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Gan R, Qiu Y, Liao J, Zhang Y, Wu J, Peng X, Lee TMC, Huang R. Mapping the mentalizing brain: An ALE meta-analysis to differentiate the representation of social scenes and ages on theory of mind. Neurosci Biobehav Rev 2024; 167:105918. [PMID: 39389437 DOI: 10.1016/j.neubiorev.2024.105918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 10/02/2024] [Accepted: 10/04/2024] [Indexed: 10/12/2024]
Abstract
Theory of mind (ToM) involves understanding others' mental states and relies on brain regions like the temporoparietal junction (TPJ) and medial prefrontal cortex (mPFC). This meta-analytic review categorizes ToM studies into six sub-components across three pairs: (1) Theory of collective mind (ToCM) and individualized theory of mind (iToM), (2) Social intention ToM and private intention ToM, and (3) ToM in adults and ToM in children. We conducted coordinate-based activation likelihood estimation (ALE) analyses and meta-analytic connectivity modeling (MACM) for each sub-component. We found that the ToM components utilized in social or group situations were associated with both the dorsomedial PFC (dmPFC) and right superior temporal sulcus (STS), whereas the ToM components focused on personal concentration were associated with both the lateral PFC and the left STS. The coactivation patterns for the group and age sub-component pairs showed significant spatial overlap with the language networks. These findings indicate that ToM is a multidimensional construct that is related to distinct functional networks for processing each of the ToM sub-components.
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Affiliation(s)
- Runchen Gan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong 510631, China
| | - Yidan Qiu
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong 510631, China
| | - Jiajun Liao
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Yuting Zhang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong 510631, China
| | - Jingyi Wu
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong 510631, China
| | - Xiaoqi Peng
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong 510631, China
| | - Tatia Mei-Chun Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China.
| | - Ruiwang Huang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong 510631, China.
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Totzek JF, Chakravarty MM, Joober R, Malla A, Shah JL, Raucher-Chéné D, Young AL, Hernaus D, Lepage M, Lavigne KM. Longitudinal inference of multiscale markers in psychosis: from hippocampal centrality to functional outcome. Mol Psychiatry 2024; 29:2929-2938. [PMID: 38605172 DOI: 10.1038/s41380-024-02549-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Multiscale neuroscience conceptualizes mental illness as arising from aberrant interactions across and within multiple biopsychosocial scales. We leverage this framework to propose a multiscale disease progression model of psychosis, in which hippocampal-cortical dysconnectivity precedes impairments in episodic memory and social cognition, which lead to more severe negative symptoms and lower functional outcome. As psychosis represents a heterogeneous collection of biological and behavioral alterations that evolve over time, we further predict this disease progression for a subtype of the patient sample, with other patients showing normal-range performance on all variables. We sampled data from two cross-sectional datasets of first- and multi-episode psychosis, resulting in a sample of 163 patients and 119 non-clinical controls. To address our proposed disease progression model and evaluate potential heterogeneity, we applied a machine-learning algorithm, SuStaIn, to the patient data. SuStaIn uniquely integrates clustering and disease progression modeling and identified three patient subtypes. Subtype 0 showed normal-range performance on all variables. In comparison, Subtype 1 showed lower episodic memory, social cognition, functional outcome, and higher negative symptoms, while Subtype 2 showed lower hippocampal-cortical connectivity and episodic memory. Subtype 1 deteriorated from episodic memory to social cognition, negative symptoms, functional outcome to bilateral hippocampal-cortical dysconnectivity, while Subtype 2 deteriorated from bilateral hippocampal-cortical dysconnectivity to episodic memory and social cognition, functional outcome to negative symptoms. This first application of SuStaIn in a multiscale psychiatric model provides distinct disease trajectories of hippocampal-cortical connectivity, which might underlie the heterogeneous behavioral manifestations of psychosis.
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Affiliation(s)
- Jana F Totzek
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - M Mallar Chakravarty
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
- Department of Biological and Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Jai L Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Delphine Raucher-Chéné
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Alexandra L Young
- Department of Computer Science, University College London, London, United Kingdom
| | - Dennis Hernaus
- Department of Psychiatry & Neuropsychology, School for Mental Health and NeuroScience MHeNS, Maastricht University, Maastricht, The Netherlands
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Douglas Research Centre, Montreal, QC, Canada.
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Veddum L, Bliksted V, Zhou Y, Andreassen AK, Knudsen CB, Greve AN, Steffensen NL, Birk M, Hemager N, Brandt JM, Gregersen M, Johnsen LK, Larsen KM, Christiaan Baaré WF, Madsen KS, Siebner HR, Plessen KJ, Thorup AAE, Østergaard L, Nordentoft M, Mors O, Lund TE, Dietz M. Brain Activation and Aberrant Effective Connectivity in the Mentalizing Network of Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00239-8. [PMID: 39182726 DOI: 10.1016/j.bpsc.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/13/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are characterized by social cognitive impairments, and recent research has identified alterations of the social brain. However, it is unknown whether familial high risk (FHR) of these disorders is associated with neurobiological alterations already present in childhood. METHODS As part of the Danish High Risk and Resilience Study-VIA 11, we examined children at FHR of schizophrenia (n = 121, 50% female) or bipolar disorder (n = 75, 47% female) and population-based control children (PBCs) (n = 128, 48% female). Using functional magnetic resonance imaging and dynamic causal modeling, we investigated brain activation and effective connectivity during the social cognition paradigm from the Human Connectome Project. RESULTS We found similar activation of the mentalizing network across groups, including visual area V5, the dorsomedial prefrontal cortex, and the posterior superior temporal sulcus (pSTS). Nonetheless, both FHR groups showed aberrant brain connectivity in the form of increased feedforward connectivity from left V5 to pSTS compared with PBCs. Children at FHR of schizophrenia had reduced intrinsic connectivity in bilateral V5 compared with PBCs, whereas children at FHR of bipolar disorder showed increased reciprocal connectivity between the left dorsomedial prefrontal cortex and the pSTS, increased intrinsic connectivity in the right pSTS, and reduced feedforward connectivity from the right pSTS to the dorsomedial prefrontal cortex compared with PBCs. CONCLUSIONS Our results provide first-time evidence of aberrant brain connectivity in the mentalizing network of children at FHR of schizophrenia or FHR of bipolar disorder. Longitudinal research is warranted to clarify whether aberrant brain connectivity during mentalizing constitutes an endophenotype associated with the development of a mental disorder later in life.
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Affiliation(s)
- Lotte Veddum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark.
| | - Vibeke Bliksted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Yuan Zhou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China
| | - Anna Krogh Andreassen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Christina Bruun Knudsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Aja Neergaard Greve
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Nanna Lawaetz Steffensen
- Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Merete Birk
- Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Nicoline Hemager
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center, Copenhagen University Hospital, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen, Denmark
| | - Julie Marie Brandt
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center, Copenhagen University Hospital, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center, Copenhagen University Hospital, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Line Korsgaard Johnsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kit Melissa Larsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - William Frans Christiaan Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kerstin Jessica Plessen
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Division of Child and Adolescent Psychiatry, Department of Psychiatry, the University Hospital of Lausanne, Lausanne, Switzerland
| | - Anne Amalie Elgaard Thorup
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center, Copenhagen University Hospital, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital Skejby-Psychiatry, Aarhus, Denmark; iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Torben Ellegaard Lund
- Center of Functionally Integrative Neuroscience, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Martin Dietz
- Center of Functionally Integrative Neuroscience, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Knobloch S, Leiding D, Wagels L, Regenbogen C, Kellermann T, Mathiak K, Schneider F, Derntl B, Habel U. Empathy in schizophrenia: neural alterations during emotion recognition and affective sharing. Front Psychiatry 2024; 15:1288028. [PMID: 38855645 PMCID: PMC11157094 DOI: 10.3389/fpsyt.2024.1288028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 05/01/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Deficits in emotion recognition and processing are characteristic for patients with schizophrenia [SCZ]. Methods We targeted both emotion recognition and affective sharing, one in static and one in dynamic facial stimuli, during functional magnetic resonance imaging [fMRI] in 22 SCZ patients and 22 matched healthy controls [HC]. Current symptomatology and cognitive deficits were assessed as potential influencing factors. Results Behaviorally, patients only showed a prolonged response time in age-discrimination trials. For emotion-processing trials, patients showed a difference in neural response, without an observable behavioral correlate. During emotion and age recognition in static stimuli, a reduced activation of the bilateral anterior cingulate cortex [ACC] and the right anterior insula [AI] emerged. In the affective sharing task, patients showed a reduced activation in the left and right caudate nucleus, right AI and inferior frontal gyrus [IFG], right cerebellum, and left thalamus, key areas of empathy. Discussion We conclude that patients have deficits in complex visual information processing regardless of emotional content on a behavioral level and that these deficits coincide with aberrant neural activation patterns in emotion processing networks. The right AI as an integrator of these networks plays a key role in these aberrant neural activation patterns and, thus, is a promising candidate area for neurofeedback approaches.
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Affiliation(s)
- Simon Knobloch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Institute of Systems Neuroscience, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Delia Leiding
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Jülich-Aachen Research Alliance (JARA) – Translational Brain Medicine, Aachen, Germany
| | - Christina Regenbogen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
| | - Thilo Kellermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Jülich-Aachen Research Alliance (JARA) – Translational Brain Medicine, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Department of the History, Philosophy and Ethics of Medicine, Centre for Health and Society (chs), School of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Jülich-Aachen Research Alliance (JARA) – Translational Brain Medicine, Aachen, Germany
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5
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Zhang C, Liang J, Yan H, Li X, Li X, Jing H, Liang W, Li R, Ou Y, Wu W, Guo H, Deng W, Xie G, Guo W. Fractional amplitude of low-frequency fluctuations in sensory-motor networks and limbic system as a potential predictor of treatment response in patients with schizophrenia. Schizophr Res 2024; 267:519-527. [PMID: 38704344 DOI: 10.1016/j.schres.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/21/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Previous investigations have revealed substantial differences in neuroimaging characteristics between healthy controls (HCs) and individuals diagnosed with schizophrenia (SCZ). However, we are not entirely sure how brain activity links to symptoms in schizophrenia, and there is a need for reliable brain imaging markers for treatment prediction. METHODS In this longitudinal study, we examined 56 individuals diagnosed with 56 SCZ and 51 HCs. The SCZ patients underwent a three-month course of antipsychotic treatment. We employed resting-state functional magnetic resonance imaging (fMRI) along with fractional Amplitude of Low Frequency Fluctuations (fALFF) and support vector regression (SVR) methods for data acquisition and subsequent analysis. RESULTS In this study, we initially noted lower fALFF values in the right postcentral/precentral gyrus and left postcentral gyrus, coupled with higher fALFF values in the left hippocampus and right putamen in SCZ patients compared to the HCs at baseline. However, when comparing fALFF values in brain regions with abnormal baseline fALFF values for SCZ patients who completed the follow-up, no significant differences in fALFF values were observed after 3 months of treatment compared to baseline data. The fALFF values in the right postcentral/precentral gyrus and left postcentral gyrus, and the left postcentral gyrus were useful in predicting treatment effects. CONCLUSION Our findings suggest that reduced fALFF values in the sensory-motor networks and increased fALFF values in the limbic system may constitute distinctive neurobiological features in SCZ patients. These findings may serve as potential neuroimaging markers for the prognosis of SCZ patients.
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Affiliation(s)
- Chunguo Zhang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Jiaquan Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoling Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Xuesong Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Huan Jing
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Wenting Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Rongwei Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Yangpan Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Weibin Wu
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Huagui Guo
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Wen Deng
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Guojun Xie
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China.
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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6
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Vai B, Calesella F, Pelucchi A, Riberto M, Poletti S, Bechi M, Cavallaro R, Francesco B. Adverse childhood experiences differently affect Theory of Mind brain networks in schizophrenia and healthy controls. J Psychiatr Res 2024; 172:81-89. [PMID: 38367321 DOI: 10.1016/j.jpsychires.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
Patients with schizophrenia (SZ) show impairments in both affective and cognitive dimensions of theory of mind (ToM). SZ are also particularly vulnerable to detrimental effect of adverse childhood experiences (ACE), influencing the overall course of the disorder and fostering poor social functioning. ACE associate with long-lasting detrimental effects on brain structure, function, and connectivity in regions involved in ToM. Here, we investigated whether ToM networks are differentially affected by ACEs in healthy controls (HC) and SZ, and if these effects can predict the disorder clinical outcome. 26 HC and 33 SZ performed a ToM task during an fMRI session. Whole-brain functional response and connectivity (FC) were extracted, investigating the interaction between ACEs and diagnosis. FC values significantly affected by ACEs were entered in a cross-validated LASSO regression predicting Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), and task performance. ACEs and diagnosis showed a widespread interaction at both affective and cognitive tasks, including connectivity between vmPFC, ACC, precentral and postcentral gyri, insula, PCC, precuneus, parahippocampal gyrus, temporal pole, thalamus, and cerebellum, and functional response in the ACC, thalamus, parahippocampal gyrus and putamen. FC predicted the PANSS score, the fantasy dimension of IRI, and the AToM response latency. Our results highlight the crucial role of early stress in differentially shaping ToM related brain networks in HC and SZ. These effects can also partially explain the clinical and behavioral outcomes of the disorder, extending our knowledge of the effects of ACEs.
