Frequency dependent alterations in regional homogeneity of baseline brain activity in schizophrenia

Frequency Dependent Changes of Regional Homogeneity in Children with Growth Hormone Deficiency

Abnormal spontaneous neural activity in children with growth hormone deficiency (GHD) has been found in previous resting-state functional magnetic resonance imaging (rs-fMRI) studies. Nevertheless, the spontaneous neural activity of GHD in different frequency bands is still unclear. Here, we combined rs-fMRI and regional homogeneity (ReHo) methods to analyze the spontaneous neural activity of 26 GHD children and 15 healthy controls (HCs) with age- and sex-matching in four frequency bands: slow-5 (0.014-0.031 Hz), slow-4 (0.031-0.081 Hz), slow-3 (0.081-0.224 Hz), and slow-2 (0.224-0.25 Hz). In the slow-5 band, GHD children compared with HCs displayed higher ReHo in the left dorsolateral part of the superior frontal gyrus, triangular part of the inferior frontal gyrus, precentral gyrus and middle frontal gyrus, and right angular gyrus, while lower ReHo in the right precentral gyrus, and several medial orbitofrontal regions. In the slow-4 band, GHD children relative to HCs revealed increased ReHo in the right middle temporal gyrus, whereas reduced ReHo in the left superior parietal gyrus, right middle occipital gyrus, and bilateral medial parts of the superior frontal gyrus. In the slow-2 band, compared with HCs, GHD children showed increased ReHo in the right anterior cingulate gyrus, and several prefrontal regions, while decreased ReHo in the left middle occipital gyrus, and right fusiform gyrus and anterior cingulate gyrus. Our findings demonstrate that regional brain activity in GHD children exhibits extensive abnormalities, and these abnormalities are related to specific frequency bands, which may provide bases for understanding its pathophysiology significance.

Hypoconnectivity networks in schizophrenia patients: A voxel-wise meta-analysis of Rs-fMRI

In recent years several meta-analyses regarding resting-state functional connectivity in patients with schizophrenia have been published. The authors have used different data analysis techniques: regional homogeneity, seed-based data analysis, independent component analysis, and amplitude of low frequencies. Hence, we aim to perform a meta-analysis to identify connectivity networks with different activation patterns between people diagnosed with schizophrenia and healthy controls using voxel-wise analysis.

METHOD

We collected primary studies exploring whole brain connectivity by functional magnetic resonance imaging at rest in patients with schizophrenia compared with healthy controls. We identified 25 studies included high-quality studies that included 1285 patients with schizophrenia and 1279 healthy controls.

RESULTS

The results indicate hypoactivation in the right precentral gyrus and the left superior temporal gyrus of patients with schizophrenia compared with healthy controls.

CONCLUSIONS

These regions have been linked with some clinical symptoms usually present in Plea with schizophrenia, such as auditory verbal hallucinations, formal thought disorder, and the comprehension and production of gestures.

Abnormalities of Regional Brain Activity in Patients With Schizophrenia: A Longitudinal Resting-State fMRI Study

BACKGROUND

Evidence from functional and structural research suggests that abnormal brain activity plays an important role in the pathophysiology of schizophrenia (SZ). However, limited studies have focused on post-treatment changes, and current conclusions are inconsistent.

STUDY DESIGN

We recruited 104 SZ patients to have resting-state functional magnetic resonance imaging scans at baseline and 8 weeks of treatment with second-generation antipsychotics, along with baseline scanning of 86 healthy controls (HCs) for comparison purposes. Individual regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and degree centrality values were calculated to evaluate the functional activity. The Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery were applied to measure psychiatric symptoms and cognitive impairment in SZ patients.

RESULTS

Compared with HCs at baseline, SZ patients had higher ALFF and ReHo values in the bilateral inferior temporal gyrus, inferior frontal gyrus, and lower ALFF and ReHo values in fusiform gyrus and precuneus. Following 8 weeks of treatment, ReHo was increased in right medial region of the superior frontal gyrus (SFGmed) and decreased in the left middle occipital gyrus and the left postcentral gyrus. Meanwhile, ReHo of the right SFGmed was increased after treatment in the response group (the reduction rate of PANSS ≥50%). Enhanced ALFF in the dorsolateral of SFG correlated with improvement in depressive factor score.

CONCLUSIONS

These findings provide novel evidence for the abnormal functional activity hypothesis of SZ, suggesting that abnormality of right SFGmed can be used as a biomarker of treatment response in SZ.

[Frequency-Specific Alterations of Spontaneous Brain Activity in First-Episode Drug-Naïve Schizophrenia]

Objective

To investigate frequency-specific alterations of spontaneous brain activity in first-episode drug-naïve schizophrenia (SZ) patients and the associations with clinical symptoms.

Methods

We collected the resting-state functional MRI (rs-fMRI) data from 84 first-episode drug-naïve SZ patients and 94 healthy controls (HCs) and calculated the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) of four frequency bands, including slow-2, slow-3, slow-4, and slow-5. Two-sample t-tests were used to evaluate the intergroup differences in ALFF and ReHo, while partial correlation analyses were conducted to explore the associations between abnormal ALFF and ReHo and the severity of clinical symptoms in the SZ group.

Results

Compared with HCs, the SZ group showed reduced ALFF in superior cerebellum and cerebellar vermis across slow-2, slow-3, and slow-4 bands, while increased ALFF was found in left superior temporal gyrus, middle temporal gyrus, and superior temporal pole at slow-4 band. Moreover, reduced ReHo was observed in the right precentral and postcentral gyri at slow-3 band in the SZ group. Additionally, the ALFF of left superior temporal gyrus, middle temporal gyrus, and superior temporal pole in slow-4 band showed a trend of positive correlation with the excited factor score of Positive and Negative Syndrome Scale (PANSS) in the SZ group.

Conclusion

Our results suggest that local alterations of spontaneous brain activity were frequency-specific in first-episode drug-naïve SZ patients.

