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Wang YM, Zhang YY, Wang Y, Cao Q, Zhang M. Task-related brain activation associated with violence in patients with schizophrenia: A meta-analysis. Asian J Psychiatr 2024; 97:104080. [PMID: 38788320 DOI: 10.1016/j.ajp.2024.104080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/20/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
This study investigates specific changes in brain function during cognitive and emotional tasks in patients with schizophrenia and a history of violence (VSCZ) compared with non-violent patients with schizophrenia and healthy controls. A comprehensive literature search was conducted at the Web of Science, Medline, and PubMed. Ten studies met the inclusion criteria. In which, eight studies compared brain activation between patients with VSCZ and non-violent patients with schizophrenia, and the former exhibited increased activation at the middle occipital gyrus and rectus compared with the latter. Seven studies compared brain activation between patients with VSCZ and controls, and the former exhibited increased activation at the anterior cingulate cortex, cerebellum VI region, lingual gyrus and fusiform. Subgroup analysis in five studies performing emotional tasks revealed that patients with VSCZ showed increased activation at the middle occipital gyrus compared with non-violent patients with schizophrenia. Our findings suggest that abnormal emotion perception and regulation significantly contribute to the increased risk of violence in patients with schizophrenia. Notably, the middle occipital gyrus and rectus emerge as key neurophysiological correlates associated with this phenomenon.
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Affiliation(s)
- Yong-Ming Wang
- School of Biology & Basic Medical Sciences, Medical College of Soochow University, Suzhou 215123, China
| | - Yi-Yang Zhang
- The Second Clinical Medical School, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Ying Wang
- School of Biology & Basic Medical Sciences, Medical College of Soochow University, Suzhou 215123, China
| | - Qun Cao
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Meng Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing 100096, China.
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2
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Lu J, Gou N, Sun Q, Huang Y, Guo H, Han D, Zhou J, Wang X. Brain structural alterations associated with impulsiveness in male violent patients with schizophrenia. BMC Psychiatry 2024; 24:281. [PMID: 38622613 PMCID: PMC11017613 DOI: 10.1186/s12888-024-05721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Violence in schizophrenia (SCZ) is a phenomenon associated with neurobiological factors. However, the neural mechanisms of violence in patients with SCZ are not yet sufficiently understood. Thus, this study aimed to explore the structural changes associated with the high risk of violence and its association with impulsiveness in patients with SCZ to reveal the possible neurobiological basis. METHOD The voxel-based morphometry approach and whole-brain analyses were used to measure the alteration of gray matter volume (GMV) for 45 schizophrenia patients with violence (VSC), 45 schizophrenia patients without violence (NSC), and 53 healthy controls (HC). Correlation analyses were used to examine the association of impulsiveness and brain regions associated with violence. RESULTS The results demonstrated reduced GMV in the right insula within the VSC group compared with the NSC group, and decreased GMV in the right temporal pole and left orbital part of superior frontal gyrus only in the VSC group compared to the HC group. Spearman correlation analyses further revealed a positive correlation between impulsiveness and GMV of the left superior temporal gyrus, bilateral insula and left medial orbital part of the superior frontal gyrus in the VSC group. CONCLUSION Our findings have provided further evidence for structural alterations in patients with SCZ who had engaged in severe violence, as well as the relationship between the specific brain alterations and impulsiveness. This work provides neural biomarkers and improves our insight into the neural underpinnings of violence in patients with SCZ.
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Affiliation(s)
- Juntao Lu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Ningzhi Gou
- Department of Psychiatry, the First Affiliated Hospital, Medical College of Xi 'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Qiaoling Sun
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Ying Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Huijuan Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Dian Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
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3
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Wolfs EML, Klaus J, Schutter DJLG. Cerebellar Grey Matter Volumes in Reactive Aggression and Impulsivity in Healthy Volunteers. CEREBELLUM (LONDON, ENGLAND) 2023; 22:223-233. [PMID: 35247193 PMCID: PMC9985584 DOI: 10.1007/s12311-021-01337-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 01/06/2023]
Abstract
Several lines of evidence point towards the involvement of the cerebellum in reactive aggression. In addition to the posterior cerebellar hemisphere, the vermis has been suggested to play a prominent role in impulse regulation. In the present study, we set out to further examine the relationships between cerebellar grey matter volumes, aggression, and impulsivity in 201 healthy volunteers. 3 T structural magnetic resonance imaging scans were acquired to investigate grey matter volumes of the cerebellar vermis and the anterior and posterior lobules. Aggression was assessed with the Buss-Perry Aggression Questionnaire and impulsivity was measured with the Barratt Impulsiveness Scale-11. Results showed that impulsivity was positively associated with grey matter volumes of the cerebellar vermis and inversely correlated with grey matter volumes of the right posterior lobule. In addition, smaller volumes of the right posterior lobules were associated with higher physical aggression. Exploratory analyses indicated that for the right hemisphere, this association was driven by grey matter volumes of lobules VIIb and VIIIa. Our findings provide correlational evidence in healthy volunteers for the involvement of the cerebellar vermis and posterior lobules in a cortico-limbic-cerebellar circuit of aggression.
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Affiliation(s)
- Elze M L Wolfs
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Jana Klaus
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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4
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Yu T, Pei W, Xu C, Zhang X, Deng C. Prediction of violence in male schizophrenia using sMRI, based on machine learning algorithms. BMC Psychiatry 2022; 22:676. [PMID: 36320010 PMCID: PMC9628088 DOI: 10.1186/s12888-022-04331-1] [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: 07/19/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Violent behavior in patients with schizophrenia (SCZ) is a major social problem. The early identification of SCZ patients with violence can facilitate implementation of targeted intervention. METHODS A total of 57 male SCZ patients were recruited into this study. The general linear model was utilized to compare differences in structural magnetic resonance imaging (sMRI) including gray matter volume, cortical surface area, and cortical thickness between 30 SCZ patients who had exhibited violence and 27 SCZ patients without a history of violence. Based on machine learning algorithms, the different sMRI features between groups were integrated into the models for prediction of violence in SCZ patients. RESULTS After controlling for the whole brain volume and age, the general linear model showed significant reductions in right bankssts thickness, inferior parietal thickness as well as left frontal pole volume in the patients with SCZ and violence relative to those without violence. Among seven machine learning algorithms, Support Vector Machine (SVM) have better performance in differentiating patients with violence from those without violence, with its balanced accuracy and area under curve (AUC) reaching 0.8231 and 0.841, respectively. CONCLUSIONS Patients with SCZ who had a history of violence displayed reduced cortical thickness and volume in several brain regions. Based on machine learning algorithms, structural MRI features are useful to improve predictive ability of SCZ patients at particular risk of violence.
