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Schumer MC, Chase HW, Rozovsky R, Eickhoff SB, Phillips ML. Prefrontal, parietal, and limbic condition-dependent differences in bipolar disorder: a large-scale meta-analysis of functional neuroimaging studies. Mol Psychiatry 2023; 28:2826-2838. [PMID: 36782061 PMCID: PMC10615766 DOI: 10.1038/s41380-023-01974-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Over the past few decades, neuroimaging research in Bipolar Disorder (BD) has identified neural differences underlying cognitive and emotional processing. However, substantial clinical and methodological heterogeneity present across neuroimaging experiments potentially hinders the identification of consistent neural biomarkers of BD. This meta-analysis aims to comprehensively reassess brain activation and connectivity in BD in order to identify replicable differences that converge across and within resting-state, cognitive, and emotional neuroimaging experiments. METHODS Neuroimaging experiments (using fMRI, PET, or arterial spin labeling) reporting whole-brain results in adults with BD and controls published from December 1999-June 18, 2019 were identified via PubMed search. Coordinates showing significant activation and/or connectivity differences between BD participants and controls during resting-state, emotional, or cognitive tasks were extracted. Four parallel, independent meta-analyses were calculated using the revised activation likelihood estimation algorithm: all experiment types, all resting-state experiments, all cognitive experiments, and all emotional experiments. To confirm reliability of identified clusters, two different meta-analytic significance tests were employed. RESULTS 205 published studies yielding 506 individual neuroimaging experiments (150 resting-state, 134 cognitive, 222 emotional) comprising 5745 BD and 8023 control participants were included. Five regions survived both significance tests. Individuals with BD showed functional differences in the right posterior cingulate cortex during resting-state experiments, the left amygdala during emotional experiments, including those using a mixed (positive/negative) valence manipulation, and the left superior and right inferior parietal lobules during cognitive experiments, while hyperactivating the left medial orbitofrontal cortex during cognitive experiments. Across all experiments, there was convergence in the right caudate extending to the ventral striatum, surviving only one significance test. CONCLUSIONS Our findings indicate reproducible localization of prefrontal, parietal, and limbic differences distinguishing BD from control participants that are condition-dependent, despite heterogeneity, and point towards a framework for identifying reproducible differences in BD that may guide diagnosis and treatment.
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Affiliation(s)
- Maya C Schumer
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Renata Rozovsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Rokham H, Falakshahi H, Fu Z, Pearlson G, Calhoun VD. Evaluation of boundaries between mood and psychosis disorder using dynamic functional network connectivity (dFNC) via deep learning classification. Hum Brain Mapp 2023; 44:3180-3195. [PMID: 36919656 PMCID: PMC10171526 DOI: 10.1002/hbm.26273] [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: 07/07/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
The validity and reliability of diagnoses in psychiatry is a challenging topic in mental health. The current mental health categorization is based primarily on symptoms and clinical course and is not biologically validated. Among multiple ongoing efforts, neurological observations alongside clinical evaluations are considered to be potential solutions to address diagnostic problems. The Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) has published multiple papers attempting to reclassify psychotic illnesses based on biological rather than symptomatic measures. However, the effort to investigate the relationship between this new categorization approach and other neuroimaging techniques, including resting-state fMRI data, is still limited. This study focused on investigating the relationship between different psychotic disorders categorization methods and resting-state fMRI-based measures called dynamic functional network connectivity (dFNC) using state-of-the-art artificial intelligence (AI) approaches. We applied our method to 613 subjects, including individuals with psychosis and healthy controls, which were classified using both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the B-SNIP biomarker-based (Biotype) approach. Statistical group differences and cross-validated classifiers were performed within each framework to assess how different categories. Results highlight interesting differences in occupancy in both DSM-IV and Biotype categorizations compared to healthy individuals, which are distributed across specific transient connectivity states. Biotypes tended to show less distinctiveness in occupancy level and included fewer cellwise differences. Classification accuracy obtained by DSM-IV and Biotype categories were both well above chance. Results provided new insights and highlighted the benefits of both DSM-IV and biology-based categories while also emphasizing the importance of future work in this direction, including employing further data types.
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Affiliation(s)
- Hooman Rokham
- Department of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Tri‐institutional Center of Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, and Emory UniversityGeorgia State UniversityAtlantaGeorgiaUSA
| | - Haleh Falakshahi
- Department of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Tri‐institutional Center of Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, and Emory UniversityGeorgia State UniversityAtlantaGeorgiaUSA
| | - Zening Fu
- Tri‐institutional Center of Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, and Emory UniversityGeorgia State UniversityAtlantaGeorgiaUSA
| | - Godfrey Pearlson
- Department of PsychiatryYale UniversityNew HavenConnecticutUSA
- Department of NeuroscienceYale UniversityNew HavenConnecticutUSA
- Olin Neuropsychiatry Research CenterHartford HospitalHartfordConnecticutUSA
| | - Vince D. Calhoun
- Department of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Tri‐institutional Center of Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, and Emory UniversityGeorgia State UniversityAtlantaGeorgiaUSA
- Department of PsychiatryYale UniversityNew HavenConnecticutUSA
- Department of Computer ScienceGeorgia State UniversityAtlantaGeorgiaUSA
- Department of PsychologyGeorgia State UniversityAtlantaGeorgiaUSA
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Magnani L, Carmisciano L, dell'Orletta F, Bettinardi O, Chiesa S, Imbesi M, Limonta G, Montagna E, Turone I, Martinasso D, Aguglia A, Serafini G, Amore M, Amerio A, Costanza A, Sibilla F, Calcagno P, Patti S, Molino G, Escelsior A, Trabucco A, Marzano L, Brunato D, Ravelli AA, Cappucciati M, Fiocchi R, Guerzoni G, Maravita D, Macchetti F, Mori E, Paglia CA, Roscigno F, Saginario A. Linguistic profile automated characterisation in pluripotential clinical high-risk mental state (CHARMS) conditions: methodology of a multicentre observational study. BMJ Open 2023; 13:e066642. [PMID: 36948562 PMCID: PMC10040055 DOI: 10.1136/bmjopen-2022-066642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Language is usually considered the social vehicle of thought in intersubjective communications. However, the relationship between language and high-order cognition seems to evade this canonical and unidirectional description (ie, the notion of language as a simple means of thought communication). In recent years, clinical high at-risk mental state (CHARMS) criteria (evolved from the Ultra-High-Risk paradigm) and the introduction of the Clinical Staging system have been proposed to address the dynamicity of early psychopathology. At the same time, natural language processing (NLP) techniques have greatly evolved and have been successfully applied to investigate different neuropsychiatric conditions. The combination of at-risk mental state paradigm, clinical staging system and automated NLP methods, the latter applied on spoken language transcripts, could represent a useful and convenient approach to the problem of early psychopathological distress within a transdiagnostic risk paradigm. METHODS AND ANALYSIS Help-seeking young people presenting psychological distress (CHARMS+/- and Clinical Stage 1a or 1b; target sample size for both groups n=90) will be assessed through several psychometric tools and multiple speech analyses during an observational period of 1-year, in the context of an Italian multicentric study. Subjects will be enrolled in different contexts: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa-IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mental Health Department-territorial mental services (ASL 3-Genoa), Genoa, Italy; and Mental Health Department-territorial mental services (AUSL-Piacenza), Piacenza, Italy. The conversion rate to full-blown psychopathology (CS 2) will be evaluated over 2 years of clinical observation, to further confirm the predictive and discriminative value of CHARMS criteria and to verify the possibility of enriching them with several linguistic features, derived from a fine-grained automated linguistic analysis of speech. ETHICS AND DISSEMINATION The methodology described in this study adheres to ethical principles as formulated in the Declaration of Helsinki and is compatible with International Conference on Harmonization (ICH)-good clinical practice. The research protocol was reviewed and approved by two different ethics committees (CER Liguria approval code: 591/2020-id.10993; Comitato Etico dell'Area Vasta Emilia Nord approval code: 2022/0071963). Participants will provide their written informed consent prior to study enrolment and parental consent will be needed in the case of participants aged less than 18 years old. Experimental results will be carefully shared through publication in peer-reviewed journals, to ensure proper data reproducibility. TRIAL REGISTRATION NUMBER DOI:10.17605/OSF.IO/BQZTN.
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Affiliation(s)
- Luca Magnani
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Luca Carmisciano
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Felice dell'Orletta
- Italian Natural Language Processing Lab, Institute of Computational Linguistics "Antonio Zampolli", CNR di Pisa, Pisa, Italy
| | - Ornella Bettinardi
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Silvia Chiesa
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Massimiliano Imbesi
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Giuliano Limonta
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Elisa Montagna
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Ilaria Turone
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Dario Martinasso
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Aguglia
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Gianluca Serafini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Mario Amore
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Amerio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Department of Psychiatry, Service of Adult Psychiatry (SPA), University Hospital of Geneva (HUG), Geneva, Switzerland
| | - Francesca Sibilla
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Pietro Calcagno
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Sara Patti
- Department of Mental Health and Pathological Addictions, Genoa Local Authority, Genoa, Liguria, Italy
| | - Gabriella Molino
- Department of Mental Health and Pathological Addictions, Genoa Local Authority, Genoa, Liguria, Italy
| | - Andrea Escelsior
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alice Trabucco
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Lisa Marzano
- Departement of Psychology, School of Science and Technology, Middlesex University, London, UK
| | - Dominique Brunato
- Italian Natural Language Processing Lab, Institute of Computational Linguistics "Antonio Zampolli", CNR di Pisa, Pisa, Italy
| | - Andrea Amelio Ravelli
- Italian Natural Language Processing Lab, Institute of Computational Linguistics "Antonio Zampolli", CNR di Pisa, Pisa, Italy
| | - Marco Cappucciati
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Roberta Fiocchi
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Gisella Guerzoni
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Davide Maravita
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Fabio Macchetti
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Elisa Mori
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Chiara Anna Paglia
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Federica Roscigno
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Antonio Saginario
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
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Bonacina G, Carollo A, Esposito G. The Genetic Side of the Mood: A Scientometric Review of the Genetic Basis of Mood Disorders. Genes (Basel) 2023; 14:genes14020352. [PMID: 36833279 PMCID: PMC9956267 DOI: 10.3390/genes14020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Mood disorders are highly heritable psychiatric disorders. Over the years, many genetic polymorphisms have been identified to pose a higher risk for the development of mood disorders. To overview the literature on the genetics of mood disorders, a scientometric analysis was performed on a sample of 5342 documents downloaded from Scopus. The most active countries and the most impactful documents in the field were identified. Furthermore, a total of 13 main thematic clusters emerged in the literature. From the qualitative inspection of clusters, it emerged that the research interest moved from a monogenic to a polygenic risk framework. Researchers have moved from the study of single genes in the early 1990s to conducting genome-wide association studies around 2015. In this way, genetic overlaps between mood disorders and other psychiatric conditions emerged too. Furthermore, around the 2010s, the interaction between genes and environmental factors emerged as pivotal in understanding the risk for mood disorders. The inspection of thematic clusters provides a valuable insight into the past and recent trends of research in the genetics of mood disorders and sheds light onto future lines of research.