Altered functional connectivity of anterior cingulate cortex in chronic insomnia: A resting-state fMRI study

The aim of our present study was to explore the connectivity pattern change between the anterior cingulate cortex (ACC) and the voxels from the whole brain in chronic insomnia (CI). With region of interest (ROI)-based functional connectivity, a two-sample t-test was performed on individual FC correlation maps from two groups based on the resting-state fMRI data acquired from 57 CI patients and 46 healthy controls (GRF correction, voxel-level P < 0.001 and cluster-level P < 0.001). A correlation analysis was performed to evaluate the relationship between the clinical features and the abnormal FC. Compared to the healthy controls, the CI patients show increased connectivity between the ACC and the right middle frontal gyrus, with decreased connectivity between the ACC and the bilateral precuneus gyrus. Correlation analysis indicated that the decreased connectivity showed positive correlations with Self-Rating Anxiety Scale (SAS) scores. Our study shows the alterations of CI patients in the level of functional integration and may indicate the dysfunction of communication within brain regions of the default mode network (DMN). These changes and their correlation with negative emotions may provide additional evidence to understand the possible neural mechanisms of CI.

Disrupted local functional connectivity in schizophrenia: An updated and extended meta-analysis

Neuroimaging studies have shown that schizophrenia is associated with disruption of resting-state local functional connectivity. However, these findings vary considerably, which hampers our understanding of the underlying pathophysiological mechanisms of schizophrenia. Here, we performed an updated and extended meta-analysis to identify the most consistent changes of local functional connectivity measured by regional homogeneity (ReHo) in schizophrenia. Specifically, a systematic search of ReHo studies in patients with schizophrenia in PubMed, Embase, and Web of Science identified 18 studies (20 datasets), including 652 patients and 596 healthy controls. In addition, we included three whole-brain statistical maps of ReHo differences calculated based on independent datasets (163 patients and 194 controls). A voxel-wise meta-analysis was then conducted to investigate ReHo alterations and their relationship with clinical characteristics using the newly developed seed-based d mapping with permutation of subject images (SDM-PSI) meta-analytic approach. Compared with healthy controls, patients with schizophrenia showed significantly higher ReHo in the bilateral medial superior frontal gyrus, while lower ReHo in the bilateral postcentral gyrus, right precentral gyrus, and right middle occipital gyrus. The following sensitivity analyses including jackknife analysis, subgroup analysis, heterogeneity test, and publication bias test demonstrated that our results were robust and highly reliable. Meta-regression analysis revealed that illness duration was negatively correlated with ReHo abnormalities in the right precentral/postcentral gyrus. This comprehensive meta-analysis not only identified consistent and reliably aberrant local functional connectivity in schizophrenia but also helped to further deepen our understanding of its pathophysiology.

Comparisons of resting-state brain activity between insomnia and schizophrenia: a coordinate-based meta-analysis

Growing evidence shows that insomnia is closely associated with schizophrenia (SCZ), but the neural mechanism under the association remains unclear. A direct comparison of the patterns of resting-state brain activities would help understand the above question. Using meta-analytic approach, 11 studies of insomnia vs. healthy controls (HC) and 39 studies of SCZ vs. HC were included to illuminate the common and distinct patterns between insomnia and SCZ. Results showed that SCZ and insomnia shared increased resting-state brain activities in frontolimbic structures including the right medial prefrontal gyrus (mPFC) and left parahippocampal gyrus. SCZ additionally revealed greater increased activities in subcortical areas including bilateral putamen, caudate and right insula and greater decreased activities in precentral gyrus and orbitofrontal gyrus. Our study reveals both shared and distinct activation patterns in SCZ and insomnia, which may provide novel insights for understanding the neural basis of the two disorders and enlighten the possibility of the development of treatment strategies for insomnia in SCZ in the future.

Alterations in Spontaneous Brain Activity in Drug-Naïve First-Episode Schizophrenia: An Anatomical/Activation Likelihood Estimation Meta-Analysis

OBJECTIVE

The etiology of schizophrenia is unknown and is associated with abnormal spontaneous brain activity. There are no consistent results regarding the change in spontaneous brain activity of people with schizophrenia. In this study, we determined the specific changes in the amplitude of low-frequency fluctuation/fractional amplitude of low-frequency fluctuation (ALFF/fALFF) and regional homogeneity (ReHo) in patients with drug-naïve first-episode schizophrenia (Dn-FES).

METHODS

A comprehensive search of databases such as PubMed, Web of Science, and Embase was conducted to find articles on resting-state functional magnetic resonance imaging using ALFF/fALFF and ReHo in schizophrenia patients compared to healthy controls (HCs) and then, anatomical/activation likelihood estimation was performed.

RESULTS

Eighteen eligible studies were included in this meta-analysis. Compared to the spontaneous brain activity of HCs, we found changes in spontaneous brain activity in Dn-FES based on these two methods, mainly including the frontal lobe, putamen, lateral globus pallidus, insula, cerebellum, and posterior cingulate cortex.

CONCLUSION

We found that widespread abnormalities of spontaneous brain activity occur in the early stages of the onset of schizophrenia and may provide a reference for the early intervention of schizophrenia.

Frequency-specific coactivation patterns in resting-state and their alterations in schizophrenia: An fMRI study

The resting‐state human brain is a dynamic system that shows frequency‐dependent characteristics. Recent studies demonstrate that coactivation pattern (CAP) analysis can identify recurring brain states with similar coactivation configurations. However, it is unclear whether and how CAPs depend on the frequency bands. The current study investigated the spatial and temporal characteristics of CAPs in the four frequency sub‐bands from slow‐5 (0.01–0.027 Hz), slow‐4 (0.027–0.073 Hz), slow‐3 (0.073–0.198 Hz), to slow‐2 (0.198–0.25 Hz), in addition to the typical low‐frequency range (0.01–0.08 Hz). In the healthy subjects, six CAP states were obtained at each frequency band in line with our prior study. Similar spatial patterns with the typical range were observed in slow‐5, 4, and 3, but not in slow‐2. While the frequency increased, all CAP states displayed shorter persistence, which caused more between‐state transitions. Specifically, from slow‐5 to slow‐4, the coactivation not only changed significantly in distributed cortical networks, but also increased in the basal ganglia as well as the amygdala. Schizophrenia patients showed significant alteration in the persistence of CAPs of slow‐5. Using leave‐one‐pair‐out, hold‐out and resampling validations, the highest classification accuracy (84%) was achieved by slow‐4 among different frequency bands. In conclusion, our findings provide novel information about spatial and temporal characteristics of CAP states at different frequency bands, which contributes to a better understanding of the frequency aspect of biomarkers for schizophrenia and other disorders.