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Affiliation(s)
- Tao Yu
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Wenzhi Pei
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Chunyuan Xu
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Xulai Zhang
- Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People's Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022, Anhui, China.
| | - Chenchen Deng
- Anhui Province Maternity & Child Health Hospital, Hefei, 230022, Anhui, China.
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Abstract
Homicide is a significant societal problem with economic costs in the billions of dollars annually and incalculable emotional impact on victims and society. Despite this high burden, we know very little about the neuroscience of individuals who commit homicide. Here we examine brain gray matter differences in incarcerated adult males who have committed homicide (n = 203) compared to other non-homicide offenders (n = 605; total n = 808). Homicide offenders' show reduced gray matter in brain areas critical for behavioral control and social cognition compared with subsets of other violent and non-violent offenders. This demonstrates, for the first time, that unique brain abnormalities may distinguish offenders who kill from other serious violent offenders and non-violent antisocial individuals.
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Elsheikh M. Study of attention measured by event-related potential as a predictive factor of violence among patients with schizophrenia and substance use disorder. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00024-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The prediction of violence in patients with psychiatric disorders remains a challenging aspect in the field of clinical research. Many studies search the linkage between aggressive behavior and certain genetic conditions, impaired socio-emotional information processing, demographic, and clinical variables. To our knowledge, by far the relationship between aggressive behavior and impaired attention is not clear. Attention is one of the clinical variables that might have a relation to increased aggressive tendency in many psychiatric patients. So the purpose of this study is to measure the attention using ERP and search for its relation to violence in schizophrenic patients and patients with substance use disorder. This cross-sectional study was carried out on a sample of schizophrenic inpatients and patients with SUD (86 male patients) at the psychiatric department of Al-Hussein University Hospital, Cairo, Egypt.
Results
The majority of the sample lies in the age group 20–29 years old (38.4%), whereas MOAS showed that the higher tendency to violence was in the dual diagnosis of schizophrenia disorder with SUD followed by patients diagnosed with SUD.
P300 wave measurement analysis reflected that the attention is highly affected in SUD patients, while schizophrenics showed delayed thinking. The relationship has a statistical significance (P = 0.001).A statistically significant direct correlation between P300 wave amplitude, latency, and the scale of violence was also found (P = 0.009 and P = 0.022) respectively.
Conclusion
Affected attention in both schizophrenic and SUD patients could be considered a potential risk factor of violence.
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Tikàsz A, Potvin S, Dugré JR, Fahim C, Zaharieva V, Lipp O, Mendrek A, Dumais A. Violent Behavior Is Associated With Emotion Salience Network Dysconnectivity in Schizophrenia. Front Psychiatry 2020; 11:143. [PMID: 32180744 PMCID: PMC7059347 DOI: 10.3389/fpsyt.2020.00143] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/17/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Despite individuals with schizophrenia being at an elevated risk of violence compared to the general population, limited efforts have been invested in investigating the neurobiological etiology explaining the increase. Among the few studies examining functional disruptions pertaining to violent schizophrenia patients using fMRI, only one study has considered functional connectivity. The current state of knowledge does not allow to infer deficits in functional connectivity specific to distinct cognitive/emotional states that have been associated with the emergence of violence in schizophrenia, such as negative emotion processing. This study sought to identify disrupted connectivity among men with schizophrenia and a history of violence (SCZ+V), compared to men with schizophrenia without a history of violence (SCZ-V) and healthy controls, during negative emotion processing using fMRI. Methods: Twenty SCZ+V, 19 SCZ-V, and 21 healthy men were scanned while viewing negative images. Results: Negative images elicited an increased connectivity between the dorsal anterior cingulate cortex (dACC) and the bilateral rostral prefrontal cortex (rPFC), as well as a decreased functional connectivity between the frontal regions (bilateral rPFC and dACC) and the putamen and hippocampus in SCZ+V men as compared to SCZ-V men and healthy controls. Concurrently, the centrality of the dACC within the network was reduced in SCV+V subjects. Conclusions: These results suggest an inefficient integration of the information by the dACC between frontal and limbic regions in SCZ+V men during negative emotion processing and highlight the importance of the ACC in the neurobiological bases of violent behavior in schizophrenia.
