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Shi H, Zhang Y, Yang Y, Zhang H, Li W, Zhong Z, Lv L. Serum S100B protein and white matter changes in schizophrenia before and after medication. Brain Res Bull 2024; 210:110927. [PMID: 38485004 DOI: 10.1016/j.brainresbull.2024.110927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
Schizophrenia patients have abnormalities in white matter (WM) integrity in brain regions. S100B has been shown to be a marker protein for glial cells. The atypical antipsychotics have neuroprotective effects on the brain. It is not clear whether antipsychotics can induce S100B changes and improve symptoms by protecting oligodendrocytes. To investigate WM and S100B changes and associations and determine the effect of quetiapine on WM and S100B in schizophrenia patients, we determined serum S100B levels with solid phase immunochromatography and fractional anisotropy(FA)values of 36 patients and 40 healthy controls. Patients exhibited significantly higher serum concentrations of S100B and decreased FA values in left postcentral,right superior frontal,right thalamus, and left inferior occipital gyrus, while higher in right temporal cortex WM compared with healthy controls. Following treatment with quetiapine, patients had decreased S100B and higher FA values in right cerebellum,right superior frontal,right thalamus, and left parietal cortex,and decreased FA values in right temporal cortex WM compared with pre-treatment values. Furthermore, S100B were negatively correlated with PANSS positive scores and positively correlated with FA values in the left postcentral cortex. In addition,the percentage change in FA values in the right temporal cortex was positively correlated with the percentage change in the S100B, percentage reduction in PANSS scores, and percentage reduction in PANSS-positive scores. Our findings demonstrated abnormalities in S100B and WM microstructure in patients with schizophrenia. These abnormalities may be partly reversed by quetiapine treatment.
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Affiliation(s)
- Han Shi
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Yan Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Haisan Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Wenqiang Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China
| | - Zhaoxi Zhong
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China.
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China.
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Podwalski P, Tyburski E, Szczygieł K, Waszczuk K, Rek-Owodziń K, Mak M, Plichta P, Bielecki M, Rudkowski K, Kucharska-Mazur J, Andrusewicz W, Misiak B, Szulc A, Michalczyk A, Michałowska S, Sagan L, Samochowiec J. White Matter Integrity of the Corpus Callosum and Psychopathological Dimensions in Deficit and Non-Deficit Schizophrenia Patients. J Clin Med 2021; 10:jcm10112225. [PMID: 34063845 PMCID: PMC8196621 DOI: 10.3390/jcm10112225] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/04/2021] [Accepted: 05/19/2021] [Indexed: 12/19/2022] Open
Abstract
Deficit syndrome (DS) is a subtype of schizophrenia characterized by primary persistent negative symptoms. The corpus callosum (CC) appears to be related to psychopathology in schizophrenia. This study assessed white matter integrity in the CC using diffusion tensor imaging (DTI) in deficit and non-deficit schizophrenia (NDS) patients. We also investigated the psychopathological dimensions of schizophrenia and their relationship to CC integrity. Fifteen DS patients, 40 NDS patients, and 30 healthy controls (HC) underwent psychiatric evaluation and neuroimaging. We divided the CC into five regions and assessed their fractional anisotropy (FA) and mean diffusivity (MD). Psychopathology was assessed with the Positive and Negative Syndrome Scale. DS patients had lower FA than NDS patients and HC, and higher MD in Region 5 of the CC than did HC. NDS patients had higher MD in Region 4 of the CC. The patient groups differed in terms of negative symptoms. After differentiating clinical groups and HC, no significant correlations were observed between DTI measures and psychopathological symptoms. Our results suggest that DS and NDS are characterized by minor impairments of the posterior CC. We confirmed that DS patients have greater negative psychopathology than NDS patients. Our results are preliminary, and further studies are needed.
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Affiliation(s)
- Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
- Correspondence:
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 61-719 Poznan, Poland;
| | - Krzysztof Szczygieł
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Maksymilian Bielecki
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Wojciech Andrusewicz
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Agata Szulc
- Department of Psychiatry, Faculty of Health Sciences, Medical University in Warsaw, 05-802 Warsaw, Poland;
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Sylwia Michałowska
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, 71-004 Szczecin, Poland;
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
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Kyriakopoulos M, Bargiotas T, Barker GJ, Frangou S. Diffusion tensor imaging in schizophrenia. Eur Psychiatry 2020; 23:255-73. [DOI: 10.1016/j.eurpsy.2007.12.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 11/19/2007] [Accepted: 12/03/2007] [Indexed: 12/12/2022] Open
Abstract
AbstractDiffusion tensor imaging (DTI) is a magnetic resonance imaging technique that is increasingly being used for the non-invasive evaluation of brain white matter abnormalities. In this review, we discuss the basic principles of DTI, its roots and the contribution of European centres in its development, and we review the findings from DTI studies in schizophrenia. We searched EMBASE, PubMed, PsychInfo, and Medline from February 1998 to December 2006 using as keywords ‘schizophrenia’, ‘diffusion’, ‘tensor’, and ‘DTI’. Forty studies fulfilling the inclusion criteria of this review were included and systematically reviewed. White matter abnormalities in many diverse brain regions were identified in schizophrenia. Although the findings are not completely consistent, frontal and temporal white matter seems to be more commonly affected. Limitations and future directions of this method are discussed.
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Jo YT, Lee J, Joo SW, Kim H, Shon SH, Yoon W, Hong Y. Additive Burden of Abnormal Diffusivity in the Brain with Schizophrenia: A Diffusion Tensor Imaging Study with Public Neuroimaging Data. Psychiatry Investig 2020; 17:341-349. [PMID: 32252513 PMCID: PMC7176571 DOI: 10.30773/pi.2019.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/20/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Diffusion tensor imaging has been extensively applied to schizophrenia research. In this study, we counted the number of abnormal brain regions with altered diffusion measures in patients with schizophrenia to enumerate the burden of abnormal diffusivity in the brain. METHODS The public neuroimaging data of the COBRE project from SchizConnect were used for the study. The studied dataset consisted of data from 57 patients with schizophrenia and 71 healthy participants. FreeSurfer and FSL were applied for image processing and analysis. After verifying 161 regions of interest (ROIs), mean diffusion measures in every single ROI in all study participants were measured and normalized into Z-scores. Each ROI was then defined as normal or abnormal on the basis of a cutoff absolute Z-score of 1.96. The number of abnormal ROIs was obtained by each diffusion measure. RESULTS The numbers of ROIs with increased radial diffusivity and increased trace were significantly larger in the patient group than in healthy participants. CONCLUSION Thus, the patient group showed a significant increase in abnormal ROIs, strongly indicating that schizophrenia is not caused by the pathology of a single brain region, but is instead attributable to the additive burden of structural alterations within multiple brain regions.
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Affiliation(s)
- Young Tak Jo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungsun Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Woo Joo
- Republic of Korea Navy, Donghae, Republic of Korea
| | - Harin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Hyun Shon
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woon Yoon
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Youjin Hong
- Department of Psychiatry, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
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Predicting response to electroconvulsive therapy combined with antipsychotics in schizophrenia using multi-parametric magnetic resonance imaging. Schizophr Res 2020; 216:262-271. [PMID: 31826827 DOI: 10.1016/j.schres.2019.11.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/04/2019] [Accepted: 11/25/2019] [Indexed: 12/23/2022]
Abstract
Electroconvulsive therapy (ECT) has been shown to be effective in schizophrenia, particularly when rapid symptom reduction is needed or in cases of resistance to drug treatment. However, there are no markers available to predict response to ECT. Here, we examine whether multi-parametric magnetic resonance imaging (MRI)-based radiomic features can predict response to ECT for individual patients. A total of 57 treatment-resistant schizophrenia patients, or schizophrenia patients with an acute episode or suicide attempts were randomly divided into primary (42 patients) and test (15 patients) cohorts. We collected T1-weighted structural MRI and diffusion MRI for 57 patients before receiving ECT and extracted 600 radiomic features for feature selection and prediction. To predict a continuous improvement in symptoms (ΔPANSS), the prediction process was performed with a support vector regression model based on a leave-one-out cross-validation framework in primary cohort and was tested in test cohort. The multi-parametric MRI-based radiomic model, including four structural MRI feature from left inferior frontal gyrus, right insula, left middle temporal gyrus and right superior temporal gyrus respectively and six diffusion MRI features from tracts connecting frontal or temporal gyrus possessed a low root mean square error of 15.183 in primary cohort and 14.980 in test cohort. The Pearson's correlation coefficients between predicted and actual values were 0.671 and 0.777 respectively. These results demonstrate that multi-parametric MRI-based radiomic features may predict response to ECT for individual patients. Such features could serve as prognostic neuroimaging biomarkers that provide a critical step toward individualized treatment response prediction in schizophrenia.
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Vergara VM, Damaraju E, Turner JA, Pearlson G, Belger A, Mathalon DH, Potkin SG, Preda A, Vaidya JG, van Erp TGM, McEwen S, Calhoun VD. Altered Domain Functional Network Connectivity Strength and Randomness in Schizophrenia. Front Psychiatry 2019; 10:499. [PMID: 31396111 PMCID: PMC6664085 DOI: 10.3389/fpsyt.2019.00499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/24/2019] [Indexed: 01/12/2023] Open
Abstract
Functional connectivity is one of the most widely used tools for investigating brain changes due to schizophrenia. Previous studies have identified abnormal functional connectivity in schizophrenia patients at the resting state brain network level. This study tests the existence of functional connectivity effects at whole brain and domain levels. Domain level refers to the integration of data from several brain networks grouped by their functional relationship. Data integration provides more consistent and accurate information compared to an individual brain network. This work considers two domain level measures: functional connectivity strength and randomness. The first measure is simply an average of connectivities within the domain. The second measure assesses the unpredictability and lack of pattern of functional connectivity within the domain. Domains with less random connectivity have higher chance of exhibiting a biologically meaningful connectivity pattern. Consistent with prior observations, individuals with schizophrenia showed aberrant domain connectivity strength between subcortical, cerebellar, and sensorial brain areas. Compared to healthy volunteers, functional connectivity between cognitive and default mode domains showed less randomness, while connectivity between default mode-sensorial areas showed more randomness in schizophrenia patients. These differences in connectivity patterns suggest deleterious rewiring trade-offs among important brain networks.
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Affiliation(s)
- Victor M Vergara
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, United States.,2The Mind Research Network, Albuquerque, NM, United States.,Psychology Department Georgia State University, Atlanta, GA, United States
| | - Eswar Damaraju
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - Jessica A Turner
- Psychology Department Georgia State University, Atlanta, GA, United States.,Neuroscience Institute, Georgia State University, Atlanta, GA, United States
| | - Godfrey Pearlson
- Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT, United States.,Olin Neuropsychiatry Research Center, Institute of Living, HHC, Hartford, CT, United States
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Daniel H Mathalon
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
| | - Steven G Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Jatin G Vaidya
- Department of Psychiatry, University of Iowa, IA, United States
| | - Theo G M van Erp
- Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States.,Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Sarah McEwen
- Pacific Neuroscience Institute, Santa Monica, CA, United States
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, United States.,2The Mind Research Network, Albuquerque, NM, United States.,Psychology Department Georgia State University, Atlanta, GA, United States.,Neuroscience Institute, Georgia State University, Atlanta, GA, United States.,Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT, United States
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Hummer TA, Francis MM, Vohs JL, Liffick E, Mehdiyoun NF, Breier A. Characterization of white matter abnormalities in early-stage schizophrenia. Early Interv Psychiatry 2018; 12:660-668. [PMID: 27621217 DOI: 10.1111/eip.12359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/27/2016] [Accepted: 07/14/2016] [Indexed: 01/04/2023]
Abstract
AIM White matter abnormalities have been reported in schizophrenia and may indicate altered cortical network integrity and structural connectivity, which have been hypothesized as key pathophysiological components of this illness. In this study, we aimed to further characterize the nature and progression of white matter alterations during the early stages of the disorder. METHODS We employed diffusion tensor imaging (DTI) approaches to investigate fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) in 40 patients with schizophrenia and related psychotic disorders (aged 18-30 years) who were within 5 years of illness, along with an age-, sex- and race-matched sample of 21 healthy controls. Relationships with illness duration, lifetime antipsychotic medication exposure and symptom levels were examined. RESULTS Patients had lower FA and higher RD than controls in numerous white matter tracts, including the corpus callosum (CC) and the superior longitudinal fasciculus. Illness duration was associated with lower FA and higher RD, most prominently in the CC. No group differences or relationships to illness duration were detected with AD, and no relationships between any DTI measurements and lifetime antipsychotic medication use were found. CONCLUSIONS This investigation provides evidence of widespread disruptions to structural connectivity in the early stages of schizophrenia. The relationship to illness duration, coupled with an absence of relationships to AD or antipsychotic drug exposure, provides evidence of a progressive disease process, although prospective assessments with repeated DTI measurements are needed to fully characterize the trajectory of white matter abnormalities in this illness.
