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Torres-Carmona E, Ueno F, Iwata Y, Nakajima S, Song J, Mar W, Abdolizadeh A, Agarwal SM, de Luca V, Remington G, Gerretsen P, Graff-Guerrero A. Elevated intrinsic cortical curvature in treatment-resistant schizophrenia: Evidence of structural deformation in functional connectivity areas and comparison with alternate indices of structure. Schizophr Res 2024; 269:103-113. [PMID: 38761434 DOI: 10.1016/j.schres.2024.05.002] [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: 11/17/2023] [Revised: 04/14/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Research suggests structural and connectivity abnormalities in patients with treatment-resistant schizophrenia (TRS) compared to first-line responders and healthy-controls. However, measures of these abnormalities are often influenced by external factors like nicotine and antipsychotics, limiting their clinical utility. Intrinsic-cortical-curvature (ICC) presents a millimetre-scale measure of brain gyrification, highly sensitive to schizophrenia differences, and associated with TRS-like traits in early stages of the disorder. Despite this evidence, ICC in TRS remains unexplored. This study investigates ICC as a marker for treatment resistance in TRS, alongside structural indices for comparison. METHODS We assessed ICC in anterior cingulate, dorsolateral prefrontal, temporal, and parietal cortices of 38 first-line responders, 30 clozapine-resistant TRS, 37 clozapine-responsive TRS, and 52 healthy-controls. For comparative purposes, Fold and Curvature indices were also analyzed. RESULTS Adjusting for age, sex, nicotine-use, and chlorpromazine equivalence, principal findings indicate ICC elevations in the left hemisphere dorsolateral prefrontal (p < 0.001, η2partial = 0.142) and temporal cortices (LH p = 0.007, η2partial = 0.060; RH p = 0.011, η2partial = 0.076) of both TRS groups, and left anterior cingulate cortex of clozapine-resistant TRS (p = 0.026, η2partial = 0.065), compared to healthy-controls. Elevations that correlated with reduced cognition (p = 0.001) and negative symptomology (p < 0.034) in clozapine-resistant TRS. Fold and Curvature indices only detected group differences in the right parietal cortex, showing interactions with age, sex, and nicotine use. ICC showed interactions with age. CONCLUSION ICC elevations were found among patients with TRS, and correlated with symptom severity. ICCs relative independence from sex, nicotine-use, and antipsychotics, may support ICC's potential as a viable marker for TRS, though age interactions should be considered.
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Affiliation(s)
- Edgardo Torres-Carmona
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Fumihiko Ueno
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Yusuke Iwata
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Neuropsychiatry, Keio University, Minato, Tokyo, Japan
| | - Shinichiro Nakajima
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Neuropsychiatry, Keio University, Minato, Tokyo, Japan
| | - Jianmeng Song
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Wanna Mar
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Ali Abdolizadeh
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Sri Mahavir Agarwal
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Institute Research Program, CAMH, Toronto, ON, Canada
| | - Vincenzo de Luca
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Institute Research Program, CAMH, Toronto, ON, Canada
| | - Gary Remington
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Institute Research Program, CAMH, Toronto, ON, Canada
| | - Philip Gerretsen
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Institute Research Program, CAMH, Toronto, ON, Canada
| | - Ariel Graff-Guerrero
- Research Imaging Centre, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Campbell Institute Research Program, CAMH, Toronto, ON, Canada.
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2
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Haaf R, Brandi ML, Albantakis L, Lahnakoski JM, Henco L, Schilbach L. Peripheral oxytocin levels are linked to hypothalamic gray matter volume in autistic adults: a cross-sectional secondary data analysis. Sci Rep 2024; 14:1380. [PMID: 38228703 PMCID: PMC10791615 DOI: 10.1038/s41598-023-50770-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024] Open
Abstract
Oxytocin (OXT) is known to modulate social behavior and cognition and has been discussed as pathophysiological and therapeutic factor for autism spectrum disorder (ASD). An accumulating body of evidence indicates the hypothalamus to be of particular importance with regard to the underlying neurobiology. Here we used a region of interest voxel-based morphometry (VBM) approach to investigate hypothalamic gray matter volume (GMV) in autistic (n = 29, age 36.03 ± 11.0) and non-autistic adults (n = 27, age 30.96 ± 11.2). Peripheral plasma OXT levels and the autism spectrum quotient (AQ) were used for correlation analyses. Results showed no differences in hypothalamic GMV in autistic compared to non-autistic adults but suggested a differential association between hypothalamic GMV and OXT levels, such that a positive association was found for the ASD group. In addition, hypothalamic GMV showed a positive association with autistic traits in the ASD group. Bearing in mind the limitations such as a relatively small sample size, a wide age range and a high rate of psychopharmacological treatment in the ASD sample, these results provide new preliminary evidence for a potentially important role of the HTH in ASD and its relationship to the OXT system, but also point towards the importance of interindividual differences.
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Affiliation(s)
- Raoul Haaf
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany.
- Graduate School, Technical University of Munich, Munich, Germany.
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
| | - Marie-Luise Brandi
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
| | - Laura Albantakis
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Outpatient and Day Clinic for Disorders of Social Interaction, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Juha M Lahnakoski
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Neurosciences and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Henco
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Graduate School of Systemic Neurosciences, Munich, Germany
| | - Leonhard Schilbach
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Outpatient and Day Clinic for Disorders of Social Interaction, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- Graduate School of Systemic Neurosciences, Munich, Germany
- Ludwig-Maximilians-Universität München, Munich, Germany
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3
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Ben-Zion Z, Korem N, Fine NB, Katz S, Siddhanta M, Funaro MC, Duek O, Spiller TR, Danböck SK, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:120-134. [PMID: 38298789 PMCID: PMC10829655 DOI: 10.1016/j.bpsgos.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 02/02/2024] Open
Abstract
Numerous studies have explored the relationship between posttraumatic stress disorder (PTSD) and the hippocampus and the amygdala because both regions are implicated in the disorder's pathogenesis and pathophysiology. Nevertheless, those key limbic regions consist of functionally and cytoarchitecturally distinct substructures that may play different roles in the etiology of PTSD. Spurred by the availability of automatic segmentation software, structural neuroimaging studies of human hippocampal and amygdala subregions have proliferated in recent years. Here, we present a preregistered scoping review of the existing structural neuroimaging studies of the hippocampus and amygdala subregions in adults diagnosed with PTSD. A total of 3513 studies assessing subregion volumes were identified, 1689 of which were screened, and 21 studies were eligible for this review (total N = 2876 individuals). Most studies examined hippocampal subregions and reported decreased CA1, CA3, dentate gyrus, and subiculum volumes in PTSD. Fewer studies investigated amygdala subregions and reported altered lateral, basal, and central nuclei volumes in PTSD. This review further highlights the conceptual and methodological limitations of the current literature and identifies future directions to increase understanding of the distinct roles of hippocampal and amygdalar subregions in posttraumatic psychopathology.
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Affiliation(s)
- Ziv Ben-Zion
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Nachshon Korem
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Naomi B Fine
- Sagol Brain Institute Tel-Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Social Sciences, School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
| | - Sophia Katz
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Megha Siddhanta
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut
| | - Or Duek
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tobias R Spiller
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Sarah K Danböck
- Yale School of Medicine, Yale University, New Haven, Connecticut
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris London University of Salzburg, Salzburg, Austria
| | - Ifat Levy
- Yale School of Medicine, Yale University, New Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Ilan Harpaz-Rotem
- Yale School of Medicine, Yale University, New Haven, Connecticut
- US Department of Veterans Affairs National Center for PTSD, Clinical Neuroscience Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Wu Tsai Institute, Yale University, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
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4
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Guardiola-Ripoll M, Almodóvar-Payá C, Arias-Magnasco A, Latorre-Guardia M, Papiol S, Canales-Rodríguez EJ, García-León MÁ, Fuentes-Claramonte P, Salavert J, Tristany J, Torres L, Rodríguez-Cano E, Salvador R, Pomarol-Clotet E, Fatjó-Vilas M. Human-specific evolutionary markers linked to foetal neurodevelopment modulate brain surface area in schizophrenia. Commun Biol 2023; 6:1040. [PMID: 37833414 PMCID: PMC10576001 DOI: 10.1038/s42003-023-05356-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/13/2023] [Indexed: 10/15/2023] Open
Abstract
Schizophrenia may represent a trade-off in the evolution of human-specific ontogenetic mechanisms that guide neurodevelopment. Human Accelerated Regions (HARs) are evolutionary markers functioning as neurodevelopmental transcription enhancers that have been associated with brain configuration, neural information processing, and schizophrenia risk. Here, we have investigated the influence of HARs' polygenic load on neuroanatomical measures through a case-control approach (128 patients with schizophrenia and 115 controls). To this end, we have calculated the global schizophrenia Polygenic Risk Score (Global PRSSZ) and that specific to HARs (HARs PRSSZ). We have also estimated the polygenic burden restricted to the HARs linked to transcriptional regulatory elements active in the foetal brain (FB-HARs PRSSZ) and the adult brain (AB-HARs PRSSZ). We have explored the main effects of the PRSs and the PRSs x diagnosis interactions on brain regional cortical thickness (CT) and surface area (SA). The results indicate that a higher FB-HARs PRSSZ is associated with patients' lower SA in the lateral orbitofrontal cortex, the superior temporal cortex, the pars triangularis and the paracentral lobule. While noHARs-derived PRSs show an effect on the risk, our neuroanatomical findings suggest that the human-specific transcriptional regulation during the prenatal period underlies SA variability, highlighting the role of these evolutionary markers in the schizophrenia genomic architecture.
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Affiliation(s)
- Maria Guardiola-Ripoll
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain.
| | - Carmen Almodóvar-Payá
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
| | | | | | - Sergi Papiol
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Erick J Canales-Rodríguez
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
- Signal Processing Laboratory 5 (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - María Ángeles García-León
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
| | - Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
| | - Josep Salavert
- Hospital Sant Rafael, Germanes Hospitalàries, Barcelona, Spain
| | - Josep Tristany
- Hospital Sagrat Cor, Germanes Hospitalàries, Martorell, Spain
| | - Llanos Torres
- Hospital Mare de Déu de la Mercè, Germanes Hospitalàries, Barcelona, Spain
| | - Elena Rodríguez-Cano
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
- Hospital Benito Menni, Germanes Hospitalàries, Sant Boi de Llobregat, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain
| | - Mar Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
- CIBERSAM (Biomedical Research Network in Mental Health; Instituto de Salud Carlos III), Madrid, Spain.
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain.
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5
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Wang C, Tishler TA, Oughourlian T, Nuechterlein KH, de la Fuente-Sandoval C, Ellingson BM. Prospective, randomized, multicenter clinical trial evaluating longitudinal changes in brain function and microstructure in first-episode schizophrenia patients treated with long-acting injectable paliperidone palmitate versus oral antipsychotics. Schizophr Res 2023; 255:222-232. [PMID: 37019033 DOI: 10.1016/j.schres.2023.03.040] [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: 03/28/2022] [Revised: 02/23/2023] [Accepted: 03/18/2023] [Indexed: 04/07/2023]
Abstract
Widespread anatomical alterations and abnormal functional connectivity have shown strong association with symptom severity in first-episode schizophrenia (FES) patients. Second-generation antipsychotic treatment might slow disease progression and possibly modify the cerebral plasticity in FES patients. However, whether a long-acting injectable antipsychotic (paliperidone palmitate [PP]), available in monthly and every-3-months formulations, is more effective than oral antipsychotics (OAP) in improving cerebral organization has been unclear. Therefore, in the current longitudinal study, we evaluated the differences in functional and microstructural changes of 68 FES patients in a randomized clinical trial of PP vs OAP. When compared to OAP treatment, PP treatment was more effective in decreasing abnormally high fronto-temporal and thalamo-temporal connectivity, as well as increasing fronto-sensorimotor and thalamo-insular connectivity. Consistent with previous studies, multiple white matter pathways showed larger changes in fractional anisotropy (FA) and mean diffusivity (MD) in response to PP compared with OAP treatment. These findings suggest that PP treatment might reduce regional abnormalities and improve cerebral connectivity networks compared with OAP treatment, and identified changes that may serve as reliable imaging biomarkers associated with medication treatment efficacy.
