1
|
McHugo M, Roeske MJ, Vandekar SN, Armstrong K, Avery SN, Heckers S. Smaller anterior hippocampal subfields in the early stage of psychosis. Transl Psychiatry 2024; 14:69. [PMID: 38296964 PMCID: PMC10830481 DOI: 10.1038/s41398-023-02719-5] [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: 10/11/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 02/02/2024] Open
Abstract
Hippocampal volume is smaller in schizophrenia, but it is unclear when in the illness the changes appear and whether specific regions (anterior, posterior) and subfields (CA1, CA2/3, dentate gyrus, subiculum) are affected. Here, we used a high-resolution T2-weighted sequence specialized for imaging hippocampal subfields to test the hypothesis that anterior CA1 volume is lower in early psychosis. We measured subfield volumes across hippocampal regions in a group of 90 individuals in the early stage of a non-affective psychotic disorder and 70 demographically similar healthy individuals. We observed smaller volume in the anterior CA1 and dentate gyrus subfields in the early psychosis group. Our findings support models that implicate anterior CA1 and dentate gyrus subfield deficits in the mechanism of psychosis.
Collapse
Affiliation(s)
- Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Maxwell J Roeske
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon N Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne N Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
2
|
Gao T, Wang X, Cen H, Li X, Zhai Z, Lu C, Dong Y, Zhang S, Zhuo K, Xiang Q, Wang Y, Liu D. Cross-modal associative memory impairment in schizophrenia. Neuropsychologia 2023; 191:108721. [PMID: 37918479 DOI: 10.1016/j.neuropsychologia.2023.108721] [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: 05/03/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Impaired associative memory function in patients with schizophrenia has received considerable attention. However, previous studies have primarily concentrated on unisensory materials, which limits our understanding of the broader implications of this impairment. In this study, we sought to expand on this knowledge by examining two types of associative memory domains in individuals with schizophrenia, leveraging both visual (Vis) and auditory (Aud) materials. A total of 32 patients with schizophrenia and 29 healthy controls were recruited to participate in the study. Each participant participated in an experiment composed of three paradigms in which different abstract materials (Aud-Aud, Aud-Vis, and Vis-Vis) were presented. Subsequently, the discriminability scores of the two groups were calculated and compared in different modal tasks. Results from the study indicated that individuals with schizophrenia demonstrated varying degrees of associative memory dysfunction in both the same and cross-modalities, with the latter having a significantly lower score than healthy controls (t = 4.120, p < 0.001). Additionally, the cross-modal associative memory function was significantly and negatively correlated with the severity of negative symptoms among individuals diagnosed with schizophrenia (r = -0.362, p = 0.042). This study provides evidence of abnormalities in the processing and memorization of information that integrates multiple sensory modalities in individuals with schizophrenia. This is of great significance for further understanding the cognitive symptoms and pathological mechanisms of schizophrenia, potentially guiding the development of relevant interventions and treatment methods.
Collapse
Affiliation(s)
- Tianhao Gao
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Xiaoliang Wang
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Haixin Cen
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Xuan Li
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Zhaolin Zhai
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Chang Lu
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Yuke Dong
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Suzhen Zhang
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Kaiming Zhuo
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Qiong Xiang
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Yan Wang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China.
