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Morita K, Miura K, Toyomaki A, Makinodan M, Ohi K, Hashimoto N, Yasuda Y, Mitsudo T, Higuchi F, Numata S, Yamada A, Aoki Y, Honda H, Mizui R, Honda M, Fujikane D, Matsumoto J, Hasegawa N, Ito S, Akiyama H, Onitsuka T, Satomura Y, Kasai K, Hashimoto R. Tablet-Based Cognitive and Eye Movement Measures as Accessible Tools for Schizophrenia Assessment: Multisite Usability Study. JMIR Ment Health 2024; 11:e56668. [PMID: 38815257 PMCID: PMC11176872 DOI: 10.2196/56668] [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: 01/25/2024] [Revised: 04/10/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Schizophrenia is a complex mental disorder characterized by significant cognitive and neurobiological alterations. Impairments in cognitive function and eye movement have been known to be promising biomarkers for schizophrenia. However, cognitive assessment methods require specialized expertise. To date, data on simplified measurement tools for assessing both cognitive function and eye movement in patients with schizophrenia are lacking. OBJECTIVE This study aims to assess the efficacy of a novel tablet-based platform combining cognitive and eye movement measures for classifying schizophrenia. METHODS Forty-four patients with schizophrenia, 67 healthy controls, and 41 patients with other psychiatric diagnoses participated in this study from 10 sites across Japan. A free-viewing eye movement task and 2 cognitive assessment tools (Codebreaker task from the THINC-integrated tool and the CognitiveFunctionTest app) were used for conducting assessments in a 12.9-inch iPad Pro. We performed comparative group and logistic regression analyses for evaluating the diagnostic efficacy of the 3 measures of interest. RESULTS Cognitive and eye movement measures differed significantly between patients with schizophrenia and healthy controls (all 3 measures; P<.001). The Codebreaker task showed the highest classification effectiveness in distinguishing schizophrenia with an area under the receiver operating characteristic curve of 0.90. Combining cognitive and eye movement measures further improved accuracy with a maximum area under the receiver operating characteristic curve of 0.94. Cognitive measures were more effective in differentiating patients with schizophrenia from healthy controls, whereas eye movement measures better differentiated schizophrenia from other psychiatric conditions. CONCLUSIONS This multisite study demonstrates the feasibility and effectiveness of a tablet-based app for assessing cognitive functioning and eye movements in patients with schizophrenia. Our results suggest the potential of tablet-based assessments of cognitive function and eye movement as simple and accessible evaluation tools, which may be useful for future clinical implementation.
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Affiliation(s)
- Kentaro Morita
- Department of Rehabilitation, The University of Tokyo Hospital, Bunkyo-ku Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku Tokyo, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuka Yasuda
- Life Grow Brilliant Mental Clinic, Medical Corporation Foster, Kita-ku Osaka, Japan
| | - Takako Mitsudo
- Division of Clinical Research, National Hospital Organization Hizen Psychiatric Center, Kanzaki-gun, Japan
| | - Fumihiro Higuchi
- Department of Neuroscience, Division of Neuropsychiatry, Yamaguchi University School of Medicine, Ube City, Japan
| | - Shusuke Numata
- Department of Psychiatry, Graduate School of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Akiko Yamada
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Sakyo-ku Kyoto, Japan
| | - Yohei Aoki
- Healthcare Innovation Group, Future Corporation, Shinagawa-ku Tokyo, Japan
| | - Hiromitsu Honda
- Healthcare Innovation Group, Future Corporation, Shinagawa-ku Tokyo, Japan
| | - Ryo Mizui
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | - Masato Honda
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | - Daisuke Fujikane
- Department of Psychiatry, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Junya Matsumoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Naomi Hasegawa
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Satsuki Ito
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hisashi Akiyama
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku Tokyo, Japan
- Center for Diversity in Medical Education and Research, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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Kammerer MK, Bott A, Strakeljahn F, Lincoln TM. Sleep spindle activity and psychotic experiences: Examining the mediating roles of attentional performance and perceptual distortions in a daytime nap study. Sleep Med 2024; 116:43-50. [PMID: 38422784 DOI: 10.1016/j.sleep.2024.02.023] [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: 10/28/2023] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
Decreased sleep spindle activity in individuals with psychotic disorders is well studied, but its contribution to psychotic symptom formation is not well understood. This study explored potential underlying mechanisms explaining the association between decreased sleep spindle activity and psychotic symptoms. To this end, we analysed the links between sleep spindle activity and psychotic experiences and probed for the mediating roles of attentional performance and perceptual distortions in a community sample of young adults (N = 70; 26.33 ± 4.84 years). Polysomnography was recorded during a 90-min daytime nap and duration, amplitude, and density from slow (10-13 Hz) and fast (13-16 Hz) spindles were extracted. Attentional performance was assessed via a test battery and with an antisaccadic eye movement task. Psychotic experiences (i.e., paranoid thoughts; hallucinatory experiences) and perceptual distortions (i.e., anomalous perceptions; sensory gating deficits) were assessed via self-report questionnaires. We conducted sequential mediation analyses with spindle activity as predictor, psychotic experiences as dependent variable, and attentional performance and perceptual distortions as mediators. We found reduced right central spindle amplitude to be associated with paranoid thoughts. Increased antisaccadic error rate was associated with anomalous perceptions and perceptual distortions were associated with psychotic experiences. We did not find significant mediation effects. The findings support the notion that reduced sleep spindle activity is involved in the formation of paranoid thoughts and that decreased antisaccadic performance is indicative of perceptual distortions as potential precursors for psychotic experiences. However, further research is needed to corroborate the proposed mediation hypothesis.