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Hu Y, Deng F, Zhang L, Hu K, Liu S, Zhong S, Yang J, Zeng X, Peng X. Depression and Quality of Life in Patients with Gliomas: A Narrative Review. J Clin Med 2022; 11:jcm11164811. [PMID: 36013047 PMCID: PMC9410515 DOI: 10.3390/jcm11164811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
In patients with gliomas, depression is a common complication that may cause severe psychological barriers and deteriorate the patient’s quality of life (QoL). Currently, the Hospital Anxiety and Depression Scale (HADS) is the most commonly used tool to diagnose depression in patients with gliomas. Female sex, unmarried status, low education level, high tumor grade, and a history of mental illness may increase the risks of depression and depressive symptoms in patients with gliomas. The QoL of patients with gliomas can be directly reduced by depression. Therefore, the evaluation and intervention of mood disorders could improve the overall QoL of patients with gliomas. Antidepressant use has become a treatment strategy for patients with gliomas and comorbid depression. This narrative review summarizes the current issues related to depression in patients with gliomas, including the prevalence, risk factors, and diagnostic criteria of depression as well as changes in QoL caused by comorbid depression and antidepressant use. The purpose of this review is to guide clinicians to assess the psychological status of patients with gliomas and to provide clinicians and oncologists with a new treatment strategy to improve the prognosis of such patients.
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Affiliation(s)
- Yue Hu
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Fang Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 238 Shangmayuanling Lane, Changsha 410078, China
| | - Lupeng Zhang
- Department of Biochemistry and Molecular Biology, Jishou University School of Medicine, 120 Renmin South Road, Jishou 416000, China
| | - Keyue Hu
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Shiqi Liu
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Suye Zhong
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Jun Yang
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Xiaomin Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 238 Shangmayuanling Lane, Changsha 410078, China
- Correspondence: (X.Z.); (X.P.)
| | - Xiaoning Peng
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
- Department of Biochemistry and Molecular Biology, Jishou University School of Medicine, 120 Renmin South Road, Jishou 416000, China
- Correspondence: (X.Z.); (X.P.)
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Habibi Asgarabad M, Ruhollah Hosseini S, Salehi Yegaei P, Moradi S, Lysaker PH. Psychopathology and Poor Clinical Insight in Psychotic Patients: Does the Diagnosis Matter? J Nerv Ment Dis 2022; 210:532-540. [PMID: 35766546 DOI: 10.1097/nmd.0000000000001475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Poor clinical insight is one of the most common features of schizophrenia spectrum disorders and plays a critical role in prognosis and treatment. Considering the biological and phenomenological overlap between schizophrenia and bipolar I disorder with psychotic features (BID) and increasing incidents of methamphetamine-induced psychotic disorder (MIPD) patients in Iran, it is necessary to have a clear picture of insight among these three groups. The aim of the present study was to compare clinical insight and other aspects of illness among three different disorders: schizophrenia, BID, and MIPD. In addition, we sought to examine the relationship of the severity of psychotic symptoms with clinical insight in each group. A total of 115 male inpatients, including 48 persons diagnosed with schizophrenia, 35 persons diagnosed with BID, and 32 persons diagnosed with MIPD, were selected. All participants completed the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale. The results of analysis of variance indicated that schizophrenia patients reported higher rates of illness duration and number of hospital admissions in comparison to the MIPD and BID groups. In addition, persons diagnosed with BID reported more of these outcomes than MIPD groups. However, the three groups showed similar patterns in terms of age of onset and educational, marital, and occupational statuses. The results also revealed that awareness of the disorder was more impaired in schizophrenia patients compared with BID and MIPD patients and in MIPD compared with BID groups. However, the level of awareness of the effect of medication, the awareness of social consequences, and the total score of clinical insight were similar across the three diagnostic groups. As expected, poor clinical insight was correlated with high levels of positive, negative, and cognitive symptoms in the schizophrenia group; with high levels of positive, cognitive, and depressive symptoms in the BID group; and with high levels of positive and excitement symptoms in MIPD. In addition, hierarchical linear regression analyses revealed that only cognitive symptoms in the schizophrenia group and excitement symptoms in the MIPD group significantly predicted the overall score of clinical insight. In the BID group, both cognitive and depressive symptoms significantly predicted clinical insight. These findings suggest that there are differing levels of poor clinical insight in schizophrenia, MIPD, and BID and that poor clinical insight found within each group may have different antecedents.
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Affiliation(s)
| | | | | | - Shahram Moradi
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway
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DeRamus TP, Wu L, Qi S, Iraji A, Silva R, Du Y, Pearlson G, Mayer A, Bustillo JR, Stromberg SF, Calhoun VD. Multimodal data fusion of cortical-subcortical morphology and functional network connectivity in psychotic spectrum disorder. Neuroimage Clin 2022; 35:103056. [PMID: 35709557 PMCID: PMC9207350 DOI: 10.1016/j.nicl.2022.103056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/18/2022] [Accepted: 05/21/2022] [Indexed: 11/20/2022]
Abstract
Overlap has been noted disorders which fall on the psychotic spectrum. Univariate studies may miss joint brain features across diagnostic categories. mCCA with jICA is paired with features across the psychotic spectrum to produce joint components. One joint component displayed a significant relationship with cognitive scores. The replicate trends of cortical-subcortical irregularity in psychotic spectrum disorders.
Multiple authors have noted overlapping symptoms and alterations across clinical, anatomical, and functional brain features in schizophrenia (SZ), schizoaffective disorder (SZA), and bipolar disorder (BPI). However, regarding brain features, few studies have approached this line of inquiry using analytical techniques optimally designed to extract the shared features across anatomical and functional information in a simultaneous manner. Univariate studies of anatomical or functional alterations across these disorders can be limited and run the risk of omitting small but potentially crucial overlapping or joint neuroanatomical (e.g., structural images) and functional features (e.g., fMRI-based features) which may serve as informative clinical indicators of across multiple diagnostic categories. To address this limitation, we paired an unsupervised multimodal canonical correlation analysis (mCCA) together with joint independent component analysis (jICA) to identify linked spatial gray matter (GM), resting-state functional network connectivity (FNC), and white matter fractional anisotropy (FA) features across these diagnostic categories. We then calculated associations between the identified linked features and trans-diagnostic behavioral measures (MATRICs Consensus Cognitive Battery, MCCB). Component number 4 of the 13 identified displayed a statistically significant relationship with overall MCCB scores across GM, resting-state FNC, and FA. These linked modalities of component 4 consisted primarily of positive correlations within subcortical structures including the caudate and putamen in the GM maps with overall MCCB, sparse negative correlations within subcortical and cortical connection tracts (e.g., corticospinal tract, superior longitudinal fasciculus) in the FA maps with overall MCCB, and negative relationships with MCCB values and loading parameters with FNC matrices displaying increased FNC in subcortical-cortical regions with auditory, somatomotor, and visual regions.
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Affiliation(s)
- T P DeRamus
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA.
| | - L Wu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - S Qi
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - A Iraji
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - R Silva
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - Y Du
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA; School of Computer and Information Technology, Shanxi University, Taiyuan, China
| | - G Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - A Mayer
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA
| | - J R Bustillo
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - S F Stromberg
- Psychiatry and Behavioral Health Clinical Program, Presbyterian Healthcare System, Albuquerque, NM, USA
| | - V D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA; The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA; Department of Computer Science, Georgia State University, Atlanta, USA; Department of Psychology, Georgia State University, Atlanta, USA
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He X, Wang N, Li Z, Zhang S, Yao Z, Xie X, Yang Z, Qiao S, Hui Z, Chen J, Du X. Network pharmacology and GEO database-based analysis of Sini powder in the prevention of depression among shift workers. ALL LIFE 2022. [DOI: 10.1080/26895293.2021.2019130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Xu He
- Shaanxi University of Traditional Chinese Medicine, Xian yang, People’s Republic of China
| | - Nanding Wang
- Xi'an Hospital of Traditional Chinese Medicine, Xi'an, People’s Republic of China
| | - Zhe Li
- Department of First Clinical Medicine, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xian Yang, People’s Republic of China
| | - Sha Zhang
- Department of Basic Medicine, Shaanxi University of Chinese Medicine, Xian Yang, People’s Republic of China
| | - Zhen Yao
- Shaanxi University of Traditional Chinese Medicine, Xian yang, People’s Republic of China
| | - Xiaoxia Xie
- Shaanxi University of Traditional Chinese Medicine, Xian yang, People’s Republic of China
| | - Zhengning Yang
- Shaanxi University of Traditional Chinese Medicine, Xian yang, People’s Republic of China
| | - Shuzhen Qiao
- Department of Encephalopathy, Traditional Chinese Medicine Hospital of Shaanxi Province, Xi Huamen, Xi’an, People’s Republic of China
| | - Zhenliang Hui
- Department of Encephalopathy, Traditional Chinese Medicine Hospital of Shaanxi Province, Xi Huamen, Xi’an, People’s Republic of China
| | - Jun Chen
- Department of Encephalopathy, Traditional Chinese Medicine Hospital of Shaanxi Province, Xi Huamen, Xi’an, People’s Republic of China
| | - Xia Du
- Shaanxi Academy of Traditional Chinese Medicine, Xi an, People’s Republic of China
- Chinese Academy of Traditional Chinese Medicine, Beijing, People’s Republic of China
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Liu J, Yang T, Zhou L, Gong J, He Y, Cui X, Luo X, Wu J. Association between schizotypal personality traits and emotional instability: mediation and moderation analysis among Chinese college students. J Affect Disord 2021; 291:83-92. [PMID: 34023751 DOI: 10.1016/j.jad.2021.04.079] [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: 09/24/2020] [Revised: 03/10/2021] [Accepted: 04/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies identified an association between schizophrenia and emotional instability. However, the relationship between schizotypal personality traits and emotional instability has not been explored to date. Furthermore, both mediating and moderating factors need to be identified. METHODS A total of 2936 students completed the Schizotypal Personality Questionnaire (SPQ), the Affective Lability Scale-Short Form (ALS-SF), and the Davos Assessment of Cognitive Biases Scale (DACOBS). RESULTS 1) The total scores of DACOBS (and all dimensions) and ALS-SF (and all dimensions) in the high schizotypal personality trait group were higher than in the low schizotypal personality trait group (all P < 0.05). 2) SPQ score and DACOBS social cognition problems, subjective cognitive problems, jumping to conclusions bias, and external attribution bias subscale scores positively predicted the total score of ALS-SF (or the dimensions of ALS-SF) in both male and female populations (all P < 0.05). 3) In the male population, DACOBS social cognition problems, subjective cognitive problems, jumping to conclusions bias, and external attribution bias subscale scores mediated the relationship between SPQ score and ALS-SF total score (or its subscales). In the female population, DACOBS attention for threat bias, external attribution bias, jumping to conclusions bias, social cognition problems, and subjective cognitive problems subscale scores mediated the relationship between SPQ score and ALS-SF total score (or its subscales). 4) Gender exerted a moderating effect on this relationship between SPQ score and ALS-SF total/anxiety-depression score (all P < 0.05). CONCLUSIONS Schizotypal personality traits might influence emotional instability through cognitive biases, and the degree of this influence varies depending on gender.
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Affiliation(s)
- Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center; Shenzhen University, Mental Health School, Shenzhen 518020, China
| | - Tingyu Yang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Lihua Zhou
- College of Education Science, Hengyang Normal University, Hengyang 421002, China
| | - Jingbo Gong
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha 41000, China
| | - Yuqiong He
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xilong Cui
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuerong Luo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530000, China.