Enhanced Resting-State Functional Connectivity of the Nucleus Accumbens in First-Episode, Medication-Naïve Patients With Early Onset Schizophrenia

There is abundant evidence that early onset schizophrenia (EOS) is associated with abnormalities in widespread regions, including the cortical, striatal, and limbic areas. As a main component of the ventral striatum, the nucleus accumbens (NAc) is implicated in the pathology of schizophrenia. However, functional connection patterns of NAc in patients with schizophrenia, especially EOS, are seldom explored. A total of 78 first-episode, medication-naïve patients with EOS and 90 healthy controls were recruited in the present study, and resting-state, seed-based functional connectivity (FC) analyses were performed to investigate temporal correlations between NAc and the rest of the brain in the two groups. Additionally, correlation analyses were done between regions showing group differences in NAc functional integration and clinical features of EOS. Group comparison found enhanced FC of the NAc in the EOS group relative to the HCs with increased FC in the right superior temporal gyrus and left superior parietal gyrus with the left NAc region of interest (ROI) and elevated FC in left middle occipital gyrus with the right NAc ROI. No significant associations were found between FC strength and symptom severity as well as the age of the patients. Our findings reveal abnormally enhanced FC of the NAc with regions located in the temporal, parietal, and occipital areas, which were implicated in auditory/visual processing, sensorimotor integration, and cognitive functions. The results suggest disturbed relationships between regions subserving reward, salience processing, and regions subserving sensory processing as well as cognitive functions, which may deepen our understanding of the role of NAc in the pathology of EOS.

Functional Connectivity Changes in Multiple-Frequency Bands in Acute Basal Ganglia Ischemic Stroke Patients: A Machine Learning Approach

Purpose

Several functional magnetic resonance imaging (fMRI) studies have investigated the resting-state functional connectivity (rs-FC) changes in the primary motor cortex (M1) in patients with acute basal ganglia ischemic stroke (BGIS). However, the frequency-specific FC changes of M1 in acute BGIS patients are still unclear. Our study was aimed at exploring the altered FC of M1 in three frequency bands and the potential features as biomarkers for the identification by using a support vector machine (SVM).

Methods

We included 28 acute BGIS patients and 42 healthy controls (HCs). Seed-based FC of two regions of interest (ROI, bilateral M1s) were calculated in conventional, slow-5, and slow-4 frequency bands. The abnormal voxel-wise FC values were defined as the features for SVM in different frequency bands.

Results

In the ipsilesional M1, the acute BGIS patients exhibited decreased FC with the right lingual gyrus in the conventional and slow-4 frequency band. Besides, the acute BGIS patients showed increased FC with the right medial superior frontal gyrus (SFGmed) in the conventional and slow-5 frequency band and decreased FC with the left lingual gyrus in the slow-5 frequency band. In the contralesional M1, the BGIS patients showed lower FC with the right SFGmed in the conventional frequency band. The higher FC values with the right lingual gyrus and left SFGmed were detected in the slow-4 frequency band. In the slow-5 frequency band, the BGIS patients showed decreased FC with the left calcarine sulcus. SVM results showed that the combined features (slow-4+slow-5) had the highest accuracy in classification prediction of acute BGIS patients, with an area under curve (AUC) of 0.86.

Conclusion

Acute BGIS patients had frequency-specific alterations in FC; SVM is a promising method for exploring these frequency-dependent FC alterations. The abnormal brain regions might be potential targets for future researchers in the rehabilitation and treatment of stroke patients.

Comparison of resting-state spontaneous brain activity between treatment-naive schizophrenia and obsessive-compulsive disorder

BACKGROUND

Schizophrenia (SZ) and obsessive-compulsive disorder (OCD) share many demographic characteristics and severity of clinical symptoms, genetic risk factors, pathophysiological underpinnings, and brain structure and function. However, the differences in the spontaneous brain activity patterns between the two diseases remain unclear. Here this study aimed to compare the features of intrinsic brain activity in treatment-naive participants with SZ and OCD and to explore the relationship between spontaneous brain activity and the severity of symptoms.

METHODS

In this study, 22 treatment-naive participants with SZ, 27 treatment-naive participants with OCD, and sixty healthy controls (HC) underwent a resting-state functional magnetic resonance imaging (fMRI) scan. The amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo) and degree of centrality (DC) were performed to examine the intrinsic brain activity of participants. Additionally, the relationships among spontaneous brain activity, the severity of symptoms, and the duration of illness were explored in SZ and OCD groups.

RESULTS

Compared with SZ group and HC group, participants with OCD had significantly higher ALFF in the right angular gyrus and the left middle frontal gyrus/precentral gyrus and significantly lower ALFF in the left superior temporal gyrus/insula/rolandic operculum and the left postcentral gyrus, while there was no significant difference in ALFF between SZ group and HC group. Compared with HC group, lower ALFF in the right supramarginal gyrus/inferior parietal lobule and lower DC in the right lingual gyrus/calcarine fissure and surrounding cortex of the two patient groups, higher ReHo in OCD group and lower ReHo in SZ group in the right angular gyrus/middle occipital gyrus brain region were documented in the present study. DC in SZ group was significantly higher than that in HC group in the right inferior parietal lobule/angular gyrus, while there were no significant DC differences between OCD group and HC group. In addition, ALFF in the left postcentral gyrus were positively correlated with positive subscale score (r = 0.588, P = 0.013) and general psychopathology subscale score (r = 0.488, P = 0.047) respectively on the Positive and Negative Syndrome Scale (PANSS) in SZ group. ALFF in the left superior temporal gyrus/insula/rolandic operculum of participants with OCD were positively correlated with compulsion subscale score (r = 0.463, P = 0.030) on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The longer the illness duration in SZ group, the smaller the ALFF of the left superior temporal gyrus/insula/rolandic operculum (Rho = 0.-492, P = 0.020). The longer the illness duration in OCD group, the higher the ALFF of the right supramarginal gyrus/inferior parietal lobule (Rho = 0.392, P = 0.043) and the left postcentral gyrus (Rho = 0.385, P = 0.048), and the lower the DC of the right inferior parietal lobule/angular gyrus (Rho = - 0.518, P = 0.006).