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Affiliation(s)
- Tom A Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael M Francis
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jenifer L Vohs
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Emily Liffick
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nicole F Mehdiyoun
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Hwang J, Legarreta M, Bueler CE, DiMuzio J, McGlade E, Lyoo IK, Yurgelun-Todd D. Increased efficiency of brain connectivity networks in veterans with suicide attempts. Neuroimage Clin 2018; 20:318-326. [PMID: 30105203 PMCID: PMC6086217 DOI: 10.1016/j.nicl.2018.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/31/2018] [Accepted: 04/21/2018] [Indexed: 01/09/2023]
Abstract
Background Suicide is a public health concern for United States veterans and civilians. Prior research has shown neurobiological factors in suicide. However, studies of neuroimaging correlates of suicide risk have been limited. This study applied complex weighted network analyses to characterize the neural connectivity in white matter in veterans with suicide behavior. Methods Twenty-eight veterans without suicide behavior (NS), 29 with a history of suicidal ideation only (SI), and 23 with prior suicide attempt (SA) completed diffusion tensor brain imaging, the Columbia Suicide Severity Rating Scale and Barratt Impulsiveness Scale (BIS). Structural connectivity networks among 82 parcellated brain regions were produced using whole-brain tractography. Global and nodal metrics of network topology have been calculated. Results SA had shorter characteristic path length and greater global efficiency and mean weighted degree of global network metrics (p < 0.024). SA had more hub nodes than NS and SI. The left posterior cingulate cortex (PCC) showed significantly greater weighted degree in SA relative to others (p < 0.0003). Nonplanning subscale of BIS correlated with the weighted degrees of the left PCC within SA. In rich club connectivity, SA had higher local connections than others (p = 0.001). Conclusion Veterans with prior suicide attempt had altered connectivity networks characteristics in the white matter. These findings may be distinctive neurobiological markers for individuals with suicide attempt. Strong connectivity in the left PCC may be implicated in impulsivity in veterans with suicide attempt.
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Affiliation(s)
- Jaeuk Hwang
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, Soonchunhyang University Hospital, Seoul, South Korea
| | - Margaret Legarreta
- MIRECC, Department of Veterans Affairs, Salt Lake City, UT, United States
| | | | - Jennifer DiMuzio
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States
| | - Erin McGlade
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; MIRECC, Department of Veterans Affairs, Salt Lake City, UT, United States
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - Deborah Yurgelun-Todd
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; MIRECC, Department of Veterans Affairs, Salt Lake City, UT, United States.
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9
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White matter microstructure predicts cognitive training-induced improvements in attention and executive functioning in schizophrenia. Schizophr Res 2018; 193:276-283. [PMID: 28689758 PMCID: PMC5999406 DOI: 10.1016/j.schres.2017.06.062] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 12/11/2022]
Abstract
We examined the relationship between white matter microstructure in schizophrenia using diffusion tensor imaging (DTI) and cognitive improvements induced by 70h (~16weeks) of cognitive training. We measured anatomical connectivity in 48 patients with schizophrenia (SZ) and 28 healthy control participants (HC) at baseline, and then examined the relationship between anatomical connectivity at baseline and training-induced cognitive gains in 30 SZ who performed diffusion imaging after completing 70h of training. Compared with healthy control participants, individuals with schizophrenia showed reduced white matter integrity at baseline, as indexed by fractional anisotropy metrics, in bilateral posterior corona radiata, bilateral retrolenticular internal capsules, bilateral posterior thalamic radiation, left anterior corona radiata, left superior longitudinal fasciculus, left sagittal stratum, right cerebral peduncle and the genu and splenium of the corpus callosum. After training, schizophrenia participants showed significant gains in attention/vigilance, speed of processing, verbal learning, visual learning and executive functioning. White matter integrity within the right fronto-occipital fasciculus predicted training-induced improvements in attention/vigilance, while white matter integrity within the right corticospinal tract and bilateral medial lemnisci predicted cognitive training-induced improvements in executive functioning, areas that did not show white matter tract deficits at baseline. These findings suggest that preserved white matter integrity connecting long-range prefrontal-thalamic-sensorimotor areas may be an important determinant for training-induced neurocognitive plasticity.
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Michielse S, Gronenschild E, Domen P, van Os J, Marcelis M. The details of structural disconnectivity in psychotic disorder: A family-based study of non-FA diffusion weighted imaging measures. Brain Res 2017; 1671:121-130. [PMID: 28709907 DOI: 10.1016/j.brainres.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/01/2017] [Accepted: 07/04/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies in psychotic disorder have shown reduced FA, often interpreted as disturbed white matter integrity. The observed 'dysintegrity' may be of multifactorial origin, as changes in FA are thought to reflect a combination of changes in myelination, fiber organization and number of axons. Examining the structural substrate of the diffusion tensor in individuals with (risk for) psychotic disorder may provide better understanding of the underlying structural changes. METHODS DTI scans were acquired from 85 patients with psychotic disorder, 93 siblings of patients with psychotic disorder and 80 controls. Cross-sectional group comparisons were performed using Tract-Based Spatial Statistics (TBSS) on six DTI measures: axial diffusivity (AXD), radial diffusivity (RD), mean diffusivity (MD), and the case linear (CL), case planar (CP) and case spherical (CS) tensor shape measures. RESULTS AXD did not differ between the groups. RD and CS values were significantly increased in patients compared to controls and siblings, with no significant differences between the latter two groups. MD was higher in patients compared to controls (but not siblings), with no difference between siblings and controls. CL was smaller in patients than in siblings and controls, and CP was smaller in both patients and siblings as compared to controls. CONCLUSION The differences between individuals with psychotic disorder and healthy controls, derived from detailed diffusion data analyses, suggest less fiber orientation and increased free water movement in the patients. There was some evidence for association with familial risk expressed by decreased fiber orientation.
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Affiliation(s)
- Stijn Michielse
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | - Ed Gronenschild
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Patrick Domen
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
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Zhao X, Sui Y, Yao J, Lv Y, Zhang X, Jin Z, Chen L, Zhang X. Reduced white matter integrity and facial emotion perception in never-medicated patients with first-episode schizophrenia: A diffusion tensor imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2017; 77:57-64. [PMID: 28385492 DOI: 10.1016/j.pnpbp.2017.03.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/08/2017] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Facial emotion perception is impaired in schizophrenia. Although the pathology of schizophrenia is thought to involve abnormality in white matter (WM), few studies have examined the correlation between facial emotion perception and WM abnormalities in never-medicated patients with first-episode schizophrenia. The present study tested associations between facial emotion perception and WM integrity in order to investigate the neural basis of impaired facial emotion perception in schizophrenia. METHODS Sixty-three schizophrenic patients and thirty control subjects underwent facial emotion categorization (FEC). The FEC data was inserted into a logistic function model with subsequent analysis by independent-samples T test and the shift point and slope as outcome measurements. Severity of symptoms was measured using a five-factor model of the Positive and Negative Syndrome Scale (PANSS). Voxelwise group comparison of WM fractional anisotropy (FA) was operated using tract-based spatial statistics (TBSS). The correlation between impaired facial emotion perception and FA reduction was examined in patients using simple regression analysis within brain areas that showed a significant FA reduction in patients compared with controls. The same correlation analysis was also performed for control subjects in the whole brain. RESULTS The patients with schizophrenia reported a higher shift point and a steeper slope than control subjects in FEC. The patients showed a significant FA reduction in left deep WM in the parietal, temporal and occipital lobes, a small portion of the corpus callosum (CC), and the corona radiata. In voxelwise correlation analysis, we found that facial emotion perception significantly correlated with reduced FA in various WM regions, including left forceps major (FM), inferior longitudinal fasciculus (ILF), inferior fronto-occipital fasciculus (IFOF), Left splenium of CC, and left ILF. The correlation analyses in healthy controls revealed no significant correlation of FA with FEC task. CONCLUSIONS These results showed disrupted WM integrity in these regions constitutes a potential neural basis for the facial emotion perception impairments in schizophrenia.
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Affiliation(s)
- Xiaoxin Zhao
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yuxiu Sui
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China..
| | - Jingjing Yao
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yiding Lv
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Xinyue Zhang
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Zhuma Jin
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Lijun Chen
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Xiangrong Zhang
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
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12
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Molina V, Lubeiro A, Soto O, Rodriguez M, Álvarez A, Hernández R, de Luis-García R. Alterations in prefrontal connectivity in schizophrenia assessed using diffusion magnetic resonance imaging. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:107-115. [PMID: 28288855 DOI: 10.1016/j.pnpbp.2017.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Spatial and biological characteristics of structural frontal disconnectivity in schizophrenia remain incompletely understood. Simultaneous streamline count (SC) and fractional anisotropy (FA) analyses may yield relevant complementary information to this end. METHODS Using 3T diffusion magnetic resonance imaging both SC and FA were calculated for the tracts linking lateral and medial subregions of prefrontal cortex (PFC) to cingulate, hippocampus, caudate and thalamus in 27 schizophrenia patients (14 first-episodes) and 27 controls. Relationships of these parameters with cognition, symptoms, treatment doses and illness duration were assessed where significant between-groups differences were detected. RESULTS Patients showed lower SC and FA in the tracts linking lateral and medial PFC to thalamus (likely corresponding to anterior thalamic peduncle) and lower FA in those linking PFC to caudate (likely through internal capsule), right caudal anterior cingulate and left hippocampus (likely corresponding to hippocampal-prefrontal pathway). Moreover, patients showed greater SC values for the tracts linking medial PFC and left caudal anterior cingulate. SC and FA values for the tracts linking PFC and caudal anterior cingulate were positively related to motor speed, executive function, problem solving and completed categories in WCST. FA for the tract linking right lateral PFC and caudate was directly related to positive symptoms and FA for the tract linking left medial PFC and left thalamus was inversely related to negative symptoms. Treatment doses were not associated with SC or FA values in any tract. Illness duration was negatively associated with SC and FA in the tracts linking PFC and subcortical areas. CONCLUSIONS Widespread alterations in frontal structural connectivity of PFC can be found in schizophrenia, and are related to cognition, symptoms and illness duration.