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10
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Affiliation(s)
- Qin Xiang Ng
- MOH Holdings Pte Ltd, Singapore, Singapore.,Institute of Mental Health, Singapore, Singapore
| | - Donovan Yutong Lim
- Institute of Mental Health, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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11
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Abstract
Schizophrenia is a complex syndrome of unknown etiology and difficult to manage. Unconjugated bilirubin has been researched as a potential biological marker of this syndrome. The objective of this review article was to gather the studies published to date on the relationship between this molecule and schizophrenia. Broad inclusion criteria have been used (PRISMA) to include as many relevant studies as possible. Fourteen studies were selected: 3 analyzed the effects of unconjugated hyperbilirubinemia in animal models; 6 demonstrated an increased incidence of schizophrenia in patients with increased unconjugated bilirubin; 2 reported an increased incidence of the disease in patients with decreased unconjugated bilirubin; and 3 linked an increased incidence of schizophrenia with an increased excretion of the oxidative product of bilirubin, the so-called biopyrrins. Because of apparently contradictory reported results, the hypothesis that the relationship between schizophrenia and unconjugated bilirubin was not linear and that there was an inflammatory dysfunction explaining this was considered. The 2 most accepted models for the pathophysiology of schizophrenia are described, and the possible role of the molecule in each is clarified. The bilirubin buffer system and its role in antioxidant defense was explored. The average levels of unconjugated bilirubin in patients with schizophrenia, schizoaffective disorder, and bipolar disorder were also compared, having been hypothesized that these diseases could be different points of a same pathological spectrum. Finally, it was concluded that unconjugated bilirubin is a promising molecule that could be used as a possible biological marker for schizophrenia, and the necessity of subsequent efforts for its research was considered.
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12
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Rao S, Han X, Shi M, Siu CO, Waye MMY, Liu G, Wing YK. Associations of the serotonin transporter promoter polymorphism (5-HTTLPR) with bipolar disorder and treatment response: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:214-226. [PMID: 30217771 DOI: 10.1016/j.pnpbp.2018.08.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Associations of the serotonin transporter promoter polymorphism (5-HTTLPR) with bipolar disorder (BPD) and treatment response in bipolar patients were not conclusive. This study not only assessed the association between the 5-HTTLPR and BPD with accumulating relevant studies, but also in the first time evaluated the effect of the 5-HTTLPR on both anti-depressive and anti-manic treatment responses in bipolar patients. METHODS PubMed, Embase, PsycINFO, Cochrane Library and Cochrane Control Trials databases were systematically searched before February 2017. This meta-analysis followed the PRISMA guidelines. RESULTS A total of 32 population-based studies (5567 cases and 6993 controls) and 9 family-based studies (837 trios) were finally screened out and statistically joined into a single meta-analysis that revealed an association between S allele and an increased risk of BPD (OR = 1.06, p = .038). Pooled analysis of the 32 population-based studies indicated an association of S-carrier genotypes with an increased risk of BPD (OR = 1.10, p = .029). Meanwhile, the association remained significant in Caucasians (OR = 1.15, p = .004), which could provide an enough power (88%) to detect a significant association. Regarding the treatment response studies, 6 studies reporting the relationship of the 5-HTTLPR in anti-depressive remission rate (1034 patients) and 7 studies reporting in response rate (1098 patients) were included for pooled analyses. We observed a significant association of S-carrier genotypes with a reduced anti-depressive remission rate (OR = 0.64, p = .006) but not with anti-depressive response rate. The association between the 5-HTTLPR with anti-manic response rate was not observed in the included 6 studies (676 patients). CONCLUSIONS The present study supported the presence of a marginal but detectable effect of the 5-HTTLPR on susceptibility to BPD. Moreover, the detected association in Caucasian was statistically reliable. Besides, the 5-HTTLPR was identified as a useful predictor for anti-depressive remission but not for anti-depressive or anti-manic response.
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Affiliation(s)
- Shitao Rao
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong, SAR, China; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong, SAR, China
| | - Xinyu Han
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong, SAR, China; College of Food and Biological Engineering, Jimei University, Xiamen, Fujian, China
| | - Mai Shi
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong, SAR, China
| | - Cynthia O Siu
- COS & Associates Ltd., Central District, Hong Kong, SAR, China
| | - Mary Miu Yee Waye
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong, SAR, China
| | - Guangming Liu
- College of Food and Biological Engineering, Jimei University, Xiamen, Fujian, China.
| | - Yun Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong, SAR, China.
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13
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Godwin D, Alpert KI, Wang L, Mamah D. Regional cortical thinning in young adults with schizophrenia but not psychotic or non-psychotic bipolar I disorder. Int J Bipolar Disord 2018; 6:16. [PMID: 29992455 PMCID: PMC6161965 DOI: 10.1186/s40345-018-0124-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/06/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Schizophrenia shares some genetic risk and clinical symptoms with bipolar disorder. Clinical heterogeneity across subjects is thought to contribute to variable structural imaging findings across studies. The current study investigates cortical thickness in young adults diagnosed with schizophrenia or bipolar I disorder with a history of hyperthymic mania. We hypothesize that cortical thickness will be most similar between SCZ and the psychotic bipolar 1 disorder subtype. METHODS Patients with schizophrenia (n = 52), psychotic bipolar I disorder (PBD; n = 49) and non-psychotic bipolar I disorder (NPBD; n = 24) and healthy controls (n = 40) were scanned in a 3T Trio MRI. The thickness of 34 cortical regions was estimated with FreeSurfer, and analyzed using univariate analyses of variance. Relationships to psychotic (SAPS) and negative (SANS) symptoms were investigated using linear regression. RESULTS Cortical thickness showed significant group effects, after covarying for sex, age, and intracranial volume (p = 0.001). SCZ subjects had thinner paracentral, inferior parietal, supramarginal and fusiform cortices compared to CON. Caudal anterior cingulate cortical thickness was increased in SCZ, PBD and NPBD. Cortical thickness in PBD and NPBD were not significantly different from controls. Significant partial correlations were observed for SAPS severity with middle temporal (r = - 0.26; p = 0.001) and fusiform (- 0.26; p = 0.001) cortical thickness. CONCLUSIONS Individuals with SCZ displayed significantly reduced cortical thickness in several cortical regions compared to both CON and bipolar. We found that SCZ participants had significant cortical thinning relative to CON and bipolar disorder most significantly in the frontal (i.e. paracentral), parietal (i.e. inferior parietal, supramarginal), and temporal (i.e. middle temporal, fusiform) cortices.
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Affiliation(s)
- Douglass Godwin
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
| | - Kathryn I. Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
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14
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Alphs L, Fu DJ, Turkoz I. Paliperidone for the treatment of schizoaffective disorder. Expert Opin Pharmacother 2016; 17:871-83. [DOI: 10.1517/14656566.2016.1161029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Chue P, Chue J. A critical appraisal of paliperidone long-acting injection in the treatment of schizoaffective disorder. Ther Clin Risk Manag 2016; 12:109-16. [PMID: 26869795 PMCID: PMC4737499 DOI: 10.2147/tcrm.s81581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Schizoaffective disorder (SCA) is a chronic and disabling mental illness that presents with mixed symptoms of schizophrenia and affective disorders. SCA is recognized as a discrete disorder, but with greater heterogeneity and symptom overlap, leading to difficulty and delay in diagnosis. Although the overall prognosis is intermediate between schizophrenia and mood disorders, SCA is associated with higher rates of suicide and hospitalization than schizophrenia. No treatment guidelines exist for SCA, and treatment is frequently complex, involving off-label use and polypharmacy (typically combinations of antipsychotics, mood stabilizers, and antidepressants). Oral paliperidone extended-release was the first agent to be approved for the treatment of SCA. As in schizophrenia and bipolar disorder, adherence to oral medications is poor, further contributing to suboptimal outcomes. The use of an antipsychotic in a long-acting injection (LAI) addresses adherence issues, thus potentially reducing relapse. Paliperidone palmitate represents the LAI formulation of paliperidone. In a long-term, double-blind, randomized, controlled trial of adult patients (n=334; intent-to-treat [ITT]) with SCA, paliperidone long-acting injection (PLAI) significantly delayed risk of relapse compared to placebo (hazard ratio 2.49, 95% confidence interval, 1.55–3.99; P<0.001). This study demonstrated the efficacy and safety of PLAI when used as either monotherapy or adjunctive therapy for the maintenance treatment of SCA. The results are consistent with a similarly designed study conducted in patients with schizophrenia, which suggests a benefit in the long-term control of not only psychotic but also affective symptoms. No new safety signals were observed. When used in monotherapy, PLAI simplifies treatment by reducing complex pharmacotherapy and obviating the necessity for daily oral medications. PLAI is the second agent, and the first LAI, to be approved for the treatment of SCA; as an LAI formulation, there is the advantage of improved adherence and simplified treatment in the long-term management of SCA.
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Affiliation(s)
- Pierre Chue
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - James Chue
- Clinical Trials and Research Program, Edmonton, AB, Canada
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16
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Crespi BJ, Go MC. Diametrical diseases reflect evolutionary-genetic tradeoffs: Evidence from psychiatry, neurology, rheumatology, oncology and immunology. Evol Med Public Health 2015; 2015:216-53. [PMID: 26354001 PMCID: PMC4600345 DOI: 10.1093/emph/eov021] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/17/2015] [Indexed: 12/21/2022] Open
Abstract
Tradeoffs centrally mediate the expression of human adaptations. We propose that tradeoffs also influence the prevalence and forms of human maladaptation manifest in disease. By this logic, increased risk for one set of diseases commonly engenders decreased risk for another, diametric, set of diseases. We describe evidence for such diametric sets of diseases from epidemiological, genetic and molecular studies in four clinical domains: (i) psychiatry (autism vs psychotic-affective conditions), (ii) rheumatology (osteoarthritis vs osteoporosis), (iii) oncology and neurology (cancer vs neurodegenerative disorders) and (iv) immunology (autoimmunity vs infectious disease). Diametric disorders are important to recognize because genotypes or environmental factors that increase risk for one set of disorders protect from opposite disorders, thereby providing novel and direct insights into disease causes, prevention and therapy. Ascertaining the mechanisms that underlie disease-related tradeoffs should also indicate means of circumventing or alleviating them, and thus reducing the incidence and impacts of human disease in a more general way.
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Affiliation(s)
| | - Matthew C Go
- Department of Biological Sciences; Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6 Present address: Department of Anthropology, University of Illinois at Urbana-Champaign, 109 Davenport Hall, 607 S Mathews Avenue, Urbana, IL 61801, USA
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17
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Kapelski P, Skibinska M, Maciukiewicz M, Pawlak J, Permoda-Osip A, Twarowska-Hauser J. Family-based association study of interleukin 6 (IL6) and its receptor (IL6R) functional polymorphisms in schizophrenia in the Polish population. J Neuroimmunol 2015. [DOI: 10.1016/j.jneuroim.2014.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18
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Mahon PB, Lee DS, Trinh H, Tward D, Miller MI, Younes L, Barta PE, Ratnanather JT. Morphometry of the amygdala in schizophrenia and psychotic bipolar disorder. Schizophr Res 2015; 164:199-202. [PMID: 25766598 PMCID: PMC4439197 DOI: 10.1016/j.schres.2015.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
Volumetric studies suggest smaller amygdalae in subjects with schizophrenia (SZ) than with bipolar disorder (BP). We use morphometry to identify subregions of amygdala differentially affected in SZ and psychotic BP. Based on template centered population analysis, the shape of the amygdala in psychotic BP differs from SZ (pleft=0.044, pright=0.042). Using a high-field 7 T atlas, the bilateral basolateral, basomedial and centromedial subregions and the right lateral subregion were significantly atrophied in SZ compared to psychotic BP (p<0.02). These results suggest that change in shape of amygdala may represent a morphologic feature distinguishing SZ from psychotic BP.