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Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Federico Calesella
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Alice Pelucchi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Martina Riberto
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Roberto Cavallaro
- Vita-Salute San Raffaele University, Milano, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Benedetti Francesco
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
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7
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Andreo-Jover J, Wootton O, Fernández-Jiménez E, Muñoz-Sanjosé A, Mediavilla R, Bravo-Ortiz MF, Susser E, Gur RC, Stein DJ. Adverse childhood experiences and cognition: A cross-sectional study in Xhosa people living with schizophrenia and matched medical controls. Compr Psychiatry 2024; 130:152459. [PMID: 38330854 DOI: 10.1016/j.comppsych.2024.152459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with impaired cognitive function in adult life in the general population as well as in people living with schizophrenia (PLS). Research on cognitive function in PLS in low- and middle-income countries (LMIC) is, however, limited. The objectives of this study were to investigate the association between ACE types and various cognitive domains in a sample of PLS and matched medical controls, and to determine the moderating effect of group membership (PLS vs. medical controls) on these associations, in the South African setting. METHODS Participants (n PLS = 520; n medical controls = 832) completed the Childhood Trauma Questionnaire-Short Form, the Structured Clinical Interview for DSM-IV (SCID-I), and the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). An efficiency or speed score was used to assess performance across 9 cognitive domains. The association between exposure to different ACE types and 9 cognitive domains was examined using partial correlations and multiple linear regression models, adjusting for sex, age and education years. Finally, potential moderating effects of group membership (PLS vs. medical controls) on the association between ACEs and cognitive domains were tested. RESULTS In the entire sample, emotional and physical abuse predicted worse performance on sensorimotor and emotion identification domains. Also, emotional abuse was negatively associated with motor function, physical abuse was negatively associated with spatial processing, and physical neglect was negatively associated with face memory and emotion identification. In contrast, emotional neglect was related to better performance on abstraction and mental flexibility. No moderating effect of group membership was found on any of these associations. CONCLUSION Exposure to ACEs was associated with social and non-social cognition in adulthood, although the magnitude of these relationships was small and similar between PLS and matched medical controls. The nature of these associations differed across ACE subtype, suggesting the need for a nuanced approach to studying a range of mechanisms that may underlie different associations. However, a number of ACE subtypes were associated with worse performance on emotional identification, indicating that some underlying mechanisms may have more transversal impact. These findings contribute to the sparse body of literature on ACEs and cognition in PLS in LMIC.
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Affiliation(s)
- Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Olivia Wootton
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Social Sciences and Communication, Madrid, Spain.
| | - Ainoa Muñoz-Sanjosé
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Department of Psychiatry, New York State Psychiatric Institute, New York, United States
| | - Ruben C Gur
- Brain Behavior Laboratories, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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8
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Ma Y, Tie N, Ni S, Ma X, Qiao P. Correlation between the changes of brain amplitude of low-frequency fluctuation and cognitive impairment in patients with neuropsychiatric lupus. Lupus 2024; 33:255-265. [PMID: 38269543 DOI: 10.1177/09612033241228783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE To explore the relationship between brain function changes and clinical serological indicators and behavioral cognitive assessment in patients with neuropsychiatric systemic lupus erythematosus (NPSLE), and understand the pathogenesis of NPSLE from the perspective of imaging. METHODS The resting-state functional imaging data, clinical serological, and behavioral cognitive assessment scores of 28 patients with NPSLE and 22 healthy controls (HC) were prospectively collected. The resting-state amplitude of low-frequency fluctuation (ALFF) values obtained from the analysis and processing were correlated with the serological data and behavioral cognitive assessment scores to determine the relationship between these data. RESULTS The average age of the patients of the NPSLE group was older than that of the HC group; significant differences in education level, Auditory Verbal Learning Test Hua Shan Version (AVLT-H), and Trail Making Test scores were observed between the two groups. The NPSLE group demonstrated increased brain activity in the insula, precentral gyrus, and superior temporal gyrus, and decreased brain activity in the superior parietal gyrus. The ALFF value of the insula positively correlated with the Anti-β2gp1 antibody and negatively correlated with the anti-nucleosome antibody and the AVL-recall (RC) score. The ALFF of the precentral gyrus negatively correlated with the AVL-immediate recall (I). The ALFF value of the superior temporal gyrus negatively correlated with the AVL-RC score. The left superior parietal gyrus positively correlated with the c-reactive protein. The right superior parietal gyrus positively correlated with the System Lupus Erythematosus Disease Activity Index and negatively correlated with the AVL-I score. CONCLUSION Patients with NPSLE show different brain activity changes in different brain regions, and the abnormal brain regions are correlated with certain lupus antibodies, inflammatory factors, and cognitive assessment, thereby suggesting that the correlation between the three could provide novel insights into the pathogenesis of NPSLE.
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Affiliation(s)
- Yue Ma
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Ning Tie
- Department of Rheumatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Sha Ni
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Xueying Ma
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Pengfei Qiao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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9
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Martino M, Magioncalda P. A three-dimensional model of neural activity and phenomenal-behavioral patterns. Mol Psychiatry 2024; 29:639-652. [PMID: 38114633 DOI: 10.1038/s41380-023-02356-w] [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] [Received: 07/18/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
How phenomenal experience and behavior are related to neural activity in physiology and psychopathology represents a fundamental question in neuroscience and psychiatry. The phenomenal-behavior patterns may be deconstructed into basic dimensions, i.e., psychomotricity, affectivity, and thought, which might have distinct neural correlates. This work provides a data overview on the relationship of these phenomenal-behavioral dimensions with brain activity across physiological and pathological conditions (including major depressive disorder, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, anxiety disorders, addictive disorders, Parkinson's disease, Tourette syndrome, Alzheimer's disease, and frontotemporal dementia). Accordingly, we propose a three-dimensional model of neural activity and phenomenal-behavioral patterns. In this model, neural activity is organized into distinct units in accordance with connectivity patterns and related input/output processing, manifesting in the different phenomenal-behavioral dimensions. (1) An external neural unit, which involves the sensorimotor circuit/brain's sensorimotor network and is connected with the external environment, processes external inputs/outputs, manifesting in the psychomotor dimension (processing of exteroception/somatomotor activity). External unit hyperactivity manifests in psychomotor excitation (hyperactivity/hyperkinesia/catatonia), while external unit hypoactivity manifests in psychomotor inhibition (retardation/hypokinesia/catatonia). (2) An internal neural unit, which involves the interoceptive-autonomic circuit/brain's salience network and is connected with the internal/body environment, processes internal inputs/outputs, manifesting in the affective dimension (processing of interoception/autonomic activity). Internal unit hyperactivity manifests in affective excitation (anxiety/dysphoria-euphoria/panic), while internal unit hypoactivity manifests in affective inhibition (anhedonia/apathy/depersonalization). (3) An associative neural unit, which involves the brain's associative areas/default-mode network and is connected with the external/internal units (but not with the environment), processes associative inputs/outputs, manifesting in the thought dimension (processing of ideas). Associative unit hyperactivity manifests in thought excitation (mind-wandering/repetitive thinking/psychosis), while associative unit hypoactivity manifests in thought inhibition (inattention/cognitive deficit/consciousness loss). Finally, these neural units interplay and dynamically combine into various neural states, resulting in the complex phenomenal experience and behavior across physiology and neuropsychiatric disorders.
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Affiliation(s)
- Matteo Martino
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
| | - Paola Magioncalda
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Radiology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
- Department of Medical Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
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10
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Voineskos AN, Hawco C, Neufeld NH, Turner JA, Ameis SH, Anticevic A, Buchanan RW, Cadenhead K, Dazzan P, Dickie EW, Gallucci J, Lahti AC, Malhotra AK, Öngür D, Lencz T, Sarpal DK, Oliver LD. Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions. World Psychiatry 2024; 23:26-51. [PMID: 38214624 PMCID: PMC10786022 DOI: 10.1002/wps.21159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicholas H Neufeld
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression and McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Alan Anticevic
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julia Gallucci
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anil K Malhotra
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Dost Öngür
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Todd Lencz
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Deepak K Sarpal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
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11
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Kent J, Pinkham A. Cerebral and cerebellar correlates of social cognitive impairment in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110850. [PMID: 37657639 DOI: 10.1016/j.pnpbp.2023.110850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/26/2023] [Accepted: 08/28/2023] [Indexed: 09/03/2023]
Abstract
Social cognition is a broad construct encompassing the ways in which individuals perceive, process, and use information about other people. Social cognition involves both lower- and higher-level processes such as emotion recognition and theory of mind, respectively. Social cognitive impairments have been repeatedly demonstrated in schizophrenia spectrum illnesses and, crucially, are related to functional outcomes. In this review, we summarize the literature investigating the brain networks implicated in social cognitive impairments in schizophrenia spectrum illnesses. In addition to cortical and limbic loci and networks, we also discuss evidence for cerebellar contributions to social cognitive impairment in this population. We conclude by synthesizing these two literatures, with an emphasis on current knowledge gaps, particularly in regard to cerebellar influences, and future directions.
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Affiliation(s)
- Jerillyn Kent
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Amy Pinkham
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States.
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12
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Zhong J, Jia Y, Zhu H, Wang D, Jia H. Effects of Ziprasidone or Haloperidol on Theory of Mind in Patients With Schizophrenia: A 16-week Pilot Trial. J Psychiatr Pract 2024; 30:32-42. [PMID: 38227725 DOI: 10.1097/pra.0000000000000752] [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: 01/18/2024]
Abstract
OBJECTIVES Schizophrenia is associated with impairment in theory of mind (ToM), which is defined as the ability to make judgments about mental states and is related to medial prefrontal cortical activity. Ziprasidone, but not haloperidol, is known to have a protective effect in the medial prefrontal cortex. Thus, we hypothesized that these 2 drugs would have different efficacy in improving ToM task performance in patients with schizophrenia. METHODS Patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of schizophrenia matched for sex, duration of illness, and education were randomized to receive ziprasidone (n=30) or haloperidol (n=30). All patients were assessed using the Positive and Negative Syndrome Scale and the Personal and Social Functioning Scale. ToM was assessed using a first-order false belief task, a second-order false belief task, the faux-pas task, and the Reading the Mind in the Eyes Task, in order of developmental complexity and difficulty. The primary outcome was change in ToM performance from baseline to 16 weeks of treatment. RESULTS For the first-order false belief task, there were no significant differences between the groups (P>0.05). For the second-order false belief task, the interaction effect was significant (P<0.05), and the simple effect of time showed a significant difference only in the ziprasidone group (P<0.001). For the faux-pas task, the interaction effect was not significant (P>0.05). For the Reading the Mind in the Eyes Task, the interaction effect was significant (P<0.05), and the simple effect of time showed a significant difference only in the ziprasidone group (P<0.001). The Positive and Negative Syndrome Scale results were similar between the groups. The ziprasidone group performed better than the haloperidol group on the Personal and Social Functioning Scale. There were no major safety concerns or adverse events. CONCLUSIONS The findings of this study suggest that ziprasidone could improve ToM and might be superior to haloperidol for improving complex ToM as well as personal and social functioning in patients with schizophrenia. TRIAL REGISTRATION CHINESE CLINICAL TRIAL REGISTER ChiCTR2200060542.
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Affiliation(s)
- Jie Zhong
- ZHONG, JIA, ZHU, and JIA: The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China; WANG: Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, People's Republic of China
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13
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de Sales SC, Philippsen M, de Jesus LS, Carriello MA, Alvim PHP, Costa DFB, da Rosa LC, Hasse-Sousa M, Czepielewski LS, Massuda R. Social cognition and psychosocial functioning in schizophrenia and bipolar disorder: Theory of mind as a key to understand schizophrenia dysfunction. Eur Neuropsychopharmacol 2023; 77:12-20. [PMID: 37660439 DOI: 10.1016/j.euroneuro.2023.08.483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
Functional impairment is a common symptom in schizophrenia (SZ) and bipolar disorder (BD). Pharmacological treatments have limited functional recovery in both disorders. Social cognition, a cognitive process, has been associated with functioning in mental disorders. Theory of mind (ToM) is considered a key factor in understanding the social cognitive deficits in SZ and BD. Our study aimed to investigate the relationship between ToM and functioning in SZ, BD, and healthy controls (HC) and compare ToM and functioning impairments between groups. A total of 208 participants (HC n = 69; BD n = 89; SZ n = 50) were evaluated with the Functioning Assessment Short Test (FAST), Reading the Mind in the Eyes Test (RMET), the Vocabulary subtest of the Wechsler Abbreviated Scale for Intelligence (WASI) and the Hopkins Verbal Learning Test - Revised (HVLT-R). Comparisons of RMET between low- and high-functioning individuals and multiple linear regression analyses were conducted for each group. Multiple regression analysis revealed that the association between ToM and psychosocial functioning was observed only in SZ (β = -1.352, p = 0.008). Low-functioning SZ participants showed a lower ToM performance compared to participants with high-functioning SZ (t = 1.80, p = 0.039, Cohen's d = 0.938). No significant associations were found in the other groups. ToM is essential to understand the functional impairment in SZ, more than in BD. Furthermore, ToM may be a primary target for intervention strategies in improving functioning in SZ.
