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de Freitas MBL, Luna LP, Beatriz M, Pinto RK, Alves CHL, Bittencourt L, Nardi AE, Oertel V, Veras AB, de Lucena DF, Alves GS. Resting-state fMRI is associated with trauma experiences, mood and psychosis in Afro-descendants with bipolar disorder and schizophrenia. Psychiatry Res Neuroimaging 2024; 340:111766. [PMID: 38408419 DOI: 10.1016/j.pscychresns.2023.111766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/19/2023] [Accepted: 11/26/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Bipolar disorder (BD) and schizophrenia (SCZ) may exhibit functional abnormalities in several brain areas, including the medial temporal and prefrontal cortex and hippocampus; however, a less explored topic is how brain connectivity is linked to premorbid trauma experiences and clinical features in non-Caucasian samples of SCZ and BD. METHODS Sixty-two individuals with SCZ (n = 20), BD (n = 21), and healthy controls (HC, n = 21) from indigenous and African ethnicity were submitted to clinical screening (Di-PAD), traumata experiences (ETISR-SF), cognitive and functional MRI assessment. The item psychosis/hallucinations in SCZ patients showed a negative correlation with the global efficiency (GE) in the right dorsal attention network. The items mania, irritable mood, and racing thoughts in the Di-PAD scale had a significant negative correlation with the GE in the parietal right default mode network. CONCLUSIONS Differences in the activation of specific networks were associated with earlier disease onset, history of physical abuse, and more severe psychotic and mood symptoms in SCZ and BD subjects of indigenous and black ethnicity. Findings provide further evidence on SZ and BD's brain connectivity disturbances, and their clinical significance, in non-Caucasian samples.
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Affiliation(s)
| | - Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Márcia Beatriz
- Neuroradiology Service, São Domingos Hospital, São Luís, Brazil; Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | | | - Candida H Lopes Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil
| | - Lays Bittencourt
- Neuropsychiatry Service, Nina Rodrigues Hospital, São Luís, Brazil
| | - Antônio E Nardi
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Viola Oertel
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Frankfurt Goethe University, Germany
| | - André B Veras
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gilberto Sousa Alves
- Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Brazil; Neuropsychiatry Service, Nina Rodrigues Hospital, São Luís, Brazil; Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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2
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Luna LP, Sousa MB, Passinho JS, Nardi AE, Oertel V, Veras AB, Alves GS. Resting-state fMRI functional connectivity and clinical correlates in Afro-descendants with schizophrenia and bipolar disorder. Psychiatry Res Neuroimaging 2023; 331:111628. [PMID: 36924740 DOI: 10.1016/j.pscychresns.2023.111628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/12/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Schizophrenia (SCZ) and bipolar disorder (BD) exhibited altered activation in several brain areas, including the prefrontal and temporal cortex; however, a less explored topic is how brain connectivity and functional disturbances occur in non-Caucasian samples of SCZ and BD. Individuals with SCZ (n=20), BD (n=21), and healthy controls (HC, n=21) from indigenous and African ethnicity were submitted to clinical screening and functional assessments. Mood, compulsive and psychotic symptoms were also correlated to network dysfunction in each group. Two distinct networks' subcomponents demonstrated significant lower global efficiency (GE) in SCZ versus HC, corresponding to left posterior dorsal attention and medial left ventral attention (VA) networks. Lower GE was found in BD versus controls in four subcomponents, including the left medial and right VA. Higher compulsion scores correlated in BD with lower GE in the left VA, whereas increased report of alcohol abuse was associated with higher GE in left default mode network. Although preliminary, differences in the activation of specific networks, notably the left hemisphere, in SCZ versus controls, and lower activation in VA areas, in BD versus controls. Results highlight default mode and salient network as relevant for the emotional processing of SCZ and BD of indigenous and black ethnicity. Abstract: schizophrenia, bipolar disorder, functional neuroimaging, ethnicity, default network.
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Affiliation(s)
- Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Jhule S Passinho
- Neuropsychology Laboratory, CEUMA University, São Luís, Maranhão, Brazil
| | - Antônio E Nardi
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Viola Oertel
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Frankfurt Goethe University, Germany
| | - André Barciela Veras
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Mato Grosso do Sul, Brazil
| | - Gilberto Sousa Alves
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Maranhão, Brazil.
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Scarpazza C, Costa C, Battaglia U, Berryessa C, Bianchetti ML, Caggiu I, Devinsky O, Ferracuti S, Focquaert F, Forgione A, Gilbert F, Pennati A, Pietrini P, Rainero I, Sartori G, Swerdlow R, Camperio Ciani AS. Acquired Pedophilia: international Delphi-method-based consensus guidelines. Transl Psychiatry 2023; 13:11. [PMID: 36653356 PMCID: PMC9849353 DOI: 10.1038/s41398-023-02314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
Idiopathic and acquired pedophilia are two different disorders with two different etiologies. However, the differential diagnosis is still very difficult, as the behavioral indicators used to discriminate the two forms of pedophilia are underexplored, and clinicians are still devoid of clear guidelines describing the clinical and neuroscientific investigations suggested to help them with this difficult task. Furthermore, the consequences of misdiagnosis are not known, and a consensus regarding the legal consequences for the two kinds of offenders is still lacking. The present study used the Delphi method to reach a global consensus on the following six topics: behavioral indicators/red flags helpful for differential diagnosis; neurological conditions potentially leading to acquired pedophilia; neuroscientific investigations important for a correct understanding of the case; consequences of misdiagnosis; legal consequences; and issues and future perspectives. An international and multidisciplinary board of scientists and clinicians took part in the consensus statements as Delphi members. The Delphi panel comprised 52 raters with interdisciplinary competencies, including neurologists, psychiatrists, neuropsychologists, forensic psychologists, expert in ethics, etc. The final recommendations consisted of 63 statements covering the six different topics. The current study is the first expert consensus on a delicate topic such as pedophilia. Important exploitable consensual recommendations that can ultimately be of immediate use by clinicians to help with differential diagnosis and plan and guide therapeutic interventions are described, as well as future perspectives for researchers.