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Affiliation(s)
- Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
| | - Todd A Tishler
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Talia Oughourlian
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico; Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Benjamin M Ellingson
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Neuroscience Interdisciplinary Graduate Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
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6
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Schulmann A, Marenco S, Vawter MP, Akula N, Limon A, Mandal A, Auluck PK, Patel Y, Lipska BK, McMahon FJ. Antipsychotic drug use complicates assessment of gene expression changes associated with schizophrenia. Transl Psychiatry 2023; 13:93. [PMID: 36932057 PMCID: PMC10023659 DOI: 10.1038/s41398-023-02392-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023] Open
Abstract
Recent postmortem transcriptomic studies of schizophrenia (SCZ) have shown hundreds of differentially expressed genes. However, the extent to which these gene expression changes reflect antipsychotic drug (APD) exposure remains uncertain. We compared differential gene expression in the prefrontal cortex of SCZ patients who tested positive for APDs at the time of death with SCZ patients who did not. APD exposure was associated with numerous changes in the brain transcriptome, especially among SCZ patients on atypical APDs. Brain transcriptome data from macaques chronically treated with APDs showed that APDs affect the expression of many functionally relevant genes, some of which show expression changes in the same directions as those observed in SCZ. Co-expression modules enriched for synaptic function showed convergent patterns between SCZ and some of the APD effects, while those associated with inflammation and glucose metabolism exhibited predominantly divergent patterns between SCZ and APD effects. In contrast, major cell-type shifts inferred in SCZ were primarily unaffected by APD use. These results show that APDs may confound SCZ-associated gene expression changes in postmortem brain tissue. Disentangling these effects will help identify causal genes and improve our neurobiological understanding of SCZ.
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Affiliation(s)
- Anton Schulmann
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA.
| | - Stefano Marenco
- Human Brain Collection Core, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Marquis P Vawter
- Functional Genomics Laboratory, Department of Psychiatry & Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Nirmala Akula
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Agenor Limon
- Department of Neurology, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Ajeet Mandal
- Human Brain Collection Core, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Pavan K Auluck
- Human Brain Collection Core, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Yash Patel
- Human Brain Collection Core, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Barbara K Lipska
- Human Brain Collection Core, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Francis J McMahon
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA.
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7
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Huang K, Kang Y, Wu Z, Wang Y, Cai S, Huang L. Asymmetrical alterations of grey matter among psychiatric disorders: A systematic analysis by voxel-based activation likelihood estimation. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110322. [PMID: 33838150 DOI: 10.1016/j.pnpbp.2021.110322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 10/21/2022]
Abstract
Schizophrenia (SZ), bipolar disorder (BD) and major depression disorder (MDD) have been regarded as highly diverged independent entities in current psychiatric diagnosis. However, ample new evidence suggests that they may have common biological traits. Neuroimaging studies showed that psychiatric disorders might associated with altered grey matter (GM) asymmetry compared to controls; however, the degree to which SZ, BD and MDD have common and/or distinct asymmetrical alterations in GM is still ambiguous. In this study, we analysed 169 voxel-based studies (including 3517 SZ patients, 1575 BD patients, 3280 MDD patients and 9733 controls) using activation likelihood estimation (ALE) meta-analysis to systematically review the existence of similar GM atrophy and asymmetrical alteration patterns among these psychiatric disorders, and the functional association between behaviour domains and topological alterations. We found that the right parahippocampal gyrus and left superior frontal gyrus showed commonly altered GM volume across all three illnesses, but did not identify common asymmetrical alteration. The asymmetrical alteration with leftward bias appeared in SZ and bipolar disorder at different locations, but more asymmetrical alteration with rightward bias appeared in MDD. Moreover, these changes have been confirmed to be associate with several symptoms and may have roles in functional networks. Our findings support the existence of common neurobiological damnification in these psychiatric disorders and provides valuable insights for the neural commonalties among different psychiatric disorders based on a large sample size.
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Affiliation(s)
- Kexin Huang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Yafei Kang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Zhongcheng Wu
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Yubo Wang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Suping Cai
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
| | - Liyu Huang
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China.
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8
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Zhuo C, Li G, Lin X, Jiang D, Xu Y, Tian H, Wang W, Song X. Strategies to solve the reverse inference fallacy in future MRI studies of schizophrenia: a review. Brain Imaging Behav 2021; 15:1115-1133. [PMID: 32304018 PMCID: PMC8032587 DOI: 10.1007/s11682-020-00284-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Few advances in schizophrenia research have been translated into clinical practice, despite 60 years of serum biomarkers studies and 50 years of genetic studies. During the last 30 years, neuroimaging studies on schizophrenia have gradually increased, partly due to the beautiful prospect that the pathophysiology of schizophrenia could be explained entirely by the Human Connectome Project (HCP). However, the fallacy of reverse inference has been a critical problem of the HCP. For this reason, there is a dire need for new strategies or research "bridges" to further schizophrenia at the biological level. To understand the importance of research "bridges," it is vital to examine the strengths and weaknesses of the recent literature. Hence, in this review, our team has summarized the recent literature (1995-2018) about magnetic resonance imaging (MRI) of schizophrenia in terms of regional and global structural and functional alterations. We have also provided a new proposal that may supplement the HCP for studying schizophrenia. As postulated, despite the vast number of MRI studies in schizophrenia, the lack of homogeneity between the studies, along with the relatedness of schizophrenia with other neurological disorders, has hindered the study of schizophrenia. In addition, the reverse inference cannot be used to diagnose schizophrenia, further limiting the clinical impact of findings from medical imaging studies. We believe that multidisciplinary technologies may be used to develop research "bridges" to further investigate schizophrenia at the single neuron or neuron cluster levels. We have postulated about future strategies for overcoming the current limitations and establishing the research "bridges," with an emphasis on multimodality imaging, molecular imaging, neuron cluster signals, single transmitter biomarkers, and nanotechnology. These research "bridges" may help solve the reverse inference fallacy and improve our understanding of schizophrenia for future studies.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, 450000, Zhengzhou, China.
- Department of Psychiatry Pattern Recognition, Department of Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, 272119, Jining, China.
- Department of Psychiatry, Wenzhou Seventh People's Hospital, 325000, Wenzhou, China.
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, 030001, Taiyuan, China.
- Department of Psychiatric-Neuroimaging-Genetics and Co-Morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, 300222, Tianjin, China.
- Biological Psychiatry of Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital, University of Alberta, Xiamen Xianyue Hospital, 361000, Xiamen, China.
- Department of Psychiatry, Tianjin Medical University, 300075, Tianjin, China.
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Department of Psychiatry, Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Shanxi Medical University, 300222, Tianjin, China.
| | - Gongying Li
- Department of Psychiatry Pattern Recognition, Department of Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, 272119, Jining, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, 325000, Wenzhou, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, 325000, Wenzhou, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, 030001, Taiyuan, China
| | - Hongjun Tian
- Department of Psychiatric-Neuroimaging-Genetics and Co-Morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, 300222, Tianjin, China
| | - Wenqiang Wang
- Biological Psychiatry of Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital, University of Alberta, Xiamen Xianyue Hospital, 361000, Xiamen, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, 450000, Zhengzhou, China
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Department of Psychiatry, Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Shanxi Medical University, 300222, Tianjin, China
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Markopoulou M, Karakasi V, Garyfallos G, Pavlidis P, Douzenis A. Research findings on Greek forensic patients found not guilty by reason of insanity. A juxtaposition of patients who committed a criminal offense during their first psychotic episode with those who did so later in the course of their illness. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2021; 75:101673. [PMID: 33517142 DOI: 10.1016/j.ijlp.2021.101673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/07/2020] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to compare the baseline characteristics (demographic, psychiatric-psychopathological and legal) among Greek forensic patients found not guilty by reason of insanity. The first step of this approach being differentiating patients who committed a criminal offense during their first psychotic episode from the ones who did so later in the course of their illness. All patients were hospitalized in the Department of Forensic Psychiatry (DFP) of the Psychiatric Hospital of Thessaloniki (PHT) from January 2015 to January 2020 and were examined in order to be included in the study. The final research sample consisted of 78 patients (70 identifying themselves as males and 8 identifying themselves as females) aged 18 and older, 21 of whom committed a criminal offense during their first psychotic episode (FEP, N = 21) and 57 did so later on in the course of their illness (Course, N = 57). Data were collected from multiple sources and several psychometric tools were used (Mini International Neuropsychiatric Interview-M.I.N·I, Positive And Negative Syndrome Scale-PANSS, Addiction Severity Index-ASI, CAGE Questionnaire, Hostility and Direction of Hostility Questionnaire-HDHQ, Global Assessment of Functioning-GAF and Aggression Questionnaire). Comparing the two groups (FEP vs. Course) we found that patients in FEP were younger, had experienced stressful life events in the last 24 months, committed more serious violent crimes, and more frequently attempted suicide after the crime. Their victims were usually members of their family. The main psychometric disparities between the two groups were found in the "Hostility" score of the Aggression questionnaire, and the items "Criticism of Others" and "Paranoid Hostility" of the HDHQ questionnaire, where patients in FEP scored lower. Patients in FEP scored significantly higher in items P1 (delusions), P4 (excitement), P6 (suspiciousness/persecution) and P7 (hostility) of the PANSS scale. No statistically significant differences were found between the two groups regarding their evaluation with the CAGE, ASI or GAF questionnaires. When comparing the patients' present scores in PANSS scale, the patients in FEP had lower total scores in the Positive and the General Psychopathology subscales. Both groups showed significant improvement during hospitalization in all scales (PANSS & GAF), except for the Negative Subscale of the PANSS scale. Through logistic regression analysis, we found that patients in FEP were younger, more likely to have recently experienced stressful life events and more likely to have assaulted a member of their family. Patients with higher scores in the "Hostility" subscale of the Aggression questionnaire were found to remain at risk for committing a crime during the course of their illness. These findings underline the need to design and develop specialized mental health services in order to identify and treat patients involved in violent crime in a timely and effective manner addressing their multiple needs.
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Affiliation(s)
- M Markopoulou
- Department of Forensic Psychiatry, General Hospital of Thessaloniki G. Papanikolaou, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece.
| | - V Karakasi
- 3(rd) Department of Psychiatry, Aristotle University of Thessaloniki, Medical School, AHEPA Hospital, Thessaloniki, Greece
| | - G Garyfallos
- 2(nd) Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital of Thessaloniki G. Papanikolaou, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
| | - P Pavlidis
- Laboratory of Forensic Sciences, Democritus University of Thrace, Medical School, Alexandroupolis, Greece
| | - A Douzenis
- 2(nd) Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Attikon" Hospital, Athens, Greece
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10
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Brain morphology does not clearly map to cognition in individuals on the bipolar-schizophrenia-spectrum: a cross-diagnostic study of cognitive subgroups. J Affect Disord 2021; 281:776-785. [PMID: 33246649 DOI: 10.1016/j.jad.2020.11.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/08/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Characterisation of brain morphological features common to cognitively similar individuals with bipolar disorder (BD) and schizophrenia spectrum disorders (SSD) may be key to understanding their shared neurobiological deficits. In the current study we examined whether three previously characterised cross-diagnostic cognitive subgroups differed among themselves and in comparison to healthy controls across measures of brain morphology. METHOD T1-weighted structural magnetic resonance imaging scans were obtained for 143 individuals; 65 healthy controls and 78 patients (SSD, n = 40; BD I, n = 38) classified into three cross-diagnostic cognitive subgroups: Globally Impaired (n = 24), Selectively Impaired (n = 32), and Superior/Near-Normal (n = 22). Cognitive subgroups were compared to each other and healthy controls on three separate analyses investigating (1) global, (2) regional, and (3) vertex-wise comparisons of brain volume, thickness, and surface area. RESULTS No significant subgroup differences were evident in global measures of brain morphology. In region of interest analyses, the Selectively Impaired subgroup had greater right accumbens volume than those Superior/Near-Normal subgroup and healthy controls, and the Superior/Near-Normal subgroup had reduced volume of the left entorhinal region compared to all other groups. In vertex-wise comparisons, the Globally Impaired subgroup had greater right precentral volume than the Selectively Impaired subgroup, and thicker cortex in the postcentral region relative to the Superior/Near-Normal subgroup. LIMITATIONS Exploration of medication effects was limited in our data. CONCLUSIONS Although some differences were evident in this sample, generally cross-diagnostic cognitive subgroups of individuals with SSD and BD did not appear to be clearly distinguished by patterns in brain morphology.
