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Sehatpour P, Iosifescu DV, De Baun HM, Shope C, Mayer MR, Gangwisch J, Dias E, Sobeih T, Choo TH, Wall MM, Medalia A, Saperstein AM, Kegeles LS, Girgis RR, Carlson M, Kantrowitz JT. Dose-Dependent Augmentation of Neuroplasticity-Based Auditory Learning in Schizophrenia: A Double-Blind, Placebo-Controlled, Randomized, Target Engagement Clinical Trial of the NMDA Glutamate Receptor Agonist d-serine. Biol Psychiatry 2023; 94:164-173. [PMID: 36958998 PMCID: PMC10313776 DOI: 10.1016/j.biopsych.2023.01.015] [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: 08/10/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Patients with schizophrenia show reduced NMDA glutamate receptor-dependent auditory plasticity, which is rate limiting for auditory cognitive remediation (AudRem). We evaluate the utility of behavioral and neurophysiological pharmacodynamic target engagement biomarkers, using a d-serine+AudRem combination. METHODS Forty-five participants with schizophrenia or schizoaffective disorder were randomized to 3 once-weekly AudRem visits + double-blind d-serine (80, 100, or 120 mg/kg) or placebo in 3 dose cohorts of 12 d-serine and 3 placebo-treated participants each. In AudRem, participants indicated which paired tone was higher in pitch. The primary outcome was plasticity improvement, operationalized as change in pitch threshold between AudRem tones [(test tone Hz - reference tone Hz)/reference tone Hz] between the initial plateau pitch threshold (mean of trials 20-30 of treatment visit 1) to pitch threshold at the end of visit(s). Target engagement was assessed by electroencephalography outcomes, including mismatch negativity (pitch primary). RESULTS There was a significant overall treatment effect for plasticity improvement (p = .014). Plasticity improvement was largest within the 80 and 100 mg/kg groups (p < .001, d > 0.67), while 120 mg/kg and placebo-treated participants showed nonsignificant within-group changes. Plasticity improvement was seen after a single treatment and was sustained on subsequent treatments. Target engagement was demonstrated by significantly larger mismatch negativity (p = .049, d = 1.0) for the 100 mg/kg dose versus placebo. CONCLUSIONS Our results demonstrate sufficient proof of principle for continued development of both the d-serine+AudRem combination and our target engagement methodology. The ultimate utility is dependent on the results of an ongoing larger, longer study of the combination for clinically relevant outcomes.
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Affiliation(s)
- Pejman Sehatpour
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York; Nathan Kline Institute, Orangeburg, New York
| | - Dan V Iosifescu
- Nathan Kline Institute, Orangeburg, New York; Psychiatry, New York University Grossman School of Medicine, New York, New York
| | - Heloise M De Baun
- Area Psychosis, New York State Psychiatric Institute, New York, New York
| | | | - Megan R Mayer
- Area Psychosis, New York State Psychiatric Institute, New York, New York
| | - James Gangwisch
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Elisa Dias
- Nathan Kline Institute, Orangeburg, New York; Psychiatry, New York University Grossman School of Medicine, New York, New York
| | | | - Tse-Hwei Choo
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Melanie M Wall
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alice Medalia
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alice M Saperstein
- Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lawrence S Kegeles
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Ragy R Girgis
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Marlene Carlson
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Joshua T Kantrowitz
- Area Psychosis, New York State Psychiatric Institute, New York, New York; Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York; Nathan Kline Institute, Orangeburg, New York.
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2
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Govani V, Shastry A, Iosifescu D, Govil P, Mayer M, Sobeih T, Choo T, Wall M, Sehatpour P, Kantrowitz J. Augmentation of learning in schizophrenia by D-serine is related to auditory and frontally-generated biomarkers: A randomized, double-blind, placebo-controlled study. RESEARCH SQUARE 2023:rs.3.rs-2943290. [PMID: 37293030 PMCID: PMC10246259 DOI: 10.21203/rs.3.rs-2943290/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Auditory cognition is impaired in schizophrenia, and typically engages a complex, distributed, hierarchical network, including both auditory and frontal input. We recently demonstrated proof of principle for the target engagement of an N-methyl-D-aspartate-type glutamate receptor (NMDAR) agonist + auditory targeted remediation (d-serine+AudRem) combination, showing significant improvement in auditory-learning induced plasticity and mismatch negativity. In this secondary analysis, we report on frontal EEG outcomes, assessing for both generalized effects and the mechanism of auditory plasticity. 21 schizophrenia or schizoaffective disorder participants were randomized to three 1x weekly AudRem + double-blind d-serine (100 mg/kg) visits. In AudRem, participants indicated which paired tone was higher in pitch. The focus of this secondary analysis was a frontally (premotor) mediated EEG outcome- event-related desynchronization in the b band (b-ERD), which was shown to be sensitive to AudRem in previous studies. d-Serine+AudRem led to significant improvement in b-ERD power across the retention and motor preparation intervals (F 1,18 =6.0, p=0.025) vs. AudRem alone. b-ERD was significantly related to baseline cognition, but not auditory-learning induced plasticity. The principal finding of this prespecified secondary analysis are that in addition to improving auditory based biomarkers, the d-serine+AudRem combination led to significant improvement in biomarkers thought to represent frontally mediated dysfunction, suggesting potential generalization of effects. Changes in auditory-learning induced plasticity were independent of these frontally mediated biomarkers. Ongoing work will assess whether d-serine+AudRem is sufficient to remediate cognition or whether targeting frontal NMDAR deficits with higher-level remediation may also be required. Trial Registration: NCT03711500.
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Fivel L, Mondino M, Brunelin J, Haesebaert F. Basic auditory processing and its relationship with symptoms in patients with schizophrenia: A systematic review. Psychiatry Res 2023; 323:115144. [PMID: 36940586 DOI: 10.1016/j.psychres.2023.115144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
Processing of basic auditory features, one of the earliest stages of auditory perception, has been the focus of considerable investigations in schizophrenia. Although numerous studies have shown abnormalities in pitch perception in schizophrenia, other basic auditory features such as intensity, duration, and sound localization have been less explored. Additionally, the relationship between basic auditory features and symptom severity shows inconsistent results, preventing concrete conclusions. Our aim was to present a comprehensive overview of basic auditory processing in schizophrenia and its relationship with symptoms. We conducted a systematic review according to the PRISMA guidelines. PubMed, Embase, and PsycINFO databases were searched for studies exploring auditory perception in schizophrenia compared to controls, with at least one behavioral task investigating basic auditory processing using pure tones. Forty-one studies were included. The majority investigated pitch processing while the others investigated intensity, duration and sound localization. The results revealed that patients have a significant deficit in the processing of all basic auditory features. Although the search for a relationship with symptoms was limited, auditory hallucinations experience appears to have an impact on basic auditory processing. Further research may examine correlations with clinical symptoms to explore the performance of patient subgroups and possibly implement remediation strategies.
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Affiliation(s)
- Laure Fivel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France.
| | - Jerome Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
| | - Frédéric Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
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4
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Slapø NB, Nerland S, Nordbø Jørgensen K, Mørch-Johnsen L, Pettersen JH, Roelfs D, Parker N, Valstad M, Pentz A, Timpe CMF, Richard G, Beck D, Werner MCF, Lagerberg TV, Melle I, Agartz I, Westlye LT, Steen NE, Andreassen OA, Moberget T, Elvsåshagen T, Jönsson EG. Auditory Cortex Thickness Is Associated With N100 Amplitude in Schizophrenia Spectrum Disorders. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad015. [PMID: 38812720 PMCID: PMC7616042 DOI: 10.1093/schizbullopen/sgad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Background and Hypothesis The auditory cortex (AC) may play a central role in the pathophysiology of schizophrenia and auditory hallucinations (AH). Previous schizophrenia studies report thinner AC and impaired AC function, as indicated by decreased N100 amplitude of the auditory evoked potential. However, whether these structural and functional alterations link to AH in schizophrenia remain poorly understood. Study Design Patients with a schizophrenia spectrum disorder (SCZspect), including patients with a lifetime experience of AH (AH+), without (AH-), and healthy controls underwent magnetic resonance imaging (39 SCZspect, 22 AH+, 17 AH-, and 146 HC) and electroencephalography (33 SCZspect, 17 AH+, 16 AH-, and 144 HC). Cortical thickness of the primary (AC1, Heschl's gyrus) and secondary (AC2, Heschl's sulcus, and the planum temporale) AC was compared between SCZspect and controls and between AH+, AH-, and controls. To examine if the association between AC thickness and N100 amplitude differed between groups, we used regression models with interaction terms. Study Results N100 amplitude was nominally smaller in SCZspect (P = .03, d = 0.42) and in AH- (P = .020, d = 0.61), while AC2 was nominally thinner in AH+ (P = .02, d = 0.53) compared with controls. AC1 thickness was positively associated with N100 amplitude in SCZspect (t = 2.56, P = .016) and AH- (t = 3.18, P = .008), while AC2 thickness was positively associated with N100 amplitude in SCZspect (t = 2.37, P = .024) and in AH+ (t = 2.68, P = .019). Conclusions The novel findings of positive associations between AC thickness and N100 amplitude in SCZspect, suggest that a common neural substrate may underlie AC thickness and N100 amplitude alterations.
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Affiliation(s)
- Nora Berz Slapø
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stener Nerland
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Kjetil Nordbø Jørgensen
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Telemark Hospital, Skien, Norway
| | - Lynn Mørch-Johnsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry, Østfold Hospital, Grålum, Norway
- Department of Clinical Research, Østfold Hospital, Grålum, Norway
| | | | - Daniel Roelfs
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nadine Parker
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mathias Valstad
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Atle Pentz
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Clara M. F. Timpe
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Geneviève Richard
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dani Beck
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Maren C. Frogner Werner
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Ingrid Melle
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatry, Telemark Hospital, Skien, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Sciences, Stockholm Region, Sweden
| | - Lars T. Westlye
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A. Andreassen
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torgeir Moberget
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Behavioral Sciences, Faculty of Health Sciences, Oslo Metropolitan University, OsloMet, Oslo, Norway
| | - Torbjørn Elvsåshagen
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Erik G. Jönsson
- Department of medicine, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Lado-Codesido M, Sánchez-Reales S, Caballero-Peláez C, Iglesias-Gaspar MT, Lado MJ, García-Caballero A, Lahera G. Emotion recognition through Spanish prosody in people with schizophrenia. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:196-205. [PMID: 35867486 PMCID: PMC10803871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
People with schizophrenia have deficits in the ability to identify emotions. An area of important dysfunction is the understanding of affective prosody, which can limit communication and social functionality. The objective of this study is to compare emotional recognition through prosody between a group of people with schizophrenia versus a control group without pathology, through the Reading the Mind in the Voice - Spanish Version scale (RMV-SV).
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Affiliation(s)
- María Lado-Codesido
- Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
- Hospital Universitario Donostia, Donostia-San Sebastián, Guipúzcoa, España
| | - Sergio Sánchez-Reales
- Unidad de Salud Mental Comunitaria de Ronda, Área de Gestión Sanitaria Serranía de Málaga, Málaga, España
| | - Carmen Caballero-Peláez
- Unidad de Salud Mental Comunitaria de Ronda, Área de Gestión Sanitaria Serranía de Málaga, Málaga, España
| | - María-Teresa Iglesias-Gaspar
- Hospital Universitario Donostia, Donostia-San Sebastián, Guipúzcoa, España
- Instituto de Investigación Sanitaria Biodonostia. Donostia-San Sebastián, Guipúzcoa, España
| | - María J. Lado
- Escuela Superior de Ingeniería Informática - Universidad de Vigo. Ourense, España
| | - Alejandro García-Caballero
- Instituto Biomédico Galicia Sur, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - Guillermo Lahera
- Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá. Alcalá de Henares, Madrid, España
- Servicio de Psiquiatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
- Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Madrid, España
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6
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Schelinski S, Tabas A, von Kriegstein K. Altered processing of communication signals in the subcortical auditory sensory pathway in autism. Hum Brain Mapp 2022; 43:1955-1972. [PMID: 35037743 PMCID: PMC8933247 DOI: 10.1002/hbm.25766] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 11/24/2021] [Accepted: 12/19/2021] [Indexed: 12/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterised by social communication difficulties. These difficulties have been mainly explained by cognitive, motivational, and emotional alterations in ASD. The communication difficulties could, however, also be associated with altered sensory processing of communication signals. Here, we assessed the functional integrity of auditory sensory pathway nuclei in ASD in three independent functional magnetic resonance imaging experiments. We focused on two aspects of auditory communication that are impaired in ASD: voice identity perception, and recognising speech-in-noise. We found reduced processing in adults with ASD as compared to typically developed control groups (pairwise matched on sex, age, and full-scale IQ) in the central midbrain structure of the auditory pathway (inferior colliculus [IC]). The right IC responded less in the ASD as compared to the control group for voice identity, in contrast to speech recognition. The right IC also responded less in the ASD as compared to the control group when passively listening to vocal in contrast to non-vocal sounds. Within the control group, the left and right IC responded more when recognising speech-in-noise as compared to when recognising speech without additional noise. In the ASD group, this was only the case in the left, but not the right IC. The results show that communication signal processing in ASD is associated with reduced subcortical sensory functioning in the midbrain. The results highlight the importance of considering sensory processing alterations in explaining communication difficulties, which are at the core of ASD.