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Affiliation(s)
- Andràs Tikàsz
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Jules R Dugré
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Cherine Fahim
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada.,Centre de recherche du CHU Ste-Justine, Montreal, QC, Canada
| | - Vessela Zaharieva
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Olivier Lipp
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Adrianna Mendrek
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychology, Bishop's University, Sherbrooke, QC, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada.,Institut Philippe-Pinel de Montréal, Montreal, QC, Canada
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8
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Liu F, Shao Y, Li X, Liu L, Zhao R, Xie B, Qiao Y. Volumetric Abnormalities in Violent Schizophrenia Patients on the General Psychiatric Ward. Front Psychiatry 2020; 11:788. [PMID: 33117201 PMCID: PMC7493665 DOI: 10.3389/fpsyt.2020.00788] [Citation(s) in RCA: 3] [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: 03/25/2020] [Accepted: 07/23/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In recent years, neuroimaging has been used increasingly to explore the biological underpinnings of violence carried out by schizophrenia patients (SPs). Studies have focused mostly on patients with a history of carrying out severe physical assaults, or comorbid with substance abuse/personality disorder (SA/PD). As a result, participants were unrepresentative and the interpretation of brain-structure changes was confusing. Here, we concentrated on SPs on a general psychiatric ward with a history of relatively lower violence, and individuals comorbid with SA or PD were excluded. We expected to identify the characteristics of brain morphometry in this population, and to explore whether the morphometric changes were universal. METHODS Forty-eight violent schizophrenia patients (VSPs), twenty-seven non-VSPs (nVSPs) and 28 nonviolent healthy controls (HCs) were investigated. Voxel-based morphometry was used to evaluate the gray matter volume (GMV) of all study participants. Whole-brain analyses were used to reveal group effects and differences between any two groups. Correlation analyses were undertaken between significant brain regions and behavioral measurements in the VSP group. RESULTS Patients showed a significantly smaller GMV in widespread frontal, temporal, and limbic regions compared with HCs. No region was found in which the two patient groups had significantly larger volumes compared with that in HCs. A significant decrease in the GMV of the right fusiform gyrus was found in the VSP group compared with that in the nVSP group (p = 0.004), where the GMV of this region had a negative correlation with the Physical Aggression [subscale of the Modified Overt Aggression Scale (MOAS)] or Hostility score. The VSP group showed a trend of GMV decrease in the left middle temporal cortex compared with that in the nVSP group (p = 0.077). Negative correlation was also found between the GMV of left inferior temporal gyrus/left Superior frontal gyrus, medial and the Hostility score. CONCLUSIONS Our results provide initial evidence demonstrating the generalizability of GMV abnormalities in SPs engaged in varying levels of violence, even when SA or PD have not been implicated. GMV reduction was correlated with only the Physical Aggression subscale score of the MOAS, suggesting that this change in brain morphology may be dependent upon different types of violent actions.
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Affiliation(s)
- FengJu Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Shao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Li
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Li Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Xie
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Qiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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9
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Cho W, Shin WS, An I, Bang M, Cho DY, Lee SH. Biological Aspects of Aggression and Violence in Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:475-486. [PMID: 31671484 PMCID: PMC6852683 DOI: 10.9758/cpn.2019.17.4.475] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 12/24/2022]
Abstract
Although the majority of patients with schizophrenia are not actually violent, an increased tendency toward violent behaviors is known to be associated with schizophrenia. There are several factors to consider when identifying the subgroup of patients with schizophrenia who may commit violent or aggressive acts. Comorbidity with substance abuse is the most important clinical indicator of increased aggressive behaviors and crime rates in patients with schizophrenia. Genetic studies have proposed that polymorphisms in the promoter region of the serotonin transporter gene and in the catechol-O-methyltransferase gene are related to aggression. Neuroimaging studies have suggested that fronto-limbic dysfunction may be related to aggression or violence. By identifying specific risk factors, a more efficient treatment plan to prevent violent behavior in schizophrenia will be possible. Management of comorbid substance use disorder may help prevent violent events and overall aggression. Currently, clozapine may be the only effective antipsychotic medication to repress aggressive behavior. With the current medical field moving toward tailored medicine, it is important to identify vulnerable schizophrenia populations and provide efficient treatment.
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Affiliation(s)
- WonKyung Cho
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA Universiy School of Medicine, Korea
| | - Won-Suk Shin
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA Universiy School of Medicine, Korea
| | - Iseul An
- Clinical Counseling Psychology Graduate School, CHA University, Korea.,Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Doo-Yeoun Cho
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA Universiy School of Medicine, Korea
| | - Sang-Hyuk Lee
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA Universiy School of Medicine, Korea.,Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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10
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Zhang YD, Zhou JS, Lu FM, Wang XP. Reduced gray matter volume in male adolescent violent offenders. PeerJ 2019; 7:e7349. [PMID: 31534834 PMCID: PMC6730529 DOI: 10.7717/peerj.7349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/25/2019] [Indexed: 01/20/2023] Open
Abstract
Background Previous studies reported that reduced gray matter volume (GMV) was associated with violent-related behaviors. However, the previous studies were conducted on adults and no study has studied the association between GMV and violent behaviors on adolescents. The purpose of the study was to investigate GMV’s effects in adolescent violent offenders based on a Chinese Han population, which can address the problem of possible confounding factors in adult studies. Methods We recruited 30 male adolescent violent offenders and 29 age- and sex-matched healthy controls (HCs). Differences in both whole-brain and GMV were evaluated using voxel-based morphometry (VBM). We assessed the accuracy of VBM using the receiver operating characteristic curve (ROC) and discriminant analysis. Results Compared with HCs, the male adolescent offenders showed significantly reduced GMV in five cortical and subcortical brain regions, including the olfactory cortex, amygdala, middle temporal gyrus and inferior parietal lobe in the left hemisphere, as well as the right superior temporal gyrus. Both ROC curve and discriminate analyses showed that these regions had relatively high sensitivities (58.6%–89.7%) and specificities (58.1%–74.2%) with 76.7% classification accuracy. Conclusions Our results indicated that reduced volume in the frontal-temporal-parietal-subcortical circuit may be closely related to violent behaviors in male adolescents, which might be an important biomarker for detecting violent behaviors in male adolescents.
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Affiliation(s)
- Ying-Dong Zhang
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Jian-Song Zhou
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Feng-Mei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.,School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, Cichuan, China
| | - Xiao-Ping Wang
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
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11
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Schoretsanitis G, Stegmayer K, Razavi N, Federspiel A, Müller TJ, Horn H, Wiest R, Strik W, Walther S. Inferior frontal gyrus gray matter volume is associated with aggressive behavior in schizophrenia spectrum disorders. Psychiatry Res Neuroimaging 2019; 290:14-21. [PMID: 31254799 DOI: 10.1016/j.pscychresns.2019.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/19/2022]
Abstract
We aimed to assess potential gray matter (GM) alterations for aggressive patterns of behavior in a sample of in- and outpatients with schizophrenia spectrum disorders. Eighty-four patients previously participating in brain volumetric studies were included. Aggression was assessed using the Modified Overt Aggression Scales (MOAS) based upon review of clinical records of the hospital register. Multiple regression analyses for total MOAS and each MOAS subscale separately were conducted correcting for age, sex, history of addiction, chlorpromazine equivalents, illness duration, and total intracranial volume. Significant effects were reported in two cases; the total MOAS scores and MOAS verbal aggression scores were associated with GM volume in left inferior frontal gyrus. From the demographic/clinical characteristics, only the number of episodes correlated with the subscales and the total MOAS scores. Our results highlight the role of GM volume in left inferior frontal gyri in patients with history of aggression. This evidence ties in well with previous data reporting involvement of these regions in response control and semantic networks.
