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Liu S, Zhong H, Qian Y, Cai H, Jia YB, Zhu J. Neural mechanism underlying the beneficial effect of Theory of Mind psychotherapy on early-onset schizophrenia: a randomized controlled trial. J Psychiatry Neurosci 2023; 48:E421-E430. [PMID: 37935475 PMCID: PMC10635708 DOI: 10.1503/jpn.230049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/03/2023] [Accepted: 08/14/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Psychosocial interventions have emerged as an important component of a comprehensive therapeutic approach in early-onset schizophrenia, typically representing a more severe form of the disorder. Despite the feasibility and efficacy of Theory of Mind (ToM) psychotherapy for schizophrenia, relatively little is known regarding the neural mechanism underlying its effect on early-onset schizophrenia. METHODS We performed a randomized, active controlled trial in patients with early-onset schizophrenia, who were randomly allocated into either an intervention (ToM psychotherapy) or an active control (health education) group. Diffusion tensor imaging data were collected to construct brain structural networks, with both global and regional topological properties measured using graph theory. RESULTS We enrolled 28 patients with early-onset schizophrenia in our study. After 5 weeks of treatment, both the intervention and active control groups showed significant improvement in psychotic symptoms, yet the improvement was greater in the intervention group. Importantly, in contrast with no brain structural network change after treatment in the active control group, the intervention group showed increased nodal centrality of the left insula that was associated with psychotic symptom improvement. LIMITATIONS We did not collect important information concerning the participants' cognitive abilities, particularly ToM performance. CONCLUSION These findings suggest a potential neural mechanism by which ToM psychotherapy exerts a beneficial effect on early-onset schizophrenia via strengthening the coordination capacity of the insula in brain structural networks, which may provide a clinically translatable biomarker for monitoring or predicting responses to ToM psychotherapy.Clinical trial registration: NCT05577338; ClinicalTrials.gov.
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Affiliation(s)
- Siyu Liu
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Hui Zhong
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Yinfeng Qian
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Huanhuan Cai
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Yan-Bin Jia
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
| | - Jiajia Zhu
- From the Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Liu, Qian, Cai, Zhu); the Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China (Liu, Qian, Cai, Zhu); the Anhui Provincial Institute of Translational Medicine, Hefei, China (Liu, Qian, Cai, Zhu); the Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China (Zhong, Jia); the Department of Child and Adolescent Psychology, Anhui Mental Health Center, Hefei, China (Zhong); and the Hefei Fourth People's Hospital, Hefei, China (Zhong)
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Maltais M, de Souto Barreto P, Perus L, Mangin JF, Grigis A, Chupin M, Bouyahia A, Gabelle A, Delrieux J, Rolland Y, Vellas B. Prospective Associations Between Diffusion Tensor Imaging Parameters and Frailty in Older Adults. J Am Geriatr Soc 2020; 68:1050-1055. [PMID: 31981370 DOI: 10.1111/jgs.16343] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cross-sectional associations have been found between frail individuals and worse white matter (WM) integrity. However, the prospective association between WM integrity and frailty is still unclear. Our objectives were to measure associations between WM integrity using diffusion tensor imaging (DTI) and the 5-year worsening of frailty in community-dwelling older adults. DESIGN Secondary analysis of the randomized controlled Multidomain Alzheimer Preventive Trial (MAPT). SETTING Thirteen memory centers in France and Monaco between 2008 and 2011. PARTICIPANTS Participants (mean age = 74.7 ± 3.9 years) with no dementia at baseline who had functional magnetic resonance imaging performed as part of the MAPT study (n = 227). MEASUREMENTS Fractional anisotropy and mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD) were acquired for 10 different brain regions. Frailty was assessed by the Fried frailty phenotype (score from 0 to 5, higher is worse) at up to seven time points for 5 years. Mixed effect ordinal logistic regression model was used to assess the prospective association between DTI parameters (independent variables) and frailty (dependent variable). All the analyses were adjusted for age, sex, baseline total intracranial volume, and the presence of one of the following cardiovascular risk factors (hypertension, diabetes, and/or hypercholesterolemia). RESULTS A statistically significant association was found between the RD, AxD, and MD for different brain regions (anterior limb of internal capsule, external capsule, posterior corona radiata, posterior thalamic radiation, superior corona radiata, superior frontal occipital fasciculus, and superior longitudinal fasciculus) and worsening of frailty over 5 years after adjusting for multiple comparisons. CONCLUSIONS This is the first study to show that WM integrity is associated with frailty in older adults. The mechanisms related to these results require further investigation. J Am Geriatr Soc 68:1050-1055, 2020.
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Affiliation(s)
- Mathieu Maltais
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,France Faculté de Médecine, Unités mixtes de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1027, University of Toulouse III, Toulouse, France
| | - Lisa Perus
- Memory Resources and Research Center, Montpellier University Hospital, INSERM U1061, University of Montpellier i-Site Montpellier Université d'Excellence (MUSE), Montpellier, France
| | - Jean-François Mangin
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Antoine Grigis
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Marie Chupin
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Ali Bouyahia
- CATI Multicenter Neuroimaging Platform, Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Paris Saclay University, Gif sur Yvette, France
| | - Audrey Gabelle
- Memory Resources and Research Center, Montpellier University Hospital, INSERM U1061, University of Montpellier i-Site Montpellier Université d'Excellence (MUSE), Montpellier, France
| | - Julien Delrieux
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,France Faculté de Médecine, Unités mixtes de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1027, University of Toulouse III, Toulouse, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,France Faculté de Médecine, Unités mixtes de recherche (UMR) Institut national de la santé et de la recherche médicale (INSERM) 1027, University of Toulouse III, Toulouse, France
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Zhang B, Zhu DM, Zhao W, Zhang Y, Yang Y, Zhang C, Zhu J, Yu Y. Selective microstructural integrity impairments of the anterior corpus callosum are associated with cognitive deficits in obstructive sleep apnea. Brain Behav 2019; 9:e01482. [PMID: 31749327 PMCID: PMC6908858 DOI: 10.1002/brb3.1482] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is some evidence that obstructive sleep apnea (OSA) patients have white matter integrity abnormality in the corpus callosum (CC). However, whether the CC subregions are differentially affected in OSA is largely unknown. METHODS Twenty patients with OSA and 24 well-matched healthy controls were enrolled and underwent diffusion tensor imaging (DTI) and clinical and cognitive assessments. DTI tractography was used to reconstruct the CC which was divided into five subregions. Intergroup differences in multiple diffusion metrics of each CC subregion and their correlations with clinical and cognitive parameters were tested. RESULTS In comparison with healthy controls, OSA patients exhibited white matter integrity alterations in the anterior CC, characterized by increased radial diffusivity (RD) in the subregion 1 and decreased fractional anisotropy (FA) along with increased mean diffusivity (MD) and RD in the subregion 2. Moreover, we found that the lower microstructural integrity in the anterior CC was correlated with worse prospective memory and sustained attention in OSA patients. CONCLUSIONS These findings indicate that the selective impairments of the anterior CC may help clarify the neural correlates of cognitive impairments in OSA.
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Affiliation(s)
- Biao Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dao-Min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China.,Anhui Mental Health Center, Hefei, China
| | - Wenming Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu Zhang
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China.,Anhui Mental Health Center, Hefei, China
| | - Ying Yang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cun Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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