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Parsaei M, Sheipouri A, Partovifar P, Shahriarinamin M, Sani SM, Taebi M, Arvin A. Diffusion magnetic resonance imaging for treatment response prediction in schizophrenia spectrum disorders: A systematic review. Psychiatry Res Neuroimaging 2024; 342:111841. [PMID: 38870842 DOI: 10.1016/j.pscychresns.2024.111841] [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: 03/02/2024] [Revised: 05/11/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
A substantial portion of schizophrenia spectrum disorder (SSD) patients exhibit resistance to antipsychotic treatments, emphasizing the need for reliable treatment response biomarkers. Previous magnetic resonance imaging (MRI) studies have identified various imaging predictors in SSD. This study focuses on evaluating the effectiveness of diffusion MRI sequences, diffusion tensor imaging (DTI) and diffusion-weighted imaging (DWI), in predicting antipsychotic response in SSD patients. A systematic search for relevant articles was conducted in PubMed, Embase, Scopus, and Web of Science on February 11, 2024. Twelve studies involving a total of 742 patients were systematically reviewed. The baseline DTI/DWI biomarkers revealed significant associations with antipsychotic treatment response. Notably a consistent negative link was found between response and baseline fractional anisotropy (FA) in fronto-temporo-limbic white matter tracts, specifically the superior longitudinal fasciculus, providing moderate-level evidence. In addition, weak-level evidence was found for the negative association between the treatment response and baseline FA in the corpus callosum, internal, and external capsule tracts. Collectively, this review demonstrated that obtaining pre-treatment brain diffusion MRI scans, particularly from white matter tracts of fronto-temporo-limbic network, can assist in delineating the treatment response trajectory in patients with SSD. However, additional larger randomized controlled trials are required to further substantiate these findings.
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Affiliation(s)
- Mohammadamin Parsaei
- Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amirmahdi Sheipouri
- NCweb Association, Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran; Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Paniz Partovifar
- Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shahriarinamin
- NCweb Association, Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroscience, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sheida Mobader Sani
- NCweb Association, Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran; Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Morvarid Taebi
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Arvin
- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
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Chen Y, Liu S, Zhang B, Zhao G, Zhang Z, Li S, Li H, Yu X, Deng H, Cao H. Baseline symptom-related white matter tracts predict individualized treatment response to 12-week antipsychotic monotherapies in first-episode schizophrenia. Transl Psychiatry 2024; 14:23. [PMID: 38218952 PMCID: PMC10787827 DOI: 10.1038/s41398-023-02714-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/15/2024] Open
Abstract
There is significant heterogeneity in individual responses to antipsychotic drugs, but there is no reliable predictor of antipsychotics response in first-episode psychosis. This study aimed to investigate whether psychotic symptom-related alterations in fractional anisotropy (FA) and mean diffusivity (MD) of white matter (WM) at the early stage of the disorder may aid in the individualized prediction of drug response. Sixty-eight first-episode patients underwent baseline structural MRI scans and were subsequently randomized to receive a single atypical antipsychotic throughout the first 12 weeks. Clinical symptoms were evaluated using the eight "core symptoms" selected from the Positive and Negative Syndrome Scale (PANSS-8). Follow-up assessments were conducted at the 4th, 8th, and 12th weeks by trained psychiatrists. LASSO regression model and cross-validation were conducted to examine the performance of baseline symptom-related alterations FA and MD of WM in the prediction of individualized treatment outcome. Fifty patients completed both clinical follow-up assessments by the 8th and 12th weeks. 30 patients were classified as responders, and 20 patients were classified as nonresponders. At baseline, the altered diffusion properties of fiber tracts in the anterior thalamic radiation, corticospinal tract, callosum forceps minor, longitudinal fasciculi (ILF), inferior frontal-occipital fasciculi (IFOF) and superior longitudinal fasciculus (SLF) were related to the severity of symptoms. These abnormal fiber tracts, especially the ILF, IFOF, and SLF, significantly predicted the response to antipsychotic treatment at the individual level (AUC = 0.828, P < 0.001). These findings demonstrate that early microstructural WM changes contribute to the pathophysiology of psychosis and may serve as meaningful individualized predictors of response to antipsychotics.