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Affiliation(s)
- Georgios Schoretsanitis
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland; Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.
| | | | - Nadja Razavi
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland
| | - Andrea Federspiel
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland
| | - Thomas J Müller
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland; Privatklinik Meiringen, Meiringen, Switzerland
| | - Helge Horn
- Institute of Psychiatry and Psychotherapy Bern, Switzerland; University of Bern, University Hospital of Psychiatry, Bern, Switzerland
| | - Roland Wiest
- Institute of Neuroradiology, Inselspital, Bern, Switzerland
| | - Werner Strik
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland
| | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Bern, Switzerland
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12
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Voxel-Based Morphometry Correlates of an Agitated-Aggressive Syndrome in the At-Risk Mental State for Psychosis and First Episode Psychosis. Sci Rep 2018; 8:16516. [PMID: 30409978 PMCID: PMC6224526 DOI: 10.1038/s41598-018-33770-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/06/2018] [Indexed: 12/29/2022] Open
Abstract
There are mixed reports on structural neuroimaging correlates of aggression in schizophrenia with weak evidence due to cohort overlaps and lack of replications. To our knowledge, no study examined volumetric neuroimaging correlates of aggression in early stages of psychosis. An agitated-aggressive syndrome is present in at-risk mental state (ARMS) and in first-episode psychosis (FEP) - it is unclear whether this syndrome is associated with structural brain abnormalities in early stages of psychosis. Using three-dimensional magnetic resonance imaging and a whole brain voxel-based morphometry approach, we examined 56 ARMS patients, 55 FEP patients and 25 healthy controls. We operationalized aggression using the Excited Component of the Brief Psychiatric Rating Scale (BPRS-EC) and dichotomized our patient group by median split into "BPRS-EC high" (n = 49) and "BPRS-EC low" groups (n = 62). The "BPRS-EC high" group had significantly smaller left lingual gyrus volume than HC. This finding was not present in the "BPRS-EC low" group. In addition, grey matter volume in the left lingual gyrus showed a negative linear correlation with BPRS-EC over all subjects (ρ = -0.318; p = 0.0001) and in the patient group (ρ = -0.202; p = 0.033). These findings provide first hints on structural brain abnormalities associated with an agitated-aggressive syndrome in ARMS and FEP patients.
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Abstract
A large proportion of the persons who join terrorist groups as well as lone-acting terrorists have a history of violent behavior or mental disorder that predated their becoming terrorists. This suggests that brain alterations found to occur in violent perpetrators may also be present in a significant percentage of terrorists. After a short delineation of phylogenetically old neuronal networks that are important for the generation of aggressive behavior in inconspicuous brains, this review summarizes structural and functional brain-imaging studies in violent offenders published over the last 10 years. Depending on the subtype of violence (impulsive or instrumental), deviations in structure or function were mainly found in the prefrontal, orbitofrontal, and insular cortex, as well as in temporolimbic structures (e.g., the amygdala, hippocampus, and parahippocampus). These brain areas are essentially responsible for the control of the archaic neuronal generators of aggression located in the hypothalamus and limbic system. This regional distribution of brain alterations also shows a remarkable overlap with those brain regions that are crucial for such prosocial traits as empathy and compassion. Feelings of superiority, dominance, and satisfaction gained by performing violent and terroristic attacks suggest that a hedonistic component via an activation of brain reward systems plays an additional role. In our current debate about the causes of terrorism, aspects of brain dysfunction should receive more attention.
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Lin H, Zhang L, Lin D, Chen W, Zhu Y, Chen C, Chan KC, Liu Y, Chen W. Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery. EBioMedicine 2018; 30:52-61. [PMID: 29548900 PMCID: PMC5952227 DOI: 10.1016/j.ebiom.2018.03.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/01/2018] [Accepted: 03/04/2018] [Indexed: 01/19/2023] Open
Abstract
Background Visual function and brain function decline concurrently with aging. Notably, cataract patients often present with accelerated age-related decreases in brain function, but the underlying mechanisms are still unclear. Optical structures of the anterior segment of the eyes, such as the lens and cornea, can be readily reconstructed to improve refraction and vision quality. However, the effects of visual restoration on human brain function and structure remain largely unexplored. Methods A prospective, controlled clinical trial was conducted. Twenty-six patients with bilateral age-related cataracts (ARCs) who underwent phacoemulsification and intraocular lens implantation and 26 healthy controls without ARC, matched for age, sex, and education, were recruited. Visual functions (including visual acuity, visual evoke potential, and contrast sensitivity), the Mini-Mental State Examination and functional magnetic resonance imaging (including the fractional amplitude of low-frequency fluctuations and grey matter volume variation) were assessed for all the participants and reexamined for ARC patients after cataract surgery. This trial was registered with ClinicalTrials.gov (NCT02644720). Findings Compared with the healthy controls, the ARC patients presented decreased brain functionality as well as structural alterations in visual and cognitive-related brain areas preoperatively. Three months postoperatively, significant functional improvements were observed in the visual and cognitive-related brain areas of the patients. Six months postoperatively, the patients' grey matter volumes in these areas were significantly increased. Notably, both the function and structure in the visual and cognitive-related brain areas of the patients improved significantly and became comparable to those of the healthy controls 6 months postoperatively. Interpretation We demonstrated that ocular reconstruction can functionally and structurally reverse cataract-induced brain changes. The integrity of the eye is essential for maintaining the structure and function of the brain within and beyond the primary visual pathway. Cataract patients with reduced visual function presented a simultaneous decrease in brain function and grey matter volume. Cataract surgery can reverse cerebral changes in both visual and cognitive-related regions associated with visual decline. The integrity of the eye is essential for maintaining the structure and function of the brain.