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Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padova, Padova, Italy. .,Padova Neuroscience Center (PNC), University of Padova, Padova, Italy. .,IRCCS S. Camillo Hospital, Venezia, Italy.
| | - Cristiano Costa
- grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padova, Padova, Italy ,grid.5608.b0000 0004 1757 3470Department of Neuroscience, University of Padova, Padova, Italy
| | - Umberto Battaglia
- grid.5608.b0000 0004 1757 3470Department of Applied Psychology, FISPPA – University of Padova, Padova, Italy
| | - Colleen Berryessa
- grid.430387.b0000 0004 1936 8796School of Criminal Justice, Rutgers University, Newark, NJ USA
| | - Maria Lucia Bianchetti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Ilenia Caggiu
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Orrin Devinsky
- grid.137628.90000 0004 1936 8753Epilepsy Center, NYU School of Medicine, New York, USA
| | - Stefano Ferracuti
- grid.7841.aDepartment of Human Neurosciences Sapienza Università di Roma, Rome, Italy
| | - Farah Focquaert
- grid.5342.00000 0001 2069 7798Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Ghent, Belgium
| | - Arianna Forgione
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Fredric Gilbert
- grid.1009.80000 0004 1936 826XEthics, Policy & Public Engagement (EPPE) ARC Centre of Excellence for Electromaterials Science (ACES), Faculty of Arts, University of Tasmania, Hobart, Australia
| | | | - Pietro Pietrini
- grid.462365.00000 0004 1790 9464IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Innocenzo Rainero
- grid.7605.40000 0001 2336 6580Neurology I, Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Turin, Italy
| | - Giuseppe Sartori
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padova, Italy
| | - Russell Swerdlow
- grid.412016.00000 0001 2177 6375University of Kansas Medical Center, Kansas City, KS USA
| | - Andrea S. Camperio Ciani
- grid.5608.b0000 0004 1757 3470Department of Applied Psychology, FISPPA – University of Padova, Padova, Italy
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Cortical changes in patients with schizophrenia across two ethnic backgrounds. Sci Rep 2022; 12:10810. [PMID: 35752706 PMCID: PMC9233668 DOI: 10.1038/s41598-022-14914-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
While it is known that cultural background influences the healthy brain, less is known about how it affects cortical changes in schizophrenia. Here, we tested whether schizophrenia differentially affected the brain in Japanese and German patients. In a sample of 155 patients with a diagnosis of schizophrenia and 191 healthy controls from Japan and Germany, we acquired 3 T-MRI of the brain. We subsequently compared cortical thickness and cortical surface area to identify whether differences between healthy controls and patients might be influenced by ethnicity. Additional analyses were performed to account for effects of duration of illness and medication. We found pronounced interactions between schizophrenia and cultural background in the cortical thickness of several areas, including the left inferior and middle temporal gyrus, as well as the right lateral occipital cortex. Regarding cortical surface area, interaction effects appeared in the insula and the occipital cortex, among others. Some of these brain areas are related to the expression of psychotic symptoms, which are known to differ across cultures. Our results indicate that cultural background impacts cortical structures in different ways, probably resulting in varying clinical manifestations, and call for the inclusion of more diverse samples in schizophrenia research.
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Tognin S, Richter A, Kempton MJ, Modinos G, Antoniades M, Azis M, Allen P, Bossong MG, Perez J, Pantelis C, Nelson B, Amminger P, Riecher-Rössler A, Barrantes-Vidal N, Krebs MO, Glenthøj B, Ruhrmann S, Sachs G, Rutten BPF, de Haan L, van der Gaag M, Valmaggia LR, McGuire P, Antoniades M, Pisani S, Modinos G, de Haan L, van der Gaag M, Velthorst E, Kraan TC, van Dam DS, Burger N, Nelson B, McGorry P, Amminger GP, Pantelis C, Politis A, Goodall J, Riecher-Rössler A, Borgwardt S, Studerus E, Bressan R, Gadelha A, Brietzke E, Asevedo G, Asevedo E, Zugman A, Barrantes-Vidal N, Domínguez-Martínez T, Racciopi A, Kwapil TR, Monsonet M, Hinojosa L, Kazes M, Daban C, Bourgin J, Gay O, Mam-Lam-Fook C, Krebs MO, Nordholm D, Randers L, Krakauer K, Glenthøj L, Glenthøj B, Nordentoft M, Ruhrmann S, Gebhard D, Arnhold J, Klosterkötter J, Sachs G, Lasser I, Winklbaur B, Aschauer H, Delespaul PA, Rutten BP, van Os J, Valmaggia LR, McGuire P. The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac040. [PMID: 35903803 PMCID: PMC9309497 DOI: 10.1093/schizbullopen/sgac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis. Methods 265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes. Results Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis. Conclusions In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthijs G Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jesus Perez
- CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | | | | | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Hospitalo-Universitaire department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Services Capital Region of Denmark, Mental Health Center Glostrup, Glostrup, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) , UK
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Alkan E, Davies G, Evans SL. Cognitive impairment in schizophrenia: relationships with cortical thickness in fronto-temporal regions, and dissociability from symptom severity. NPJ SCHIZOPHRENIA 2021; 7:20. [PMID: 33737508 PMCID: PMC7973472 DOI: 10.1038/s41537-021-00149-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
Cognitive impairments are a core and persistent characteristic of schizophrenia with implications for daily functioning. These show only limited response to antipsychotic treatment and their neural basis is not well characterised. Previous studies point to relationships between cortical thickness and cognitive performance in fronto-temporal brain regions in schizophrenia patients (SZH). There is also evidence that these relationships might be independent of symptom severity, suggesting dissociable disease processes. We set out to explore these possibilities in a sample of 70 SZH and 72 age and gender-matched healthy controls (provided by the Center of Biomedical Research Excellence (COBRE)). Cortical thickness within fronto-temporal regions implicated by previous work was considered in relation to performance across various cognitive domains (from the MATRICS Cognitive Battery). Compared to controls, SZH had thinner cortices across most fronto-temporal regions and significantly lower performance on all cognitive domains. Robust relationships with cortical thickness were found: visual learning and attention performance correlated with bilateral superior and middle frontal thickness in SZH only. Correlations between attention performance and right transverse temporal thickness were also specific to SZH. Findings point to the importance of these regions for cognitive performance in SZH, possibly reflecting compensatory processes and/or aberrant connectivity. No links to symptom severity were observed in these regions, suggesting these relationships are dissociable from underlying psychotic symptomology. Findings enhance understanding of the brain structural underpinnings and possible aetiology of cognitive impairment in SZH.
