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Tang B, Yao L, Strawn JR, Zhang W, Lui S. Neurostructural, Neurofunctional, and Clinical Features of Chronic, Untreated Schizophrenia: A Narrative Review. Schizophr Bull 2024:sbae152. [PMID: 39212651 DOI: 10.1093/schbul/sbae152] [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: 09/04/2024]
Abstract
Studies of individuals with chronic, untreated schizophrenia (CUS) can provide important insights into the natural course of schizophrenia and how antipsychotic pharmacotherapy affects neurobiological aspects of illness course and progression. We systematically review 17 studies on the neuroimaging, cognitive, and epidemiological aspects of CUS individuals. These studies were conducted at the Shanghai Mental Health Center, Institute of Mental Health at Peking University, and Huaxi MR Research Center between 2013 and 2021. CUS is associated with cognitive impairment, severe symptoms, and specific demographic characteristics and is different significantly from those observed in antipsychotic-treated individuals. Furthermore, CUS individuals have neurostructural and neurofunctional alterations in frontal and temporal regions, corpus callosum, subcortical, and visual processing areas, as well as default-mode and somatomotor networks. As the disease progresses, significant structural deteriorations occur, such as accelerated cortical thinning in frontal and temporal lobes, greater reduction in fractional anisotropy in the genu of corpus callosum, and decline in nodal metrics of gray mater network in thalamus, correlating with worsening cognitive deficits and clinical outcomes. In addition, striatal hypertrophy also occurs, independent of antipsychotic treatment. Contrasting with the negative neurostructural and neurofunctional effects of short-term antipsychotic treatment, long-term therapy frequently results in significant improvements. It notably enhances white matter integrity and the functions of key subcortical regions such as the amygdala, hippocampus, and striatum, potentially improving cognitive functions. This narrative review highlights the progressive neurobiological sequelae of CUS, the importance of early detection, and long-term treatment of schizophrenia, particularly because treatment may attenuate neurobiological deterioration and improve clinical outcomes.
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Affiliation(s)
- Biqiu Tang
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Li Yao
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Jeffrey R Strawn
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Wenjing Zhang
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
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Du Y, Niu J, Xing Y, Li B, Calhoun VD. Neuroimage Analysis Methods and Artificial Intelligence Techniques for Reliable Biomarkers and Accurate Diagnosis of Schizophrenia: Achievements Made by Chinese Scholars Around the Past Decade. Schizophr Bull 2024:sbae110. [PMID: 38982882 DOI: 10.1093/schbul/sbae110] [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: 07/11/2024]
Abstract
BACKGROUND AND HYPOTHESIS Schizophrenia (SZ) is characterized by significant cognitive and behavioral disruptions. Neuroimaging techniques, particularly magnetic resonance imaging (MRI), have been widely utilized to investigate biomarkers of SZ, distinguish SZ from healthy conditions or other mental disorders, and explore biotypes within SZ or across SZ and other mental disorders, which aim to promote the accurate diagnosis of SZ. In China, research on SZ using MRI has grown considerably in recent years. STUDY DESIGN The article reviews advanced neuroimaging and artificial intelligence (AI) methods using single-modal or multimodal MRI to reveal the mechanism of SZ and promote accurate diagnosis of SZ, with a particular emphasis on the achievements made by Chinese scholars around the past decade. STUDY RESULTS Our article focuses on the methods for capturing subtle brain functional and structural properties from the high-dimensional MRI data, the multimodal fusion and feature selection methods for obtaining important and sparse neuroimaging features, the supervised statistical analysis and classification for distinguishing disorders, and the unsupervised clustering and semi-supervised learning methods for identifying neuroimage-based biotypes. Crucially, our article highlights the characteristics of each method and underscores the interconnections among various approaches regarding biomarker extraction and neuroimage-based diagnosis, which is beneficial not only for comprehending SZ but also for exploring other mental disorders. CONCLUSIONS We offer a valuable review of advanced neuroimage analysis and AI methods primarily focused on SZ research by Chinese scholars, aiming to promote the diagnosis, treatment, and prevention of SZ, as well as other mental disorders, both within China and internationally.