The eyes and brain are anatomically and functionally connected. Age related cataract (ARC) is associated with structural and functional impairments of the brain. However, whether these changes are reversible after cataract surgery is largely unknown. We assessed the patients based on subjective cognitive evaluations and objective functional magnetic resonance imaging before and after surgery. Significant improvements in brain function and increases in the grey matter volumes of the visual, cognitive-related, and somatosensory brain areas were observed, demonstrating that the impaired brain function and structure of ARC patients can be reversed after restoration of visual acuity.
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Affiliation(s)
- Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China.
| | - Li Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China; Department of Ophthalmology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, People's Republic of China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China; Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China; Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Kevin C Chan
- NYU Eye Center, Department of Ophthalmology, NYU School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA; Department of Radiology, NYU School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China.
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China.
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15
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Fjellvang M, Grøning L, Haukvik UK. Imaging Violence in Schizophrenia: A Systematic Review and Critical Discussion of the MRI Literature. Front Psychiatry 2018; 9:333. [PMID: 30083111 PMCID: PMC6064955 DOI: 10.3389/fpsyt.2018.00333] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/02/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Persons with schizophrenia have a small but significant increase in risk of violence, which remains after controlling for known environmental risk factors. In vivo MRI-studies may point toward the biological underpinnings of psychotic violence, and neuroimaging has increasingly been used in forensic and legal settings despite unclear relevance. Objectives: (1) To present the first systematic review, following standardized guidelines, of MRI studies of violence with schizophrenia. (2) To critically discuss the promises and pitfalls of using this literature to understand violence in schizophrenia in clinical, forensic, and legal settings. Methods: Following the PRISMA guidelines and literature searches until January 2018, we found 21 original studies that fulfilled the inclusion criteria: (1) Studies of persons with schizophrenia, (2) a history of violence or aggressive behavior, (3) the use of one or more MRI-modalities (sMRI, DTI, fMRI). Results: The most consistent findings from the structural studies were reduced volumes of the hippocampus and the frontal lobe (in particular the orbitofrontal and anterior cingulate cortex) in schizophrenia patients with a history of violence or higher aggression scores. The functional studies mainly showed differences and aggression correlates in the frontal lobe and amygdala. However, the studies were methodologically heterogeneous, with four particular areas of concern: different definitions of violence, region of interest vs. whole-brain studies, small subject samples, and group comparisons in a heterogeneous diagnostic category (schizophrenia). Conclusion: The literature reports subtle, but inconsistent group level differences in brain structure and function associated with violence and aggression with schizophrenia, in particular in areas involved in the formation of psychosis symptoms and affective regulation. Due to methodological challenges the results should be interpreted with caution. In order to come closer to the neurobiological underpinnings of violence in schizophrenia future studies could: (1) address the neurobiological differences of premeditated and reactive violence, (2) use RDoC criteria, for example, or other symptom-based systems to categorize psychosis patients, (3) increase subject cohorts and apply new data driven methods. In this perspective, MRI-studies of violence in schizophrenia have the potential to inform clinical violence prediction and legal evaluations in the future.
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Affiliation(s)
- Maria Fjellvang
- Department of Mental Health and Addiction, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linda Grøning
- SIFER WEST, Haukeland University Hospital, Bergen, Norway.,Faculty of Law, University of Bergen, Bergen, Norway
| | - Unn K Haukvik
- Department of Mental Health and Addiction, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
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16
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Widmayer S, Sowislo JF, Jungfer HA, Borgwardt S, Lang UE, Stieglitz RD, Huber CG. Structural Magnetic Resonance Imaging Correlates of Aggression in Psychosis: A Systematic Review and Effect Size Analysis. Front Psychiatry 2018; 9:217. [PMID: 29930519 PMCID: PMC6000417 DOI: 10.3389/fpsyt.2018.00217] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/07/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Aggression in psychoses is of high clinical importance, and volumetric MRI techniques have been used to explore its structural brain correlates. Methods: We conducted a systematic review searching EMBASE, ScienceDirect, and PsycINFO through September 2017 using thesauri representing aggression, psychosis, and brain imaging. We calculated effect sizes for each study and mean Hedge's g for whole brain (WB) volume. Methodological quality was established using the PRISMA checklist (PROSPERO: CRD42014014461). Results: Our sample consisted of 12 studies with 470 patients and 155 healthy controls (HC). After subtracting subjects due to cohort overlaps, 314 patients and 96 HC remained. Qualitative analyses showed lower volumes of WB, prefrontal regions, temporal lobe, hippocampus, thalamus and cerebellum, and higher volumes of lateral ventricles, amygdala, and putamen in violent vs. non-violent people with schizophrenia. In quantitative analyses, violent persons with schizophrenia exhibited a significantly lower WB volume than HC (p = 0.004), and also lower than non-violent persons with schizophrenia (p = 0.007). Conclusions: We reviewed evidence for differences in brain volume correlates of aggression in persons with schizophrenia. Our results point toward a reduced whole brain volume in violent as opposed to non-violent persons with schizophrenia. However, considerable sample overlap in the literature, lack of reporting of potential confounding variables, and missing research on affective psychoses limit our explanatory power. To permit stronger conclusions, further studies evaluating structural correlates of aggression in psychotic disorders are needed.
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Affiliation(s)
- Sonja Widmayer
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland
| | - Julia F Sowislo
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland
| | - Hermann A Jungfer
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland.,Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Asklepios Klinik Nord-Ochsenzoll, Hamburg, Germany
| | - Stefan Borgwardt
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland
| | - Undine E Lang
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland
| | - Rolf D Stieglitz
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland.,Fakultät für Psychologie, Universität Basel, Basel, Switzerland
| | - Christian G Huber
- Erwachsenen-Psychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Basel, Switzerland
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17
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Abstract
Violence is a serious public health issue across the world. This article assists clinicians in understanding the most up-to-date literature regarding structural and functional brain theories related to risk of violence. In this article, we review anatomic regions of the brain that have been implicated in violence and associated personality constructs associated with violence. We discuss different imaging techniques that have been used to uncover abnormal brain volume, associations, and functions throughout the brain in samples with violence history or risk. Finally, we discuss implications of these findings both for treatment considerations and future research directions.
