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Tang Y, Li Y, Cao P, Dong Y, Xu G, Si Q, Li R, Sui Y. Striatum and globus pallidus structural abnormalities in schizophrenia: A retrospective study of the different stages of the disease. Prog Neuropsychopharmacol Biol Psychiatry 2024; 133:111022. [PMID: 38692473 DOI: 10.1016/j.pnpbp.2024.111022] [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: 11/28/2023] [Revised: 04/14/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND The basal ganglia are important structures for the release of dopamine in the limbic circuits of the midbrain, and the striatum and globus pallidus are the major nuclei of the basal ganglia, and the dysfunction of these regions has been the basis of many models that have attempted to explain the underlying mechanisms of schizophrenia symptoms. The purpose of this study was to investigate the changes in the volume of the striatum subregion and globus pallidus in three different stages of schizophrenia, and to analyze whether these volume changes were related to antipsychotic drugs and schizophrenia symptoms. METHODS In this study, we investigated the volume of the striatum and globus pallidus in patients with schizophrenia at three different stages. The study included 57 patients with first-episode schizophrenia (FSZ), 51 patients with early-stage schizophrenia (ESZ), 86 patients with chronic schizophrenia (CSZ), and 191 healthy controls (HC), all of whom underwent structured magnetic resonance imaging (MRI) scans. Covariance analysis was performed using SPSS 26.0 was used for covariance analysis to determine whether there were significant differences in striatal subregion and globus pallidus volume between groups, and stratified analysis was used to further eliminate the effect of age on brain volume. Finally, the correlation analysis between the region of interest and the cumulative dose of antipsychotic drugs and psychotic symptoms was performed. RESULTS The comparison between the different stages of the illness showed significant volume differences in the left caudate nucleus (lCAU) (F = 2.665, adjusted p = 0.048), left putamen (lPUT) (F = 12.749, adjusted p < 0.001), left pallidum (lPAL) (F = 41.111, adjusted p < 0.001), and right pallidum (rPAL) (F = 14.479, adjusted p < 0.001). Post-hoc analysis with corrections showed that the volume differences in the lCAU subregion disappeared. Further stratified analysis controlling for age showed that compared with the HC, the lPAL (t = 4.347, p < 0.001) was initially significantly enlarged in the FSZ group, the lPUT (t = 4.493, p < 0.001), rPUT (t = 2.190, p = 0.031), lPAL (t = 7.894, p < 0.001), and rPAL (t = 4.983, p < 0.001) volumes were all significantly increased in the ESZ group, and the lPUT (t = 3.314, p = 0.002), lPAL (t = 6.334, p < 0.001), and rPAL (t = 3.604, p < 0.001) subregion volumes were also significantly increased in the CSZ group. Correlation analysis showed that lPUT and bilateral globus pallidus were associated with cumulative dose of antipsychotics, but were not associated with clinical symptoms in each subregion. CONCLUSION The findings suggest that different subregions of the striatum and globus pallidus show significant volume differences at different stages of schizophrenia compared to HC. These volume differences may be strong radiographic evidence for schizophrenia. In addition, the lPAL was the only significantly different brain region observed in the FSZ group, suggesting that it may be a sensitive indicator of early brain structural changes in schizophrenia. Finally, our findings support the hypothesis that antipsychotic drugs have an effect on the volume of brain structures.
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Affiliation(s)
- Yilin Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, China
| | - Yuting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, China
| | - Peiyu Cao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, China
| | - Yingbo Dong
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, China
| | - Guoxin Xu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, China
| | - Qi Si
- Huai'an No. 3 People's Hospital, China
| | | | - Yuxiu Sui
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, China.
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Perez-Rando M, García-Martí G, Escarti MJ, Salgado-Pineda P, McKenna PJ, Pomarol-Clotet E, Grasa E, Postiguillo A, Corripio I, Nacher J. Alterations in the volume and shape of the basal ganglia and thalamus in schizophrenia with auditory hallucinations. Prog Neuropsychopharmacol Biol Psychiatry 2024; 131:110960. [PMID: 38325744 DOI: 10.1016/j.pnpbp.2024.110960] [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: 11/03/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/09/2024]
Abstract
Different lines of evidence indicate that the structure and physiology of the basal ganglia and the thalamus is disturbed in schizophrenia. However, it is unknown whether the volume and shape of these subcortical structures are affected in schizophrenia with auditory hallucinations (AH), a core positive symptom of the disorder. We took structural MRI from 63 patients with schizophrenia, including 36 patients with AH and 27 patients who had never experienced AH (NAH), and 51 matched healthy controls. We extracted volumes for the left and right thalamus, globus pallidus, putamen, caudate and nucleus accumbens. Shape analysis was also carried out. When comparing to controls, the volume of the right globus pallidus, thalamus, and putamen, was only affected in AH patients. The volume of the left putamen was also increased in individuals with AH, whereas the left globus pallidus was affected in both groups of patients. The shapes of right and left putamen and thalamus were also affected in both groups. The shape of the left globus pallidus was only altered in patients lacking AH, both in comparison to controls and to cases with AH. Lastly, the general PANSS subscale was correlated with the volume of the right thalamus, and the right and left putamen, in patients with AH. We have found volume and shape alterations of many basal ganglia and thalamus in patients with and without AH, suggesting in some cases a possible relationship between this positive symptom and these morphometric alterations.