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Affiliation(s)
- Yuhui Du
- School of Computer and Information Technology, Shanxi University, Taiyuan, 030006, China
| | - Ju Niu
- School of Computer and Information Technology, Shanxi University, Taiyuan, 030006, China
| | - Ying Xing
- School of Computer and Information Technology, Shanxi University, Taiyuan, 030006, China
| | - Bang Li
- School of Computer and Information Technology, Shanxi University, Taiyuan, 030006, China
| | - Vince D Calhoun
- The Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, 30303, GA, USA
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Van Dyken PC, MacKinley M, Khan AR, Palaniyappan L. Cortical Network Disruption Is Minimal in Early Stages of Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae010. [PMID: 39144115 PMCID: PMC11207789 DOI: 10.1093/schizbullopen/sgae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis Schizophrenia is associated with white matter disruption and topological reorganization of cortical connectivity but the trajectory of these changes, from the first psychotic episode to established illness, is poorly understood. Current studies in first-episode psychosis (FEP) patients using diffusion magnetic resonance imaging (dMRI) suggest such disruption may be detectable at the onset of psychosis, but specific results vary widely, and few reports have contextualized their findings with direct comparison to young adults with established illness. Study Design Diffusion and T1-weighted 7T MR scans were obtained from N = 112 individuals (58 with untreated FEP, 17 with established schizophrenia, 37 healthy controls) recruited from London, Ontario. Voxel- and network-based analyses were used to detect changes in diffusion microstructural parameters. Graph theory metrics were used to probe changes in the cortical network hierarchy and to assess the vulnerability of hub regions to disruption. The analysis was replicated with N = 111 (57 patients, 54 controls) from the Human Connectome Project-Early Psychosis (HCP-EP) dataset. Study Results Widespread microstructural changes were found in people with established illness, but changes in FEP patients were minimal. Unlike the established illness group, no appreciable topological changes in the cortical network were observed in FEP patients. These results were replicated in the early psychosis patients of the HCP-EP datasets, which were indistinguishable from controls in most metrics. Conclusions The white matter structural changes observed in established schizophrenia are not a prominent feature in the early stages of this illness.
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Affiliation(s)
- Peter C Van Dyken
- Neuroscience Graduate Program, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Michael MacKinley
- Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada
| | - Ali R Khan
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lena Palaniyappan
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Liu S, Zhong H, Qian Y, Cai H, Jia YB, Zhu J. Neural mechanism underlying the beneficial effect of Theory of Mind psychotherapy on early-onset schizophrenia: a randomized controlled trial. J Psychiatry Neurosci 2023; 48:E421-E430. [PMID: 37935475 PMCID: PMC10635708 DOI: 10.1503/jpn.230049] [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: 03/27/2023] [Revised: 06/03/2023] [Accepted: 08/14/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Psychosocial interventions have emerged as an important component of a comprehensive therapeutic approach in early-onset schizophrenia, typically representing a more severe form of the disorder. Despite the feasibility and efficacy of Theory of Mind (ToM) psychotherapy for schizophrenia, relatively little is known regarding the neural mechanism underlying its effect on early-onset schizophrenia. METHODS We performed a randomized, active controlled trial in patients with early-onset schizophrenia, who were randomly allocated into either an intervention (ToM psychotherapy) or an active control (health education) group. Diffusion tensor imaging data were collected to construct brain structural networks, with both global and regional topological properties measured using graph theory. RESULTS We enrolled 28 patients with early-onset schizophrenia in our study. After 5 weeks of treatment, both the intervention and active control groups showed significant improvement in psychotic symptoms, yet the improvement was greater in the intervention group. Importantly, in contrast with no brain structural network change after treatment in the active control group, the intervention group showed increased nodal centrality of the left insula that was associated with psychotic symptom improvement. LIMITATIONS We did not collect important information concerning the participants' cognitive abilities, particularly ToM performance. CONCLUSION These findings suggest a potential neural mechanism by which ToM psychotherapy exerts a beneficial effect on early-onset schizophrenia via strengthening the coordination capacity of the insula in brain structural networks, which may provide a clinically translatable biomarker for monitoring or predicting responses to ToM psychotherapy.Clinical trial registration: NCT05577338; ClinicalTrials.gov.