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Affiliation(s)
- Delaney Smith
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH 43214, USA; Twin Valley Behavioral Healthcare, 2200 West Broad Street, Columbus, OH 43223, USA.
| | - Riley Smith
- Department of Physical Medicine and Rehabilitation, Wayne State University/Beaumont, 18181 Oakwood Boulevard, Suite 411, Dearborn, MI 48124, USA
| | - Douglas Misquitta
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH 43214, USA
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18
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Liu X, Zhuo C, Qin W, Zhu J, Xu L, Xu Y, Yu C. Selective functional connectivity abnormality of the transition zone of the inferior parietal lobule in schizophrenia. NEUROIMAGE-CLINICAL 2016; 11:789-795. [PMID: 27354957 PMCID: PMC4910186 DOI: 10.1016/j.nicl.2016.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/17/2016] [Accepted: 05/31/2016] [Indexed: 12/02/2022]
Abstract
Structural and functional alterations in the inferior parietal lobule (IPL) in schizophrenia have been frequently reported; however, the IPL connectivity changes in schizophrenia remain largely unknown. Based on heterogeneity of the IPL in structure, connection and function, we hypothesize that the resting-state functional connectivities (rsFCs) of the IPL subregions are differentially affected in schizophrenia. This study included 95 schizophrenia patients and 104 healthy controls. The IPL subregions were defined according to a previous in vivo connection-based parcellation study. We calculated the rsFC of each IPL subregion and compared them between the two groups while controlling for the effects of age, gender, and grey matter volume. Among the six subregions of the left IPL and the five subregions of the right IPL, only the bilateral PFm (a transition zone of the IPL) subregions exhibited abnormal rsFC in schizophrenia. Specifically, the left PFm showed increased rsFC with the bilateral lingual gyri in schizophrenia patients than in healthy controls. The right PFm exhibited increased rsFC with the right lingual gyrus and inferior occipital gyrus, and bilateral mid-cingulate and sensorimotor cortices in schizophrenia patients. These findings suggest a selective rsFC abnormality in the IPL subregions in schizophrenia, characterized by the increased rsFC between the PFm subregion of the IPL and the visual and sensorimotor areas. Investigation of the subregional-level rsFC changes of the IPL in schizophrenia The PFm is only IPL subregion with significant rsFC changes in schizophrenia. Suggesting a selective rsFC abnormality in the IPL subregions in schizophrenia
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Affiliation(s)
- Xingyun Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chuanjun Zhuo
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin 300222, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jiajia Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lixue Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yongjie Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
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19
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Tikàsz A, Potvin S, Lungu O, Joyal CC, Hodgins S, Mendrek A, Dumais A. Anterior cingulate hyperactivations during negative emotion processing among men with schizophrenia and a history of violent behavior. Neuropsychiatr Dis Treat 2016; 12:1397-410. [PMID: 27366072 PMCID: PMC4913973 DOI: 10.2147/ndt.s107545] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Evidence suggests a 2.1-4.6 times increase in the risk of violent behavior in schizophrenia compared to the general population. Current theories propose that the processing of negative emotions is defective in violent individuals and that dysfunctions within the neural circuits involved in emotion processing are implicated in violence. Although schizophrenia patients show enhanced sensitivity to negative stimuli, there are only few functional neuroimaging studies that have examined emotion processing among men with schizophrenia and a history of violence. OBJECTIVE The present study aimed to identify the brain regions with greater neurofunctional alterations, as detected by functional magnetic resonance imaging during an emotion processing task, of men with schizophrenia who had engaged in violent behavior compared with those who had not. METHODS Sixty men were studied; 20 with schizophrenia and a history of violence, 19 with schizophrenia and no violence, and 21 healthy men were scanned while viewing positive, negative, and neutral images. RESULTS Negative images elicited hyperactivations in the anterior cingulate cortex (ACC), left and right lingual gyrus, and the left precentral gyrus in violent men with schizophrenia, compared to nonviolent men with schizophrenia and healthy men. Neutral images elicited hyperactivations in the right and left middle occipital gyrus, left lingual gyrus, and the left fusiform gyrus in violent men with schizophrenia, compared to the other two groups. DISCUSSION Violent men with schizophrenia displayed specific increases in ACC in response to negative images. Given the role of the ACC in information integration, these results indicate a specific dysfunction in the processing of negative emotions that may trigger violent behavior in men with schizophrenia.
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Affiliation(s)
- Andràs Tikàsz
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Trois-Rivières, QC, Canada; Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Trois-Rivières, QC, Canada; Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada
| | - Ovidiu Lungu
- Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Trois-Rivières, QC, Canada; Centre for Research in Aging, Donald Berman Maimonides Geriatric Centre, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Christian C Joyal
- Institut Philippe-Pinel de Montréal, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sheilagh Hodgins
- Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada; Institut Philippe-Pinel de Montréal, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Adrianna Mendrek
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Trois-Rivières, QC, Canada; Department of Psychology, Bishop's University, Sherbrooke, QC, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Trois-Rivières, QC, Canada; Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada; Institut Philippe-Pinel de Montréal, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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20
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Tényi T, Halmai T, Antal A, Benke B, Jeges S, Tényi D, Tóth ÁL, Csábi G. Minor physical anomalies are more common in schizophrenia patients with the history of homicide. Psychiatry Res 2015; 225:702-5. [PMID: 25500346 DOI: 10.1016/j.psychres.2014.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 10/09/2014] [Accepted: 11/06/2014] [Indexed: 10/24/2022]
Abstract
Minor physical anomalies may be external markers of abnormal brain development, so the more common appearance of these signs in homicidal schizophrenia might suggest the possibility of a more seriously aberrant neurodevelopment in this subgroup. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with schizophrenia with the history of committed or attempted homicide comparing them to patients with schizophrenia without homicide in their history and to normal control subjects. Using a list of 57 minor physical anomalies, 44 patients with the diagnosis of schizophrenia were examined with the history of committed or attempted homicide, as a comparison 22 patients with the diagnosis of schizophrenia without the history of any kind of homicide and violence and 21 normal control subjects were examined. Minor physical anomalies are more common in homicidal schizophrenia patients compared to non-homicidal schizophrenia patients and normal controls, which could support a stronger neurodevelopmental component of etiology in this subgroup of schizophrenia. The higher rate of minor physical anomalies found predominantly in the head and mouth regions in homicidal schizophrenia patients might suggest the possibility of a more seriously aberrant brain development in the case of homicidal schizophrenia.
