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Li H, Zhang W, Song H, Zhuo L, Yao H, Sun H, Liu R, Feng R, Tang C, Lui S. Altered temporal lobe connectivity is associated with psychotic symptoms in drug-naïve adolescent patients with first-episode schizophrenia. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02485-9. [PMID: 38832962 DOI: 10.1007/s00787-024-02485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/23/2024] [Indexed: 06/06/2024]
Abstract
Research on individuals with a younger onset age of schizophrenia is important for identifying neurobiological processes derived from the interaction of genes and the environment that lead to the manifestation of schizophrenia. Schizophrenia has long been recognized as a disorder of dysconnectivity, but it is largely unknown how brain connectivity changes are associated with psychotic symptoms. Twenty-one adolescent-onset schizophrenia (AOS) patients and 21 matched healthy controls (HCs) were recruited and underwent resting-state functional magnetic resonance imaging. Regional homogeneity (ReHo) was used to investigate local brain connectivity alterations in AOS. Regions with significant ReHo changes in patients were selected as "seeds" for further functional connectivity (FC) analysis and Granger causality analysis (GCA), and associations of the obtained functional brain measures with psychotic symptoms in patients with AOS were examined. Compared with HCs, AOS patients showed significantly increased ReHo in the right middle temporal gyrus (MTG), which was positively correlated with PANSS-positive scores, PSYRATS-delusion scores and auditory hallucination scores. With the MTG as the seed, lower connectivity with the bilateral postcentral gyrus (PCG) and higher connectivity with the right precuneus were observed in patients. The reduced FC between the right MTG and bilateral PCG was significantly and positively correlated with hallucination scores. GCA indicated decreased Granger causality from the right MTG to the left middle frontal gyrus (MFG) and from the right MFG to the right MTG in AOS patients, but such effects did not significantly associate with psychotic symptoms. Abnormalities in the connectivity within the MTG and its connectivity with other networks were identified and were significantly correlated with hallucination and delusion ratings. This region may be a key neural substrate of psychotic symptoms in AOS.
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Affiliation(s)
- Hongwei Li
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Wenjing Zhang
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Hui Song
- Department of Psychiatry, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Lihua Zhuo
- Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Hongchao Yao
- Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Hui Sun
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ruishan Liu
- Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Ruohan Feng
- Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Chungen Tang
- Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, China
| | - Su Lui
- Department of Radiology, and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China.
- Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
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2
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Farrugia C, Galdi P, Irazu IA, Scerri K, Bajada CJ. Local gradient analysis of human brain function using the Vogt-Bailey Index. Brain Struct Funct 2024; 229:497-512. [PMID: 38294531 PMCID: PMC10917869 DOI: 10.1007/s00429-023-02751-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/09/2023] [Indexed: 02/01/2024]
Abstract
In this work, we take a closer look at the Vogt-Bailey (VB) index, proposed in Bajada et al. (NeuroImage 221:117140, 2020) as a tool for studying local functional homogeneity in the human cortex. We interpret the VB index in terms of the minimum ratio cut, a scaled cut-set weight that indicates whether a network can easily be disconnected into two parts having a comparable number of nodes. In our case, the nodes of the network consist of a brain vertex/voxel and its neighbours, and a given edge is weighted according to the affinity of the nodes it connects (as reflected by the modified Pearson correlation between their fMRI time series). Consequently, the minimum ratio cut quantifies the degree of small-scale similarity in brain activity: the greater the similarity, the 'heavier' the edges and the more difficult it is to disconnect the network, hence the higher the value of the minimum ratio cut. We compare the performance of the VB index with that of the Regional Homogeneity (ReHo) algorithm, commonly used to assess whether voxels in close proximity have synchronised fMRI signals, and find that the VB index is uniquely placed to detect sharp changes in the (local) functional organization of the human cortex.
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Affiliation(s)
- Christine Farrugia
- Faculty of Engineering, L-Università ta' Malta, Msida, Malta.
- University of Malta Magnetic Resonance Imaging Platform (UMRI), L-Università ta' Malta, Msida, Malta.
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
| | - Paola Galdi
- School of Informatics, The University of Edinburgh, Edinburgh, UK
| | | | - Kenneth Scerri
- Faculty of Engineering, L-Università ta' Malta, Msida, Malta
| | - Claude J Bajada
- University of Malta Magnetic Resonance Imaging Platform (UMRI), L-Università ta' Malta, Msida, Malta.