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Affiliation(s)
- Siyu Liu
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Hui Zhong
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Yinfeng Qian
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Huanhuan Cai
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Yan-Bin Jia
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Jiajia Zhu
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
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Tuovinen N, Hofer A. Resting-state functional MRI in treatment-resistant schizophrenia. FRONTIERS IN NEUROIMAGING 2023; 2:1127508. [PMID: 37554635 PMCID: PMC10406237 DOI: 10.3389/fnimg.2023.1127508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/17/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Abnormalities in brain regions involved in the pathophysiology of schizophrenia (SCZ) may present insight into individual clinical symptoms. Specifically, functional connectivity irregularities may provide potential biomarkers for treatment response or treatment resistance, as such changes can occur before any structural changes are visible. We reviewed resting-state functional magnetic resonance imaging (rs-fMRI) findings from the last decade to provide an overview of the current knowledge on brain functional connectivity abnormalities and their associations to symptoms in treatment-resistant schizophrenia (TRS) and ultra-treatment-resistant schizophrenia (UTRS) and to look for support for the dysconnection hypothesis. METHODS PubMed database was searched for articles published in the last 10 years applying rs-fMRI in TRS patients, i.e., who had not responded to at least two adequate treatment trials with different antipsychotic drugs. RESULTS Eighteen articles were selected for this review involving 648 participants (TRS and control cohorts). The studies showed frontal hypoconnectivity before the initiation of treatment with CLZ or riluzole, an increase in frontal connectivity after riluzole treatment, fronto-temporal hypoconnectivity that may be specific for non-responders, widespread abnormal connectivity during mixed treatments, and ECT-induced effects on the limbic system. CONCLUSION Probably due to the heterogeneity in the patient cohorts concerning antipsychotic treatment and other clinical variables (e.g., treatment response, lifetime antipsychotic drug exposure, duration of illness, treatment adherence), widespread abnormalities in connectivity were noted. However, irregularities in frontal brain regions, especially in the prefrontal cortex, were noted which are consistent with previous SCZ literature and the dysconnectivity hypothesis. There were major limitations, as most studies did not differentiate between TRS and UTRS (i.e., CLZ-resistant schizophrenia) and investigated heterogeneous cohorts treated with mixed treatments (with or without CLZ). This is critical as in different subtypes of the disorder an interplay between dopaminergic and glutamatergic pathways involving frontal, striatal, and hippocampal brain regions in separate ways is likely. Better definitions of TRS and UTRS are necessary in future longitudinal studies to correctly differentiate brain regions underlying the pathophysiology of SCZ, which could serve as potential functional biomarkers for treatment resistance.