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Affiliation(s)
- Pamela B. Mahon
- Mood Disorders Center, Johns Hopkins University, Baltimore, MD, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA,Corresponding Author: Pamela B. Mahon, Department of Psychiatry, Johns Hopkins School of Medicine, 600 N Wolfe St, Phipps 300, Baltimore, MD 21287,
| | - David S. Lee
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
| | - Huong Trinh
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
| | - Daniel Tward
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA
| | - Michael I. Miller
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Laurent Younes
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Patrick E. Barta
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - J. Tilak Ratnanather
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, USA,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
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19
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Arat HE, Chouinard VA, Cohen BM, Lewandowski KE, Öngür D. Diffusion tensor imaging in first degree relatives of schizophrenia and bipolar disorder patients. Schizophr Res 2015; 161:329-39. [PMID: 25542860 PMCID: PMC4308443 DOI: 10.1016/j.schres.2014.12.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES White matter (WM) abnormalities are one of the most widely and consistently reported findings in schizophrenia (SZ) and bipolar disorder (BD). If these abnormalities are inherited determinants of illness, suitable to be classified as an endophenotype, relatives of patients must also have them at higher rate compared to the general population. In this review, we evaluate published diffusion tensor imaging (DTI) studies comparing first degree relatives of SZ and BD patients and healthy control subjects. METHODS We searched PubMed, Embase and PsychInfo for DTI studies which included an unaffected relative and a healthy comparison group. RESULTS 22 studies fulfilled the inclusion criteria. WM abnormalities were found in many diverse regions in relatives of SZ patients. Although the findings were not completely consistent across studies, the most implicated areas were the frontal and temporal WM regions and the corpus callosum. Studies in relatives of BD patients were fewer in number with less consistent findings reported across studies. CONCLUSIONS Our review supports the concept of WM abnormalities as an endophenotype in SZ, with somewhat weaker evidence in BD, but larger and higher quality studies are needed to make a definitive comment.
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Affiliation(s)
- Hidayet E. Arat
- Dokuz Eylul University, Faculty of Medicine Department of Psychiatry, Izmir, Turkey,McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA
| | - Virginie-Anne Chouinard
- McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA,Harvard Medical School, Department of Psychiatry, Boston, MA, 02114 USA
| | - Bruce M. Cohen
- McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA,Harvard Medical School, Department of Psychiatry, Boston, MA, 02114 USA
| | - Kathryn E. Lewandowski
- McLean Hospital, 115 Mill St., Belmont, MA, 02478 USA,Harvard Medical School, Department of Psychiatry, Boston, MA, 02114 USA
| | - Dost Öngür
- McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Harvard Medical School, Department of Psychiatry, Boston, MA 02114, USA.
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20
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Rosenfeld ES, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS, Nonterah C, Stevens MC. Prolonged hemodynamic response during incidental facial emotion processing in inter-episode bipolar I disorder. Brain Imaging Behav 2014; 8:73-86. [PMID: 23975275 DOI: 10.1007/s11682-013-9246-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This fMRI study examined whether hemodynamic responses to affectively-salient stimuli were abnormally prolonged in remitted bipolar disorder, possibly representing a novel illness biomarker. A group of 18 DSM-IV bipolar I-diagnosed adults in remission and a demographically-matched control group performed an event-related fMRI gender-discrimination task in which face stimuli had task-irrelevant neutral, happy or angry expressions designed to elicit incidental emotional processing. Participants' brain activation was modeled using a "fully informed" SPM5 basis set. Mixed-model ANOVA tested for diagnostic group differences in BOLD response amplitude and shape within brain regions-of-interest selected from ALE meta-analysis of previous comparable fMRI studies. Bipolar-diagnosed patients had a generally longer duration and/or later-peaking hemodynamic response in amygdala and numerous prefrontal cortex brain regions. Data are consistent with existing models of bipolar limbic hyperactivity, but the prolonged frontolimbic response more precisely details abnormalities recognized in previous studies. Prolonged hemodynamic responses were unrelated to stimulus type, task performance, or degree of residual mood symptoms, suggesting an important novel trait vulnerability brain dysfunction in bipolar disorder. Bipolar patients also failed to engage pregenual cingulate and left orbitofrontal cortex-regions important to models of automatic emotion regulation-while engaging a delayed dorsolateral prefrontal cortex response not seen in controls. These results raise questions about whether there are meaningful relationships between bipolar dysfunction of specific ventromedial prefrontal cortex regions believed to automatically regulate emotional reactions and the prolonged responses in more lateral aspects of prefrontal cortex.
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Affiliation(s)
- Ethan S Rosenfeld
- Olin Neuropsychiatry Research Center, The Institute of Living/Hartford Hospital, 200 Retreat Ave, Whitehall Building, Hartford, CT, 06106, USA
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21
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Narayanan B, O’Neil K, Berwise C, Stevens MC, Calhoun VD, Clementz BA, Tamminga CA, Sweeney JA, Keshavan MS, Pearlson GD. Resting state electroencephalogram oscillatory abnormalities in schizophrenia and psychotic bipolar patients and their relatives from the bipolar and schizophrenia network on intermediate phenotypes study. Biol Psychiatry 2014; 76:456-65. [PMID: 24439302 PMCID: PMC5045030 DOI: 10.1016/j.biopsych.2013.12.008] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 12/11/2013] [Accepted: 12/12/2013] [Indexed: 01/27/2023]
Abstract
BACKGROUND Abnormal resting state electroencephalogram (EEG) oscillations are reported in schizophrenia (SZ) and bipolar disorder, illnesses with overlapping symptoms and genetic risk. However, less evidence exists on whether similar EEG spectral abnormalities are present in individuals with both disorders or whether these abnormalities are present in first-degree relatives, possibly representing genetic predisposition for these disorders. METHODS Investigators examined 64-channel resting state EEGs of 225 SZ probands and 201 first-degree relatives (SZR), 234 psychotic bipolar (PBP) probands and 231 first-degree relatives (PBPR), and 200 healthy control subjects. Eight independent resting state EEG spectral components and associated spatial weights were derived using group independent component analysis. Analysis of covariance was conducted on spatial weights to evaluate group differences. Relative risk estimates and familiality were evaluated on abnormal spectral profiles in probands and relatives. RESULTS Both SZ and PBP probands exhibited increased delta, theta, and slow and fast alpha activity. Post-hoc pair-wise comparison revealed increased frontocentral slow beta activity in SZ and PBP probands as well as SZR and PBPR. Augmented frontal delta activity was exhibited by SZ probands and SZR, whereas PBP probands and PBPR showed augmented fast alpha activity. CONCLUSIONS Both SZ and PBP probands demonstrated aberrant low-frequency activity. Slow beta activity was abnormal in SZ and PBP probands as well as SZR and PBPR perhaps indicating a common endophenotype for both disorders. Delta and fast alpha activity were unique endophenotypes for SZ and PBP probands, respectively. The EEG spectral activity exhibited moderate relative risk and heritability estimates, serving as intermediate phenotypes in future genetic studies for examining biological mechanisms underlying the pathogenesis of the two disorders.
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Affiliation(s)
- Balaji Narayanan
- Olin Neuropsychiatry Research Center, Hartford Hospital (IOL campus), Hartford, Connecticut.
| | - Kasey O’Neil
- Olin Neuropsychiatry Research Center, Hartford, CT-06106
| | | | | | | | | | - Carol A. Tamminga
- Department of Psychiatry, UT Southwestern Medical School, Dallas, TX 75390
| | - John A. Sweeney
- Department of Psychiatry, UT Southwestern Medical School, Dallas, TX 75390
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA02215
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Hartford, CT-06106,Departments of Psychiatry & Neurobiology, Yale University School of Medicine, New Haven, CT 06510
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Abstract
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has provided diagnostic reliability across observers while neglecting biological validity. The current theme issue explores the boundaries between schizophrenia and bipolar disorder, using neuro-cognition, systems neuroscience, and genetics as points of departure to begin consideration of a biologically based reclassification of these illnesses.
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Affiliation(s)
- Godfrey D. Pearlson
- Departments of Psychiatry and Neurobiology, Yale University, New Haven, CT;,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT;,*To whom correspondence should be addressed; Whitehall Building 207, ONRC, IOL, 200 Washington Street, Hartford, CT 06106, US; tel: 860-545-7678, fax: 860-545-7797, e-mail:
| | - Judith M. Ford
- San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA
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24
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Abstract
Characterization of patients with both psychotic and mood symptoms, either concurrently or at different points during their illness, has always posed a nosological challenge and this is reflected in the poor reliability, low diagnostic stability, and questionable validity of DSM-IV Schizoaffective Disorder. The clinical reality of the frequent co-occurrence of psychosis and Mood Episodes has also resulted in over-utilization of a diagnostic category that was originally intended to only rarely be needed. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, an effort is made to improve reliability of this condition by providing more specific criteria and the concept of Schizoaffective Disorder shifts from an episode diagnosis in DSM-IV to a life-course of the illness in DSM-5. When psychotic symptoms occur exclusively during a Mood Episode, DSM-5 indicates that the diagnosis is the appropriate Mood Disorder with Psychotic Features, but when such a psychotic condition includes at least a two-week period of psychosis without prominent mood symptoms, the diagnosis may be either Schizoaffective Disorder or Schizophrenia. In the DSM-5, the diagnosis of Schizoaffective Disorder can be made only if full Mood Disorder episodes have been present for the majority of the total active and residual course of illness, from the onset of psychotic symptoms up until the current diagnosis. In earlier DSM versions the boundary between Schizophrenia and Schizoaffective Disorder was only qualitatively defined, leading to poor reliability. This change will provide a clearer separation between Schizophrenia with mood symptoms from Schizoaffective Disorder and will also likely reduce rates of diagnosis of Schizoaffective Disorder while increasing the stability of this diagnosis once made.
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Resting state functional connectivity of five neural networks in bipolar disorder and schizophrenia. J Affect Disord 2013; 150:601-9. [PMID: 23489402 PMCID: PMC3749249 DOI: 10.1016/j.jad.2013.01.051] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/30/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Bipolar disorder (BPD) and schizophrenia (SCZ) share clinical characteristics and genetic contributions. Functional dysconnectivity across various brain networks has been reported to contribute to the pathophysiology of both SCZ and BPD. However, research examining resting-state neural network dysfunction across multiple networks to understand the relationship between these two disorders is lacking. METHODS We conducted a resting-state functional connectivity fMRI study of 35 BPD and 25 SCZ patients, and 33 controls. Using previously defined regions-of-interest, we computed the mean connectivity within and between five neural networks: default mode (DM), fronto-parietal (FP), cingulo-opercular (CO), cerebellar (CER), and salience (SAL). Repeated measures ANOVAs were used to compare groups, adjusting false discovery rate to control for multiple comparisons. The relationship of connectivity with the SANS/SAPS, vocabulary and matrix reasoning was investigated using hierarchical linear regression analyses. RESULTS Decreased within-network connectivity was only found for the CO network in BPD. Across groups, connectivity was decreased between CO-CER (p<0.001), to a larger degree in SCZ than in BPD. In SCZ, there was also decreased connectivity in CO-SAL, FP-CO, and FP-CER, while BPD showed decreased CER-SAL connectivity. Disorganization symptoms were predicted by connectivity between CO-CER and CER-SAL. DISCUSSION Our findings indicate dysfunction in the connections between networks involved in cognitive and emotional processing in the pathophysiology of BPD and SCZ. Both similarities and differences in connectivity were observed across disorders. Further studies are required to investigate relationships of neural networks to more diverse clinical and cognitive domains underlying psychiatric disorders.