| | - Dengtang Liu
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China; Institute of Mental Health, Fudan University, Shanghai, 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| |
Collapse
|
3
|
Avery SN, Rogers BP, McHugo M, Armstrong K, Blackford JU, Vandekar SN, Woodward ND, Heckers S. Hippocampal Network Dysfunction in Early Psychosis: A 2-Year Longitudinal Study. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:979-989. [PMID: 37881573 PMCID: PMC10593896 DOI: 10.1016/j.bpsgos.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/17/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
Background Hippocampal abnormalities are among the most consistent findings in schizophrenia. Numerous studies have reported deficits in hippocampal volume, function, and connectivity in the chronic stage of illness. While hippocampal volume and function deficits are also present in the early stage of illness, there is mixed evidence of both higher and lower functional connectivity. Here, we use graph theory to test the hypothesis that hippocampal network connectivity is broadly lowered in early psychosis and progressively worsens over 2 years. Methods We examined longitudinal resting-state functional connectivity in 140 participants (68 individuals in the early stage of psychosis, 72 demographically similar healthy control individuals). We used an anatomically driven approach to quantify hippocampal network connectivity at 2 levels: 1) a core hippocampal-medial temporal lobe cortex (MTLC) network; and 2) an extended hippocampal-cortical network. Group and time effects were tested in a linear mixed effects model. Results Early psychosis patients showed elevated functional connectivity in the core hippocampal-MTLC network, but contrary to our hypothesis, did not show alterations within the broader hippocampal-cortical network. Hippocampal-MTLC network hyperconnectivity normalized longitudinally and predicted improvement in positive symptoms but was not associated with increasing illness duration. Conclusions These results show abnormally elevated functional connectivity in a core hippocampal-MTLC network in early psychosis, suggesting that selectively increased hippocampal signaling within a localized cortical circuit may be a marker of the early stage of psychosis. Hippocampal-MTLC hyperconnectivity could have prognostic and therapeutic implications.
Collapse
Affiliation(s)
- Suzanne N. Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, Tennessee
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
4
|
Kang K, Jones MT, Armstrong K, Avery S, McHugo M, Heckers S, Vandekar S. Accurate Confidence and Bayesian Interval Estimation for Non-centrality Parameters and Effect Size Indices. PSYCHOMETRIKA 2023; 88:253-273. [PMID: 36725775 PMCID: PMC9977896 DOI: 10.1007/s11336-022-09899-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Indexed: 06/18/2023]
Abstract
Reporting effect size index estimates with their confidence intervals (CIs) can be an excellent way to simultaneously communicate the strength and precision of the observed evidence. We recently proposed a robust effect size index (RESI) that is advantageous over common indices because it's widely applicable to different types of data. Here, we use statistical theory and simulations to develop and evaluate RESI estimators and confidence/credible intervals that rely on different covariance estimators. Our results show (1) counter to intuition, the randomness of covariates reduces coverage for Chi-squared and F CIs; (2) when the variance of the estimators is estimated, the non-central Chi-squared and F CIs using the parametric and robust RESI estimators fail to cover the true effect size at the nominal level. Using the robust estimator along with the proposed nonparametric bootstrap or Bayesian (credible) intervals provides valid inference for the RESI, even when model assumptions may be violated. This work forms a unified effect size reporting procedure, such that effect sizes with confidence/credible intervals can be easily reported in an analysis of variance (ANOVA) table format.
Collapse
Affiliation(s)
- Kaidi Kang
- Department of Biostatistics, Vanderbilt University, 2525 West End Ave.,#1136, Nashville, TN, 37203, USA.
| | - Megan T Jones
- Department of Biostatistics, Vanderbilt University, 2525 West End Ave.,#1136, Nashville, TN, 37203, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, USA
| | - Suzanne Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, USA
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University, 2525 West End Ave.,#1136, Nashville, TN, 37203, USA.
| |
Collapse
|
5
|
Koller WN, Cannon TD. Aberrant memory and delusional ideation: A pernicious partnership? Clin Psychol Rev 2023; 99:102231. [PMID: 36469975 DOI: 10.1016/j.cpr.2022.102231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/02/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Delusions can be conceptualized as beliefs that are both at odds with consensus reality and espoused with high conviction. While delusions represent a cardinal symptom of schizophrenia, delusion-like beliefs can be found in the general population. Do similar cognitive mechanisms support delusionality across this spectrum? If so, what are they? Here, we examine evidence for a mechanistic role of the (associative) memory system in the formation and maintenance of delusions and delusion-like beliefs. While general neurocognitive metrics do not tend to associate with delusionality, our scoping review of the clinical and subclinical literature reveals several subdomains of memory function that do. These include a propensity to commit errors of commission (i.e., false alarms and intrusions), source memory biases, and metamemory impairment. We discuss how several of these effects may stem from aberrant associative memory function and offer recommendations for future research. Further, we propose a state/trait interaction model in which underlying traits (i.e., impaired associative and metamemory function) may become coupled with delusionality during states of acute psychosis, when memory function is particularly challenged by aberrant salience attribution and noisy perceptual input. According to this model, delusions may arise as explanations to high-salience (but low-source) mnemonic content that is endorsed with high confidence.