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Affiliation(s)
- Stefanie Schelinski
- Faculty of Psychology, Chair of Cognitive and Clinical NeuroscienceTechnische Universität DresdenDresdenGermany
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Alejandro Tabas
- Faculty of Psychology, Chair of Cognitive and Clinical NeuroscienceTechnische Universität DresdenDresdenGermany
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Katharina von Kriegstein
- Faculty of Psychology, Chair of Cognitive and Clinical NeuroscienceTechnische Universität DresdenDresdenGermany
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
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7
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Mismatch negativity as an index of target engagement for excitation/inhibition-based treatment development: a double-blind, placebo-controlled, randomized, single-dose cross-over study of the serotonin type-3 receptor antagonist CVN058. Neuropsychopharmacology 2022; 47:711-718. [PMID: 34667294 PMCID: PMC8782925 DOI: 10.1038/s41386-021-01170-8] [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: 05/14/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
Serotonin type-3 receptor (5-HT3R) antagonists show potential as a treatment for cognitive deficits in schizophrenia. CVN058, a brain-penetrant, potent and selective 5-HT3R antagonist, shows efficacy in rodent models of cognition and was well-tolerated in Phase-1 studies. We evaluated the target engagement of CVN058 using mismatch negativity (MMN) in a randomized, double-blind, placebo-controlled, cross-over study. Subjects were stable outpatients with schizophrenia or schizoaffective disorder treated with antipsychotics. Subjects were not permitted to use other 5-HT3R modulators or serotonin reuptake inhibitors. Each subject received a high (150 mg) and low (15 mg or 75 mg) oral dose of CVN058 and placebo in a randomized order across 3 single-day treatment visits separated by at least 1 week. The primary pre-registered outcome was amplitude of duration MMN. Amplitude of other MMN deviants (frequency, intensity, frequency modulation, and location), P50, P300 and auditory steady-state response (ASSR) were exploratory endpoints. 19 of 22 randomized subjects (86.4%) completed the study. Baseline PANSS scores indicated moderate impairment. CVN058 150 mg led to significant improvement vs. placebo on the primary outcome of duration MMN (p = 0.02, Cohen's d = 0.48). A significant treatment effect was also seen in a combined analysis across all MMN deviants (p < 0.001, d = 0.57). Effects on location MMN were independently significant (p < 0.007, d = 0.46). No other significant effects were seen for other deviants, doses or EEG measures. There were no clinically significant treatment related adverse effects. These results show MMN to be a sensitive target engagement biomarker for 5-HT3R, and support the potential utility of CVN058 in correcting the excitatory/inhibitory imbalance in schizophrenia.
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8
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Zhu Y, Xu L, Wang W, Guo Q, Chen S, Zhang C, Zhang T, Hu X, Enck P, Li C, Sheng J, Wang J. Gender differences in attentive bias during social information processing in schizophrenia: An eye-tracking study. Asian J Psychiatr 2021; 66:102871. [PMID: 34619492 DOI: 10.1016/j.ajp.2021.102871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/06/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
Interpersonal communication is a specific scenario in which patients with psychiatric symptoms may manifest different behavioral patterns due to psychopathology. This was a pilot study by eye-tracking technology to investigate attentive bias during social information processing in schizophrenia. We enrolled 39 patients with schizophrenia from Shanghai Mental Health Center and 42 age-, gender- and education-matched healthy controls. The experiment was a free-viewing task, in which pictures with three types of degree of interpersonal communication were shown. We used two measures: 1) initial fixation duration, 2) total gaze duration. The Positive and Negative Syndrome Scale (PANSS) was used to determine symptom severity. The ratio of first fixation duration for pictures of communicating vs. non-communicating persons was significantly lower in patients than in controls (Mann-Whitney U = 512, p = 0.004). We found that male patients showed a significantly lower ratio of first fixation duration than male controls (Mann-Whitney U = 190, p = 0.028), while it was marginally lower in female patients than female controls (Mann-Whitney U = 77, p = 0.057). The ratio of first fixation duration for pictures of communicating persons vs. no persons was negatively correlated with PANSS negative symptoms in male patients (rho = -0.458, p = 0.024). In contrast, it was negatively correlated with PANSS positive symptoms in female patients (-0.701, p = 0.004). These findings suggest altered attentive bias during social information processing with a pattern of avoidance at first sight towards pictures of communicating persons in schizophrenia. It is worthwhile to note that social functioning impairment is associated with the severity of symptoms.
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Affiliation(s)
- Yikang Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wenzheng Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qian Guo
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Shan Chen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Caidi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China
| | - Jianhua Sheng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China.
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9
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Luo H, Zhao Y, Fan F, Fan H, Wang Y, Qu W, Wang Z, Tan Y, Zhang X, Tan S. A bottom-up model of functional outcome in schizophrenia. Sci Rep 2021; 11:7577. [PMID: 33828168 PMCID: PMC8027854 DOI: 10.1038/s41598-021-87172-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Schizophrenia results in poor functional outcomes owing to numerous factors. This study provides the first test of a bottom-up causal model of functional outcome in schizophrenia, using neurocognition, vocal emotional cognition, alexithymia, and negative symptoms as predictors of functional outcome. We investigated a cross-sectional sample of 135 individuals with schizophrenia and 78 controls. Using a series of structural equation modelling analyses, a single pathway was generated among scores from the MATRICS Consensus Cognitive Battery (MCCB), vocal emotion recognition test, Toronto Alexithymia Scale (TAS), Brief Negative Symptom Scale, and the Personal and Social Performance Scale. The scores for each dimension of the MCCB in the schizophrenia group were significantly lower than that in the control group. The recognition accuracy for different emotions (anger, disgust, fear, sadness, surprise, and satire, but not calm was significantly lower in the schizophrenia group than in the control group. Moreover, the scores on the three dimensions of TAS were significantly higher in the schizophrenia group than in the control group. On path analysis modelling, the proposed bottom-up causal model showed a strong fit with the data and formed a single pathway, from neurocognition to vocal emotional cognition, to alexithymia, to negative symptoms, and to poor functional outcomes. The study results strongly support the proposed bottom-up causal model of functional outcome in schizophrenia. The model could be used to better understand the causal factors related to the functional outcome, as well as for the development of intervention strategies to improve functional outcomes in schizophrenia.
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Affiliation(s)
- Hongge Luo
- grid.440734.00000 0001 0707 0296School of Public Health, North China University of Science and Technology, Tangshan, China ,grid.440734.00000 0001 0707 0296College of Psychology, North China University of Science and Technology, Tangshan, China
| | - Yanli Zhao
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Fengmei Fan
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Hongzhen Fan
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Yunhui Wang
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Wei Qu
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Zhiren Wang
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Yunlong Tan
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Xiujun Zhang
- grid.440734.00000 0001 0707 0296School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Shuping Tan
- grid.11135.370000 0001 2256 9319Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
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10
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Sehatpour P, Avissar M, Kantrowitz JT, Corcoran CM, De Baun HM, Patel GH, Girgis RR, Brucato G, Lopez-Calderon J, Silipo G, Dias E, Martinez A, Javitt DC. Deficits in Pre-attentive Processing of Spatial Location and Negative Symptoms in Subjects at Clinical High Risk for Schizophrenia. Front Psychiatry 2021; 11:629144. [PMID: 33603682 PMCID: PMC7884473 DOI: 10.3389/fpsyt.2020.629144] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/28/2020] [Indexed: 12/11/2022] Open
Abstract
Deficits in mismatch negativity (MMN) generation are among the best-established biomarkers for cognitive dysfunction in schizophrenia and predict conversion to schizophrenia (Sz) among individuals at symptomatic clinical high risk (CHR). Impairments in MMN index dysfunction at both subcortical and cortical components of the early auditory system. To date, the large majority of studies have been conducted using deviants that differ from preceding standards in either tonal frequency (pitch) or duration. By contrast, MMN to sound location deviation has been studied to only a limited degree in Sz and has not previously been examined in CHR populations. Here, we evaluated location MMN across Sz and CHR using an optimized, multi-deviant pattern that included a location-deviant, as defined using interaural time delay (ITD) stimuli along with pitch, duration, frequency modulation (FM) and intensity deviants in a sample of 42 Sz, 33 CHR and 28 healthy control (HC) subjects. In addition, we obtained resting state functional connectivity (rsfMRI) on CHR subjects. Sz showed impaired MMN performance across all deviant types, along with strong correlation between MMN deficits and impaired neurocognitive function. In this sample of largely non-converting CHR subjects, no deficits were observed in either pitch or duration MMN. By contrast, CHR subjects showed significant impairments in location MMN generation particularly over right hemisphere and significant correlation between impaired location MMN and negative symptoms including deterioration of role function. In addition, significant correlations were observed between location MMN and rsfMRI involving brainstem circuits. In general, location detection using ITD stimuli depends upon precise processing within midbrain regions and provides a rapid and robust reorientation of attention. Present findings reinforce the utility of MMN as a pre-attentive index of auditory cognitive dysfunction in Sz and suggest that location MMN may index brain circuits distinct from those indexed by other deviant types.
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Affiliation(s)
- Pejman Sehatpour
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Michael Avissar
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Joshua T. Kantrowitz
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | | | - Heloise M. De Baun
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Gaurav H. Patel
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Ragy R. Girgis
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Gary Brucato
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Javier Lopez-Calderon
- Centro de Investigaciones Médicas, Escuela de Medicina, Universidad de Talca, Talca, Chile
| | - Gail Silipo
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Elisa Dias
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Antigona Martinez
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Daniel C. Javitt
- College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, United States
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
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11
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Lin Y, Ding H, Zhang Y. Multisensory Integration of Emotion in Schizophrenic Patients. Multisens Res 2020; 33:865-901. [PMID: 33706267 DOI: 10.1163/22134808-bja10016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/24/2020] [Indexed: 01/04/2023]
Abstract
Multisensory integration (MSI) of emotion has been increasingly recognized as an essential element of schizophrenic patients' impairments, leading to the breakdown of their interpersonal functioning. The present review provides an updated synopsis of schizophrenics' MSI abilities in emotion processing by examining relevant behavioral and neurological research. Existing behavioral studies have adopted well-established experimental paradigms to investigate how participants understand multisensory emotion stimuli, and interpret their reciprocal interactions. Yet it remains controversial with regard to congruence-induced facilitation effects, modality dominance effects, and generalized vs specific impairment hypotheses. Such inconsistencies are likely due to differences and variations in experimental manipulations, participants' clinical symptomatology, and cognitive abilities. Recent electrophysiological and neuroimaging research has revealed aberrant indices in event-related potential (ERP) and brain activation patterns, further suggesting impaired temporal processing and dysfunctional brain regions, connectivity and circuities at different stages of MSI in emotion processing. The limitations of existing studies and implications for future MSI work are discussed in light of research designs and techniques, study samples and stimuli, and clinical applications.