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11
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Mackintosh AJ, de Bock R, Lim Z, Trulley VN, Schmidt A, Borgwardt S, Andreou C. Psychotic disorders, dopaminergic agents and EEG/MEG resting-state functional connectivity: A systematic review. Neurosci Biobehav Rev 2020; 120:354-371. [PMID: 33171145 DOI: 10.1016/j.neubiorev.2020.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/28/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022]
Abstract
Both dysconnectivity and dopamine hypotheses are two well researched pathophysiological models of psychosis. However, little is known about the association of dopamine dysregulation with brain functional connectivity in psychotic disorders, specifically through the administration of antipsychotic medication. In this systematic review, we summarize the existing evidence on the association of dopaminergic effects with electro- and magnetoencephalographic (EEG/MEG) resting-state brain functional connectivity assessed by sensor- as well as source-level measures. A wide heterogeneity of results was found amongst the 20 included studies with increased and decreased functional connectivity in medicated psychosis patients vs. healthy controls in widespread brain areas across all frequency bands. No systematic difference in results was seen between studies with medicated and those with unmedicated psychosis patients and very few studies directly investigated the effect of dopamine agents with a pre-post design. The reported evidence clearly calls for longitudinal EEG and MEG studies with large participant samples to directly explore the association of antipsychotic medication effects with neural network changes over time during illness progression and to ultimately support the development of new treatment strategies.
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Affiliation(s)
- Amatya Johanna Mackintosh
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland
| | - Renate de Bock
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland
| | - Zehwi Lim
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Valerie-Noelle Trulley
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - André Schmidt
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Stefan Borgwardt
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Christina Andreou
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany.
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12
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Aberrant structural connectivity in childhood maltreatment: A meta-analysis. Neurosci Biobehav Rev 2020; 116:406-414. [DOI: 10.1016/j.neubiorev.2020.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/21/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022]
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13
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Mow JL, Gandhi A, Fulford D. Imaging the "social brain" in schizophrenia: A systematic review of neuroimaging studies of social reward and punishment. Neurosci Biobehav Rev 2020; 118:704-722. [PMID: 32841653 DOI: 10.1016/j.neubiorev.2020.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/20/2020] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize research on the neurobiology of social motivation in SSD, we performed a systematic literature review of neuroimaging studies involving the presentation of social stimuli intended to elicit feelings of reward and/or punishment. Across 11 studies meeting criteria, people with SSD demonstrated weaker modulation of brain activity in regions within a proposed social interaction network, including prefrontal, cingulate, and striatal regions, as well as the amygdala and insula. Firm conclusions regarding neural differences in SSD in these regions, as well as connections within networks, are limited due to conceptual and methodological inconsistencies across the available studies. We conclude by making recommendations for the study of social reward and punishment processing in SSD in future research.
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Affiliation(s)
- Jessica L Mow
- Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States.
| | - Arti Gandhi
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, United States
| | - Daniel Fulford
- Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States; Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, United States
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Moilanen J, Huhtaniska S, Haapea M, Jääskeläinen E, Veijola J, Isohanni M, Koponen H, Miettunen J. Brain morphometry of individuals with schizophrenia with and without antipsychotic medication – The Northern Finland Birth Cohort 1966 Study. Eur Psychiatry 2020; 30:598-605. [DOI: 10.1016/j.eurpsy.2015.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 10/23/2022] Open
Abstract
AbstractBackgroundIn schizophrenia, brain morphometric changes may be associated with antipsychotic medication. Only limited data is available concerning individuals with schizophrenia without antipsychotic medication. We aimed to study the associations of: use versus no use of antipsychotic medication; length of continuous time without antipsychotic medication; cumulative dose of lifetime antipsychotic medication; and type of antipsychotic medication; with brain morphometry in schizophrenia after an average of 10 years of illness.MethodsData of 63 individuals with schizophrenia (mean duration of illness 10.4 years) from the Northern Finland Birth Cohort 1966 were gathered by interview and from hospital and outpatient records. Structural MRI data at age 34 years were acquired and grey matter volume maps with voxel-based morphometry were analyzed using FSL tools.ResultsOf the individuals studied, 15 (24%) had taken no antipsychotic medication during the previous year. Individuals with antipsychotic medication had lower total grey matter (TGM) volume compared with non-medicated subjects, although this association was not statistically significant (Cohen's d = –0.51, P = 0.078). Time without antipsychotic medication associated with increased TGM (P = 0.028). Longer time without antipsychotic medication associated with increased regional volume in right precentral gyrus and right middle frontal gyrus. There were no associations between cumulative dose of lifetime antipsychotic medication or type of antipsychotic medication and brain morphometry.ConclusionsUnlike some previous investigators, we found no association between cumulative dose of lifetime antipsychotic medication and brain morphological changes in this population-based sample. However, longer continuous time without antipsychotic medication preceding the MRI scan associated with increased gray matter volume.
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15
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Wang J, Jiang Y, Tang Y, Xia M, Curtin A, Li J, Sheng J, Zhang T, Li C, Hui L, Zhu H, Biswal BB, Jia Q, Luo C, Wang J. Altered functional connectivity of the thalamus induced by modified electroconvulsive therapy for schizophrenia. Schizophr Res 2020; 218:209-218. [PMID: 31956007 DOI: 10.1016/j.schres.2019.12.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/29/2019] [Accepted: 12/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) has been shown to be effective in schizophrenia (SZ), particularly in drug-refractory cases or when rapid symptom relief is needed. However, its precise mechanisms of action remain largely unclear. To clarify the mechanisms underlying modified electroconvulsive therapy (mECT) for SZ, we conducted a longitudinal cohort study evaluating functional connectivity of the thalamus before and after mECT treatment using sub-regions of thalamus as regions of interest (ROIs). METHODS Twenty-one SZ individuals taking only antipsychotics (DSZ group) for 4 weeks and 21 SZ patients receiving a regular course of mECT combining with antipsychotics (MSZ group) were observed in parallel. All patients underwent magnetic resonance imaging scans at baseline (t1) and follow-up (t2, ~4 weeks) time points. Data were compared to a matched healthy control group (HC group) consisting of 23 persons who were only scanned at baseline. Group differences in changes of thalamic functional connectivity between two SZ groups over time, as well as in functional connectivity among two SZ groups and HC group were assessed. RESULTS Significant interaction of group by time was found in functional connectivity of the right thalamus to right putamen during the course of about 4-week treatment. Post-hoc analysis showed a significantly enhanced functional connectivity of the right thalamus to right putamen in the MSZ group contrasting to the DSZ group. In addition, a decreased and an increased functional connectivity of the thalamus to sensory cortex were observed within the MSZ and DSZ group after 4-week treatment trial, respectively. CONCLUSION Our findings suggest that changes in functional connectivity of the thalamus may be associated with the brain mechanisms of mECT for schizophrenia.
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Affiliation(s)
- Junjie Wang
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Yuchao Jiang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China.
| | - Mengqing Xia
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Adrian Curtin
- School of Biomedical Engineering & Health Sciences, Drexel University, Philadelphia, PA 19104, USA; Med-X Institute, Shanghai Jiaotong University, Shanghai 200300, China
| | - Jin Li
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Jianhua Sheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, China; Brain Science and Technology Research Center, Shanghai Jiaotong University, Shanghai 200030, China; Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiaotong University, Shanghai 200030, China
| | - Li Hui
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China
| | - Hongliang Zhu
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China
| | - Bharat B Biswal
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Qiufang Jia
- Institute of Mental Health, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215137, China.
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, China; Brain Science and Technology Research Center, Shanghai Jiaotong University, Shanghai 200030, China; Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiaotong University, Shanghai 200030, China
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16
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Di Sero A, Jørgensen KN, Nerland S, Melle I, Andreassen OA, Jovicich J, Agartz I. Antipsychotic treatment and basal ganglia volumes: Exploring the role of receptor occupancy, dosage and remission status. Schizophr Res 2019; 208:114-123. [PMID: 31006616 DOI: 10.1016/j.schres.2019.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 12/13/2022]
Abstract
Antipsychotic treatment may affect brain morphology, and enlargement of the basal ganglia (BG) is a replicated finding. Here we investigated associations between antipsychotic treatment and BG volumes in patients with psychotic and bipolar disorders. We hypothesized that current treatment and, among those medicated, higher dosage, estimated D2R occupancy and being in remission would predict larger BG volumes. Structural covariance analysis was performed to examine if correlations between BG volumes and cortical thickness differed by treatment status. 224 patients treated with antipsychotics; 26 previously treated, 29 never treated and 301 healthy controls (HC) were included from the TOP study cohort (NORMENT, Norway). T1-weighted MR images were processed using FreeSurfer. D2R occupancy was estimated based on serum concentration measurements for patients receiving stable monotherapy. Statistical analyses were adjusted for age, gender and estimated intracranial volume (ICV). We found larger right (p < 0.003) and left putamen (p < 0.02) and right globus pallidus (GP) (p < 0.03) in currently medicated patients compared to HC. Bilateral regional cortical thinning was also observed in currently and previously medicated patients compared to HC. In medicated patients, higher chlorpromazine equivalent dose (CPZ) was associated with larger left GP (p < 0.04). There was no association with estimated D2R occupancy (n = 47) or remission status. Lower positive correlation between left putamen volume and cortical thickness of the left lateral occipital cortex was found in medicated patients compared to HC. We replicated the BG enlargement in medicated patients, but found no association with estimated D2R occupancy. Further studies are needed to clarify the underlying mechanisms.
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Affiliation(s)
- Alessia Di Sero
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Center for Mind and Brain Sciences, University of Trento, Trento, Italy; Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - Kjetil N Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway.
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Melle
- Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway; Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway; Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Jorge Jovicich
- Center for Mind and Brain Sciences, University of Trento, Trento, Italy
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Norwegian Centre for Research on Mental Disorders, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway; Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
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Lu X, Zhong Y, Ma Z, Wu Y, Fox PT, Zhang N, Wang C. Structural imaging biomarkers for bipolar disorder: Meta-analyses of whole-brain voxel-based morphometry studies. Depress Anxiety 2019; 36:353-364. [PMID: 30475436 DOI: 10.1002/da.22866] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/20/2018] [Accepted: 11/06/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a common and destructive psychiatric illness worldwide. Although it is known that BD is associated with morphological abnormalities of the brain, the regions implicated in BD remain unclear. Therefore, we aimed to update current knowledge on potential structural imaging biomarkers of BD. METHODS Studies published up to January 31, 2018, were identified by a comprehensive literature search of PubMed, EBSCO, and BrainMap voxel-based morphometry (VBM) database. Whole-brain VBM studies that examined gray matter (GM) abnormalities of group comparisons between BD and healthy controls (HC) and reported results as coordinates in a standard reference space were included. Different meta-analyses were performed by activation likelihood estimation (ALE) algorithm. RESULTS A total of 46 studies with 56 experiments, including 1720 subjects and 268 foci were included. Seven different meta-analyses were calculated separately across experiments reporting decreased or increased GM volume among BD, BDΙ, BD-adults, and BD-youths groups. Fifteen regions of significantly different GM volume between four groups and HC were identified. There were extensive GM deficits in the prefrontal and temporal cortex, and enlargements in the putamen, cingulate cortex, and precuneus. CONCLUSIONS The results revealed that the thinning of prefrontal cortex was a key region in the pathophysiology of BD. The enlargement of the cingulate cortex may be implicated in a compensatory mechanism. It underscored important differences between BD-adults and BD-youths and specific biomarkers of three subgroups.