- Faculty of Medicine and Surgery, L-Università ta' Malta, Msida, Malta.
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3
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Ma X, Yang WFZ, Zheng W, Li Z, Tang J, Yuan L, Ouyang L, Wang Y, Li C, Jin K, Wang L, Bearden CE, He Y, Chen X. Neuronal dysfunction in individuals at early stage of schizophrenia, A resting-state fMRI study. Psychiatry Res 2023; 322:115123. [PMID: 36827856 DOI: 10.1016/j.psychres.2023.115123] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
Schizophrenia has been associated with abnormal intrinsic brain activity, involving various cognitive impairments. Qualitatively similar abnormalities are seen in individuals at ultra-high risk (UHR) for psychosis. In this study, resting-state fMRI (rs-fMRI) data were collected from 44 drug-naïve first-episode schizophrenia (Dn-FES) patients, 48 UHR individuals, and 40 healthy controls (HCs). The fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and functional connectivity (FC), were performed to evaluate resting brain function. A support vector machine (SVM) was applied for classification analysis. Compared to HCs, both clinical groups showed increased fALFF in the central executive network (CEN), decreased ReHo in the ventral visual pathway (VVP) and decreased FC in temporal-sensorimotor regions. Excellent performance was achieved by using fALFF value in distinguishing both FES (sensitivity=83.21%, specificity=80.58%, accuracy=81.37%, p=0.009) and UHR (sensitivity=75.88%, specificity=85.72%, accuracy=80.72%, p<0.001) from HC group. Moreover, the study highlighted the importance of frontal and temporal alteration in the pathogenesis of schizophrenia. However, no fMRI features were observed that could well distinguish Dn-FES from UHR group. To conclude, fALFF in the CEN may provide potential power for identifying individuals at the early stage of schizophrenia and the alteration in the frontal and temporal lobe may be important to these individuals.
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Affiliation(s)
- Xiaoqian Ma
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, United States
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, United States
| | - Wenxiao Zheng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Department of Clinical Medicine, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zongchang Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Jinsong Tang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Liu Yuan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Lijun Ouyang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Yujue Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China
| | - Chunwang Li
- Department of Radiology, Hunan Children's Hospital, Changsha, China
| | - Ke Jin
- Department of Radiology, Hunan Children's Hospital, Changsha, China
| | - Lingyan Wang
- Department of Deratology&Traditional Chinese Medicine, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital)
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, United States
| | - Ying He
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; National Technology Institute of Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Hunan Medical Center for Mental Health, Changsha, Hunan, China.
| | - Xiaogang Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, No.139, Renmin Rd, Second Xiangya Hospital, Changsha, Hunan, China; Mental Health Institute of Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; National Technology Institute of Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China; Hunan Medical Center for Mental Health, Changsha, Hunan, China.
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Marcos-Vidal L, Martínez-García M, Martín de Blas D, Navas-Sánchez FJ, Pretus C, Ramos-Quiroga JA, Richarte V, Vilarroya Ó, Sepulcre J, Desco M, Carmona S. Local Functional Connectivity as a Parsimonious Explanation of the Main Frameworks for ADHD in Medication-Naïve Adults. J Atten Disord 2022; 26:1788-1801. [PMID: 35684934 DOI: 10.1177/10870547221101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Neuroimaging studies in children with ADHD indicate that their brain exhibits an atypical functional connectivity pattern characterized by increased local connectivity and decreased distant connectivity. We aim to evaluate if the local and distant distribution of functional connectivity is also altered in adult samples with ADHD who have never received medication before. Methods: We compared local and distant functional connectivity between 31 medication-naïve adults with ADHD and 31 healthy controls and tested whether this pattern was associated with symptoms severity scores. Results: ADHD sample showed increased local connectivity in the dACC and the SFG and decreased local connectivity in the PCC. Conclusion: Results parallel those obtained in children samples suggesting a deficient integration within the DMN and segregation between DMN, FPN, and VAN. These results are consistent with the three main frameworks that explain ADHD: the neurodevelopmental delay hypothesis, the DMN interference hypothesis, and multi-network models.