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Affiliation(s)
- Vicente Molina
- Psychiatry Department, School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005 Valladolid, Spain; Psychiatry Service, Clinical Hospital of Valladolid, Ramón y Cajal, 3, 47003 Valladolid, Spain; Neurosciences Institute of Castilla y León (INCYL), Pintor Fernando Gallego, 1, 37007, University of Salamanca, Spain; CIBERSAM (Biomedical Research Network in Mental Health), Instituto de Salud Carlos III, Spain.
| | - Alba Lubeiro
- Psychiatry Department, School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005 Valladolid, Spain
| | - Oscar Soto
- Psychiatry Department, School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005 Valladolid, Spain
| | - Margarita Rodriguez
- Radiology Service, Clinical Hospital of Valladolid, Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Aldara Álvarez
- Psychiatry Service, Clinical Hospital of Valladolid, Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Rebeca Hernández
- Psychiatry Service, Clinical Hospital of Valladolid, Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Rodrigo de Luis-García
- Imaging Processing Laboratory, University of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain
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13
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Ganella EP, Bartholomeusz CF, Seguin C, Whittle S, Bousman C, Phassouliotis C, Everall I, Pantelis C, Zalesky A. Functional brain networks in treatment-resistant schizophrenia. Schizophr Res 2017; 184:73-81. [PMID: 28011131 DOI: 10.1016/j.schres.2016.12.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/09/2016] [Accepted: 12/09/2016] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Up to 20% of individuals with schizophrenia show minimal or no response to medication and are considered to have 'treatment-resistant' schizophrenia (TRS). Unlike early and established schizophrenia, few studies have investigated resting-state functional connectivity (rs-FC) in TRS. Here, we test for disruptions in FC and altered efficiency of functional brain networks in a well-characterized cohort of TRS patients. METHODS Resting-state functional magnetic resonance imaging was used to investigate functional brain networks in 42 TRS participants prescribed clozapine (30 males, mean age=41.3(10)) and 42 healthy controls (24 males, mean age=38.4(10)). Graph analysis was used to characterize between-group differences in local and global efficiency of functional brain network organization as well as the strength of FC. RESULTS Global brain FC was reduced in TRS patients (p=0.0001). Relative to controls, 3.4% of all functional connections showed reduced strength in TRS (p<0.001), predominantly involving fronto-temporal, fronto-occipital and temporo-occipital connections. Global efficiency was reduced in TRS (p=0.0015), whereas local efficiency was increased (p=0.0042). CONCLUSIONS TRS is associated with widespread reductions in rs-FC and altered network topology. Increased local functional network efficiency coupled with decreased global efficiency suggests that hub-to-hub connections are preferentially affected in TRS. These findings further our understanding of the neurobiological impairments in TRS.
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Affiliation(s)
- Eleni P Ganella
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia; The Cooperative Research Centre (CRC) for Mental Health, Victoria, Australia; North Western Mental Health, Melbourne Health, Parkville, Victoria, Australia.
| | - Cali F Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Caio Seguin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; The Cooperative Research Centre (CRC) for Mental Health, Victoria, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, Victoria, Australia; Swinburne University of Technology, Centre for Human Psychopharmacology, Hawthorne, Victoria, Australia; The University of Melbourne, Department of General Practice, Parkville, Victoria, Australia
| | - Christina Phassouliotis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Ian Everall
- The Cooperative Research Centre (CRC) for Mental Health, Victoria, Australia; North Western Mental Health, Melbourne Health, Parkville, Victoria, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, Victoria, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, Victoria, Australia; Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; The Cooperative Research Centre (CRC) for Mental Health, Victoria, Australia; North Western Mental Health, Melbourne Health, Parkville, Victoria, Australia; Florey Institute for Neurosciences and Mental Health, Parkville, Victoria, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Carlton South, Victoria, Australia; Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia; Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia
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14
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Klauser P, Baker ST, Cropley VL, Bousman C, Fornito A, Cocchi L, Fullerton JM, Rasser P, Schall U, Henskens F, Michie PT, Loughland C, Catts SV, Mowry B, Weickert TW, Shannon Weickert C, Carr V, Lenroot R, Pantelis C, Zalesky A. White Matter Disruptions in Schizophrenia Are Spatially Widespread and Topologically Converge on Brain Network Hubs. Schizophr Bull 2017; 43:425-435. [PMID: 27535082 PMCID: PMC5605265 DOI: 10.1093/schbul/sbw100] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
White matter abnormalities associated with schizophrenia have been widely reported, although the consistency of findings across studies is moderate. In this study, neuroimaging was used to investigate white matter pathology and its impact on whole-brain white matter connectivity in one of the largest samples of patients with schizophrenia. Fractional anisotropy (FA) and mean diffusivity (MD) were compared between patients with schizophrenia or schizoaffective disorder (n = 326) and age-matched healthy controls (n = 197). Between-group differences in FA and MD were assessed using voxel-based analysis and permutation testing. Automated whole-brain white matter fiber tracking and the network-based statistic were used to characterize the impact of white matter pathology on the connectome and its rich club. Significant reductions in FA associated with schizophrenia were widespread, encompassing more than 40% (234ml) of cerebral white matter by volume and involving all cerebral lobes. Significant increases in MD were also widespread and distributed similarly. The corpus callosum, cingulum, and thalamic radiations exhibited the most extensive pathology according to effect size. More than 50% of cortico-cortical and cortico-subcortical white matter fiber bundles comprising the connectome were disrupted in schizophrenia. Connections between hub regions comprising the rich club were disproportionately affected. Pathology did not differ between patients with schizophrenia and schizoaffective disorder and was not mediated by medication. In conclusion, although connectivity between cerebral hubs is most extensively disturbed in schizophrenia, white matter pathology is widespread, affecting all cerebral lobes and the cerebellum, leading to disruptions in the majority of the brain's fiber bundles.
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Affiliation(s)
- Paul Klauser
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia;,Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia;,Lausanne University Hospital, Department of Psychiatry, Prilly, Switzerland
| | - Simon T. Baker
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Vanessa L. Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia;,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Alex Fornito
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia;,Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Luca Cocchi
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Janice M. Fullerton
- Neuroscience Research Australia, Randwick, New South Wales, Australia;,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Paul Rasser
- Centre for Brain and Mental Health Research, University of Newcastle, Waratah, New South Wales, Australia;,Hunter Medical Research Institute, Newcastle, New South Wales, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia
| | - Ulrich Schall
- Centre for Brain and Mental Health Research, University of Newcastle, Waratah, New South Wales, Australia;,Hunter Medical Research Institute, Newcastle, New South Wales, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia
| | - Frans Henskens
- School of Electrical Engineering and Computer Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Patricia T. Michie
- Centre for Brain and Mental Health Research, University of Newcastle, Waratah, New South Wales, Australia;,Hunter Medical Research Institute, Newcastle, New South Wales, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia;,School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Carmel Loughland
- Neuroscience Research Australia, Randwick, New South Wales, Australia;,Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Stanley V. Catts
- School of Medicine, The University of Queensland, Brisbane, Qeensland, Australia
| | - Bryan Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia;,Queensland Centre for Mental Health Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Thomas W. Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia;,Neuroscience Research Australia, Randwick, New South Wales, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia;,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia;,Neuroscience Research Australia, Randwick, New South Wales, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia;,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Vaughan Carr
- Schizophrenia Research Institute, Randwick, New South Wales, Australia;,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia;,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Rhoshel Lenroot
- Neuroscience Research Australia, Randwick, New South Wales, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia;,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia;,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia;,Schizophrenia Research Institute, Randwick, New South Wales, Australia;,Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
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15
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Lee JS, Kim CY, Joo YH, Newell D, Bouix S, Shenton ME, Kubicki M. Increased diffusivity in gray matter in recent onset schizophrenia is associated with clinical symptoms and social cognition. Schizophr Res 2016; 176:144-150. [PMID: 27554199 PMCID: PMC5392041 DOI: 10.1016/j.schres.2016.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Diffusion weighted MRI (dMRI) is a method sensitive to pathological changes affecting tissue microstructure. Most dMRI studies in schizophrenia, however, have focused solely on white matter. There is a possibility, however, that subtle changes in diffusivity exist in gray matter (GM). Accordingly, we investigated diffusivity in GM in patients with recent onset schizophrenia. METHODS We enrolled 45 patients and 21 age and sex-matched healthy controls. All subjects were evaluated using the short form of the Wechsler Adult Intelligence Scale, the Positive and Negative Syndrome Scale (PANSS), and the video based social cognition scale. DMRI and T1W images were acquired on a 3 Tesla magnet, and mean Fractional Anisotropy (FA), Trace (TR) and volume were calculated for each of the 68 cortical GM Regions of Interest parcellated using FreeSurfer. RESULTS There was no significant difference of FA and GM volume between groups after Bonferroni correction. For the dMRI measures, however, patients evinced increased TR in the left bank of the superior temporal sulcus, the right inferior parietal, the right inferior temporal, and the right middle temporal gyri. In addition, higher TR in the right middle temporal gyrus and the right inferior temporal gyrus, respectively, was associated with decreased social function and higher PANSS score in patients with schizophrenia. CONCLUSION This study demonstrates high sensitivity of dMRI to subtle pathology in GM in recent onset schizophrenia, as well as an association between increased diffusivity in temporal GM regions and abnormalities in social cognition and exacerbation of psychiatric symptoms.
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Affiliation(s)
- Jung Sun Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Chang-Yoon Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeon Ho Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dominick Newell
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Brockton Division, Brockton, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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16
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Vijayakumar N, Bartholomeusz C, Whitford T, Hermens DF, Nelson B, Rice S, Whittle S, Pantelis C, McGorry P, Schäfer MR, Amminger GP. White matter integrity in individuals at ultra-high risk for psychosis: a systematic review and discussion of the role of polyunsaturated fatty acids. BMC Psychiatry 2016; 16:287. [PMID: 27515430 PMCID: PMC4982267 DOI: 10.1186/s12888-016-0932-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 06/15/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Schizophrenia is thought to be a neurodevelopmental disorder with pathophysiological processes beginning in the brain prior to the emergence of clinical symptoms. Recent evidence from neuroimaging studies using techniques such as diffusion tensor imaging has identified white matter abnormalities that are suggestive of disrupted brain myelination and neuronal connectivity. Identifying whether such effects exist in individuals at high risk for developing psychosis may help with prevention and early intervention strategies. In addition, there is preliminary evidence for a role of lipid biology in the onset of psychosis, along with well-established evidence of its role in myelination of white matter tracts. As such, this article synthesises the literature on polyunsaturated fatty acids (PUFAs) in myelination and schizophrenia, hypothesizing that white matter abnormalities may potentially mediate the relationship between PUFAs and schizophrenia. METHODS Diffusion tensor imaging studies were identified through a systematic search of existing literature. Studies examined white matter integrity in ultra-high risk (UHR) samples, as assessed using structured diagnostic interviews. Data was extracted and summarised as a narrative review. RESULTS Twelve studies met inclusion criteria, and findings identified reduced fractional anisotropy and higher diffusivity. Although the exact location of abnormalities remains uncertain, fronto-temporal and fronto-limbic connections, including the superior longitudinal and uncinate fasiculus, cingulum, and corpus callosum appear to be implicated. Because of preliminary evidence suggesting lipid biology may be relevant for the onset of psychosis, a discussion is provided of the role of polyunsaturated fatty acids (PUFAs) in myelination and risk for psychosis. CONCLUSIONS While the function of PUFAs in myelination is well-established, there is growing evidence of reduced PUFA concentration in UHR samples, highlighting the need for research to examine the relationship between PUFA and white matter integrity in high-risk samples and age-matched healthy controls. Such investigations will help to better understand the pathophysiology of the disorder, and potentially assist in the development of novel treatment and early intervention strategies.
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Affiliation(s)
- Nandita Vijayakumar
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
- Department of Psychology, University of Oregon, Eugene, USA
| | - Cali Bartholomeusz
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Thomas Whitford
- Brain & Mind Research Institute, Central Clinical School, University of Sydney, Sydney, Australia
| | | | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - Miriam R. Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
| | - G. Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052 Australia
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17
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Psomiades M, Fonteneau C, Mondino M, Luck D, Haesebaert F, Suaud-Chagny MF, Brunelin J. Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study. NEUROIMAGE-CLINICAL 2016; 12:970-975. [PMID: 27995063 PMCID: PMC5153606 DOI: 10.1016/j.nicl.2016.04.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
Auditory verbal hallucinations (AVH) of schizophrenia are associated with a disrupted connectivity between frontal and temporoparietal language areas. We hypothesized that this dysconnectivity is underpinned by white matter abnormalities in the left arcuate fasciculus, the main fiber bundle connecting speech production and perception areas. We therefore investigated the relationship between AVH severity and the integrity of the arcuate fasciculus measured by diffusion tensor imaging (DTI) tractography in patients with schizophrenia. Thirty-eight patients with treatment-resistant schizophrenia were included: 26 presented with daily severe treatment-resistant AVH, 12 reported prominent negative symptoms and no AVH. Fractional anisotropy (FA) was measured along the length of the left and right anterior arcuate fasciculi and severity of AVH was assessed using P3 PANSS item. FA values were significantly higher in the left arcuate fasciculus in patients with AVH than in no AVH patients (F(1,35) = 3.86; p = 0.05). No difference was observed in the right arcuate fasciculus. There was a significant positive correlation between FA value in the left arcuate fasciculus and the severity of AVH (r = 0.36; p = 0.02). No correlation was observed between FA values and PANSS total score suggesting a specific relationship between AVH severity and the left arcuate fasciculus integrity. These results support the hypothesis of a relationship between left frontotemporal connectivity and AVH in patients with schizophrenia and suggest that whilst a disruption of frontotemporal connectivity might be present to ensure the emergence of AVH, more severe anatomical alterations may prevent the occurrence of AVH in patients with schizophrenia. Fractional anisotropy (FA) in the left arcuate fasciculus (AF) correlated with severity of hallucinations. Hallucinating patients had greater FA in the left AF than non-hallucinating patients. We did not find any association between hallucinations and FA in the right AF.