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Affiliation(s)
- Xin Lu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Zijuan Ma
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Wu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peter T Fox
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,South Texas Veterans Healthcare System, University of Texas Health San Antonio, San Antonio, United States.,Research Imaging Institute, University of Texas Health San Antonio, San Antonio, United States
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
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18
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Katagiri N, Pantelis C, Nemoto T, Tsujino N, Saito J, Hori M, Yamaguchi T, Funatogawa T, Mizuno M. Longitudinal changes in striatum and sub-threshold positive symptoms in individuals with an 'at risk mental state' (ARMS). Psychiatry Res Neuroimaging 2019; 285:25-30. [PMID: 30716687 DOI: 10.1016/j.pscychresns.2019.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/23/2018] [Accepted: 01/26/2019] [Indexed: 10/27/2022]
Abstract
Recent studies have revealed that several psychotic symptom changes observed in the 'at risk mental state' (ARMS) are associated with changes in the striatum. We investigated if structural changes in the striatum are associated with recovery of sub-threshold psychotic symptoms in subjects with an ARMS who did not develop psychosis (ARMS-N). Sixteen healthy controls and 42 subjects with an ARMS participated in this study. Striatal volumes (caudate, putamen, and nucleus accumbens) were analyzed using MRI. The sub-threshold psychotic symptoms of the subjects with an ARMS were measured using the SOPS. Imaging and symptoms were reevaluated after 52 weeks. Significant right putamen volume reduction was observed at the follow-up in ARMS-N subjects. Improvement in sub-threshold positive symptoms significantly correlated with an increase in volume in the right accumbens at follow up. No relationship was found for negative symptoms. From these findings, the association between improvement in sub-threshold positive symptoms and an increase in the volume of the right accumbens may suggest that changes in the accumbens, which is a major site for dopamine innervation, are associated with symptom recovery. These findings may point to neurobiological resilience that may be associated with lower transition to psychosis.
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Affiliation(s)
- Naoyuki Katagiri
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan.
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, Victoritoka, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan; Saiseikai Yokohamashi Tobu Hospital Psychiatry, Yokohama-City, Kanagawa, Japan
| | - Junichi Saito
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan; Saiseikai Yokohamashi Tobu Hospital Psychiatry, Yokohama-City, Kanagawa, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan
| | - Tomoyuki Funatogawa
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan
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19
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Polygenic risk for schizophrenia and associated brain structural changes: A systematic review. Compr Psychiatry 2019; 88:77-82. [PMID: 30529765 DOI: 10.1016/j.comppsych.2018.11.014] [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: 09/17/2018] [Revised: 10/22/2018] [Accepted: 11/27/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Genome wide association studies (GWAS) of schizophrenia allow the generation of Polygenic Risk Scores (PRS). PRS can be used to determine the contribution to altered brain structures in this disorder, which have been well described. However, findings from studies using PRS to predict brain structural changes in schizophrenia have been inconsistent. We therefore performed a systematic review to determine the association between schizophrenia PRS and brain structure. METHODS Following PRISMA systematic review guidelines, databases were searched for literature using key search terms. Inclusion criteria for the discovery sample required case-control schizophrenia GWAS summary statistics from European populations. The target sample was required to be of European ancestry, and have brain structure and genotype information. Quality assessment of the publications was conducted using the Mixed Methods Appraisal Tool for quantitative non-randomised studies. MAIN FINDINGS A total of seven studies were found to be eligible for review. Five studies found no significant association and two studies found a significant association of schizophrenia PRS with total brain, reduced white matter volume, and globus pallidus volume. However, the latter studies were conducted using smaller discovery (ncases = 9394 ncontrols = 12,462) and target samples compared to the studies with substantially larger discovery (ncases = 33,636 ncontrols = 43,008) and target samples where no association was observed. Taken together, the results suggest that schizophrenia PRS are not significantly associated with brain structural changes in this disorder. CONCLUSIONS The lack of significant association between schizophrenia PRS and brain structural changes may indicate that intermediate phenotypes other than brain structure should be the focus of future work. Alternatively, however, the lack of association found here may point to limitations of the current evidence-base, and so point to the need for future better powered studies.
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20
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Kong L, Cui H, Zhang T, Wang Y, Huang J, Zhu Y, Tang Y, Herold CJ, Schröder J, Cheung EFC, Chan RCK, Wang J. Neurological soft signs and grey matter abnormalities in individuals with ultra-high risk for psychosis. Psych J 2018; 8:252-260. [PMID: 30515993 DOI: 10.1002/pchj.258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/08/2018] [Accepted: 10/16/2018] [Indexed: 01/27/2023]
Abstract
Neurological soft signs (NSSs), conventionally defined as subtle neurological abnormalities, are frequently found in individuals with schizophrenia. Many neuroimaging studies have also reported that NSSs are associated with grey matter changes in patients with schizophrenia at different stages of the illness. However, these findings may be confounded by the effect of antipsychotic medications, chronicity, and duration of untreated psychosis. Examining NSSs in individuals with ultra-high risk (UHR) for psychosis may help to identify the neuroanatomical substrates of NSSs related to the illness itself and to avoid these potential confounding effects. A sample of 21 individuals with UHR were included in the present study. NSSs were rated using the abridged version of the Cambridge Neurological Inventory. Grey matter volume was assessed using optimized voxel-based morphometry on images acquired by a high-resolution 3-T magnetic resonance imaging scanner. We found that higher NSS scores in individuals with UHR were associated with decreased grey matter volume at the superior and medial frontal cortex, the rectal cortex, the pre- and post-central cortex, the insula, the caudate, and the cerebellum. Our results suggest that these brain structural characteristics may represent the neuroanatomical substrate of NSSs in individuals with UHR. These findings contribute to the understanding of the intrinsic features of psychosis associated with NSSs and may provide insights into pre-schizophrenia pathophysiology.
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Affiliation(s)
- Li Kong
- College of Education, Shanghai Normal University, Shanghai, China.,Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yikang Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Christina J Herold
- Section of Geriatric Psychiatry, Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Eric F C Cheung
- Department of Adult Psychiatry, Castle Peak Hospital, Hong Kong, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
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Huhtaniska S, Korkala I, Heikka T, Björnholm L, Lehtiniemi H, Hulkko AP, Moilanen J, Tohka J, Manjón J, Coupé P, Kiviniemi V, Isohanni M, Koponen H, Murray GK, Miettunen J, Jääskeläinen E. Antipsychotic and benzodiazepine use and brain morphology in schizophrenia and affective psychoses - Systematic reviews and birth cohort study. Psychiatry Res Neuroimaging 2018; 281:43-52. [PMID: 30219591 DOI: 10.1016/j.pscychresns.2018.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
The aim of this paper was to investigate differences in brain structure volumes between schizophrenia and affective psychoses, and whether cumulative lifetime antipsychotic or benzodiazepine doses relate to brain morphology in these groups. We conducted two systematic reviews on the topic and investigated 44 schizophrenia cases and 19 with affective psychoses from the Northern Finland Birth Cohort 1966. The association between lifetime antipsychotic and benzodiazepine dose and brain MRI scans at the age of 43 was investigated using linear regression. Intracranial volume, sex, illness severity, and antipsychotic/benzodiazepine doses were used as covariates. There were no differences between the groups in brain structure volumes. In schizophrenia, after adjusting for benzodiazepine dose and symptoms, a negative association between lifetime antipsychotic dose and the nucleus accumbens volume remained. In affective psychoses, higher lifetime benzodiazepine dose associated with larger volumes of total gray matter and hippocampal volume after controlling for antipsychotic use and symptoms. It seems that in addition to antipsychotics, the severity of symptoms and benzodiazepine dose are also associated with brain structure volumes. These results suggest, that benzodiazepine effects should also be investigated also independently and not only as a confounder.
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Affiliation(s)
- Sanna Huhtaniska
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland.
| | - Iikka Korkala
- Center for Life Course Health Research, University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Tuomas Heikka
- Center for Life Course Health Research, University of Oulu, Finland
| | - Lassi Björnholm
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Heli Lehtiniemi
- Center for Life Course Health Research, University of Oulu, Finland
| | - Anja P Hulkko
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jani Moilanen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Jussi Tohka
- AI Virtanen Institute for Molecular Sciences, University of Eastern Finland, Finland
| | - José Manjón
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Spain
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique, Unité Mixte de Recherche CNRS (UMR 5800), PICTURA Research Group, France
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
| | - Hannu Koponen
- University of Helsinki, Helsinki University Hospital, Psychiatry, Helsinki, Finland
| | - Graham K Murray
- University of Cambridge, Department of Psychiatry, United Kingdom; University of Cambridge, Behavioural and Clinical Neuroscience Institute, United Kingdom
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
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22
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Langbein K, Hesse J, Gussew A, Milleit B, Lavoie S, Amminger GP, Gaser C, Wagner G, Reichenbach JR, Hipler UC, Winter D, Smesny S. Disturbed glutathione antioxidative defense is associated with structural brain changes in neuroleptic-naïve first-episode psychosis patients. Prostaglandins Leukot Essent Fatty Acids 2018; 136:103-110. [PMID: 29111383 DOI: 10.1016/j.plefa.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 09/30/2017] [Accepted: 10/16/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Oxidative stress and impaired antioxidant defense are reported in schizophrenia and are thought to be associated with disturbed neurodevelopment, brain structural alterations, glutamatergic imbalance, negative symptomatology, and cognitive impairment. To test some of these assumptions we investigated the glutathione (GSH) antioxidant defense system (AODS) and brain structural abnormalities in drug-naïve individuals with first acute episode of psychosis (FEP). METHOD The study involved 27 drug-naïve FEP patients and 31 healthy controls (HC). GSH AODS markers and TBARS (thiobarbituric acid reactive substances) were measured in blood plasma and erythrocytes. High-resolution T1-weighted 3T MRI were acquired from all subjects. To investigate brain structural abnormalities and effects of illness on interactions between GSH metabolites or enzyme activities and local grey matter density, voxel-based morphometry (VBM) with the computational anatomy toolbox (CAT12) was used. Symptomatology was assessed using the Positive and Negative Syndrome Scale (PANSS) and the Symptom Checklist 1990 revised (SCL-90-R). RESULTS (i) In FEP patients, glutathione reductase activity (GSR) was lower than in the HC group. GSR activity in plasma was inversely correlated with SCL-90-R scores of depression and PANSS scores of the negative symptom subscale. (ii) A reduction of GM was observed in left inferior frontal, bilateral temporal, as well as parietal cortices of FEP patients. (iii) Interaction analyses revealed an influence of illness on GSR/GM associations in the left orbitofrontal cortex (BA 47). CONCLUSION Our findings support the notion of altered GSH antioxidative defense in untreated acute psychosis as a potential pathomechanism for localized brain structural abnormalities. This pathology relates to a key brain region of social cognition, affective motivation control and decision making, and is clinically accompanied by depressive and negative symptoms.
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Affiliation(s)
- K Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - J Hesse
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - A Gussew
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - B Milleit
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Dermatology, University Hospital Jena, Jena, Germany
| | - S Lavoie
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - G P Amminger
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - C Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - G Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - U-C Hipler
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - D Winter
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - S Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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23
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Liu J, Chen J, Perrone-Bizzozero N, Calhoun VD. A Perspective of the Cross-Tissue Interplay of Genetics, Epigenetics, and Transcriptomics, and Their Relation to Brain Based Phenotypes in Schizophrenia. Front Genet 2018; 9:343. [PMID: 30190726 PMCID: PMC6115489 DOI: 10.3389/fgene.2018.00343] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/09/2018] [Indexed: 12/11/2022] Open
Abstract
Genetic association studies of psychiatric disorders have provided unprecedented insight into disease risk profiles with high confidence. Yet, the next research challenge is how to translate this rich information into mechanisms of disease, and further help interventions and treatments. Given other comprehensive reviews elsewhere, here we want to discuss the research approaches that integrate information across various tissue types. Taking schizophrenia as an example, the tissues, cells, or organisms being investigated include postmortem brain tissues or neurons, peripheral blood and saliva, in vivo brain imaging, and in vitro cell lines, particularly human induced pluripotent stem cells (iPSC) and iPSC derived neurons. There is a wealth of information on the molecular signatures including genetics, epigenetics, and transcriptomics of various tissues, along with neuronal phenotypic measurements including neuronal morphometry and function, together with brain imaging and other techniques that provide data from various spatial temporal points of disease development. Through consistent or complementary processes across tissues, such as cross-tissue methylation quantitative trait loci (QTL) and expression QTL effects, systemic integration of such information holds the promise to put the pieces of puzzle together for a more complete view of schizophrenia disease pathogenesis.