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Affiliation(s)
- Erkan Alkan
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Geoff Davies
- Brighton & Sussex Medical School/Sussex Partnership NHS Foundation Trust, Sussex, UK
| | - Simon L Evans
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
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Scarpazza C, Miolla A, Zampieri I, Melis G, Sartori G, Ferracuti S, Pietrini P. Translational Application of a Neuro-Scientific Multi-Modal Approach Into Forensic Psychiatric Evaluation: Why and How? Front Psychiatry 2021; 12:597918. [PMID: 33613339 PMCID: PMC7892615 DOI: 10.3389/fpsyt.2021.597918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 01/14/2021] [Indexed: 01/01/2023] Open
Abstract
A prominent body of literature indicates that insanity evaluations, which are intended to provide influential expert reports for judges to reach a decision "beyond any reasonable doubt," suffer from a low inter-rater reliability. This paper reviews the limitations of the classical approach to insanity evaluation and the criticisms to the introduction of neuro-scientific approach in court. Here, we explain why in our opinion these criticisms, that seriously hamper the translational implementation of neuroscience into the forensic setting, do not survive scientific scrutiny. Moreover, we discuss how the neuro-scientific multimodal approach may improve the inter-rater reliability in insanity evaluation. Critically, neuroscience does not aim to introduce a brain-based concept of insanity. Indeed, criteria for responsibility and insanity are and should remain clinical. Rather, following the falsificationist approach and the convergence of evidence principle, the neuro-scientific multimodal approach is being proposed as a way to improve reliability of insanity evaluation and to mitigate the influence of cognitive biases on the formulation of insanity opinions, with the final aim to reduce errors and controversies.
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Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padova, Padova, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alessio Miolla
- Department of General Psychology, University of Padova, Padova, Italy
| | - Ilaria Zampieri
- Molecular Mind Laboratory, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Giulia Melis
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giuseppe Sartori
- Department of General Psychology, University of Padova, Padova, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, “Sapienza” University of Rome, Rome, Italy
| | - Pietro Pietrini
- Molecular Mind Laboratory, IMT School for Advanced Studies Lucca, Lucca, Italy
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8
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Vieira S, Gong Q, Scarpazza C, Lui S, Huang X, Crespo-Facorro B, Tordesillas-Gutierrez D, de la Foz VOG, Setien-Suero E, Scheepers F, van Haren NE, Kahn R, Reis Marques T, Ciufolini S, Di Forti M, Murray RM, David A, Dazzan P, McGuire P, Mechelli A. Neuroanatomical abnormalities in first-episode psychosis across independent samples: a multi-centre mega-analysis. Psychol Med 2021; 51:340-350. [PMID: 31858920 PMCID: PMC7893510 DOI: 10.1017/s0033291719003568] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 10/10/2019] [Accepted: 11/21/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neuroanatomical abnormalities in first-episode psychosis (FEP) tend to be subtle and widespread. The vast majority of previous studies have used small samples, and therefore may have been underpowered. In addition, most studies have examined participants at a single research site, and therefore the results may be specific to the local sample investigated. Consequently, the findings reported in the existing literature are highly heterogeneous. This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP that are expressed consistently across several independent samples. METHODS Structural Magnetic Resonance Imaging data were acquired from a total of 572 FEP and 502 age and gender comparable healthy controls at five sites. Voxel-based morphometry was used to investigate differences in grey matter volume (GMV) between the two groups. Statistical inferences were made at p < 0.05 after family-wise error correction for multiple comparisons. RESULTS FEP showed a widespread pattern of decreased GMV in fronto-temporal, insular and occipital regions bilaterally; these decreases were not dependent on anti-psychotic medication. The region with the most pronounced decrease - gyrus rectus - was negatively correlated with the severity of positive and negative symptoms. CONCLUSIONS This study identified a consistent pattern of fronto-temporal, insular and occipital abnormalities in five independent FEP samples; furthermore, the extent of these alterations is dependent on the severity of symptoms and duration of illness. This provides evidence for reliable neuroanatomical alternations in FEP, expressed above and beyond site-related differences in anti-psychotic medication, scanning parameters and recruitment criteria.
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Affiliation(s)
- Sandra Vieira
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Cristina Scarpazza
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of General Psychology, University of Padova, Padova, Italy
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - Diana Tordesillas-Gutierrez
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Víctor Ortiz-García de la Foz
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - Esther Setien-Suero
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - Floor Scheepers
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - René Kahn
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Simone Ciufolini
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anthony David
- UCL Institute of Mental Health, University College London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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9
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Scarpazza C, Zampieri I, Miolla A, Melis G, Pietrini P, Sartori G. A multidisciplinary approach to insanity assessment as a way to reduce cognitive biases. Forensic Sci Int 2020; 319:110652. [PMID: 33360246 DOI: 10.1016/j.forsciint.2020.110652] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/21/2022]
Abstract
Insanity assessment requires the evaluation of the psychopathological condition that underlies the mens rea. Psychopathological evaluation may be quite challenging due to (i) absence of biomarkers; (ii) low inter-rater reliability; (iii) presence of cognitive bias. This intrinsic low reliability of forensic psychiatric diagnosis does impact on insanity assessment, leading to arbitrary and unjust legal outcomes for the examinee. Thus, strategies to improve the reliability of insanity evaluation are strongly needed. A multidisciplinary approach has been proposed as a way to enrich clinical diagnosis with reliable and biologically founded data, thus minimizing subjectivity, reducing controversies and increasing inter-subject concordance in insanity assessment. By discussing a real case, here we show how the convergence of multiple indices can produce evidence that cannot be denied without introducing logical fallacies. Applying this approach, the forensic discussion will move from the presence/absence of psychopathology to the impact of psychopathology on insanity. This article illustrates how a multidisciplinary evaluation, which integrates neuroscientific methods with the classical insanity assessment, may lead to a more accurate approach in insanity evaluation. Critically, this approach will minimize the impact of cognitive bias on insanity opinion and thus result in an improvement of the whole criminal justice process.