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Affiliation(s)
- Mathias K Kammerer
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany.
| | - Antonia Bott
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany
| | - Felix Strakeljahn
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany
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3
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Adámek P, Grygarová D, Jajcay L, Bakštein E, Fürstová P, Juríčková V, Jonáš J, Langová V, Neskoroďana I, Kesner L, Horáček J. The Gaze of Schizophrenia Patients Captured by Bottom-up Saliency. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:21. [PMID: 38378724 PMCID: PMC10879495 DOI: 10.1038/s41537-024-00438-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024]
Abstract
Schizophrenia (SCHZ) notably impacts various human perceptual modalities, including vision. Prior research has identified marked abnormalities in perceptual organization in SCHZ, predominantly attributed to deficits in bottom-up processing. Our study introduces a novel paradigm to differentiate the roles of top-down and bottom-up processes in visual perception in SCHZ. We analysed eye-tracking fixation ground truth maps from 28 SCHZ patients and 25 healthy controls (HC), comparing these with two mathematical models of visual saliency: one bottom-up, based on the physical attributes of images, and the other top-down, incorporating machine learning. While the bottom-up (GBVS) model revealed no significant overall differences between groups (beta = 0.01, p = 0.281, with a marginal increase in SCHZ patients), it did show enhanced performance by SCHZ patients with highly salient images. Conversely, the top-down (EML-Net) model indicated no general group difference (beta = -0.03, p = 0.206, lower in SCHZ patients) but highlighted significantly reduced performance in SCHZ patients for images depicting social interactions (beta = -0.06, p < 0.001). Over time, the disparity between the groups diminished for both models. The previously reported bottom-up bias in SCHZ patients was apparent only during the initial stages of visual exploration and corresponded with progressively shorter fixation durations in this group. Our research proposes an innovative approach to understanding early visual information processing in SCHZ patients, shedding light on the interplay between bottom-up perception and top-down cognition.
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Affiliation(s)
- Petr Adámek
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic.
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Dominika Grygarová
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lucia Jajcay
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- Institute of Computer Science of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Eduard Bakštein
- Early Episodes of SMI Research Center, National Institute of Mental Health, Klecany, Czech Republic
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University, Prague, Czech Republic
| | - Petra Fürstová
- Early Episodes of SMI Research Center, National Institute of Mental Health, Klecany, Czech Republic
| | - Veronika Juríčková
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Juraj Jonáš
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Veronika Langová
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Iryna Neskoroďana
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
| | - Ladislav Kesner
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- Department of Art History, Masaryk University, Brno, Czech Republic
| | - Jiří Horáček
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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4
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Zhang D, Xu L, Liu X, Cui H, Wei Y, Zheng W, Hong Y, Qian Z, Hu Y, Tang Y, Li C, Liu Z, Chen T, Liu H, Zhang T, Wang J. Eye Movement Characteristics for Predicting a Transition to Psychosis: Longitudinal Changes and Implications. Schizophr Bull 2024:sbae001. [PMID: 38245498 DOI: 10.1093/schbul/sbae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND HYPOTHESIS Substantive inquiry into the predictive power of eye movement (EM) features for clinical high-risk (CHR) conversion and their longitudinal trajectories is currently sparse. This study aimed to investigate the efficiency of machine learning predictive models relying on EM indices and examine the longitudinal alterations of these indices across the temporal continuum. STUDY DESIGN EM assessments (fixation stability, free-viewing, and smooth pursuit tasks) were performed on 140 CHR and 98 healthy control participants at baseline, followed by a 1-year longitudinal observational study. We adopted Cox regression analysis and constructed random forest prediction models. We also employed linear mixed-effects models (LMMs) to analyze longitudinal changes of indices while stratifying by group and time. STUDY RESULTS Of the 123 CHR participants who underwent a 1-year clinical follow-up, 25 progressed to full-blown psychosis, while 98 remained non-converters. Compared with the non-converters, the converters exhibited prolonged fixation durations, decreased saccade amplitudes during the free-viewing task; larger saccades, and reduced velocity gain during the smooth pursuit task. Furthermore, based on 4 baseline EM measures, a random forest model classified converters and non-converters with an accuracy of 0.776 (95% CI: 0.633, 0.882). Finally, LMMs demonstrated no significant longitudinal alterations in the aforementioned indices among converters after 1 year. CONCLUSIONS Aberrant EMs may precede psychosis onset and remain stable after 1 year, and applying eye-tracking technology combined with a modeling approach could potentially aid in predicting CHRs evolution into overt psychosis.