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Affiliation(s)
- Jingyu Liu
- Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States
- Department of Neurosciences, University of New Mexico, Albuquerque, NM, United States
| | - Jiayu Chen
- Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States
| | - Nora Perrone-Bizzozero
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, United States
| | - Vince D. Calhoun
- Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States
- Department of Neurosciences, University of New Mexico, Albuquerque, NM, United States
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24
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Bachmann S, Schröder J. Neurological Soft Signs in Schizophrenia: An Update on the State- versus Trait-Perspective. Front Psychiatry 2018; 8:272. [PMID: 29375401 PMCID: PMC5766896 DOI: 10.3389/fpsyt.2017.00272] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/21/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Neurological soft signs (NSS) represent minor neurological signs, which indicate non-specific cerebral dysfunction. In schizophrenia, their presence has been documented extensively across all stages of the disease. Until recently, NSS were considered an endophenotype or a trait phenomenon. During the past years, however, researchers report fluctuations of the NSS scores. AIMS To further clarify the question whether NSS exhibit state or trait components or both, studies that have investigated NSS longitudinally were reviewed. METHOD Studies which have assessed NSS longitudinally in adults suffering from schizophrenia, were searched for. The time frame was January 1966 to June 2017. Studies on teenagers were excluded because of interferences between brain maturation and pathology. RESULTS Twenty-nine follow-up studies were identified. They included patients during different stages of their illness and mainly used established instruments for NSS assessment. Patients with a first episode or a remitting course predominantly show a decrease of NSS over time, whereas a worsening of NSS can be found in the chronically ill. It was shown that change of NSS total scores over time is predominantly caused by motor system subscales and to a lesser extent by sensory integration scales. With respect to medication, the majority of studies agree on a relationship between medication response and improvement of NSS while the type of antipsychotic does not seem to play a major role. Moreover, where information on side-effects is given, it does not favor a strong relationship with NSS. However, NSS seem to correlate with negative and cognitive symptoms. CONCLUSION Studies manifest a conformity regarding the presence of NSS in schizophrenia patients on the one hand. On the other hand, fluctuations of NSS scores have been widely described in subgroups. Taken together results strongly support a state-trait dichotomy of NSS. Thus, the usage of NSS as an endophenotype has to be called into question.
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Affiliation(s)
- Silke Bachmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospitals of Halle (Saale), Halle, Germany
- Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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25
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Dieleman N, Koek HL, Hendrikse J. Short-term mechanisms influencing volumetric brain dynamics. NEUROIMAGE-CLINICAL 2017; 16:507-513. [PMID: 28971004 PMCID: PMC5609861 DOI: 10.1016/j.nicl.2017.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 07/28/2017] [Accepted: 09/04/2017] [Indexed: 12/14/2022]
Abstract
With the use of magnetic resonance imaging (MRI) and brain analysis tools, it has become possible to measure brain volume changes up to around 0.5%. Besides long-term brain changes caused by atrophy in aging or neurodegenerative disease, short-term mechanisms that influence brain volume may exist. When we focus on short-term changes of the brain, changes may be either physiological or pathological. As such determining the cause of volumetric dynamics of the brain is essential. Additionally for an accurate interpretation of longitudinal brain volume measures by means of neurodegeneration, knowledge about the short-term changes is needed. Therefore, in this review, we discuss the possible mechanisms influencing brain volumes on a short-term basis and set-out a framework of MRI techniques to be used for volumetric changes as well as the used analysis tools. 3D T1-weighted images are the images of choice when it comes to MRI of brain volume. These images are excellent to determine brain volume and can be used together with an analysis tool to determine the degree of volume change. Mechanisms that decrease global brain volume are: fluid restriction, evening MRI measurements, corticosteroids, antipsychotics and short-term effects of pathological processes like Alzheimer's disease, hypertension and Diabetes mellitus type II. Mechanisms increasing the brain volume include fluid intake, morning MRI measurements, surgical revascularization and probably medications like anti-inflammatory drugs and anti-hypertensive medication. Exercise was found to have no effect on brain volume on a short-term basis, which may imply that dehydration caused by exercise differs from dehydration by fluid restriction. In the upcoming years, attention should be directed towards studies investigating physiological short-term changes within the light of long-term pathological changes. Ultimately this may lead to a better understanding of the physiological short-term effects of pathological processes and may aid in early detection of these diseases. Fluid-restriction, evening MRI, corticosteroids, & antipsychotics decrease volume Fluid-intake, morning MRI, surgical revascularization & medications increase volume Short-term changes within the light of long-term pathological changes should be investigated Short-term changes may introduce bias in longitudinal data
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Affiliation(s)
- Nikki Dieleman
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics, University Medical Center Utrecht, The Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, The Netherlands
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26
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Alamian G, Hincapié AS, Pascarella A, Thiery T, Combrisson E, Saive AL, Martel V, Althukov D, Haesebaert F, Jerbi K. Measuring alterations in oscillatory brain networks in schizophrenia with resting-state MEG: State-of-the-art and methodological challenges. Clin Neurophysiol 2017; 128:1719-1736. [DOI: 10.1016/j.clinph.2017.06.246] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/08/2017] [Accepted: 06/19/2017] [Indexed: 02/06/2023]
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27
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Delvecchio G, Lorandi A, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Brain anatomy of symptom stratification in schizophrenia: a voxel-based morphometry study. Nord J Psychiatry 2017; 71:348-354. [PMID: 28290743 DOI: 10.1080/08039488.2017.1300323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although some Magnetic Resonance Imaging (MRI) studies have investigated the relationship between clinical severity and neuroanatomical alterations in patients with schizophrenia (SCZ), the biological signature associated with illness severity in schizophrenia is still uncertain. Therefore, this study aims to investigate structural brain abnormalities in SCZ, with particular regards to the identification of potential deficits associated with the severity of illness. METHODS In total, 1.5T MRI data were acquired for 61 subjects with SCZ and 59 matched healthy controls (HC). The patient group was divided in two sub-groups based on clinical severity, one composed of 34 mild-to-moderately ill patients, and the other of 27 severely ill patients, and compared with matched HC. RESULTS The whole group of patients with SCZ had significantly reduced grey matter (GM) volumes in the left inferior and middle temporal gyrus compared to HC (p < 0.05, pFWE corrected). Furthermore, compared to HC, patients with mild-to-moderate illness showed decreased GM volumes in the inferior and middle temporal gyrus, whereas those with severe illness had reduced GM volumes in the middle temporal gyrus and cerebellum bilaterally (all p < 0.001 uncorrected). No differences were observed between the two sub-groups of patients. CONCLUSION The results showed significant GM volume reductions in temporal regions in patients with SCZ compared to matched HC, confirming the role of these regions in the pathophysiology of SCZ. Furthermore, specific cerebellar grey matter volume reductions were identified in patients with severe illness, which may contribute to stratifying patients with SCZ according to their clinical phenotype expression, ultimately helping in guiding targeted therapeutic/rehabilitation interventions.
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Affiliation(s)
- Giuseppe Delvecchio
- a Scientific Institute, IRCCS Eugenio Medea , San Vito al Tagliamento , Pordenone , Italy
| | - Alessandra Lorandi
- b Section of Psychiatry , Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy
| | - Cinzia Perlini
- c Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology , University of Verona , Verona , Italy.,d Department of Public Health and Community Medicine, InterUniversity Centre for Behavioural Neurosciences, University of Verona , Verona , Italy
| | - Marco Barillari
- e Section of Radiology , Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy
| | - Mirella Ruggeri
- f Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry , University of Verona , Verona , Italy
| | - A Carlo Altamura
- g Department of Neurosciences and Mental Health , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan , Milan , Italy
| | - Marcella Bellani
- b Section of Psychiatry , Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy.,d Department of Public Health and Community Medicine, InterUniversity Centre for Behavioural Neurosciences, University of Verona , Verona , Italy
| | - Paolo Brambilla
- g Department of Neurosciences and Mental Health , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan , Milan , Italy.,h Department of Psychiatry and Behavioural Neurosciences , University of Texas , Houston , TX , USA
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Chye Y, Solowij N, Suo C, Batalla A, Cousijn J, Goudriaan AE, Martin-Santos R, Whittle S, Lorenzetti V, Yücel M. Orbitofrontal and caudate volumes in cannabis users: a multi-site mega-analysis comparing dependent versus non-dependent users. Psychopharmacology (Berl) 2017; 234:1985-1995. [PMID: 28364340 DOI: 10.1007/s00213-017-4606-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 03/13/2017] [Indexed: 11/25/2022]
Abstract
RATIONALE Cannabis (CB) use and dependence are associated with regionally specific alterations to brain circuitry and substantial psychosocial impairment. OBJECTIVES The objective of this study was to investigate the association between CB use and dependence, and the volumes of brain regions critically involved in goal-directed learning and behaviour-the orbitofrontal cortex (OFC) and caudate. METHODS In the largest multi-site structural imaging study of CB users vs healthy controls (HC), 140 CB users and 121 HC were recruited from four research sites. Group differences in OFC and caudate volumes were investigated between HC and CB users and between 70 dependent (CB-dep) and 50 non-dependent (CB-nondep) users. The relationship between quantity of CB use and age of onset of use and caudate and OFC volumes was explored. RESULTS CB users (consisting of CB-dep and CB-nondep) did not significantly differ from HC in OFC or caudate volume. CB-dep compared to CB-nondep users exhibited significantly smaller volume in the medial and the lateral OFC. Lateral OFC volume was particularly smaller in CB-dep females, and reduced volume in the CB-dep group was associated with higher monthly cannabis dosage. CONCLUSIONS Smaller medial OFC volume may be driven by CB dependence-related mechanisms, while smaller lateral OFC volume may be due to ongoing exposure to cannabinoid compounds. The results highlight a distinction between cannabis use and dependence and warrant examination of gender-specific effects in studies of CB dependence.
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Affiliation(s)
- Yann Chye
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Chao Suo
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Albert Batalla
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Janna Cousijn
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Valentina Lorenzetti
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia.
- School of Psychological Sciences, Institute of Psychology, Health and Society, The University of Liverpool, Liverpool, UK.
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.
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Hirjak D, Huber M, Kirchler E, Kubera KM, Karner M, Sambataro F, Freudenmann RW, Wolf RC. Cortical features of distinct developmental trajectories in patients with delusional infestation. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:72-79. [PMID: 28257853 DOI: 10.1016/j.pnpbp.2017.02.018] [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: 12/21/2016] [Revised: 02/23/2017] [Accepted: 02/27/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Although there is strong neuroimaging evidence that cortical alterations are a core feature of schizophrenia spectrum disorders, it still remains unclear to what extent such abnormalities occur in monothematic delusional disorders. In individuals with delusional infestation (DI), the delusional belief to be infested with pathogens, previous structural MRI studies have shown prefrontal, temporal, parietal, insular, thalamic and striatal gray matter volume changes. Differential contributions of cortical features of evolutionary and genetic origin (such as cortical thickness, area and folding) which may distinctly contribute to DI pathophysiology are unclear at present. METHODS In this study, 18 patients with DI and 20 healthy controls (HC) underwent MRI scanning at 1.0T. Using surface-based analyses we calculated cortical thickness, surface area and local gyrification index (LGI). Whole-brain differences between patients and controls were investigated. RESULTS Surface analyses revealed frontoparietal patterns exhibiting altered cortical thickness, surface area and LGI in DI patients compared to controls. Higher cortical thickness was found in the right medial orbitofrontal cortex (p<0.05, cluster-wise probability [CWP] corrected). Smaller surface area in patients was found in the left inferior temporal gyrus, the precuneus, the pars orbitalis of the right frontal gyrus, and the lingual gyrus (p<0.05, CWP corr.). Lower LGI was found in the left postcentral, bilateral precentral, right middle temporal, inferior parietal, and superior parietal gyri (p<0.01, CWP corr.). CONCLUSION This study lends further support to the hypothesis that cortical features of distinct evolutionary and genetic origin differently contribute to the pathogenesis of delusional disorders. Regions in which atrophy was observed are part of neural circuits associated with perception, visuospatial control and self-awareness. The data are in line with the notion of a content-specific neural signature of DI.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany.
| | - Markus Huber
- Department of Psychiatry, General Hospital Bruneck, South Tyrol, Italy
| | - Erwin Kirchler
- Department of Psychiatry, General Hospital Bruneck, South Tyrol, Italy
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Martin Karner
- Department of Radiology, General Hospital Bruneck, South Tyrol, Italy
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences, Udine University, Italy
| | | | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
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Dietsche B, Kircher T, Falkenberg I. Structural brain changes in schizophrenia at different stages of the illness: A selective review of longitudinal magnetic resonance imaging studies. Aust N Z J Psychiatry 2017; 51:500-508. [PMID: 28415873 DOI: 10.1177/0004867417699473] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Schizophrenia is a devastating mental disorder accompanied by aberrant structural brain connectivity. The question whether schizophrenia is a progressive brain disorder is yet to be resolved. Thus, it is not clear when these structural alterations occur and how they develop over time. METHODS In our selective review, we summarized recent findings from longitudinal magnetic resonance imaging studies investigating structural brain alterations and its impact on clinical outcome at different stages of the illness: (1) subjects at ultra-high risk of developing psychosis, (2) patients with a first episode psychosis, and (3) chronically ill patients. Moreover, we reviewed studies examining the longitudinal effects of medication on brain structure in patients with schizophrenia. RESULTS (1) Studies from pre-clinical stages to conversion showed a more pronounced cortical gray matter loss (i.e. superior temporal and inferior frontal regions) in those individuals who later made transition to psychosis. (2) Studies investigating patients with a first episode psychosis revealed a decline in multiple gray matter regions (i.e. frontal regions and thalamus) over time as well as progressive cortical thinning in the superior and inferior frontal cortex. (3) Studies focusing on patients with chronic schizophrenia showed that gray matter decreased to a greater extent (i.e. frontal and temporal areas, thalamus, and cingulate cortices)-especially in poor-outcome patients. Very few studies reported effects on white matter microstructure in the longitudinal course of the illness. CONCLUSION There is adequate evidence to suggest that schizophrenia is associated with progressive gray matter abnormalities particularly during the initial stages of illness. However, causal relationships between structural changes and illness course-especially in chronically ill patients-should be interpreted with caution. Findings might be confounded by longer periods of treatment and higher doses of antipsychotics or epiphenomena related to the illness.
