [Indexed: 12/20/2022] Open
Abstract
Previous magnetic resonance imaging (MRI) studies reported increased brain gyrification in schizophrenia and schizotypal disorder, a prototypic disorder within the schizophrenia spectrum. This may reflect deviations in early neurodevelopment; however, it currently remains unclear whether the gyrification pattern longitudinally changes over the course of the schizophrenia spectrum. The present MRI study using FreeSurfer compared longitudinal changes (mean inter-scan interval of 2.7 years) in the local gyrification index (LGI) in the entire cortex among 23 patients with first-episode schizophrenia, 14 with schizotypal disorder, and 39 healthy controls. Significant differences were observed in longitudinal LGI changes between these groups; the schizophrenia group exhibited a progressive decline in LGI, predominantly in the fronto-temporal regions, whereas LGI increased over time in several brain regions in the schizotypal and control groups. In the schizophrenia group, a greater reduction in LGI over time in the right precentral and post central regions correlated with smaller improvements in negative symptoms during the follow-up period. The cumulative medication dosage during follow-up negatively correlated with a longitudinal LGI increase in the right superior parietal area in the schizotypal group, but did not affect longitudinal LGI changes in the schizophrenia group. Collectively, these results suggest that gyrification patterns in the schizophrenia spectrum reflect both early neurodevelopmental abnormalities as a vulnerability factor and active brain pathology in the early stages of schizophrenia.
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Affiliation(s)
- Tien Viet Pham
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Manabu Kubota
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan.,Toyama City Hospital, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama School of Medicine, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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23
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Pultsina K, Alekhin A, Petrova E, Vorobieva N. Efficiency of the attention networks and severity of positive and negative symptoms in schizophrenia. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:88-96. [DOI: 10.17116/jnevro202212202188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Rampino A, Torretta S, Gelao B, Veneziani F, Iacoviello M, Marakhovskaya A, Masellis R, Andriola I, Sportelli L, Pergola G, Minelli A, Magri C, Gennarelli M, Vita A, Beaulieu JM, Bertolino A, Blasi G. Evidence of an interaction between FXR1 and GSK3β polymorphisms on levels of Negative Symptoms of Schizophrenia and their response to antipsychotics. Eur Psychiatry 2021; 64:e39. [PMID: 33866994 PMCID: PMC8260562 DOI: 10.1192/j.eurpsy.2021.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Genome-Wide Association Studies (GWASs) have identified several genes associated with Schizophrenia (SCZ) and exponentially increased knowledge on the genetic basis of the disease. In addition, products of GWAS genes interact with neuronal factors coded by genes lacking association, such that this interaction may confer risk for specific phenotypes of this brain disorder. In this regard, fragile X mental retardation syndrome-related 1 (FXR1) gene has been GWAS associated with SCZ. FXR1 protein is regulated by glycogen synthase kinase-3β (GSK3β), which has been implicated in pathophysiology of SCZ and response to antipsychotics (APs). rs496250 and rs12630592, two eQTLs (Expression Quantitative Trait Loci) of FXR1 and GSK3β, respectively, interact on emotion stability and amygdala/prefrontal cortex activity during emotion processing. These two phenotypes are associated with Negative Symptoms (NSs) of SCZ suggesting that the interaction between these SNPs may also affect NS severity and responsiveness to medication. METHODS To test this hypothesis, in two independent samples of patients with SCZ, we investigated rs496250 by rs12630592 interaction on NS severity and response to APs. We also tested a putative link between APs administration and FXR1 expression, as already reported for GSK3β expression. RESULTS We found that rs496250 and rs12630592 interact on NS severity. We also found evidence suggesting interaction of these polymorphisms also on response to APs. This interaction was not present when looking at positive and general psychopathology scores. Furthermore, chronic olanzapine administration led to a reduction of FXR1 expression in mouse frontal cortex. DISCUSSION Our findings suggest that, like GSK3β, FXR1 is affected by APs while shedding new light on the role of the FXR1/GSK3β pathway for NSs of SCZ.