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Affiliation(s)
- Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2, H-7623 Pécs, Hungary.
| | - Tamás Halmai
- Forensic Psychiatric Mental Institution, Budapest, Hungary
| | - Albert Antal
- Forensic Psychiatric Mental Institution, Budapest, Hungary
| | - Bálint Benke
- Forensic Psychiatric Mental Institution, Budapest, Hungary
| | - Sára Jeges
- Institute of Nursing and Patients Care, Faculty of Health Sciences, University of Pécs, Hungary
| | - Dalma Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2, H-7623 Pécs, Hungary
| | - Ákos Levente Tóth
- Institute of Physical Education and Sport Science, Faculty of Sciences, University of Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, University of Pécs, Faculty of Medicine, Pécs, Hungary
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21
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Richard-Devantoy S, Orsat M, Dumais A, Turecki G, Jollant F. Neurocognitive vulnerability: suicidal and homicidal behaviours in patients with schizophrenia. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:18-25. [PMID: 24444320 PMCID: PMC4079223 DOI: 10.1177/070674371405900105] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Schizophrenia is associated with an increase in the risk of both homicide and suicide. The objectives of this study were to systematically review all published articles that examined the relation between neurocognitive deficits and suicidal or homicidal behaviours in schizophrenia, and to identify vulnerabilities in suicidal and homicidal behaviour that may share a common pathway in schizophrenia. METHODS A systematic review of the literature was performed using MEDLINE to include all studies published up to August 31, 2012. RESULTS Among the 1760 studies, 7 neuropsychological and 12 brain imaging studies met the selection criteria and were included in the final analysis. The neuropsychological and functional neuroimaging studies were inconclusive. The structural imaging studies reported various alterations in patients with schizophrenia and a history of homicidal behaviour, including: reduced inferior frontal and temporal cortices, increased mediodorsal white matter, and increased amygdala volumes. Patients with a history of suicidal acts showed volumetric reductions in left orbitofrontal and superior temporal cortices, while right amygdala volume was increased, though, these findings have rarely been replicated. Finally, no study has directly compared neurocognitive markers of suicidal and homicidal risk. CONCLUSION These results suggest that brain alterations, in addition to those associated with schizophrenia, may predispose some patients to a higher risk of homicide or suicide in particular circumstances. Moreover, some of these alterations may be shared between homicidal and suicidal patients. However, owing to several limitations, including the small number of available studies, no firm conclusions can be drawn and further investigations are necessary.
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Affiliation(s)
- Stéphane Richard-Devantoy
- Psychiatrist, Postdoctoral Fellow in Neuroscience, Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, McGill University, Montreal, Quebec; Associate Member, Laboratoire de Psychologie des Pays de la Loire, UPRES EA 4638, Université d'Angers, Angers, France
| | - Manuel Orsat
- Psychiatrist, Secteur 16 de Psychiatrie Adultes, Centre Hospitalier Spécialisé de la Sarthe, Allonnes, France
| | - Alexandre Dumais
- Psychiatrist, Assistant Professor, Department of Psychiatry and Research Centre-Pinel Institut, University of Montreal, Montreal, Quebec
| | - Gustavo Turecki
- Professor, Departments of Psychiatry, Human Genetics, and Neurology and Neurosurgery, McGill University, Montreal, Quebec; Vice-Chair, Research and Academic Affairs, Department of Psychiatry, McGill University, Montreal, Quebec; Director, McGill Group for Suicide Studies, Montreal, Quebec; Co-Director, Douglas-Bell Canada Brain Bank (suicide studies), Montreal, Quebec; Head, Depressive Disorders Program, Douglas Institute, Montreal, Quebec; Director, Réseau québécois de recherche sur le suicide, Montreal, Quebec
| | - Fabrice Jollant
- Assistant Professor, Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, McGill University, Montreal, Quebec
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22
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Weiss EM. Neuroimaging and neurocognitive correlates of aggression and violence in schizophrenia. SCIENTIFICA 2012; 2012:158646. [PMID: 24278673 PMCID: PMC3820648 DOI: 10.6064/2012/158646] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/02/2012] [Indexed: 06/02/2023]
Abstract
Individuals diagnosed with major mental disorders such as schizophrenia are more likely to have engaged in violent behavior than mentally healthy members of the same communities. Although aggressive acts can have numerous causes, research about the underlying neurobiology of violence and aggression in schizophrenia can lead to a better understanding of the heterogeneous nature of that behavior and can assist in developing new treatment strategies. The purpose of this paper is to review the recent literature and discuss some of the neurobiological correlates of aggression and violence. The focus will be on schizophrenia, and the results of neuroimaging and neuropsychological studies that have directly investigated brain functioning and/or structure in aggressive and violent samples will be discussed as well as other domains that might predispose to aggression and violence such as deficits in responding to the emotional expressions of others, impulsivity, and psychopathological symptoms. Finally gender differences regarding aggression and violence are discussed. In this context several methodological and conceptional issues that limited the comparison of these studies will be addressed.
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Affiliation(s)
- Elisabeth M. Weiss
- Department of Psychology, Karl-Franzens University of Graz, University-Platz 2, 8010 Graz, Austria
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23
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Abstract
There is much evidence that schizophrenia patients have an increased risk for aggression and violent behavior, including homicide. The neurobiological basis and correlates of this risk have not been much studied. While genome-wide association studies are lacking, a number of candidate genes have been investigated. By far, the most intensively studied is the catechol-O-methyltransferase (COMT) gene on chromosome 22. COMT is involved in the metabolism of dopamine, a key neurotransmitter in schizophrenia pathophysiology. Several studies suggest that the Val158Met polymorphism of this gene affects COMT activity. Methionine (Met)/Met homozygote schizophrenia patients show 4- to 5-fold lower COMT activity than valine (Val)/Val homozygotes, and some but not all studies have found an association with aggression and violence. Recently, a new functional single-nucleotide polymorphism in the COMT gene, Ala72Ser, was found to be associated with homicidal behavior in schizophrenia, but this finding warrants further replication. Studies published so far indicate that an association with the monoamine oxidase A, B, or tryptophan hydroxylase 1 genes is unlikely. Data for the brain-derived neurotrophic factor gene are conflicting and limited. Data from the limited number of neuroimaging studies performed to date are interesting. Frontal and temporal lobe abnormalities are found consistently in aggressive schizophrenia patients. Positron emission tomography and single photon-emission computed tomography (SPECT) data indicate deficits also in the orbitofrontal and temporal cortex. Some functional magnetic resonance imaging studies found a negative association of violent behavior with frontal and right-sided inferior parietal activity. Neuroimaging studies may well help further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behavior.