Collapse
Affiliation(s)
- William N Koller
- Department of Psychology, Yale University, Hillhouse Avenue, New Haven, CT 06520-8205, United States of America.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, Hillhouse Avenue, New Haven, CT 06520-8205, United States of America
| |
Collapse
|
6
|
McHugo M, Avery S, Armstrong K, Rogers BP, Vandekar SN, Woodward ND, Blackford JU, Heckers S. Anterior hippocampal dysfunction in early psychosis: a 2-year follow-up study. Psychol Med 2023; 53:160-169. [PMID: 33875028 PMCID: PMC8919704 DOI: 10.1017/s0033291721001318] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cross-sectional studies indicate that hippocampal function is abnormal across stages of psychosis. Neural theories of psychosis pathophysiology suggest that dysfunction worsens with illness stage. Here, we test the hypothesis that hippocampal function is impaired in the early stage of psychosis and declines further over the next 2 years. METHODS We measured hippocampal function over 2 years using a scene processing task in 147 participants (76 individuals in the early stage of a non-affective psychotic disorder and 71 demographically similar healthy control individuals). Two-year follow-up was completed in 97 individuals (50 early psychosis, 47 healthy control). Voxelwise longitudinal analysis of activation in response to scenes was carried out within a hippocampal region of interest to test for group differences at baseline and a group by time interaction. RESULTS At baseline, we observed lower anterior hippocampal activation in the early psychosis group relative to the healthy control group. Contrary to our hypothesis, hippocampal activation remained consistent and did not show the predicted decline over 2 years in the early psychosis group. Healthy controls showed a modest reduction in hippocampal activation after 2 years. CONCLUSIONS The results of this study suggest that hippocampal dysfunction in early psychosis does not worsen over 2 years and highlight the need for longer-term longitudinal studies.
Collapse
Affiliation(s)
- Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, TN, USA
| | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Research and Development, Tennessee Valley Healthcare System, United States Department of Veteran Affairs
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
7
|
Li L, Rami FZ, Lee BM, Kim WS, Kim SW, Lee BJ, Yu JC, Lee KY, Won SH, Lee SH, Kim SH, Kang SH, Kim E, Chung YC. Three-year outcomes and predictors for full recovery in patients with early-stage psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:87. [PMID: 36302861 PMCID: PMC9613771 DOI: 10.1038/s41537-022-00301-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/15/2022] [Indexed: 05/19/2023]
Abstract
In the present study, various outcomes over 3-year period in patients with early stage psychosis including remission, recovery, relapse and medication adherence were investigated. Predictor for full recovery at year 3 was also examined. Three-year follow-up data in 534 patients with schizophrenia spectrum disorders (SSD) and psychotic disorder not otherwise specified (PNOS) were examined for overall outcome trajectories. The data of completers at year 3 (n = 157) were used to identify predictors for recovery using logistic regression. The rates of symptomatic remission and full recovery at 6-, 12-, 24-, and 36-month follow-up were 76.10, 69.20, 79.50, and 79.10%, and 22.80, 26.40, 28.60, and 39.60%, respectively. The rates of drop-out and relapse at 6-, 12-, 24-, and 36-month follow-up were 25.4, 29.5, 38.6, and 51.1%, and 3.7, 8.9, 19.0, and 38.9%, respectively. The rates of good adherence and prescription of Long-Acting Injectable Antipsychotics (LAIA) at 6-, 12-, 24- and 36-month follow-up were 87.8, 88.0, 91.9, and 93.9%, and 18.3, 21.7, 22.0, and 25.5%, respectively. Significant predictors for full recovery were duration of untreated psychosis (DUP), family intimacy and physical activity. We observed similar or better results on remission, recovery, and relapse rates compared to other previous studies. Effective psychosocial intervention should be provided to shorten the gap between remission and recovery rates and to address DUP, family issues, and exercise to enhance recovery.