CONCLUSION

SZ and OCD show some similarities in spontaneous brain activity in parietal and occipital lobes, but exhibit different patterns of spontaneous brain activity in frontal, temporal, parietal, occipital, and insula brain regions, which might imply different underlying neurobiological mechanisms in the two diseases. Compared with OCD, SZ implicates more significant abnormalities in the functional connections among brain regions.

Modular-level alterations of single-subject gray matter networks in schizophrenia

Schizophrenia is often regarded as a psychiatric disorder caused by disrupted connections in the brain. Evidence suggests that the gray matter of schizophrenia patients is damaged in a modular pattern. Recently, abnormal topological organization was observed in the gray matter networks of patients with schizophrenia. However, the modular-level alteration of gray matter networks in schizophrenia remains unclear. In this study, single-subject gray matter networks were constructed for a total of 217 subjects (116 patients with schizophrenia and 101 controls). We analyzed the topological characteristics of the brain network and the strengths of connections between and within modules. Compared with the outcomes in the control group, the global efficiency and participation coefficient values of the single-subject gray matter networks in schizophrenic patients were significantly reduced. The nodal participation coefficient of the regions involving the frontoparietal attention network, default mode network and subcortical network were significantly decreased in subjects with schizophrenia. The intermodule connections between the frontoparietal attention network and visual network and between the default mode network and subcortical network, in the frontoparietal attention network were significantly reduced in the patient group. In the frontoparietal attention network, the intramodule nodal connection strength of the left orbital inferior frontal gyrus and right inferior parietal gyrus was significantly decreased in schizophrenia patients. Reduced intermodule nodal connection strength between the frontoparietal attention network and visual network was associated with the severity of schizophrenia symptoms. These findings suggest that abnormal intramodule and intermodule connections in the structural brain network may a biomarker of schizophrenia symptoms.

Frequency-specific altered global signal topography in drug-naïve first-episode patients with adolescent-onset schizophrenia

Adolescent-onset schizophrenia (AOS) is a severe neuropsychiatric disease associated with frequency-specific abnormalities across distributed neural systems in a slow rhythm. Recently, functional magnetic resonance imaging (fMRI) studies have determined that the global signal. (GS) is an important source of the local neuronal activity in 0.01-0.1 Hz frequency band. However, it remains unknown whether the effects follow a specific spatially preferential pattern in different frequency bands in schizophrenia. To address this issue, resting-state fMRI data from 39 drug-naïve AOS patients and 31 healthy controls (HCs) were used to assess the changes in GS topography patterns in the slow-4 (0.027-0.073 Hz) and slow-5 bands (0.01-0.027 Hz). Results revealed that GS mainly affects the default mode network (DMN) in slow-4 and sensory regions in the slow-5 band respectively, and GS has a stronger driving effect in the slow-5 band. Moreover, significant frequency-by-group interaction was observed in the frontoparietal network. Compared with HCs, patients with AOS exhibited altered GS topography mainly located in the DMN. Our findings demonstrated that the influence of the GS on brain networks altered in a frequency-specific way in schizophrenia.

Regional Homogeneity Brain Alterations in Schizophrenia: An Activation Likelihood Estimation Meta-Analysis

OBJECTIVE

Resting state functional magnetic resonance imaging (rsfMRI) provides a lot of evidence for local abnormal brain activity in schizophrenia, but the results are not consistent. Our aim is to find out the consistent abnormal brain regions of the patients with schizophrenia by using regional homogeneity (ReHo), and indirectly understand the degree of brain damage of the patients with drug-naive first episode schizophrenia (Dn-FES) and chronic schizophrenia.

METHODS

We performed the experiment by activation likelihood estimation (ALE) software to analysis the differences between people with schizophrenia group (all schizophrenia group and chronic schizophrenia group) and healthy controls.

RESULTS

Thirteen functional imaging studies were included in quantitative meta-analysis. All schizophrenia group showed decreased ReHo in bilateral precentral gyrus (PreCG) and left middle occipital gyrus (MOG), and increased ReHo in bilateral superior frontal gyrus (SFG) and right insula. Chronic schizophrenia group showed decreased ReHo in bilateral MOG, right fusiform gyrus, left PreCG, left cerebellum, right precuneus, left medial frontal gyrus and left anterior cingulate cortex (ACC). No significant increased brain areas were found in patients with chronic schizophrenia.

CONCLUSION

Our findings suggest that patients with chronic schizophrenia have more extensive brain damage than FES, which may contribute to our understanding of the progressive pathophysiology of schizophrenia.

Whole-Brain Functional Network Connectivity Abnormalities in Affective and Non-Affective Early Phase Psychosis

Psychosis disorders share overlapping symptoms and are characterized by a wide-spread breakdown in functional brain integration. Although neuroimaging studies have identified numerous connectivity abnormalities in affective and non-affective psychoses, whether they have specific or unique connectivity abnormalities, especially within the early stage is still poorly understood. The early phase of psychosis is a critical period with fewer chronic confounds and when treatment intervention may be most effective. In this work, we examined whole-brain functional network connectivity (FNC) from both static and dynamic perspectives in patients with affective psychosis (PAP) or with non-affective psychosis (PnAP) and healthy controls (HCs). A fully automated independent component analysis (ICA) pipeline called "Neuromark" was applied to high-quality functional magnetic resonance imaging (fMRI) data with 113 early-phase psychosis patients (32 PAP and 81 PnAP) and 52 HCs. Relative to the HCs, both psychosis groups showed common abnormalities in static FNC (sFNC) between the thalamus and sensorimotor domain, and between subcortical regions and the cerebellum. PAP had specifically decreased sFNC between the superior temporal gyrus and the paracentral lobule, and between the cerebellum and the middle temporal gyrus/inferior parietal lobule. On the other hand, PnAP showed increased sFNC between the fusiform gyrus and the superior medial frontal gyrus. Dynamic FNC (dFNC) was investigated using a combination of a sliding window approach, clustering analysis, and graph analysis. Three reoccurring brain states were identified, among which both psychosis groups had fewer occurrences in one antagonism state (state 2) and showed decreased network efficiency within an intermediate state (state 1). Compared with HCs and PnAP, PAP also showed a significantly increased number of state transitions, indicating more unstable brain connections in affective psychosis. We further found that the identified connectivity features were associated with the overall positive and negative syndrome scale, an assessment instrument for general psychopathology and positive symptoms. Our findings support the view that subcortical-cortical information processing is disrupted within five years of the initial onset of psychosis and provide new evidence that abnormalities in both static and dynamic connectivity consist of shared and unique features for the early affective and non-affective psychoses.