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Anticevic A, Cole MW, Repovs G, Murray JD, Brumbaugh MS, Winkler AM, Savic A, Krystal JH, Pearlson GD, Glahn DC. Characterizing thalamo-cortical disturbances in schizophrenia and bipolar illness. Cereb Cortex 2013; 24:3116-30. [PMID: 23825317 DOI: 10.1093/cercor/bht165] [Citation(s) in RCA: 361] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Schizophrenia is a devastating neuropsychiatric syndrome associated with distributed brain dysconnectivity that may involve large-scale thalamo-cortical systems. Incomplete characterization of thalamic connectivity in schizophrenia limits our understanding of its relationship to symptoms and to diagnoses with shared clinical presentation, such as bipolar illness, which may exist on a spectrum. Using resting-state functional magnetic resonance imaging, we characterized thalamic connectivity in 90 schizophrenia patients versus 90 matched controls via: (1) Subject-specific anatomically defined thalamic seeds; (2) anatomical and data-driven clustering to assay within-thalamus dysconnectivity; and (3) machine learning to classify diagnostic membership via thalamic connectivity for schizophrenia and for 47 bipolar patients and 47 matched controls. Schizophrenia analyses revealed functionally related disturbances: Thalamic over-connectivity with bilateral sensory-motor cortices, which predicted symptoms, but thalamic under-connectivity with prefrontal-striatal-cerebellar regions relative to controls, possibly reflective of sensory gating and top-down control disturbances. Clustering revealed that this dysconnectivity was prominent for thalamic nuclei densely connected with the prefrontal cortex. Classification and cross-diagnostic results suggest that thalamic dysconnectivity may be a neural marker for disturbances across diagnoses. Present findings, using one of the largest schizophrenia and bipolar neuroimaging samples to date, inform basic understanding of large-scale thalamo-cortical systems and provide vital clues about the complex nature of its disturbances in severe mental illness.
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Affiliation(s)
- Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA NIAAA Center for the Translational Neuroscience of Alcoholism, New Haven, CT 06519, USA Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT 06519, USA
| | - Michael W Cole
- Department of Psychology, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Grega Repovs
- Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John D Murray
- Department of Neurobiology, Department of Physics, Yale University, New Haven, CT 06510, USA
| | - Margaret S Brumbaugh
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT 06106, USA
| | - Anderson M Winkler
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT 06106, USA Oxford University, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK and
| | - Aleksandar Savic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT 06519, USA University Psychiatric Hospital Vrapce, University of Zagreb, Zagreb 10000, Croatia
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA NIAAA Center for the Translational Neuroscience of Alcoholism, New Haven, CT 06519, USA Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT 06519, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA Department of Neurobiology, Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT 06106, USA
| | - David C Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT 06106, USA
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Green MJ, Cairns MJ, Wu J, Dragovic M, Jablensky A, Tooney PA, Scott RJ, Carr VJ. Genome-wide supported variant MIR137 and severe negative symptoms predict membership of an impaired cognitive subtype of schizophrenia. Mol Psychiatry 2013; 18:774-80. [PMID: 22733126 DOI: 10.1038/mp.2012.84] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Progress in determining the aetiology of schizophrenia (Sz) has arguably been limited by a poorly defined phenotype. We sought to delineate empirically derived cognitive subtypes of Sz to investigate the association of a genetic variant identified in a recent genome-wide association study with specific phenotypic characteristics of Sz. We applied Grade of Membership (GoM) analyses to 617 patients meeting ICD-10 criteria for Sz (n=526) or schizoaffective disorder (n=91), using cognitive performance indicators collected within the Australian Schizophrenia Research Bank. Cognitive variables included subscales from the Repeatable Battery for the Assessment of Neuropsychological Status, the Controlled Oral Word Association Test and the Letter Number Sequencing Test, and standardised estimates of premorbid and current intelligence quotient. The most parsimonious GoM solution yielded two subtypes of clinical cases reflecting those with cognitive deficits (CDs; N=294), comprising 47.6% of the sample who were impaired across all cognitive measures, and a cognitively spared group (CS; N=323) made up of the remaining 52.4% who performed relatively well on all cognitive tests. The CD subgroup were more likely to be unemployed, had an earlier illness onset, and greater severity of functional disability and negative symptoms than the CS group. Risk alleles on the MIR137 single-nucleotide polymorphism (SNP) predicted membership of CD subtype only in combination with higher severity of negative symptoms. These findings provide the first evidence for association of the MIR137 SNP with a specific Sz phenotype characterised by severe CDs and negative symptoms, consistent with the emerging role of microRNAs in the regulation of proteins responsible for neural development and function.
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Affiliation(s)
- M J Green
- School of Psychiatry, University of New South Wales, Research Unit for Schizophrenia Epidemiology, St Vincent's Hospital, Darlinghurst, NSW, Australia.
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Jamadar S, O’Neil KM, Pearlson GD, Ansari M, Gill A, Jagannathan K, Assaf M. Impairment in semantic retrieval is associated with symptoms in schizophrenia but not bipolar disorder. Biol Psychiatry 2013; 73:555-64. [PMID: 22985694 PMCID: PMC3581745 DOI: 10.1016/j.biopsych.2012.07.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 07/04/2012] [Accepted: 07/05/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The Semantic Object Retrieval Task (SORT) requires participants to indicate whether word pairs recall a third object. Schizophrenia individuals (SZ) tend to report associations between nonassociated word pairs; this overretrieval is related to formal thought disorder (FTD). Since semantic memory impairments and psychosis are also found in bipolar disorder (BP), we examined whether SORT impairments and their relationship to symptoms are also present in BP. METHODS Participants (n = 239; healthy control subjects [HC] = 133; BP = 32; SZ = 74) completed SORT while undergoing functional magnetic resonance imaging (fMRI) scanning. RESULTS Retrieval accuracy negatively correlated with negative symptoms and no-retrieval accuracy negatively correlated with FTD severity in SZ but not BP. Retrieval versus no-retrieval trials activated a distributed fronto-parieto-temporal network; bilateral inferior parietal lobule (IPL) activity was larger in HC versus SZ and HC versus BP, with no difference in SZ versus BP. Right IPL activity positively correlated with positive and general psychosis symptoms in SZ but not BP. CONCLUSIONS SZ reported more associations between unrelated word pairs than HC; this overretrieval increased with FTD severity. Schizophrenia individuals were also more likely to fail to find associations between related word pairs; this underretrieval increased with negative symptom severity. fMRI symptom correlations in IPL in SZ are consistent with arguments that IPL abnormality relates to loosening of associations in SZ. By comparison, BP showed intermediate impairments on SORT, uncorrelated with symptoms, suggesting that the relationship between SORT performance, fMRI activity, and psychotic symptoms is schizophrenia-specific.
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Affiliation(s)
- Sharna Jamadar
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, Connecticut 06106, USA.
| | - Kasey M. O’Neil
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford CT, USA
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford CT, USA,Departments of Psychiatry and Neurobiology, Yale University, New Haven CT, USA
| | - Mahvesh Ansari
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford CT, USA
| | - Adrienne Gill
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford CT, USA
| | | | - Michal Assaf
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford CT, USA,Departments of Psychiatry and Neurobiology, Yale University, New Haven CT, USA
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Moates AF, Ivleva EI, O’Neill HB, Krishna N, Cullum CM, Thaker GK, Tamminga CA. Predictive pursuit association with deficits in working memory in psychosis. Biol Psychiatry 2012; 72:752-7. [PMID: 22554452 PMCID: PMC3427716 DOI: 10.1016/j.biopsych.2012.03.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 03/28/2012] [Accepted: 03/28/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Deficits in smooth pursuit eye movements are an established phenotype for schizophrenia (SZ) and are being investigated as a potential liability marker for bipolar disorder. Although the molecular determinants of this deficit are still unclear, research has verified deficits in predictive pursuit mechanisms in SZ. Because predictive pursuit might depend on the working memory system, we have hypothesized a relationship between the two in healthy control subjects (HC) and SZ and here examine whether it extends to psychotic bipolar disorder (BDP). METHODS Volunteers with SZ (n = 38), BDP (n = 31), and HC (n = 32) performed a novel eye movement task to assess predictive pursuit as well as a standard visuospatial measure of working memory. RESULTS Individuals with SZ and BDP both showed reduced predictive pursuit gain compared with HC (p < .05). Moreover, each patient group showed worse performance in visuospatial working memory compared with control subjects (p < .05). A strong correlation (r = .53, p = .007) was found between predictive pursuit gain and working memory in HC, a relationship that showed a trend correlation within the BDP group but not among SZ. CONCLUSIONS Individuals with SZ and BDP showed similar deficits in predictive pursuit, suggesting that this alteration could be a characteristic trait of the psychosis domain. The correlation between predictive pursuit and working memory in HC supports the assumption that working memory is related to predictive pursuit eye movements; however, the degradation of working memory in people with psychosis disrupts its association with eye-tracking behavior.
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Affiliation(s)
- Amanda F. Moates
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX,Correspondence: Amanda F. Moates, Ph.D., Department of Psychiatry, UT Southwestern Medical Center, 6363 Forest Park Road, Dallas, TX 75390 - 8828, Phone 214 648 5253, Fax 214 648 5321,
| | - Elena I. Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Hugh B. O’Neill
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Nithin Krishna
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - C. Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Gunvant K. Thaker
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Carol A. Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
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DeRosse P, Malhotra AK, Lencz T. Molecular genetics of the psychosis phenotype. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2012; 57:446-53. [PMID: 22762300 PMCID: PMC4211610 DOI: 10.1177/070674371205700708] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Relative to recent successes in elucidating the genetic mechanisms associated with complex diseases, including macular degeneration, diabetes mellitus, type 2, heart disease, and cancer, molecular genetic approaches to psychiatric illness have met with more limited success. While factors such as small allelic effects, allelic heterogeneity, and variation in population substructure have received considerable attention in attempt to explain the paucity of significant results in psychiatric genetics, significantly less focus has been directed toward phenotypic factors. METHOD Data derived from molecular genetic studies of the psychosis phenotype in patients with a range of psychiatric illnesses are reviewed. RESULTS Available data suggest that genes do not respect the boundaries of the current diagnostic system but may confer risk for symptom-based phenotypic variation that traverses those boundaries. CONCLUSIONS Molecular genetic studies offer convincing evidence for a relation between genetic variation and symptom-based phenotypic variation within psychiatric illness. These data may provide novel insights into the pathophysiology of schizophrenia and other related disorders. The exploration of relations between genetic variation and symptom variation that traverses traditional diagnostic boundaries may ultimately lead to more refined classification systems that more closely reflect the genetic etiology of psychiatric illness.