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Affiliation(s)
- Cristina Scarpazza
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy.
| | - Ilaria Zampieri
- Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy.
| | - Alessio Miolla
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy.
| | - Giulia Melis
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy.
| | - Pietro Pietrini
- Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy.
| | - Giuseppe Sartori
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy.
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10
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Koszła O, Targowska-Duda KM, Kędzierska E, Kaczor AA. In Vitro and In Vivo Models for the Investigation of Potential Drugs Against Schizophrenia. Biomolecules 2020; 10:biom10010160. [PMID: 31963851 PMCID: PMC7022578 DOI: 10.3390/biom10010160] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 02/06/2023] Open
Abstract
Schizophrenia (SZ) is a complex psychiatric disorder characterized by positive, negative, and cognitive symptoms, and is not satisfactorily treated by current antipsychotics. Progress in understanding the basic pathomechanism of the disease has been hampered by the lack of appropriate models. In order to develop modern drugs against SZ, efficient methods to study them in in vitro and in vivo models of this disease are required. In this review a short presentation of current hypotheses and concepts of SZ is followed by a description of current progress in the field of SZ experimental models. A critical discussion of advantages and limitations of in vitro models and pharmacological, genetic, and neurodevelopmental in vivo models for positive, negative, and cognitive symptoms of the disease is provided. In particular, this review concerns the important issue of how cellular and animal systems can help to meet the challenges of modeling the disease, which fully manifests only in humans, as experimental studies of SZ in humans are limited. Next, it is emphasized that novel clinical candidates should be evaluated in animal models for treatment-resistant SZ. In conclusion, the plurality of available in vitro and in vivo models is a consequence of the complex nature of SZ, and there are extensive possibilities for their integration. Future development of more efficient antipsychotics reflecting the pleiotropy of symptoms in SZ requires the incorporation of various models into one uniting model of the multifactorial disorder and use of this model for the evaluation of new drugs.
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Affiliation(s)
- Oliwia Koszła
- Department of Synthesis and Chemical Technology of Pharmaceutical Substances, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki St., PL-20093 Lublin, Poland;
| | - Katarzyna M. Targowska-Duda
- Department of Biopharmacy, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki St., PL-20093 Lublin, Poland
| | - Ewa Kędzierska
- Department of Pharmacology and Pharmacodynamics, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki St., PL-20093 Lublin, Poland;
| | - Agnieszka A. Kaczor
- Department of Synthesis and Chemical Technology of Pharmaceutical Substances, Faculty of Pharmacy, Medical University of Lublin, 4A Chodźki St., PL-20093 Lublin, Poland;
- School of Pharmacy, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Correspondence:
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11
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Vieira S, Gong QY, Pinaya WHL, Scarpazza C, Tognin S, Crespo-Facorro B, Tordesillas-Gutierrez D, Ortiz-García V, Setien-Suero E, Scheepers FE, Van Haren NEM, Marques TR, Murray RM, David A, Dazzan P, McGuire P, Mechelli A. Using Machine Learning and Structural Neuroimaging to Detect First Episode Psychosis: Reconsidering the Evidence. Schizophr Bull 2020; 46:17-26. [PMID: 30809667 PMCID: PMC6942152 DOI: 10.1093/schbul/sby189] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Despite the high level of interest in the use of machine learning (ML) and neuroimaging to detect psychosis at the individual level, the reliability of the findings is unclear due to potential methodological issues that may have inflated the existing literature. This study aimed to elucidate the extent to which the application of ML to neuroanatomical data allows detection of first episode psychosis (FEP), while putting in place methodological precautions to avoid overoptimistic results. We tested both traditional ML and an emerging approach known as deep learning (DL) using 3 feature sets of interest: (1) surface-based regional volumes and cortical thickness, (2) voxel-based gray matter volume (GMV) and (3) voxel-based cortical thickness (VBCT). To assess the reliability of the findings, we repeated all analyses in 5 independent datasets, totaling 956 participants (514 FEP and 444 within-site matched controls). The performance was assessed via nested cross-validation (CV) and cross-site CV. Accuracies ranged from 50% to 70% for surfaced-based features; from 50% to 63% for GMV; and from 51% to 68% for VBCT. The best accuracies (70%) were achieved when DL was applied to surface-based features; however, these models generalized poorly to other sites. Findings from this study suggest that, when methodological precautions are adopted to avoid overoptimistic results, detection of individuals in the early stages of psychosis is more challenging than originally thought. In light of this, we argue that the current evidence for the diagnostic value of ML and structural neuroimaging should be reconsidered toward a more cautious interpretation.
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Affiliation(s)
- Sandra Vieira
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Qi-yong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China
| | - Walter H L Pinaya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Centre of Mathematics, Computation, and Cognition, Universidade Federal do ABC, São Paulo, Brazil
| | - Cristina Scarpazza
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Department of General Psychology, University of Padova, Padova, Italy
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - Diana Tordesillas-Gutierrez
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Victor Ortiz-García
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - Esther Setien-Suero
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - Floortje E Scheepers
- Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Neeltje E M Van Haren
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Tiago R Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Anthony David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
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12
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Koelkebeck K, Dannlowski U, Ohrmann P, Suslow T, Murai T, Bauer J, Pedersen A, Matsukawa N, Son S, Haidl T, Miyata J. Gray matter volume reductions in patients with schizophrenia: A replication study across two cultural backgrounds. Psychiatry Res Neuroimaging 2019; 292:32-40. [PMID: 31499256 DOI: 10.1016/j.pscychresns.2019.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/21/2019] [Accepted: 08/30/2019] [Indexed: 01/14/2023]
Abstract
Structural gray matter (GM) volume reductions in patients with schizophrenia have rarely been replicated across two different sites, the impact of culture and clinical characteristics remains unresolved. Hence, we assessed GM volume reductions in patients with schizophrenia using 3 T magnetic resonace imaging to replicate results across two independent and culturally different backgrounds (Germany, Japan), and to investigate the impact of brain volume reductions on clinical characteristics. In total, 163 German (80 patients) and 203 Japanese (83 patients) participants were included in the analysis. Voxel-based morphometry (VBM) was used to investigate structural differences between the groups and across the two sites, comparing local GM volumes. Clinical variables were used to analyze effects unrelated to the socio-cultural background. Across both data sets, widespread GM reductions in frontal and temporal cortical parts were found between patients and controls, indicating strong effects of diagnosis and only small effects of site. The investigation of clinical characteristics revealed the strongest effects for chlorpromazine equivalents on GM volume reductions primarily in the Japanese sample. Although the effects of site are small, several brain regions do not overlap between the two groups. Thus, GM may be affected differently at the two sites in patients with schizophrenia.