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Affiliation(s)
- Yi Lin
- 1Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, 800 Dong Chuan Rd., Minhang District, Shanghai, 200240, China
| | - Hongwei Ding
- 1Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, 800 Dong Chuan Rd., Minhang District, Shanghai, 200240, China
| | - Yang Zhang
- 2Department of Speech-Language-Hearing Sciences & Center for Neurobehavioral Development, University of Minnesota, Twin Cities, MN 55455, USA
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12
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Abstract
Schizophrenia is a major mental illness associated with profound disability. Current treatments for schizophrenia (antipsychotics) all have a similar mechanism of action and are primarily dopamine type 2 receptor (D2R) antagonists. Antipsychotics are not fully effective for the majority of schizophrenia patients, suggesting the need for alternative approaches. The primary focus of this review is to assess the evidence for the role of the serotonin type 2A receptor (5-HT2AR) in schizophrenia. Topics include an overview of 5-HT2AR physiology and pathophysiology in schizophrenia, 5-HT2AR interaction with other neurotransmitter systems, including the glutamatergic system, a review of the 5-HT2AR/d-lysergic acid diethylamide (LSD) model of schizophrenia, a contrast of the 5-HT2AR and glutamatergic models of schizophrenia, and finally, a review of Food and Drug Administration (FDA)-approved and investigational 5-HT2AR-modulating compounds. Recent studies with lumeteperone, pimavanserin, and roluperidone are highlighted.
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13
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Miley K, Fisher M, Nahum M, Howard E, Rowlands A, Brandrett B, Woolley J, Hooker CI, Biagianti B, Ramsay I, Vinogradov S. Six month durability of targeted cognitive training supplemented with social cognition exercises in schizophrenia. Schizophr Res Cogn 2020; 20:100171. [PMID: 31908976 PMCID: PMC6938953 DOI: 10.1016/j.scog.2019.100171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 12/15/2022]
Abstract
Background Deficits in cognition, social cognition, and motivation are significant predictors of poor functional outcomes in schizophrenia. Evidence of durable benefit following social cognitive training is limited. We previously reported the effects of 70 h of targeted cognitive training supplemented with social cognitive exercises (TCT + SCT) verses targeted cognitive training alone (TCT). Here, we report the effects six months after training. Methods 111 participants with schizophrenia spectrum disorders were randomly assigned to TCT + SCT or TCT-only. Six months after training, thirty-four subjects (18 TCT + SCT, 16 TCT-only) were assessed on cognition, social cognition, reward processing, symptoms, and functioning. Intent to treat analyses was used to test the durability of gains, and the association of gains with improvements in functioning and reward processing were tested. Results Both groups showed durable improvements in multiple cognitive domains, symptoms, and functional capacity. Gains in global cognition were significantly associated with gains in functional capacity. In the TCT + SCT group, participants showed durable improvements in prosody identification and reward processing, relative to the TCT-only group. Gains in reward processing in the TCT + SCT group were significantly associated with improvements in social functioning. Conclusions Both TCT + SCT and TCT-only result in durable improvements in cognition, symptoms, and functional capacity six months post-intervention. Supplementing TCT with social cognitive training offers greater and enduring benefits in prosody identification and reward processing. These results suggest that novel cognitive training approaches that integrate social cognitive exercises may lead to greater improvements in reward processing and functioning in individuals with schizophrenia.
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Affiliation(s)
- Kathleen Miley
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America.,School of Nursing, University of Minnesota, 308 SE Harvard St., Minneapolis, MN 55454, United States of America
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, PO Box 24026, Mount Scopus, Jerusalem, 94210, Israel
| | - Elizabeth Howard
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Abby Rowlands
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Benjamin Brandrett
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Josh Woolley
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 400, Chicago, IL, United States of America
| | - Bruno Biagianti
- Posit Science, Inc., 160 Pine St., Suite 200, San Francisco, CA 94111, United States of America
| | - Ian Ramsay
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
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14
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de la Garrigue N, Glasser J, Sehatpour P, Iosifescu DV, Dias E, Carlson M, Shope C, Sobeih T, Choo TH, Wall MM, Kegeles LS, Gangwisch J, Mayer M, Brazis S, De Baun HM, Wolfer S, Bermudez D, Arnold M, Rette D, Meftah AM, Conant M, Lieberman JA, Kantrowitz JT. Grant Report on d-Serine Augmentation of Neuroplasticity-Based Auditory Learning in Schizophrenia †. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2020; 5:e200018. [PMID: 32856005 PMCID: PMC7448686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We report on the rationale and design of an ongoing NIMH sponsored R61-R33 project in schizophrenia/schizoaffective disorder. This project studies augmenting the efficacy of auditory neuroplasticity cognitive remediation (AudRem) with d-serine, an N-methyl-d-aspartate-type glutamate receptor (NMDAR) glycine-site agonist. We operationalize improved (smaller) thresholds in pitch (frequency) between successive auditory stimuli after AudRem as improved plasticity, and mismatch negativity (MMN) and auditory θ as measures of functional target engagement of both NMDAR agonism and plasticity. Previous studies showed that AudRem alone produces significant, but small cognitive improvements, while d-serine alone improves symptoms and MMN. However, the strongest results for plasticity outcomes (improved pitch thresholds, auditory MMN and θ) were found when combining d-serine and AudRem. AudRem improvements correlated with reading and other auditory cognitive tasks, suggesting plasticity improvements are predictive of functionally relevant outcomes. While d-serine appears to be efficacious for acute AudRem enhancement, the optimal dose remains an open question, as does the ability of combined d-serine + AudRem to produce sustained improvement. In the ongoing R61, 45 schizophrenia patients will be randomized to receive three placebo-controlled, double-blind d-serine + AudRem sessions across three separate 15 subject dose cohorts (80/100/120 mg/kg). Successful completion of the R61 is defined by ≥moderate effect size changes in target engagement and correlation with function, without safety issues. During the three-year R33, we will assess the sustained effects of d-serine + AudRem. In addition to testing a potentially viable treatment, this project will develop a methodology to assess the efficacy of novel NMDAR modulators, using d-serine as a "gold-standard".
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Affiliation(s)
| | - Juliana Glasser
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Pejman Sehatpour
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA,Nathan Kline Institute, Orangeburg, NY 10962, USA
| | - Dan V. Iosifescu
- Nathan Kline Institute, Orangeburg, NY 10962, USA,NYU Langone Medical Center, New York, NY 10016, USA
| | - Elisa Dias
- Nathan Kline Institute, Orangeburg, NY 10962, USA,NYU Langone Medical Center, New York, NY 10016, USA
| | - Marlene Carlson
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | | | - Tarek Sobeih
- Nathan Kline Institute, Orangeburg, NY 10962, USA
| | - Tse-Hwei Choo
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Melanie M. Wall
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Lawrence S. Kegeles
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - James Gangwisch
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Megan Mayer
- New York State Psychiatric Institute, New York, NY 10032, USA
| | | | | | | | - Dalton Bermudez
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Molly Arnold
- Nathan Kline Institute, Orangeburg, NY 10962, USA
| | | | - Amir M. Meftah
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melissa Conant
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Jeffrey A. Lieberman
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
| | - Joshua T. Kantrowitz
- New York State Psychiatric Institute, New York, NY 10032, USA,Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA,Nathan Kline Institute, Orangeburg, NY 10962, USA,Correspondence: Joshua T. Kantrowitz, ; Tel.: +1-646-774-6738
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15
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Dondé C, Martínez A, Kantrowitz JT, Silipo G, Dias EC, Patel GH, Sanchez-Peña J, Corcoran CM, Medalia A, Saperstein A, Vail B, Javitt DC. Bimodal distribution of tone-matching deficits indicates discrete pathophysiological entities within the syndrome of schizophrenia. Transl Psychiatry 2019; 9:221. [PMID: 31492832 PMCID: PMC6731304 DOI: 10.1038/s41398-019-0557-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 12/11/2022] Open
Abstract
To date, no measures are available that permit differentiation of discrete, clinically distinct subtypes of schizophrenia (SZ) with potential differential underlying pathophysiologies. Over recent years, there has been increasing recognition that SZ is heterogeneously associated with deficits in early auditory processing (EAP), as demonstrated using clinically applicable tasks such as tone-matching task (TMT). Here, we pooled TMT performances across 310 SZ individuals and 219 healthy controls (HC), along with clinical, cognitive, and resting-state functional-connectivity MRI (rsFC-MRI) measures. In addition, TMT was measured in a group of 24 patients at symptomatic clinical high risk (CHR) for SZ and 24 age-matched HC (age range 7-27 years). We provide the first demonstration that the EAP deficits are bimodally distributed across SZ subjects (P < 0.0001 vs. unimodal distribution), with one group showing entirely unimpaired TMT performance (SZ-EAP+), and a second showing an extremely large TMT impairment (SZ-EAP-), relative to both controls (d = 2.1) and SZ-EAP+ patients (d = 3.4). The SZ-EAP- group predominated among samples drawn from inpatient sites, showed higher levels of cognitive symptoms (PANSS), worse social cognition and a differential deficit in neurocognition (MATRICS battery), and reduced functional capacity. rsFC-MRI analyses showed significant reduction in SZ-EAP- relative to controls between subcortical and cortical auditory regions. As opposed to SZ, CHR patients showed intact EAP function. In HC age-matched to CHR, EAP ability was shown to increase across the age range of vulnerability preceding SZ onset. These results indicate that EAP measure segregates between discrete SZ subgroups. As TMT can be readily implemented within routine clinical settings, its use may be critical to account for the heterogeneity of clinical outcomes currently observed across SZ patients, as well as for pre-clinical detection and efficacious treatment selection.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France. .,University Lyon 1, Villeurbanne, F-69000, France. .,Centre Hospitalier Le Vinatier, Bron, France. .,Nathan Kline Institute, Orangeburg, NY, USA. .,Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
| | - Antigona Martínez
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA ,0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Joshua T. Kantrowitz
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA ,0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Gail Silipo
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA
| | - Elisa C. Dias
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA
| | - Gaurav H. Patel
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Juan Sanchez-Peña
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Cheryl M. Corcoran
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA ,0000 0001 0670 2351grid.59734.3cDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Alice Medalia
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Alice Saperstein
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Blair Vail
- 0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Daniel C. Javitt
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, NY USA ,0000 0001 2285 2675grid.239585.0Deppartment of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY USA
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16
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Kantrowitz JT. N-methyl-d-aspartate-type glutamate receptor modulators and related medications for the enhancement of auditory system plasticity in schizophrenia. Schizophr Res 2019; 207:70-79. [PMID: 29459050 DOI: 10.1016/j.schres.2018.02.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/30/2018] [Accepted: 02/02/2018] [Indexed: 12/14/2022]
Abstract
Deficits in N-methyl-d-aspartate-type (NMDAR) function contribute to cognitive deficits in schizophrenia, particularly dysfunction in neuroplasticity, defined as reduced learning during training on exercises that place implicit, increasing demands on early sensory (auditory and visual) information processing. Auditory mismatch negativity (MMN) can be both a target engagement biomarker for the NMDAR and a proxy measure of neurophysiological plasticity. This review covers the evidence for using NMDAR modulator and related compounds for enhancement of cognition, with a particular focus on early auditory processing/plasticity. Compounds covered include glycine site agonists, glycine and system A-type transporter inhibitors, d-amino acid oxidase inhibitors, memantine and nicotinic alpha-7 acetylcholine receptor agonists. As opposed to daily treatment studies focusing on schizophrenia in general, intermittent, non-daily treatment combining NMDAR modulators with neuroplasticity-based paradigms, using MMN as target-engagement biomarkers show promise as treatments to both remediate plasticity deficits and overall functional deficits.
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Affiliation(s)
- Joshua T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, NY 10032, USA.