Altered Complexity of Spontaneous Brain Activity in Schizophrenia and Bipolar Disorder Patients

BACKGROUND

Schizophrenia (SC) and bipolar disorder (BP) share elements of symptoms and the underlying neural mechanisms for both remain unclear. Recently, the complexity of spontaneous functional MRI (fMRI) signals in brain activity has been investigated in SC and BP using multiscale sample entropy (MSE) with inconsistent results.

PURPOSE

To perform MSE analysis across five time scales to assess differences in resting-state fMRI signal complexity in SC, BP, and normal controls (NC).

STUDY TYPE

Retrospective.

POPULATION

Fifty SC, 49 BP, and 49 NC.

FIELD STRENGTH/SEQUENCE

A 3 T, T2* weighted echo planar imaging (EPI) sequence.

ASSESSMENT

The mean MSEs of all gray matter (GM) and of 12 regions of interest (ROIs) were extracted using masks across the five scales. The regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) in these ROIs were also determined and the relationship between the three measures was investigated. The correlations between cognitive assessment scores and MSE values were also explored.

STATISTICAL TESTS

Bonferroni correction, One-way ANOVA, Spearman rank correlation coefficient (r), Gaussian random field (GRF) correction.

RESULTS

There were decreased GM MSE values in the patient groups (F = 9.629, P < 0.05). SC and BP patients demonstrated lower complexity than NCs in the calcarine fissure, precuneus, inferior occipital gyrus, lingual gyrus and cerebellum, and higher complexity in the median cingulate, thalamus, hippocampus, middle temporal gyrus and middle frontal gyrus. There were significant differences between SC and BP patients in the precuneus (F = 4.890, P < 0.05) and inferior occipital gyrus (F = 5.820, P < 0.05). Calcarine fissure, cingulate, temporal gyrus, occipital gyrus, hippocampus, precuneus, frontal gyrus, and lingual gyrus MSE values were significantly correlated with both ReHo (r > 0.282, P < 0.05) and ALFF (r > 0.278, P < 0.05). Furthermore, median temporal MSE (r = -0.321, P < 0.05) on scale 3 and (r = -0.307, P < 0.05) on scale 4 and median cingulate MSE (r = -0.337, P < 0.05) on scale 5 was significantly negatively correlated with cognitive assessment scores.

DATA CONCLUSION

These data highlight different patterns of brain signal intensity complexity in SC and BP.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY: Stage 1.

Local versus long-range connectivity patterns of auditory disturbance in schizophrenia

Auditory hallucinations are a debilitating symptom of schizophrenia. Effective treatment is limited because the underlying neural mechanisms remain unknown. Our study investigates how local and long-range functional connectivity is associated with auditory perceptual disturbances (APD) in schizophrenia. APD was assessed using the Auditory Perceptual Trait and State Scale. Resting state fMRI data were collected for N=99 patients with schizophrenia. Local functional connectivity was estimated using regional homogeneity (ReHo) analysis; long-range connectivity was estimated using resting state functional connectivity (rsFC) analysis. Mediation analyses tested whether local (ReHo) connectivity significantly mediated associations between long-distance rsFC and APD. Severity of APD was significantly associated with reduced ReHo in left and right putamen, left temporoparietal junction (TPJ), and right hippocampus-pallidum. Higher APD was also associated with reduced rsFC between the right putamen and the contralateral putamen and auditory cortex. Local and long-distance connectivity measures together explained 40.3% of variance in APD (P < 0.001), with the strongest predictor being the left TPJ ReHo (P < 0.001). Additionally, TPJ ReHo significantly mediated the relationship between right putamen - left putamen rsFC and APD (Sobel test, P = 0.001). Our findings suggest that both local and long-range functional connectivity deficits contribute to APD, emphasizing the role of striatum and auditory cortex. Considering the translational impact of these circuit-based findings within the context of prior clinical trials to treat auditory hallucinations, we propose a model in which correction of both local and long-distance functional connectivity deficits may be necessary to treat auditory hallucinations.

Increased regional homogeneity modulated by metacognitive training predicts therapeutic efficacy in patients with schizophrenia

Previous studies have demonstrated the efficacy of metacognitive training (MCT) in schizophrenia. However, the underlying mechanisms related to therapeutic effect of MCT remain unknown. The present study explored the treatment effects of MCT on brain regional neural activity using regional homogeneity (ReHo) and whether these regions' activities could predict individual treatment response in schizophrenia. Forty-one patients with schizophrenia and 20 healthy controls were scanned using resting-state functional magnetic resonance imaging. Patients were randomly divided into drug therapy (DT) and drug plus psychotherapy (DPP) groups. The DT group received only olanzapine treatment, whereas the DPP group received olanzapine and MCT for 8 weeks. The results revealed that ReHo in the right precuneus, left superior medial prefrontal cortex (MPFC), right parahippocampal gyrus and left rectus was significantly increased in the DPP group after 8 weeks of treatment. Patients in the DT group showed significantly increased ReHo in the left ventral MPFC/anterior cingulate cortex (ACC), left superior MPFC/middle frontal gyrus (MFG), left precuneus, right rectus and left MFG, and significantly decreased ReHo in the bilateral cerebellum VIII and left inferior occipital gyrus (IOG) after treatment. Support vector regression analyses showed that high ReHo levels at baseline in the right precuneus and left superior MPFC could predict symptomatic improvement of Positive and Negative Syndrome Scale (PANSS) after 8 weeks of DPP treatment. Moreover, high ReHo levels at baseline and alterations of ReHo in the left ventral MPFC/ACC could predict symptomatic improvement of PANSS after 8 weeks of DT treatment. This study suggests that MCT is associated with the modulation of ReHo in schizophrenia. ReHo in the right precuneus and left superior MPFC may predict individual therapeutic response for MCT in patients with schizophrenia.