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Affiliation(s)
- Luis Marcos-Vidal
- Universidad Carlos III de Madrid, Madrid, Spain.,Instituto de Investigación Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain
| | - Magdalena Martínez-García
- Instituto de Investigación Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain
| | | | | | - Clara Pretus
- Unitat de Reserca en Neurociencia Cognitiva, Departament de Psiquiatría i Neurociencia Legal, Universitat Autònoma de Barcelona, Spain.,Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain.,Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Vanesa Richarte
- Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain.,Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Óscar Vilarroya
- Unitat de Reserca en Neurociencia Cognitiva, Departament de Psiquiatría i Neurociencia Legal, Universitat Autònoma de Barcelona, Spain.,Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Jorge Sepulcre
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.,Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Manuel Desco
- Universidad Carlos III de Madrid, Madrid, Spain.,Instituto de Investigación Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain.,Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Susanna Carmona
- Universidad Carlos III de Madrid, Madrid, Spain.,Instituto de Investigación Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain
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5
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Marcos-Vidal L, Martínez-García M, Martín-de Blas D, Navas-Sánchez FJ, Pretus C, Ramos-Quiroga JA, Richarte V, Vilarroya Ó, Sepulcre J, Desco M, Carmona S. Local Functional Connectivity as a Parsimonious Explanation of the Main Frameworks for ADHD in Medication-Naïve Adults. J Atten Disord 2022; 26:1563-1575. [PMID: 35947490 DOI: 10.1177/10870547211031998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Neuroimaging studies in children with ADHD indicate that their brain exhibits an atypical functional connectivity pattern characterized by increased local connectivity and decreased distant connectivity. We aim to evaluate if the local and distant distribution of functional connectivity is also altered in adult samples with ADHD who have never received medication before. METHODS We compared local and distant functional connectivity between 31 medication-naïve adults with ADHD and 31 healthy controls and tested whether this pattern was associated with symptoms severity scores. RESULTS ADHD sample showed increased local connectivity in the dACC and the SFG and decreased local connectivity in the PCC. CONCLUSION Results parallel those obtained in children samples suggesting a deficient integration within the DMN and segregation between DMN, FPN, and VAN. These results are consistent with the three main frameworks that explain ADHD: the neurodevelopmental delay hypothesis, the DMN interference hypothesis and multi-network models.
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Affiliation(s)
- Luis Marcos-Vidal
- Universidad Carlos III de Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Health Institute Carlos III, Madrid, Spain
| | - Magdalena Martínez-García
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Health Institute Carlos III, Madrid, Spain
| | | | | | - Clara Pretus
- Universitat Autònoma de Barcelona, Spain.,Fundació Institut Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Health Institute Carlos III, Madrid, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Research Institute, Barcelona, Spain
| | - Vanesa Richarte
- Health Institute Carlos III, Madrid, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Research Institute, Barcelona, Spain
| | - Óscar Vilarroya
- Universitat Autònoma de Barcelona, Spain.,Fundació Institut Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Jorge Sepulcre
- Massachusetts General Hospital and Harvard Medical School, Charlestown, USA
| | - Manuel Desco
- Universidad Carlos III de Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Health Institute Carlos III, Madrid, Spain.,Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Susanna Carmona
- Universidad Carlos III de Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Health Institute Carlos III, Madrid, Spain
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6
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Tong W, Dong Z, Guo W, Zhang M, Zhang Y, Du Y, Zhao J, Lv L, Liu Y, Wang X, Kou Y, Zhang H, Zhang H. Progressive Changes in Brain Regional Homogeneity Induced by Electroconvulsive Therapy Among Patients With Schizophrenia. J ECT 2022; 38:117-123. [PMID: 35613010 DOI: 10.1097/yct.0000000000000815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Electroconvulsive therapy (ECT) has significant effects on improving psychotic symptoms in schizophrenia (SZ), but the changes of brain function induced by it are unclear. The purpose of the study was to explore progressive ECT-induced changes in regional homogeneity (ReHo) at multiple time points before, during, and after a course of ECT. METHODS The 27 in-patients with SZ (SZ group) who met the recruitment criteria accepted clinical evaluations and resting-state functional magnetic resonance imaging scans before the first ECT (pre-ECT), after the first ECT (ECT1), and after the eighth ECT (ECT8), all conducted within 10 to 12 hours. Forty-three healthy controls (HCs; HC group) who matched well with the patients for age, sex, and years of education were recruited. For Positive and Negative Syndrome Scale (PANSS) and ReHo, progressive changes were examined. RESULTS Pair-wise comparisons of patient pre-ECT, ECT1, and ECT8 ReHo values with HC ReHo values revealed that ECT normalized the ReHo values in bilateral superior occipital gyrus (SOG), right lingual gyrus (LG), left medial prefrontal cortex. Furthermore, improved ReHo in bilateral SOG and right LG appeared after the first ECT application. The ReHo values in right middle occipital gyrus, right middle temporal gyrus, and right inferior parietal lobule were not significantly altered by ECT. The total PANSS score was lower even after the first ECT application (mean ΔPANSSECT1, 11.7%; range, 2%-32.8%) and markedly reduced after the eighth application (mean ΔPANSSECT8, 86.3%; range, 72.5%-97.9%). CONCLUSIONS The antipsychotic effects of ECT may be achieved through regulating synchronization of some regions such as bilateral SOG, right LG, and left medial prefrontal cortex. Furthermore, the enhanced synchronizations also take place in other regions.