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17
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Dondé C, Silipo G, Dias EC, Javitt DC. Hierarchical deficits in auditory information processing in schizophrenia. Schizophr Res 2019; 206:135-141. [PMID: 30551982 PMCID: PMC6526044 DOI: 10.1016/j.schres.2018.12.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/11/2018] [Accepted: 12/04/2018] [Indexed: 01/31/2023]
Abstract
Deficits in auditory processing contribute significantly to impaired functional outcome in schizophrenia (SZ), but mediating factors remain under investigation. Here we evaluated two hierarchical components of early auditory processing: pitch-change detection (i.e. identifying if 2 tones have "same" or "different" pitch), which is preferentially associated with early auditory cortex, and serial pitch-pattern detection (i.e. identifying if 3 tones have "same" or "different" pitch, and, if "different", which one differed from the others), which depends also on auditory association regions. Deficits in pitch-change detection deficits in SZ have been widely reported and correlated with higher auditory disturbances such as Auditory Emotion Recognition (AER). Deficits in serial pitch-pattern discrimination have been less studied. Here, we investigated both pitch perception components, along with integrity of AER in SZ patients vs. controls using behavioral paradigms. We hypothesized that the deficits could be viewed as hierarchically organized in SZ, with deficits in low-level function propagating sequentially through subsequent levels of processing. Participants included 27 SZ and 40 controls. The magnitude of the deficits in SZ participants was large in both the pitch-change (d = 1.15) and serial pitch-pattern tasks (d = 1.21) with no significant differential task effect. The effect size of the AER deficits was extremely large (d = 2.82). In the SZ group, performance in both pitch tasks correlated significantly with impaired AER performance. However, a mediation analysis showed that serial pitch-pattern detection mediated the relationship between simpler pitch-change detection and AER in patients. Findings are consistent with hierarchical models of cognitive dysfunction in SZ with deficits in early information processing contributing to higher level impairments. Furthermore, findings are consistent with recent neurophysiological results suggesting similar level impairments for processing of simple vs. more complex tonal dysfunction in SZ.
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Affiliation(s)
- Clément Dondé
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Centre Hospitalier Le Vinatier, Bron, France; Nathan Kline Institute, Orangeburg, NY, USA; Dept. of Psychiatry, Columbia University Medical Center, New York, NY, USA.
| | - Gail Silipo
- Nathan Kline Institute, Orangeburg, NY, USA.
| | | | - Daniel C. Javitt
- Nathan Kline Institute, Orangeburg, NY USA,Dept. of Psychiatry, Columbia University Medical Center, New York, NY USA
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18
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Affective modulation of target detection in deficit and non-deficit schizophrenia. Schizophr Res 2019; 204:138-145. [PMID: 30126815 PMCID: PMC6378118 DOI: 10.1016/j.schres.2018.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/20/2018] [Accepted: 08/13/2018] [Indexed: 11/22/2022]
Abstract
Emotional deficits are an integral feature of schizophrenia (SZ), but our understanding of these deficits is limited. In the present study, we examined whether the severity of emotional deficits reflects difficulty in the cognitive processing of affectively valenced stimuli. Healthy controls (HC; N = 170) and stable outpatients with SZ (N = 245), characterized as either deficit syndrome (DS; N = 62) or non-deficit syndrome (NDS; N = 183), completed an Affective Go/NoGo task requiring discrimination of positively, negatively or neutrally valenced words. Accuracy (d') and response bias (c) were calculated for each of the three conditions, and a series of ANOVAs were carried out to examine group differences. Examination of accuracy revealed significant main effects of group and valence and a significant valence × group interaction, indicating that while affective valence impacted accuracy for the HC and NDS groups, the DS group maintained the same low level of accuracy across all levels of affective valence. Examination of response bias also revealed significant main effects of group and valence and a significant valence × group interaction. Specifically, within the HC and NDS groups, response bias did not differ between negatively and positively valenced words while response bias in the DS group was lowest for neutral, higher for negatively valenced and higher still for positively valenced words. These results suggest that emotional deficits in DS may be directly related to deficits in processing affective information. Moreover, although this deficit is observed across both positively and negatively valenced stimuli, it is most pronounced for positively valenced material.
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Kraus MS, Walker TM, Jarskog LF, Millet RA, Keefe RSE. Basic auditory processing deficits and their association with auditory emotion recognition in schizophrenia. Schizophr Res 2019; 204:155-161. [PMID: 30268821 DOI: 10.1016/j.schres.2018.08.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with schizophrenia are impaired in their ability to recognize emotions based on vocal cues and these impairments are associated with poor global outcome. Basic perceptual processes, such as auditory pitch processing, are impaired in schizophrenia and contribute to difficulty identifying emotions. However, previous work has focused on a relatively narrow assessment of auditory deficits and their relation to emotion recognition impairment in schizophrenia. METHODS We have assessed 87 patients with schizophrenia and 73 healthy controls on a comprehensive battery of tasks spanning the five empirically derived domains of auditory function. We also explored the relationship between basic auditory processing and auditory emotion recognition within the patient group using correlational analysis. RESULTS Patients exhibited widespread auditory impairments across multiple domains of auditory function, with mostly medium effect sizes. Performance on all of the basic auditory tests correlated with auditory emotion recognition at the p < .01 level in the patient group, with 9 out of 13 tests correlating with emotion recognition at r = 0.40 or greater. After controlling for cognition, many of the largest correlations involved spectral processing within the phase-locking range and discrimination of vocally based stimuli. CONCLUSIONS While many auditory skills contribute to this impairment, deficient formant discrimination appears to be a key skill contributing to impaired emotion recognition as this was the only basic auditory skill to enter a step-wise multiple regression after first entering a measure of cognitive impairment, and formant discrimination accounted for significant unique variance in emotion recognition performance after accounting for deficits in pitch processing.
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Affiliation(s)
- Michael S Kraus
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA.
| | - Trina M Walker
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA
| | - L Fredrik Jarskog
- North Carolina Psychiatric Research Center, Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Dr # 1, Chapel Hill, NC 27514, USA
| | - Robert A Millet
- Carolina Behavioral Care, 4102 Ben Franklin Blvd Durham, NC 27704, USA
| | - Richard S E Keefe
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA
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20
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Lado-Codesido M, Méndez Pérez C, Mateos R, Olivares JM, García Caballero A. Improving emotion recognition in schizophrenia with "VOICES": An on-line prosodic self-training. PLoS One 2019; 14:e0210816. [PMID: 30682067 PMCID: PMC6347191 DOI: 10.1371/journal.pone.0210816] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/31/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Emotion recognition (ER) deficits have been extensively demonstrated in schizophrenia. These deficiencies are not only restricted to facial emotion recognition but also include emotional prosody (tone of the voice) recognition deficits. They have been significantly associated with symptom severity and poor social functioning. The aim of this study was to test the efficacy, in real clinical conditions, of an online self-training prosodic game included in the Social Cognition rehabilitation program e-Motional Training. Method A randomized, single-blind multicenter clinical trial was conducted with 50 outpatients with schizophrenia or schizoaffective disorder. The control group was treated with Treatment-as-usual (TAU), based on drug therapy, case management and individual and group psychotherapy (not focused on Social Cognition). The intervention group was treated with TAU plus the employment of Voices, an online self-training program devised for prosodic rehabilitation. Statistical analysis Linear regression was used to evaluate the effectiveness of the intervention in emotion recognition measured with the Reading the Mind in the Voice–Spanish Version (RMV-SV). Results There were statistically significant differences between the intervention and control group measured with RMV-SV (β = 3,6[IC 95%], p<0.001), with a response variable in RMV post R2 = 0,617. Discussion Voices, a prosodic rehabilitation game included in e-Motional Training, seems to be a promising tool for improving emotional voice recognition deficits in schizophrenia, filling the need for such interventions.
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Affiliation(s)
- María Lado-Codesido
- University of Santiago de Compostela, Santiago de Compostela, Spain, Donostia University Hospital, San Sebastián, Spain
| | | | - Raimundo Mateos
- Department of Psychiatry, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Manuel Olivares
- Department of Psychiatry, Biomedical Institute of Galicia Sur, Biomedical Research Center in Mental Health Network (CIBERSAM), University Hospital Complex of Vigo, Pontevedra, Spain
| | - Alejandro García Caballero
- Department of Psychiatry, Biomedical Institute of Galicia Sur, Biomedical Research Center in Mental Health Network (CIBERSAM), University Hospital Complex of Ourense, Ourense, Spain
- Department of Psychiatry, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- * E-mail:
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21
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de Bézenac CE, Swindells RA, Corcoran R. The Necessity of Ambiguity in Self-Other Processing: A Psychosocial Perspective With Implications for Mental Health. Front Psychol 2018; 9:2114. [PMID: 30455657 PMCID: PMC6231079 DOI: 10.3389/fpsyg.2018.02114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/12/2018] [Indexed: 12/04/2022] Open
Abstract
While distinguishing between the actions and physical boundaries of self and other (non-self) is usually straightforward there are contexts in which such differentiation is challenging. For example, self-other ambiguity may occur when actions of others are similar or complementary to those of the self. Even in the absence of such situational challenges, individuals experiencing hallucinations have difficulties with this distinction, often experiencing thoughts or actions of self as belonging to other agents. This paper explores the role of ambiguity in self-other differentiation, drawing from developmental, psychodynamic, and neurocognitive perspectives. A key proposal is that engagement in contexts that make distinctions between self and other challenging yet necessary allow reality-testing skills related to agency to develop. Attunement in typical caregiver-infant interactions is framed as a safe but inherently ambiguous environment that provides optimal condition for the infant to develop a coherent self-other sense. Vulnerability to psychosis may be related to limited access to such an environment in early development. However, the perceptual, cognitive, and social skills that contribution to attribution are likely to be malleable following infancy and improve though opportunities for boundary play in similarly ambiguous settings. Using music-making to illustrate, we postulate that engagement in intricate joint-actions that blurs agentic boundaries can contribute to the continued development of an adaptive sense of self and other essential to healthy social functioning. Increased insight into the self-other ambiguity may enhance our understanding of mechanisms underlying "self-disorders" such as schizophrenia and eventually extend the range of social and arts-based therapeutic possibilities.
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Affiliation(s)
| | - Rachel Ann Swindells
- Research Institute for Health and Social Change, Manchester Metropolitan University, Manchester, United Kingdom
| | - Rhiannon Corcoran
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, United Kingdom
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22
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Lin Y, Ding H, Zhang Y. Emotional Prosody Processing in Schizophrenic Patients: A Selective Review and Meta-Analysis. J Clin Med 2018; 7:jcm7100363. [PMID: 30336573 PMCID: PMC6210777 DOI: 10.3390/jcm7100363] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/10/2018] [Accepted: 10/14/2018] [Indexed: 12/11/2022] Open
Abstract
Emotional prosody (EP) has been increasingly recognized as an important area of schizophrenic patients’ dysfunctions in their language use and social communication. The present review aims to provide an updated synopsis on emotional prosody processing (EPP) in schizophrenic disorders, with a specific focus on performance characteristics, the influential factors and underlying neural mechanisms. A literature search up to 2018 was conducted with online databases, and final selections were limited to empirical studies which investigated the prosodic processing of at least one of the six basic emotions in patients with a clear diagnosis of schizophrenia without co-morbid diseases. A narrative synthesis was performed, covering the range of research topics, task paradigms, stimulus presentation, study populations and statistical power with a quantitative meta-analytic approach in Comprehensive Meta-Analysis Version 2.0. Study outcomes indicated that schizophrenic patients’ EPP deficits were consistently observed across studies (d = −0.92, 95% CI = −1.06 < δ < −0.78), with identification tasks (d = −0.95, 95% CI = −1.11 < δ < −0.80) being more difficult to process than discrimination tasks (d = −0.74, 95% CI = −1.03 < δ < −0.44) and emotional stimuli being more difficult than neutral stimuli. Patients’ performance was influenced by both participant- and experiment-related factors. Their social cognitive deficits in EP could be further explained by right-lateralized impairments and abnormalities in primary auditory cortex, medial prefrontal cortex and auditory-insula connectivity. The data pointed to impaired pre-attentive and attentive processes, both of which played important roles in the abnormal EPP in the schizophrenic population. The current selective review and meta-analysis support the clinical advocacy of including EP in early diagnosis and rehabilitation in the general framework of social cognition and neurocognition deficits in schizophrenic disorders. Future cross-sectional and longitudinal studies are further suggested to investigate schizophrenic patients’ perception and production of EP in different languages and cultures, modality forms and neuro-cognitive domains.
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Affiliation(s)
- Yi Lin
- Institute of Cross-Linguistic Processing and Cognition, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Hongwei Ding
- Institute of Cross-Linguistic Processing and Cognition, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Yang Zhang
- Department of Speech-Language-Hearing Sciences & Center for Neurobehavioral Development, University of Minnesota, Twin Cities, MN 55455, USA.