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Affiliation(s)
- Dan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xu Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yanyan Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wensi Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yawen Hong
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhenying Qian
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yegang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhi Liu
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, PR China
- School of Communication and Information Engineering, Shanghai University, Shanghai, PR China
| | - Tao Chen
- Labor and Worklife Program, Harvard University, Cambridge, MA, USA
- Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada
- Niacin (Shanghai) Technology Co., Ltd., Shanghai, PR China
| | - Haichun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, PR China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, PR China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China
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5
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Demian D, Petrak M, Zielinski G, Massingale S, Alexander A, Fuemmeler L, Lin CC. Clinical Saccadometry: Establishing Evaluative Standards Using a Simplified Video Oculography Protocol in the Adult Population. J Am Acad Audiol 2023. [PMID: 37989200 DOI: 10.1055/s-0043-1772582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND Saccadometry is an advanced ocular motor test battery that allows for the functional evaluation of the varied brain regions and circuits involved in the generation of fast, purposeful, and accurate saccadic eye movements. The test battery is composed of prosaccade (PS) and antisaccade (AS) tests that progressively increase cognitive demand. Existing saccadometry protocols qualitatively describe trends across the lifespan, but have not been widely adopted by clinicians. PURPOSE The aims of this study are to design an efficient and simplified clinical saccadometry protocol using video oculography (VOG) equipment and establish associated evaluative standards across the lifespan. STUDY SAMPLE Data were reported on 273 adults ages 18 to 69 years. RESULTS Evaluative data on four measures: directional error rate (DE), latency (Lat), peak velocity (Vel), and accuracy (Acc) during PS and AS measurements were provided. Age-group differences were found in Lat (p < 0.01) and Vel (p = 0.04) during PS and age-group differences were found in DE (p = 0.04), Lat (p < 0.01) and Vel (p < 0.01) during AS. Gender differences were found in DE (p = 0.01) and Lat (p < 0.01) during AS. CONCLUSIONS This study established a standardized and time-efficient protocol with evaluative standards for individuals ages 18 to 69 years old to enable the use of saccadometry as an objective measure in the clinic. Saccadometry allows clinicians to look beyond the traditional saccade test and evaluate complex oculomotor and cognitive functions that will better help clinicians differentiate between peripheral and central diagnoses.
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Affiliation(s)
- Daniel Demian
- Venn Med, Toronto, Ontario, Canada
- Interacoustics, Middelfart, Denmark
| | - Michelle Petrak
- Interacoustics, Middelfart, Denmark
- Northwest Speech and Hearing, Arlington Heights, Illinois
| | - Glen Zielinski
- Interacoustics, Middelfart, Denmark
- Northwest Functional Neurology, Lake Oswego, Oregon
| | - Shelly Massingale
- Interacoustics, Middelfart, Denmark
- Banner Sports Medicine and Concussion Specialists, Phoenix, Arizona
| | - Amy Alexander
- Interacoustics, Middelfart, Denmark
- Banner Sports Medicine and Concussion Specialists, Phoenix, Arizona
| | - Liz Fuemmeler
- Interacoustics, Middelfart, Denmark
- Hearing and Balance Specialists of Kansas City, Kansas City, Missouri
| | - Chia-Cheng Lin
- Department of Physical Therapy, East Carolina University, Greenville, North Carolina
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Zhang D, Guo Q, Xu L, Liu X, Zhang T, Liu X, Chen H, Li G, Wang J. The impact of COVID-19 pandemic on individuals at clinical high-risk for psychosis: Evidence from eye-tracking measures. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110578. [PMID: 35618148 PMCID: PMC9126616 DOI: 10.1016/j.pnpbp.2022.110578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/19/2022]
Abstract
Emerging evidence suggested that people with severe mental disorders were more vulnerable to the negative effects of the COVID-19 pandemic. However, few researches investigated the influence of global pandemics on people at clinical high risk (CHR) for psychosis. This study aimed to investigate the impact of the COVID-19 pandemic on clinical symptoms, psychological distress, and eye-tracking characteristics in CHR individuals and healthy participants. Forty-nine CHR individuals and 50 healthy controls (HC) were assessed by PTSD Checklist for DSM-5 (PCL-5), Perceived Stress Scale, 10-item version (PSS-10), and Coronavirus Impact Scale (CIS). Eye movement performances were measured by the tests of fixation stability, free-viewing, and anti-saccade. According to the mean score of CIS, participants were stratified into high-impact (n = 35) and low-impact (n = 64) subgroups. Compared with the HC group, CHR participants reported significantly higher levels of post-traumatic symptoms caused by the COVID-19 pandemic and showed abnormalities in most of the eye movement indexes. Among the altered indexes, the saccade amplitude of fixation stability test (far distractor), the scan path length of free-viewing test, and the accuracy of anti-saccade test were negatively affected by the severity of impact level in the CHR group. Moreover, the altered eye movement indexes were significantly associated with the total scores of CIS, PCL-5, and subscales of the Scale of Prodromal Syndromes (SOPS) among CHR individuals. Overall, our findings suggested the negative impact of the COVID-19 pandemic on the eye movement characteristics of CHR individuals. The present study provides valuable information on physiological distress related to the COVID-19 pandemic and sensitive neuropsychological biomarkers that interacted with social and environment stress in the CHR population.