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Affiliation(s)
- Wenjing Tong
- From the School of Psychology of Xinxiang Medical University
| | | | - Wenbin Guo
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha
| | - Meng Zhang
- From the School of Psychology of Xinxiang Medical University
| | - Yujuan Zhang
- Department of Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang
| | - Yunhong Du
- Department of Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang
| | - Jingping Zhao
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha
| | - Luxian Lv
- Department of Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang
| | - Yahui Liu
- From the School of Psychology of Xinxiang Medical University
| | - Xueke Wang
- From the School of Psychology of Xinxiang Medical University
| | - Yanna Kou
- Department of Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang
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7
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Tang D, Zhang X, Xu Y, Dai L, Sun J, Hu H, Jiang H, Jin P, Chen L, Fang J. The Central Response of Electroacupuncture on Trigeminal Neuralgia Based on Resting-State Functional Magnetic Resonance Imaging: A Protocol for a Pre-Experimental, Single-Centre, Randomized, Controlled Trial. J Pain Res 2021; 14:3321-3331. [PMID: 34707400 PMCID: PMC8543029 DOI: 10.2147/jpr.s334078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To verify the efficacy of electroacupuncture (EA) on classical trigeminal neuralgia (CTN), and to observe the brain functional status of patients with CTN and the intervention effects of EA on brain function by resting-state functional magnetic resonance imaging (rs-fMRI). Methods and Analysis Thirty CTN patients will be randomly divided into EA combined with carbamazepine group and carbamazepine group in 2:1 ratio by using a random number table. Patients in EA combined with carbamazepine will receive EA treatment and carbamazepine for four weeks. The carbamazepine group will only receive carbamazepine treatment. VAS (visual analogue scale), HAMA (Hamilton Anxiety Scale), HAMD (Hamilton Depression Scale) and SF-36 (short form 36 health survey) will be performed before, after four-week treatments and at three-month follow-up in CTN patients. Six CTN patients will be randomly selected from EA combined with carbamazepine group and carbamazepine group, respectively, before treatment, and twelve paired healthy participants will be recruited at the same time. The twelve CTN patients will be scanned by rs-fMRI before and after treatment, and the healthy participants will be scanned by rs-fMRI only at baseline. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) analysis will be carried out to compare the dysfunctional brain regions between CTN patients and healthy participants, as well as the differences between two groups of patients with CTN after treatment. Trial Registration ChiCTR-1900027873.