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23
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Parker EM, Sweet RA. Stereological Assessments of Neuronal Pathology in Auditory Cortex in Schizophrenia. Front Neuroanat 2018; 11:131. [PMID: 29375326 PMCID: PMC5767177 DOI: 10.3389/fnana.2017.00131] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 12/18/2017] [Indexed: 12/21/2022] Open
Abstract
It has long been known that auditory processing is disrupted in schizophrenia. More recently, postmortem studies have provided direct evidence that morphological alterations to neurons in auditory cortex are implicated in the pathophysiology of this illness, confirming previous predictions. Potential neural substrates for auditory impairment and gray matter loss in auditory cortex in schizophrenia have been identified, described, and are the focus of this review article. Pyramidal cell somal volume is reduced in auditory cortex, as are dendritic spine density and number in schizophrenia. Pyramidal cells are not lost in this region in schizophrenia, indicating that dendritic spine reductions reflect fewer spines per pyramidal cell, consistent with the reduced neuropil hypothesis of schizophrenia. Stereological methods have aided in the proper collection, reporting and interpretation of this data. Mechanistic studies exploring relationships between genetic risk for schizophrenia and altered dendrite morphology represent an important avenue for future research in order to further elucidate cellular pathology in auditory cortex in schizophrenia.
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Affiliation(s)
- Emily M Parker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Robert A Sweet
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States.,VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
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24
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Perrin MA, Kantrowitz JT, Silipo G, Dias E, Jabado O, Javitt DC. Mismatch negativity (MMN) to spatial deviants and behavioral spatial discrimination ability in the etiology of auditory verbal hallucinations and thought disorder in schizophrenia. Schizophr Res 2018; 191:140-147. [PMID: 28532686 DOI: 10.1016/j.schres.2017.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 02/02/2023]
Abstract
UNLABELLED Persistent auditory verbal hallucinations (AVH) in schizophrenia are increasingly tied to dysfunction at the level of auditory cortex. AVH may reflect in part misattribution of internally generated thoughts to external spatial locations. Here, we investigated the association between persistent AVH and spatial localization abilities assessed both behaviorally and by mismatch negativity (MMN) to location deviants. METHODS Spatial- and tonal- discrimination abilities were assessed in patients (n=20) and controls (n=20) using free-field tones. MMN was assessed to spatial-location-, pitch- and duration-deviants. AVH and thought disorder were assessed using clinical evaluation. RESULTS As predicted, patients showed significant reductions in behavioral spatial-discrimination (p<0.0001) and tone-matching (p<0.001) ability, along with impaired MMN generation to location (p<0.03) and pitch (p<0.05) deviants. Hallucinating (AVH+) and non-hallucinating (AVH-) subjects showed similar deficits in location MMN to left-hemifield stimuli (p<0.0001 vs. control). By contrast, AVH- patients differed significantly from controls (p=0.009) and AVH+ patients (p=0.018) for MMN to right-lateral hemifield (left auditory cortex) stimuli, whereas AVH+ patients showed paradoxically preserved MMN generation (p=0.99 vs. controls). Severity of thought disorder correlated with impaired spatial discrimination, especially to right-hemifield stimuli (p=0.013), but did not correlate significantly with MMN or tone matching deficits. CONCLUSION These findings demonstrate a significant relationship between auditory cortical spatial localization abilities and AVH susceptibility, with relatively preserved function of left vs. right auditory cortex predisposing to more severe AVH, and support models that attribute persistent AVH to impaired source-monitoring. The findings suggest new approaches for therapeutic intervention for both AVH and thought disorder in schizophrenia.
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Affiliation(s)
- Megan A Perrin
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, United States; Department of Clinical Neuropsychology, Queens College, United States; The Graduate Center, City University of New York, United States
| | - Joshua T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, United States; Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, United States
| | - Gail Silipo
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, United States
| | - Elisa Dias
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, United States
| | - Omar Jabado
- Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, United States
| | - Daniel C Javitt
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, United States; Department of Psychiatry, Columbia College of Physicians and Surgeons, United States.
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25
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Teichert T. Loudness- and time-dependence of auditory evoked potentials is blunted by the NMDA channel blocker MK-801. Psychiatry Res 2017. [PMID: 28645081 PMCID: PMC5723527 DOI: 10.1016/j.psychres.2017.06.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Amplitudes of auditory evoked potentials (AEP) increase with the intensity/loudness of sounds (loudness-dependence of AEP, LDAEP), and the time between adjacent sounds (time-dependence of AEP, TDAEP). Both, blunted LDAEP and blunted TDAEP are markers of altered auditory function in schizophrenia (SZ). However, while blunted LDAEP has been attributed to altered serotonergic function, blunted TDAEP has been linked to altered NMDA receptor function. Despite phenomenological similarities of the two effects, no common pharmacological underpinnings have been identified. To test whether LDAEP and TDAEP are both affected by NMDA receptor blockade, two rhesus macaques passively listened to auditory clicks of 5 different intensities presented with stimulus-onset asynchronies ranging between 0.2 and 6.4s. 8 AEP components were analyzed, including the N85, the presumed human N1 homolog. LDAEP and TDAEP were estimated as the slopes of AEP amplitude with intensity and the logarithm of stimulus-onset asynchrony, respectively. On different days, AEPs were collected after systemic injection of MK-801 or vehicle. Both TDAEP and LDAEP of the N85 were blunted by the NMDA blocker MK-801 and recapitulate the SZ phenotype. In summary, LDAEP and TDAEP share important pharmacological commonalities that may help identify a common pharmacological intervention to normalize both electrophysiological phenotypes in SZ.
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Affiliation(s)
- Tobias Teichert
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
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26
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Frühholz S, Staib M. Neurocircuitry of impaired affective sound processing: A clinical disorders perspective. Neurosci Biobehav Rev 2017; 83:516-524. [PMID: 28919431 DOI: 10.1016/j.neubiorev.2017.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/08/2017] [Accepted: 09/05/2017] [Indexed: 12/22/2022]
Abstract
Decoding affective meaning from sensory information is central to accurate and adaptive behavior in many natural and social contexts. Human vocalizations (speech and non-speech), environmental sounds (e.g. thunder, noise, or animal sounds) and human-produced sounds (e.g. technical sounds or music) can carry a wealth of important aversive, threatening, appealing, or pleasurable affective information that sometimes implicitly influences and guides our behavior. A deficit in processing such affective information is detrimental to adaptive environmental behavior, psychological well-being, and social interactive abilities. These deficits can originate from a diversity of psychiatric and neurological disorders, and are associated with neural dysfunctions across largely distributed brain networks. Recent neuroimaging studies in psychiatric and neurological patients outline the cortical and subcortical neurocircuitry of the complimentary and differential functional roles for affective sound processing. This points to and confirms a recently proposed distributed network rather than a single brain region underlying affective sound processing, and highlights the notion of a multi-functional process that can be differentially impaired in clinical disorders.
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Affiliation(s)
- Sascha Frühholz
- Department of Psychology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland.
| | - Matthias Staib
- Department of Psychology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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27
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Dunn W, Rassovsky Y, Wynn J, Wu AD, Iacoboni M, Hellemann G, Green MF. The effect of bilateral transcranial direct current stimulation on early auditory processing in schizophrenia: a preliminary study. J Neural Transm (Vienna) 2017; 124:1145-1149. [PMID: 28687908 DOI: 10.1007/s00702-017-1752-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 06/28/2017] [Indexed: 12/16/2022]
Abstract
Transcranial direct current stimulation (tDCS) was applied bilaterally over the auditory cortex in 12 schizophrenia patients to modulate early auditory processing. Performance on a tone discrimination task (tone-matching task-TMT) and auditory mismatch negativity were assessed after counterbalanced anodal, cathodal, and sham tDCS. Cathodal stimulation improved TMT performance (p < 0.03) compared to sham condition. Post-hoc analyses revealed a stimulation condition by negative symptom interaction in which greater negative symptoms were associated with a better TMT performance after anodal tDCS.
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Affiliation(s)
- Walter Dunn
- Department of Veterans Affairs VISN-22 Mental Illness Research, Education and Clinical Center, Los Angeles, CA, USA. .,Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA. .,West Los Angeles VA Medical Center, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA.
| | - Yuri Rassovsky
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.,Department of Psychology and Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Jonathan Wynn
- Department of Veterans Affairs VISN-22 Mental Illness Research, Education and Clinical Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Allan D Wu
- Department of Neurology, University of California, Los Angeles, USA
| | - Marco Iacoboni
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.,Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Michael F Green
- Department of Veterans Affairs VISN-22 Mental Illness Research, Education and Clinical Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
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Abstract
The specific efficacy of antipsychotics on negative symptoms is questionable, suggesting an urgent need for specific treatments for negative symptoms. This review includes studies published since 2014 with a primary or secondary focus on treating negative symptoms in schizophrenia. Special emphasis is given to recently published meta-analyses. Topics include novel pharmacological approaches, including glutamatergic-based and nicotinic-acetylcholinergic treatments, treatments approved for other indications by the US FDA (or other regulatory bodies) (antipsychotics, antidepressants, and mood stabilizers), brain stimulation, and behavioral- and activity-based approaches, including physical exercise. Potential complications regarding the design of current negative symptom trials are discussed and include inconsistent placebo effects, lack of reliable biomarkers, negative symptom scale and inclusion criteria variability, attempts to distinguish between primary and secondary negative symptoms, lack of focus on early psychosis, and the potential iatrogenic bias of clinical trials.
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Affiliation(s)
- Joshua T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA. .,Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, NY, 10032, USA. .,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10023, USA.
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29
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Tone-matching ability in patients with schizophrenia: A systematic review and meta-analysis. Schizophr Res 2017; 181:94-99. [PMID: 27742161 DOI: 10.1016/j.schres.2016.10.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/23/2016] [Accepted: 10/04/2016] [Indexed: 12/14/2022]
Abstract
CONTEXT Patients with schizophrenia display abnormalities in pitch discrimination of non-verbal tones as revealed by the Tone-Matching Task (TMT). It may lead to deficits in higher-order cognitive functions and clinical symptoms. OBJECTIVES We conducted a systematic review and meta-analysis pooling data about TMT score differences between patients with schizophrenia and healthy controls, to evaluate the deficit's effect size, and to develop reliable knowledge about pitch processing impairment and its pejorative impact. METHOD Relevant publications were identified by a systematic search of PubMed and EMBASE databases. Then, we excluded non-relevant studies for the meta-analysis. Effect size for percent of correct responses to the TMT was expressed as standardized mean difference (SMD). RESULTS Eighteen of 167 identified studies met eligibility criteria for review, of which 10 were included in the meta-analysis. Our meta-analysis showed that the effect size for the percent of correct response to the TMT between patients (N=371) and controls (N=342) was large: SMD=1.17 [95% CI: 0.926-1.418] (z-value=9.338 and p-value<0.001). Meta-analysis showed moderate heterogeneity between studies (Q(9)=17.22, p=0.04, I2=47.74%). The relationship between tone-matching impairment and clinical symptoms of schizophrenia remains heterogeneous across studies. Some authors observed significant correlations between tone-matching performance and a number of higher-order cognitive abilities. CONCLUSION This review and meta-analysis highlights a large significant disturbance in tone-matching ability in patients as compared with controls. The study of basic auditory processing opens promising perspectives for pathophysiological modelling of the disorder and therapeutic issues.