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Affiliation(s)
- Pamela DeRosse
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.
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An MRI study of amygdala in schizophrenia and psychotic bipolar disorder. Schizophr Res 2012; 138:188-91. [PMID: 22559949 PMCID: PMC3372630 DOI: 10.1016/j.schres.2012.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 03/28/2012] [Accepted: 04/03/2012] [Indexed: 11/22/2022]
Abstract
Meta-analyses report larger amygdala in subjects with bipolar disorder compared to schizophrenia. However, few studies have compared the size of amygdala in psychotic bipolar disorder with schizophrenia. Here we examine size of amygdala in a sample of 36 patients with psychotic bipolar disorder, 31 patients with schizophrenia and 27 healthy comparison subjects. Patients with schizophrenia had smaller amygdala compared with patients with psychotic bipolar disorder (p=0.014). These results suggest that change in volume of amygdala may represent a morphologic feature distinguishing psychotic bipolar disorder from schizophrenia.
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Differences in resting-state functional magnetic resonance imaging functional network connectivity between schizophrenia and psychotic bipolar probands and their unaffected first-degree relatives. Biol Psychiatry 2012; 71:881-9. [PMID: 22401986 PMCID: PMC3968680 DOI: 10.1016/j.biopsych.2012.01.025] [Citation(s) in RCA: 207] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 01/31/2012] [Accepted: 01/31/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Schizophrenia and bipolar disorder share overlapping symptoms and genetic etiology. Functional brain dysconnectivity is seen in both disorders. METHODS We compared 70 schizophrenia and 64 psychotic bipolar probands, their respective unaffected first-degree relatives (n = 70, and n = 52), and 118 healthy subjects, all group age-, gender-, and ethnicity-matched. We used functional network connectivity analysis to measure differential connectivity among 16 functional magnetic resonance imaging resting state networks. First, we examined connectivity differences between probands and control subjects. Next, we probed these dysfunctional connections in relatives for potential endophenotypes. Network connectivity was then correlated with Positive and Negative Syndrome Scale (PANSS) scores to reveal clinical relationships. RESULTS Three different network pairs were differentially connected in probands (false-discovery rate corrected q < .05) involving five individual resting-state networks: (A) fronto/occipital, (B) anterior default mode/prefrontal, (C) meso/paralimbic, (D) fronto-temporal/paralimbic, and (E) sensory-motor. One abnormal pair was unique to schizophrenia, (C-E), one unique to bipolar, (C-D), and one (A-B) was shared. Two of these three combinations (A-B, C-E) were also abnormal in bipolar relatives but none was normal in schizophrenia relatives (nonsignificant trend for C-E). The paralimbic circuit (C-D), which uniquely distinguished bipolar probands, contained multiple mood-relevant regions. Network relationship C-D correlated significantly with PANSS negative scores in bipolar probands, and A-B with PANSS positive and general scores in schizophrenia. CONCLUSIONS Schizophrenia and psychotic bipolar probands share several abnormal resting state network connections, but there are also unique neural network underpinnings between disorders. We identified specific connections that might also be candidate psychosis endophenotypes.
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Ivleva EI, Morris DW, Osuji J, Moates AF, Carmody TJ, Thaker GK, Cullum M, Tamminga CA. Cognitive endophenotypes of psychosis within dimension and diagnosis. Psychiatry Res 2012; 196:38-44. [PMID: 22342122 PMCID: PMC3351583 DOI: 10.1016/j.psychres.2011.08.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 08/21/2011] [Accepted: 08/28/2011] [Indexed: 01/27/2023]
Abstract
This study sought to characterize the psychosis phenotype, contrasting cognitive features within traditional diagnosis and psychosis dimension in a family sample containing both schizophrenia and psychotic bipolar I disorder. Seventy-six probands with psychosis [44 probands with schizophrenia, 32 probands with psychotic bipolar I disorder] and 55 first-degree relatives [30 relatives of schizophrenia probands, 25 relatives of bipolar probands] were recruited. Standardized clinical and neuropsychological measures were administered. No differences in cognitive performance emerged between probands with schizophrenia and probands with psychotic bipolar disorder, or between relatives of probands with schizophrenia and relatives of probands with bipolar disorder in the domains of working and declarative memory, executive function and attention. Relatives overall showed higher cognitive performance compared to probands, as expected. However, when we segmented the probands and relatives along a psychosis dimension, independent of diagnostic groups, results revealed lower cognitive performance in probands compared to relatives without psychosis spectrum disorders, whereas relatives with psychosis spectrum disorders showed an intermediate level of performance across all cognitive domains. In this study, cognitive performance did not distinguish either probands or their first-degree relatives within traditional diagnostic groups (schizophrenia and psychotic bipolar disorder), but distinguished probands and relatives with and without lifetime psychosis manifestations independent of diagnostic categories. These data support the notion that schizophrenia and psychotic bipolar disorder present a clinical continuum with overlapping cognitive features defining the psychosis phenotype.
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Affiliation(s)
- Elena I. Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA,Corresponding author: Elena I. Ivleva, M.D., Ph.D., Department of Psychiatry, UT Southwestern Medical Center, 6363 Forest Park Road, BL6.633, Dallas, TX 75390, USA, Phone 214 648 0843, Fax 214 648 5321,
| | - David W. Morris
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Julian Osuji
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Amanda F. Moates
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Thomas J. Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Gunvant K. Thaker
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA,Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Carol A. Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Morris RW, Sparks A, Mitchell PB, Weickert CS, Green MJ. Lack of cortico-limbic coupling in bipolar disorder and schizophrenia during emotion regulation. Transl Psychiatry 2012; 2:e90. [PMID: 22832855 PMCID: PMC3309531 DOI: 10.1038/tp.2012.16] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Bipolar disorder (BD) and schizophrenia (Sz) share dysfunction in prefrontal inhibitory brain systems, yet exhibit distinct forms of affective disturbance. We aimed to distinguish these disorders on the basis of differential activation in cortico-limbic pathways during voluntary emotion regulation. Patients with DSM-IV diagnosed Sz (12) or BD-I (13) and 15 healthy control (HC) participants performed a well-established emotion regulation task while undergoing functional magnetic resonance imaging. The task required participants to voluntarily upregulate or downregulate their subjective affect while viewing emotionally negative images or maintain their affective response as a comparison condition. In BD, abnormal overactivity (hyperactivation) occurred in the right ventrolateral prefrontal cortex (VLPFC) during up- and downregulation of negative affect, relative to HC. Among Sz, prefrontal hypoactivation of the right VLPFC occurred during downregulation (opposite to BD), whereas upregulation elicited hyperactivity in the right VLPFC similar to BD. Amygdala activity was significantly related to subjective negative affect in HC and BD, but not Sz. Furthermore, amygdala activity was inversely coupled with the activity in the left PFC during downregulation in HC (r=-0.76), while such coupling did not occur in BD or Sz. These preliminary results indicate that differential cortico-limbic activation can distinguish the clinical groups in line with affective disturbance: BD is characterized by ineffective cortical control over limbic regions during emotion regulation, while Sz is characterized by an apparent failure to engage cortical (hypofrontality) and limbic regions during downregulation.
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Affiliation(s)
- R W Morris
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia
| | - A Sparks
- Black Dog Institute, Randwick, NSW, Australia
| | - P B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Randwick, NSW, Australia
| | - C S Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
| | - M J Green
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Black Dog Institute, Randwick, NSW, Australia,School of Psychiatry, University of New South Wales, NSW 2052, Australia. E-mail:
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Keshavan MS, Morris DW, Sweeney JA, Pearlson G, Thaker G, Seidman LJ, Eack SM, Tamminga C. A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia: the Schizo-Bipolar Scale. Schizophr Res 2011; 133:250-4. [PMID: 21996268 PMCID: PMC3381911 DOI: 10.1016/j.schres.2011.09.005] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 09/04/2011] [Accepted: 09/08/2011] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is increasing evidence for phenomenological, biological and genetic overlap between schizophrenia and bipolar disorder, bringing into question the traditional dichotomy between them. Neurobiological models linked to dimensional clinical data may provide a better foundation to represent diagnostic variation in neuropsychiatric disorders. METHOD To capture the interaction between psychosis and affective symptoms dimensionally, we devised a brief descriptive scale based on the type and relative proportions of psychotic and affective symptoms over the illness course. The scale was administered to a series of 762 patients with psychotic disorders, including schizophrenia, schizoaffective and psychotic bipolar disorder assessed as part of the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) study. RESULTS The resulting Schizo-Bipolar Scale scores across these disorders showed neither a clear dichotomy nor a simple continuous distribution. While the majority of cases had ratings close to prototypic schizophrenia or bipolar disorder, a large group (45% of cases) fell on the continuum between these two prototypes. CONCLUSIONS Our data suggest a hybrid conceptualization model with a representation of cases with prototypic schizophrenia or bipolar disorder at the extremes, but a large group of patients on the continuum between them that traditionally would be considered schizoaffective. A dimensional approach, using the Schizo-Bipolar Scale, characterized patients across a spectrum of psychopathology. This scale may provide a valuable means to examine the relationships between schizophrenia and psychotic bipolar disorder.
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Affiliation(s)
- Matcheri S. Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA,Address correspondence to Dr. Keshavan, Beth Israel Deaconess Medical Center and Harvard Medical School, 401 Park Drive, Boston MA 02215
| | - David W. Morris
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas
| | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas
| | - Godfrey Pearlson
- Department of Psychiatry and Neurobiology, Yale University School of Medicine and Olin Neuropsychiatric Research Center
| | | | - Larry J Seidman
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA
| | - Shaun M. Eack
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine and School of Social Work, University of Pittsburgh
| | - Carol Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas
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Nieto RG, Castellanos FX. A meta-analysis of neuropsychological functioning in patients with early onset schizophrenia and pediatric bipolar disorder. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2011; 40:266-80. [PMID: 21391023 DOI: 10.1080/15374416.2011.546049] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Despite the nosological distinction between bipolar disorder and schizophrenia, there is increasing evidence that these conditions share phenomenological characteristics. To examine the similarities in their patterns of cognitive impairment, we conducted a meta-analysis from 12 studies of Early Onset Schizophrenia (EOS) and 12 studies of Pediatric Bipolar Disorder (PBD). We found that individuals with PBD suffer from cognitive deficits (e.g., verbal learning and memory, processing speed, or executive control) that are milder but similar in nature to those of patients with EOS. Qualitative similarities between the neuropsychological profiles produced by these groups of patients might represent a "continuum of psychosis" or reflect some degree of genetic biological overlap.
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Affiliation(s)
- Rebeca Garcia Nieto
- Child Study Center, New York University Langone Medical Center, New York, NY, USA.