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Affiliation(s)
- Ying Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Hope Recovery and Rehabilitation Center, West China Hospital of Sichuan University, Chengdu, China
| | - Shanming Liu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Gaofeng Zhao
- Shandong Daizhuang Hospital, Jining, Shangdong, China
| | - Zhuoqiu Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Shuiying Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Haiming Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hong Deng
- Hope Recovery and Rehabilitation Center, West China Hospital of Sichuan University, Chengdu, China.
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
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Bosma MJ, Cox SR, Ziermans T, Buchanan CR, Shen X, Tucker-Drob EM, Adams MJ, Whalley HC, Lawrie SM. White matter, cognition and psychotic-like experiences in UK Biobank. Psychol Med 2023; 53:2370-2379. [PMID: 37310314 PMCID: PMC10123836 DOI: 10.1017/s0033291721004244] [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: 03/15/2021] [Revised: 09/09/2021] [Accepted: 09/29/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) are risk factors for the development of psychiatric conditions like schizophrenia, particularly if associated with distress. As PLEs have been related to alterations in both white matter and cognition, we investigated whether cognition (g-factor and processing speed) mediates the relationship between white matter and PLEs. METHODS We investigated two independent samples (6170 and 19 891) from the UK Biobank, through path analysis. For both samples, measures of whole-brain fractional anisotropy (gFA) and mean diffusivity (gMD), as indications of white matter microstructure, were derived from probabilistic tractography. For the smaller sample, variables whole-brain white matter network efficiency and microstructure were also derived from structural connectome data. RESULTS The mediation of cognition on the relationships between white matter properties and PLEs was non-significant. However, lower gFA was associated with having PLEs in combination with distress in the full available sample (standardized β = -0.053, p = 0.011). Additionally, lower gFA/higher gMD was associated with lower g-factor (standardized β = 0.049, p < 0.001; standardized β = -0.027, p = 0.003), and partially mediated by processing speed with a proportion mediated of 7% (p = < 0.001) for gFA and 11% (p < 0.001) for gMD. CONCLUSIONS We show that lower global white matter microstructure is associated with having PLEs in combination with distress, which suggests a direction of future research that could help clarify how and why individuals progress from subclinical to clinical psychotic symptoms. Furthermore, we replicated that processing speed mediates the relationship between white matter microstructure and g-factor.
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Affiliation(s)
- M. J. Bosma
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - S. R. Cox
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - T. Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - C. R. Buchanan
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - X. Shen
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland, UK
| | - E. M. Tucker-Drob
- Department of Psychology, University of Texas at Austin, Austin, USA
| | - M. J. Adams
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland, UK
| | - H. C. Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland, UK
| | - S. M. Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland, UK
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Yang M, Gao S, Xiong W, Zhang XY. Sex-differential associations between cognitive impairments and white matter abnormalities in first episode and drug-naïve schizophrenia. Early Interv Psychiatry 2021; 15:1179-1187. [PMID: 33058544 DOI: 10.1111/eip.13059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/24/2020] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Abstract
AIM Previous evidence has suggested that schizophrenia patients may display sex differences in cognitive impairments and cognitive impairments are related to disrupted white matter (WM) microstructure. The current research aims to address the intriguing possibility for the sex-specific association between cognitive deficits and WM abnormalities in first-episode and drug-naïve schizophrenia. METHODS Cognitive performance on the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) was measured in 39 FEND patients (females:males = 23:16) and 30 healthy controls (females:males = 17:13), together with whole-brain WM fractional anisotropy (FA) values determined using voxel-based diffusion tensor imaging. Correlations between cognitive performance and FA values were assessed. RESULTS Patients performed significantly worse than healthy controls in the total score and most of the subscores of MCCB. Female patients displayed better cognitive performance than male patients on the Trail Making A Test, the Hopkins Verbal Learning Test and the Spatial Span Test in the Wechsler Memory Scale. More importantly, sex-differential association between cognitive performance and FA values was found in patients, but not in healthy controls. In particular, FA values in the cerebellum were negatively correlated with the continuous performance and digital sequence scores in male patients but positively correlated with the performance on the Spatial Span Test in the Wechsler Memory Scale in female patients. CONCLUSIONS These findings suggest sex-specific neurobiological substrates involved in cognitive deficits in early-onset schizophrenia and have important implications for differentially targeted interventions between males and females.