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Affiliation(s)
- Antonio Rampino
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | - Silvia Torretta
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Barbara Gelao
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Federica Veneziani
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Matteo Iacoviello
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Rita Masellis
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Ileana Andriola
- Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | - Leonardo Sportelli
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giulio Pergola
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Chiara Magri
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Antonio Vita
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Alessandro Bertolino
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | - Giuseppe Blasi
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
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25
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Vanes LD, Dolan RJ. Transdiagnostic neuroimaging markers of psychiatric risk: A narrative review. NEUROIMAGE-CLINICAL 2021; 30:102634. [PMID: 33780864 PMCID: PMC8022867 DOI: 10.1016/j.nicl.2021.102634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023]
Abstract
We review the literature on neural correlates of a general psychopathology factor General psychopathology relates to structural and functional neurodevelopment Disrupted network connectivity maturation may underlie psychiatric vulnerability
Several decades of neuroimaging research in psychiatry have shed light on structural and functional neural abnormalities associated with individual psychiatric disorders. However, there is increasing evidence for substantial overlap in the patterns of neural dysfunction seen across disorders, suggesting that risk for psychiatric illness may be shared across diagnostic boundaries. Gaining insights on the existence of shared neural mechanisms which may transdiagnostically underlie psychopathology is important for psychiatric research in order to tease apart the unique and common aspects of different disorders, but also clinically, so as to help identify individuals early on who may be biologically vulnerable to psychiatric disorder in general. In this narrative review, we first evaluate recent studies investigating the functional and structural neural correlates of a general psychopathology factor, which is thought to reflect the shared variance across common mental health symptoms and therefore index psychiatric vulnerability. We then link insights from this research to existing meta-analytic evidence for shared patterns of neural dysfunction across categorical psychiatric disorders. We conclude by providing an integrative account of vulnerability to mental illness, whereby delayed or disrupted maturation of large-scale networks (particularly default-mode, executive, and sensorimotor networks), and more generally between-network connectivity, results in a compromised ability to integrate and switch between internally and externally focused tasks.
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Affiliation(s)
- Lucy D Vanes
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, United Kingdom.
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
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Nath M, Wong TP, Srivastava LK. Neurodevelopmental insights into circuit dysconnectivity in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110047. [PMID: 32721441 DOI: 10.1016/j.pnpbp.2020.110047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/01/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022]
Abstract
Schizophrenia is increasingly being recognized as a disorder of brain circuits of developmental origin. Animal models, however, have been technically limited in exploring the effects of early developmental circuit abnormalities on the maturation of the brain and associated behavioural outputs. This review discusses evidence of the developmental emergence of circuit abnormalities in schizophrenia, followed by a critical assessment on how animal models need to be adapted through optimized tools in order to spatially and temporally manipulate early developmental events, thereby providing insight into the causal contribution of developmental perturbations to schizophrenia.
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Affiliation(s)
- Moushumi Nath
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada.
| | - Tak Pan Wong
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
| | - Lalit K Srivastava
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
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Taylor JA, Larsen KM, Garrido MI. Multi-dimensional predictions of psychotic symptoms via machine learning. Hum Brain Mapp 2020; 41:5151-5163. [PMID: 32870535 PMCID: PMC7670649 DOI: 10.1002/hbm.25181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/09/2020] [Accepted: 08/09/2020] [Indexed: 11/10/2022] Open
Abstract
The diagnostic criteria for schizophrenia comprise a diverse range of heterogeneous symptoms. As a result, individuals each present a distinct set of symptoms despite having the same overall diagnosis. Whilst previous machine learning studies have primarily focused on dichotomous patient-control classification, we predict the severity of each individual symptom on a continuum. We applied machine learning regression within a multi-modal fusion framework to fMRI and behavioural data acquired during an auditory oddball task in 80 schizophrenia patients. Brain activity was highly predictive of some, but not all symptoms, namely hallucinations, avolition, anhedonia and attention. Critically, each of these symptoms was associated with specific functional alterations across different brain regions. We also found that modelling symptoms as an ensemble of subscales was more accurate, specific and informative than models which predict compound scores directly. In principle, this approach is transferrable to any psychiatric condition or multi-dimensional diagnosis.
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Affiliation(s)
- Jeremy A Taylor
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Kit M Larsen
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia.,Australian Research Council Centre of Excellence for Integrative Brain Function, Clayton, Victoria, Australia.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Child and Adolescent Mental Health Care, Mental Health Services Capital Region Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Marta I Garrido
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia.,Australian Research Council Centre of Excellence for Integrative Brain Function, Clayton, Victoria, Australia.,Centre for Advanced Imaging, University of Queensland, St Lucia, Queensland, Australia
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