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Abstract
Reduced cortical γ-aminobutyric acid (GABA) levels and altered markers for subpopulations of GABA interneurons have been reported in major depressive disorder (MDD) by in-vivo brain imaging and post-mortem histological studies. Subgroups of GABA interneurons exert differential inhibitory control on principal pyramidal neurons and can be identified based on the non-overlapping expression of the calcium-binding proteins parvalbumin (PV) or calretinin (CR) or the neuropeptide somatostatin (SST). As altered markers of GABAergic functions may also be present in bipolar disorder (BPD), the specificity of particular GABA-related molecular deficits in mood disorders is not known. We used real-time quantitative polymerase chain reaction (qPCR) to assess expression levels of two GABA synthesizing enzymes (glutamate decarboxylase; GAD65 and GAD67) and of three markers of GABA neuron subpopulations (PV, CR, SST) in the dorsolateral prefrontal cortex (DLPFC; Brodmann area 9) in triads (n=19) of control subjects and matched subjects with BPD or MDD. BPD subjects demonstrated significantly reduced PV mRNA, trend level reduction in SST mRNA and no alterations in GAD67, GAD65, or CR mRNA levels; MDD subjects demonstrated reduced SST mRNA expression without alterations in the other transcripts. The characteristic age-related decline in SST expression was not observed in MDD, as low expression was detected across age in MDD subjects. After controlling for age, MDD subjects demonstrated significantly reduced SST mRNA expression. Decreased SST levels in MDD were confirmed at the protein precursor level. Results were not explained by other clinical, demographic or technical parameters. In summary, MDD was characterized by low DLPFC SST, whereas decreased PV mRNA appears to distinguish BPD from MDD.
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Simonsen C, Sundet K, Vaskinn A, Birkenaes AB, Engh JA, Færden A, Jónsdóttir H, Ringen PA, Opjordsmoen S, Melle I, Friis S, Andreassen OA. Neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends on history of psychosis rather than diagnostic group. Schizophr Bull 2011; 37:73-83. [PMID: 19443616 PMCID: PMC3004191 DOI: 10.1093/schbul/sbp034] [Citation(s) in RCA: 221] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Neurocognitive dysfunction is milder in bipolar disorders than in schizophrenia spectrum disorders, supporting a dimensional approach to severe mental disorders. The aim of this study was to investigate the role of lifetime history of psychosis for neurocognitive functioning across these disorders. We asked whether neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends more on history of psychosis than diagnostic category or subtype. METHODS A sample of individuals with schizophrenia (n=102), schizoaffective disorder (n=27), and bipolar disorder (I or II) with history of psychosis (n=75) and without history of psychosis (n=61) and healthy controls (n=280), from a large ongoing study on severe mental disorder, were included. Neurocognitive function was measured with a comprehensive neuropsychological test battery. RESULTS Compared with controls, all 3 groups with a history of psychosis performed poorer across neurocognitive measures, while the bipolar group without a history of psychosis was only impaired on a measure of processing speed. The groups with a history of psychosis did not differ from each other but performed poorer than the group without a history of psychosis on a number of neurocognitive measures. These neurocognitive group differences were of a magnitude expected to have clinical significance. In the bipolar sample, history of psychosis explained more of the neurocognitive variance than bipolar diagnostic subtype. CONCLUSIONS Our findings suggest that neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders is determined more by history of psychosis than by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnostic category or subtype, supporting a more dimensional approach in future diagnostic systems.
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Affiliation(s)
- Carmen Simonsen
- Department of Psychology, University of Oslo, 0317 Oslo, Norway.
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, 0317 Oslo, Norway
| | - Anja Vaskinn
- Clinic for Mental Health, Oslo University Hospital, Aker, 0320 Oslo, Norway
| | - Astrid B. Birkenaes
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Clinic for Mental Health, Oslo University Hospital, Aker, 0320 Oslo, Norway
| | - John A. Engh
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
| | - Ann Færden
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
| | - Halldóra Jónsdóttir
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
| | - Petter Andreas Ringen
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Clinic for Mental Health, Oslo University Hospital, Aker, 0320 Oslo, Norway
| | - Stein Opjordsmoen
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
| | - Ingrid Melle
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
| | - Svein Friis
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
| | - Ole A. Andreassen
- Department of Psychiatry, Oslo University Hospital, Ulleval, 0407 Oslo, Norway,Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
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Neurocognitive markers of psychosis in bipolar disorder: a meta-analytic study. J Affect Disord 2010; 127:1-9. [PMID: 20231037 DOI: 10.1016/j.jad.2010.02.117] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 02/15/2010] [Accepted: 02/15/2010] [Indexed: 01/07/2023]
Abstract
BACKGROUND It has been suggested that patients with psychotic bipolar disorder (BDP+) might have more severe cognitive deficits than non-psychotic bipolar disorder patients (BDP-). However, only a handful of studies have compared cognition between BDP+ and BDP-. Our aim was to examine cognitive deficits associated with psychosis in BD using meta-analytic methods. METHODS After a systematic literature review, we conducted a meta-analysis on studies that compared cognition in bipolar disorder (BD) patients with and without a history of psychosis. In addition the effects of clinical and demographic confounder factors were examined with meta-regression analyses. RESULTS There were no significant differences for gender and duration of illness between groups. Compared with BDP-, BDP+ patients had more inpatient admissions, a younger onset of illness and used antipsychotics more commonly. BDP+ patients also performed significantly worse in 4 of 6 cognitive domains (planning and reasoning, working memory, verbal memory and processing speed). There were also differences for some individual tasks (List Learning, Delayed Recall, Trail Making B, Wisconsin Card Sorting Test, Digits Backwards, Stroop Interference, Semantic Fluency) with BDP+ patients showing moderately greater impairment on these tasks (d=0.30-0.55). CONCLUSIONS A history of psychosis is associated with greater severity of cognitive deficits in BD. However, this effect is modest, and these findings do not suggest a complete categorical distinction between BDP+ and BDP-. Psychosis in BD might reflect partly distinct neurobiological processes.
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40
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Ivleva EI, Morris DW, Moates AF, Suppes T, Thaker GK, Tamminga CA. Genetics and intermediate phenotypes of the schizophrenia--bipolar disorder boundary. Neurosci Biobehav Rev 2010; 34:897-921. [PMID: 19954751 DOI: 10.1016/j.neubiorev.2009.11.022] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 11/20/2009] [Accepted: 11/23/2009] [Indexed: 12/20/2022]
Abstract
Categorization of psychotic illnesses into schizophrenic and affective psychoses remains an ongoing controversy. Although Kraepelinian subtyping of psychosis was historically beneficial, modern genetic and neurophysiological studies do not support dichotomous conceptualization of psychosis. Evidence suggests that schizophrenia and bipolar disorder rather present a clinical continuum with partially overlapping symptom dimensions, neurophysiology, genetics and treatment responses. Recent large scale genetic studies have produced inconsistent findings and exposed an urgent need for re-thinking phenomenology-based approach in psychiatric research. Epidemiological, linkage and molecular genetic studies, as well as studies in intermediate phenotypes (neurocognitive, neurophysiological and anatomical imaging) in schizophrenia and bipolar disorders are reviewed in order to support a dimensional conceptualization of psychosis. Overlapping and unique genetic and intermediate phenotypic signatures of the two psychoses are comprehensively recapitulated. Alternative strategies which may be implicated into genetic research are discussed.
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Affiliation(s)
- Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA.
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Goes F, Willour V, Zandi P, Belmonte P, MacKinnon D, Mondimore F, Schweizer B, DePaulo J, Gershon E, McMahon F, Potash J. Sex-specific association of the Reelin gene with bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:549-553. [PMID: 19691043 PMCID: PMC3032172 DOI: 10.1002/ajmg.b.31018] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The Reelin gene (RELN) encodes a secretory glycoprotein critical for brain development and synaptic plasticity. Post-mortem studies have shown lower Reelin protein levels in the brains of patients with schizophrenia and bipolar disorder (BP) compared with controls. In a recent genome-wide association study of schizophrenia, the strongest association was found in a marker within RELN, although this association was seen only in women. In this study, we investigated whether genetic variation in RELN is associated with BP in a large family sample. We genotyped 75 tagSNPs and 6 coding SNPs in 1,188 individuals from 318 nuclear families, including 554 affected offspring. Quality control measures, transmission-disequilibrium tests (TDTs), and empirical simulations were performed in PLINK. We found a significant overtransmission of the C allele of rs362719 to BP offspring (OR = 1.47, P = 5.9 x 10(-4)); this withstood empirical correction for testing of multiple markers (empirical P = 0.048). In a hypothesis-driven secondary analysis, we found that the association with rs362719 was almost entirely accounted for by overtransmission of the putative risk allele to affected females (OR(Female) = 1.79, P = 8.9 x 10(-5) vs. OR(Male) = 1.12, P = 0.63). These results provide preliminary evidence that genetic variation in RELN is associated with susceptibility to BP and, in particular, to BP in females. However, our findings should be interpreted with caution until further replication and functional assays provide convergent support.
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Affiliation(s)
- F.S. Goes
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - V.L. Willour
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - P.P. Zandi
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - P.L. Belmonte
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - D.F. MacKinnon
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - F.M. Mondimore
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - B. Schweizer
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - J.R. DePaulo
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - E.S. Gershon
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - F.J. McMahon
- Genetic Basis of Mood and Anxiety Disorders Unit, Mood and Anxiety Program, National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| | - J.B. Potash
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland,Correspondence to: Dr. J.B. Potash, M.D., M.P.H., Meyer 4-119, 600 N. Wolfe St., Baltimore, MD 21287-7419.
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Schulze TG. Genetic research into bipolar disorder: the need for a research framework that integrates sophisticated molecular biology and clinically informed phenotype characterization. Psychiatr Clin North Am 2010; 33:67-82. [PMID: 20159340 PMCID: PMC2824617 DOI: 10.1016/j.psc.2009.10.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Research into the genetic basis of bipolar disorder (BD) has reached a turning point. Genome-wide association studies (GWAS), encompassing several thousand samples, have produced replicated evidence for some novel susceptibility genes; however, the genetic variants implicated so far account for only a fraction of disease liability, a phenomenon not limited to psychiatric phenotypes but characteristic of all complex genetic traits studied to date. It appears that pure genomic approaches, such as GWAS alone, will not suffice to unravel the genetic basis of a complex illness like BD. Genomic approaches will need to be complemented by a variety of strategies, including phenomics, epigenomics, pharmacogenomics, and neurobiology, as well as the study of environmental factors. This review highlights the most promising findings from recent GWAS and candidate gene studies in BD. It furthermore sketches out a potential research framework integrating various lines of research into the molecular biological basis of BD.
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Affiliation(s)
- Thomas G. Schulze
- Unit on the Genetic Basis of Mood & Anxiety Disorders, NIMH, NIH, Bethesda, MD, USA, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA, Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
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43
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Strong genetic evidence for a selective influence of GABAA receptors on a component of the bipolar disorder phenotype. Mol Psychiatry 2010; 15:146-53. [PMID: 19078961 PMCID: PMC3967096 DOI: 10.1038/mp.2008.66] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite compelling evidence for a major genetic contribution to risk of bipolar mood disorder, conclusive evidence implicating specific genes or pathophysiological systems has proved elusive. In part this is likely to be related to the unknown validity of current phenotype definitions and consequent aetiological heterogeneity of samples. In the recent Wellcome Trust Case Control Consortium genome-wide association analysis of bipolar disorder (1868 cases, 2938 controls) one of the most strongly associated polymorphisms lay within the gene encoding the GABA(A) receptor beta1 subunit, GABRB1. Aiming to increase biological homogeneity, we sought the diagnostic subset that showed the strongest signal at this polymorphism and used this to test for independent evidence of association with other members of the GABA(A) receptor gene family. The index signal was significantly enriched in the 279 cases meeting Research Diagnostic Criteria for schizoaffective disorder, bipolar type (P=3.8 x 10(-6)). Independently, these cases showed strong evidence that variation in GABA(A) receptor genes influences risk for this phenotype (independent system-wide P=6.6 x 10(-5)) with association signals also at GABRA4, GABRB3, GABRA5 and GABRR3. [corrected] Our findings have the potential to inform understanding of presentation, pathogenesis and nosology of bipolar disorders. Our method of phenotype refinement may be useful in studies of other complex psychiatric and non-psychiatric disorders.