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Affiliation(s)
- Marion Psomiades
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Clara Fonteneau
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marine Mondino
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
| | - David Luck
- Institut Universitaire en Santé Mentale de Montréal Research Center, Québec, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada
| | - Frederic Haesebaert
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marie-Françoise Suaud-Chagny
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France; Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
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Uhlmann A, Fouche JP, Lederer K, Meintjes EM, Wilson D, Stein DJ. White matter microstructure and impulsivity in methamphetamine dependence with and without a history of psychosis. Hum Brain Mapp 2016; 37:2055-67. [PMID: 26936688 DOI: 10.1002/hbm.23159] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 02/04/2016] [Accepted: 02/16/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Methamphetamine (MA) use may lead to white matter injury and to a range of behavioral problems and psychiatric disorders, including psychosis. The present study sought to assess white matter microstructural impairment as well as impulsive behavior in MA dependence and MA-associated psychosis (MAP). METHODS Thirty patients with a history of MAP, 39 participants with MA dependence and 40 healthy controls underwent diffusion tensor imaging (DTI). Participants also completed the UPPS-P impulsive behavior questionnaire. We applied tract-based spatial statistics (TBSS) to investigate group differences in mean diffusivity (MD), fractional anisotropy (FA), axial (λ‖ ) and radial diffusivity (λ⊥ ), and their association with impulsivity scores and psychotic symptoms. RESULTS The MAP group displayed widespread higher MD, λ‖ and λ⊥ levels compared to both controls and the MA group, and lower FA in extensive white matter areas relative to controls. MD levels correlated positively with negative psychotic symptoms in MAP. No significant DTI group differences were found between the MA group and controls. Both clinical groups showed high levels of impulsivity, and this dysfunction was associated with DTI measures in frontal white matter tracts. CONCLUSIONS MAP patients show distinct patterns of impaired white matter integrity of global nature relative to controls and the MA group. Future work to investigate the precise nature and timing of alterations in MAP is needed. The results are further suggestive of frontal white matter pathology playing a role in impulsivity in MA dependence and MAP. Hum Brain Mapp 37:2055-2067, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa.,Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Katharina Lederer
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Ernesta M Meintjes
- Department of Human Biology, University of Cape Town, MRC/UCT Medical Imaging Research Unit, South Africa
| | - Don Wilson
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
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19
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Reid MA, White DM, Kraguljac NV, Lahti AC. A combined diffusion tensor imaging and magnetic resonance spectroscopy study of patients with schizophrenia. Schizophr Res 2016; 170:341-50. [PMID: 26718333 PMCID: PMC5982513 DOI: 10.1016/j.schres.2015.12.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 12/31/2022]
Abstract
Diffusion tensor imaging (DTI) studies in schizophrenia consistently show global reductions in fractional anisotropy (FA), a putative marker of white matter integrity. The cingulum bundle, which facilitates communication between the anterior cingulate cortex (ACC) and hippocampus, is frequently implicated in schizophrenia. Magnetic resonance spectroscopy (MRS) studies report metabolic abnormalities in the ACC and hippocampus of patients. Combining DTI and MRS offers exploration of the relationship between cortical neuronal biochemistry and the integrity of white matter tracts connecting specific cortical regions; however, few studies have attempted this in schizophrenia. Twenty-nine schizophrenia patients and twenty controls participated in this 3 T imaging study in which we used DTI and tract-based spatial statistics (TBSS) to assess white matter integrity and MRS to quantify metabolites in the ACC and hippocampus. We found FA reductions with overlapping radial diffusivity (RD) elevations in patients in multiple tracts, suggesting white matter abnormalities in schizophrenia are driven by loss of myelin integrity. In controls, we found significant negative correlations between hippocampal N-acetylaspartate/creatine and RD and axial diffusivity (AD) as well as a significant negative correlation between FA and ACC glutamate+glutamine/creatine in the hippocampal part of the cingulum bundle. It is possible that the extent of myelin damage could have resulted in the absence of DTI-MRS correlations in our patient group. In conclusion, we demonstrate the potential utility of a multi-modal neuroimaging approach to help further our understanding of the relationship between white matter microstructure and neurochemistry in distinct cortical regions connected by white matter tracts.
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Affiliation(s)
- Meredith A. Reid
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA,To whom correspondence should be addressed: Adrienne C. Lahti, MD, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, SC 501, 1720 2 Ave S, Birmingham, AL 35294-0017, USA, +1 205-996-6776, Fax: +1 205-975-4879,
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20
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Wu CH, Hwang TJ, Chen YJ, Hsu YC, Lo YC, Liu CM, Hwu HG, Liu CC, Hsieh MH, Chien YL, Chen CM, Isaac Tseng WY. Primary and secondary alterations of white matter connectivity in schizophrenia: A study on first-episode and chronic patients using whole-brain tractography-based analysis. Schizophr Res 2015; 169:54-61. [PMID: 26443482 DOI: 10.1016/j.schres.2015.09.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 09/15/2015] [Accepted: 09/21/2015] [Indexed: 01/12/2023]
Abstract
Schizophrenia is a debilitating mental disorder that is associated with an impaired connection of cerebral white matter. Studies on patients with chronic and first-episode schizophrenia have found widespread white matter abnormalities. However, it is unclear whether the altered connections are inherent in or secondary to the disease. Here, we sought to identify white matter tracts with altered connections and to distinguish primary or secondary alterations among 74 fiber tracts across the whole brain using an automatic tractography-based analysis method. Thirty-one chronic, 25 first-episode patients with schizophrenia and 31 healthy controls were recruited to receive diffusion spectrum magnetic resonance imaging at 3T. Seven tracts were found to exhibit significant differences between the groups; they included the right arcuate fasciculus, bilateral fornices, left superior longitudinal fasciculus I, and fibers of the corpus callosum to the bilateral dorsolateral prefrontal cortices (DLPFC), bilateral temporal poles, and bilateral hippocampi. Post-hoc between-group analyses revealed that the connection of the callosal fibers to the bilateral DLPFC was significantly decreased in chronic patients but not in first-episode patients. In a stepwise regression analysis, the decline of the tract connection was significantly predicted by the duration of illness. In contrast, the remaining six tracts showed significant alterations in both first-episode and chronic patients and did not associate with clinical variables. In conclusion, reduced white matter connectivity of the callosal fibers to the bilateral DLPFC may be a secondary change that degrades progressively in the chronic stage, whereas alterations in the other six tracts may be inherent in the disease.
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Affiliation(s)
- Chen-Hao Wu
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Jen Chen
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Chin Hsu
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Chun Lo
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Ming Chen
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Molecular Imaging Center, National Taiwan University, Taipei, Taiwan.
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21
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Decomposition of brain diffusion imaging data uncovers latent schizophrenias with distinct patterns of white matter anisotropy. Neuroimage 2015; 120:43-54. [PMID: 26151103 DOI: 10.1016/j.neuroimage.2015.06.083] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/01/2015] [Accepted: 06/28/2015] [Indexed: 11/24/2022] Open
Abstract
Fractional anisotropy (FA) analysis of diffusion tensor-images (DTI) has yielded inconsistent abnormalities in schizophrenia (SZ). Inconsistencies may arise from averaging heterogeneous groups of patients. Here we investigate whether SZ is a heterogeneous group of disorders distinguished by distinct patterns of FA reductions. We developed a Generalized Factorization Method (GFM) to identify biclusters (i.e., subsets of subjects associated with a subset of particular characteristics, such as low FA in specific regions). GFM appropriately assembles a collection of unsupervised techniques with Non-negative Matrix Factorization to generate biclusters, rather than averaging across all subjects and all their characteristics. DTI tract-based spatial statistics images, which output is the locally maximal FA projected onto the group white matter skeleton, were analyzed in 47 SZ and 36 healthy subjects, identifying 8 biclusters. The mean FA of the voxels of each bicluster was significantly different from those of other SZ subjects or 36 healthy controls. The eight biclusters were organized into four more general patterns of low FA in specific regions: 1) genu of corpus callosum (GCC), 2) fornix (FX)+external capsule (EC), 3) splenium of CC (SCC)+retrolenticular limb (RLIC)+posterior limb (PLIC) of the internal capsule, and 4) anterior limb of the internal capsule. These patterns were significantly associated with particular clinical features: Pattern 1 (GCC) with bizarre behavior, pattern 2 (FX+EC) with prominent delusions, and pattern 3 (SCC+RLIC+PLIC) with negative symptoms including disorganized speech. The uncovered patterns suggest that SZ is a heterogeneous group of disorders that can be distinguished by different patterns of FA reductions associated with distinct clinical features.
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22
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Abstract
Neuroimaging studies have identified patterns of brain abnormalities in various stages of schizophrenia, but whether these abnormalities reflect primary factors associated with the causes of illness or secondary phenomena such as medications has been unclear. Recent work conducted within the prodromal risk paradigm suggests that progressive change in brain structure and function occurs around the time when clinically high-risk individuals transition into full-blown psychosis, effects that cannot be explained by exposure to medications or illness chronicity. This article reviews recent work bearing on the question of the timing of onset and course of brain changes, focusing on structural MRI, diffusion tensor imaging, and resting state connectivity MRI, in association with the onset and course of psychosis. We conclude with a consideration of potential mechanisms underlying progressive tissue changes during the prodromal phase of schizophrenia and implications for prevention.
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Affiliation(s)
- Yoonho Chung
- Deparment of Psychology, Yale University, New Haven CT
| | - Tyrone D. Cannon
- Deparment of Psychology, Yale University, New Haven CT
- Department of Psychiatry, Yale University, New Haven CT
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23
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Iwabuchi SJ, Liddle PF, Palaniyappan L. Structural connectivity of the salience-executive loop in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2015; 265:163-6. [PMID: 25256265 DOI: 10.1007/s00406-014-0547-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/19/2014] [Indexed: 12/18/2022]
Abstract
Previously, differences have been shown in effective connectivity of the salience network between healthy controls and patients with schizophrenia. Specifically, the right anterior insula (rAI) fails to modulate the dorsolateral prefrontal cortex (DLPFC). In 35 controls and 31 patients with schizophrenia, we extended these findings by investigating the white matter connectivity of this pathway using tractography, and its relationship with the disrupted effective connectivity. We showed increased fractional anisotropy in the pathway connecting the rAI with the DLPFC, which related to reduced effective connectivity. This may be due to either secondary changes in white matter or a primary defect in structural integrity resulting from deficient axonal pruning. This novel finding warrants further investigation of white matter connectivity in schizophrenia and the mechanisms underlying this pathophysiology.
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Affiliation(s)
- Sarina J Iwabuchi
- Translational Neuroimaging, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Room-09 C Floor, Triumph Road, Nottingham, NG7 2TU, UK,
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24
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Roalf DR, Gur RE, Verma R, Parker WA, Quarmley M, Ruparel K, Gur RC. White matter microstructure in schizophrenia: associations to neurocognition and clinical symptomatology. Schizophr Res 2015; 161:42-9. [PMID: 25445621 PMCID: PMC4410368 DOI: 10.1016/j.schres.2014.09.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies in schizophrenia report widespread aberrations in brain white matter (WM). These appear related to poorer neurocognitive performance and higher levels of negative and positive symptomatology. However, identification of the most salient WM aberrations to neurocognition and clinical symptoms is limited by relatively small samples with divergent results. METHODS We examined 53 well-characterized patients with schizophrenia and 62 healthy controls. All participants were administered a computerized neurocognitive battery, which evaluated performance in several domains. Patients were assessed for negative and positive symptoms. Fractional anisotropy (FA) of WM cortical regions and WM fiber tracts were compared across the groups. FA values were also used to predict neurocognitive performance and symptoms. RESULTS We confirm widespread aberrant WM microstructure in a relatively large sample of well-characterized patients with schizophrenia in comparison to healthy participants. Moreover, we illustrate the utility of FA measures in predicting global neurocognitive performance in healthy participants and schizophrenia patients, especially for reaction time. FA was less predictive of clinical symptomatology. CONCLUSIONS Using a standardized computerized neurocognitive battery and diffusion tensor imaging we show that behavioral performance is moderated by a particular constellation of WM microstructure in healthy individuals that differs in schizophrenia.