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Affiliation(s)
- Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
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Altamura AC, Delvecchio G, Paletta S, Di Pace C, Reggiori A, Fiorentini A, Mirabile MD, Paoli RA, Cinnante C, Triulzi F, Mauri MC, Brambilla P. Gray matter volumes may predict the clinical response to paliperidone palmitate long-acting in acute psychosis: A pilot longitudinal neuroimaging study. Psychiatry Res Neuroimaging 2017; 261:80-84. [PMID: 28161644 DOI: 10.1016/j.pscychresns.2017.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 11/17/2022]
Abstract
In schizophrenia, paliperidone palmitate (PP) long acting injectable (LAI) has been reported to sustain plasma concentrations and improve clinical symptoms. Moreover, it has also been demonstrated the important role of total gray matter (GM) volumes in predicting the clinical outcome. However, no studies investigating the association between PP-LAI treatment and brain morphometry has been published so far. Therefore, the main aim of our 24 weeks prospective observational exploratory study was to investigate the relation between brain anatomy and clinical outcome in seven patients with acute psychosis treated with PP-LAI. At baseline and every month (from T0 to T6) patients were clinically evaluated with the Brief Psychiatric Rating Scale (BPRS). 3T Magnetic Resonance Imaging at baseline was acquired and total GM and intracranial volumes were extracted to explore their predictive values on BPRS scores. After 24 weeks of treatment with PP-LAI, patients showed statistically significant improvements in BPRS scores. Moreover, subjects with higher total GM volumes had a significantly higher BPRS improvement at 24 weeks compared to patients with lower total GM volumes. Our findings confirm the effectiveness of PP-LAI in treating acute psychosis and suggest that greater GM volumes predict drug response, potentially supporting a favorable prognosis.
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Affiliation(s)
- A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Silvia Paletta
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Chiara Di Pace
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Alessandra Reggiori
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - M Donatella Mirabile
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Riccardo A Paoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Claudia Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo C Mauri
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA.
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Ganzola R, Duchesne S. Voxel-based morphometry meta-analysis of gray and white matter finds significant areas of differences in bipolar patients from healthy controls. Bipolar Disord 2017; 19:74-83. [PMID: 28444949 DOI: 10.1111/bdi.12488] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/06/2017] [Accepted: 03/12/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We present a retrospective meta-analysis of voxel-based morphometry (VBM) of gray (GM) and white matter (WM) differences between patients with bipolar disorder (BD) and behaviorally healthy controls. METHODS We used the activation likelihood estimation and Sleuth software for our meta-analysis, considering P-value maps at the cluster level inference of .05 with uncorrected P<.001. Results were visualized with the software MANGO. RESULTS We included twenty-five articles in the analysis, and separated the comparisons where BD patients had lower GM or WM concentrations than controls (573 subjects, 21 experiments, and 117 locations/180 subjects, five experiments, and 15 locations, respectively) and the comparisons where BD patients had greater GM concentrations than controls (217 subjects, nine experiments, and 49 locations). Higher WM concentrations in BD patients were not detected. We observed for BD reduced GM concentrations in the left medial frontal gyrus and right inferior/precentral gyri encompassing the insular cortex, and greater GM concentrations in the left putamen. Further, lower WM concentrations were detected in the left inferior longitudinal fasciculus, left superior corona radiata, and left posterior cingulum. CONCLUSIONS This meta-analysis confirms deterioration of frontal and insular regions as already found in previous meta-analysis. GM reductions in these regions could be related to emotional processing and decision making, which are typically impaired in BD. Moreover, we found abnormalities in precentral frontal areas and putamen that have been linked to more basic functions, which could point to sensory and specific cognitive deficits. Finally, WM reductions involved circuitry that may contribute to emotional dysregulation in BD.
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Affiliation(s)
- Rossana Ganzola
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada
| | - Simon Duchesne
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada.,Départment de Radiologie, Faculté de Médecine, Université Laval, Québec City, Québec, Canada
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33
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Casanova R, Wang X, Reyes J, Akita Y, Serre ML, Vizuete W, Chui HC, Driscoll I, Resnick SM, Espeland MA, Chen JC. A Voxel-Based Morphometry Study Reveals Local Brain Structural Alterations Associated with Ambient Fine Particles in Older Women. Front Hum Neurosci 2016; 10:495. [PMID: 27790103 PMCID: PMC5061768 DOI: 10.3389/fnhum.2016.00495] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/20/2016] [Indexed: 12/19/2022] Open
Abstract
Objective: Exposure to ambient fine particulate matter (PM2.5: PM with aerodynamic diameters < 2.5 μm) has been linked with cognitive deficits in older adults. Using fine-grained voxel-wise analyses, we examined whether PM2.5 exposure also affects brain structure. Methods: Brain MRI data were obtained from 1365 women (aged 71–89) in the Women's Health Initiative Memory Study and local brain volumes were estimated using RAVENS (regional analysis of volumes in normalized space). Based on geocoded residential locations and air monitoring data from the U.S. Environmental Protection Agency, we employed a spatiotemporal model to estimate long-term (3-year average) exposure to ambient PM2.5 preceding MRI scans. Voxel-wise linear regression models were fit separately to gray matter (GM) and white matter (WM) maps to analyze associations between brain structure and PM2.5 exposure, with adjustment for potential confounders. Results: Increased PM2.5 exposure was associated with smaller volumes in both cortical GM and subcortical WM areas. For GM, associations were clustered in the bilateral superior, middle, and medial frontal gyri. For WM, the largest clusters were in the frontal lobe, with smaller clusters in the temporal, parietal, and occipital lobes. No statistically significant associations were observed between PM2.5 exposure and hippocampal volumes. Conclusions: Long-term PM2.5 exposures may accelerate loss of both GM and WM in older women. While our previous work linked smaller WM volumes to PM2.5, this is the first neuroimaging study reporting associations between air pollution exposure and smaller volumes of cortical GM. Our data support the hypothesized synaptic neurotoxicity of airborne particles.
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Affiliation(s)
- Ramon Casanova
- Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Xinhui Wang
- Department of Preventive Medicine, University of Southern California Los Angeles, CA, USA
| | | | | | - Marc L Serre
- University of North Carolina Chapel Hill, NC, USA
| | | | - Helena C Chui
- Department of Neurology, University of Southern California Los Angeles, CA, USA
| | - Ira Driscoll
- Department of Psychology, University of Wisconsin-Milwaukee Milwaukee, WI, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, National Institutes of Health Baltimore, MD, USA
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California Los Angeles, CA, USA
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34
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De Rossi P, Dacquino C, Piras F, Caltagirone C, Spalletta G. Left nucleus accumbens atrophy in deficit schizophrenia: A preliminary study. Psychiatry Res Neuroimaging 2016; 254:48-55. [PMID: 27322868 DOI: 10.1016/j.pscychresns.2016.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 06/02/2016] [Accepted: 06/04/2016] [Indexed: 01/21/2023]
Abstract
A question that remains to be answered is whether schizophrenia can be characterized by a single etiopathophysiology or whether separate sub-syndromes should be differentiated to define specific mechanisms for each sub-type. Individuals affected by the deficit subtype of schizophrenia (DSZ) display avolitional/amotivational features that respond poorly to conventional treatments. Characterizing DSZ from a neuroanatomical point of view may help clarify this issue and develop new treatment strategies. To determine if DSZ is associated with structural alterations in specific deep grey matter structures linked to its key clinical features, 22 DSZ patients, 22 non-deficit schizophrenia (NDSZ) patients and 22 healthy controls (HC) were recruited for a case-control cross-sectional study. High-resolution magnetic resonance imaging was performed in all subjects and volumes of deep grey matter structures were measured using FreeSurfer. DSZ patients displayed smaller left accumbens volumes compared to both NDSZ patients and HC. Moreover, age and duration of illness were significantly associated with lower volume of the left accumbens in DSZ but not in NDSZ. Findings indicate that DSZ is associated with lower volume of the nucleus accumbens in the dominant hemisphere. This is consistent with the psychopathological features and functional impairments present in DSZ and thus indicates a potential mechanism.
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Affiliation(s)
- Pietro De Rossi
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department NESMOS, Faculty of Medicine and Psychology, University "Sapienza" of Rome, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
| | - Claudia Dacquino
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Fabrizio Piras
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department of Neuroscience, "Tor Vergata" University, 00173, Rome, Italy
| | - Gianfranco Spalletta
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Jørgensen KN, Nesvåg R, Gunleiksrud S, Raballo A, Jönsson EG, Agartz I. First- and second-generation antipsychotic drug treatment and subcortical brain morphology in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2016; 266:451-60. [PMID: 26547434 DOI: 10.1007/s00406-015-0650-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 10/26/2015] [Indexed: 01/22/2023]
Abstract
Antipsychotic medication may influence brain structure, but to what extent effects of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) differ is still not clear. Here we aimed to disentangle the effects of FGA and SGA on variation in volumes of subcortical structures in patients with long-term treated schizophrenia. Magnetic resonance images were obtained from 95 patients with schizophrenia and 106 healthy control subjects. Among the patients, 40 received only FGA and 42 received only SGA. FreeSurfer 5.3.0 was used to obtain volumes of 27 subcortical structures as well as total brain volume and estimated intracranial volume. Findings of reduced total brain volume, enlarged ventricular volume and reduced hippocampal volume bilaterally among patients were replicated, largely independent of medication class. In the basal ganglia, FGA users had larger putamen bilaterally and right caudate volume compared to healthy controls, and the right putamen was significantly larger than among SGA users. FGA and SGA users had similar and larger globus pallidus volumes compared to healthy controls. Post hoc analyses revealed that the difference between FGA and SGA could be attributed to smaller volumes in the clozapine users specifically. We therefore conclude that basal ganglia volume enlargements are not specific to FGA.