Disrupted Regional Homogeneity in Drug-Naive Patients With Bipolar Disorder

OBJECTIVE

Studies on alterations in the regional neural activity in the brain of patients with bipolar disorder (BD) have provided conflicting results because of different medications used and study designs. A low bone mineral density (BMD) is also observed in patients with BD. This study aimed to further explore regional neural activities in unmedicated patients with BD and their association with BMD.

METHODS

In this study, 40 patients with BD and 42 healthy controls were scanned through resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with regional homogeneity (ReHo) and pattern classification. Pearson's correlation analyses were performed to explore the correlations between abnormal ReHo and BMD.

RESULTS

A significant increase in ReHo values in the left inferior frontal gyrus (IFG)/temporal pole, left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem, and right superior temporal gyrus (STG) and a decrease in ReHo in the occipital gyrus (OG; left middle OG/superior OG/bilateral cuneus) were found in the patients with BD (p < 0.05) compared with those in the healthy controls. No significant correlation was observed between the abnormal ReHo values in any of the brain regions of the patients with BMD.Support vector machine (SVM) analyses revealed that the ReHo values in the right STG for distinguishing patients from healthy controls showed an accuracy of 91.89%, a sensitivity of 75.68%, and a specificity of 83.78%. The ReHo values in the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem indicated an accuracy of 78.38%, a sensitivity of 75.68%, and a specificity of 81.08%.

CONCLUSION

This study further confirms the abnormal brain activities in extensive regions, and these brain regions are primarily located in the fronto-temporal-occipital circuit and the cerebellum vermis of patients with BD. The regional neural activity in the right STG and the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem may serve as potential imaging markers to distinguish patients with BD from healthy controls.

Sex-linked neurofunctional basis of psychological resilience in late adolescence: a resting-state functional magnetic resonance imaging study

Psychological resilience refers to the ability to adapt effectively in the face of adversity, which is closely related to an individual's psychological and physical health and well-being. Although previous behavioural studies have shown sex differences in psychological resilience, little is known about the neural basis of sex differences in psychological resilience. Here, we measured amplitude of low-frequency fluctuations (ALFF) via resting-state functional magnetic resonance imaging to investigate the sex-linked neurofunctional basis of psychological resilience in 231 healthy adolescents. At the behavioural level, we replicated previous findings indicating that males are more resilient than females. At the neural level, we found sex differences in the relationship between psychological resilience and ALFF in the right orbitofrontal cortex (OFC). Specifically, males showed a positive correlation between psychological resilience and ALFF in the right OFC, while females showed a negative correlation in this region. The sex-specific association between psychological resilience and spontaneous brain activity might be dependent on differences in hormonal systems and brain development between male and female adolescents. Taken together, the results of our study might provide the first evidence of sex-specific neurofunctional substrates of psychological resilience in adolescents, emphasizing the vital role of sex effects in future psychological resilience-related studies.

Reconfiguration of Dynamic Functional Connectivity in Sensory and Perceptual System in Schizophrenia

Schizophrenia is thought as a self-disorder with dysfunctional brain connectivity. This self-disorder is often attributed to high-order cognitive impairment. Yet due to the frequent report of sensorial and perceptual deficits, it has been hypothesized that self-disorder in schizophrenia is dysfunctional communication between sensory and cognitive processes. To further verify this assumption, the present study comprehensively examined dynamic reconfigurations of resting-state functional connectivity (rsFC) in schizophrenia at voxel level, region level, and network levels (102 patients vs. 124 controls). We found patients who show consistently increased rsFC variability in sensory and perceptual system, including visual network, sensorimotor network, attention network, and thalamus at all the three levels. However, decreased variability in high-order networks, such as default mode network and frontal-parietal network were only consistently observed at region and network levels. Taken together, these findings highlighted the rudimentary role of elevated instability of information communication in sensory and perceptual system and attenuated whole-brain integration of high-order network in schizophrenia, which provided novel neural evidence to support the hypothesis of disrupted perceptual and cognitive function in schizophrenia. The foci of effects also highlighted that targeting perceptual deficits can be regarded as the key to enhance our understanding of pathophysiology in schizophrenia and promote new treatment intervention.

Current methods and new directions in resting state fMRI

Resting state functional connectivity magnetic resonance imaging (rsfcMRI) has become a key component of investigations of neurocognitive and psychiatric behaviors. Over the past two decades, several methods and paradigms have been adopted to utilize and interpret data from resting-state fluctuations in the brain. These findings have increased our understanding of changes in many disease states. As the amount of resting state data available for research increases with big datasets and data-sharing projects, it is important to review the established traditional analysis methods and recognize areas where research methodology can be adapted to better accommodate the scale and complexity of rsfcMRI analysis. In this paper, we review established methods of analysis as well as areas that have been receiving increasing attention such as dynamic rsfcMRI, independent vector analysis, multiband rsfcMRI and network of networks.