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Affiliation(s)
- Dan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Qian Guo
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China; Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Xu Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - TianHong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Xiaohua Liu
- Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Haiying Chen
- Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Guanjun Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai 201203, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, PR China.
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7
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Zhang D, Xu L, Xie Y, Tang X, Hu Y, Liu X, Wu G, Qian Z, Tang Y, Liu Z, Chen T, Liu H, Zhang T, Wang J. Eye movement indices as predictors of conversion to psychosis in individuals at clinical high risk. Eur Arch Psychiatry Clin Neurosci 2022; 273:553-563. [PMID: 35857090 DOI: 10.1007/s00406-022-01463-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 06/27/2022] [Indexed: 12/17/2022]
Abstract
Eye movement abnormalities have been established as an "endophenotype" of schizophrenia. However, less is known about the possibility of these abnormalities as biomarkers for psychosis conversion among clinical high risk (CHR) populations. In the present study, 108 CHR individuals and 70 healthy controls (HC) underwent clinical assessments and eye-tracking tests, comprising fixation stability and free-viewing tasks. According to three-year follow-up outcomes, CHR participants were further stratified into CHR-converter (CHR-C; n = 21) and CHR-nonconverter (CHR-NC; n = 87) subgroups. Prediction models were constructed using Cox regression and logistic regression. The CHR-C group showed more saccades of the fixation stability test (no distractor) and a reduced saccade amplitude of the free-viewing test than HC. Moreover, the CHR-NC group exhibited excessive saccades and an increased saccade amplitude of the fixation stability test (no distractor; with distractor) compared with HC. Furthermore, two indices could effectively discriminate CHR-C from CHR-NC with an area under the receiver-operating characteristic (ROC) curve of 0.80, including the saccade number of the fixation stability test (no distractor) and the saccade amplitude of the free-viewing test. Combined with negative symptom scores of the Scale of Prodromal Symptoms, the area was 0.81. These findings support that eye movement alterations might emerge before the onset of clinically overt psychosis and could assist in predicting psychosis transition among CHR populations.
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Affiliation(s)
- Dan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Yuou Xie
- First Clinical Medical College of Nanjing Medical University, Nanjing, 211103, People's Republic of China
| | - Xiaochen Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Yegang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Xu Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Guisen Wu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Zhenying Qian
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Zhi Liu
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, 200444, People's Republic of China.,School of Communication and Information Engineering, Shanghai University, Shanghai, 200444, People's Republic of China
| | - Tao Chen
- Senior Research Fellow, Labor and Worklife Program, Harvard University, Cambridge, MA, USA.,Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada.,Niacin (Shanghai) Technology Co., Ltd., Shanghai, People's Republic of China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China. .,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, People's Republic of China. .,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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8
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Markers of Schizophrenia—A Critical Narrative Update. J Clin Med 2022; 11:jcm11143964. [PMID: 35887728 PMCID: PMC9323796 DOI: 10.3390/jcm11143964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/17/2022] Open
Abstract
Schizophrenia is a long-term mental disease, associated with functional impairment. Therefore, it is important to make an accurate diagnosis and implement the proper treatment. Biomarkers may be a potential tool for these purposes. Regarding advances in biomarker studies in psychosis, the current symptom-based criteria seem to be no longer sufficient in clinical settings. This narrative review describes biomarkers of psychosis focusing on the biochemical (peripheral and central), neurophysiological, neuropsychological and neuroimaging findings as well as the multimodal approach related with them. Endophenotype markers (especially neuropsychological and occulomotor disturbances) can be currently used in a clinical settings, whereas neuroimaging glutamate/glutamine and D2/D3 receptor density changes, as well as immunological Th2 and PRL levels, seem to be potential biomarkers that need further accuracy tests. When searching for biochemical/immunological markers in the diagnosis of psychosis, the appropriate time of body fluid collection needs to be considered to minimize the influence of the stress axis on their concentrations. In schizophrenia diagnostics, a multimodal approach seems to be highly recommended.
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9
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Smith ES, Crawford TJ. Positive and Negative Symptoms Are Associated with Distinct Effects on Predictive Saccades. Brain Sci 2022; 12:brainsci12040418. [PMID: 35447950 PMCID: PMC9025332 DOI: 10.3390/brainsci12040418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/10/2022] [Accepted: 03/19/2022] [Indexed: 02/05/2023] Open
Abstract
The predictive saccade task is a motor learning paradigm requiring saccades to track a visual target moving in a predictable pattern. Previous research has explored extensively anti-saccade deficits observed across psychosis, but less is known about predictive saccade-related mechanisms. The dataset analysed came from the studies of Crawford et al, published in 1995, where neuroleptically medicated schizophrenia and bipolar affective disorder patients were compared with non-medicated patients and control participants using a predictive saccade paradigm. The participant groups consisted of medicated schizophrenia patients (n = 40), non-medicated schizophrenia patients (n = 18), medicated bipolar disorder patients (n = 14), non-medicated bipolar disorder patients (n = 18), and controls (n = 31). The current analyses explore relationships between predictive saccades and symptomatology, and the potential interaction of medication. Analyses revealed that the schizophrenia and bipolar disorder diagnostic categories are indistinguishable in patterns of predictive control across several saccadic parameters, supporting a dimensional hypothesis. Once collapsed into predominantly high-/low- negative/positive symptoms, regardless of diagnosis, differences were revealed, with significant hypometria and lower gain in those with more negative symptoms. This illustrates how the presentation of the deficits is homogeneous across diagnosis, but heterogeneous when surveyed by symptomatology; attesting that a diagnostic label is less informative than symptomatology when exploring predictive saccades.