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Affiliation(s)
- Michael Soyka
- Psychiatric Hospital, Ludwig Maximilian University, Nussbaumstrasse 7, 80336 Munich, Germany.
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24
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Yang Y, Raine A, Han CB, Schug RA, Toga AW, Narr KL. Reduced hippocampal and parahippocampal volumes in murderers with schizophrenia. Psychiatry Res 2010; 182:9-13. [PMID: 20227253 PMCID: PMC2855857 DOI: 10.1016/j.pscychresns.2009.10.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2009] [Revised: 10/27/2009] [Accepted: 10/29/2009] [Indexed: 11/19/2022]
Abstract
Evidence has accumulated to suggest that individuals with schizophrenia are at increased risk for violent offending. Furthermore, converging evidence suggests that abnormalities in the fronto-limbic system, including the prefrontal cortex, the hippocampus, and the parahippocampal gyrus, may contribute towards both neuropsychological disturbances in schizophrenia and violent behavior. Since the behavioral and clinical consequences of disturbed fronto-limbic circuitry appear to differ in schizophrenia and violence, it may be argued that patients with schizophrenia who exhibit violent behavior would demonstrate different structural abnormalities compared to their non-violent counterparts. However, the neurobiological basis underlying homicide offenders with schizophrenia remains unclear and little is known regarding the cross-cultural applicability of the findings. Using a 2 x 2 factorial design on a total Chinese sample of 92 males and females, we found reduced gray matter volume in the hippocampus and parahippocampal gyrus in murderers with schizophrenia, in the parahippocampal gyrus in murderers without schizophrenia, and in the prefrontal cortex in non-violent schizophrenia compared to normal controls. Results provide initial evidence demonstrating cross-cultural generalizability of prior fronto-limbic findings on violent schizophrenia. Future studies examining subtle morphological changes in frontal and limbic structures in association with clinical and behavioral characteristics may help further clarify the neurobiological basis of violent behavior.
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Affiliation(s)
- Yaling Yang
- Laboratory of NeuroImaging, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Mudge J, Miller NA, Khrebtukova I, Lindquist IE, May GD, Huntley JJ, Luo S, Zhang L, van Velkinburgh JC, Farmer AD, Lewis S, Beavis WD, Schilkey FD, Virk SM, Black CF, Myers MK, Mader LC, Langley RJ, Utsey JP, Kim RW, Roberts RC, Khalsa SK, Garcia M, Ambriz-Griffith V, Harlan R, Czika W, Martin S, Wolfinger RD, Perrone-Bizzozero NI, Schroth GP, Kingsmore SF. Genomic convergence analysis of schizophrenia: mRNA sequencing reveals altered synaptic vesicular transport in post-mortem cerebellum. PLoS One 2008; 3:e3625. [PMID: 18985160 PMCID: PMC2576459 DOI: 10.1371/journal.pone.0003625] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 10/10/2008] [Indexed: 02/06/2023] Open
Abstract
Schizophrenia (SCZ) is a common, disabling mental illness with high heritability but complex, poorly understood genetic etiology. As the first phase of a genomic convergence analysis of SCZ, we generated 16.7 billion nucleotides of short read, shotgun sequences of cDNA from post-mortem cerebellar cortices of 14 patients and six, matched controls. A rigorous analysis pipeline was developed for analysis of digital gene expression studies. Sequences aligned to approximately 33,200 transcripts in each sample, with average coverage of 450 reads per gene. Following adjustments for confounding clinical, sample and experimental sources of variation, 215 genes differed significantly in expression between cases and controls. Golgi apparatus, vesicular transport, membrane association, Zinc binding and regulation of transcription were over-represented among differentially expressed genes. Twenty three genes with altered expression and involvement in presynaptic vesicular transport, Golgi function and GABAergic neurotransmission define a unifying molecular hypothesis for dysfunction in cerebellar cortex in SCZ.
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Affiliation(s)
- Joann Mudge
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Neil A. Miller
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | | | - Ingrid E. Lindquist
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Gregory D. May
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Jim J. Huntley
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Shujun Luo
- Illumina Inc., Hayward, California, United States of America
| | - Lu Zhang
- Illumina Inc., Hayward, California, United States of America
| | | | - Andrew D. Farmer
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Sharon Lewis
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - William D. Beavis
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Faye D. Schilkey
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Selene M. Virk
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - C. Forrest Black
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - M. Kathy Myers
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Lar C. Mader
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Ray J. Langley
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - John P. Utsey
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Ryan W. Kim
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
| | - Rosalinda C. Roberts
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Sat Kirpal Khalsa
- Northern New Mexico College, Española, New Mexico, United States of America
| | - Meredith Garcia
- Northern New Mexico College, Española, New Mexico, United States of America
| | | | - Richard Harlan
- Northern New Mexico College, Española, New Mexico, United States of America
| | - Wendy Czika
- SAS Institute, Cary, North Carolina, United States of America
| | - Stanton Martin
- SAS Institute, Cary, North Carolina, United States of America
| | | | - Nora I. Perrone-Bizzozero
- Department of Neurosciences, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Gary P. Schroth
- Illumina Inc., Hayward, California, United States of America
| | - Stephen F. Kingsmore
- National Center for Genome Resources, Santa Fe, New Mexico, United States of America
- * E-mail:
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26
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Affiliation(s)
- Basant K Puri
- MRI Unit, MRC Clinical Sciences Centre, Imaging Sciences Department, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
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