Frequency-Specific Regional Homogeneity Alterations in Tourette Syndrome

Tourette syndrome (TS) is a developmental neuropsychiatric disorder with onset during childhood. Because of its complex spectrum of phenotypes, the underlying pathophysiology of TS is still unclear. Resting-state functional magnetic resonance imaging demonstrated aberrant spontaneous neural synchronization in conventional frequency band (0.01-0.08 Hz) in TS. No published studies have reported abnormalities of local synchronization across different frequency bands. We estimated the alterations of local synchronization across five bands ranging from 0 to 0.25 Hz. Seventy-nine children with TS and 63 age-, sex-, and handedness-matched healthy children were recruited. Frequency-specific regional homogeneity (ReHo) and independent component analysis were used to identify functional alterations between TS and healthy children. TS patients showed significantly increased ReHo in the left precentral gyrus and decreased ReHo in the right operculum. Abnormal ReHo alterations of the superior frontal gyrus, superior parietal gyrus, anterior cingulate gyrus, putamen, superior temporal gyrus, and operculum were observed in different frequency bands. TS patients showed increased connectivity of the right superior frontal gyrus within the left executive control network. In addition, a significantly negative correlation was found between Yale Global Tic Severity Scale (YGTSS) vocal score and ReHo values of the right operculum in the highest frequency bands (0.198-0.25 Hz), while a significant positive correlation was found between YGTSS motor score and altered connectivity of the right superior frontal gyrus. The present study revealed frequency-specific abnormal alterations of ReHo in the whole brain and altered connectivity within the executive control network of TS children. Its neural importance and clinical practicability require further investigation.

Enhanced Prefrontal Regional Homogeneity and Its Correlations With Cognitive Dysfunction/Psychopathology in Patients With First-Diagnosed and Drug-Naive Schizophrenia

Background: Schizophrenia, regarded as a neurodevelopmental disorder, is characterized by positive symptoms, negative symptoms, and cognitive dysfunction. Investigating the spontaneous brain activity in patients with schizophrenia can help us understand the underlying pathophysiologic mechanism of schizophrenia. However, results concerning abnormal neural activities and their correlations with cognitive dysfunction/psychopathology of patients with schizophrenia were inconsistent. Methods: We recruited 57 first-diagnosed and drug-naive patients with schizophrenia and 50 matched healthy controls underwent magnetic resonance imaging. The Positive and Negative Syndrome Scale (PANSS) and the MATRICS Consensus Cognitive Battery were used to assess the psychopathology/cognitive dysfunction. Regional homogeneity (ReHo) was used to explore neural activities. Correlation analyses were calculated between abnormal ReHo values and PANSS scores/standardized cognitive scores. Lastly, support vector machine analyses were conducted to evaluate the accuracy of abnormal ReHo values in distinguishing patients with schizophrenia from healthy controls. Results: Patients with schizophrenia showed cognitive dysfunction, and increased ReHo values in the right gyrus rectus, right inferior frontal gyrus/insula and left inferior frontal gyrus/insula compared with those of healthy controls. The ReHo values in the right inferior frontal gyrus/insula were positively correlated with negative symptom scores and negatively correlated with Hopkins verbal learning test-revised/verbal learning. Our results showed that the combination of increased ReHo values in the left inferior frontal gyrus/insula and right gyrus rectus had 78.5% (84/107) accuracy, 85.96% (49/57) sensitivity, and 70.00% specificity, which were higher than other combinations. Conclusions: Hyperactivities were primarily located in the prefrontal regions, and increased ReHo values in the right inferior frontal gyrus/insula might reflect the severity of negative symptoms and verbal learning abilities. The combined increases of ReHo values in these regions might be an underlying biomarker in differentiating patients with schizophrenia from healthy controls.

Characterizing functional regional homogeneity (ReHo) as a B-SNIP psychosis biomarker using traditional and machine learning approaches

BACKGROUND

Recently, a biologically-driven psychosis classification (B-SNIP Biotypes) was derived using brain-based cognitive and electrophysiological markers. Here, we characterized a local functional-connectivity measure, regional homogeneity (ReHo), as a biomarker across Biotypes and conventional DSM diagnoses.

METHODS

Whole-brain ReHo measures of resting-state functional MRI were examined in psychosis patients and healthy controls organized by Biotype and by DSM-IV-TR diagnosis (n = 737). Group-level ANOVA and individual-level prediction models using support vector machines (SVM) were employed to evaluate the discriminative characteristics in comparisons of 1) DSM diagnostic groups, 2) Biotypes, to controls, and 3) within-proband subgroups with each other.

RESULTS

Probands grouped by Biotype versus controls showed a unique abnormality pattern: Biotype-1 displayed bidirectional ReHo differences in more widespread areas, with higher ReHo in para-hippocampus, fusiform, inferior temporal, cerebellum, thalamus and caudate, plus lower ReHo in the postcentral gyrus, middle temporal, cuneus, and middle occipital cortex; Biotype-2 and Biotype-3 showed lesser and unidirectional ReHo changes. Among diagnostic groups, only schizophrenia showed higher ReHo versus control values in the inferior/middle temporal area and fusiform gyrus. For within-patient comparisons, Biotype-1 showed characteristic ReHo when compared to Biotype-2 and Biotype-3. SVM results more accurately identified Biotypes than DSM diagnoses.

CONCLUSION

We characterized patterns of ReHo abnormalities across both Biotypes and DSM sub-groups. Both group-level statistical and machine-learning methods were more sensitive in capturing ReHo deficits in Biotypes than DSM. Overall ReHo is a robust psychosis biomarker.

Uncoupled relationship in the brain between regional homogeneity and attention function in first-episode, drug-naïve schizophrenia

The relationship between the cognitive impairment and the structural and functional abnormalities in the brains of patients with schizophrenia (SZ) is not yet clear. This study aims to investigate the relationship, thereby exploring the neuromechanism underlying SZ. We collected multimodal MRI data from 68 first-episode, drug-naïve patients with SZ, and 64 well-matched healthy controls, and used regional homogeneity (ReHo) and gray matter volume (GMV) to assess the functional and structural integrity of the brains, respectively. We then evaluated in the entire brain the correlations between ReHo/GMV and the participants' neuropsychological assessment scores for each group using a partial correlation analysis controlling for age and sex. We found significant uncoupling between attention performance and mean ReHo in the left middle frontal gyrus, right superior/inferior parietal lobe (IPL), right angular gyrus (AG) and right middle/inferior temporal lobe (ITG) in SZ compared with healthy controls. Moreover, we found that the SZ group showed decreased GMV in the right IPL and AG, and a significant coupling between ReHo and GMV in the right ITG. Our findings suggest that the attention dysfunction found in SZ may be associated with the structural and functional abnormalities as well as the structure-function interrelation in several SZ-related brain regions.