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Affiliation(s)
- Eleanor S. Smith
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK;
| | - Trevor J. Crawford
- Centre for Ageing Research, Department of Psychology, Lancaster University, Lancaster LA1 4YF, UK
- Correspondence:
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10
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Navalón P, Sahuquillo-Leal R, Moreno-Giménez A, Salmerón L, Benavent P, Sierra P, Cañada Y, Cañada-Martínez A, Berk M, García-Blanco A. Attentional engagement and inhibitory control according to positive and negative symptoms in schizophrenia: An emotional antisaccade task. Schizophr Res 2022; 239:142-150. [PMID: 34891078 DOI: 10.1016/j.schres.2021.11.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 10/18/2021] [Accepted: 11/27/2021] [Indexed: 11/18/2022]
Abstract
Despite schizophrenia (SZ) is characterized by a high psychopathological heterogeneity, the underlying psychological mechanisms that result in different clinical profiles are unclear. This study examined the cognitive processing of emotional faces (angry, happy, neutral, and sad) by means of assessing inhibitory control (antisaccade task) and attentional engagement (prosaccade task) with the eye-tracking paradigm. Firstly, two clinical SZ subgroups classified according to the predominance of positive (PSZ; n = 20) or negative symptoms (NSZ; n = 34) and a control group of 32 individuals were compared. Secondly, the association between prosaccade and antisaccade measurements and the severity of positive and negative symptoms were analyzed. The PSZ group showed slower antisaccades when angry faces were displayed, and higher positive symptoms were associated with slower prosaccade latencies to ones. Conversely, the NSZ group made overall slower prosaccades with an emotional advantage for angry faces, and higher negative symptoms were associated with faster antisaccade latencies to ones. Hence, whereas positive SZ profile is related to a lack of attentional engagement and an impaired inhibitory control to threatening information; negative SZ profile is linked to a lack of attentional engagement to faces, mainly with non-threat ones, and with an advantage to ignore distracting threatening stimuli. These findings support affective information-processing theories suggesting a hypersensitivity to threat for positive SZ profiles, and a desensitization to socio-emotional information for negative ones. Consequently, characterizing psychological mechanisms of SZ may allow improving current treatments to threat management when positive symptoms are predominant, or emotion sensitization when negative symptoms prevail.
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Affiliation(s)
- Pablo Navalón
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Neonatal Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Rosa Sahuquillo-Leal
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Valencia, Spain
| | | | | | - Pilar Benavent
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Pilar Sierra
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Yolanda Cañada
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Cañada-Martínez
- Data Science, Biostatistics, and Bioinformatics, La Fe Health Research Institute, Valencia, Spain
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Ana García-Blanco
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Neonatal Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, Valencia, Spain.
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11
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Moreau I, Hébert M, Maziade M, Painchaud A, Mérette C. The Electroretinogram as a Potential Biomarker of Psychosis in Children at Familial Risk. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac016. [PMID: 39144760 PMCID: PMC11206048 DOI: 10.1093/schizbullopen/sgac016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
We previously proposed the electroretinogram (ERG) as a promising biomarker of major psychiatric disorders such as schizophrenia (SZ) and bipolar disorder (BP), given that we found anomalies in the ERG parameters of patients with these diagnoses as well as in their children who are at high risk (HR) of developing such disorders. The aim of the present study is to investigate the usefulness of the ERG for individual detection, among HR children, of an ERG profile resembling that of a SZ patient, as this may indicate a stronger likelihood of transition to psychosis. Using a logistic regression model previously derived from the ERG assessments of SZ patients and control (CT) subjects, individual risk scores were obtained for 61 HR and 80 CT youth. Those with a very high individual risk score were classified as "schizophrenia-like" (SZ-like). We found that the HR subjects were 3.5 times more likely to be classified as SZ-like than the CT subjects (95% CI [1.1-11.8]). Furthermore, among the HR subjects, we studied the relationship between the SZ-like classification and psychotic-like experiences and found that HR subjects classified as SZ-like were 2.7 times more likely than all remaining HR subjects to have experienced psychotic-like symptoms (95% CI [1.3-4.6]), and 6.8 times more likely than those with a very low individual risk score (95% CI [1.4-40.4]). Our results suggest that a model previously derived from ERG data on SZ patients could be a potential tool for early detection of the susceptibility to a psychotic-like disorder among familial HR children.