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Affiliation(s)
| | | | | | | | | | | | - Laura Canani da Rosa
- Departamento de Psicologia do Desenvolvimento e da Personalidade da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Departamento de Psicologia do Desenvolvimento e da Personalidade da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Sanguinetti Czepielewski
- Departamento de Psicologia do Desenvolvimento e da Personalidade da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Raffael Massuda
- Departamento de Psiquiatria da Universidade Federal do Paraná
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14
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Lemmers-Jansen I, Velthorst E, Fett AK. The social cognitive and neural mechanisms that underlie social functioning in individuals with schizophrenia - a review. Transl Psychiatry 2023; 13:327. [PMID: 37865631 PMCID: PMC10590451 DOI: 10.1038/s41398-023-02593-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 10/23/2023] Open
Abstract
In many individuals with a diagnosis of schizophrenia social functioning is impaired across the lifespan. Social cognition has emerged as one of the possible factors that may contribute to these challenges. Neuroimaging research can give further insights into the underlying mechanisms of social (cognitive) difficulties. This review summarises the evidence on the associations between social cognition in the domains of theory of mind and emotion perception and processing, and individuals' social functioning and social skills, as well as associated neural mechanisms. Eighteen behavioural studies were conducted since the last major review and meta-analysis in the field (inclusion between 7/2017 and 1/2022). No major review has investigated the link between the neural mechanisms of social cognition and their association with social functioning in schizophrenia. Fourteen relevant studies were included (from 1/2000 to 1/2022). The findings of the behavioural studies showed that associations with social outcomes were slightly stronger for theory of mind than for emotion perception and processing. Moreover, performance in both social cognitive domains was more strongly associated with performance on social skill measures than questionnaire-based assessment of social functioning in the community. Studies on the underlying neural substrate of these associations presented mixed findings. In general, higher activation in various regions of the social brain was associated with better social functioning. The available evidence suggests some shared regions that might underlie the social cognition-social outcome link between different domains. However, due to the heterogeneity in approaches and findings, the current knowledge base will need to be expanded before firm conclusions can be drawn.
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Affiliation(s)
- Imke Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (iBBA) Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eva Velthorst
- GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands
| | - Anne-Kathrin Fett
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, City, University of London, London, UK.
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15
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Wasserthal S, Lehmann M, Neumann C, Delis A, Philipsen A, Hurlemann R, Ettinger U, Schultz J. Effects of NMDA-receptor blockade by ketamine on mentalizing and its neural correlates in humans: a randomized control trial. Sci Rep 2023; 13:17184. [PMID: 37821513 PMCID: PMC10567921 DOI: 10.1038/s41598-023-44443-6] [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: 09/26/2022] [Accepted: 10/08/2023] [Indexed: 10/13/2023] Open
Abstract
Schizophrenia is associated with various deficits in social cognition that remain relatively unaltered by antipsychotic treatment. While faulty glutamate signaling has been associated with general cognitive deficits as well as negative symptoms of schizophrenia, no direct link between manipulation of glutamate signaling and deficits in mentalizing has been demonstrated thus far. Here, we experimentally investigated whether ketamine, an uncompetitive N-methyl-D-aspartate receptor antagonist known to induce psychotomimetic effects, influences mentalizing and its neural correlates. In a randomized, placebo-controlled between-subjects experiment, we intravenously administered ketamine or placebo to healthy participants performing a video-based social cognition task during functional magnetic resonance imaging. Psychotomimetic effects of ketamine were assessed using the Positive and Negative Syndrome Scale. Compared to placebo, ketamine led to significantly more psychotic symptoms and reduced mentalizing performance (more "no mentalizing" errors). Ketamine also influenced blood oxygen level dependent (BOLD) response during mentalizing compared to placebo. Specifically, ketamine increased BOLD in right posterior superior temporal sulcus (pSTS) and increased connectivity between pSTS and anterior precuneus. These increases may reflect a dysfunctional shift of attention induced by ketamine that leads to mentalizing deficits. Our findings show that a psychotomimetic dose of ketamine impairs mentalizing and influences its neural correlates, a result compatible with the notion that deficient glutamate signaling may contribute to deficits in mentalizing in schizophrenia. The results also support efforts to seek novel psychopharmacological treatments for psychosis and schizophrenia targeting glutamatergic transmission.
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Affiliation(s)
- Sven Wasserthal
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Mirko Lehmann
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Claudia Neumann
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Achilles Delis
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - René Hurlemann
- Department of Psychiatry, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
| | | | - Johannes Schultz
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute for Experimental Epileptology and Cognition Research, Medical Faculty, University of Bonn, Bonn, Germany
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16
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Sanders AFP, Hobbs DA, Knaus TA, Beaton EA. Structural Connectivity and Emotion Recognition Impairment in Children and Adolescents with Chromosome 22q11.2 Deletion Syndrome. J Autism Dev Disord 2023; 53:4021-4034. [PMID: 35917023 PMCID: PMC10898588 DOI: 10.1007/s10803-022-05675-z] [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] [Accepted: 07/04/2022] [Indexed: 11/26/2022]
Abstract
Children with chromosome 22q11.2 deletion syndrome (22q11.2DS) exhibit impaired ability to process and understand emotions in others. We measured structural connectivity in children and adolescents with 22q11.2DS (n = 28) and healthy controls (n = 29). Compared to controls, those with 22q11.2DS had poorer social skills and more difficulty recognizing facial emotions. Children with 22q11.2DS also had higher fractional anisotropic diffusion in right amygdala to fusiform gyrus white matter pathways. Right amygdala to fusiform gyrus fractional anisotropy values partially mediated the relationship between 22q11.2DS and social skills, as well as the relationship between 22q11.2DS and emotion recognition accuracy. These findings provide insight into the neural origins of social skills deficits seen in 22q11.2DS and may serve as a biomarker for risk of future psychiatric problems.
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Affiliation(s)
- Ashley F P Sanders
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Diana A Hobbs
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Tracey A Knaus
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
| | - Elliott A Beaton
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA.
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17
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Robin M, Surjous L, Belbèze J, Bonnardel L, Lamas C, Silva J, Peres V, Corcos M. Four attachment-based categories of emotion regulation in adolescent psychic troubles. Front Psychol 2023; 14:1133980. [PMID: 37275718 PMCID: PMC10237043 DOI: 10.3389/fpsyg.2023.1133980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/06/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Emotion regulation is altered in many psychiatric disorders in adolescence, but the understanding of mechanisms that underlie this alteration is still poor. Methods The PERCEPT study explores alexithymia, empathy, facial emotion recognition (FER) and defence mechanisms in a sample of adolescents in psychiatric care (n = 61, 74% of girls, mean age = 15.03 y.o.), in relation with participants' attachment styles. Results Results revealed correlations between attachment dimensions and all of the emotion regulation variables, suggesting that attachment modalities have functional links with emotional regulation at its different levels: FER accuracy was inversely correlated with avoidant attachment, while affective empathy, difficulty in identifying feelings (alexithymia) and immature as well as neurotic defence mechanisms were positively correlated with anxious attachment. Moreover, attachment categories delineated distinct emotional perception profiles. In particular, preoccupied attachment included adolescents with the highest levels of facial emotion perception (sensitivity and accuracy) and of affective empathy, whereas detached attachment included adolescents with the lowest levels of these variables. Neurotic defence mechanisms and difficulty to identify feelings were correlated with preoccupied attachment; immature defence mechanisms and difficulty to describe feelings to others characterized fearful attachment. Discussion These results suggest that attachment categories underlie emotion regulation processes in psychiatric disorders in adolescence. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- CESP, INSERM U1178, Paris-Saclay University, Villejuif, France
| | - Luc Surjous
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Paris Cité University, Paris, France
| | - Jean Belbèze
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Paris Cité University, Paris, France
| | - Lucile Bonnardel
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Claire Lamas
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Jérôme Silva
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Victoire Peres
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Maurice Corcos
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Paris Cité University, Paris, France
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18
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Zouraraki C, Karamaouna P, Giakoumaki SG. Cognitive Processes and Resting-State Functional Neuroimaging Findings in High Schizotypal Individuals and Schizotypal Personality Disorder Patients: A Systematic Review. Brain Sci 2023; 13:615. [PMID: 37190580 PMCID: PMC10137138 DOI: 10.3390/brainsci13040615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 04/07/2023] Open
Abstract
Ample research findings indicate that there is altered brain functioning in the schizophrenia spectrum. Nevertheless, functional neuroimaging findings remain ambiguous for healthy individuals expressing high schizotypal traits and patients with schizotypal personality disorder (SPD). The purpose of this systematic review was to identify patterns of task-related and resting-state neural abnormalities across these conditions. MEDLINE-PubMed and PsycINFO were systematically searched and forty-eight studies were selected. Forty studies assessed healthy individuals with high schizotypal traits and eight studies examined SPD patients with functional neuroimaging techniques (fNIRS; fMRI; Resting-state fMRI). Functional alterations in striatal, frontal and temporal regions were found in healthy individuals with high schizotypal traits. Schizotypal personality disorder was associated with default mode network abnormalities but further research is required in order to better conceive its neural correlates. There was also evidence for functional compensatory mechanisms associated with both conditions. To conclude, the findings suggest that brain dysfunctions are evident in individuals who lie along the subclinical part of the spectrum, further supporting the continuum model for schizophrenia susceptibility. Additional research is required in order to delineate the counterbalancing processes implicated in the schizophrenia spectrum, as this approach will provide promising insights for both conversion and protection from conversion into schizophrenia.
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Affiliation(s)
- Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, 74100 Rethymno, Greece; (C.Z.); (P.K.)
- University of Crete Research Center for the Humanities, The Social and Education Sciences (UCRC), University of Crete, Gallos University Campus, 74100 Rethymno, Greece
| | - Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, 74100 Rethymno, Greece; (C.Z.); (P.K.)
- University of Crete Research Center for the Humanities, The Social and Education Sciences (UCRC), University of Crete, Gallos University Campus, 74100 Rethymno, Greece
| | - Stella G. Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, 74100 Rethymno, Greece; (C.Z.); (P.K.)
- University of Crete Research Center for the Humanities, The Social and Education Sciences (UCRC), University of Crete, Gallos University Campus, 74100 Rethymno, Greece
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19
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Hudson M, Santavirta S, Putkinen V, Seppälä K, Sun L, Karjalainen T, Karlsson HK, Hirvonen J, Nummenmaa L. Neural responses to biological motion distinguish autistic and schizotypal traits. Soc Cogn Affect Neurosci 2023; 18:nsad011. [PMID: 36847146 PMCID: PMC10032360 DOI: 10.1093/scan/nsad011] [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: 09/15/2022] [Revised: 01/26/2023] [Accepted: 02/24/2023] [Indexed: 03/01/2023] Open
Abstract
Difficulties in social interactions characterize both autism and schizophrenia and are correlated in the neurotypical population. It is unknown whether this represents a shared etiology or superficial phenotypic overlap. Both conditions exhibit atypical neural activity in response to the perception of social stimuli and decreased neural synchronization between individuals. This study investigated if neural activity and neural synchronization associated with biological motion perception are differentially associated with autistic and schizotypal traits in the neurotypical population. Participants viewed naturalistic social interactions while hemodynamic brain activity was measured with fMRI, which was modeled against a continuous measure of the extent of biological motion. General linear model analysis revealed that biological motion perception was associated with neural activity across the action observation network. However, intersubject phase synchronization analysis revealed neural activity to be synchronized between individuals in occipital and parietal areas but desynchronized in temporal and frontal regions. Autistic traits were associated with decreased neural activity (precuneus and middle cingulate gyrus), and schizotypal traits were associated with decreased neural synchronization (middle and inferior frontal gyri). Biological motion perception elicits divergent patterns of neural activity and synchronization, which dissociate autistic and schizotypal traits in the general population, suggesting that they originate from different neural mechanisms.