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30
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Fisher M, Nahum M, Howard E, Rowlands A, Brandrett B, Kermott A, Woolley J, Vinogradov S. Supplementing intensive targeted computerized cognitive training with social cognitive exercises for people with schizophrenia: An interim report. Psychiatr Rehabil J 2017; 40:21-32. [PMID: 28368179 PMCID: PMC5380146 DOI: 10.1037/prj0000244] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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
OBJECTIVE Individuals with schizophrenia demonstrate cognitive, social cognitive, and motivational deficits that contribute to impairment in real-world functioning. In the current study, we investigated the effects of supplementing computerized neurocognitive training with social cognitive exercises, as compared with neurocognitive training alone. METHOD In this ongoing, double-blind, randomized controlled trial of 111 participants with psychosis, we compare the effects of supplementing intensive targeted cognitive training with social cognitive training exercises (TCT + SCT) with the effects of targeted cognitive training alone (TCT-only). Participants were assessed on cognition, symptoms, functional capacity, and functional outcomes, as well as social cognition and measures related to reward processing. RESULTS Both treatment groups showed significant improvement in multiple cognitive domains and improvement in functional capacity. However, as predicted, TCT + SCT group participants showed significant improvement in prosody identification and reward processing relative to TCT-only participants. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Our findings indicate that supplementing intensive computerized cognitive training with social cognitive exercises in people with psychosis confers greater benefits in prosody identification and reward processing relative to cognitive training alone, even though both approaches drive significant improvements in cognition and functional capacity. Impairments in both prosody identification and reward processing have been associated with greater negative symptoms and poorer functional outcomes in schizophrenia, raising the possibility that this form of treatment may lead to better long-term outcomes than traditional cognitive training approaches. Follow-up assessments will determine whether results are durable and generalize over time to improvements in symptoms and functioning. (PsycINFO Database Record
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Mor Nahum
- Posit Science Inc., San Francisco, CA, United States
| | - Elizabeth Howard
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Abby Rowlands
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Benjamin Brandrett
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Amy Kermott
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Joshua Woolley
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
- Department of Psychiatry, University of California, San Francisco, CA, United States
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Teichert T, Gurnsey K, Salisbury D, Sweet RA. Contextual processing in unpredictable auditory environments: the limited resource model of auditory refractoriness in the rhesus. J Neurophysiol 2016; 116:2125-2139. [PMID: 27512021 DOI: 10.1152/jn.00419.2016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/09/2016] [Indexed: 01/15/2023] Open
Abstract
Auditory refractoriness refers to the finding of smaller electroencephalographic (EEG) responses to tones preceded by shorter periods of silence. To date, its physiological mechanisms remain unclear, limiting the insights gained from findings of abnormal refractoriness in individuals with schizophrenia. To resolve this roadblock, we studied auditory refractoriness in the rhesus, one of the most important animal models of auditory function, using grids of up to 32 chronically implanted cranial EEG electrodes. Four macaques passively listened to sounds whose identity and timing was random, thus preventing animals from forming valid predictions about upcoming sounds. Stimulus onset asynchrony ranged between 0.2 and 12.8 s, thus encompassing the clinically relevant timescale of refractoriness. Our results show refractoriness in all 8 previously identified middle- and long-latency components that peaked between 14 and 170 ms after tone onset. Refractoriness may reflect the formation and gradual decay of a basic sensory memory trace that may be mirrored by the expenditure and gradual recovery of a limited physiological resource that determines generator excitability. For all 8 components, results were consistent with the assumption that processing of each tone expends ∼65% of the available resource. Differences between components are caused by how quickly the resource recovers. Recovery time constants of different components ranged between 0.5 and 2 s. This work provides a solid conceptual, methodological, and computational foundation to dissect the physiological mechanisms of auditory refractoriness in the rhesus. Such knowledge may, in turn, help develop novel pharmacological, mechanism-targeted interventions.
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Affiliation(s)
- Tobias Teichert
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania; .,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kate Gurnsey
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dean Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert A Sweet
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania; and.,Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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Feingold D, Hasson-Ohayon I, Laukka P, Vishne T, Dembinsky Y, Kravets S. Emotion recognition deficits among persons with schizophrenia: Beyond stimulus complexity level and presentation modality. Psychiatry Res 2016; 240:60-65. [PMID: 27085665 DOI: 10.1016/j.psychres.2016.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 02/14/2016] [Accepted: 04/08/2016] [Indexed: 10/22/2022]
Abstract
Studies have shown that persons with schizophrenia have lower accuracy in emotion recognition compared to persons without schizophrenia. However, the impact of the complexity level of the stimuli or the modality of presentation has not been extensively addressed. Forty three persons with a diagnosis of schizophrenia and 43 healthy controls, matched for age and gender, were administered tests assessing emotion recognition from stimuli with low and high levels of complexity presented via visual, auditory and semantic channels. For both groups, recognition rates were higher for high-complexity stimuli compared to low-complexity stimuli. Additionally, both groups obtained higher recognition rates for visual and semantic stimuli than for auditory stimuli, but persons with schizophrenia obtained lower accuracy than persons in the control group for all presentation modalities. Persons diagnosed with schizophrenia did not present a level of complexity specific deficit or modality-specific deficit compared to healthy controls. Results suggest that emotion recognition deficits in schizophrenia are beyond level of complexity of stimuli and modality, and present a global difficulty in cognitive functioning.
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Affiliation(s)
- Daniel Feingold
- Department of Psychology, Ariel University, Ariel, Israel; Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel.
| | | | - Petri Laukka
- Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Social Sciences, Södertörn University, Huddinge, Sweden
| | | | - Yael Dembinsky
- Psychiatry Department, Sourasky Medical Center, Tel-Aviv, Israel
| | - Shlomo Kravets
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
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A Cognitive Neuroscience View of Voice-Processing Abnormalities in Schizophrenia: A Window into Auditory Verbal Hallucinations? Harv Rev Psychiatry 2016; 24:148-63. [PMID: 26954598 DOI: 10.1097/hrp.0000000000000082] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Auditory verbal hallucinations (AVH) are a core symptom of schizophrenia. Like "real" voices, AVH carry a rich amount of linguistic and paralinguistic cues that convey not only speech, but also affect and identity, information. Disturbed processing of voice identity, affective, and speech information has been reported in patients with schizophrenia. More recent evidence has suggested a link between voice-processing abnormalities and specific clinical symptoms of schizophrenia, especially AVH. It is still not well understood, however, to what extent these dimensions are impaired and how abnormalities in these processes might contribute to AVH. In this review, we consider behavioral, neuroimaging, and electrophysiological data to investigate the speech, identity, and affective dimensions of voice processing in schizophrenia, and we discuss how abnormalities in these processes might help to elucidate the mechanisms underlying specific phenomenological features of AVH. Schizophrenia patients exhibit behavioral and neural disturbances in the three dimensions of voice processing. Evidence suggesting a role of dysfunctional voice processing in AVH seems to be stronger for the identity and speech dimensions than for the affective domain.
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Abstract
UNLABELLED Deficits in auditory emotion recognition (AER) are a core feature of schizophrenia and a key component of social cognitive impairment. AER deficits are tied behaviorally to impaired ability to interpret tonal ("prosodic") features of speech that normally convey emotion, such as modulations in base pitch (F0M) and pitch variability (F0SD). These modulations can be recreated using synthetic frequency modulated (FM) tones that mimic the prosodic contours of specific emotional stimuli. The present study investigates neural mechanisms underlying impaired AER using a combined event-related potential/resting-state functional connectivity (rsfMRI) approach in 84 schizophrenia/schizoaffective disorder patients and 66 healthy comparison subjects. Mismatch negativity (MMN) to FM tones was assessed in 43 patients/36 controls. rsfMRI between auditory cortex and medial temporal (insula) regions was assessed in 55 patients/51 controls. The relationship between AER, MMN to FM tones, and rsfMRI was assessed in the subset who performed all assessments (14 patients, 21 controls). As predicted, patients showed robust reductions in MMN across FM stimulus type (p = 0.005), particularly to modulations in F0M, along with impairments in AER and FM tone discrimination. MMN source analysis indicated dipoles in both auditory cortex and anterior insula, whereas rsfMRI analyses showed reduced auditory-insula connectivity. MMN to FM tones and functional connectivity together accounted for ∼50% of the variance in AER performance across individuals. These findings demonstrate that impaired preattentive processing of tonal information and reduced auditory-insula connectivity are critical determinants of social cognitive dysfunction in schizophrenia, and thus represent key targets for future research and clinical intervention. SIGNIFICANCE STATEMENT Schizophrenia patients show deficits in the ability to infer emotion based upon tone of voice [auditory emotion recognition (AER)] that drive impairments in social cognition and global functional outcome. This study evaluated neural substrates of impaired AER in schizophrenia using a combined event-related potential/resting-state fMRI approach. Patients showed impaired mismatch negativity response to emotionally relevant frequency modulated tones along with impaired functional connectivity between auditory and medial temporal (anterior insula) cortex. These deficits contributed in parallel to impaired AER and accounted for ∼50% of variance in AER performance. Overall, these findings demonstrate the importance of both auditory-level dysfunction and impaired auditory/insula connectivity in the pathophysiology of social cognitive dysfunction in schizophrenia.
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Corcoran CM, Keilp JG, Kayser J, Klim C, Butler PD, Bruder GE, Gur RC, Javitt DC. Emotion recognition deficits as predictors of transition in individuals at clinical high risk for schizophrenia: a neurodevelopmental perspective. Psychol Med 2015; 45:2959-2973. [PMID: 26040537 PMCID: PMC5080982 DOI: 10.1017/s0033291715000902] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Schizophrenia is characterized by profound and disabling deficits in the ability to recognize emotion in facial expression and tone of voice. Although these deficits are well documented in established schizophrenia using recently validated tasks, their predictive utility in at-risk populations has not been formally evaluated. METHOD The Penn Emotion Recognition and Discrimination tasks, and recently developed measures of auditory emotion recognition, were administered to 49 clinical high-risk subjects prospectively followed for 2 years for schizophrenia outcome, and 31 healthy controls, and a developmental cohort of 43 individuals aged 7-26 years. Deficit in emotion recognition in at-risk subjects was compared with deficit in established schizophrenia, and with normal neurocognitive growth curves from childhood to early adulthood. RESULTS Deficits in emotion recognition significantly distinguished at-risk patients who transitioned to schizophrenia. By contrast, more general neurocognitive measures, such as attention vigilance or processing speed, were non-predictive. The best classification model for schizophrenia onset included both face emotion processing and negative symptoms, with accuracy of 96%, and area under the receiver-operating characteristic curve of 0.99. In a parallel developmental study, emotion recognition abilities were found to reach maturity prior to traditional age of risk for schizophrenia, suggesting they may serve as objective markers of early developmental insult. CONCLUSIONS Profound deficits in emotion recognition exist in at-risk patients prior to schizophrenia onset. They may serve as an index of early developmental insult, and represent an effective target for early identification and remediation. Future studies investigating emotion recognition deficits at both mechanistic and predictive levels are strongly encouraged.
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Affiliation(s)
- C. M. Corcoran
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - J. G. Keilp
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - J. Kayser
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - C. Klim
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - P. D. Butler
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- Department of Psychiatry, New York University, New York, NY, USA
| | - G. E. Bruder
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - R. C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - D. C. Javitt
- Department of Psychiatry, Columbia University, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Abstract
Individuals with schizophrenia exhibit impaired social cognition, which manifests as difficulties in identifying emotions, feeing connected to others, inferring people's thoughts and reacting emotionally to others. These social cognitive impairments interfere with social connections and are strong determinants of the degree of impaired daily functioning in such individuals. Here, we review recent findings from the fields of social cognition and social neuroscience and identify the social processes that are impaired in schizophrenia. We also consider empathy as an example of a complex social cognitive function that integrates several social processes and is impaired in schizophrenia. This information may guide interventions to improve social cognition in patients with this disorder.
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Javitt DC, Sweet RA. Auditory dysfunction in schizophrenia: integrating clinical and basic features. Nat Rev Neurosci 2015; 16:535-50. [PMID: 26289573 PMCID: PMC4692466 DOI: 10.1038/nrn4002] [Citation(s) in RCA: 252] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Schizophrenia is a complex neuropsychiatric disorder that is associated with persistent psychosocial disability in affected individuals. Although studies of schizophrenia have traditionally focused on deficits in higher-order processes such as working memory and executive function, there is an increasing realization that, in this disorder, deficits can be found throughout the cortex and are manifest even at the level of early sensory processing. These deficits are highly amenable to translational investigation and represent potential novel targets for clinical intervention. Deficits, moreover, have been linked to specific structural abnormalities in post-mortem auditory cortex tissue from individuals with schizophrenia, providing unique insights into underlying pathophysiological mechanisms.