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Affiliation(s)
- Isabel Moreau
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département d’informatique et de génie logiciel, Université Laval, Québec, QC, Canada
| | - Marc Hébert
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département d’ophtalmologie et oto-rhino-laryngologie – chirurgie cervico-faciale, Université Laval, Québec, QC, Canada
| | - Michel Maziade
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Québec, QC, Canada
| | - Alexandra Painchaud
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Québec, QC, Canada
| | - Chantal Mérette
- Centre de recherche CERVO, Centre intégré de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Département de psychiatrie et neurosciences, Université Laval, Québec, QC, Canada
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12
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Julayanont P, Suryadevara U. Psychosis. Continuum (Minneap Minn) 2021; 27:1682-1711. [PMID: 34881732 DOI: 10.1212/con.0000000000001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW Psychosis can manifest in primary psychotic disorders, neurologic diseases, and medical conditions. This article reviews the definition of psychotic symptoms and the evaluation and management of psychosis in primary psychiatric and neurologic disorders frequently seen in neurologic practice. RECENT FINDINGS Emerging evidence supports significant connections between psychosis and structural and functional brain changes in both primary psychotic and neurologic disorders. In addition to antidopaminergic activity, the mechanism of new-generation antipsychotics shifts to act on serotonin receptors, which potentially contributes to their benefits in the treatment of negative symptoms of psychosis and a lesser frequency of extrapyramidal side effects compared with typical antipsychotics. This is also helpful in the treatment of psychosis in patients who have neurodegenerative diseases and are vulnerable to developing extrapyramidal side effects from typical antipsychotics. SUMMARY Even with significant overlap, management of psychosis in primary psychotic disorders differs from the approach of psychosis in neurologic diseases. This article helps clinicians learn how to practically evaluate psychosis from both psychiatric and neurologic perspectives.
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13
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Smith ES, Crawford TJ. Memory-Guided Saccades in Psychosis: Effects of Medication and Stimulus Location. Brain Sci 2021; 11:1071. [PMID: 34439693 PMCID: PMC8393375 DOI: 10.3390/brainsci11081071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 11/16/2022] Open
Abstract
The memory-guided saccade task requires the remembrance of a peripheral target location, whilst inhibiting the urge to make a saccade ahead of an auditory cue. The literature has explored the endophenotypic deficits associated with differences in target laterality, but less is known about target amplitude. The data presented came from Crawford et al. (1995), employing a memory-guided saccade task among neuroleptically medicated and non-medicated patients with schizophrenia (n = 31, n = 12), neuroleptically medicated and non-medicated bipolar affective disorder (n = 12, n = 17), and neurotypical controls (n = 30). The current analyses explore the relationships between memory-guided saccades toward targets with different eccentricities (7.5° and 15°), the discernible behaviour exhibited amongst diagnostic groups, and cohorts distinguished based on psychotic symptomatology. Saccade gain control and final eye position were reduced among medicated-schizophrenia patients. These metrics were reduced further among targets with greater amplitudes (15°), indicating greater deficit. The medicated cohort exhibited reduced gain control and final eye positions in both amplitudes compared to the non-medicated cohort, with deficits markedly observed for the furthest targets. No group differences in symptomatology (positive and negative) were reported, however, a greater deficit was observed toward the larger amplitude. This suggests that within the memory-guided saccade paradigm, diagnostic classification is more prominent in characterising disparities in saccade performance than symptomatology.
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Affiliation(s)
- Eleanor S. Smith
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Trevor J. Crawford
- Department of Psychology, Centre for Ageing Research, Lancaster University, Lancaster LA1 4YF, UK;
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14
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Athanasopoulos F, Saprikis OV, Margeli M, Klein C, Smyrnis N. Towards Clinically Relevant Oculomotor Biomarkers in Early Schizophrenia. Front Behav Neurosci 2021; 15:688683. [PMID: 34177483 PMCID: PMC8222521 DOI: 10.3389/fnbeh.2021.688683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022] Open
Abstract
In recent years, psychiatric research has focused on the evaluation and implementation of biomarkers in the clinical praxis. Oculomotor function deviances are among the most consistent and replicable cognitive deficits in schizophrenia and have been suggested as viable candidates for biomarkers. In this narrative review, we focus on oculomotor function in first-episode psychosis, recent onset schizophrenia as well as individuals at high risk for developing psychosis. We critically discuss the evidence for the possible utilization of oculomotor function measures as diagnostic, susceptibility, predictive, monitoring, and prognostic biomarkers for these conditions. Based on the current state of research we conclude that there are not sufficient data to unequivocally support the use of oculomotor function measures as biomarkers in schizophrenia.