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Affiliation(s)
- Matthew Hudson
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
- School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK
- Brain Research & Imaging Centre, Faculty of Health, University of Plymouth, Research Way, Plymouth PL6 8BU, UK
| | - Severi Santavirta
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Vesa Putkinen
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Kerttu Seppälä
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
- Department of Medical Physics, Turku University Hospital, Turku 20520, Finland
| | - Lihua Sun
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Tomi Karjalainen
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Henry K Karlsson
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Turku University Hospital, Turku 20520, Finland
| | - Jussi Hirvonen
- Department of Radiology, University of Turku and Turku University Hospital, Turku 20520, Finland
- Medical Imaging Centre, Department of Radiology, Tampere University and Tampere University Hospital, Tampere 33100, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku 20520, Finland
- Department of Psychology, University of Turku, Turku 20520, Finland
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20
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Li Q, Xu X, Qian Y, Cai H, Zhao W, Zhu J, Yu Y. Resting-state brain functional alterations and their genetic mechanisms in drug-naive first-episode psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:13. [PMID: 36841861 PMCID: PMC9968350 DOI: 10.1038/s41537-023-00338-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 02/27/2023]
Abstract
Extensive research has established the presence of resting-state brain functional damage in psychosis. However, the genetic mechanisms of such disease phenotype are yet to be unveiled. We investigated resting-state brain functional alterations in patients with drug-naive first-episode psychosis (DFP) by performing a neuroimaging meta-analysis of 8 original studies comprising 500 patients and 469 controls. Combined with the Allen Human Brain Atlas, we further conducted transcriptome-neuroimaging spatial correlations to identify genes whose expression levels were linked to brain functional alterations in DFP, followed by a range of gene functional characteristic analyses. Meta-analysis revealed a mixture of increased and decreased brain function in widespread areas including the default-mode, visual, motor, striatal, and cerebellar systems in DFP. Moreover, these brain functional alterations were spatially associated with the expression of 1662 genes, which were enriched for molecular functions, cellular components, and biological processes of the cerebral cortex, as well as psychiatric disorders including schizophrenia. Specific expression analyses demonstrated that these genes were specifically expressed in the brain tissue, in cortical neurons and immune cells, and during nearly all developmental periods. Concurrently, the genes could construct a protein-protein interaction network supported by hub genes and were linked to multiple behavioral domains including emotion, attention, perception, and motor. Our findings provide empirical evidence for the notion that brain functional damage in DFP involves a complex interaction of polygenes with various functional characteristics.
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Affiliation(s)
- Qian Li
- grid.459419.4Department of Radiology, Chaohu Hospital of Anhui Medical University, 238000 Hefei, China ,grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, China ,Research Center of Clinical Medical Imaging, Anhui Province, 230032 Hefei, China ,Anhui Provincial Institute of Translational Medicine, 230032 Hefei, China
| | - Xiaotao Xu
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, China ,Research Center of Clinical Medical Imaging, Anhui Province, 230032 Hefei, China ,Anhui Provincial Institute of Translational Medicine, 230032 Hefei, China
| | - Yinfeng Qian
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, China ,Research Center of Clinical Medical Imaging, Anhui Province, 230032 Hefei, China ,Anhui Provincial Institute of Translational Medicine, 230032 Hefei, China
| | - Huanhuan Cai
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, China ,Research Center of Clinical Medical Imaging, Anhui Province, 230032 Hefei, China ,Anhui Provincial Institute of Translational Medicine, 230032 Hefei, China
| | - Wenming Zhao
- grid.412679.f0000 0004 1771 3402Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, China ,Research Center of Clinical Medical Imaging, Anhui Province, 230032 Hefei, China ,Anhui Provincial Institute of Translational Medicine, 230032 Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022, Hefei, China. .,Research Center of Clinical Medical Imaging, Anhui Province, 230032, Hefei, China. .,Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 230022, Hefei, China. .,Research Center of Clinical Medical Imaging, Anhui Province, 230032, Hefei, China. .,Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China.
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21
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Vucurovic K, Raucher-Chéné D, Obert A, Gobin P, Henry A, Barrière S, Traykova M, Gierski F, Portefaix C, Caillies S, Kaladjian A. Activation of the left medial temporal gyrus and adjacent brain areas during affective theory of mind processing correlates with trait schizotypy in a nonclinical population. Soc Cogn Affect Neurosci 2023; 18:6701589. [PMID: 36107738 PMCID: PMC9949503 DOI: 10.1093/scan/nsac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/31/2022] [Accepted: 09/13/2022] [Indexed: 11/12/2022] Open
Abstract
Schizophrenia, a severe psychiatric disorder, is associated with abnormal brain activation during theory of mind (ToM) processing. Researchers recently suggested that there is a continuum running from subclinical schizotypal personality traits to fully expressed schizophrenia symptoms. Nevertheless, it remains unclear whether schizotypal personality traits in a nonclinical population are associated with atypical brain activation during ToM tasks. Our aim was to investigate correlations between fMRI brain activation during affective ToM (ToMA) and cognitive ToM (ToMC) tasks and scores on the Schizotypal Personality Questionnaire (SPQ) and the Basic Empathy Scale in 39 healthy individuals. The total SPQ score positively correlated with brain activation during ToMA processing in clusters extending from the left medial temporal gyrus (MTG), lingual gyrus and fusiform gyrus to the parahippocampal gyrus (Brodmann area: 19). During ToMA processing, the right inferior occipital gyrus, right MTG, precuneus and posterior cingulate cortex negatively correlated with the emotional disconnection subscore and the total score of self-reported empathy. These posterior brain regions are known to be involved in memory and language, as well as in creative reasoning, in nonclinical individuals. Our findings highlight changes in brain processing associated with trait schizotypy in nonclinical individuals during ToMA but not ToMC processing.
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Affiliation(s)
- Ksenija Vucurovic
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Centre Rémois de Psychothérapie et Neuromodulation, 51100 Reims, France
| | - Delphine Raucher-Chéné
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France.,McGill University, Douglas Mental Health University Institute, 11290 Montreal, Canada
| | - Alexandre Obert
- Champollion National University Institute, Cognition Sciences, Technology & Ergonomics Laboratory, University of Toulouse, 81000 Albi, France
| | - Pamela Gobin
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Audrey Henry
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Sarah Barrière
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Martina Traykova
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France
| | - Fabien Gierski
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France.,INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, 80000 Amiens, France
| | - Christophe Portefaix
- Radiology Department, Reims University Hospital, 51100 Reims, France.,University of Reims Champagne-Ardenne, CReSTIC Laboratory, 51100 Reims, France
| | - Stéphanie Caillies
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France
| | - Arthur Kaladjian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société, EA 6291, 51100 Reims, France.,Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 51100 Reims, France.,University of Reims Champagne-Ardenne Faculty of Medicine, 51100 Reims, France
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22
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Deng X, Zhang S, Chen X, Coplan RJ, Xiao B, Ding X. Links between social avoidance and frontal alpha asymmetry during processing emotional facial stimuli: An exploratory study. Biol Psychol 2023; 178:108516. [PMID: 36792050 DOI: 10.1016/j.biopsycho.2023.108516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
Individuals who are socially avoidant actively remove themselves from opportunities for social interaction and have a strong desire for solitude. Although social avoidance is associated with a host of adjustment difficulties, its neural substrates remain under-explored. To address this gap, we conducted an exploratory study to compare electroencephalography (EEG) frontal alpha asymmetry (FAA) scores during processing emotional facial stimuli in socially avoidant and non-withdrawn comparison individuals. From an original sample of N = 384 undergraduate students, 25 avoidant and 27 comparison individuals were identified. For this subset of participants, EEG modulations and self-reported experience ratings during a picture processing task were assessed. Among the results, the socially avoidant group's ratings of positive stimuli were significantly lower than the non-withdrawn comparison group. The socially avoidant group also had significantly lower FAA scores in response to positive stimuli than the comparison group. Further, asymmetry scores of the comparison group in the positive conditions were higher than in the negative and neutral conditions. However, there were no significant differences between these three conditions in the socially avoidant group. Our results suggest that socially avoidant individuals may eschew interpersonal relationships because of a relatively greater right hemisphere cortical activity, which may contribute to a withdrawal motivation when confronted with negative emotional stimuli in social contexts.
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Affiliation(s)
- Xinmei Deng
- School of Psychology, Shenzhen University, Shenzhen, China; The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, China
| | - Simin Zhang
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Xiaomin Chen
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Robert J Coplan
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Bowen Xiao
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, Canada
| | - Xuechen Ding
- Department of Psychology, Shanghai Normal University, Shanghai, China; The Research Base of Online Education for Shanghai Middle and Primary Schools, Shanghai, China.
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23
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Zouraraki C, Karamaouna P, Giakoumaki SG. Facial emotion recognition and schizotypal traits: A systematic review of behavioural studies. Early Interv Psychiatry 2023; 17:121-140. [PMID: 35840128 DOI: 10.1111/eip.13328] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 03/19/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
AIM Previous research has indicated that individuals expressing high schizotypal traits and patients with Schizotypal Personality Disorder (SPD), show deficits in facial emotion recognition, compared to low schizotypal or control groups. On the other hand, non-significant findings also exist and the association of facial emotion recognition deficits with the different schizotypal dimensions is not well defined, thus limiting any conclusive outcomes. Therefore, the aim of this systematic review was to further clarify this relationship. METHODS PsychInfo, Web of Science, Scopus and PubMed were systematically searched, and 23 papers with a cross-sectional design were selected. Nineteen studies examined individuals with high schizotypal traits and four studies evaluated SPD individuals with behavioural facial emotion recognition paradigms and self-report measures or clinical interviews for schizotypal traits. All selected studies were published between 1994 and August 2020. RESULTS According to the evidence of studies, high schizotypal individuals and SPD patients have poorer performance in facial emotion recognition tasks. Negative schizotypy was related to lower accuracy for positive and negative emotions and faster emotion labeling while positive schizotypy was associated with worse accuracy for positive, negative and neutral emotions and more biases. Disorganized schizotypy was associated with poorer accuracy for negative emotions and suspiciousness with higher accuracy for disgust faces but lower total accuracy. CONCLUSIONS These findings are consistent with the vulnerability for schizophrenia spectrum disorders and support the idea that emotion recognition deficits are trait markers for these conditions. Thus, the effectiveness of early-intervention programmes could increase by also targeting this class of deficits.
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Affiliation(s)
- Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece
- University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece
- University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece
- University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
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24
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Livet A, Pétrin-Pomerleau P, Pocuca N, Afzali MH, Potvin S, Conrod PJ. Development of the French version of the Davos Assessment of Cognitive Biases Scale in a non-clinical sample of young adults. Early Interv Psychiatry 2023; 17:141-148. [PMID: 35362245 DOI: 10.1111/eip.13297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/24/2022] [Accepted: 03/13/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND In accordance with continuum and cognitive behaviour models of psychosis, cognitive biases precede the onset and the maintenance of positive symptoms. The Davos Assessment of Cognitive Biases Scale (DACOBS), a self-report measure, was developed to explore the prevalence of specific cognitive biases. This study aims to validate the French version of this instrument. METHODS We first translated the English version of the DACOBS into French. Then, using a sample of 213 French speaking young adults (mean age = 20.54, SD = 1.65; 83% females), we examined the factor structure, internal consistency, concurrent, and convergent validities of the current version. RESULTS We found an 18-item, four-factor version of the French DACOBS comprising external attribution bias (five items), social cognition problems (five items), subjective cognition problems (five items), and safety behaviours (five items), provided best fit-to-data. Internal consistency for the resulting subscales ranged from acceptable to excellent (Cronbach's α range = .62-.86). All subscales were significantly, positively associated with a measure of psychotic-like experiences and positively associated with established measures of theoretically relevant constructs, demonstrating concurrent and convergent validity of the French DACOBS. CONCLUSIONS The French DACOBS is a reliable and valid and reliable instrument assessing cognitive biases, in a French-speaking youth population. Ultimately, the French DACOBS may be used to identify at-risk youth which may benefit from cognitive interventions targeting cognitive biases, safety behaviours and social cognition which could potentially prevent transition to psychosis in youth.
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Affiliation(s)
- Audrey Livet
- CHU Sainte-Justine, Mother and Child University Hospital Center, CHU Sainte-Justine Research Center, Montréal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Philippe Pétrin-Pomerleau
- CHU Sainte-Justine, Mother and Child University Hospital Center, CHU Sainte-Justine Research Center, Montréal, QC, Canada
| | - Nina Pocuca
- CHU Sainte-Justine, Mother and Child University Hospital Center, CHU Sainte-Justine Research Center, Montréal, QC, Canada
- School of Psychoeducation, Faculty of Arts and Sciences, Université de Montréal, Montréal, QC, Canada
| | - Mohammad H Afzali
- CHU Sainte-Justine, Mother and Child University Hospital Center, CHU Sainte-Justine Research Center, Montréal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Stephane Potvin
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- CIUSS de l'Est de l'île de Montréal, Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia J Conrod
- CHU Sainte-Justine, Mother and Child University Hospital Center, CHU Sainte-Justine Research Center, Montréal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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25
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Vos S, Collignon O, Boets B. The Sound of Emotion: Pinpointing Emotional Voice Processing Via Frequency Tagging EEG. Brain Sci 2023; 13:brainsci13020162. [PMID: 36831705 PMCID: PMC9954097 DOI: 10.3390/brainsci13020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Successfully engaging in social communication requires efficient processing of subtle socio-communicative cues. Voices convey a wealth of social information, such as gender, identity, and the emotional state of the speaker. We tested whether our brain can systematically and automatically differentiate and track a periodic stream of emotional utterances among a series of neutral vocal utterances. We recorded frequency-tagged EEG responses of 20 neurotypical male adults while presenting streams of neutral utterances at a 4 Hz base rate, interleaved with emotional utterances every third stimulus, hence at a 1.333 Hz oddball frequency. Four emotions (happy, sad, angry, and fear) were presented as different conditions in different streams. To control the impact of low-level acoustic cues, we maximized variability among the stimuli and included a control condition with scrambled utterances. This scrambling preserves low-level acoustic characteristics but ensures that the emotional character is no longer recognizable. Results revealed significant oddball EEG responses for all conditions, indicating that every emotion category can be discriminated from the neutral stimuli, and every emotional oddball response was significantly higher than the response for the scrambled utterances. These findings demonstrate that emotion discrimination is fast, automatic, and is not merely driven by low-level perceptual features. Eventually, here, we present a new database for vocal emotion research with short emotional utterances (EVID) together with an innovative frequency-tagging EEG paradigm for implicit vocal emotion discrimination.