Collapse
Affiliation(s)
- Ling Li
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Bo Mi Lee
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Woo-Sung Kim
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Je-Chun Yu
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - Kyu Young Lee
- Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea
| | - Shi Hyun Kang
- Department of Social Psychiatry and Rehabilitation, National Center for Mental Health, Seoul, Republic of Korea
| | - Euitae Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
| |
Collapse
|
8
|
Raucher-Chéné D, Lavigne KM, Lepage M. Episodic Memory and Schizophrenia: From Characterization of Relational Memory Impairments to Neuroimaging Biomarkers. Curr Top Behav Neurosci 2022; 63:115-136. [PMID: 35902545 DOI: 10.1007/7854_2022_379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Episodic memory research in schizophrenia has a long history already which has clearly established significant impairments and strong associations with brain measures and functional outcome. The purpose of this chapter is not to make an exhaustive review of the recent literature but to highlight some relatively recent developments in the cognitive neuroscience field of episodic memory and schizophrenia. Hence, we present a contemporary view focusing specifically of relational memory which represents a form of episodic memory that refers to associations or binding among items or elements presented together. We describe the major tasks used and illustrate how their combination with brain imaging has: (1) favored the use of experimental memory tasks to isolate specific processes with specific neural correlates, (2) led to a distributed view of the neural correlates of memory impairments in schizophrenia where multiple regions are contributing, and (3) made possible the identification of fMRI biomarkers specific to episodic memory. We then briefly propose what we see as the next steps for memory research in schizophrenia so that the impact of this work can be maximized.
Collapse
Affiliation(s)
- Delphine Raucher-Chéné
- Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France.,Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | - Katie M Lavigne
- Douglas Research Centre, Verdun, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Research Centre, Verdun, QC, Canada. .,Department of Psychiatry, McGill University, Montréal, QC, Canada.
| |
Collapse
|
9
|
McHugo M, Rogers BP, Avery SN, Armstrong K, Blackford JU, Vandekar SN, Roeske MJ, Woodward ND, Heckers S. Increased amplitude of hippocampal low frequency fluctuations in early psychosis: A two-year follow-up study. Schizophr Res 2022; 241:260-266. [PMID: 35180665 PMCID: PMC8960358 DOI: 10.1016/j.schres.2022.02.003] [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: 12/17/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/30/2022]
Abstract
Neuroimaging studies have revealed hippocampal hyperactivity in schizophrenia. In the early stage of the illness, hyperactivity is present in the anterior hippocampus and is thought to spread to other regions as the illness progresses. However, there is limited evidence for changes in basal hippocampal function following the onset of psychosis. Resting state functional MRI signal amplitude may be a proxy measure for increased metabolism and disrupted oscillatory activity, both consequences of an excitation/inhibition imbalance underlying hippocampal hyperactivity. Here, we used fractional amplitude of low frequency fluctuations (fALFF) to test the hypothesis of progressive hippocampal hyperactivity in a two-year longitudinal case-control study. We found higher fALFF in the anterior and posterior hippocampus of individuals in the early stage of non-affective psychosis at study entry. Contrary to our hypothesis of progressive hippocampal dysfunction, we found evidence for normalization of fALFF over time in psychosis. Our findings support a model in which hippocampal fALFF is a marker of psychosis vulnerability or acute illness state rather than an enduring feature of the illness.