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Affiliation(s)
- Marta Perez-Rando
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain.
| | - Gracián García-Martí
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Quironsalud Hospital, Valencia, Spain
| | - Maria J Escarti
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain; Servicio de Psiquiatría, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Pilar Salgado-Pineda
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Spain
| | - Peter J McKenna
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Spain
| | - Edith Pomarol-Clotet
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Spain
| | - Eva Grasa
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Mental Health, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí, Barcelona, Spain
| | - Alba Postiguillo
- Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain
| | - Iluminada Corripio
- CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Mental Health and Psychiatry Department, Vic Hospital Consortium, Francesc Pla, Vic, Spain
| | - Juan Nacher
- Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain; CIBERSAM, ISCIII Spanish National Network for Research in Mental Health, Madrid, Spain; Biomedical Research Institute of Valencia (INCLIVA), Valencia, Spain.
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Ito S, Ohi K, Yasuda Y, Fujimoto M, Yamamori H, Matsumoto J, Fukumoto K, Kodaka F, Hasegawa N, Ishimaru K, Miura K, Yasui-Furukori N, Hashimoto R. Better adherence to guidelines among psychiatrists providing pharmacological therapy is associated with longer work hours in patients with schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:78. [PMID: 37935686 PMCID: PMC10630392 DOI: 10.1038/s41537-023-00407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023]
Abstract
Schizophrenia is a psychiatric disorder that is associated with various social dysfunctions, including shorter work hours. To measure the degree to which psychiatrists adhere to guidelines for pharmacological therapy of schizophrenia, we recently developed the individual fitness score (IFS) for adherence among psychiatrists in each patient. However, it remains unclear whether better adherence among psychiatrists is associated with higher patients' social functional outcomes, such as work hours. In this study, we examined the relationship between adherence to guidelines among psychiatrists and work hours in patients with schizophrenia. To evaluate the association between adherence to guidelines for pharmacological therapy among psychiatrists for treating schizophrenia and work hours, we used the IFS and social activity assessment, respectively, in 286 patients with schizophrenia. The correlation between IFS values and work hours was investigated in the patients. The adherence among psychiatrists to guidelines was significantly and positively correlated with work hours in patients with schizophrenia (rho = 0.18, p = 2.15 × 10-3). When we divided the patients into treatment-resistant schizophrenia (TRS) and nontreatment-resistant schizophrenia (non-TRS) groups, most patients with TRS (n = 40) had shorter work hours (0-15 h/week). Even after excluding patients with TRS, the positive correlation between adherence to guidelines among psychiatrists and work hours in patients with non-TRS (n = 246) was still significant (rho = 0.19, p = 3.32 × 10-3). We found that work hours were longer in patients who received the guideline-recommended pharmacotherapy. Our findings suggest that widespread education and training for psychiatrists may be necessary to improve functional outcomes in patients with schizophrenia.