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Affiliation(s)
- Mi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Shan Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Weisen Xiong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xiang Yang Zhang
- 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
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The effect of antipsychotic medications on white matter integrity in first-episode drug-naïve patients with psychosis: A review of DTI studies. Asian J Psychiatr 2021; 61:102688. [PMID: 34000500 DOI: 10.1016/j.ajp.2021.102688] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Psychotic episodes have been associated with damage to both grey matter (GM) and white matter (WM). Although a recent meta-analysis suggest that in long term treatment, first generation antipsychotics (FGA) are associated with progressive reduction in GM, second generation antipsychotics (SGA) seem to have benefits to WM microstructure. METHODS A search was conducted to identify controlled trials published from January 2000 to January 2021, which assessed WM integrity as measured by DTI in drug-naïve patients with FEP before and after antipsychotic administration. RESULTS 3 studies met the criteria for inclusion. All studies demonstrated lower FA in psychotic patients vs HC. A 6-week study reported that antipsychotic medication results in a further decrease in FA within the bilateral ACG and right ACR, regions important in emotional processing. An 8-week study found that antipsychotic treatment increase FA in the SLF, resulting in improved symptoms and increased processing speed. A 3rd study found an increase in FA in several regions along with a negative correlation between FA and PANSS at remission. CONCLUSIONS Drug-naïve FEP patients have WM dysfunction at baseline and antipsychotic medications appear to alter or improve WM especially at remission. More controlled trials are warranted to validate these conclusions.
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Roalf DR, de la Garza AG, Rosen A, Calkins ME, Moore TM, Quarmley M, Ruparel K, Xia CH, Rupert PE, Satterthwaite TD, Shinohara RT, Elliott MA, Gur RC, Gur RE. Alterations in white matter microstructure in individuals at persistent risk for psychosis. Mol Psychiatry 2020; 25:2441-2454. [PMID: 30723287 PMCID: PMC6682472 DOI: 10.1038/s41380-019-0360-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/02/2019] [Accepted: 01/11/2019] [Indexed: 12/18/2022]
Abstract
Abnormalities in brain white matter (WM) are reported in youth at-risk for psychosis. Yet, the neurodevelopmental time course of these abnormalities remains unclear. Thus, longitudinal diffusion-weighted imaging (DWI) was used to investigate WM abnormalities in youth at-risk for psychosis. A subset of individuals from the Philadelphia Neurodevelopmental Cohort (PNC) completed two DWI scans approximately 20 months apart. Youths were identified through structured interview as having subthreshold persistent psychosis risk symptoms (n = 46), and were compared to healthy typically developing participants (TD; n = 98). Analyses were conducted at voxelwise and regional levels. Nonlinear developmental patterns were examined using penalized splines within a generalized additive model. Compared to TD, youth with persistent psychosis risk symptoms had lower whole-brain WM fractional anisotropy (FA) and higher radial diffusivity (RD). Voxelwise analyses revealed clusters of significant WM abnormalities within the temporal and parietal lobes. Lower FA within the cingulum bundle of hippocampus and cerebrospinal tracts were the most robust deficits in individuals with persistent psychosis symptoms. These findings were consistent over two visits. Thus, it appears that WM abnormalities are present early in youth with persistent psychosis risk symptoms, however, there is little evidence to suggest that these features emerge in late adolescence or early adulthood. Future studies should seek to characterize WM abnormalities in younger individuals and follow individuals as subthreshold psychotic symptoms emerge.