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Affiliation(s)
- David R. Roalf
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States,Department of Radiology, University of Pennsylvania Perelman School of Medicine, United States
| | - Ragini Verma
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, United States
| | - William A. Parker
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, United States
| | - Megan Quarmley
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Kosha Ruparel
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Ruben C. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States,Department of Radiology, University of Pennsylvania Perelman School of Medicine, United States
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25
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Kates WR, Olszewski AK, Gnirke MH, Kikinis Z, Nelson J, Antshel KM, Fremont W, Radoeva PD, Middleton FA, Shenton ME, Coman IL. White matter microstructural abnormalities of the cingulum bundle in youths with 22q11.2 deletion syndrome: associations with medication, neuropsychological function, and prodromal symptoms of psychosis. Schizophr Res 2015; 161:76-84. [PMID: 25066496 PMCID: PMC4277733 DOI: 10.1016/j.schres.2014.07.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 07/02/2014] [Accepted: 07/03/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND The 22q11.2 deletion syndrome (22q11.2DS) is regarded as an etiologically homogenous model for understanding neuroanatomic disruptions associated with a high risk for schizophrenia. This study utilized diffusion tensor imaging (DTI) to analyze white matter microstructure in individuals with 22q11.2DS. We focused on the cingulum bundle (CB), previously shown to be disrupted in patients with schizophrenia and associated with symptoms of psychosis. METHODS White matter microstructure was assessed in the anterior, superior, and posterior CB using the tractography algorithm in DTIStudio. Neuropsychological function, presence of prodromal symptoms of psychosis, and medication history were assessed in all participants. RESULTS Relative to controls, young adults with 22q11.2DS showed alterations in most DTI metrics of the CB. Alterations were associated with positive prodromal symptoms of psychosis. However, when individuals with 22q11.2DS were divided by usage of antipsychotics/mood stabilizers, the medicated and non-medicated groups differed significantly in axial diffusivity of the anterior CB and in fractional anisotropy of the superior CB. DTI metrics did not differ between the medicated group and the control group. CONCLUSIONS Results suggest that the microstructure of the CB is altered in individuals with 22q11.2DS, and that those alterations may underlie positive prodromal symptoms of psychosis. Our findings further provide preliminary evidence that antipsychotic/mood stabilizer usage may have a reparative effect on white matter microstructure in prodromal 22q11.2DS, independent of the potential effects of psychosis. Future studies of white matter pathology in individuals with 22q11.2DS should test for potential effects of medication on white matter microstructure.
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Affiliation(s)
- Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States.
| | - Amy K Olszewski
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Matthew H Gnirke
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Zora Kikinis
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Joshua Nelson
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Kevin M Antshel
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States; Department of Psychology, Syracuse University, Syracuse, NY, United States
| | - Wanda Fremont
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Petya D Radoeva
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Frank A Middleton
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States; Department of Neuroscience and Physiology, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; VA Boston Healthcare System, Brockton Division, Brockton, MA, United States
| | - Ioana L Coman
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
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26
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Ozcelik-Eroglu E, Ertugrul A, Oguz KK, Has AC, Karahan S, Yazici MK. Effect of clozapine on white matter integrity in patients with schizophrenia: a diffusion tensor imaging study. Psychiatry Res 2014; 223:226-35. [PMID: 25012780 DOI: 10.1016/j.pscychresns.2014.06.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 02/20/2014] [Accepted: 06/13/2014] [Indexed: 01/02/2023]
Abstract
Several diffusion tensor imaging (DTI) studies have reported disturbed white matter integrity in various brain regions in patients with schizophrenia, whereas only a few studied the effect of antipsychotics on DTI measures. The aim of this study was to investigate the effect of 12 weeks of clozapine treatment on DTI findings in patients with schizophrenia, and to compare the findings with those in unaffected controls. The study included 16 patients with schizophrenia who were assessed with the Positive and Negative Syndrome Scale, a neurocognitive test battery, and DTI at baseline and 12 weeks after the initiation of clozapine treatment. Eight unaffected controls were assessed once with the neurocognitive test battery and DTI. Voxel-wise analysis of DTI data was performed via tract-based spatial statistics (TBSS). Compared with the control group, the patient group exhibited lower fractional anisotropy (FA) in 16 brain regions, including the bilateral superior longitudinal fasciculi, inferior fronto-occipital fasciculi, superior and inferior parietal lobules, cingulate bundles, cerebellum, middle cerebellar peduncles, and left inferior longitudinal fasciculus, whereas the patients had higher FA in six regions, including the right parahippocampus, left anterior thalamic radiation, and right posterior limb of the internal capsule before clozapine treatment. After 12 weeks of treatment with clozapine, white matter FA was increased in widespread brain regions. In two of the regions where FA had initially been lower in patients compared with controls (left inferior fronto-occipital fasciculus and superior parietal lobule), clozapine appeared to increase FA. An improvement in semantic fluency was correlated with the increase in FA value in the left inferior fronto-occipital fasciculus. An increase in FA following 12 weeks of treatment with clozapine suggests that this treatment alters white matter microstructural integrity in patients with schizophrenia previously treated with typical and/or atypical antipsychotics and, in some locations, reverses a previous deficit.
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Affiliation(s)
- Elcin Ozcelik-Eroglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Aygun Ertugrul
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Kader Karli Oguz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey; National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey
| | - Arzu Ceylan Has
- National Magnetic Resonance Research Center, Bilkent University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mumin Kazim Yazici
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
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27
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Wheeler AL, Voineskos AN. A review of structural neuroimaging in schizophrenia: from connectivity to connectomics. Front Hum Neurosci 2014; 8:653. [PMID: 25202257 PMCID: PMC4142355 DOI: 10.3389/fnhum.2014.00653] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 08/05/2014] [Indexed: 11/13/2022] Open
Abstract
In patients with schizophrenia neuroimaging studies have revealed global differences with some brain regions showing focal abnormalities. Examining neurocircuitry, diffusion-weighted imaging studies have identified altered structural integrity of white matter in frontal and temporal brain regions and tracts such as the cingulum bundles, uncinate fasciculi, internal capsules and corpus callosum associated with the illness. Furthermore, structural co-variance analyses have revealed altered structural relationships among regional morphology in the thalamus, frontal, temporal and parietal cortices in schizophrenia patients. The distributed nature of these abnormalities in schizophrenia suggests that multiple brain circuits are impaired, a neural feature that may be better addressed with network level analyses. However, even with the advent of these newer analyses, a large amount of variability in findings remains, likely partially due to the considerable heterogeneity present in this disorder.
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Affiliation(s)
- Anne L Wheeler
- Kimel Family Translational Imaging Genetics Laboratory, Centre for Addiction and Mental Health, Research Imaging Centre Toronto, ON, Canada ; Department of Psychiatry, University of Toronto Toronto, ON, Canada
| | - Aristotle N Voineskos
- Kimel Family Translational Imaging Genetics Laboratory, Centre for Addiction and Mental Health, Research Imaging Centre Toronto, ON, Canada ; Department of Psychiatry, University of Toronto Toronto, ON, Canada
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28
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Asami T, Lee SH, Bouix S, Rathi Y, Whitford TJ, Niznikiewicz M, Nestor P, McCarley RW, Shenton ME, Kubicki M. Cerebral white matter abnormalities and their associations with negative but not positive symptoms of schizophrenia. Psychiatry Res 2014; 222:52-9. [PMID: 24650453 PMCID: PMC4083818 DOI: 10.1016/j.pscychresns.2014.02.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 12/11/2013] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
Abstract
Although diffusion tensor imaging (DTI) studies have reported fractional anisotropy (FA) abnormalities in multiple white matter (WM) regions in schizophrenia, relationship between abnormal FA and negative symptoms has not been fully explored. DTI data were acquired from twenty-four patients with chronic schizophrenia and twenty-five healthy controls. Regional brain abnormalities were evaluated by conducting FA comparisons in the cerebral and each lobar WMs between groups. Focal abnormalities were also evaluated with a voxel-wise tract specific method. Associations between structural WM changes and negative symptoms were assessed using the Scale for the Assessment of Negative Symptoms (SANS). The patient group showed decreased FA in the cerebrum, especially in the frontal lobe, compared with controls. A voxel-wise analysis showed FA decreases in almost all WM tracts in schizophrenia. Correlation analyses demonstrated negative relationships between FA in the cerebrum, particularly in the left hemisphere, and SANS global and global rating scores (Anhedonia-Asociality, Attention, and Affective-Flattening), and also associations between FA of left frontal lobe and SANS global score, Anhedonia-Asociality, and Attention. This study demonstrates that patients with chronic schizophrenia evince widespread cerebral FA abnormalities and that these abnormalities, especially in the left hemisphere, are associated with negative symptoms.
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Affiliation(s)
- Takeshi Asami
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, U.S.A,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Sang Hyuk Lee
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, U.S.A,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Thomas J. Whitford
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A,School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Margaret Niznikiewicz
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, U.S.A
| | - Paul Nestor
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, U.S.A
| | - Robert W. McCarley
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, U.S.A
| | - Martha E. Shenton
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, U.S.A,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A,Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts U.S.A
| | - Marek Kubicki
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA; Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA.
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Impaired empathic abilities and reduced white matter integrity in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2014; 48:117-23. [PMID: 24099786 DOI: 10.1016/j.pnpbp.2013.09.018] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 09/16/2013] [Accepted: 09/27/2013] [Indexed: 11/21/2022]
Abstract
Empathic abilities are impaired in schizophrenia. Although the pathology of schizophrenia is thought to involve disrupted white matter integrity, the relationship between empathic disabilities and altered white matter in the disorder remains unclear. The present study tested associations between empathic disabilities and white matter integrity in order to investigate the neural basis of impaired empathy in schizophrenia. Sixty-nine patients with schizophrenia and 69 age-, gender-, handedness-, education- and IQ level-matched healthy controls underwent diffusion-weighted imaging. Empathic abilities were assessed using the Interpersonal Reactivity Index (IRI). Using tract-based spatial statistics (TBSS), the associations between empathic abilities and white matter fractional anisotropy (FA), a measure of white matter integrity, were examined in the patient group within brain areas that showed a significant FA reduction compared with the controls. The patients with schizophrenia reported lower perspective taking and higher personal distress according to the IRI. The patients showed a significant FA reduction in bilateral deep white matter in the frontal, temporal, parietal and occipital lobes, a large portion of the corpus callosum, and the corona radiata. In schizophrenia patients, fantasy subscales positively correlated with FA in the left inferior fronto-occipital fasciculi and anterior thalamic radiation, and personal distress subscales negatively correlated with FA in the splenium of the corpus callosum. These results suggest that disrupted white matter integrity in these regions constitutes a pathology underpinning specific components of empathic disabilities in schizophrenia, highlighting that different aspects of empathic impairments in the disorder would have, at least partially, distinct neuropathological bases.
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Wang Q, Cheung C, Deng W, Li M, Huang C, Ma X, Wang Y, Jiang L, McAlonan G, Sham P, Collier DA, Gong Q, Chua SE, Li T. Fronto-parietal white matter microstructural deficits are linked to performance IQ in a first-episode schizophrenia Han Chinese sample. Psychol Med 2013; 43:2047-2056. [PMID: 23237024 DOI: 10.1017/s0033291712002905] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Evidence shows that cognitive deficits and white matter (WM) dysconnectivity can independently be associated with clinical manifestations in schizophrenia. It is important to explore this triadic relationship in order to investigate whether the triplet could serve as potential extended endophenotypes of schizophrenia. METHOD Diffusion tensor images and clinical performances were evaluated in 122 individuals with first-episode schizophrenia and 122 age- and gender-matched controls. In addition, 65 of 122 of the patient group and 40 of 122 controls were measured using intelligence quotient (IQ) testing. RESULTS The schizophrenia group showed lower fractional anisotropy (FA) values than controls in the right cerebral frontal lobar sub-gyral (RFSG) WM. The schizophrenia group also showed a significant positive correlation between FA in the RFSG and performance IQ (PIQ) ; in turn, their PIQ score showed a significant negative correlation with negative syndromes. CONCLUSIONS Overall, these findings support the hypothesis that WM deficits may be a core deficit that contributes to cognitive deficits as well as to negative symptoms.