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Affiliation(s)
- Katja Koelkebeck
- Department of Psychiatry and Psychotherapy, University of Muenster, School of Medicine, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Muenster, School of Medicine, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany
| | - Patricia Ohrmann
- Department of Psychiatry and Psychotherapy, University of Muenster, School of Medicine, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany
| | - Thomas Suslow
- University of Leipzig, Department of Psychosomatic Medicine and Psychotherapy, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Toshiya Murai
- Department of Psychiatry, University of Kyoto, School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Jochen Bauer
- Institute of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149 Muenster, Germany
| | - Anya Pedersen
- Clinical Psychology and Psychotherapy, University of Kiel, Olshausenstrasse 62, 24118 Kiel, Germany
| | - Noriko Matsukawa
- Department of Psychiatry, University of Kyoto, School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Shuraku Son
- Department of Psychiatry, University of Kyoto, School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Theresa Haidl
- Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Strasse 62, 50934 Cologne, Germany
| | - Jun Miyata
- Department of Psychiatry, University of Kyoto, School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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13
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Huang H, Dong M, Zhang L, Zhong BL, Ng CH, Ungvari GS, Yuan Z, Meng X, Xiang YT. Psychopathology and extrapyramidal side effects in smoking and non-smoking patients with schizophrenia: Systematic review and meta-analysis of comparative studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:476-482. [PMID: 30794823 DOI: 10.1016/j.pnpbp.2019.02.011] [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: 10/08/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 12/21/2022]
Abstract
The association between smoking and psychopathology and extrapyramidal side effects (EPSE) in schizophrenia has been controversial. This systematic review and meta-analysis compared psychopathology and EPSE between smoking and non-smoking schizophrenia patients. The PubMed, EMBASE, PsycINFO, Cochrane Library, and Web of Science databases were independently and systematically searched by two researchers to identify relevant articles. Standardized mean differences (SMDs) and their 95% confidence intervals (CI) were calculated with random effect models. Subgroup and meta-regression analyses were performed to explore sources of heterogeneity. The systematic review and meta-analysis included 29 studies that compared psychotic, depressive and anxiety symptoms and EPSE between smoking (n = 3591) and non-smoking schizophrenia patients (n = 2980). Smoking patients had significantly more severe positive symptoms (24 studies; SMD = 0.33, 95% CI: 0.16 to 0.50, P < 0.001), but less severe EPSE (7 studies; SMD = -0.20, 95% CI: -0.38 to -0.02, P = 0. 03). No significant group differences in negative, depressive and anxiety symptoms were found. In conclusion, this systematic review and meta-analysis found that smoking schizophrenia patients had more severe positive symptoms but less severe EPSE than non-smoking patients.
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Affiliation(s)
- Hui Huang
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Dong
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, the Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, School of Mental Health, Capital Medical University, Beijing, China
| | - Bao-Liang Zhong
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Zhen Yuan
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiangfei Meng
- Department of Psychiatry, McGill University and the Douglas Mental Health University Institute, Montreal, Canada
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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14
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A transdiagnostic neuroanatomical signature of psychiatric illness. Neuropsychopharmacology 2019; 44:869-875. [PMID: 30127342 PMCID: PMC6461829 DOI: 10.1038/s41386-018-0175-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/15/2018] [Accepted: 07/19/2018] [Indexed: 02/05/2023]
Abstract
Despite an increasing focus on transdiagnostic approaches to mental health, it remains unclear whether different diagnostic categories share a common neuronatomical basis. The current investigation sought to investigate whether a transdiagnostic set of structural alterations characterized schizophrenia, depression, post-traumatic stress disorder, and obsessive-compulsive disorder, and determine whether any such alterations reflected markers of psychiatric illness or pre-existing familial vulnerability. A total of 404 patients with a psychiatric diagnosis were recruited (psychosis, n = 129; unipolar depression, n = 92; post-traumatic stress disorder, n = 91; obsessive-compulsive disorder, n = 92) alongside n = 201 healthy controls and n = 20 unaffected first-degree relatives. We collected structural magnetic resonance imaging scans from each participant, and tested for transdiagnostic alterations using Voxel-based morphometry. Inferences were made at p < 0.05 after family-wise error correction for multiple comparisons. The four psychiatric groups relative to healthy controls were all characterized by significantly greater gray matter volume in the putamen (right: z-score: 5.97, p-value < 0.001; left: z-score: 4.97, p-value = 0.001); the volume of this region was positively correlated with severity of symptoms across groups (r = 0.313; p < 0.001). Putamen enlargement was also evident in unaffected relatives compared to healthy controls (right: z-score: 8.13, p-value < 0.001; left: z-score: 9.38, p-value < 0.001). Taken collectively, these findings indicate that increased putamen volume may reflect a transdiagnostic marker of familial vulnerability to psychopathology. This is consistent with emerging conceptualizations of psychiatric illness, in which each disorder is understood as a combination of diagnosis-specific features and a transdiagnostic factor reflecting general psychopathology.