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Affiliation(s)
- David R. Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Angel Garcia de la Garza
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Adon Rosen
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tyler M. Moore
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Megan Quarmley
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cedric Huchuan Xia
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Petra E. Rupert
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T. Shinohara
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Mark A. Elliott
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.,Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Raquel E. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.,Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA.,Department of Child and Adolescent Psychiatry, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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Karlsgodt KH. White Matter Microstructure across the Psychosis Spectrum. Trends Neurosci 2020; 43:406-416. [PMID: 32349908 DOI: 10.1016/j.tins.2020.03.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/12/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
Abstract
Diffusion-weighted imaging (DWI) is a neuroimaging technique that has allowed us an unprecedented look at the role that white matter microstructure may play in mental illnesses, such as psychosis. Psychosis-related illnesses, including schizophrenia, are increasingly viewed as existing along a spectrum; spectrums may be defined based on factors such as stage of illness, symptom severity, or genetic liability. This review first focuses on an overview of some of the recent findings from DWI studies. Then, it examines the ways in which DWI analyses have been extended across the broader psychosis spectrum, or spectrums, and what we have learned from such approaches.
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Affiliation(s)
- Katherine H Karlsgodt
- Departments of Psychology and Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, USA.
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Pudas J, Björnholm L, Nikkinen J, Veijola J. Cerebellar white matter in young adults with a familial risk for psychosis. Psychiatry Res Neuroimaging 2019; 287:41-48. [PMID: 30952031 DOI: 10.1016/j.pscychresns.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Juho Pudas
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
| | - Lassi Björnholm
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Juha Nikkinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Radiotherapy, Oulu University Hospital, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
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Gibson LE, Cooper S, Reeves LE, Olino TM, Ellman LM. Attentional biases and trauma status: Do psychotic-like experiences matter? PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2018; 11:300-306. [PMID: 30010376 DOI: 10.1037/tra0000380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE In a large undergraduate sample, we explored whether attentional biases were similar between individuals reporting positive psychotic-like experiences (PLEs) with a history of traumatic life events (TLEs) compared with individuals with a TLE history alone. METHOD Participants completed the Emotional Stroop Task, and self-report questionnaires of TLEs and PLEs. RESULTS Although reaction time (RT) to physical, sexual, emotional, and overall trauma words was associated with TLEs, only RT to physical abuse and overall trauma words remained significantly associated with TLE status after controlling for age, race, and neutral word RT. Contrary to our hypotheses, PLEs were not associated with RT to TLE words and there were no significant interactions between TLE history and PLEs on RT to TLE-salient stimuli. CONCLUSION Findings suggest that psychosis risk alone does not appear to exacerbate attentional biases and that TLE history may exert similar influence on attention regardless of psychosis risk. In conclusion, phenotypes associated with TLEs may be similar in populations potentially at risk for psychosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Savill M, D'Ambrosio J, Cannon TD, Loewy RL. Psychosis risk screening in different populations using the Prodromal Questionnaire: A systematic review. Early Interv Psychiatry 2018; 12:3-14. [PMID: 28782283 PMCID: PMC5812357 DOI: 10.1111/eip.12446] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/18/2017] [Accepted: 03/18/2017] [Indexed: 01/31/2023]
Abstract
AIM Diagnosing individuals at ultra high risk (UHR) for psychosis can improve early access to treatment, and a two-stage model utilizing self-report screening followed by a clinical interview can be accurate and efficient. However, it is currently unclear which screening cut-offs to adopt with different populations. METHODS A systematic review of diagnostic accuracy studies evaluating the Prodromal Questionnaire (PQ) as a preliminary screener for UHR and psychosis was conducted to examine screening effectiveness in different contexts. MedLine, PsycInfo, SCOPUS and ProQuest Dissertations and Abstracts databases were electronically searched, along with a review screen and citation search of key papers. Findings were summarized in a narrative synthesis. RESULTS In total, 14 diagnostic accuracy studies and 45 studies using the PQ as a screening tool for UHR and psychosis were included. In all settings, the 3 different versions of the PQ were all found to accurately identify UHR and full psychosis. Higher cut-off points were required in non-help-seeking samples, relative to general help-seeking populations, which in turn were higher than those needed in samples highly enriched with UHR participants. CONCLUSION The findings support the use of the PQ as a preliminary screening tool for UHR in different settings; however, higher thresholds in lower UHR-prevalence populations are necessary to minimize false positives. Including the distress criteria, rather than just number of symptoms, may improve screening effectiveness. Different thresholds may be appropriate in different contexts depending on the importance of sensitivity vs specificity. Protocol registration: CRD42016033004.