Collapse
Affiliation(s)
- Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Baxter P. Rogers
- Vanderbilt University Institute of Imaging Sciences, Nashville, TN, USA
| | - Suzanne N. Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maxwell J. Roeske
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
10
|
Plassard AJ, Bao S, McHugo M, Beason-Held L, Blackford JU, Heckers S, Landman BA. Automated, open-source segmentation of the Hippocampus and amygdala with the open Vanderbilt archive of the temporal lobe. Magn Reson Imaging 2021; 81:17-23. [PMID: 33901584 PMCID: PMC8715642 DOI: 10.1016/j.mri.2021.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
Examining volumetric differences of the amygdala and anterior-posterior regions of the hippocampus is important for understanding cognition and clinical disorders. However, the gold standard manual segmentation of these structures is time and labor-intensive. Automated, accurate, and reproducible techniques to segment the hippocampus and amygdala are desirable. Here, we present a hierarchical approach to multi-atlas segmentation of the hippocampus head, body and tail and the amygdala based on atlases from 195 individuals. The Open Vanderbilt Archive of the temporal Lobe (OVAL) segmentation technique outperforms the commonly used FreeSurfer, FSL FIRST, and whole-brain multi-atlas segmentation approaches for the full hippocampus and amygdala and nears or exceeds inter-rater reproducibility for segmentation of the hippocampus head, body and tail. OVAL has been released in open-source and is freely available.
Collapse
Affiliation(s)
- Andrew J Plassard
- Vanderbilt University, Computer Science, 2301 Vanderbilt Place, Nashville, TN 37235, USA.
| | - Shunxing Bao
- Vanderbilt University, Computer Science, 2301 Vanderbilt Place, Nashville, TN 37235, USA.
| | - Maureen McHugo
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.
| | - Lori Beason-Held
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, 31 Center Dr, #5C27 MSC 2292, Building 31, Room 5C27, Bethesda, Maryland, 20892-0001, USA.
| | - Jennifer U Blackford
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.
| | - Stephan Heckers
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA.
| | - Bennett A Landman
- Vanderbilt University, Computer Science, 2301 Vanderbilt Place, Nashville, TN 37235, USA; Vanderbilt University, Electrical Engineering, 2301 Vanderbilt Place, Nashville, TN 37235, USA.
| |
Collapse
|
11
|
Avery SN, McHugo M, Armstrong K, Blackford JU, Woodward ND, Heckers S. Stable habituation deficits in the early stage of psychosis: a 2-year follow-up study. Transl Psychiatry 2021; 11:20. [PMID: 33414431 PMCID: PMC7791099 DOI: 10.1038/s41398-020-01167-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 01/29/2023] Open
Abstract
Neural habituation, the decrease in brain response to repeated stimuli, is a fundamental, highly conserved mechanism that acts as an essential filter for our complex sensory environment. Convergent evidence indicates neural habituation is disrupted in both early and chronic stages of schizophrenia, with deficits co-occurring in brain regions that show inhibitory dysfunction. As inhibitory deficits have been proposed to contribute to the onset and progression of illness, habituation may be an important treatment target. However, a crucial first step is clarifying whether habituation deficits progress with illness. In the present study, we measured neural habituation in 138 participants (70 early psychosis patients (<2 years of illness), 68 healthy controls), with 108 participants assessed longitudinally at both baseline and 2-year follow-up. At follow-up, all early psychosis patients met criteria for a schizophrenia spectrum disorder (i.e., schizophreniform disorder, schizophrenia, schizoaffective disorder). Habituation slopes (i.e., rate of fMRI signal change) to repeated images were computed for the anterior hippocampus, occipital cortex, and the fusiform face area. Habituation slopes were entered into a linear mixed model to test for effects of group and time by region. We found that early psychosis patients showed habituation deficits relative to healthy control participants across brain regions, and that these deficits were maintained, but did not worsen, over two years. These results suggest a stable period of habituation deficits in the early stage of schizophrenia.
Collapse
Affiliation(s)
- Suzanne N. Avery
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Maureen McHugo
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Kristan Armstrong
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Jennifer Urbano Blackford
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA ,grid.413806.8Research Health Scientist, Research and Development, Department of Veterans Affairs Medical Center, Nashville, TN USA
| | - Neil D. Woodward
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Stephan Heckers
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| |
Collapse
|