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Affiliation(s)
- Fotios Athanasopoulos
- 2nd Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece.,Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece
| | - Orionas-Vasilis Saprikis
- 2nd Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece.,Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece
| | - Myrto Margeli
- 2nd Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece.,Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece
| | - Christoph Klein
- 2nd Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece.,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Freiburg, Germany.,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Nikolaos Smyrnis
- 2nd Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece.,Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece
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15
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Wolf A, Ueda K. Contribution of Eye-Tracking to Study Cognitive Impairments Among Clinical Populations. Front Psychol 2021; 12:590986. [PMID: 34163391 PMCID: PMC8215550 DOI: 10.3389/fpsyg.2021.590986] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/07/2021] [Indexed: 11/29/2022] Open
Abstract
In the field of psychology, the merge of decision-theory and neuroscientific methods produces an array of scientifically recognized paradigms. For example, by exploring consumer’s eye-movement behavior, researchers aim to deepen the understanding of how patterns of retinal activation are being meaningfully transformed into visual experiences and connected with specific reactions (e.g., purchase). Notably, eye-movements provide knowledge of one’s homeostatic balance and gatekeep information that shape decisions. Hence, vision science investigates the quality of observed environments determined under various experimental conditions. Moreover, it answers questions on how human process visual stimuli and use gained information for a successful strategy to achieve certain goals. While capturing cognitive states with the support of the eye-trackers progresses at a relatively fast pace in decision-making research, measuring the visual performance of real-life tasks, which require complex cognitive skills, is tentatively translated into clinical experiments. Nevertheless, the potential of the human eye as a highly valuable source of biomarkers has been underlined. In this article, we aim to draw readers attention to decision-making experimental paradigms supported with eye-tracking technology among clinical populations. Such interdisciplinary approach may become an important component that will (i) help in objectively illustrating patient’s models of beliefs and values, (ii) support clinical interventions, and (iii) contribute to health services. It is possible that shortly, eye-movement data from decision-making experiments will grant the scientific community a greater understanding of mechanisms underlining mental states and consumption practices that medical professionals consider as obsessions, disorders or addiction.
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Affiliation(s)
- Alexandra Wolf
- JSPS International Research Fellow, Research Center for Applied Perceptual Science, Kyushu University, Fukuoka, Japan
| | - Kazuo Ueda
- Unit of Perceptual Psychology, Dept. Human Science, Research Center for Applied Perceptual Science, Division of Auditory and Visual Perception Research, Research and Development Center for Five-Sense Devices, Kyushu University, Fukuoka, Japan
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16
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Li X, Fan F, Chen X, Li J, Ning L, Lin K, Chen Z, Qin Z, Yeung AS, Li X, Wang L, So KF. Computer Vision for Brain Disorders Based Primarily on Ocular Responses. Front Neurol 2021; 12:584270. [PMID: 33967931 PMCID: PMC8096911 DOI: 10.3389/fneur.2021.584270] [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: 07/16/2020] [Accepted: 03/15/2021] [Indexed: 11/18/2022] Open
Abstract
Real-time ocular responses are tightly associated with emotional and cognitive processing within the central nervous system. Patterns seen in saccades, pupillary responses, and spontaneous blinking, as well as retinal microvasculature and morphology visualized via office-based ophthalmic imaging, are potential biomarkers for the screening and evaluation of cognitive and psychiatric disorders. In this review, we outline multiple techniques in which ocular assessments may serve as a non-invasive approach for the early detections of various brain disorders, such as autism spectrum disorder (ASD), Alzheimer's disease (AD), schizophrenia (SZ), and major depressive disorder (MDD). In addition, rapid advances in artificial intelligence (AI) present a growing opportunity to use machine learning-based AI, especially computer vision (CV) with deep-learning neural networks, to shed new light on the field of cognitive neuroscience, which is most likely to lead to novel evaluations and interventions for brain disorders. Hence, we highlight the potential of using AI to evaluate brain disorders based primarily on ocular features.
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Affiliation(s)
- Xiaotao Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States.,BIAI INC., Chelmsford, MA, United States.,BIAI Intelligence Biotech LLC, Shenzhen, China
| | - Fangfang Fan
- Department of Neurology, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Xuejing Chen
- Retina Division, Department of Ophthalmology, Boston University Eye Associates, Boston University, Boston, MA, United States
| | - Juan Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,BIAI INC., Chelmsford, MA, United States.,BIAI Intelligence Biotech LLC, Shenzhen, China
| | - Li Ning
- Center for High Performance Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Kangguang Lin
- Department of Affective Disorders and Academician Workstation of Mood and Brain Sciences, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong-Hong Kong-Macau Institute of Central Nervous System (CNS) Regeneration, Jinan University, Guangzhou, China
| | - Zan Chen
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Zhenyun Qin
- Key Laboratory for Nonlinear Mathematical Models and Methods, School of Mathematical Science, Fudan University, Shanghai, China
| | - Albert S Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Xiaojian Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Liping Wang
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Kwok-Fai So
- Guangdong-Hong Kong-Macau Institute of Central Nervous System (CNS) Regeneration, Jinan University, Guangzhou, China.,The State Key Laboratory of Brain and Cognitive Sciences, Department of Ophthalmology, University of Hong Kong, Pok Fu Lam, Hong Kong
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17
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Wolf A, Ueda K, Hirano Y. Recent updates of eye movement abnormalities in patients with schizophrenia: A scoping review. Psychiatry Clin Neurosci 2021; 75:82-100. [PMID: 33314465 PMCID: PMC7986125 DOI: 10.1111/pcn.13188] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/27/2020] [Accepted: 12/09/2020] [Indexed: 12/15/2022]
Abstract
AIM Although eye-tracking technology expands beyond capturing eye data just for the sole purpose of ensuring participants maintain their gaze at the presented fixation cross, gaze technology remains of less importance in clinical research. Recently, impairments in visual information encoding processes indexed by novel gaze metrics have been frequently reported in patients with schizophrenia. This work undertakes a scoping review of research on saccadic dysfunctions and exploratory eye movement deficits among patients with schizophrenia. It gathers promising pieces of evidence of eye movement abnormalities in attention-demanding tasks on the schizophrenia spectrum that have mounted in recent years and their outcomes as potential biological markers. METHODS The protocol was drafted based on PRISMA for scoping review guidelines. Electronic databases were systematically searched to identify articles published between 2010 and 2020 that examined visual processing in patients with schizophrenia and reported eye movement characteristics as potential biomarkers for this mental illness. RESULTS The use of modern eye-tracking instrumentation has been reported by numerous neuroscientific studies to successfully and non-invasively improve the detection of visual information processing impairments among the screened population at risk of and identified with schizophrenia. CONCLUSIONS Eye-tracking technology has the potential to contribute to the process of early intervention and more apparent separation of the diagnostic entities, being put together by the syndrome-based approach to the diagnosis of schizophrenia. However, context-processing paradigms should be conducted and reported in equally accessible publications to build comprehensive models.