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15
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Kwak YB, Kim M, Cho KIK, Lee J, Lee TY, Kwon JS. Reduced cortical thickness in subjects at clinical high risk for psychosis and clinical attributes. Aust N Z J Psychiatry 2019; 53:219-227. [PMID: 30369245 DOI: 10.1177/0004867418807299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Although neuroanatomical abnormalities in subjects at clinical high risk for psychosis have been considered a putative biomarker of psychosis, relevance of cortical thickness alterations remains contested due to discrepant findings. Inconsistencies persist in Asian clinical high risk studies, despite their advantageous settings well-controlled for confounds. Attributes of cortical thickness alterations in clinical high risk subjects warrant further examination. METHODS We examined cortical thickness at the whole-brain level in 74 clinical high risk subjects and 34 demographically matched healthy controls recruited from Seoul Youth Clinic, South Korea. Clinical symptoms were assessed using the Scale of Prodromal Symptoms, and their associations with cortical thickness were explored using partial correlation analysis. RESULTS Compared to healthy control, clinical high risk exhibited significant cortical thinning in bilateral prefrontal cortex and inferior parietal lobule clusters. Reduced thickness in the left prefrontal cortex cluster was associated with more severe Scale of Prodromal Symptoms general symptoms scores and the right inferior parietal lobule cluster with Scale of Prodromal Symptoms disorganization symptoms. CONCLUSIONS Thickness deficits found in the present clinical high risk sample demonstrated a degree of consistency with those reported in the previous Seoul Youth Clinic study. While inconsistencies reported between the present and previous Seoul Youth Clinic samples may reflect markedly decreased rate of converters, consistencies may be relevant to clinical attributes beyond transition, such as the prevalence of comorbidities. Particular recruitment strategies employed for sample selections should also be considered for findings in Asian clinical high risk samples. Our results suggest potential utility of cortical thickness alterations in clinical high risk subjects beyond the frame of transition.
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Affiliation(s)
- Yoo Bin Kwak
- 1 Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Minah Kim
- 2 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Kang Ik Kevin Cho
- 1 Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.,3 Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Junhee Lee
- 2 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Tae Yong Lee
- 4 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Soo Kwon
- 1 Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.,2 Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea.,3 Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
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16
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Newton R, Rouleau A, Nylander AG, Loze JY, Resemann HK, Steeves S, Crespo-Facorro B. Diverse definitions of the early course of schizophrenia-a targeted literature review. NPJ SCHIZOPHRENIA 2018; 4:21. [PMID: 30323274 PMCID: PMC6189105 DOI: 10.1038/s41537-018-0063-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder and patients experience significant comorbidity, especially cognitive and psychosocial deficits, already at the onset of disease. Previous research suggests that treatment during the earlier stages of disease reduces disease burden, and that a longer time of untreated psychosis has a negative impact on treatment outcomes. A targeted literature review was conducted to gain insight into the definitions currently used to describe patients with a recent diagnosis of schizophrenia in the early course of disease ('early' schizophrenia). A total of 483 relevant English-language publications of clinical guidelines and studies were identified for inclusion after searches of MEDLINE, MEDLINE In-Process, relevant clinical trial databases and Google for records published between January 2005 and October 2015. The extracted data revealed a wide variety of terminology and definitions used to describe patients with 'early' or 'recent-onset' schizophrenia, with no apparent consensus. The most commonly used criteria to define patients with early schizophrenia included experience of their first episode of schizophrenia or disease duration of less than 1, 2 or 5 years. These varied definitions likely result in substantial disparities of patient populations between studies and variable population heterogeneity. Better agreement on the definition of early schizophrenia could aid interpretation and comparison of studies in this patient population and consensus on definitions should allow for better identification and management of schizophrenia patients in the early course of their disease.
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Affiliation(s)
- Richard Newton
- Austin Health, University of Melbourne, Melbourne, VIC, Australia.,Peninsula Health, Frankston, VIC, Australia
| | | | | | | | | | | | - Benedicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
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17
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Lee A, Shen M, Qiu A. Psychiatric polygenic risk associates with cortical morphology and functional organization in aging. Transl Psychiatry 2017; 7:1276. [PMID: 29225336 PMCID: PMC5802582 DOI: 10.1038/s41398-017-0036-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/04/2017] [Accepted: 09/07/2017] [Indexed: 01/23/2023] Open
Abstract
Common brain abnormalities in cortical morphology and functional organization are observed in psychiatric disorders and aging, reflecting shared genetic influences. This preliminary study aimed to examine the contribution of a polygenetic risk for psychiatric disorders (PRScross) to aging brain and to identify molecular mechanisms through the use of multimodal brain images, genotypes, and transcriptome data. We showed age-related cortical thinning in bilateral inferior frontal cortex (IFC) and superior temporal gyrus and alterations in the functional connectivity between bilateral IFC and between right IFC and right inferior parietal lobe as a function of PRScross. Interestingly, the genes in PRScross, that contributed most to aging neurodegeneration, were expressed in the functioanlly connected cortical regions. Especially, genes identified through the genotype-functional connectivity association analysis were commonly expressed in both cortical regions and formed strong gene networks with biological processes related to neural plasticity and synaptogenesis, regulated by glutamatergic and GABAergic transmission, neurotrophin signaling, and metabolism. This study suggested integrating genotype and transcriptome with neuroimage data sheds new light on the mechanisms of aging brain.
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Affiliation(s)
- Annie Lee
- 0000 0001 2180 6431grid.4280.eDepartment of Biomedical Engineering, National University of Singapore, Singapore, 117576 Singapore
| | - Mojun Shen
- 0000 0004 0637 0221grid.185448.4Singapore Institute for Clinical Sciences, The Agency for Science, Technology and Research, Singapore, 117609 Singapore
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore, 117576, Singapore. .,Singapore Institute for Clinical Sciences, The Agency for Science, Technology and Research, Singapore, 117609, Singapore. .,Clinical Imaging Research Center, National University of Singapore, Singapore, 117456, Singapore.