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Affiliation(s)
- Satsuki Ito
- Department of Developmental and Clinical Psychology, The Division of Human Developmental Sciences, Graduate School of Humanity and Sciences, Ochanomizu University, Tokyo, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Life Grow Brilliant Mental Clinic, Medical Corporation Foster, Osaka, Japan
| | - Michiko Fujimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Hidenaga Yamamori
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Osaka University, Graduate School of Medicine, Osaka, Japan
- Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - Junya Matsumoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kentaro Fukumoto
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Fumitoshi Kodaka
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Naomi Hasegawa
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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Matsumoto J, Fukunaga M, Miura K, Nemoto K, Okada N, Hashimoto N, Morita K, Koshiyama D, Ohi K, Takahashi T, Koeda M, Yamamori H, Fujimoto M, Yasuda Y, Ito S, Yamazaki R, Hasegawa N, Narita H, Yokoyama S, Mishima R, Miyata J, Kobayashi Y, Sasabayashi D, Harada K, Yamamoto M, Hirano Y, Itahashi T, Nakataki M, Hashimoto RI, Tha KK, Koike S, Matsubara T, Okada G, Yoshimura R, Abe O, van Erp TGM, Turner JA, Jahanshad N, Thompson PM, Onitsuka T, Watanabe Y, Matsuo K, Yamasue H, Okamoto Y, Suzuki M, Ozaki N, Kasai K, Hashimoto R. Cerebral cortical structural alteration patterns across four major psychiatric disorders in 5549 individuals. Mol Psychiatry 2023; 28:4915-4923. [PMID: 37596354 PMCID: PMC10914601 DOI: 10.1038/s41380-023-02224-7] [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: 12/12/2022] [Revised: 07/30/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023]
Abstract
According to the operational diagnostic criteria, psychiatric disorders such as schizophrenia (SZ), bipolar disorder (BD), major depressive disorder (MDD), and autism spectrum disorder (ASD) are classified based on symptoms. While its cluster of symptoms defines each of these psychiatric disorders, there is also an overlap in symptoms between the disorders. We hypothesized that there are also similarities and differences in cortical structural neuroimaging features among these psychiatric disorders. T1-weighted magnetic resonance imaging scans were performed for 5,549 subjects recruited from 14 sites. Effect sizes were determined using a linear regression model within each protocol, and these effect sizes were meta-analyzed. The similarity of the differences in cortical thickness and surface area of each disorder group was calculated using cosine similarity, which was calculated from the effect sizes of each cortical regions. The thinnest cortex was found in SZ, followed by BD and MDD. The cosine similarity values between disorders were 0.943 for SZ and BD, 0.959 for SZ and MDD, and 0.943 for BD and MDD, which indicated that a common pattern of cortical thickness alterations was found among SZ, BD, and MDD. Additionally, a generally smaller cortical surface area was found in SZ and MDD than in BD, and the effect was larger in SZ. The cosine similarity values between disorders were 0.945 for SZ and MDD, 0.867 for SZ and ASD, and 0.811 for MDD and ASD, which indicated a common pattern of cortical surface area alterations among SZ, MDD, and ASD. Patterns of alterations in cortical thickness and surface area were revealed in the four major psychiatric disorders. To our knowledge, this is the first report of a cross-disorder analysis conducted on four major psychiatric disorders. Cross-disorder brain imaging research can help to advance our understanding of the pathogenesis of psychiatric disorders and common symptoms.
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Affiliation(s)
- Junya Matsumoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
| | - Masaki Fukunaga
- Section of Brain Function Information, National Institute for Physiological Sciences, Okazaki, 444-8585, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, 305-8575, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, 113-0033, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 060-8638, Japan
| | - Kentaro Morita
- Department of Rehabilitation, University of Tokyo Hospital, Tokyo, 113-8655, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan
- Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, 930-0194, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, 930-0194, Japan
| | - Michihiko Koeda
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8602, Japan
| | - Hidenaga Yamamori
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Japan Community Health Care Organization Osaka Hospital, Osaka, 553-0003, Japan
| | - Michiko Fujimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
- Life Grow Brilliant Mental Clinic, Medical Corporation Foster, Osaka, 530-0013, Japan
| | - Satsuki Ito
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
- Department of Developmental and Clinical Psychology, The Division of Human Developmental Sciences, Graduate School of Humanity and Sciences, Ochanomizu University, Tokyo, 112-8610, Japan
| | - Ryuichi Yamazaki
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, 105-8461, Japan
| | - Naomi Hasegawa
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan
| | - Hisashi Narita
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 060-8638, Japan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Ryo Mishima
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yuko Kobayashi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, 930-0194, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, 930-0194, Japan
| | - Kenichiro Harada
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, 755-8505, Japan
| | - Maeri Yamamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Yoji Hirano
- Department of Psychiatry, Division of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Institute of Industrial Science, The University of Tokyo, Tokyo, 153-8505, Japan
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, 157-8577, Japan
| | - Masahito Nakataki
- Department of Psychiatry, Tokushima University Hospital, Tokushima, 770-8503, Japan
| | - Ryu-Ichiro Hashimoto
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, 157-8577, Japan
- Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, Hachioji, 192-0397, Japan
| | - Khin K Tha
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, 060-8638, Japan
| | - Shinsuke Koike
- The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, 113-0033, Japan
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, 153-8902, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, 153-8902, Japan
| | - Toshio Matsubara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, 755-8505, Japan
| | - Go Okada
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Theo G M van Erp
- Clinical Translatational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, 92697, USA
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, 92697, USA
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, the Ohio State University, Columbus, OH, 43210, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90292, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90292, USA
| | - Toshiaki Onitsuka
- National Hospital Organization Sakakibara Hospital, Tsu, 514-1292, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Otsu, 520-2192, Japan
| | - Koji Matsuo
- Department of Psychiatry, Faculty of Medicine, Saitama Medical University, Saitama, 350-0495, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, 930-0194, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, 930-0194, Japan
| | - Norio Ozaki
- Pathophysiology of Mental Disorders, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, 113-0033, Japan
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, 153-8902, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, 187-8553, Japan.
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan.
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