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Affiliation(s)
- Alexandra Wolf
- International Research Fellow of Japan Society for the Promotion of Science, Fukuoka, Japan.,Department of Human Science, Research Center for Applied Perceptual Science, Kyushu University, Fukuoka, Japan
| | - Kazuo Ueda
- Department of Human Science, Research Center for Applied Perceptual Science, Kyushu University, Fukuoka, Japan
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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18
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Koropouli E, Melanitis N, Dimitriou VI, Grigoriou A, Karavasilis E, Nikita KS, Tzavellas E, Paparrigopoulos T. New-Onset Psychosis Associated With a Lesion Localized in the Rostral Tectum: Insights Into Pathway-Specific Connectivity Disrupted in Psychosis. Schizophr Bull 2020; 46:1296-1305. [PMID: 32103274 PMCID: PMC7505199 DOI: 10.1093/schbul/sbaa018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate pathway-specific connectivity disrupted in psychosis. METHODS We carried out a case study of a middle-aged patient who presented with new-onset psychosis associated with a space-occupying lesion localized in the right superior colliculus/periaqueductal gray. The study sought to investigate potential connectivity deficits related to the lesion by the use of diffusion tensor imaging and resting-state functional magnetic resonance imaging. To this aim, we generated a functional connectivity map of the patient's brain, centered on the lesion area, and compared this map with the corresponding map of 10 sex- and age-matched control individuals identified from the Max Planck Institute-Leipzig Mind-Brain-Body database. RESULTS Our analysis revealed a discrete area in the right rostral tectum, in the immediate vicinity of the lesion, whose activity is inversely correlated with the activity of left amygdala, whereas left amygdala is functionally associated with select areas of the temporal, parietal, and occipital lobes. Based on a comparative analysis of the patient with 10 control individuals, the lesion has impacted on the connectivity of rostral tectum (superior colliculus/periaqueductal gray) with left amygdala as well as on the connectivity of left amygdala with subcortical and cortical areas. CONCLUSIONS The superior colliculus/periaqueductal gray might play important roles in the initiation and perpetuation of psychosis, at least partially through dysregulation of left amygdala activity.
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Affiliation(s)
- Eleftheria Koropouli
- First Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Nikos Melanitis
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Vasileios I Dimitriou
- First Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Asimina Grigoriou
- First Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Konstantina S Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Elias Tzavellas
- First Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Thomas Paparrigopoulos
- First Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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19
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Waszkiewicz N. Mentally Sick or Not-(Bio)Markers of Psychiatric Disorders Needed. J Clin Med 2020; 9:jcm9082375. [PMID: 32722366 PMCID: PMC7465438 DOI: 10.3390/jcm9082375] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Białystok, Plac Brodowicza 1, 16-070 Choroszcz, Poland
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20
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Suh DY, Vandekar SN, Heckers S, Avery SN. Visual exploration differences during relational memory encoding in early psychosis. Psychiatry Res 2020; 287:112910. [PMID: 32200141 PMCID: PMC7176542 DOI: 10.1016/j.psychres.2020.112910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 01/17/2023]
Abstract
Relational memory, or the ability to form contextual associations among items encountered closely in time, is impaired in schizophrenia. The ability to bind items into a relational memory is dependent on the hippocampus, a region that is abnormal in schizophrenia. However, the hippocampus is also involved in exploratory behavior, leaving open the question whether relational memory deficits in schizophrenia are due to failure of relational binding or diminished visual exploration of individual items during encoding. We studied visual exploration patterns during the encoding of face-scene pairs in 66 healthy control subjects and 69 early psychosis patients, to test the hypothesis that differences in visual exploration during the encoding phase can explain task accuracy differences between the two groups. Psychosis patients had lower explicit test accuracy and were less likely to transition from mouth to eyes during encoding. The visual exploration pattern differences between groups did not mediate the relationship between group and explicit test accuracy. We conclude that early psychosis patients have an abnormal pattern of binding items together during encoding that warrants further research.
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Affiliation(s)
- David Y Suh
- Vanderbilt University School of Medicine, Nashville, TN USA
| | - Simon N Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Suzanne N Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA.
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