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Affiliation(s)
- Kjetil N Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, P.O. Box 85, 0319, Vinderen, Oslo, Norway. .,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ragnar Nesvåg
- Department of Psychiatric Research, Diakonhjemmet Hospital, P.O. Box 85, 0319, Vinderen, Oslo, Norway.,Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sindre Gunleiksrud
- Department of Psychiatric Research, Diakonhjemmet Hospital, P.O. Box 85, 0319, Vinderen, Oslo, Norway
| | - Andrea Raballo
- Department of Psychiatric Research, Diakonhjemmet Hospital, P.O. Box 85, 0319, Vinderen, Oslo, Norway.,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik G Jönsson
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, HUBIN Project, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, P.O. Box 85, 0319, Vinderen, Oslo, Norway.,NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, HUBIN Project, Karolinska Institutet and Hospital, Stockholm, Sweden
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36
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Asensio S, Morales JL, Senabre I, Romero MJ, Beltran MA, Flores-Bellver M, Barcia JM, Romero FJ. Magnetic resonance imaging structural alterations in brain of alcohol abusers and its association with impulsivity. Addict Biol 2016; 21:962-71. [PMID: 25988724 DOI: 10.1111/adb.12257] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite the suggestion that impulsivity plays a central role in the transfer from a recreational drug use to a substance use disorder, very few studies focused on neurobiological markers for addiction. This study aimed to identify volumetric alterations in a sample of patients with mild alcohol use disorder with a short history of alcohol use, compared with a control group, and also focused on its association with impulsivity levels. Most magnetic resonance imaging studies have focused on severe alcohol use disorder, formerly called alcohol-dependent patients, showing alcohol-related structural alterations and their association with alcohol use history variables but not with personality parameters like impulsivity. Our hypothesis is that our group of alcohol users may already display structural alterations especially in brain regions related to inhibitory control like medial-prefrontal regions, and that those structural alterations could be more associated to personality traits like impulsivity than to drug use variables. Our results clearly demonstrate that our population showed lower regional grey and white matter volumes in the medial-prefrontal and orbitofrontal cortices, as well as higher regional white matter volume in the ventral striatum and the internal capsule. Volumetric alterations were associated to the Barratt's impulsivity score: the more impulsive the subjects, the lower the medial-prefrontal cortex grey matter volume.
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Affiliation(s)
- Samuel Asensio
- Facultad de Ciencias de la Salud; Universidad Cardenal Herrera-CEU; Spain
| | - Julia L. Morales
- Facultad de Medicina y Odontología; Universidad Católica de Valencia ‘San Vicente Mártir’; Spain
| | - Isabel Senabre
- Facultad de Ciencias de la Salud; Universidad Cardenal Herrera-CEU; Spain
| | - Maria J. Romero
- Facultad de Medicina y Odontología; Universidad Católica de Valencia ‘San Vicente Mártir’; Spain
| | | | - Miguel Flores-Bellver
- Facultad de Medicina y Odontología; Universidad Católica de Valencia ‘San Vicente Mártir’; Spain
| | - Jorge M. Barcia
- Facultad de Medicina y Odontología; Universidad Católica de Valencia ‘San Vicente Mártir’; Spain
| | - Francisco J. Romero
- Facultad de Medicina y Odontología; Universidad Católica de Valencia ‘San Vicente Mártir’; Spain
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Tedroff J, Waters S, Barker RA, Roos R, Squitieri F. Antidopaminergic Medication is Associated with More Rapidly Progressive Huntington's Disease. J Huntingtons Dis 2016; 4:131-40. [PMID: 26397894 DOI: 10.3233/jhd-150143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder leading to progressive motor, cognitive and functional decline. Antidopaminergic medications (ADMs) are frequently used to treat chorea and behavioural disturbances in HD. OBJECTIVE We aimed to assess how the use of such medications was associated with the severity and progression of the motor aspects of the condition, given that there have been concerns that such drugs may actually promote neurological deterioration. METHODS Using multiple linear regression, supplemented by principal component analysis to explore the overall correlation patterns and help identify relevant covariates, we assessed severity and progression of motor symptoms and functional decline in 651 manifest patients from the REGISTRY cohort followed for two years. ADM treated versus non-treated subjects were compared with respect to motor impairment at baseline and progression rate by means of multiple regression, adjusting for CAG-repeat and age. RESULTS Patients treated with ADMs had significantly worse motor scores with greater functional disability at their first visit. They also showed a higher annual rate of progression of motor signs and disability over the next two years. In particular the rate of progression for oculomotor symptoms and bradykinesia was markedly increased whereas the rate of progression of chorea and dystonia was similar for ADM and drug naïve patients. These differences in clinical severity and progression could not be explained by differences in disease burden, duration of disease or other possible prognostic factors. CONCLUSIONS The results from this analysis suggest ADM treatment is associated with more advanced and rapidly progressing HD although whether these drugs are causative in driving this progression requires further, prospective studies.
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Affiliation(s)
- Joakim Tedroff
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Susanna Waters
- Department of Pharmacology, Gothenburg University, Gothenburg, Sweden
| | - Roger A Barker
- John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - Raymund Roos
- Department Neurology, LUMC Leiden, The Netherlands
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Uhlmann A, Fouche JP, Koen N, Meintjes EM, Wilson D, Stein DJ. Fronto-temporal alterations and affect regulation in methamphetamine dependence with and without a history of psychosis. Psychiatry Res Neuroimaging 2016; 248:30-38. [PMID: 26792587 DOI: 10.1016/j.pscychresns.2016.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 10/26/2015] [Accepted: 01/03/2016] [Indexed: 02/02/2023]
Abstract
Methamphetamine (MA) has been shown to have neurotoxic effects associated with brain structure changes and schizophrenia-like psychotic symptoms. Although these abnormalities may in turn be related to cognitive impairment and increased aggression, their association with affect dysregulation is less well studied. We investigated cortical thickness and subcortical volumes in 21 participants with MA dependence, 19 patients with MA-associated psychosis (MAP), and 19 healthy controls. Participants' affect regulation abilities were assessed through self-report scales on emotion reactivity (ERS) and difficulties in emotion regulation (DERS) and correlated with differences in cortical thickness. MAP patients showed thinner cortices in the fusiform and inferior temporal gyrus (ITG), orbitofrontal (OFC) and inferior frontal gyrus (IFG), and insula, compared to the MA group. MAP also showed significantly lower hippocampal volumes relative to MA and CTRL. Both clinical groups showed impairment in affect regulation, but only in MAP was this dysfunction associated with thinner cortices in ITG, OFC and IFG. Our findings suggest significant differences in cortical thickness in MA dependence with and without psychosis. Lower fronto-temporal cortical thickness and smaller hippocampal volumes in MAP are consistent with neuroimaging findings in other psychotic disorders, supporting the notion of MAP being a useful model of psychosis.
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Affiliation(s)
- Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ernesta M Meintjes
- MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Don Wilson
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Liberg B, Ekman CJ, Sellgren C, Johansson AG, Landén M. Subcortical morphometry and psychomotor function in euthymic bipolar disorder with a history of psychosis. Brain Imaging Behav 2016; 9:333-41. [PMID: 25034133 DOI: 10.1007/s11682-014-9313-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Psychomotor disturbances are prominent in bipolar disorder patients with a history of psychosis, but their neural correlates remain largely unexplored. We hypothesized that these psychomotor disturbances are associated with morphometric changes in functionally specific regions of the basal ganglia and thalamus. To test if psychomotor performance is associated with changes in volume and shape in these brain regions, we investigated 20 euthymic bipolar disorder patients with a history of psychosis and 20 healthy controls with structural magnetic resonance imaging and vertex-based morphometry. Within the patient group, the local shape of the basal ganglia was significantly associated with longer duration of illness, increased number of manic episodes, and treatment with antipsychotics. There were neither any statistically significant associations between psychomotor performance and morphometric measures in the patient group, nor any significant morphometric differences between patients and controls. We conclude that euthymic subjects with bipolar disorder and a previous history of psychosis show shape changes in regions of the basal ganglia associated to clinical variables that may predict psychomotor disturbances in bipolar disorder.
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Affiliation(s)
- Benny Liberg
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden,
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Abstract
This article reviews the results of longitudinal studies on frontal brain volume reduction in patients with schizophrenia spectrum disorders and focuses on the relationship with antipsychotic treatment. Based on a systematic literature search all studies were included in which results on changes of brain volumes over a longer period of time were correlated with antipsychotic treatment dose and disease severity. The findings indicate that there is evidence for grey and white matter volume changes of the frontal brain, which cannot be explained by the severity of the disease alone but are also very likely a manifestation of long-term effects of antipsychotics. Whether second generation antipsychotics have an advantage compared to first generation antipsychotics is currently unclear. Considering the contribution of antipsychotics to the changes in brain structure, which seem to depend on cumulative dosage and can exert adverse effects on neurocognition, negative and positive symptoms and psychosocial functioning, the guidelines for antipsychotic long-term drug treatment should be reconsidered. This is the reason why we and others recommend prescribing the lowest dose necessary to control symptoms. In non-schizophrenic psychiatric disorders, antipsychotics should be used only with great caution after a careful risk-benefit assessment. Moreover, treatment approaches which can help to minimize antipsychotic medication or even administer them only selectively are of increasing importance.
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Regional Abnormality of Grey Matter in Schizophrenia: Effect from the Illness or Treatment? PLoS One 2016; 11:e0147204. [PMID: 26789520 PMCID: PMC4720276 DOI: 10.1371/journal.pone.0147204] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/30/2015] [Indexed: 12/25/2022] Open
Abstract
Both schizophrenia and antipsychotic treatment are known to modulate brain morphology. However, it is difficult to establish whether observed structural brain abnormalities are due to disease or the effects of treatment. The aim of this study was to investigate the effects of illness and antipsychotic treatment on brain structures in antipsychotic-naïve first-episode schizophrenia based on a longitudinal short-term design. Twenty antipsychotic-naïve subjects with first-episode schizophrenia and twenty-four age- and sex-matched healthy controls underwent 3T MRI scans. Voxel-based morphometry (VBM) was used to examine the brain structural abnormality in patients compared to healthy controls. Nine patients were included in the follow-up examination after 8 weeks of treatment. Tensor-based morphometry (TBM) was used to identify longitudinal brain structural changes. We observed significantly reduced grey matter volume in the right superior temporal gyrus in antipsychotic-naïve patients with schizophrenia compared with healthy controls. After 8 weeks of treatment, patients showed significantly increased grey matter volume primarily in the bilateral prefrontal cortex, insula, right thalamus, left superior occipital cortex and the bilateral cerebellum. In addition, a greater enlargement of the prefrontal cortex is associated with the improvement in negative symptoms, and a more enlarged thalamus is associated with greater improvement in positive symptoms. Our results suggest the following: (1) the abnormality in the right superior temporal gyrus is present in the early stages of schizophrenia, possibly representing the core region related to schizophrenia; and (2) atypical antipsychotics could modulate brain morphology involving the thalamus, cortical grey matter and cerebellum. In addition, examination of the prefrontal cortex and thalamus might facilitate an efficient response to atypical antipsychotics in terms of symptom improvement.
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Azorin JM, Simon N, Adida M, Belzeaux R. Pharmacological treatment of schizophrenia with comorbid substance use disorder. Expert Opin Pharmacother 2015; 17:231-53. [DOI: 10.1517/14656566.2016.1114101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Hong SB, Lee TY, Kwak YB, Kim SN, Kwon JS. Baseline putamen volume as a predictor of positive symptom reduction in patients at clinical high risk for psychosis: A preliminary study. Schizophr Res 2015; 169:178-185. [PMID: 26527246 DOI: 10.1016/j.schres.2015.10.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/13/2015] [Accepted: 10/20/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Illness course in individuals at clinical high risk (CHR) status for psychosis is heterogeneous, which limits effective treatment for all CHR subgroups. Baseline predictors of positive symptom trajectory in the CHR group will reduce such limitations. We singled out the putamen, thought to be involved in the generation of the key schizophrenia symptoms early in the course of disease, as a potential predictor of positive symptom trajectory in CHR patients. METHOD We recruited 45 CHR patients and 29 age- and gender-matched healthy controls (HC). The CHR group was divided into patients with positive symptom reduction (CHR-R) and patients without positive symptom reduction (CHR-NR) at 6 months. Comparisons were made between the baseline putamen volumes of CHR-R, CHR-NR and HC groups. The relationship between baseline putamen volumes and clinical measures was investigated. RESULTS Left putamen volumes of CHR-R patients were significantly smaller than those of HCs (p=0.002) and of CHR-NR patients (p=0.024). CHR-R patients had significantly reduced leftward laterality compared to HCs (p=0.007). In the CHR-R group, bilateral putamen volumes were correlated with positive symptom severity at baseline (r=-0.552, p=0.001) and at 6 months (r=-0.360, p=0.043), and predicted positive symptom score change in 6 months at a trend level (p=0.092). CONCLUSION Smaller left putamen volumes in CHR-R patients, and the correlation between positive symptom severity and putamen volumes suggest that putamen volume is a possible risk-stratifier and predictor of clinical course in the CHR population.