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Affiliation(s)
- Silke Vos
- Center for Developmental Psychiatry, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, 3000 Leuven, Belgium
- Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-16-37-76-83
| | - Olivier Collignon
- Institute of Research in Psychology & Institute of Neuroscience, Université Catholique de Louvain, 1348 Louvain-La-Neuve, Belgium
- School of Health Sciences, HES-SO Valais-Wallis, The Sense Innovation and Research Center, 1007 Lausanne and 1950 Sion, Switzerland
| | - Bart Boets
- Center for Developmental Psychiatry, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Leuven Autism Research (LAuRes), KU Leuven, 3000 Leuven, Belgium
- Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
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Fiorito AM, Aleman A, Blasi G, Bourque J, Cao H, Chan RCK, Chowdury A, Conrod P, Diwadkar VA, Goghari VM, Guinjoan S, Gur RE, Gur RC, Kwon JS, Lieslehto J, Lukow PB, Meyer-Lindenberg A, Modinos G, Quarto T, Spilka MJ, Shivakumar V, Venkatasubramanian G, Villarreal M, Wang Y, Wolf DH, Yun JY, Fakra E, Sescousse G. Are Brain Responses to Emotion a Reliable Endophenotype of Schizophrenia? An Image-Based Functional Magnetic Resonance Imaging Meta-analysis. Biol Psychiatry 2023; 93:167-177. [PMID: 36085080 DOI: 10.1016/j.biopsych.2022.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Impaired emotion processing constitutes a key dimension of schizophrenia and a possible endophenotype of this illness. Empirical studies consistently report poorer emotion recognition performance in patients with schizophrenia as well as in individuals at enhanced risk of schizophrenia. Functional magnetic resonance imaging studies also report consistent patterns of abnormal brain activation in response to emotional stimuli in patients, in particular, decreased amygdala activation. In contrast, brain-level abnormalities in at-risk individuals are more elusive. We address this gap using an image-based meta-analysis of the functional magnetic resonance imaging literature. METHODS Functional magnetic resonance imaging studies investigating brain responses to negative emotional stimuli and reporting a comparison between at-risk individuals and healthy control subjects were identified. Frequentist and Bayesian voxelwise meta-analyses were performed separately, by implementing a random-effect model with unthresholded group-level T-maps from individual studies as input. RESULTS In total, 17 studies with a cumulative total of 677 at-risk individuals and 805 healthy control subjects were included. Frequentist analyses did not reveal significant differences between at-risk individuals and healthy control subjects. Similar results were observed with Bayesian analyses, which provided strong evidence for the absence of meaningful brain activation differences across the entire brain. Region of interest analyses specifically focusing on the amygdala confirmed the lack of group differences in this region. CONCLUSIONS These results suggest that brain activation patterns in response to emotional stimuli are unlikely to constitute a reliable endophenotype of schizophrenia. We suggest that future studies instead focus on impaired functional connectivity as an alternative and promising endophenotype.
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Affiliation(s)
- Anna M Fiorito
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, PSYR2 Team, University of Lyon, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.
| | - André Aleman
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, The Netherlands
| | - Giuseppe Blasi
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Josiane Bourque
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Asadur Chowdury
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Department of Psychiatry and Addiction, University of Montréal, Montreal, Quebec, Canada
| | - Vaibhav A Diwadkar
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Vina M Goghari
- Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | | | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Johannes Lieslehto
- University of Eastern Finland, Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland
| | - Paulina B Lukow
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Michael J Spilka
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | | | - Mirta Villarreal
- Instituto de Neurociencias FLENI-CONICET, Facultad de Ciencias Exactas y Naturales, UBA, Buenos Aires, Argentina
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eric Fakra
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, PSYR2 Team, University of Lyon, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Guillaume Sescousse
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, PSYR2 Team, University of Lyon, Lyon, France; Centre Hospitalier Le Vinatier, Bron, France
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Cai M, Wang R, Liu M, Du X, Xue K, Ji Y, Wang Z, Zhang Y, Guo L, Qin W, Zhu W, Fu J, Liu F. Disrupted local functional connectivity in schizophrenia: An updated and extended meta-analysis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:93. [PMID: 36347874 PMCID: PMC9643538 DOI: 10.1038/s41537-022-00311-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/31/2022] [Indexed: 06/06/2023]
Abstract
Neuroimaging studies have shown that schizophrenia is associated with disruption of resting-state local functional connectivity. However, these findings vary considerably, which hampers our understanding of the underlying pathophysiological mechanisms of schizophrenia. Here, we performed an updated and extended meta-analysis to identify the most consistent changes of local functional connectivity measured by regional homogeneity (ReHo) in schizophrenia. Specifically, a systematic search of ReHo studies in patients with schizophrenia in PubMed, Embase, and Web of Science identified 18 studies (20 datasets), including 652 patients and 596 healthy controls. In addition, we included three whole-brain statistical maps of ReHo differences calculated based on independent datasets (163 patients and 194 controls). A voxel-wise meta-analysis was then conducted to investigate ReHo alterations and their relationship with clinical characteristics using the newly developed seed-based d mapping with permutation of subject images (SDM-PSI) meta-analytic approach. Compared with healthy controls, patients with schizophrenia showed significantly higher ReHo in the bilateral medial superior frontal gyrus, while lower ReHo in the bilateral postcentral gyrus, right precentral gyrus, and right middle occipital gyrus. The following sensitivity analyses including jackknife analysis, subgroup analysis, heterogeneity test, and publication bias test demonstrated that our results were robust and highly reliable. Meta-regression analysis revealed that illness duration was negatively correlated with ReHo abnormalities in the right precentral/postcentral gyrus. This comprehensive meta-analysis not only identified consistent and reliably aberrant local functional connectivity in schizophrenia but also helped to further deepen our understanding of its pathophysiology.
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Affiliation(s)
- Mengjing Cai
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Rui Wang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300070, China
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Mengge Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Xiaotong Du
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Kaizhong Xue
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Yuan Ji
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Zirui Wang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Yijing Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Lining Guo
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Wenshuang Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Jilian Fu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Feng Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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Schoeneman Patel SE, Haut KM, Guty E, Dodell-Feder D, Saxena A, Nahum M, Hooker CI. Social cognition training improves recognition of distinct facial emotions and decreases misattribution errors in healthy individuals. Front Psychiatry 2022; 13:1026418. [PMID: 36424990 PMCID: PMC9680726 DOI: 10.3389/fpsyt.2022.1026418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
Facial emotion recognition is a key component of social cognition. Impaired facial emotion recognition is tied to poor psychological wellbeing and deficient social functioning. While previous research has demonstrated the potential for social cognition training to improve overall facial emotion recognition, questions remain regarding what aspects of emotion recognition improve. We report results from a randomized controlled trial that evaluates whether computerized social cognition training can improve recognition of distinct facial emotions in healthy participants. This investigation was designed to better understand the therapeutic potential of social cognition training for individuals with neuropsychiatric disorders. Fifty-five healthy adult participants were randomly assigned to an internet-based intervention during which they either completed social cognition training (SCT) or played control computer games (CON) for 10.5 h over 2-3 weeks. Facial emotion recognition was measured with the Penn ER-40, which was conducted before and after training. The following variables were collected and analyzed: facial emotion recognition accuracy for each emotion (i.e., anger, fear, happy, neutral (no emotional expression), and sad), reaction times for each emotion, and response error types (i.e., frequency of an emotion being chosen incorrectly, frequency of an emotion being missed, and frequency of an emotion being confused for another particular emotion). ANOVAs and t-tests were used to elucidate intervention effects both within and between groups. Results showed that the SCT group improved their accuracy for angry and neutral faces. They also improved their reaction times for neutral, fearful, and sad faces. Compared to the CON group, the SCT group had significantly faster reaction times to neutral faces after training. Lastly, the SCT group decreased their tendency to confuse angry faces for no emotional expression and to confuse no emotional expression for sad faces. In contrast, the CON group did not significantly improve their accuracy or reaction times on any emotional expression, and they did not improve their response error types. We conclude that social cognition training can improve recognition of distinct emotions in healthy participants and decrease response error patterns, suggesting it has the potential to improve impaired emotion recognition and social functioning in individuals with facial emotion recognition deficits.
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Affiliation(s)
- Samantha Evy Schoeneman Patel
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kristen M. Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Erin Guty
- Department of Psychology, Pennsylvania State University, State College, PA, United States
- The Charleston Consortium Psychology Internship, Ralph H. Johnson Veterans Affairs Medical Center, Medical University of South Carolina, Charleston, SC, United States
| | - David Dodell-Feder
- Department of Psychology, University of Rochester, Rochester, NY, United States
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, United States
| | - Abhishek Saxena
- Department of Psychology, University of Rochester, Rochester, NY, United States
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Christine I. Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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29
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Braak S, Su T, Krudop W, Pijnenburg YAL, Reus LM, van der Wee N, Bilderbeck AC, Dawson GR, van Rossum IW, Campos AV, Arango C, Saris IMJ, Kas MJ, Penninx BWJH. Theory of Mind and social functioning among neuropsychiatric disorders: A transdiagnostic study. Eur Neuropsychopharmacol 2022; 64:19-29. [PMID: 36070667 DOI: 10.1016/j.euroneuro.2022.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022]
Abstract
Social dysfunction is commonly present in neuropsychiatric disorders of schizophrenia (SZ) and Alzheimer's disease (AD). Theory of Mind (ToM) deficits have been linked to social dysfunction in disease-specific studies. Nevertheless, it remains unclear how ToM is related to social functioning across these disorders, and which factors contribute to this relationship. We investigated transdiagnostic associations between ToM and social functioning among SZ/AD patients and healthy controls, and explored to what extent these associations relate to information processing speed or facial emotion recognition capacity. A total of 163 participants were included (SZ: n=56, AD: n=50 and age-matched controls: n=57). Social functioning was assessed with the Social Functioning Scale (SFS) and the De Jong-Gierveld Loneliness Scale (LON). ToM was measured with the Hinting Task. Information processing speed was measured by the Digit Symbol Substitution Test (DSST) and facial emotion recognition capacity by the facial emotion recognition task (FERT). Case-control deficits in Hinting Task performance were larger in AD (rrb = -0.57) compared to SZ (rrb = -0.35). Poorer Hinting Task performance was transdiagnostically associated with the SFS (βHinting-Task = 1.20, p<0.01) and LON (βHinting-Task = -0.27, p<0.05). DSST, but not FERT, reduced the association between the SFS and Hinting Task performance, however the association remained significant (βHinting-Task = 0.95, p<0.05). DSST and FERT performances did not change the association between LON and Hinting Task performance. Taken together, ToM deficits are transdiagnostically associated with social dysfunction and this is partly related to reduced information processing speed.
