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Dodd K, Legget KT, Cornier MA, Novick AM, McHugo M, Berman BD, Lawful BP, Tregellas JR. Relationship between functional connectivity and weight-gain risk of antipsychotics in schizophrenia. Schizophr Res 2024; 267:173-181. [PMID: 38552340 DOI: 10.1016/j.schres.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/19/2024] [Accepted: 03/18/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The mechanisms by which antipsychotic medications (APs) contribute to obesity in schizophrenia are not well understood. Because AP effects on functional brain connectivity may contribute to weight effects, the current study investigated how AP-associated weight-gain risk relates to functional connectivity in schizophrenia. METHODS Fifty-five individuals with schizophrenia (final N = 54) were divided into groups based on previously reported AP weight-gain risk (no APs/low risk [N = 19]; moderate risk [N = 17]; high risk [N = 18]). Resting-state functional magnetic resonance imaging (fMRI) was completed after an overnight fast ("fasted") and post-meal ("fed"). Correlations between AP weight-gain risk and functional connectivity were assessed at the whole-brain level and in reward- and eating-related brain regions (anterior insula, caudate, nucleus accumbens). RESULTS When fasted, greater AP weight-gain risk was associated with increased connectivity between thalamus and sensorimotor cortex (pFDR = 0.021). When fed, greater AP weight-gain risk was associated with increased connectivity between left caudate and left precentral/postcentral gyri (pFDR = 0.048) and between right caudate and multiple regions, including the left precentral/postcentral gyri (pFDR = 0.001), intracalcarine/precuneal/cuneal cortices (pFDR < 0.001), and fusiform gyrus (pFDR = 0.008). When fed, greater AP weight-gain risk was also associated with decreased connectivity between right anterior insula and ventromedial prefrontal cortex (pFDR = 0.002). CONCLUSIONS APs with higher weight-gain risk were associated with greater connectivity between reward-related regions and sensorimotor regions when fasted, perhaps relating to motor anticipation for consumption. Higher weight-gain risk APs were also associated with increased connectivity between reward, salience, and visual regions when fed, potentially reflecting greater desire for consumption following satiety.
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Affiliation(s)
- Keith Dodd
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA; Department of Bioengineering, University of Colorado Denver, 12705 E Montview Blvd Suite 100, Aurora, CO 80045, USA
| | - Kristina T Legget
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA; Research Service, Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St, Aurora, CO 80045, USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Clinical Sciences Building, CSB 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Andrew M Novick
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA
| | - Maureen McHugo
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA
| | - Brian D Berman
- Department of Neurology, Virginia Commonwealth University, 1101 E Marshall Street, Richmond, VA 23298, USA
| | - Benjamin P Lawful
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA; Research Service, Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St, Aurora, CO 80045, USA.
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Karl D, Wieland A, Shevchenko Y, Grundinger N, Machunze N, Gerhardt S, Flor H, Vollstädt-Klein S. Using computer-based habit versus chess-based cognitive remediation training as add-on therapy to modify the imbalance between habitual behavior and cognitive control in tobacco use disorder: protocol of a randomized controlled, fMRI study. BMC Psychol 2023; 11:24. [PMID: 36698210 PMCID: PMC9875438 DOI: 10.1186/s40359-023-01055-z] [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: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although the vast majority of smokers are aware of the enormous preventable health hazards caused by smoking, only a small percentage of smokers manage to remain abstinent in the long term. One possible explanation for this discrepancy lies in the inflexibility of addictive behavior and associated disadvantageous decision-making. According to a dual-process theory of decision-making, two distinct decision systems can be identified. One slow deliberate system based on desirable expectations of outcome value described as goal-directed behavior and a fast reflexive system based on habitual instrumental behavior and driven by reinforcement experienced in the past. In the course of addiction development, an imbalance occurs between habitual behavior and goal-directed. The present study aims to investigate the modifiability of the balance between habitual and goal-directed behavior at the neurobiological and behavioral level in smokers using two different novel add-on therapies. We hypothesize that both interventions change the balance between goal-directed and habitual behavior, but by different mechanisms. Whereas a cognitive remediation treatment should directly improve cognitive control, in contrast an implicit priming task should affect the early processing and the emotional valence of smoking and smoking cues. METHODS We will conduct a randomized controlled study in treatment-seeking individuals with tobacco use disorder applying either chess-based cognitive remediation training (N = 30) or implicit computer-based habit-modifying training (N = 30) as add on therapy compared to the standard smoking cessation group therapy (N = 30) only. We will address neurobiological and neuropsychological correlates associated with craving, reward devaluation, cue reactivity and attentional bias. In addition, various effects of treatment and prediction of treatment outcome will be examined using behavioral and neural measures. DISCUSSION The present study will apply different examination methods such as functional magnetic resonance imaging, neuropsychological tests, and self-report before and after the interventions. This allows the identification of intervention-specific mechanisms and therefore potential neurobiology-based specific treatment targets for individuals with Tobacco Use Disorder. TRIAL REGISTRATION Registered at clinicaltrials.gov/ct2/show/NCT03764969 (05 December 2018).
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Affiliation(s)
- Damian Karl
- grid.7700.00000 0001 2190 4373Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 21 20, PO Box 12, 68072 Mannheim, Germany
| | - Alfred Wieland
- grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Yury Shevchenko
- grid.7700.00000 0001 2190 4373Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 21 20, PO Box 12, 68072 Mannheim, Germany ,grid.9811.10000 0001 0658 7699Research Methods, Assessment, and iScience, Department of Psychology, University of Konstanz, Constance, Germany
| | - Nadja Grundinger
- grid.7700.00000 0001 2190 4373Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 21 20, PO Box 12, 68072 Mannheim, Germany
| | - Noah Machunze
- grid.7700.00000 0001 2190 4373Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 21 20, PO Box 12, 68072 Mannheim, Germany
| | - Sarah Gerhardt
- grid.7700.00000 0001 2190 4373Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 21 20, PO Box 12, 68072 Mannheim, Germany
| | - Herta Flor
- grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Sabine Vollstädt-Klein
- grid.7700.00000 0001 2190 4373Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 21 20, PO Box 12, 68072 Mannheim, Germany ,grid.7700.00000 0001 2190 4373Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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