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Affiliation(s)
- Sang Bin Hong
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Yoo Bin Kwak
- Department of Brain & Cognitive Sciences, Seoul National University College of National Sciences, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain & Cognitive Sciences, Seoul National University College of National Sciences, Seoul, Republic of Korea
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Hirjak D, Thomann PA, Kubera KM, Wolf ND, Sambataro F, Wolf RC. Motor dysfunction within the schizophrenia-spectrum: A dimensional step towards an underappreciated domain. Schizophr Res 2015; 169:217-233. [PMID: 26547881 DOI: 10.1016/j.schres.2015.10.022] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/09/2015] [Accepted: 10/15/2015] [Indexed: 12/14/2022]
Abstract
At the beginning of the 20th century, genuine motor abnormalities (GMA) were considered to be intricately linked to schizophrenia. Subsequently, however, GMA have been increasingly regarded as unspecific transdiagnostic phenomena or related to side effects of antipsychotic treatment. Despite possible medication confounds, within the schizophrenia spectrum GMA have been categorized into three broad categories, i.e. neurological soft signs, abnormal involuntary movements and catatonia. Schizophrenia patients show a substantial overlap across a broad range of distinct motor signs and symptoms suggesting a prominent involvement of the motor system in disease pathophysiology. There have been several attempts to increase reliability and validity in diagnosing schizophrenia based on behavior and neurobiology, yet relatively little attention has been paid to the motor domain in the past. Nevertheless, accumulating neuroscientific evidence suggests the possibility of a motor endophenotype in schizophrenia, and that GMA could represent a specific dimension within the schizophrenia-spectrum. Here, we review current neuroimaging research on GMA in schizophrenia with an emphasis on distinct and common mechanisms of brain dysfunction. Based on a dimensional approach we show that multimodal neuroimaging combined with fine-grained clinical examination can result in a comprehensive characterization of structural and functional brain changes that are presumed to underlie core GMA in schizophrenia. We discuss the possibility of a distinct motor domain, together with its implications for future research. Investigating GMA by means of multimodal neuroimaging can essentially contribute at identifying novel and biologically reliable phenotypes in psychiatry.
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Affiliation(s)
- Dusan Hirjak
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Nadine D Wolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Udine, Italy
| | - Robert C Wolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany
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Emsley R, Asmal L, du Plessis S, Chiliza B, Kidd M, Carr J, Vink M. Dorsal striatal volumes in never-treated patients with first-episode schizophrenia before and during acute treatment. Schizophr Res 2015; 169:89-94. [PMID: 26441006 DOI: 10.1016/j.schres.2015.09.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/06/2015] [Accepted: 09/08/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Studies of pre-and post-treatment striatal volume in schizophrenia have reported conflicting results. MATERIALS AND METHODS We assessed dorsal striatal (caudate and putamen) volumes bilaterally in 22 never-treated, non-substance-abusing patients with first-episode schizophrenia or schizophreniform disorder and 23 healthy controls matched for age, sex and educational status. Patients received either risperidone or flupenthixol long acting injection and were compared by structural MRI with controls at weeks 0, 4 and 13. T1-weighted data on a 3T MRI scanner were obtained and images were reconstructed using FreeSurfer. Treatment outcome was assessed by changes in psychopathology, insight, functionality, cognitive performance and motor symptoms. RESULTS Caudate, but not putamen volumes was significantly larger in patients bilaterally at baseline (P=0.01). Linear mixed effects repeated measures found no significant group × time interactions for any of the regions. Caudate volume was not significantly associated with improvements in psychotic symptoms. Also, the findings of a regression model were inconsistent insofar as larger caudate volume was associated with less improvement in depression scores, greater improvement in functionality and greater improvement in verbal learning but less improvement in reasoning and problem solving (left caudate) and composite cognitive score (right caudate). CONCLUSIONS The increased caudate volumes prior to treatment are contrary to previous reports in never-treated patients with first-episode schizophrenia, and together with our failure to demonstrate volume changes related to acute treatment, call into question previous proposals that enlarged caudate volume is a consequence of antipsychotic treatment.
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Affiliation(s)
- Robin Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Stéfan du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Bonginkosi Chiliza
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Martin Kidd
- Centre for Statistical Consultation, Stellenbosch University, South Africa
| | - Jonathan Carr
- Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Matthijs Vink
- Department of Psychiatry, University Medical Centre Utrecht, The Netherlands
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Ahmed M, Cannon DM, Scanlon C, Holleran L, Schmidt H, McFarland J, Langan C, McCarthy P, Barker GJ, Hallahan B, McDonald C. Progressive Brain Atrophy and Cortical Thinning in Schizophrenia after Commencing Clozapine Treatment. Neuropsychopharmacology 2015; 40:2409-17. [PMID: 25829144 PMCID: PMC4538355 DOI: 10.1038/npp.2015.90] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/10/2015] [Accepted: 03/10/2015] [Indexed: 01/20/2023]
Abstract
Despite evidence that clozapine may be neuroprotective, there are few longitudinal magnetic resonance imaging (MRI) studies that have specifically explored an association between commencement of clozapine treatment for schizophrenia and changes in regional brain volume or cortical thickness. A total of 33 patients with treatment-resistant schizophrenia and 31 healthy controls matched for age and gender underwent structural MRI brain scans at baseline and 6-9 months after commencing clozapine. MRI images were analyzed using SIENA (Structural Image Evaluation, using Normalization, of Atrophy) and FreeSurfer to investigate changes over time in brain volume and cortical thickness respectively. Significantly greater reductions in volume were detected in the right and left medial prefrontal cortex and in the periventricular area in the patient group regardless of treatment response. Widespread further cortical thinning was observed in patients compared with healthy controls. The majority of patients improved symptomatically and functionally over the study period, and patients who improved were more likely to have less cortical thinning of the left medial frontal cortex and the right middle temporal cortex. These findings demonstrate on-going reductions in brain volume and progressive cortical thinning in patients with schizophrenia who are switched to clozapine treatment. It is possible that this gray matter loss reflects a progressive disease process irrespective of medication use or that it is contributed to by switching to clozapine treatment. The clinical improvement of most patients indicates that antipsychotic-related gray matter volume loss may not necessarily be harmful or reflect neurotoxicity.
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Affiliation(s)
- Mohamed Ahmed
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Dara M Cannon
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Cathy Scanlon
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Laurena Holleran
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Heike Schmidt
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - John McFarland
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Camilla Langan
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Peter McCarthy
- Department of Radiology, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Gareth J Barker
- Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, London, UK
| | - Brian Hallahan
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Colm McDonald
- Clinical Neuroimaging Laboratory, Department of Psychiatry, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
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Subcortical volumes differentiate Major Depressive Disorder, Bipolar Disorder, and remitted Major Depressive Disorder. J Psychiatr Res 2015; 68:91-8. [PMID: 26228406 DOI: 10.1016/j.jpsychires.2015.06.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/05/2015] [Indexed: 12/16/2022]
Abstract
Subcortical gray matter regions have been implicated in mood disorders, including Major Depressive Disorder (MDD) and Bipolar Disorder (BD). It is unclear, however, whether or how these regions differ among mood disorders and whether such abnormalities are state- or trait-like. In this study, we examined differences in subcortical gray matter volumes among euthymic BD, MDD, remitted MDD (RMD), and healthy (CTL) individuals. Using automated gray matter segmentation of T1-weighted MRI images, we estimated volumes of 16 major subcortical gray matter structures in 40 BD, 57 MDD, 35 RMD, and 61 CTL individuals. We used multivariate analysis of variance to examine group differences in these structures, and support vector machines (SVMs) to assess individual-by-individual classification. Analyses yielded significant group differences for caudate (p = 0.029) and ventral diencephalon (VD) volumes (p = 0.003). For the caudate, both the BD (p = 0.004) and the MDD (p = 0.037) participants had smaller volumes than did the CTL participants. For the VD, the MDD participants had larger volumes than did the BD and CTL participants (ps < 0.005). SVM distinguished MDD from BD with 59.5% accuracy. These findings indicate that mood disorders are characterized by anomalies in subcortical gray matter volumes and that the caudate and VD contribute uniquely to differential affective pathology. Identifying abnormalities in subcortical gray matter may prove useful for the prevention, diagnosis, and treatment of mood disorders.
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Abstract
Childhood-onset schizophrenia is a rare pediatric onset psychiatric disorder continuous with and typically more severe than its adult counterpart. Neuroimaging research conducted on this population has revealed similarly severe neural abnormalities. When taken as a whole, neuroimaging research in this population shows generally decreased cortical gray matter coupled with white matter connectivity abnormalities, suggesting an anatomical basis for deficits in executive function. Subcortical abnormalities are pronounced in limbic structures, where volumetric deficits are likely related to social skill deficits, and cerebellar deficits that have been correlated to cognitive abnormalities. Structures relevant to motor processing also show a significant alteration, with volumetric increase in basal ganglia structures likely due to antipsychotic administration. Neuroimaging of this disorder shows an important clinical image of exaggerated cortical loss, altered white matter connectivity, and differences in structural development of subcortical areas during the course of development and provides important background to the disease state.
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49
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Negative symptoms in schizophrenia show association with amygdala volumes and neural activation during affective processing. Acta Neuropsychiatr 2015; 27:213-20. [PMID: 25777814 DOI: 10.1017/neu.2015.11] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Negative symptoms in schizophrenia have been associated with structural and functional alterations of the amygdala. We hypothesised that there would be between-group differences in amygdala volume and neural activation patterns during processing of affective stimuli among patients with schizophrenia and healthy controls. We further hypothesised correlations between neuroimaging metrics and clinical ratings of negative symptoms in patients with schizophrenia. METHODS We used structural and functional magnetic resonance imaging to assess volume and neural activation of the amygdala in 28 patients with schizophrenia and 28 healthy controls. RESULTS We found no between-group differences in amygdala volume or neural activation. However, we found a significant negative correlation between emotional blunting and neural activation in the left amygdala during processing of positive affect. We also found a significant negative correlation between stereotyped thinking and the volume of right amygdala. CONCLUSION Our findings implicate the amygdala in a subgroup of negative symptoms in schizophrenia that are characterised by reduced expression with blunted affect and stereotyped thinking.
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50
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Juuhl-Langseth M, Hartberg CB, Holmén A, Thormodsen R, Groote IR, Rimol LM, Emblem KE, Agartz I, Rund BR. Impaired Verbal Learning Is Associated with Larger Caudate Volumes in Early Onset Schizophrenia Spectrum Disorders. PLoS One 2015; 10:e0130435. [PMID: 26230626 PMCID: PMC4521864 DOI: 10.1371/journal.pone.0130435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 05/20/2015] [Indexed: 01/31/2023] Open
Abstract
Background Both brain structural abnormalities and neurocognitive impairments are core features of schizophrenia. We have previously reported enlargements in subcortical brain structure volumes and impairment of neurocognitive functioning as measured by the MATRICS Cognitive Consensus Battery (MCCB) in early onset schizophrenia spectrum disorders (EOS). To our knowledge, no previous study has investigated whether neurocognitive performance and volumetric abnormalities in subcortical brain structures are related in EOS. Methods Twenty-four patients with EOS and 33 healthy controls (HC) were included in the study. Relationships between the caudate nucleus, the lateral and fourth ventricles volumes and neurocognitive performance were investigated with multivariate linear regression analyses. Intracranial volume, age, antipsychotic medication and IQ were included as independent predictor-variables. Results The caudate volume was negatively correlated with verbal learning performance uniquely in the EOS group (r=-.454, p=.034). There were comparable positive correlations between the lateral ventricular volume and the processing speed, attention and reasoning and problem solving domains for both the EOS patients and the healthy controls. Antipsychotic medication was related to ventricular enlargements, but did not affect the brain structure-function relationship. Conclusion Enlargement of the caudate volume was related to poorer verbal learning performance in patients with EOS. Despite a 32% enlargement of the lateral ventricles in the EOS group, associations to processing speed, attention and reasoning and problem solving were similar for both the EOS and the HC groups.
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Affiliation(s)
- Monica Juuhl-Langseth
- Research Unit Child and Adolescent Mental Health, Oslo University Hospital, Oslo Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- * E-mail:
| | - Cecilie B. Hartberg
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Aina Holmén
- Department of Psychology, University of Oslo, Oslo, Norway
- Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | | | - Inge R. Groote
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Lars M. Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kyrre E. Emblem
- The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Ingrid Agartz
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Bjørn R. Rund
- Department of Psychology, University of Oslo, Oslo, Norway
- Vestre Viken Hospital Trust, Drammen, Norway
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