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Affiliation(s)
- S Braak
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress program, Amsterdam, the Netherlands.
| | - T Su
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress program, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amsterdam, the Netherlands
| | - W Krudop
- St Antonius ziekenhuis, Department of Psychiatry, Utrecht, the Netherlands
| | - Y A L Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands; Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - L M Reus
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands; Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - N van der Wee
- Leiden University Medical Centre, Department of Psychiatry, the Netherlands
| | - A C Bilderbeck
- P1vital Ltd. Manor House, Howbery Park, Wallingford, United Kingdom
| | - G R Dawson
- P1vital Ltd. Manor House, Howbery Park, Wallingford, United Kingdom
| | - I Winter- van Rossum
- University Medical Center Utrecht Brain Center, Department of Psychiatry The Netherlands
| | - A Vieira Campos
- Department of Neurology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa, Spain; Centre of Biomedical Research in Mental Health, CIBERSAM, Spain
| | - C Arango
- Centre of Biomedical Research in Mental Health, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañon University Hospital, IiSGM, Spain; Universidad Complutense de Madrid, Spain
| | - I M J Saris
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress program, Amsterdam, the Netherlands
| | - M J Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - B W J H Penninx
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress program, Amsterdam, the Netherlands
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30
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Goh KK, Lu ML. Relationship between the domains of theory of mind, social dysfunction, and oxytocin in schizophrenia. J Psychiatr Res 2022; 155:420-429. [PMID: 36182771 DOI: 10.1016/j.jpsychires.2022.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 08/28/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022]
Abstract
Social dysfunction, manifested by impaired social cognition, is contributing to poorer prognosis of patients with schizophrenia. Growing evidence indicates that oxytocin acts as a neurotransmitter in the regulation of social cognition. It still lacks a thorough understanding of how oxytocin is linked with deficits in social cognition and social functioning in schizophrenia. To this end, we aimed to study the role of plasma oxytocin levels in the relationship between subdomains of social cognition and social dysfunction in patients with schizophrenia. Social Functioning Scale was administered to measure social dysfunction while Faux Pas Recognition Test was used to assess the Theory of Mind (ToM) in 40 patients with schizophrenia and 40 age-matched healthy controls. Patients with schizophrenia exhibited more deficits in ToM, more severe social dysfunction, and had lower plasma oxytocin levels, relative to healthy controls. A pooled correlation analysis of all participants revealed significant effects of plasma oxytocin levels on the ToM and social dysfunction. In patients with schizophrenia, plasma oxytocin levels were positively correlated with the affective but not cognitive component of the ToM, and the effects of plasma oxytocin levels on social functioning were partially mediated by affective ToM. Our findings underscore the importance of oxytocin as a potential predictor of ToM and social functioning in patients with schizophrenia. It may be worthwhile for future studies of oxytocin in schizophrenia to focus on an affected behavioral domain, e.g., social cognition, rather than diagnosis, and the targeted domain should be deconstructed into more detailed subdomains.
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Affiliation(s)
- Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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31
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Corpus Callosum Microstructural Tract Integrity Relates to Longer Emotion Recognition Reaction Time in People with Schizophrenia. Brain Sci 2022; 12:brainsci12091208. [PMID: 36138944 PMCID: PMC9496923 DOI: 10.3390/brainsci12091208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: Schizophrenia is a complex functionally debilitating neurodevelopmental disorder, with associated social cognitive impairment. Corpus Callosum (CC) white matter tracts deficits are reported for people with schizophrenia; however, few studies focus on interhemispheric processing relative to social cognition tasks. This study aimed to determine if a relationship between the CC and social cognition exists. Method: In this cross-section study, a sample of n = 178 typical controls and n = 58 people with schizophrenia completed measures of mentalising (Reading the Mind in the Eyes), emotion recognition outcome and reaction time (Emotion Recognition Test), and clinical symptoms (Positive and Negative Symptom Scale), alongside diffusion-based tract imaging. The CC and its subregions, i.e., the genu, body, and splenium were the regions of interest (ROI). Results: Reduced white matter tract integrity was observed in the CC for patients when compared to controls. Patients performed slower, and less accurately on emotion recognition tasks, which significantly and negatively correlated to the structural integrity of the CC genu. Tract integrity further significantly and negatively related to clinical symptomatology. Conclusions: People with schizophrenia have altered white matter integrity in the genu of the CC, compared to controls, which relates to cognitive deficits associated with recognising emotional stimuli accurately and quickly, and severity of clinical symptoms.
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32
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Ruiz-Castañeda P, Santiago Molina E, Aguirre Loaiza H, Daza González MT. Positive symptoms of schizophrenia and their relationship with cognitive and emotional executive functions. Cogn Res Princ Implic 2022; 7:78. [PMID: 35960384 PMCID: PMC9374871 DOI: 10.1186/s41235-022-00428-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Positive symptoms of schizophrenia are associated with significant difficulties in daily functioning, and these difficulties have been associated with impaired executive functions (EEFF). However, specific cognitive and socio-emotional executive deficits have not been fully established. OBJECTIVE The present study has several objectives. First, we aimed to examine the specific deficits in cognitive and socio-emotional EEFF in a group of patients with schizophrenia with a predominance of positive symptoms, as well as to determine if these patients present clinically significant scores in any of the three fronto-subcortical behavioral syndromes: Dorsolateral, Orbitofrontal, or Anterior Cingulate. METHOD The sample consisted of 54 patients, 27 with a predominance of positive symptoms, and 27 healthy controls matched for gender, age, and education. The two groups completed four cognitive and three socio-emotional EEFF tasks. In the group of patients, positive symptoms were evaluated using the scale for the Evaluation of Positive Symptoms (SANS), while the behavioral alterations associated with the three fronto-subcortical syndromes were evaluated using the Frontal System Behavior Scale (FrSBe). RESULTS The patients, in comparison with a control group, presented specific deficits in cognitive and socio-emotional EEFF. In addition, a high percentage of patients presented clinically significant scores on the three fronto-subcortical syndromes. CONCLUSION The affectation that these patients present, in terms of both cognitive and emotional components, highlights the importance of developing a neuropsychological EEFF intervention that promotes the recovery of the affected cognitive capacities and improves the social and emotional functioning of the affected patients.
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Affiliation(s)
- Pamela Ruiz-Castañeda
- Neuropsychological Evaluation and Rehabilitation Center (CERNEP), University of Almeria, Carretera de Sacramento, s / n. La Cañada de San Urbano. 04120, Almeria, Spain
- Department of Psychology, University of Almeria Spain, Carretera de Sacramento, s /n. La Cañada de San Urbano. 04120, Almeria, Spain
| | - Encarnación Santiago Molina
- Mental Health Hospitalization Unit of Torrecárdenas University Hospital, Calle Hermandad de Donantes de Sangre, s/n, 04009, Almería, Spain
| | - Haney Aguirre Loaiza
- Department of Psychology, Catholic University of Pereira, Avenida Sur/Las Americas Cra 21 # 49-95, Pereira, Colombia
| | - María Teresa Daza González
- Neuropsychological Evaluation and Rehabilitation Center (CERNEP), University of Almeria, Carretera de Sacramento, s / n. La Cañada de San Urbano. 04120, Almeria, Spain.
- Department of Psychology, University of Almeria Spain, Carretera de Sacramento, s /n. La Cañada de San Urbano. 04120, Almeria, Spain.
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33
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Resting-state functional connectivity of salience network in schizophrenia and depression. Sci Rep 2022; 12:11204. [PMID: 35778603 PMCID: PMC9249853 DOI: 10.1038/s41598-022-15489-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 06/24/2022] [Indexed: 11/08/2022] Open
Abstract
To explore the salience network (SN) functional alterations in schizophrenia and depression, resting-state functional magnetic resonance imaging (rs-fMRI) data from 29 patients with schizophrenia (SCH), 28 patients with depression (DEP) and 30 healthy controls (HC) were obtained. The SN was derived from data-driven group independent component analysis (gICA). ANCOVA and post hoc tests were performed to discover the FC differences of SN between groups. The ANCOVA demonstrated a significant group effect in FC with right inferior and middle temporal gyrus (ITG and MTG), left caudate, and right precentral gyrus. Post-hoc analyses revealed an opposite altered FC pattern between SN and right ITG and MTG for both patient groups. The DEP group showed a reduced FC between SN and right ITG and MTG compared with HC whereas the SCH group showed an increased FC. In addition, the SCH group showed decreased FC between SN and left caudate, and enhanced FC between SN and right precentral gyrus compared to the other two groups. Our findings suggest distinct FC of SN in schizophrenia and depression, supporting that the resting-state FC pattern of SN may be a transdiagnostic difference between depression and schizophrenia and may play a critical role in the pathogenesis of these two disorders.
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34
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Raucher-Chéné D, Lavigne KM, Makowski C, Lepage M. Altered Surface Area Covariance in the Mentalizing Network in Schizophrenia: Insight Into Theory of Mind Processing. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:706-715. [PMID: 32919946 DOI: 10.1016/j.bpsc.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Theory of mind (ToM), the cognitive capacity to attribute mental states to self and others, is robustly affected in schizophrenia. The neural substrates of ToM impairment have been largely studied with functional imaging, but little is known about structural abnormalities. We compared structural covariance (between-subjects correlations of brain regional measures) of magnetic resonance imaging-based cortical surface area between patients with schizophrenia and healthy control subjects and between schizophrenia subgroups based on the patients' ToM ability to examine ToM-specific effects on structural covariance in schizophrenia. METHODS T1-weighted structural images were acquired on a 3T magnetic resonance imaging scanner, and ToM was assessed with the Hinting Task for 104 patients with schizophrenia and 69 healthy control subjects. The sum of surface area was computed for 12 regions of interest selected and compared between groups to examine structural covariance within the often reported mentalizing network: rostral and caudal middle frontal gyrus, inferior parietal lobule, precuneus, and middle and superior temporal gyrus. High and low ToM groups were defined using a median split on the Hinting Task. RESULTS Cortical surface contraction was observed in the schizophrenia group, predominantly in temporoparietal regions. Patients with schizophrenia also exhibited significantly stronger covariance between the right rostral middle frontal gyrus and the right superior temporal gyrus than control subjects (r = 4.015; p < .001). Direct comparisons between high and low ToM subgroups revealed stronger contralateral frontotemporal covariances in the low ToM group. CONCLUSIONS Our results provide evidence for structural changes underlying ToM impairments in schizophrenia that need to be confirmed to develop new therapeutic perspectives.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Cognition, Health, and Society Laboratory EA 6291, University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, Etablissement Public de Santé Mentale de la Marne, Reims, France
| | - Katie M Lavigne
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Carolina Makowski
- Center for Multimodal Imaging and Genetics, University of California, San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California, San Diego School of Medicine, La Jolla, California
| | - Martin Lepage
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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Hou J, Schmitt S, Zhao X, Wang J, Chen J, Mao Z, Qi A, Lu Z, Kircher T, Yang Y, Shi J. Neural Correlates of Facial Emotion Recognition in Non-help-seeking University Students With Ultra-High Risk for Psychosis. Front Psychol 2022; 13:812208. [PMID: 35756282 PMCID: PMC9226575 DOI: 10.3389/fpsyg.2022.812208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Since the introduction of the neurodevelopmental perspective of schizophrenia research on individuals at ultra-high risk for psychosis (UHR) has gained increasing interest, aiming at early detection and intervention. Results from fMRI studies investigating behavioral and brain functional changes in UHR during facial emotion recognition, an essential component of social cognition, showed heterogenous results, probably due clinical diversity across these investigations. This fMRI study investigated emotion recognition in a sub-group of the UHR spectrum, namely non-help-seeking, drug-naïve UHR with high cognitive functioning to reveal the neurofunctional underpinnings of their social functioning in comparison to healthy controls. Methods Two large cohorts of students from an elite University (n 1 = 4,040, n 2 = 4,364) were screened firstly with the Prodromal Questionnaires and by surpassing predefined cut-offs then interviewed with the semi-structured Interview for Psychosis-Risk Syndromes to verify their UHR status. Twenty-one identified non-help-seeking UHR and 23 non-UHR control subjects were scanned with functional magnetic resonance imaging while classifying emotions (i.e., neutral, happy, disgust and fear) in a facial emotion recognition task. Results Behaviorally, no group differences were found concerning accuracy, reaction times, sensitivity or specificity, except that non-help-seeking UHR showed higher specificity when recognizing neutral facial expressions. In comparison to healthy non-UHR controls, non-help-seeking UHR showed generally higher activation in the superior temporal and left Heschl's gyrus as well as in the somatosensory, insular and midcingulate cortex than the control subjects during the entire recognition task regardless of the emotion categories. In an exploratory analysis, in the non-help-seeking UHR group, functional activity in the left superior temporal gyrus was significantly correlated with deficits in the ability to experience emotions at uncorrected statistical thresholds. Conclusions Compared to healthy controls, non-help-seeking UHR show no behavioral deficits during facial emotion recognition, but functional hyperactivities in brain regions associated with this cognitive process. Our study may inspire future early intervention and provide loci for treatment using neural stimulation.
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Affiliation(s)
- Jiaojiao Hou
- Department of Psychosomatic Medicine, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
- Hannover Medical School, Clinics for Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - Xudong Zhao
- Department of Psychosomatic Medicine, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Jiayi Wang
- Tongji University School of Medicine, Shanghai, China
| | - Jianxing Chen
- Tongji University School of Medicine, Shanghai, China
| | - Ziyu Mao
- Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Ansi Qi
- Department of Medical Psychology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Lu
- Department of Psychiatry, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Yunbo Yang
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Jingyu Shi
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
- Division of Medical Humanities and Behavioral Sciences, Tongji University School of Medicine, Shanghai, China
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El Ray LA, Fathy H, Mattar Y, Badie Taher D. Emotion identification and mentalization in non-psychotic first-degree relatives of young adult patients with schizophrenia disorder. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00495-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
Background
Social cognition is a multi-factorial construct defined as the ability to process social information for adaptive functioning. A large body of evidence acknowledges deficits in social cognition as important features in schizophrenia and that such impairment represent a trait deficit. The aim of this study is to assess two social cognitive functions (emotional identification and mentalization) in young non-psychotic first-degree relatives of patients with schizophrenia; and to compare their performance with that of young patients with schizophrenia as well as with young healthy controls. This a comparative, cross-sectional study including 30 young patients with age range 15–25 with schizophrenia disorder, Thirty young non-psychotic siblings of the patients and 30 young healthy subjects. The patients were subjected to PANNNS to assess severity of psychotic symptoms. Selected tests for assessment of basic cognitive abilities and social cognitive functions (using Reading Mind in the Eye Test, Emotion Identification Test and Emotional Intelligence scale) were used for the three groups.