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Affiliation(s)
- Noora Tuovinen
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
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Gao Z, Xiao Y, Zhu F, Tao B, Yu W, Lui S. The whole-brain connectome landscape in patients with schizophrenia: a systematic review and meta-analysis of graph theoretical characteristics. Neurosci Biobehav Rev 2023; 148:105144. [PMID: 36990373 DOI: 10.1016/j.neubiorev.2023.105144] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/14/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
The alterations of connectome in schizophrenia have been reported, but the results remain inconsistent. We conducted a systematic review and random-effects meta-analysis on structural or functional connectome MRI studies comparing global graph theoretical characteristics between schizophrenia and healthy controls. Meta-regression and subgroup analyses were performed to examine confounding effects. Based on the included 48 studies, Structural connectome in schizophrenia showed a significant decrease in segregation (lower clustering coefficient and local efficiency, Hedge's g= -0.352 and -0.864, respectively) and integration (higher characteristic path length and lower global efficiency, Hedge's g= 0.532 and -0.577 respectively). The functional connectome showed no difference between groups except γ. Moderator analysis indicated that clinical and methodological factors exerted a potential effect on the graph theoretical characteristics. Our analysis revealed a weaker small-worldization trend in structural connectome of schizophrenia. For the relatively unchanged functional connectome, more homogenous and high-quality studies are warranted to elucidate whether the change was blurred by heterogeneity or the presentation of pathophysiological reconfiguration.
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Sun H, Zhang W, Cao H, Sun H, Dai J, Li S, Zeng J, Wei X, Tang B, Gong Q, Lui S. Linked brain connectivity patterns with psychopathological and cognitive phenotypes in drug-naïve first-episode schizophrenia. PSYCHORADIOLOGY 2022; 2:43-51. [PMID: 38665967 PMCID: PMC10994520 DOI: 10.1093/psyrad/kkac006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 02/05/2023]
Abstract
Background Schizophrenia is considered to be a disorder of dysconnectivity characterized by abnormal functional integration between distinct brain regions. Different brain connection abnormalities were found to be correlated with various clinical manifestations, but whether a common deficit in functional connectivity (FC) in relation to both clinical symptoms and cognitive impairments could present in first-episode patients who have never received any medication remains elusive. Objective To find a core deficit in the brain connectome that is related to both psychopathological and cognitive manifestations. Methods A total of 75 patients with first-episode schizophrenia and 51 healthy control participants underwent scanning of the brain and clinical ratings of behaviors. A principal component analysis was performed on the clinical ratings of symptom and cognition. Partial correlation analyses were conducted between the main psychopathological components and resting-state FC that were found abnormal in schizophrenia patients. Results Using the principal component analysis, the first principal component (PC1) explained 37% of the total variance of seven clinical features. The ratings of GAF and BACS contributed negatively to PC1, while those of PANSS, HAMD, and HAMA contributed positively. The FCs positively correlated with PC1 mainly included connections related to the insula, precuneus gyrus, and some frontal brain regions. FCs negatively correlated with PC1 mainly included connections between the left middle cingulate cortex and superior and middle occipital regions. Conclusion In conclusion, we found a linked pattern of FC associated with both psychopathological and cognitive manifestations in drug-naïve first-episode schizophrenia characterized as the dysconnection related to the frontal and visual cortex, which may represent a core deficit of brain FC in patients with schizophrenia.
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Affiliation(s)
- Hui Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Hengyi Cao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, 11030 Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, 11004 Glen Oaks, NY, USA
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Jing Dai
- Department of Psychoradiology, Chengdu Mental Health Center, 610031 Chengdu, China
| | - Siyi Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Jiaxin Zeng
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Xia Wei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Biqiu Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, 610041 Chengdu, China