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44
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NPY mRNA expression in the prefrontal cortex: Selective reduction in the superficial white matter of subjects with schizoaffective disorder. Schizophr Res 2009; 115:261-9. [PMID: 19804960 PMCID: PMC2783408 DOI: 10.1016/j.schres.2009.09.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 09/08/2009] [Accepted: 09/10/2009] [Indexed: 01/05/2023]
Abstract
BACKGROUND Alterations in the inhibitory circuitry of the dorsolateral prefrontal cortex (DLPFC) in schizophrenia include reduced expression of the messenger RNA (mRNA) for somatostatin (SST), a neuropeptide present in a subpopulation of gamma-aminobutyric acid (GABA) neurons. Neuropeptide Y (NPY) is expressed in a subset of SST-containing interneurons and lower levels of NPY mRNA have also been reported in schizophrenia spectrum disorders. However, whether the alterations in these two transcripts identify the same, particularly vulnerable, subset of GABA neurons has not been examined. METHODS We used in situ hybridization to quantify NPY mRNA levels in DLPFC gray and white matter from 23 pairs of subjects with schizophrenia or schizoaffective disorder and matched normal control subjects; results were compared to those from a previous study of SST mRNA expression in the same subjects. RESULTS In contrast to SST mRNA, NPY mRNA levels were not significantly lower in the gray matter of subjects with schizophrenia or schizoaffective disorder. However, NPY, but not SST, mRNA expression was significantly lower in the superficial white matter of subjects with schizoaffective disorder. CONCLUSION These findings suggest that the alterations in SST-containing interneurons in schizophrenia and schizoaffective disorder are selective for the subset that do not express NPY mRNA, and that lower NPY mRNA expression in the superficial white matter may distinguish subjects with schizoaffective disorder from those with schizophrenia.
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45
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Glatt SJ, Chandler SD, Bousman CA, Chana G, Lucero GR, Tatro E, May T, Lohr JB, Kremen WS, Everall IP, Tsuang MT. Alternatively Spliced Genes as Biomarkers for Schizophrenia, Bipolar Disorder and Psychosis: A Blood-Based Spliceome-Profiling Exploratory Study. ACTA ACUST UNITED AC 2009; 7:164-188. [PMID: 21532980 DOI: 10.2174/1875692110907030164] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: Transcriptomic biomarkers of psychiatric diseases obtained from a query of peripheral tissues that are clinically accessible (e.g., blood cells instead of post-mortem brain tissue) have substantial practical appeal to discern the molecular subtypes of common complex diseases such as major psychosis. To this end, spliceome-profiling is a new methodological approach that has considerable conceptual relevance for discovery and clinical translation of novel biomarkers for psychiatric illnesses. Advances in microarray technology now allow for improved sensitivity in measuring the transcriptome while simultaneously querying the "exome" (all exons) and "spliceome" (all alternatively spliced variants). The present study aimed to evaluate the feasibility of spliceome-profiling to discern transcriptomic biomarkers of psychosis. METHODS: We measured exome and spliceome expression in peripheral blood mononuclear cells from 13 schizophrenia patients, nine bipolar disorder patients, and eight healthy control subjects. Each diagnostic group was compared to each other, and the combined group of bipolar disorder and schizophrenia patients was also compared to the control group. Furthermore, we compared subjects with a history of psychosis to subjects without such history. RESULTS: After applying Bonferroni corrections for the 21,866 full-length gene transcripts analyzed, we found significant interactions between diagnostic group and exon identity, consistent with group differences in rates or types of alternative splicing. Relative to the control group, 18 genes in the bipolar disorder group, eight genes in the schizophrenia group, and 15 genes in the combined bipolar disorder and schizophrenia group appeared differentially spliced. Importantly, thirty-three genes showed differential splicing patterns between the bipolar disorder and schizophrenia groups. More frequent exon inclusion and/or over-expression was observed in psychosis. Finally, these observations are reconciled with an analysis of the ontologies, the pathways and the protein domains significantly over-represented among the alternatively spliced genes, several of which support prior discoveries. CONCLUSIONS: To our knowledge, this is the first blood-based spliceome-profiling study of schizophrenia and bipolar disorder to be reported. The battery of alternatively spliced genes and exons identified in this discovery-oriented exploratory study, if replicated, may have potential utility to discern the molecular subtypes of psychosis. Spliceome-profiling, as a new methodological approach in transcriptomics, warrants further work to evaluate its utility in personalized medicine. Potentially, this approach could also permit the future development of tissue-sampling methodologies in a form that is more acceptable to patients and thereby allow monitoring of dynamic and time-dependent plasticity in disease severity and response to therapeutic interventions in clinical psychiatry.
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Affiliation(s)
- S J Glatt
- Department of Psychiatry and Behavioral Sciences, and Medical Genetics Research Center; SUNY Upstate Medical University; 750 East Adams Street; Syracuse, NY, 13210; USA
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Abstract
Bipolar disorder and schizophrenia share common clinical features, and antipsychotic medications can treat both conditions effectively. An assessment of 73,929 people with bipolar disorder and/or schizophrenia from a Swedish registry found evidence that the two disorders also share more than half of their genetic determinants.
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47
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Abstract
A diagnosis of schizoaffective disorder is frequently used to describe a psychotic person with significant symptoms of depression and/or mania. The word schizoaffective was introduced by Jacob Kasanin in 1933 and has appeared in all editions of the DSM since 1952. However, the current DSM-IV-TR diagnosis of schizoaffective disorder is not reliable and is of limited clinical utility. The validity is built primarily on the prediction of course and outcome and on emerging findings from genetic and neurobiological studies. This review of the current status of schizoaffective disorder concludes with several suggestions for a revision of the diagnosis within a categorical or dimensional nosology of psychotic and affective disorders.
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Affiliation(s)
- Stephan Heckers
- Vanderbilt University Psychiatric Hospital, 1601 23rd Avenue South, Room 3060, Nashville, TN 37212, USA.
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48
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Corpus callosum size and shape in first-episode affective and schizophrenia-spectrum psychosis. Psychiatry Res 2009; 173:77-82. [PMID: 19447585 DOI: 10.1016/j.pscychresns.2008.09.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 08/20/2008] [Accepted: 09/17/2008] [Indexed: 11/23/2022]
Abstract
Reductions in the size of the anterior callosum have been described for both first-episode and established schizophrenia and bipolar affective disorder, but never in individuals with psychotic bipolar disorder. We recruited 110 first-episode psychosis subjects (74 schizophrenia spectrum and 36 affective psychosis) and 36 age- and gender-matched controls. The callosum was extracted from a mid-sagittal slice from T1-weighted magnetic resonance images, and total area, length and curvature of the callosum were compared. The schizophrenia-spectrum group showed reductions in thickness of the genu across schizophreniform and schizoaffective disorder and schizophrenia, and the schizoaffective disorder group also showed an increase in thickness in the splenium and isthmus. None of these changes were seen in the affective disorder group, although a non-significant increase in the region of the isthmus and splenium was seen, particularly in the depressed group. Psychotic affective disorders do not show the anterior callosal reductions that are seen in the schizophrenia-spectrum group at first episode. The schizoaffective patients show additional posterior callosal expansions that may be a marker of an affective diathesis. This suggests that schizoaffective disorder may represent two interacting illness processes or be mid-way along a continuum of these two broad categories of illness at first psychosis.
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49
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Goes FS, Willour VL, Zandi PP, Belmonte PL, MacKinnon DF, Mondimore FM, Schweizer B, Gershon ES, McMahon FJ, Potash JB. Family-based association study of Neuregulin 1 with psychotic bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:693-702. [PMID: 19127563 PMCID: PMC4026923 DOI: 10.1002/ajmg.b.30895] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The Neuregulin 1 gene (NRG1) has been associated with schizophrenia, and, to a lesser extent, with bipolar disorder (BP). We investigated the association of NRG1 with BP in a large family sample, and then performed analyses according to the presence of psychotic features or mood-incongruent psychotic features. We genotyped 116 tagSNPs and four Icelandic "core" SNPs in 1,199 subjects from 314 nuclear families. Of 515 BP offspring, 341 had psychotic features, and 103 had mood-incongruent psychotic features. In single-marker and sliding window haplotype analyses using FBAT, there was little association using the standard BP or mood-incongruent psychotic BP phenotypes, but stronger signals were seen in the psychotic BP phenotype. The most significant associations with psychotic BP were in haplotypes within the 5' "core" region. The strongest global P-value was across three SNPs: NRG241930-NRG243177-rs7819063 (P = 0.0016), with an undertransmitted haplotype showing an individual P = 0.0007. The most significant individual haplotype was an undertransmitted two-allele subset of the above (NRG243177-rs7819063, P = 0.0004). Additional associations with psychotic BP were found across six SNPs in a 270 kb central region of the gene. The most 3' of these, rs7005606 (P = 0.0029), is located approximately 4 kb from the type I NRG1 isoform promoter. In sum, our study suggests that NRG1 may be specifically associated with the psychotic subset of BP; however, our results should be interpreted cautiously since they do not meet correction for multiple testing and await independent replication.
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Affiliation(s)
- Fernando S. Goes
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Virginia L. Willour
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Peter P. Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela L. Belmonte
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Dean F. MacKinnon
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Barbara Schweizer
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | | | - Francis J. McMahon
- Genetic Basis of Mood and Anxiety Disorders Unit, Mood and Anxiety Program, National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| | - James B. Potash
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland,Correspondence to: James B. Potash, M.D., M.P.H., Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Meyer 4-119, 600 N. Wolfe St., Baltimore, MD 21287. )
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Krelling R, Cordeiro Q, Miracca E, Gutt EK, Petresco S, Moreno RA, Vallada H. Molecular genetic case-control women investigation from the first Brazilian high-risk study on functional psychosis. ACTA ACUST UNITED AC 2009; 30:341-5. [PMID: 19142409 DOI: 10.1590/s1516-44462008005000013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 08/27/2008] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Data from epidemiological studies have demonstrated that genetics is an important risk factor for psychosis. The present study is part of a larger project, pioneer in Brazil, which has been conducted by other researchers who intend to follow a high-risk population (children) for the development of schizophrenia and bipolar disorder. In this first phase of the project, the objective was to investigate the distribution of four candidate genetic polymorphisms for functional psychosis (Ser9Gly DRD3, 5HTTLPR, the VNTR 3'-UTR SLC6A3 and Val66Met BDNF) in a case-control sample. METHOD A total of 105 women (58 with schizophrenia and 47 with bipolar disorder) and 62 gender-matched controls were investigated. RESULTS Allele and genotype distributions of all identified functional polymorphisms did not differ statistically between cases and controls. CONCLUSIONS These results suggest that the investigated polymorphisms were not related to susceptibility to functional psychoses in our Brazilian sample. These findings need to be validated in larger and independent studies.
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Affiliation(s)
- Renata Krelling
- Genetics and Pharmacogenetics Programme, Institute and Department of Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
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