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Affiliation(s)
- Mark Savill
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Jennifer D'Ambrosio
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Tyrone D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, Connecticut
| | - Rachel L Loewy
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
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11
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Krakauer K, Ebdrup BH, Glenthøj BY, Raghava JM, Nordholm D, Randers L, Rostrup E, Nordentoft M. Patterns of white matter microstructure in individuals at ultra-high-risk for psychosis: associations to level of functioning and clinical symptoms. Psychol Med 2017; 47:2689-2707. [PMID: 28464976 DOI: 10.1017/s0033291717001210] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Individuals at ultra-high-risk (UHR) for psychosis present with emerging symptoms and decline in functioning. Previous univariate analyses have indicated widespread white matter (WM) aberrations in multiple brain regions in UHR individuals and patients with schizophrenia. Using multivariate statistics, we investigated whole brain WM microstructure and associations between WM, clinical symptoms, and level of functioning in UHR individuals. METHODS Forty-five UHR individuals and 45 matched healthy controls (HCs) underwent magnetic resonance diffusion tensor imaging (DTI) at 3 Tesla. UHR individuals were assessed with the Comprehensive Assessment of At-Risk Mental States, Scale for the Assessment of Negative Symptoms, and Social and Occupational Functioning Assessment Scale. Partial least-squares correlation analysis (PLSC) was used as statistical method. RESULTS PLSC group comparisons revealed one significant latent variable (LV) accounting for 52% of the cross-block covariance. This LV indicated a pattern of lower fractional anisotropy (FA), axial diffusivity (AD), and mode of anisotropy (MO) concomitant with higher radial diffusivity (RD) in widespread brain regions in UHR individuals compared with HCs. Within UHR individuals, PLSC revealed five significant LVs associated with symptoms and level of functioning. The first LV accounted for 31% of the cross-block covariance and indicated a pattern where higher symptom score and lower level of functioning correlated to lower FA, AD, MO, and higher RD. CONCLUSIONS UHR individuals demonstrate complex brain patterns of WM abnormalities. Despite the subtle psychopathology of UHR individuals, aberrations in WM appear associated with positive and negative symptoms as well as level of functioning.
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Affiliation(s)
- K Krakauer
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
| | - B H Ebdrup
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS,DK-2600 Glostrup,Denmark
| | - B Y Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS,DK-2600 Glostrup,Denmark
| | - J M Raghava
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS,DK-2600 Glostrup,Denmark
| | - D Nordholm
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
| | - L Randers
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
| | - E Rostrup
- Functional Imaging Unit,Clinical Physiology,Nuclear Medicine and PET,Copenhagen University Hospital Rigshospitalet,DK-2600 Glostrup,Denmark
| | - M Nordentoft
- Mental Health Centre Copenhagen,Copenhagen University Hospital,DK-2900 Hellerup,Denmark
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