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Affiliation(s)
- Q Wang
- The Mental Health Center and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Rigucci S, Rossi-Espagnet C, Ferracuti S, De Carolis A, Corigliano V, Carducci F, Mancinelli I, Cicone F, Tatarelli R, Bozzao A, Girardi P, Comparelli A. Anatomical substrates of cognitive and clinical dimensions in first episode schizophrenia. Acta Psychiatr Scand 2013; 128:261-70. [PMID: 23216145 DOI: 10.1111/acps.12051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore gray (GM) and white matter (WM) abnormalities and the relationships with neuropsychopathology in first-episode schizophrenia (FES). METHOD Nineteen patients with first episode of non-affective psychosis and 18 controls underwent a magnetic resonance voxel-based morphometry. Additionally, WM fractional anisotropy (FA) was calculated. For correlative analysis, symptoms and neuropsychological performances were scored by PANSS and by a comprehensive neuropsychological assessment respectively. RESULTS Patients showed significantly decreased volume of left temporal lobe and disarray of all major WM tracts. Disorganized PANSS factor was inversely related to left cerebellar GM volume (corrected P = 0.03) and to WM FA of the left cerebellum, inferior fronto-occipital fasciculi (IFOF), and inferior longitudinal fasciculi (corrected P < 0.05). PANSS negative factor was inversely related to FA in the IFOF and superior longitudinal fasciculi (corrected P < 0.05). Impairment in facial emotion identification showed associations with temporo-occipital GM volume decrease (corrected P = 0.003) and WM disarray of superior and middle temporal gyri, anterior thalamic radiation, and superior longitudinal fasciculi (corrected P < 0.05). Speed of processing and visual memory correlated with WM abnormalities in fronto-temporal tracts. CONCLUSION These results confirm how the structural development of key brain regions is related to neuropsychopathological dysfunction in FES, consistently with a neurodevelopmentally derived misconnection syndrome.
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Affiliation(s)
- S Rigucci
- Unit of Psychiatry, Sant'Andrea Hospital, Department of Neurosciences, Mental Health and Sensory Organs (Ne.S.M.O.S.), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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White T, Ehrlich S, Ho BC, Manoach DS, Caprihan A, Schulz SC, Andreasen NC, Gollub RL, Calhoun VD, Magnotta VA. Spatial characteristics of white matter abnormalities in schizophrenia. Schizophr Bull 2013; 39:1077-86. [PMID: 22987296 PMCID: PMC3756779 DOI: 10.1093/schbul/sbs106] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
There is considerable evidence implicating brain white matter (WM) abnormalities in the pathophysiology of schizophrenia; however, the spatial localization of WM abnormalities reported in the existing studies is heterogeneous. Thus, the goal of this study was to quantify the spatial characteristics of WM abnormalities in schizophrenia. One hundred and fourteen patients with schizophrenia and 138 matched controls participated in this multisite study involving the Universities of Iowa, Minnesota, and New Mexico, and the Massachusetts General Hospital. We measured fractional anisotropy (FA) in brain WM regions extracted using 3 different image-processing algorithms: regions of interest, tract-based spatial statistics, and the pothole approach. We found that FA was significantly lower in patients using each of the 3 image-processing algorithms. The region-of-interest approach showed multiple regions with lower FA in patients with schizophrenia, with overlap at all 4 sites in the corpus callosum and posterior thalamic radiation. The tract-based spatial statistic approach showed (1) global differences in 3 of the 4 cohorts and (2) lower frontal FA at the Iowa site. Finally, the pothole approach showed a significantly greater number of WM potholes in patients compared to controls at each of the 4 sites. In conclusion, the spatial characteristics of WM abnormalities in schizophrenia reflect a combination of a global low-level decrease in FA, suggesting a diffuse process, coupled with widely dispersed focal reductions in FA that vary spatially among individuals (ie, potholes).
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Affiliation(s)
- Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, the Netherlands.
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Chen L, Chen X, Liu W, Wang Q, Jiang T, Wang J, Wang X, Zhou B, Tang J. White matter microstructural abnormalities in patients with late-onset schizophrenia identified by a voxel-based diffusion tensor imaging. Psychiatry Res 2013; 212:201-7. [PMID: 23146248 DOI: 10.1016/j.pscychresns.2012.05.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Revised: 03/02/2012] [Accepted: 05/24/2012] [Indexed: 11/16/2022]
Abstract
Reduced fractional anisotropy (FA) has been previously found in diffusion tensor imaging (DTI) studies of white matter in schizophrenic patients. However, there are no reports in the literature that address FA alterations in late-onset schizophrenia (LOS). The current study measured FA in whole white matter and subsequently analyzed its association with psychotic symptoms in LOS. DTI was carried out in 20 patients with LOS and 17 age-, gender- and education-matched healthy subjects. Fractional anisotropy in different areas of white matter was compared between groups using a voxelwise analysis after inter-subject registration to standard Montreal Neurological Institute (MNI) space. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Cognitive functions were measured using the Wisconsin Card Sorting Test (WCST), the Digit Span Test, and the Trail-making Test. Significant reduction in FA was found in the left parietal lobe and right posterior cingulum in LOS patients compared with healthy subjects. Significant deficits in cognitive functions were observed in LOS. No significant correlation was found between FA value and PANSS scores, cognitive test scores, age, or antipsychotic medication dosages in LOS patients. Our study suggests that abnormalities in white matter integrity may contribute to the pathophysiology of LOS. However, these microstructural abnormalities provided no evidence for the emergence of psychotic symptoms in LOS.
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Affiliation(s)
- Liping Chen
- Institute of Mental Health, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
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Liu X, Lai Y, Wang X, Hao C, Chen L, Zhou Z, Yu X, Hong N. Reduced white matter integrity and cognitive deficit in never-medicated chronic schizophrenia: a diffusion tensor study using TBSS. Behav Brain Res 2013; 252:157-63. [PMID: 23747517 DOI: 10.1016/j.bbr.2013.05.061] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/26/2013] [Accepted: 05/30/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Disrupted white matter (WM) integrity is the pathological hallmark of schizophrenia. Previous studies have reported the cognitive deficits that are associated with WM disruption in schizophrenia with anti-psychiatric treatment. However, no study has yet revealed the correlation between cognition and WM abnormalities in never-medicated chronic schizophrenia. METHODS We used the diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) approach to investigate the whole-brain difference in the WM fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) values between 17 schizophrenia patients and 17 healthy controls matched in age, gender and education level. Patients' cognition was assessed through the MATRICS Consensus Cognitive Battery (MCCB). We explored the association between WM reduction and cognitive, clinical characteristics (severity of clinical symptoms, age, age of onset, illness duration). RESULTS Voxel-wise statistics revealed that schizophrenia patients showed significant FA reduction in left inferior longitudinal fasciculus (ILF) and left inferior fronto-occipital fasciculus (IFOF), and no difference in MD, AD or RD as compared to healthy subjects. Furthermore, in the patients group, lower FA value of the left ILF and left IFOF significantly correlated with worse processing speed, as well as verbal learning and visual learning abilities. There was no correlation between the FA value and the severity of clinical symptoms, age, and age of onset or illness duration. CONCLUSION Our results provide evidence to support that the disconnection of WM pathways may contribute to the pathophysiology of schizophrenia and suggest that the disturbance of left ILF and left IFOF integrity may contribute to cognitive deficits in schizophrenia, independent of effects of antipsychotic medication.
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Affiliation(s)
- Xiaoyi Liu
- Department of Radiology, People's Hospital, Peking University, Beijing, China
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Fiber pathway pathology, synapse loss and decline of cortical function in schizophrenia. PLoS One 2013; 8:e60518. [PMID: 23593232 PMCID: PMC3620229 DOI: 10.1371/journal.pone.0060518] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 02/28/2013] [Indexed: 11/19/2022] Open
Abstract
A quantitative cortical model is developed, based on both computational and simulation approaches, which relates measured changes in cortical activity of gray matter with changes in the integrity of longitudinal fiber pathways. The model consists of modules of up to 5,000 neurons each, 80% excitatory and 20% inhibitory, with these having different degrees of synaptic connectiveness both within a module as well as between modules. It is shown that if the inter-modular synaptic connections are reduced to zero while maintaining the intra-modular synaptic connections constant, then activity in the modules is reduced by about 50%. This agrees with experimental observations in which cortical electrical activity in a region of interest, measured using the rate of oxidative glucose metabolism (CMRglc(ox)), is reduced by about 50% when the cortical region is isolated, either by surgical means or by transient cold block. There is also a 50% decrease in measured cortical activity following inactivation of the nucleus of Meynert and the intra-laminar nuclei of the thalamus, which arise either following appropriate lesions or in sleep. This occurs in the model if the inter-modular synaptic connections require input from these nuclei in order to function. In schizophrenia there is a 24% decrease in functional anisotropy of longitudinal fasciculi accompanied by a 7% decrease in cortical activity (CMRglc(ox)).The cortical model predicts this, namely for a 24% decrease in the functioning of the inter-modular connections, either through the complete loss of 24% of axons subserving the connections or due to such a decrease in the efficacy of all the inter-modular connections, there will be about a 7% decrease in the activity of the modules. This work suggests that deterioration of longitudinal fasciculi in schizophrenia explains the loss of activity in the gray matter.
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Wang H, Li C, Wang H, Mei F, Liu Z, Shen HY, Xiao L. Cuprizone-induced demyelination in mice: age-related vulnerability and exploratory behavior deficit. Neurosci Bull 2013; 29:251-9. [PMID: 23558591 DOI: 10.1007/s12264-013-1323-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 02/17/2013] [Indexed: 12/27/2022] Open
Abstract
Schizophrenia is a mental disease that mainly affects young individuals (15 to 35 years old) but its etiology remains largely undefined. Recently, accumulating evidence indicated that demyelination and/or dysfunction of oligodendrocytes is an important feature of its pathogenesis. We hypothesized that the vulnerability of young individuals to demyelination may contribute to the onset of schizophrenia. In the present study, three different age cohorts of mice, i.e. juvenile (3 weeks), young-adult (6 weeks) and middle-aged (8 months), were subjected to a 6-week diet containing 0.2% cuprizone (CPZ) to create an animal model of acute demyelination. Then, age-related vulnerability to CPZ-induced demyelination, behavioral outcomes, and myelination-related molecular biological changes were assessed. We demonstrated: (1) CPZ treatment led to more severe demyelination in juvenile and young-adult mice than in middle-aged mice in the corpus callosum, a region closely associated with the pathophysiology of schizophrenia; (2) the higher levels of demyelination in juvenile and young-adult mice were correlated with a greater reduction of myelin basic protein, more loss of CC-1-positive mature oligodendrocytes, and higher levels of astrocyte activation; and (3) CPZ treatment resulted in a more prominent exploratory behavior deficit in juvenile and young-adult mice than in middle-aged mice. Together, our data demonstrate an age-related vulnerability to demyelination with a concurrent behavioral deficit, providing supporting evidence for better understanding the susceptibility of the young to the onset of schizophrenia.