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Affiliation(s)
- Daniel C Javitt
- Division of Experimental Therapeutics, Departments of Psychiatry and Neuroscience, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, Unit 21, New York, New York 10032, USA
- Program in Cognitive Neuroscience and Schizophrenia, Nathan S. Kline Institute, 140 Old Orangeburg Rd, Orangeburg, New York 10962, USA
| | - Robert A Sweet
- Departments of Psychiatry and Neurology, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA
- VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Research Office Building (151R), University Drive C, Pittsburgh, Pennsylvania 15240, USA
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MacDonald ML, Ding Y, Newman J, Hemby S, Penzes P, Lewis DA, Yates N, Sweet RA. Altered glutamate protein co-expression network topology linked to spine loss in the auditory cortex of schizophrenia. Biol Psychiatry 2015; 77:959-68. [PMID: 25433904 PMCID: PMC4428927 DOI: 10.1016/j.biopsych.2014.09.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/11/2014] [Accepted: 09/02/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Impaired glutamatergic signaling is believed to underlie auditory cortex pyramidal neuron dendritic spine loss and auditory symptoms in schizophrenia. Many schizophrenia risk loci converge on the synaptic glutamate signaling network. We therefore hypothesized that alterations in glutamate signaling protein expression and co-expression network features are present in schizophrenia. METHODS Gray matter homogenates were prepared from auditory cortex gray matter of 22 schizophrenia and 23 matched control subjects, a subset of whom had been previously assessed for dendritic spine density. One hundred fifty-five selected synaptic proteins were quantified by targeted mass spectrometry. Protein co-expression networks were constructed using weighted gene co-expression network analysis. RESULTS Proteins with evidence for altered expression in schizophrenia were significantly enriched for glutamate signaling pathway proteins (GRIA4, GRIA3, ATP1A3, and GNAQ). Synaptic protein co-expression was significantly decreased in schizophrenia with the exception of a small group of postsynaptic density proteins, whose co-expression increased and inversely correlated with spine density in schizophrenia subjects. CONCLUSIONS We observed alterations in the expression of glutamate signaling pathway proteins. Among these, the novel observation of reduced ATP1A3 expression is supported by strong genetic evidence indicating it may contribute to psychosis and cognitive impairment phenotypes. The observations of altered protein network topology further highlight the complexity of glutamate signaling network pathology in schizophrenia and provide a framework for evaluating future experiments to model the contribution of genetic risk to disease pathology.
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Affiliation(s)
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA
| | - Jason Newman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Scott Hemby
- Neuroscience Program, Wake Forest University School of Medicine, Winston-Salem, NC,Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Peter Penzes
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, Il,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Il
| | - David A. Lewis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - Robert A. Sweet
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA,Department of Neurology, University of Pittsburgh, Pittsburgh, PA
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de Bézenac CE, Sluming V, O'Sullivan N, Corcoran R. Ambiguity between self and other: Individual differences in action attribution. Conscious Cogn 2015; 35:1-15. [PMID: 25956971 DOI: 10.1016/j.concog.2015.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 04/13/2015] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Abstract
Individuals differ in their ability to attribute actions to self or other. This variance is thought to explain, in part, the experience of voice-hearing. Misattribution can also be context-driven. For example, causal ambiguity can arise when the actions of two or more individuals are coordinated and produce similar effects (e.g., music-making). Experience in such challenging contexts may refine skills of action attribution. Forty participants completed a novel finger-tapping task which parametrically manipulated the proportion of control that 'self' versus 'other' possessed over resulting auditory tones. Results showed that action misattribution peaked in the middle of the self-to-other continuum and was biased towards other. This pattern was related to both high hallucination-proneness and to low musical-experience. Findings suggest not only that causal ambiguity plays a key role in agency but also that action attribution abilities may improve with practice, potentially providing an avenue for remediation of the positive symptoms of schizophrenia.
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Affiliation(s)
- Christophe E de Bézenac
- Psychological Sciences, University of Liverpool, Waterhouse Building, Block B, 2nd Floor, L69 3BX, United Kingdom.
| | - Vanessa Sluming
- Institute of Translational Medicine, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool L69 3 GB, United Kingdom.
| | - Noreen O'Sullivan
- Psychological Sciences, University of Liverpool, Waterhouse Building, Block B, 2nd Floor, L69 3BX, United Kingdom.
| | - Rhiannon Corcoran
- Psychological Sciences, University of Liverpool, Waterhouse Building, Block B, 2nd Floor, L69 3BX, United Kingdom.
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Preliminary evidence for reduced auditory lateral suppression in schizophrenia. Schizophr Res 2015; 162:269-75. [PMID: 25583249 PMCID: PMC4339496 DOI: 10.1016/j.schres.2014.12.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 12/18/2014] [Accepted: 12/22/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Well-documented auditory processing deficits such as impaired frequency discrimination and reduced suppression of auditory brain responses in schizophrenia (SZ) may contribute to abnormal auditory functioning in everyday life. Lateral suppression of non-stimulated neurons by stimulated neurons has not been extensively assessed in SZ and likely plays an important role in precise encoding of sounds. Therefore, this study evaluated whether lateral suppression of activity in auditory cortex is impaired in SZ. METHODS SZ participants and control participants watched a silent movie with subtitles while listening to trials composed of a 0.5s control stimulus (CS), a 3s filtered masking noise (FN), and a 0.5s test stimulus (TS). The CS and TS were identical on each trial and had energy corresponding to the high energy (recurrent suppression) or low energy (lateral suppression) portions of the FN. Event-related potentials were recorded and suppression was measured as the amplitude change between CS and TS. RESULTS Peak amplitudes of the auditory P2 component (160-260ms) showed reduced lateral but not recurrent suppression in SZ participants. CONCLUSIONS Reduced lateral suppression in SZ participants may lead to overlap of neuronal populations representing different auditory stimuli. Such imprecise neural representations may contribute to the difficulties SZ participants have in discriminating complex stimuli in everyday life.
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Petkova E, Lu F, Kantrowitz J, Sanchez JL, Lehrfeld J, Scaramello N, Silipo G, DiCostanza J, Ross M, Su Z, Javitt DC, Butler PD. Auditory tasks for assessment of sensory function and affective prosody in schizophrenia. Compr Psychiatry 2014; 55:1862-74. [PMID: 25214372 PMCID: PMC4691012 DOI: 10.1016/j.comppsych.2014.08.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 08/11/2014] [Accepted: 08/14/2014] [Indexed: 01/05/2023] Open
Abstract
Schizophrenia patients exhibit impairments in auditory-based social cognition, indicated by deficits in detection of prosody, such as affective prosody and basic pitch perception. However, little is known about the psychometric properties of behavioral tests used to assess these functions. The goal of this paper is to characterize the properties of prosody and pitch perception tasks and to investigate whether they can be shortened. The pitch perception test evaluated is a tone-matching task developed by Javitt and colleagues (J-TMT). The prosody test evaluated is the auditory emotion recognition task developed by Juslin and Laukka (JL-AER). The sample includes 124 schizophrenia patients (SZ) and 131 healthy controls (HC). Properties, including facility and discrimination, of each item were assessed. Effects of item characteristics (e.g., emotion) were also evaluated. Shortened versions of the tests are proposed based on facility, discrimination, and/or ability of item characteristics to discriminate between patients and controls. Test-retest reliability is high for patients and controls for both the original and short forms of the J-TMT and JL-AER. Thus, the original as well as short forms of the J-TMT and JL-AER are suggested for inclusion in clinical trials of social cognitive and perceptual treatments. The development of short forms further increases the utility of these auditory tasks in clinical trials and clinical practice. The large SZ vs. HC differences reported here also highlight the profound nature of auditory deficits and a need for remediation.
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Affiliation(s)
- Eva Petkova
- Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, New York, NY 10016, USA; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA.
| | - Feihan Lu
- Department of Statistics, Columbia University, New York, NY 10027
| | - Joshua Kantrowitz
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962,Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10027
| | - Jamie L. Sanchez
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Jonathan Lehrfeld
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Nayla Scaramello
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Gail Silipo
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Joanna DiCostanza
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Marina Ross
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Zhe Su
- Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, New York, NY 10016
| | - Daniel C. Javitt
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962,Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10027
| | - Pamela D. Butler
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962,Department of Psychiatry, New York University School of Medicine, New York, NY 10016
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Chhabra S, Badcock JC, Maybery MT, Leung D. Voice identity discrimination and hallucination-proneness in healthy young adults: a further challenge to the continuum model of psychosis? Cogn Neuropsychiatry 2014; 19:305-18. [PMID: 24328826 DOI: 10.1080/13546805.2013.865512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Auditory hallucinations occur in schizophrenia and also in the general population. However, evidence points to differences in the nature and the mechanisms of clinical and non-clinical hallucinations, challenging the dominant assumption that they represent the same phenomenon. The current study extended this evidence by examining voice identity perception in hallucination-prone individuals. In schizophrenia, deficiencies discriminating between real (external) voices have been linked to basic acoustic cues, but voice discrimination has not yet been investigated in non-clinical hallucinations. METHODS Using a task identical to that employed in patients, multidimensional scaling of voice dissimilarity judgements was used to examine how healthy individuals differing in hallucination-proneness (30 high and 30 low hallucination-prone individuals) distinguish pairs of unfamiliar voices. The resulting dimensions were interpreted with reference to acoustic measures relevant to voice identity. RESULTS A two-dimensional "voice space", defined by fundamental frequency (F0) and formant dispersion (Df), was derived for high and low hallucination-prone groups. There were no significant differences in speaker discrimination for high versus low hallucination-prone individuals on the basis of either F0 or Df. CONCLUSIONS These findings suggest voice identity perception is not impaired in healthy individuals predisposed to hallucinations, adding a further challenge to the continuum model of psychotic symptoms.
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Affiliation(s)
- Saruchi Chhabra
- a School of Psychology , University of Western Australia , 35 Stirling Hwy, Crawley , WA 6009 , Australia
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43
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Kantrowitz JT, Scaramello N, Jakubovitz A, Lehrfeld JM, Laukka P, Elfenbein HA, Silipo G, Javitt DC. Amusia and protolanguage impairments in schizophrenia. Psychol Med 2014; 44:2739-2748. [PMID: 25066878 PMCID: PMC5373691 DOI: 10.1017/s0033291714000373] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Both language and music are thought to have evolved from a musical protolanguage that communicated social information, including emotion. Individuals with perceptual music disorders (amusia) show deficits in auditory emotion recognition (AER). Although auditory perceptual deficits have been studied in schizophrenia, their relationship with musical/protolinguistic competence has not previously been assessed. METHOD Musical ability was assessed in 31 schizophrenia/schizo-affective patients and 44 healthy controls using the Montreal Battery for Evaluation of Amusia (MBEA). AER was assessed using a novel battery in which actors provided portrayals of five separate emotions. The Disorganization factor of the Positive and Negative Syndrome Scale (PANSS) was used as a proxy for language/thought disorder and the MATRICS Consensus Cognitive Battery (MCCB) was used to assess cognition. RESULTS Highly significant deficits were seen between patients and controls across auditory tasks (p < 0.001). Moreover, significant differences were seen in AER between the amusia and intact music-perceiving groups, which remained significant after controlling for group status and education. Correlations with AER were specific to the melody domain, and correlations between protolanguage (melody domain) and language were independent of overall cognition. DISCUSSION This is the first study to document a specific relationship between amusia, AER and thought disorder, suggesting a shared linguistic/protolinguistic impairment. Once amusia was considered, other cognitive factors were no longer significant predictors of AER, suggesting that musical ability in general and melodic discrimination ability in particular may be crucial targets for treatment development and cognitive remediation in schizophrenia.
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Affiliation(s)
- J. T. Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - N. Scaramello
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - A. Jakubovitz
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - J. M. Lehrfeld
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - P. Laukka
- Department of Psychology, Stockholm University, Sweden
| | - H. A. Elfenbein
- Olin Business School, Washington University, St Louis, MO, USA
| | - G. Silipo
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - D. C. Javitt
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
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Dondaine T, Robert G, Péron J, Grandjean D, Vérin M, Drapier D, Millet B. Biases in facial and vocal emotion recognition in chronic schizophrenia. Front Psychol 2014; 5:900. [PMID: 25202287 PMCID: PMC4141280 DOI: 10.3389/fpsyg.2014.00900] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 07/29/2014] [Indexed: 01/26/2023] Open
Abstract
There has been extensive research on impaired emotion recognition in schizophrenia in the facial and vocal modalities. The literature points to biases toward non-relevant emotions for emotional faces but few studies have examined biases in emotional recognition across different modalities (facial and vocal). In order to test emotion recognition biases, we exposed 23 patients with stabilized chronic schizophrenia and 23 healthy controls (HCs) to emotional facial and vocal tasks asking them to rate emotional intensity on visual analog scales. We showed that patients with schizophrenia provided higher intensity ratings on the non-target scales (e.g., surprise scale for fear stimuli) than HCs for the both tasks. Furthermore, with the exception of neutral vocal stimuli, they provided the same intensity ratings on the target scales as the HCs. These findings suggest that patients with chronic schizophrenia have emotional biases when judging emotional stimuli in the visual and vocal modalities. These biases may stem from a basic sensorial deficit, a high-order cognitive dysfunction, or both. The respective roles of prefrontal-subcortical circuitry and the basal ganglia are discussed.