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18
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Scarpazza C, Pellegrini S, Pietrini P, Sartori G. The Role of Neuroscience in the Evaluation of Mental Insanity: on the Controversies in Italy. NEUROETHICS-NETH 2017. [DOI: 10.1007/s12152-017-9349-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Onay A, Eser HY, Ulaşoğlu-Yıldız Ç, Aslan S, Talı ET. A combined VBM and DTI study of schizophrenia: bilateral decreased insula volume and cerebral white matter disintegrity corresponding to subinsular white matter projections unlinked to clinical symptomatology. Diagn Interv Radiol 2017; 23:390-397. [PMID: 28870884 PMCID: PMC5602366 DOI: 10.5152/dir.2017.16519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 01/18/2017] [Accepted: 04/07/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE Grey matter and white matter changes within the brain are well defined in schizophrenia. However, most studies focused on either grey matter changes or white matter integrity separately; only in limited number of studies these changes were interpreted in the same frame. In addition, the relationship of these findings with clinical variables is not clearly established. Here, we aimed to investigate the grey matter and white matter changes in schizophrenia patients and exhibit the relation of these imaging findings with clinical variables. METHODS A total of 20 schizophrenia patients and 16 matched healthy controls underwent magnetic resonance imaging to investigate the grey matter and white matter alterations that occur in schizophrenia patients using voxel-based morphometry (VBM) and whole brain voxel-wise analysis of diffusion tensor imaging (DTI) parameters with SPM8, respectively. While the preprocessing steps of VBM were performed with the default parameters of VBM8 toolbox, the preprocessing steps of DTI were carried out using FSL. Additionally, VBM results were correlated with clinical variables. RESULTS Bilateral insula showed decreased grey matter volume in schizophrenia patients compared with healthy controls (P < 0.01). The opposite contrast did not show a significant difference. Psychiatric scores, duration of illness, and age were not correlated with the decreased grey matter volume of insula in schizophrenia patients. DTI analysis revealed a significant increase in mean, radial, and axial diffusivity, mainly of the fibers of bilateral anterior thalamic radiation and superior longitudinal fasciculus with left predominance, which intersected with bilateral subinsular white matter (P < 0.05). CONCLUSION Our findings suggest that insula may be the main affected brain region in schizophrenia, which is also well supported by the literature. Our results were independent of disease duration and schizophrenia symptoms. White matter alterations were observed within bilateral anterior thalamic radiation and superior longitudinal fasciculus that intersects with subinsular white matter. Studies with larger sample sizes and more detailed clinical assessments are required to understand the function of insula in the neurobiology of schizophrenia.
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Affiliation(s)
| | | | - Çiğdem Ulaşoğlu-Yıldız
- From the Departments of Radiology (A.O. , ) and Psychiatry (H.Y.E.), Koç University School of Medicine, İstanbul, Turkey; Hulusi Behçet Life Sciences Research Center (Ç.U.Y.), İstanbul University İstanbul School of Medicine, İstanbul, Turkey; the Departments of Psychiatry (S.A.) and Radiology (E.T.T.), Gazi University School of Medicine, Ankara, Turkey
| | - Selçuk Aslan
- From the Departments of Radiology (A.O. , ) and Psychiatry (H.Y.E.), Koç University School of Medicine, İstanbul, Turkey; Hulusi Behçet Life Sciences Research Center (Ç.U.Y.), İstanbul University İstanbul School of Medicine, İstanbul, Turkey; the Departments of Psychiatry (S.A.) and Radiology (E.T.T.), Gazi University School of Medicine, Ankara, Turkey
| | - Erhan Turgut Talı
- From the Departments of Radiology (A.O. , ) and Psychiatry (H.Y.E.), Koç University School of Medicine, İstanbul, Turkey; Hulusi Behçet Life Sciences Research Center (Ç.U.Y.), İstanbul University İstanbul School of Medicine, İstanbul, Turkey; the Departments of Psychiatry (S.A.) and Radiology (E.T.T.), Gazi University School of Medicine, Ankara, Turkey
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Sex disparities in substance abuse research: Evaluating 23 years of structural neuroimaging studies. Drug Alcohol Depend 2017; 173:92-98. [PMID: 28212516 PMCID: PMC5581940 DOI: 10.1016/j.drugalcdep.2016.12.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/02/2016] [Accepted: 12/16/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sex differences in brain structure and clinical course of substance use disorders underscores the need to include women in structural brain imaging studies. The NIH has supported the need for research to address sex differences. We evaluated female enrollment in substance abuse structural brain imaging research and the methods used to study sex differences in substance effects. METHODS Structural brain imaging studies published through 2016 (n=230) were evaluated for number of participants by sex and substance use status and methods used to evaluate sex differences. Temporal trends in the numbers of participants by sex and substance use status were analyzed. We evaluated how often sex effects were appropriately analyzed and the proportion of studies that found sex by substance interactions on volumetric measures. RESULTS Female enrollment increased over time, but remained significantly lower than male enrollment (p=0.01), with the greatest bias for alcohol and opiate studies. 79% of studies included both sexes; however, 74% did not evaluate sex effects or used an analytic approach that precluded detection of sex by substance use interactions. 85% of studies that stratified by sex reported different substance effects on brain volumes. Only 33% of studies examining two-way interactions found significant interactions, highlighting that many studies were underpowered to detect interactions. CONCLUSIONS Although female participation in substance use studies of brain morphometry has increased, sex disparity persists. Studying adequate numbers of both sexes and employing correct analytic approaches is critical for understanding sex differences in brain morphometric changes in substance abuse.