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Tao B, Xiao Y, Cao H, Zhang W, Yang C, Lencer R, Gong Q, Lui S. Characteristics of the corpus callosum in chronic schizophrenia treated with clozapine or risperidone and those never-treated. BMC Psychiatry 2021; 21:538. [PMID: 34715831 PMCID: PMC8556985 DOI: 10.1186/s12888-021-03552-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The corpus callosum (CC) deficits have been well documented in chronic schizophrenia. However, the long-term impacts of antipsychotic monotherapies on callosal anatomy remain unclear. This cross-sectional study sought to explore micro- and macro-structural characteristics of the CC in never-treated patients and those with long-term mono-antipsychotic treatment. METHODS The study included 23 clozapine-treated schizophrenia patients (CT-SCZ), 19 risperidone-treated schizophrenia patients (RT-SCZ), 23 never-treated schizophrenia patients (NT-SCZ), and 35 healthy controls (HCs). High resolution structural images and diffusion tensor imaging (DTI) data for each participant were obtained via a 3.0 T MR scanner. FreeSurfer was used to examine the volumes and fractional anisotropy (FA) values of the CC for each participant. RESULTS There were significant deficits in the total and sub-regional CC volume and white matter integrity in NT-SCZ in comparison with healthy subjects. Compared with NT-SCZ, both CT-SCZ and RT-SCZ showed significantly increased FA values in the anterior CC region, while only RT-SCZ showed significantly increased volume in the mid-anterior CC region. Moreover, the volume of the mid-anterior CC region was significantly smaller in CT-SCZ compared to HCs. No correlations of clinical symptoms with callosal metrics were observed in schizophrenia patients. CONCLUSIONS Our findings provide insight into micro- and macro-structural characteristics of the CC in chronic schizophrenia patients with or without antipsychotics. These results suggest that the pathology itself is responsible for cerebral abnormalities in schizophrenia and that chronic exposure to antipsychotics may have an impact on white matter structure of schizophrenia patients, especially in those with risperidone treatment.
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Affiliation(s)
- Bo Tao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang, Chengdu, 610041 China ,grid.412901.f0000 0004 1770 1022Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Xiao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang, Chengdu, 610041 China ,grid.412901.f0000 0004 1770 1022Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Hengyi Cao
- grid.250903.d0000 0000 9566 0634Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY USA ,grid.440243.50000 0004 0453 5950Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY USA
| | - Wenjing Zhang
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang, Chengdu, 610041 China ,grid.412901.f0000 0004 1770 1022Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Chengmin Yang
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang, Chengdu, 610041 China ,grid.412901.f0000 0004 1770 1022Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Rebekka Lencer
- grid.4562.50000 0001 0057 2672Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Qiyong Gong
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang, Chengdu, 610041 China ,grid.412901.f0000 0004 1770 1022Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xuexiang, Chengdu, 610041, China. .,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, China.
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Tao B, Xiao Y, Yang B, Zeng J, Zhang W, Hu N, Yang C, Lencer R, Gong Q, Sweeney JA, Lui S. Morphological alterations of the corpus callosum in antipsychotic-naive first-episode schizophrenia before and 1-year after treatment. Schizophr Res 2021; 231:115-121. [PMID: 33839369 DOI: 10.1016/j.schres.2021.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 03/28/2021] [Accepted: 03/28/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The corpus callosum (CC) is known to be altered in patients with schizophrenia. However, its morphologic characteristics are less well studied in treatment-naive first-episode schizophrenia patients, as is the effect of antipsychotic treatment on this structure. METHODS T-1 weighted MRI scans were obtained from 160 antipsychotic-naïve first-episode schizophrenia patients (AN-FES) and 155 healthy controls (HCs) before treatment initiation. Among the patients, forty-four were available for follow-up studies after one year of antipsychotic treatment, and were divided into good-outcome (n = 31) and poor-outcome subgroups (n = 13) based on whether there was a 50% reduction in Positive and Negative Symptom Scale (PANSS) total scores from baseline. A computer algorithm was applied to automatically identify the mid-sagittal plane (MSP) and obtain morphological measurement parameters of the CC. RESULTS Compared with HCs, AN-FES patients showed a significant reduction of thickness in the posterior midbody of the CC. This deficit was correlated with severity of negative symptoms. After one year of antipsychotic treatment, there was no significant change in CC morphological measurements in schizophrenia patients, nor was there a significant difference of CC morphological measurements between good-outcome and poor-outcome subgroups at baseline or at 1-year follow-up. CONCLUSION Thickness of the posterior midbody of the CC is reduced in the early course of schizophrenia before treatment. This alteration was not affected by antipsychotic treatment and was unrelated to treatment outcome at 1-year.