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Affiliation(s)
- Thibaut Dondaine
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
| | - Gabriel Robert
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
| | - Julie Péron
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology, University of Geneva Switzerland ; Swiss Center for Affective Sciences, University of Geneva Switzerland
| | - Didier Grandjean
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology, University of Geneva Switzerland ; Swiss Center for Affective Sciences, University of Geneva Switzerland
| | - Marc Vérin
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Neurology Unit, University Hospital of Rennes France
| | - Dominique Drapier
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
| | - Bruno Millet
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
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45
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Hatada S, Sawada K, Akamatsu M, Doi E, Minese M, Yamashita M, Thornton AE, Honer WG, Inoue S. Impaired musical ability in people with schizophrenia. J Psychiatry Neurosci 2014; 39:118-26. [PMID: 24119791 PMCID: PMC3937280 DOI: 10.1503/jpn.120207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Assessment of the musical ability of people with schizophrenia has attracted little interest despite the diverse and substantive findings of impairments in sound perception and processing and the therapeutic effect of music in people with the illness. The present study investigated the musical ability of people with schizophrenia and the association with psychiatric symptoms and cognition. METHODS We recruited patients with chronic schizophrenia and healthy controls for participation in our study. To measure musical ability and cognitive function, we used the Montreal Battery of Evaluation of Amusia (MBEA) and the Brief Assessment of Cognition in Schizophrenia (BACS). We carried out a mediation analysis to investigate a possible pathway to a deficit in musical ability. RESULTS We enrolled 50 patients and 58 controls in the study. The MBEA global score in patients with schizophrenia was significantly lower than that in controls (p < 0.001), and was strongly associated with both the composite cognitive function score (r = 0.645, p < 0.001) and the negative symptom score (r = -0.504, p < 0.001). Further analyses revealed direct and indirect effects of negative symptoms on musical ability. The indirect effects were mediated through cognitive impairment. LIMITATIONS The relatively small sample size did not permit full evaluation of the possible effects of age, sex, education, medication and cultural influences on the results. CONCLUSION Examining the associations between musical deficits, negative symptoms and cognitive imapirment in patients with schizophrenia may identify shared biological mechanisms.
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Affiliation(s)
| | - Ken Sawada
- Correspondence to: K. Sawada, Department of Psychiatry, University of British Columbia, Vancouver, BC;
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Kantrowitz JT, Hoptman MJ, Leitman DI, Silipo G, Javitt DC. The 5% difference: early sensory processing predicts sarcasm perception in schizophrenia and schizo-affective disorder. Psychol Med 2014; 44:25-36. [PMID: 23611263 PMCID: PMC3855910 DOI: 10.1017/s0033291713000834] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Intact sarcasm perception is a crucial component of social cognition and mentalizing (the ability to understand the mental state of oneself and others). In sarcasm, tone of voice is used to negate the literal meaning of an utterance. In particular, changes in pitch are used to distinguish between sincere and sarcastic utterances. Schizophrenia patients show well-replicated deficits in auditory function and functional connectivity (FC) within and between auditory cortical regions. In this study we investigated the contributions of auditory deficits to sarcasm perception in schizophrenia. METHOD Auditory measures including pitch processing, auditory emotion recognition (AER) and sarcasm detection were obtained from 76 patients with schizophrenia/schizo-affective disorder and 72 controls. Resting-state FC (rsFC) was obtained from a subsample and was analyzed using seeds placed in both auditory cortex and meta-analysis-defined core-mentalizing regions relative to auditory performance. RESULTS Patients showed large effect-size deficits across auditory measures. Sarcasm deficits correlated significantly with general functioning and impaired pitch processing both across groups and within the patient group alone. Patients also showed reduced sensitivity to alterations in mean pitch and variability. For patients, sarcasm discrimination correlated exclusively with the level of rsFC within primary auditory regions whereas for controls, correlations were observed exclusively within core-mentalizing regions (the right posterior superior temporal gyrus, anterior superior temporal sulcus and insula, and left posterior medial temporal gyrus). CONCLUSIONS These findings confirm the contribution of auditory deficits to theory of mind (ToM) impairments in schizophrenia, and demonstrate that FC within auditory, but not core-mentalizing, regions is rate limiting with respect to sarcasm detection in schizophrenia.
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Affiliation(s)
- J T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
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Iliadou V(V, Apalla K, Kaprinis S, Nimatoudis I, Kaprinis G, Iacovides A. Is Central Auditory Processing Disorder Present in Psychosis? Am J Audiol 2013; 22:201-208. [DOI: 10.1044/1059-0889(2013/12-0073)] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Purpose
The scope of this study was to trace central auditory processing issues in patients with first-episode psychosis using a psychoacoustic test battery approach.
Method
Patients (
n
= 17) and volunteer control subjects (
n
= 17) with no personal or family history of schizophrenia were included in the study on the basis of normal hearing sensitivity. The authors implemented a central auditory processing battery consisting of monaural and binaural tests with verbal and nonverbal stimuli.
Results
Perceptual deficits in both nonverbal and verbal auditory stimuli are reported in this study, with temporal central auditory processing deficits and a mean left-ear advantage documented in the patient group.
Conclusion
This study points to the possibility of the existence of central auditory processing deficits in first-episode psychosis leading to schizophrenia. Audiologists should be aware of the psychiatric research pointing to enhanced verbal memory as a result of auditory training, linking bottom-up remediation with top-down improvement.
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Tucker R, Farhall J, Thomas N, Groot C, Rossell SL. An examination of auditory processing and affective prosody in relatives of patients with auditory hallucinations. Front Hum Neurosci 2013; 7:531. [PMID: 24046737 PMCID: PMC3764330 DOI: 10.3389/fnhum.2013.00531] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/15/2013] [Indexed: 11/13/2022] Open
Abstract
Research on auditory verbal hallucinations (AVHs) indicates that AVH schizophrenia patients show greater abnormalities on tasks requiring recognition of affective prosody (AP) than non-AVH patients. Detecting AP requires accurate perception of manipulations in pitch, amplitude and duration. Schizophrenia patients with AVHs also experience difficulty detecting these acoustic manipulations; with a number of theorists speculating that difficulties in pitch, amplitude and duration discrimination underlie AP abnormalities. This study examined whether both AP and these aspects of auditory processing are also impaired in first degree relatives of persons with AVHs. It also examined whether pitch, amplitude and duration discrimination were related to AP, and to hallucination proneness. Unaffected relatives of AVH schizophrenia patients (N = 19) and matched healthy controls (N = 33) were compared using tone discrimination tasks, an AP task, and clinical measures. Relatives were slower at identifying emotions on the AP task (p = 0.002), with secondary analysis showing this was especially so for happy (p = 0.014) and neutral (p = 0.001) sentences. There was a significant interaction effect for pitch between tone deviation level and group (p = 0.019), and relatives performed worse than controls on amplitude discrimination and duration discrimination. AP performance for happy and neutral sentences was significantly correlated with amplitude perception. Lastly, AVH proneness in the entire sample was significantly correlated with pitch discrimination (r = 0.44) and pitch perception was shown to predict AVH proneness in the sample (p = 0.005). These results suggest basic impairments in auditory processing are present in relatives of AVH patients; they potentially underlie processing speed in AP tasks, and predict AVH proneness. This indicates auditory processing deficits may be a core feature of AVHs in schizophrenia, and are worthy of further study as a potential endophenotype for AVHs.
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Affiliation(s)
- Rachel Tucker
- School of Psychological Sciences, La Trobe University Melbourne, VIC, Australia
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Dias EC, Bickel S, Epstein ML, Sehatpour P, Javitt DC. Abnormal task modulation of oscillatory neural activity in schizophrenia. Front Psychol 2013; 4:540. [PMID: 23986729 PMCID: PMC3753429 DOI: 10.3389/fpsyg.2013.00540] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/31/2013] [Indexed: 01/16/2023] Open
Abstract
Schizophrenia patients have deficits in cognitive function that are a core feature of the disorder. AX-CPT is commonly used to study cognition in schizophrenia, and patients have characteristic pattern of behavioral and ERP response. In AX-CPT subjects respond when a flashed cue “A” is followed by a target “X,” ignoring other letter combinations. Patients show reduced hit rate to “go” trials, and increased false alarms to sequences that require inhibition of a prepotent response. EEG recordings show reduced sensory (P1/N1), as well as later cognitive components (N2, P3, CNV). Behavioral deficits correlate most strongly with sensory dysfunction. Oscillatory analyses provide critical information regarding sensory/cognitive processing over and above standard ERP analyses. Recent analyses of induced oscillatory activity in single trials during AX-CPT in healthy volunteers showed characteristic response patterns in theta, alpha, and beta frequencies tied to specific sensory and cognitive processes. Alpha and beta modulated during the trials and beta modulation over the frontal cortex correlated with reaction time. In this study, EEG data was obtained from 18 schizophrenia patients and 13 controls during AX-CPT performance, and single trial decomposition of the signal yielded power in the target wavelengths. Significant task-related event-related desynchronization (ERD) was observed in both alpha and beta frequency bands over parieto-occipital cortex related to sensory encoding of the cue. This modulation was reduced in patients for beta, but not for alpha. In addition, significant beta ERD was observed over motor cortex, related to motor preparation for the response, and was also reduced in patients. These findings demonstrate impaired dynamic modulation of beta frequency rhythms in schizophrenia, and suggest that failures of oscillatory activity may underlie impaired sensory information processing in schizophrenia that in turn contributes to cognitive deficits.
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Affiliation(s)
- Elisa C Dias
- Center for Schizophrenia Research, Nathan Kline Institute for Psychiatric Research Orangeburg, NY, USA
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Paquette S, Peretz I, Belin P. The "Musical Emotional Bursts": a validated set of musical affect bursts to investigate auditory affective processing. Front Psychol 2013; 4:509. [PMID: 23964255 PMCID: PMC3741467 DOI: 10.3389/fpsyg.2013.00509] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/18/2013] [Indexed: 11/18/2022] Open
Abstract
The Musical Emotional Bursts (MEB) consist of 80 brief musical executions expressing basic emotional states (happiness, sadness and fear) and neutrality. These musical bursts were designed to be the musical analog of the Montreal Affective Voices (MAV)—a set of brief non-verbal affective vocalizations portraying different basic emotions. The MEB consist of short (mean duration: 1.6 s) improvisations on a given emotion or of imitations of a given MAV stimulus, played on a violin (10 stimuli × 4 [3 emotions + neutral]), or a clarinet (10 stimuli × 4 [3 emotions + neutral]). The MEB arguably represent a primitive form of music emotional expression, just like the MAV represent a primitive form of vocal, non-linguistic emotional expression. To create the MEB, stimuli were recorded from 10 violinists and 10 clarinetists, and then evaluated by 60 participants. Participants evaluated 240 stimuli [30 stimuli × 4 (3 emotions + neutral) × 2 instruments] by performing either a forced-choice emotion categorization task, a valence rating task or an arousal rating task (20 subjects per task); 40 MAVs were also used in the same session with similar task instructions. Recognition accuracy of emotional categories expressed by the MEB (n:80) was lower than for the MAVs but still very high with an average percent correct recognition score of 80.4%. Highest recognition accuracies were obtained for happy clarinet (92.0%) and fearful or sad violin (88.0% each) MEB stimuli. The MEB can be used to compare the cerebral processing of emotional expressions in music and vocal communication, or used for testing affective perception in patients with communication problems.
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Affiliation(s)
- Sébastien Paquette
- Department of Psychology, International Laboratory for Brain Music and Sound Research, Center for Research on Brain, Language and Music, University of Montreal Montreal, QC, Canada
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