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Affiliation(s)
- Hongkai Wang
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Third Military Medical University, Chongqing 400038, China
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Reading SAJ, Oishi K, Redgrave GW, McEntee J, Shanahan M, Yoritomo N, Younes L, Mori S, Miller MI, van Zijl P, Margolis RL, Ross CA. Diffuse abnormality of low to moderately organized white matter in schizophrenia. Brain Connect 2013; 1:511-9. [PMID: 22500774 DOI: 10.1089/brain.2011.0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Increasing evidence suggests that abnormal white matter is central to the pathophysiology and, potentially, the pathogenesis of schizophrenia (SCZ). The spatial distribution of observed abnormalities and the type of white matter involved remain to be elucidated. Seventeen chronically ill individuals with SCZ and 17 age- and gender-matched controls were studied using a 3T magnetic resonance imaging diffusion tensor imaging protocol designed to examine the abnormalities of white matter by region and by level of architectural infrastructure as assessed by fractional anisotropy (FA) in native space. After assessing whole-brain FA, FA was divided into quartiles, capturing all brain regions with FA values from 0 to 0.25, 0.25 to 0.5, 0.5 to 0.75, and 0.75 to 1.0. Mean whole-brain FA was 4.6% smaller in the SCZ group than in healthy controls. This difference was largely accounted for by FA values from the second quartile (between 0.25 and 0.5). Second quartile FA was decreased in all 130 brain regions of the template in the SCZ group, with the difference reaching statistical significance in 41 regions. Correspondingly, the amount of brain tissue with an FA of ∼0.4 was significantly reduced in the SCZ group, while the amount of brain tissue falling in the lowest quartile of FA was increased. These findings strongly imply a diffuse loss of white matter integrity in SCZ. Our finding that the loss of integrity disproportionately involves white matter of low to moderate organization suggests an approach to the specificity of white matter abnormalities in SCZ based on microstructure rather than spatial distribution.
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Affiliation(s)
- Sarah A J Reading
- Division of Neuroimaging, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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Lopez-Larson M, King JB, McGlade E, Bueler E, Stoeckel A, Epstein DJ, Yurgelun-Todd D. Enlarged thalamic volumes and increased fractional anisotropy in the thalamic radiations in veterans with suicide behaviors. Front Psychiatry 2013; 4:83. [PMID: 23964245 PMCID: PMC3740266 DOI: 10.3389/fpsyt.2013.00083] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/25/2013] [Indexed: 11/30/2022] Open
Abstract
Post-mortem studies have suggested a link between the thalamus, psychiatric disorders, and suicide. We evaluated the thalamus and anterior thalamic radiations (ATR) in a group of Veterans with and without a history of suicidal behavior (SB) to determine if thalamic abnormalities were associated with an increased risk of SB. Forty Veterans with mild traumatic brain injury (TBI) and no SB (TBI-SB), 19 Veterans with mild TBI and a history of SB (TB + SB), and 15 healthy controls (HC) underwent magnetic resonance imaging scanning including a structural and diffusion tensor imaging scan. SBs were evaluated utilizing the Columbia Suicide Rating Scale and impulsivity was measured using the Barratt Impulsiveness Scale (BIS). Differences in thalamic volumes and ATR fractional anisotropy (FA) were examined between (1) TBI + SB versus HC and (2) TBI + SB versus combined HC and TBI-SB and (3) between TBI + SB and TBI-SB. Left and right thalamic volumes were significantly increased in those with TBI + SB compared to the HC, TBI-SB, and the combined group. Veterans with TBI + SB had increased FA bilaterally compared to the HC, HC and TBI-SB group, and the TBI-SB only group. Significant positive associations were found for bilateral ATR and BIS in the TBI + SB group. Our findings of thalamic enlargement and increased FA in individuals with TBI + SB suggest that this region may be a biomarker for suicide risk. Our findings are consistent with previous evidence indicating that suicide may be associated with behavioral disinhibition and frontal-thalamic-limbic dysfunction and suggest a neurobiologic mechanism that may increase vulnerability to suicide.
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Affiliation(s)
- Melissa Lopez-Larson
- The Brain Institute, University of Utah , Salt Lake City, UT , USA ; University of Utah School of Medicine , Salt Lake City, UT , USA ; George E. Whalen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC) , Salt Lake City, UT , USA
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Knöchel C, O'Dwyer L, Alves G, Reinke B, Magerkurth J, Rotarska-Jagiela A, Prvulovic D, Hampel H, Linden DEJ, Oertel-Knöchel V. Association between white matter fiber integrity and subclinical psychotic symptoms in schizophrenia patients and unaffected relatives. Schizophr Res 2012; 140:129-35. [PMID: 22817874 DOI: 10.1016/j.schres.2012.06.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 05/09/2012] [Accepted: 06/01/2012] [Indexed: 01/23/2023]
Abstract
In this study, we investigate whether aberrant integrity of white matter (WM) fiber tracts represents a genetically determined biological marker of schizophrenia (SZ), and its relation with clinical symptoms. We collected brain DTI data from 28 SZ patients, 18 first-degree relatives and 22 matched controls and used voxel-based analysis with tract-based spatial statistics (TBSS) in order to compare fractional anisotropy (FA) between groups. Mean voxel-based FA values from the entire skeleton of each group were compared. We did a multiple regression analysis, followed by single post-hoc contrasts between groups. FA values were extracted from the statistically significant areas. The results showed significantly smaller FA values for SZ patients in comparison with controls in cortico-spinal tracts, in commissural fibers, in thalamic projections, in association fibers and in cingulum bundles. A significant increase of FA in SZ patients in comparison with healthy controls was only found in the arcuate fasciculus. Relatives had intermediate values between patients and controls which were deemed significant in the comparison to patients and controls in association fibers, arcuate fasciculus and cingulum bundles. Lower FA values in association fibers were significantly associated with predisposition toward hallucinations (in SZ patients and relatives), with higher PANSS scores of positive symptoms and with duration of illness (SZ patients). Our results suggest that clinical and subclinical presentations of psychotic symptoms are associated with aberrant integrity of multiple WM tracts. This association may represent an endophenotype of schizophrenia, since it is present in unaffected relatives as well. Such endophenotypes may serve as quantitative traits for future genetic studies and as candidate markers for early and preclinical identification of subjects at risk.
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Affiliation(s)
- Christian Knöchel
- Laboratory of Neuroscience, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany.
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Nakamura K, Kawasaki Y, Takahashi T, Furuichi A, Noguchi K, Seto H, Suzuki M. Reduced white matter fractional anisotropy and clinical symptoms in schizophrenia: a voxel-based diffusion tensor imaging study. Psychiatry Res 2012; 202:233-8. [PMID: 22819228 DOI: 10.1016/j.pscychresns.2011.09.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 07/23/2011] [Accepted: 09/07/2011] [Indexed: 10/28/2022]
Abstract
Although not consistently replicated, diffusion tensor imaging (DTI) studies in schizophrenia have revealed lower fractional anisotropy (FA) in various white matter regions, a finding consistent with the disruption of white matter integrity. In this study, we used voxel-based DTI to investigate possible whole-brain differences in the white matter FA values between 58 schizophrenia patients and 58 healthy controls. We also explored the association between FA values and clinical symptoms in schizophrenia. Compared with the controls, the schizophrenia patients showed significant FA reductions in bilateral superior longitudinal fasciculus, bilateral inferior fronto-occipital fasciculus, and genu of right internal capsule. Furthermore, in the patient group, the FA value of the anterior part of the corpus callosum was negatively correlated with the avolition score on the Scale for the Assessment of Negative Symptoms. These findings suggest widespread disruption of white matter integrity in schizophrenia, which could partly explain the severity of negative symptomatology.
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Affiliation(s)
- Kazue Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan.
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Kuswanto CN, Woon PS, Zheng XB, Qiu A, Sitoh YY, Chan YH, Liu J, Williams H, Ong WY, Sim K. Genome-wide supported psychosis risk variant in ZNF804A gene and impact on cortico-limbic WM integrity in schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:255-62. [PMID: 22328493 DOI: 10.1002/ajmg.b.32032] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 01/19/2012] [Indexed: 11/06/2022]
Abstract
Genome-wide association, case association genetic and meta-analytic studies have highlighted ZNF804A as a robust genome-wide supported susceptibility gene for schizophrenia (SCZ). In view of the possible involvement of ZNF804A gene in early neurodevelopment and cellular processes including oligodendrocyte proliferation and differentiation, we examined the effect of ZNF804A on brain WM (WM) integrity in patients with SCZ. Based on extant data in healthy controls (HC), we hypothesized that ZNF804A risk variant rs1344706 is associated with lower fractional anisotropy (FA) in brain regions within cortico-limbic circuits, namely frontal, parietal, medial temporal lobes, and cingulate gyri in SCZ. A total of 200 Chinese participants (125 patients with DSM-IV diagnosis of SCZ and 75 controls) were genotyped using blood samples, a subset of 153 participants (89 patients with DSM-IV diagnosis of SCZ and 64 controls) underwent structural magnetic resonance imaging and diffusion tensor imaging (DTI). There are significant effects of diagnosis (left cingulate gyrus: Adjusted F(1,149) = 9.36, P = 0.003) and diagnosis-genotype interactions (left parietal lobe: Adjusted F(1,147) = 7.39, P = 0.007; right parietal lobe: Adjusted F(1,147) = 6.95, P = 0.009; right medial temporal lobe: Adjusted F(1,147) = 8.79, P = 0.004; left cingulate gyrus: Adjusted F(1,147) = 8.02, P = 0.005). Specifically, we found that patients with SCZ who are risk T homozygotes have lower FA in bilateral parietal lobes, and left cingulate gyrus compared with G carriers. Compared with risk T homozygotes in HC, patients with SCZ who are risk T homozygotes have decreased FA in bilateral parietal lobes, and left cingulate gyrus as well as right medial temporal lobe. Our findings suggest that ZNF804A risk variant influence WM integrity involving cortico-limbic brain regions in SCZ and highlight the importance of investigating the impact of genome-wide supported risk factors on intermediate phenotypes with potential to shed light on the neurobiology of SCZ.
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Baumann PS, Cammoun L, Conus P, Do KQ, Marquet P, Meskaldji D, Meuli R, Thiran JP, Hagmann P. High b-value diffusion-weighted imaging: a sensitive method to reveal white matter differences in schizophrenia. Psychiatry Res 2012; 201:144-51. [PMID: 22386971 DOI: 10.1016/j.pscychresns.2011.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 08/07/2011] [Accepted: 08/08/2011] [Indexed: 11/30/2022]
Abstract
Over the last 10 years, diffusion-weighted imaging (DWI) has become an important tool to investigate white matter (WM) anomalies in schizophrenia. Despite technological improvement and the exponential use of this technique, discrepancies remain and little is known about optimal parameters to apply for diffusion weighting during image acquisition. Specifically, high b-value diffusion-weighted imaging known to be more sensitive to slow diffusion is not widely used, even though subtle myelin alterations as thought to happen in schizophrenia are likely to affect slow-diffusing protons. Schizophrenia patients and healthy controls were scanned with a high b-value (4000 s/mm(2)) protocol. Apparent diffusion coefficient (ADC) measures turned out to be very sensitive in detecting differences between schizophrenia patients and healthy volunteers even in a relatively small sample. We speculate that this is related to the sensitivity of high b-value imaging to the slow-diffusing compartment believed to reflect mainly the intra-axonal and myelin bound water pool. We also compared these results to a low b-value imaging experiment performed on the same population in the same scanning session. Even though the acquisition protocols are not strictly comparable, we noticed important differences in sensitivities in the favor of high b-value imaging, warranting further exploration.