Results
the relatives group show better performance than the patients groups and worse performance than the control group in subtests of basic cognition and social cognition functions using Reading Mind in the Eye Test and Ekman, in addition, there was negative correlation between severity of negative psychotic features and facial emotional identification as measured by Ekman.
Conclusion
Youth who are first-degree relatives of schizophrenia patients show social cognitive deficits, supporting the hypothesis of the role of social cognition impairment as endophenotypic trait in schizophrenia disorder.
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The effects of developmental trauma on theory of mind and its relationship to psychotic experiences: A behavioural study. Psychiatry Res 2022; 312:114544. [PMID: 35417825 DOI: 10.1016/j.psychres.2022.114544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/30/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Developmental psychological trauma induces vulnerability to psychosis. However, the mechanisms underlying this association are poorly understood. Impairments in Theory of Mind (ToM) have been observed in adult survivors of developmental trauma and individuals with psychosis. ToM is therefore a candidate mechanism underlying the association between developmental trauma and psychosis. METHODS We used a computerised version of the Director task - where a participant is instructed by a confederate to move an object around a 4 × 4 grid, whilst taking account of whether these objects are visible to a confederate who instructs the participant - to investigate impairments in ToM in 209 participants (age: M = 37.8, SD=13.6; 56% female). Participants were divided into a) developmental trauma-positive (DT+) and control groups (DT-) based on their history of developmental trauma and b) then further into subclinical (S) and healthy groups (H) as based on psychotic experiences indexed by the CAPE-P15. After exclusion, the numbers in each group were: DT+H (47), DT+S (84), DT-H (54), DT-S (12). (Total: 197). RESULTS Developmental trauma exposure was associated with psychotic experiences (OR: 7.89, p < .001), which remained significant after controlling for demographic and clinical confounds (adjusted R2 = 0.452, R2 change = 0.0184, p = .009). Participants with developmental trauma (F1, 194) = 5.46, p = .020, ηp2 = 0.027) and participants more prone to psychotic experiences (F1, 194) = 4.71, p = .031, ηp2 = 0.024) demonstrated significantly lower accuracy on the Director task relative to their respective control, after controlling for the effects of age. CONCLUSIONS ToM deficits are associated with self-reported developmental trauma and psychotic experiences. Further work is needed to explore these relationships further and whether they represent generalised or specific effect effects on developmental trauma and psychopathological domains.
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Weng Y, Lin J, Ahorsu DK, Tsang HWH. Neuropathways of theory of mind in schizophrenia: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 137:104625. [PMID: 35339482 DOI: 10.1016/j.neubiorev.2022.104625] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Social cognition is significantly associated with daily functioning in patients with schizophrenia. Its neural basis remains unknown. METHODS A systematic literature search was performed. Studies using imaging to measure theory of mind (ToM) in schizophrenia were identified. Imaging data were synthesized using the seed-based d mapping approach. Potential neuropathways were hypothesized based on the identified brain regions activated during ToM tasks. RESULTS A total of 25 studies were included in the present study. Compared with healthy people, patients with schizophrenia showed hyperactivations in superior longitudinal fasciculus II and hypoactivations in superior frontal gyrus, precuneus and cuneus, and precentral gyrus during ToM tasks. The primary brain regions involved in the potential neuropathways in schizophrenia were the middle temporal gyrus, superior and inferior frontal gyrus, and supplementary motor areas. CONCLUSION Deactivated brain regions in schizophrenia overlapped with the default mode and salience networks. Our findings shed light on how to develop a diagnostic tool for deficits in social cognition using neuroimaging techniques and effective therapeutic interventions to rectify dysfunction in schizophrenia.
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Affiliation(s)
- Yiting Weng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China
| | - Jingxia Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China; Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China
| | - Daniel Kwasi Ahorsu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China; Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China.
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Association of reduced local activities in the default mode and sensorimotor networks with clinical characteristics in first-diagnosed of schizophrenia. Neuroscience 2022; 495:47-57. [DOI: 10.1016/j.neuroscience.2022.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 01/10/2023]
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40
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Oliver LD, Hawco C, Viviano JD, Voineskos AN. From the Group to the Individual in Schizophrenia Spectrum Disorders: Biomarkers of Social Cognitive Impairments and Therapeutic Translation. Biol Psychiatry 2022; 91:699-708. [PMID: 34799097 DOI: 10.1016/j.biopsych.2021.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/11/2021] [Accepted: 09/11/2021] [Indexed: 12/23/2022]
Abstract
People with schizophrenia spectrum disorders (SSDs) often experience persistent social cognitive impairments, associated with poor functional outcome. There are currently no approved treatment options for these debilitating symptoms, highlighting the need for novel therapeutic strategies. Work to date has elucidated differential social processes and underlying neural circuitry affected in SSDs, which may be amenable to modulation using neurostimulation. Further, advances in functional connectivity mapping and electric field modeling may be used to identify individualized treatment targets to maximize the impact of brain stimulation on social cognitive networks. Here, we review literature supporting a roadmap for translating functional connectivity biomarker discovery to individualized treatment development for social cognitive impairments in SSDs. First, we outline the relevance of social cognitive impairments in SSDs. We review machine learning approaches for dimensional brain-behavior biomarker discovery, emphasizing the importance of individual differences. We synthesize research showing that brain stimulation techniques, such as repetitive transcranial magnetic stimulation, can be used to target relevant networks. Further, functional connectivity-based individualized targeting may enhance treatment response. We then outline recent approaches to account for neuroanatomical variability and optimize coil positioning to individually maximize target engagement. Overall, the synthesized literature provides support for the utility and feasibility of this translational approach to precision treatment. The proposed roadmap to translate biomarkers of social cognitive impairments to individualized treatment is currently under evaluation in precision-guided trials. Such a translational approach may also be applicable across conditions and generalizable for the development of individualized neurostimulation targeting other behavioral deficits.
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Affiliation(s)
- Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joseph D Viviano
- Mila-Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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41
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Eken A, Akaslan DS, Baskak B, Münir K. Diagnostic Classification of Schizophrenia and Bipolar Disorder by Using Dynamic Functional Connectivity: an fNIRS Study. J Neurosci Methods 2022; 376:109596. [DOI: 10.1016/j.jneumeth.2022.109596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/26/2022] [Accepted: 04/08/2022] [Indexed: 11/27/2022]
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Picó-Pérez M, Vieira R, Fernández-Rodríguez M, De Barros MAP, Radua J, Morgado P. Multimodal meta-analysis of structural gray matter, neurocognitive and social cognitive fMRI findings in schizophrenia patients. Psychol Med 2022; 52:614-624. [PMID: 35129109 DOI: 10.1017/s0033291721005523] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuroimaging research has shown that patients with schizophrenia (SCZ) present brain structural and functional alterations, but the results across imaging modalities and task paradigms are difficult to reconcile. Specifically, no meta-analyses have tested whether the same brain systems that are structurally different in SCZ patients are also involved in neurocognitive and social cognitive tasks. To answer this, we conducted separate meta-analyses of voxel-based morphometry, neurocognitive functional magnetic resonance imaging (fMRI), and social cognitive fMRI studies. Next, with a multimodal approach, we identified the common alterations across meta-analyses. Further exploratory meta-analyses were performed taking into account several clinical variables (illness duration, medication status, and symptom severity). A cluster covering the dorsomedial prefrontal cortex (dmPFC) and the supplementary motor area (SMA), and the right inferior frontal gyrus (IFG), presented shared structural and neurocognitive-related activation decreases, while the right angular gyrus presented shared decreases between structural and social cognitive-related activation. The exploratory meta-analyses replicated to some extent these findings, while new regions of alterations appeared in patient subgroups with specific clinical features. In conclusion, we found task-specific correlates of brain structure and function in SCZ, which help summarize and integrate a growing literature.
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Affiliation(s)
- Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Marcos Fernández-Rodríguez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Maria Antónia Pereira De Barros
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
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Zekelman LR, Zhang F, Makris N, He J, Chen Y, Xue T, Liera D, Drane DL, Rathi Y, Golby AJ, O'Donnell LJ. White matter association tracts underlying language and theory of mind: An investigation of 809 brains from the Human Connectome Project. Neuroimage 2022; 246:118739. [PMID: 34856375 PMCID: PMC8862285 DOI: 10.1016/j.neuroimage.2021.118739] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/20/2021] [Accepted: 11/15/2021] [Indexed: 12/24/2022] Open
Abstract
Language and theory of mind (ToM) are the cognitive capacities that allow for the successful interpretation and expression of meaning. While functional MRI investigations are able to consistently localize language and ToM to specific cortical regions, diffusion MRI investigations point to an inconsistent and sometimes overlapping set of white matter tracts associated with these two cognitive domains. To further examine the white matter tracts that may underlie these domains, we use a two-tensor tractography method to investigate the white matter microstructure of 809 participants from the Human Connectome Project. 20 association white matter tracts (10 in each hemisphere) are uniquely identified by leveraging a neuroanatomist-curated automated white matter tract atlas. The fractional anisotropy (FA), mean diffusivity (MD), and number of streamlines (NoS) are measured for each white matter tract. Performance on neuropsychological assessments of semantic memory (NIH Toolbox Picture Vocabulary Test, TPVT) and emotion perception (Penn Emotion Recognition Test, PERT) are used to measure critical subcomponents of the language and ToM networks, respectively. Regression models are constructed to examine how structural measurements of left and right white matter tracts influence performance across these two assessments. We find that semantic memory performance is influenced by the number of streamlines of the left superior longitudinal fasciculus III (SLF-III), and emotion perception performance is influenced by the number of streamlines of the right SLF-III. Additionally, we find that performance on both semantic memory & emotion perception is influenced by the FA of the left arcuate fasciculus (AF). The results point to multiple, overlapping white matter tracts that underlie the cognitive domains of language and ToM. Results are discussed in terms of hemispheric dominance and concordance with prior investigations.
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Affiliation(s)
- Leo R Zekelman
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, USA.
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Nikos Makris
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, USA; Center for Morphometric Analysis, Department of Psychiatry and Neurology, A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Jianzhong He
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Institution of Information Processing and Automation, Zhejiang University of Technology, Hangzhou, China
| | - Yuqian Chen
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; School of Computer Science, University of Sydney, NSW, Australia
| | - Tengfei Xue
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; School of Computer Science, University of Sydney, NSW, Australia
| | | | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, US
| | - Yogesh Rathi
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Alexandra J Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Lauren J O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
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Decreased gray matter volume is associated with theory of mind deficit in adolescents with schizophrenia. Brain Imaging Behav 2022; 16:1441-1450. [PMID: 35060009 DOI: 10.1007/s11682-021-00591-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/02/2022]
Abstract
Schizophrenia patients often suffer from deficit in theory of mind (TOM). Prior neuroimaging studies revealed neuroimaging correlates of TOM deficit in adults with schizophrenia, neuroimaging correlates of TOM in adolescents is less well established. This study aimed to investigate gray matter volume (GMV) abnormalities and TOM deficits in schizophrenic adolescents, and examine the relationship between them. Twenty adolescent schizophrenic patients and 25 age, sex-matched healthy controls underwent T1-weighted magnetic resonance imaging (MRI) scans, and were examined for TOM based on the Reading the Mind in the Eyes test (RMET). Univariate voxel-based morphometry (VBM) and multivariate source-based morphometry (SBM) were employed to examine alterations of two GMV phenotypes in schizophrenic adolescents: voxel-wise GMV and covarying structural brain patterns (SBPs). Compared with controls, our results revealed a significant deficit in RMET performance of the patients, Voxel-wise VBM analysis revealed that patients exhibited decreased GMV in bilateral insula, orbitofrontal cortex, and right rolandic operculum, and GMV of these brain regions were positively correlated with RMET performance. Multivariate SBM analysis identified a significantly different between-group SBP comprising of bilateral insula and inferior frontal cortex, bilateral superior temporal cortex, and bilateral lateral parietal cortex and right rolandic operculum. The loading scores of this SBP was positively correlated with RMET performance. This study revealed impairment of TOM ability in schizophrenic adolescents and revealed an association between TOM deficit and decreased GMV in regions which are crucial for social cognition, thereby provided insight and possible target regions for understanding the neural pathology and normalizing TOM deficit in adolescent schizophrenia patients.