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Affiliation(s)
- Ding Tang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Xufen Zhang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Yani Xu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Linglin Dai
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianlan Sun
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Hantong Hu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Huangwei Jiang
- Department of Radiological, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Ping Jin
- Department of Radiological, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Lifang Chen
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianqiao Fang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
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8
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Feng ZJ, Deng XP, Zhao N, Jin J, Yue J, Hu YS, Jing Y, Wang HX, Knösche TR, Zang YF, Wang J. Resting-State fMRI Functional Connectivity Strength Predicts Local Activity Change in the Dorsal Cingulate Cortex: A Multi-Target Focused rTMS Study. Cereb Cortex 2021; 32:2773-2784. [PMID: 34689201 PMCID: PMC9247427 DOI: 10.1093/cercor/bhab380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/19/2022] Open
Abstract
Previous resting state functional magnetic resonance imaging (RS-fMRI) studies suggested that repetitive transcranial magnetic stimulation (rTMS) can modulate local activity in distant areas via functional connectivity (FC). A brain region has more than one connection with the superficial cortical areas. The current study proposed a multi-target focused rTMS protocol for indirectly stimulating a deep region, and to investigate 1) whether FC strength between stimulation targets (right middle frontal gyrus [rMFG] and right inferior parietal lobule [rIPL]) and effective region (dorsal anterior cingulate cortex [dACC]) can predict local activity changes of dACC and 2) whether multiple stimulation targets can focus on the dACC via FC. A total of 24 healthy participants received rTMS with two stimulation targets, both showing strong FC with the dACC. There were four rTMS conditions (>1 week apart, 10 Hz, 1800 pulses for each): rMFG-target, rIPL-target, Double-targets (900 pulses for each target), and Sham. The results failed to validate the multi-target focused rTMS hypothesis. But rMFG-target significantly decreased the local activity in the dACC. In addition, stronger dACC-rMFG FC was associated with a greater local activity change in the dACC. Future studies should use stronger FC to focus stimulation effects on the deep region.
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Affiliation(s)
- Zi-Jian Feng
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Xin-Ping Deng
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Na Zhao
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Jing Jin
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Juan Yue
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Yun-Song Hu
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Ying Jing
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Hong-Xiao Wang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Thomas R Knösche
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig 04103, Germany
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China.,Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 310015, China
| | - Jue Wang
- Institute of sports medicine and health, Chengdu Sport University, Chengdu 610041, China
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Salazar de Pablo G, Catalan A, Fusar-Poli P. Clinical Validity of DSM-5 Attenuated Psychosis Syndrome: Advances in Diagnosis, Prognosis, and Treatment. JAMA Psychiatry 2020; 77:311-320. [PMID: 31746950 DOI: 10.1001/jamapsychiatry.2019.3561] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Since the release of the DSM-5 diagnosis of attenuated psychosis syndrome (DSM-5-APS) in 2013, several research studies have investigated its clinical validity. Although critical and narrative reviews have reviewed these progresses, no systematic review has comprehensively summarized the available evidence regarding the clinical validity of DSM-5-APS. OBJECTIVE To provide current evidence on the clinical validity of DSM-5-APS, focusing on recent advances in diagnosis, prognosis, and treatment. EVIDENCE REVIEW A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, conference proceedings, and trial registries from database inception to June 16, 2019, was conducted following PRISMA and MOOSE guidelines and PROSPERO protocol. Studies with original data investigating individuals diagnosed using DSM-5-APS or meeting comparable criteria were included. The results of the systematic review were summarized in tables and narratively synthesized against established evidence-based antecedent, concurrent, and prognostic validators. A quantitative meta-analysis was conducted to explore the cumulative risk of psychosis onset at 6, 12, 24, and 36 months in individuals diagnosed using DSM-5-APS criteria. FINDINGS The systematic review included 56 articles, which reported on 124 validators, including 15 antecedent, 55 concurrent, and 54 prognostic validators. The epidemiological prevalence of the general non-help-seeking young population meeting DSM-5-APS criteria was 0.3%; the prevalence of individuals meeting DSM-5-APS criteria was variable in clinical samples. The interrater reliability for DSM-5-APS criteria was comparable with that of other DSM-5 mental disorders and can be optimized by the use of specific psychometric instruments. DSM-5-APS criteria were associated with frequent depressive comorbid disorders, distress, suicidality, and functional impairment. The meta-analysis included 23 prospective cohort studies, including 2376 individuals. The meta-analytical risk of psychosis onset was 11% at 6 months, 15% at 12 months, 20% at 24 months, and 23% at 36 months. Research into predisposing and precipitating epidemiological factors, neurobiological correlates, and effective treatments for DSM-5-APS criteria has been limited. CONCLUSIONS AND RELEVANCE Over recent years, DSM-5-APS criteria have received substantial concurrent and prognostic validation, mostly driven by research into the clinical high-risk state for psychosis. Precipitating and predisposing factors, neurobiological correlates, and effective treatments are undetermined to date.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Institute of Psychiatry and Mental Health, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.,Mental Health Group, BioCruces Health Research Institute, Bizkaia, Spain.,Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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