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Affiliation(s)
- Philipp Sebastian Baumann
- Department of Psychiatry, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
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Kunimatsu N, Aoki S, Kunimatsu A, Abe O, Yamada H, Masutani Y, Kasai K, Yamasue H, Ohtomo K. Tract-specific analysis of white matter integrity disruption in schizophrenia. Psychiatry Res 2012; 201:136-43. [PMID: 22398298 DOI: 10.1016/j.pscychresns.2011.07.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Revised: 06/04/2011] [Accepted: 07/11/2011] [Indexed: 11/25/2022]
Abstract
Several studies have suggested that white matter integrity is disrupted in some brain regions in patients with schizophrenia. The purpose of this study was to assess the white matter integrity of the cingulum, uncinate fasciculus, fornix, and corpus callosum using diffusion tensor imaging (DTI). Participants comprised 39 patients with schizophrenia (19 males and 20 females) and 40 age-matched normal controls (20 males and 20 females). We quantitatively assessed the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the anterior cingulum, body of the cingulum, uncinate fasciculus, fornix, and corpus callosum on a tract-specific basis using diffusion tensor tractography (DTT). Group differences in FA and ADC between the patients and normal controls were sought. Additional exploratory analyses of the relationship between the FA or ADC and four clinical parameters (i.e., illness duration, positive symptom scores, negative symptom scores, and medication dosage) were performed. Results were analyzed in gender-combined and gender-separated group comparisons. FA was significantly lower on both sides of the anterior cingulum, uncinate fasciculus, and fornix in the schizophrenia patients irrespective of gender group separation. In the gender-combined analyses, significantly higher ADC values were demonstrated in the schizophrenia patients in both sides of the anterior cingulum, body of the cingulum and uncinate fasciculus, the left fornix, and the corpus callosum, compared with those of the normal controls. In the gender-separated analyses, the male patients showed higher ADC in the left anterior cingulum, the bilateral cingulum bodies, and the bilateral uncinate fasciculi. The female patients showed higher ADC in the right anterior cingulum, the left fornix, and the bilateral uncinate fasciculus. In correlation analyses, a significant negative correlation was found between illness duration and ADC in the right anterior cingulum in the gender-combined analyses. The gender-separated analyses found that the male patients had a significant negative correlation between negative symptom scores and FA in the right fornix, a positive correlation between illness duration and FA in the right anterior cingulum, and a negative correlation between illness duration and FA in the left uncinate fasciculus. Our DTI study showed that the integrity of white matter is disrupted in patients with schizophrenia. The results of our sub-analyses suggest that changes in FA and ADC may be related to negative symptom scores or illness duration.
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Affiliation(s)
- Natsuko Kunimatsu
- Department of Diagnostic Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, Japan.
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Abstract
Individuals with schizotypal personality disorder (SPD) share genetic, phenomenologic, and cognitive abnormalities with people diagnosed with schizophrenia. To date, 15 structural MRI studies of the brain have examined size, and 3 diffusion tensor imaging studies have examined white matter connectivity in SPD. Overall, both types of structural neuroimaging modalities have shown temporal lobe abnormalities similar to those observed in schizophrenia, while frontal lobe regions appear to show more sparing. This intriguing pattern suggests that frontal lobe sparing may suppress psychosis, which is consistent with the idea of a possible neuroprotective factor. In this paper, we review these 18 studies and discuss whether individuals with SPD who both resemble and differ from schizophrenia patients in their phenomenology, share some or all of the structural brain imaging characteristics of schizophrenia. We attempt to group the MRI abnormalities in SPD into three patterns: 1) a spectrum of severity-abnormalities are similar to those observed in schizophrenia but not so severe; 2) a spectrum of region-abnormalities affecting some, but not all, brain regions affected in schizophrenia; and 3) a spectrum of compensation-abnormalities reflecting greater-than-normal white matter volume, possibly serving as a buffer or compensatory mechanism protecting the individual with SPD from the frank psychosis observed in schizophrenia.
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Abstract
INTRODUCTION There is an urgent need to define the neurobiological and cognitive underpinnings of suicidal ideation and behavior in veterans with traumatic brain injury (TBI). Separate studies implicate frontal white matter systems in the pathophysiology of TBI, suicidality, and impulsivity. We examined the relationship between the integrity of major frontal white matter (WM) systems on measures of impulsivity and suicidality in veterans with TBI. METHODS Fifteen male veterans with TBI and 17 matched healthy controls (HC) received clinical ratings, measures of impulsivity and MRI scans on a 3T magnet. Diffusion tensor imaging (DTI) data for the genu and cingulum were analyzed using Freesurfer and FSL. Correlations were performed for fractional anisotropy (FA) (DTI) values and measures of suicidality and impulsivity for veterans with TBI. RESULTS Significantly decreased in FA values in the left cingulum (P = 0.02), and left (P = 0.02) and total genu (P = 0.01) were observed in the TBI group relative to controls. Measures of impulsivity were significantly greater for the TBI group and total and right cingulum FA positively correlated with current suicidal ideation and measures of impulsivity (P <0.03). CONCLUSION These data demonstrate a significant reduction in FA in frontal WM tracts in veterans with mild TBI that was associated with both impulsivity and suicidality. These findings may reflect a neurobiological vulnerability to suicidal risk related to white matter microstructure.
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Walterfang M, Velakoulis D, Whitford TJ, Pantelis C. Understanding aberrant white matter development in schizophrenia: an avenue for therapy? Expert Rev Neurother 2011; 11:971-87. [PMID: 21721915 DOI: 10.1586/ern.11.76] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although historically gray matter changes have been the focus of neuropathological and neuroradiological studies in schizophrenia, in recent years an increasing body of research has implicated white matter structures and its constituent components (axons, their myelin sheaths and supporting oligodendrocytes). This article summarizes this body of literature, examining neuropathological, neurogenetic and neuroradiological evidence for white matter pathology in schizophrenia. We then look at the possible role that antipsychotic medication may play in these studies, examining both its role as a potential confounder in studies examining neuronal density and brain volume, but also the possible role that these medications may play in promoting myelination through their effects on oligodendrocytes. Finally, the role of potential novel therapies is discussed.
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Affiliation(s)
- Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia.
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Phillips OR, Nuechterlein KH, Asarnow RF, Clark KA, Cabeen R, Yang Y, Woods RP, Toga AW, Narr KL. Mapping corticocortical structural integrity in schizophrenia and effects of genetic liability. Biol Psychiatry 2011; 70:680-9. [PMID: 21571255 PMCID: PMC3838300 DOI: 10.1016/j.biopsych.2011.03.039] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 03/03/2011] [Accepted: 03/23/2011] [Indexed: 12/31/2022]
Abstract
BACKGROUND Structural and diffusion tensor imaging studies implicate gray and white matter (WM) abnormalities and disruptions of neural circuitry in schizophrenia. However, the structural integrity of the superficial WM, comprising short-range association (U-fibers) and intracortical axons, has not been investigated in schizophrenia. METHODS High-resolution structural and diffusion tensor images and sophisticated cortical pattern matching methods were used to measure and compare global and local variations in superficial WM fractional anisotropy between schizophrenia patients and their relatives and community comparison subjects and their relatives (n = 150). RESULTS Compared with control subjects, patients showed reduced superficial WM fractional anisotropy distributed across each hemisphere, particularly in left temporal and bilateral occipital regions (all p < .05, corrected). Furthermore, by modeling biological risk for schizophrenia in patients, patient relatives, and control subjects, fractional anisotropy was shown to vary in accordance with relatedness to a patient in both hemispheres and in the temporal and occipital lobes (p < .05, corrected). However, effects did not survive correction procedures for two-group comparisons between patient relatives and control subjects. CONCLUSIONS Results extend previous findings restricted to deep WM pathways to demonstrate that disturbances in corticocortical connectivity are associated with schizophrenia and might indicate a genetic predisposition for the disorder. Because the structural integrity of WM plays a crucial role in the functionality of networks linking gray matter regions, disturbances in the coherence and organization of fibers at the juncture of the neuropil might relate to features of schizophrenia at least partially attributable to disease-related genetic factors.
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Murphy ML, Frodl T. Meta-analysis of diffusion tensor imaging studies shows altered fractional anisotropy occurring in distinct brain areas in association with depression. BIOLOGY OF MOOD & ANXIETY DISORDERS 2011; 1:3. [PMID: 22738088 PMCID: PMC3377129 DOI: 10.1186/2045-5380-1-3] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 09/27/2011] [Indexed: 11/10/2022]
Abstract
Fractional anisotropy anomalies occurring in the white matter tracts in the brains of depressed patients may reflect microstructural changes underlying the pathophysiology of this disorder. We conducted a meta-analysis of fractional anisotropy abnormalities occurring in major depressive disorder using voxel-based diffusion tensor imaging studies. Using the Embase, PubMed and Google Scholar databases, 89 relevant data sets were identified, of which 7 (including 188 patients with major depressive disorder and 221 healthy controls) met our inclusion criteria. Authors were contacted to retrieve any additional data required. Coordinates were extracted from clusters of significant white matter fractional anisotropy differences between patients and controls. Relevant demographic, clinical and methodological variables were extracted from each study or obtained directly from authors. The meta-analysis was carried out using Signed Differential Mapping. Patients with depression showed decreased white matter fractional anisotropy values in the superior longitudinal fasciculus and increased fractional anisotropy values in the fronto-occipital fasciculus compared to controls. Using quartile and jackknife sensitivity analysis, we found that reduced fractional anisotropy in the left superior longitudinal fasciculus was very stable, with increases in the right fronto-occipital fasciculus driven by just one study. In conclusion, our meta-analysis revealed a significant reduction in fractional anisotropy values in the left superior longitudinal fasciculus, which may ultimately play an important role in the pathology of depression.
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Affiliation(s)
- Melissa L Murphy
- Department of Psychiatry and Institute of Neuroscience, School of Medicine, Trinity College Dublin, University of Dublin, College Green, Dublin 2, Ireland.
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Melonakos E, Shenton M, Rathi Y, Terry D, Bouix S, Kubicki M. Voxel-based morphometry (VBM) studies in schizophrenia-can white matter changes be reliably detected with VBM? Psychiatry Res 2011; 193:65-70. [PMID: 21684124 PMCID: PMC3382976 DOI: 10.1016/j.pscychresns.2011.01.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 01/14/2011] [Accepted: 01/14/2011] [Indexed: 11/16/2022]
Abstract
Voxel-based morphometry (VBM) is a hypothesis-free, whole-brain, voxel-by-voxel analytic method that attempts to compare imaging data between populations. Schizophrenia studies have utilized this method to localize differences in diffusion tensor imaging (DTI) derived fractional anisotropy (FA), a measure of white matter integrity, between patients and healthy controls. The number of publications has grown, although it is unclear how reliable and reproducible this method is, given the subtle white matter abnormalities expected in schizophrenia. Here we analyze and combine results from 23 studies published to date that use VBM to study schizophrenia in order to evaluate the reproducibility of this method in DTI analysis. Coordinates of each region reported in DTI VBM studies published thus far in schizophrenia were plotted onto a Montreal Neurological Institute atlas, and their anatomical locations were recorded. Results indicated that the reductions of FA in patients with schizophrenia were scattered across the brain. Moreover, even the most consistently reported regions were reported independently in less than 35% of the articles studied. Other instances of reduced FA were replicated at an even lower rate. Our findings demonstrate striking inconsistency, with none of the regions reported in much more than a third of the published articles. This poor replication rate suggests that the application of VBM to DTI data may not be the optimal way for finding the subtle microstructural abnormalities suggested in schizophrenia.
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Affiliation(s)
- Eric Melonakos
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Doug Terry
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA,Corresponding author’s address: Psychiatry Neuroimaging Laboratory, 1249 Boylston St., Boston, MA 02215, Tel.: 617 525-6105, fax: 617 525-6150
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50
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Xu H, Li XM. White matter abnormalities and animal models examining a putative role of altered white matter in schizophrenia. SCHIZOPHRENIA RESEARCH AND TREATMENT 2011; 2011:826976. [PMID: 22937274 PMCID: PMC3420616 DOI: 10.1155/2011/826976] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 06/21/2011] [Indexed: 11/18/2022]
Abstract
Schizophrenia is a severe mental disorder affecting about 1% of the population worldwide. Although the dopamine (DA) hypothesis is still keeping a dominant position in schizophrenia research, new advances have been emerging in recent years, which suggest the implication of white matter abnormalities in schizophrenia. In this paper, we will briefly review some of recent human studies showing white matter abnormalities in schizophrenic brains and altered oligodendrocyte-(OL-) and myelin-related genes in patients with schizophrenia and will consider abnormal behaviors reported in patients with white matter diseases. Following these, we will selectively introduce some animal models examining a putative role of white matter abnormalities in schizophrenia. The emphasis will be put on the cuprizone (CPZ) model. CPZ-fed mice show demyelination and OLs loss, display schizophrenia-related behaviors, and have higher DA levels in the prefrontal cortex. These features suggest that the CPZ model is a novel animal model of schizophrenia.
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Affiliation(s)
- Haiyun Xu
- Department of Anatomy, Southern Illinois University Carbondale, Carbondale, IL 62901, USA
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada R3T 2N2
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