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Guo P, Hu S, Jiang X, Zheng H, Mo D, Cao X, Zhu J, Zhong H. Associations of Neurocognition and Social Cognition With Brain Structure and Function in Early-Onset Schizophrenia. Front Psychiatry 2022; 13:798105. [PMID: 35222115 PMCID: PMC8866448 DOI: 10.3389/fpsyt.2022.798105] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cognitive impairment is a core feature of schizophrenia that is more serious in patients with early-onset schizophrenia (EOS). However, the neuroimaging basis of cognitive functions, including neurocognition and social cognition, remains unclear in patients with EOS. METHODS Forty-three patients with EOS underwent structural and resting state functional magnetic resonance imaging scans. Brain structure and function were evaluated through the analysis of brain gray matter volume (GMV) and amplitude of low-frequency fluctuations (ALFF). They underwent comprehensive assessments for neurocognition (verbal memory, verbal expression, attention, and executive function) and social cognition (theory of mind and attributional bias). Correlation analyses were conducted to detect the potential link between cognitive function indices and brain imaging parameters. RESULTS First, neurocognition was linked to brain structure characterized by higher immediate recall scores associated with increased GMV in the left temporal pole, higher verbal fluency scores associated with increased GMV in the left temporal pole: middle temporal gyrus, and higher Stroop-word scores associated with increased GMV in the right middle frontal gyrus. Second, social cognition was related to brain function characterized by lower sense of reality scores associated with increased ALFF in the left precentral gyrus, higher scores of accidental hostility bias associated with increased ALFF in the right middle temporal gyrus, and higher scores of accidental aggression bias associated with increased ALFF in the left precentral gyrus. CONCLUSION These findings may add to the existing knowledge about the cognitive function-brain relationship. They may have clinical significance for studying the mechanism of neurocognitive and social cognitive impairment in patients with EOS and providing potential neural targets for their treatment and intervention.
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Affiliation(s)
- Pengfei Guo
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Shuwen Hu
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Xiaolu Jiang
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Hongyu Zheng
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Daming Mo
- Department of Child and Adolescent Mental Disorder, Anhui Mental Health Center, Hefei, China
| | - Xiaomei Cao
- Department of Child and Adolescent Mental Disorder, Anhui Mental Health Center, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hui Zhong
- Department of Child and Adolescent Mental Disorder, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Child and Adolescent Mental Disorder, Anhui Mental Health Center, Hefei, China
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Cavieres A, Acuña V, Limarí P, Zambrano N, Maldonado R, Elliot R. The Type of Information People with Schizophrenia Use in Ambiguous Social Situations. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:35-40. [PMID: 35279235 DOI: 10.1016/j.rcpeng.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/25/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Rather than focusing on the extensively studied social perception and recognition impairments in people with schizophrenia, this study focuses on the type of social information considered relevant by people with schizophrenia, and how they use it to arrive at conclusions about social situations. METHODS Participants included 50 outpatients with schizophrenia from the Hospital del Salvador at Valparaíso, Chile, and 50 healthy comparators matched by age and gender. Subjects completed the Social Information Preference Test (SIPT), which presents scenes depicting ambiguous social situations with faces, thoughts, and facts about the scene hidden from view. Participants were required to select a limited number of these items and then choose between possible interpretations of the scene (positive, neutral, or negative). Additionally, they are asked to provide a feeling of certainty in their answers, using a 7-point visual analogue scale. RESULTS People with schizophrenia, as well as controls had a strong preference for knowing the thoughts of the characters. Both groups were least likely to choose emotional expressions. Patients were significantly less likely to choose object/information than controls. Both groups showed a high certainty in their responses and no tendency to choose negative interpretations. LIMITATIONS compensated clinical status of the patients may have influenced the results. CONCLUSIONS The results of this study suggest that, despite difficulties perceiving clues about the mental state of others, people with schizophrenia use this information to make sense of social situations, and apparently, they do not have problems in understanding social interactions.
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Affiliation(s)
- Alvaro Cavieres
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Chile.
| | - Vanessa Acuña
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Chile
| | - Patricio Limarí
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Chile
| | - Natalia Zambrano
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Chile
| | - Rocío Maldonado
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Chile
| | - Rebecca Elliot
- Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, University of Manchester, United Kingdom
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Park SH, Kim T, Ha M, Moon SY, Lho SK, Kim M, Kwon JS. Intrinsic cerebellar functional connectivity of social cognition and theory of mind in first-episode psychosis patients. NPJ SCHIZOPHRENIA 2021; 7:59. [PMID: 34862393 PMCID: PMC8642425 DOI: 10.1038/s41537-021-00193-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023]
Abstract
Neuroimaging studies have revealed how intrinsic dysconnectivity among cortical regions of the mentalizing network (MENT) and the mirror neuron system (MNS) could explain the theory of mind (ToM) deficit in schizophrenia patients. However, despite the concurrent involvement of the cerebellum with the cortex in social cognition, the dysfunction in intrinsic interplay between the cerebellar nodes of MENT/MNS and the cortex in schizophrenia patients remains unknown. Thus, we aimed to investigate whether resting-state cerebello-cortical dysconnectivity exists in first-episode psychosis (FEP) patients in relationship with their ToM deficit. A total of 37 FEP patients and 80 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Using a priori-defined cerebellar seeds that functionally connect to the MENT (right crus II) and MNS (right crus I), we compared cerebello-cortical functional connectivities (FCs) in FEP patients and HCs. Correlations between cerebello-parietal connectivities and ToM performance were investigated in FEP patients. FEP patients showed hyperconnectivity between the right crus II and anterior cingulate gyrus and between the right crus I and supplementary motor area, bilateral postcentral gyrus, and right central/parietal operculum (CO/PO). Hypoconnectivity was found between the right crus II and left supramarginal gyrus (SMG) in FEP patients. FCs between the right crus II and left SMG and between the right crus I and right CO/PO were significantly correlated with ToM scores in FEP patients. In accordance with the "cognitive dysmetria" hypothesis, our results highlight the importance of cerbello-cortical dysconnectivities in understanding social cognitive deficits in schizophrenia patients.
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Affiliation(s)
- Soo Hwan Park
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Sun-Young Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Silvia Kyungjin Lho
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
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Koller-Schlaud K, Querbach J, Behr J, Ströhle A, Rentzsch J. Test-Retest Reliability of Frontal and Parietal Alpha Asymmetry during Presentation of Emotional Face Stimuli in Healthy Subjects. Neuropsychobiology 2021; 79:428-436. [PMID: 32182618 DOI: 10.1159/000505783] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 01/05/2020] [Indexed: 11/19/2022]
Abstract
Resting-state and event-related frontal alpha asymmetry have been suggested as potential neurobiological biomarkers for depression and other psychiatric conditions. To be used as such, sufficient test-retest reliability needs to be demonstrated. However, test-retest reliability is underinvestigated for event-related alpha asymmetry. The objective of this study was to examine both short-term within-session and long-term between-session reliability of stimulus-related medial and lateral frontal as well as parietal alpha EEG asymmetry in healthy subjects during a simple emotional face processing task. Twenty-three healthy adults participated in two sessions with a test-retest interval of about 1 week. Reliability was estimated with Pearson's correlation coefficient and paired t test. Results revealed moderate to high within-session reliability of stimulus-related alpha asymmetry for all electrode sites and both conditions. Alpha asymmetry mean values did not change significantly within sessions. Between-session reliability was fair for frontomedial and moderate for frontolateral stimulus-related asymmetry. Exploratory exclusion of subjects with unstable between-session self-rating scores of emotional state and empathy toward stimuli resulted in some higher reliability values. Our results indicate that stimulus-related alpha asymmetry may serve as a useful electrophysiological tool given its adequate within-session reliability. However, long-term stability of stimulus-related frontal alpha asymmetry over 1 week was comparatively low and varied depending on electrode position. Influencing state factors during EEG recording, such as current mood or stimulus engagement, should be considered in future study designs and analyses. Further, we recommend to analyze alpha asymmetry from both frontomedial and frontolateral sites.
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Affiliation(s)
- Kristin Koller-Schlaud
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Julia Querbach
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Joachim Behr
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Faculty of Health Science Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School Theodor Fontane, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Rentzsch
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany, .,Department of Psychiatry, Psychotherapy, and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany,
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Perret M, Lavallé L, Haesebaert F, Suaud-Chagny MF, Brunelin J, Mondino M. Neuroanatomical correlates of reality monitoring in patients with schizophrenia and auditory hallucinations. Eur Psychiatry 2021; 64:e58. [PMID: 34548121 PMCID: PMC8516745 DOI: 10.1192/j.eurpsy.2021.2234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Reality-monitoring process enables to discriminate memories of internally generated information from memories of externally derived information. Studies have reported impaired reality-monitoring abilities in schizophrenia patients with auditory hallucinations (AHs), specifically with an exacerbated externalization bias, as well as alterations in neural activity within frontotemporoparietal areas. In healthy subjects, impaired reality-monitoring abilities have been associated with reduction of the paracingulate sulcus (PCS). The current study aimed to identify neuroanatomical correlates of reality monitoring in patients with schizophrenia. Methods Thirty-five patients with schizophrenia and AHs underwent a reality-monitoring task and a 3D anatomical MRI scan at 1.5 T. PCS lengths were measured separately for each hemisphere, and whole-brain voxel-based morphometry analyses were performed using the Computational Anatomy Toolbox (version 12.6) to evaluate the gray-matter volume (GMV). Partial correlation analyses were used to investigate the relationship between reality-monitoring and neuroanatomical outcomes (PCS length and GMV), with age and intracranial volume as covariates. Results The right PCS length was positively correlated with reality-monitoring accuracy (Spearman’s ρ = 0.431, p = 0.012) and negatively with the externalization bias (Spearman’s ρ = −0.379, p = 0.029). Reality-monitoring accuracy was positively correlated with GMV in the right angular gyrus, whereas externalization bias was negatively correlated with GMV in the left supramarginal gyrus/superior temporal gyrus, in the right lingual gyrus and in the bilateral inferior temporal/fusiform gyri (voxel-level p < 0.001 and cluster-level p < 0.05, FDR-corrected). Conclusions Reduced reality-monitoring abilities were significantly associated with shorter right PCS and reduced GMV in temporal and parietal regions of the reality-monitoring network in schizophrenia patients with AHs.
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Affiliation(s)
- Mélanie Perret
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, LyonF-69000, France.,University Lyon 1, Villeurbanne F-69000, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Layla Lavallé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, LyonF-69000, France.,University Lyon 1, Villeurbanne F-69000, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, LyonF-69000, France.,University Lyon 1, Villeurbanne F-69000, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Marie-Françoise Suaud-Chagny
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, LyonF-69000, France.,University Lyon 1, Villeurbanne F-69000, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, LyonF-69000, France.,University Lyon 1, Villeurbanne F-69000, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Marine Mondino
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, LyonF-69000, France.,University Lyon 1, Villeurbanne F-69000, France.,Centre Hospitalier Le Vinatier, Bron, France
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Lee SC, Chen KW, Liu CC, Kuo CJ, Hsueh IP, Hsieh CL. Using machine learning to improve the discriminative power of the FERD screener in classifying patients with schizophrenia and healthy adults. J Affect Disord 2021; 292:102-107. [PMID: 34111689 DOI: 10.1016/j.jad.2021.05.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
Background Facial emotion recognition deficit (FERD) seems to be an obvious feature of patients with schizophrenia and has great potential for classifying patients and non-patients. The FERD screener was previously developed to classify patients from healthy adults. However, an obvious drawback of this screener is that the recommended cut-off scores could enhance either sensitivity or specificity (about 0.92) only, while the other one is at an only acceptable level (about 0.66). Machine learning (ML) algorithms are famous for their feature extraction and data classification abilities, which are promising for improving the discriminative power of screeners. This study aimed to improve the discriminative power of the FERD screener using an ML algorithm. Methods The data were extracted from a previous study. Artificial neural networks were generated to estimate the probability of being a patient with schizophrenia or a healthy adult based on the examinee's responses on the FERD screener (168 items). The performances of the ML-FERD screener were examined using a stratified five-fold cross-validation method. Results Across the five subsets of data, the ML-FERD screener showed extremely high areas under the receiver operating characteristic curve of 0.97-0.99. With the optimized cut-off scores, the average sensitivity and specificity of the ML-FERD screener were 0.90 (0.85-0.93) and 0.93 (0.86-1.00), respectively. Limitations The characteristics of patients were not representative, and the age was mismatched to control group. Conclusion The ML-FERD screener appears to have a better discriminative power to classify patients with schizophrenia and healthy adults than does the FERD screener.
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Affiliation(s)
- Shih-Chieh Lee
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;; Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Kuan-Wei Chen
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;; Department of Occupational Therapy, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan;; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chian-Jue Kuo
- Songde Branch (Taipei City Psychiatric Center), Taipei City Hospital, Taipei, Taiwan;; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan;; Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - I-Ping Hsueh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;; Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan..
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