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Chang M, Womer FY, Bai C, Zhou Q, Wei S, Jiang X, Geng H, Zhou Y, Tang Y, Wang F. Voxel-Based Morphometry in Individuals at Genetic High Risk for Schizophrenia and Patients with Schizophrenia during Their First Episode of Psychosis. PLoS One 2016; 11:e0163749. [PMID: 27723806 PMCID: PMC5056757 DOI: 10.1371/journal.pone.0163749] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/13/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Understanding morphologic changes in vulnerable and early disease state of schizophrenia (SZ) may provide further insight into the development of psychosis. METHOD Whole brain voxel-based morphometry was performed to identify gray matter (GM) regional differences in 60 individuals with SZ during their first psychotic episode (FE-SZ), 31 individuals at genetic high risk for SZ (GHR-SZ) individuals, and 71 healthy controls. RESULTS Significant differences were found in several regions including the prefrontal cortex, parietal lobe, temporal lobe, hippocampus, occipital lobe, and cerebellum among the three groups (p<0.05, corrected). Compared to the HC group, the FE-SZ group had significantly decreased GM volumes in several regions including the cerebellum, hippocampus, fusiform gyrus, lingual gyrus, supramarginal gyrus, and superior, middle, and inferior temporal gyri and significantly increased GM volumes in the middle frontal gyrus and inferior operculum frontal gyrus (p<0.05). The GHR-SZ group had significant decreases in GM volumes in the supramaginal gyrus, precentral gyrus, and rolandic operculum and significant increases in GM volumes in the cerebellum, fusiform gyrus, middle frontal gyrus, inferior operculum frontal gyrus, and superior, middle, and inferior temporal gyri when compared to the HC group (p<0.05). Compared to the GHR-SZ group, the FE-SZ group had significant decreases in GM volumes in several regions including the cerebellum, fusiform gyrus, supramarginal gyrus, and superior, middle, and inferior temporal gyri (p<0.05). CONCLUSIONS The findings herein implicate the involvement of multisensory integration in SZ development and pathophysiology. Additionally, the patterns of observed differences suggest possible indicators of disease, vulnerability, and resiliency in SZ.
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Affiliation(s)
- Miao Chang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Fay Y. Womer
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Chuan Bai
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Qian Zhou
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Shengnan Wei
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Xiaowei Jiang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Haiyang Geng
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yanqing Tang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Fei Wang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail:
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22
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Hopkins J. Free Energy and Virtual Reality in Neuroscience and Psychoanalysis: A Complexity Theory of Dreaming and Mental Disorder. Front Psychol 2016; 7:922. [PMID: 27471478 PMCID: PMC4946392 DOI: 10.3389/fpsyg.2016.00922] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/03/2016] [Indexed: 11/22/2022] Open
Abstract
The main concepts of the free energy (FE) neuroscience developed by Karl Friston and colleagues parallel those of Freud's Project for a Scientific Psychology. In Hobson et al. (2014) these include an innate virtual reality generator that produces the fictive prior beliefs that Freud described as the primary process. This enables Friston's account to encompass a unified treatment-a complexity theory-of the role of virtual reality in both dreaming and mental disorder. In both accounts the brain operates to minimize FE aroused by sensory impingements-including interoceptive impingements that report compliance with biological imperatives-and constructs a representation/model of the causes of impingement that enables this minimization. In Friston's account (variational) FE equals complexity minus accuracy, and is minimized by increasing accuracy and decreasing complexity. Roughly the brain (or model) increases accuracy together with complexity in waking. This is mediated by consciousness-creating active inference-by which it explains sensory impingements in terms of perceptual experiences of their causes. In sleep it reduces complexity by processes that include both synaptic pruning and consciousness/virtual reality/dreaming in REM. The consciousness-creating active inference that effects complexity-reduction in REM dreaming must operate on FE-arousing data distinct from sensory impingement. The most relevant source is remembered arousals of emotion, both recent and remote, as processed in SWS and REM on "active systems" accounts of memory consolidation/reconsolidation. Freud describes these remembered arousals as condensed in the dreamwork for use in the conscious contents of dreams, and similar condensation can be seen in symptoms. Complexity partly reflects emotional conflict and trauma. This indicates that dreams and symptoms are both produced to reduce complexity in the form of potentially adverse (traumatic or conflicting) arousals of amygdala-related emotions. Mental disorder is thus caused by computational complexity together with mechanisms like synaptic pruning that have evolved for complexity-reduction; and important features of disorder can be understood in these terms. Details of the consilience among Freudian, systems consolidation, and complexity-reduction accounts appear clearly in the analysis of a single fragment of a dream, indicating also how complexity reduction proceeds by a process resembling Bayesian model selection.
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Affiliation(s)
- Jim Hopkins
- Research Department of Clinical Educational and Health Psychology, University College LondonLondon, UK
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23
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Li Y, Xie S, Liu B, Song M, Chen Y, Li P, Lu L, Lv L, Wang H, Yan H, Yan J, Zhang H, Zhang D, Jiang T. Diffusion magnetic resonance imaging study of schizophrenia in the context of abnormal neurodevelopment using multiple site data in a Chinese Han population. Transl Psychiatry 2016; 6:e715. [PMID: 26784969 PMCID: PMC5068876 DOI: 10.1038/tp.2015.202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 11/05/2015] [Indexed: 12/19/2022] Open
Abstract
Schizophrenia has increasingly been considered a neurodevelopmental disorder, and the advancement of neuroimaging techniques and associated computational methods has enabled quantitative re-examination of this important theory on the pathogenesis of the disease. Inspired by previous findings from neonatal brains, we proposed that an increase in diffusion magnetic resonance imaging (dMRI) mean diffusivity (MD) should be observed in the cerebral cortex of schizophrenia patients compared with healthy controls, corresponding to lower tissue complexity and potentially a failure to reach cortical maturation. We tested this hypothesis using dMRI data from a Chinese Han population comprising patients from four different hospital sites. Utilizing data-driven methods based on the state-of-the-art tensor-based registration algorithm, significantly increased MD measurements were consistently observed in the cortex of schizophrenia patients across all four sites, despite differences in psychopathology, exposure to antipsychotic medication and scanners used for image acquisition. Specifically, we found increased MD in the limbic system of the schizophrenic brain, mainly involving the bilateral insular and prefrontal cortices. In light of the existing literature, we speculate that this may represent a neuroanatomical signature of the disorder, reflecting microstructural deficits due to developmental abnormalities. Our findings not only provide strong support to the abnormal neurodevelopment theory of schizophrenia, but also highlight an important neuroimaging endophenotype for monitoring the developmental trajectory of high-risk subjects of the disease, thereby facilitating early detection and prevention.
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Affiliation(s)
- Y Li
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - S Xie
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - B Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - M Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Y Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - P Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - L Lu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - L Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - H Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - H Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - J Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - H Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- Department of Psychology, Xinxiang Medical University, Xinxiang, China
| | - D Zhang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
- Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - T Jiang
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
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