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Affiliation(s)
- Bo Tao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Xiao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Beisheng Yang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaxin Zeng
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Na Hu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Chengmin Yang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
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10
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Tronchin G, McPhilemy G, Ahmed M, Kilmartin L, Costello L, Forde NJ, Nabulsi L, Akudjedu TN, Holleran L, Hallahan B, Cannon DM, McDonald C. White matter microstructure and structural networks in treatment-resistant schizophrenia patients after commencing clozapine treatment: A longitudinal diffusion imaging study. Psychiatry Res 2021; 298:113772. [PMID: 33556689 DOI: 10.1016/j.psychres.2021.113772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/26/2021] [Indexed: 02/08/2023]
Abstract
This study investigates changes on white matter microstructure and neural networks after 6 months of switching to clozapine in schizophrenia patients compared to controls, and whether any changes are related to clinical variables. T1 and diffusion-weighted MRI images were acquired at baseline before commencing clozapine and after 6 months of treatment for 22 patients with treatment-resistant schizophrenia and 23 controls. The Tract-based spatial statistics approach was used to compare changes over time between groups in fractional anisotropy (FA). Changes in structural network organisation weighted by FA and number of streamlines were assessed using graph theory. Patients displayed a significant reduction of FA over time (p<0.05) compared to controls in the genu and body of the corpus callosum and bilaterally in the anterior and superior corona radiata. There was no correlation between FA change in patients and changes in clinical variables or serum level of clozapine. There was no changes in structural network organisation between groups (F(7,280)=2.80;p = 0.187). This longitudinal study demonstrated progressive focal FA abnormalities in key anterior tracts, but preserved brain structural network organisation in patients. The FA reduction was independent of any clinical measures and may reflect progression of the underlying pathophysiology of this malignant form of schizophrenia illness.
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Affiliation(s)
- Giulia Tronchin
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland.
| | - Genevieve McPhilemy
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Mohamed Ahmed
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Liam Kilmartin
- College of Science and Engineering, National University of Ireland Galway, Galway, Republic of Ireland
| | - Laura Costello
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Natalie J Forde
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Leila Nabulsi
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland; Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
| | - Theophilus N Akudjedu
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland; Institute of Medical Imaging & Visualisation, Faculty of Health & Social Science, Bournemouth University, Bournemouth, United Kingdom
| | - Laurena Holleran
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
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11
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Sanson A, Riva MA. Anti-Stress Properties of Atypical Antipsychotics. Pharmaceuticals (Basel) 2020; 13:E322. [PMID: 33092112 PMCID: PMC7589119 DOI: 10.3390/ph13100322] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022] Open
Abstract
Stress exposure represents a major environmental risk factor for schizophrenia and other psychiatric disorders, as it plays a pivotal role in the etiology as well as in the manifestation of disease symptomatology. It may be inferred that pharmacological treatments must be able to modulate the behavioral, functional, and molecular alterations produced by stress exposure to achieve significant clinical outcomes. This review aims at examining existing clinical and preclinical evidence that supports the ability of atypical antipsychotic drugs (AAPDs) to modulate stress-related alterations. Indeed, while the pharmacodynamic differences between AAPDs have been extensively characterized, less is known on their ability to regulate downstream mechanisms that are critical for functional recovery and patient stabilization. We will discuss stress-related mechanisms, spanning from neuroendocrine function to inflammation and neuronal plasticity, which are relevant for the manifestation of schizophrenic symptomatology, and we will discuss if and how AAPDs may interfere with such mechanisms. Considering the impact of stress in everyday life, we believe that a better understanding of the potential effects of AAPDs on stress-related mechanisms may provide novel and important insights for improving therapeutic strategies aimed at promoting coping mechanisms and enhancing the quality of life of patients affected by psychiatric disorders.
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Affiliation(s)
| | - Marco A. Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Giuseppe Balzaretti 9, 20133 Milan, Italy;
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