Abnormalities of regional homogeneity and its correlation with clinical symptoms in Naïve patients with first-episode schizophrenia

Several resting-state neuroimaging studies have indicated abnormal regional homogeneity (ReHo) in chronic schizophrenia; however, little work has been conducted to investigate naïve patients with first-episode schizophrenia (FES). Even less investigated is the association between ReHo measures and clinical symptom severity in naïve patients with FES. The current study evaluated ReHo alterations in whole brain, and assessed the correlations between ReHo measures and clinical variables in naïve patients with FES. Forty-four naïve patients with FES and 26 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Group-level analysis was utilized to analyze the ReHo differences between FES and HC in a voxel-by-voxel manner. Severity of symptoms was evaluated using a five-factor model of the Positive and Negative Syndrome Scale (PANSS). The correlation between the severity of symptoms and ReHo map was examined in patients using voxel-wise correlation analyses within brain areas that showed a significant ReHo alteration in patients compared with controls. Compared with the healthy control group, the FES group showed a significant decrease in ReHo values in the left medial frontal gyrus (MFG), right precentral gyrus, left superior temporal gyrus (STG), left left middle temporal gyrus (MTG), left thalamus, and significant increase in ReHo values in the left MFG, left inferior parietal lobule (IPL), left precuneus, and right lentiform nucleus (LN). In addition, the correlation analysis showed the PANSS total score negatively correlated with ReHo in the right precentral gyrus and positively correlated with ReHo in the left thalamus, the positive factor positively correlated with ReHo in the right thalamus, the disorganized/concrete factor positively correlated with ReHo in left posterior cingulate gyrus (PCG), the excited factor positively correlated with ReHo in the left precuneus, and the depressed factor negatively correlated with ReHo in the right postcentral gyrus and positively correlated with ReHo in the right thalamus. Our results indicate that widespread ReHo abnormalities occurred in an early stage of schizophrenic onset, suggesting a potential neural basis for the pathogenesis and symptomatology of schizophrenia.

Linked 4-Way Multimodal Brain Differences in Schizophrenia in a Large Chinese Han Population

Multimodal fusion has been regarded as a promising tool to discover covarying patterns of multiple imaging types impaired in brain diseases, such as schizophrenia (SZ). In this article, we aim to investigate the covarying abnormalities underlying SZ in a large Chinese Han population (307 SZs, 298 healthy controls [HCs]). Four types of magnetic resonance imaging (MRI) features, including regional homogeneity (ReHo) from resting-state functional MRI, gray matter volume (GM) from structural MRI, fractional anisotropy (FA) from diffusion MRI, and functional network connectivity (FNC) resulted from group independent component analysis, were jointly analyzed by a data-driven multivariate fusion method. Results suggest that a widely distributed network disruption appears in SZ patients, with synchronous changes in both functional and structural regions, especially the basal ganglia network, salience network (SAN), and the frontoparietal network. Such a multimodal coalteration was also replicated in another independent Chinese sample (40 SZs, 66 HCs). Our results on auditory verbal hallucination (AVH) also provide evidence for the hypothesis that prefrontal hypoactivation and temporal hyperactivation in SZ may lead to failure of executive control and inhibition, which is relevant to AVH. In addition, impaired working memory performance was found associated with GM reduction and FA decrease in SZ in prefrontal and superior temporal area, in both discovery and replication datasets. In summary, by leveraging multiple imaging and clinical information into one framework to observe brain in multiple views, we can integrate multiple inferences about SZ from large-scale population and offer unique perspectives regarding the missing links between the brain function and structure that may not be achieved by separate unimodal analyses.

Altered spatial and temporal concordance among intrinsic brain activity measures in schizophrenia

Various data-driven voxel-wise measures derived from resting-state functional magnetic resonance imaging (rs-fMRI) have been developed to characterize spontaneous brain activity. These measures have been widely applied to explore brain functional changes in schizophrenia and have enjoyed significant success in unraveling the neural mechanisms of this disorder. However, their spatial and temporal coupling alterations in schizophrenia remain largely unknown. To address this issue, 88 schizophrenia patients and 116 gender- and age-matched healthy controls underwent rs-fMRI examinations. Kendall's W was used to calculate volume-wise (across voxels) and voxel-wise (across time windows) concordance among multiple commonly used measures, including fractional amplitude of low frequency fluctuations, regional homogeneity, voxel-mirrored homotopic connectivity, degree centrality and global signal connectivity. Inter-group differences in the concordance were investigated. Results revealed that whole gray matter volume-wise concordance was reduced in schizophrenia patients relative to healthy controls. Although two groups showed similar spatial distributions of the voxel-wise concordance, quantitative comparison analysis revealed that schizophrenia patients exhibited decreased voxel-wise concordance in gray matter areas spanning the bilateral frontal, parietal, occipital, temporal and insular cortices. In addition, these concordance changes were negatively correlated with onset age in schizophrenia patients. Our findings suggest that the concordance approaches may provide new insights into the neural mechanisms of schizophrenia and have the potential to be extended to neuropsychiatric disorders.

Dynamic Complexity of Spontaneous BOLD Activity in Alzheimer's Disease and Mild Cognitive Impairment Using Multiscale Entropy Analysis

Alzheimer's disease (AD) is characterized by progressive deterioration of brain function among elderly people. Studies revealed aberrant correlations in spontaneous blood oxygen level-dependent (BOLD) signals in resting-state functional magnetic resonance imaging (rs-fMRI) over a wide range of temporal scales. However, the study of the temporal dynamics of BOLD signals in subjects with AD and mild cognitive impairment (MCI) remains largely unexplored. Multiscale entropy (MSE) analysis is a method for estimating the complexity of finite time series over multiple time scales. In this research, we applied MSE analysis to investigate the abnormal complexity of BOLD signals using the rs-fMRI data from the Alzheimer's disease neuroimaging initiative (ADNI) database. There were 30 normal controls (NCs), 33 early MCI (EMCI), 32 late MCI (LMCI), and 29 AD patients. Following preprocessing of the BOLD signals, whole-brain MSE maps across six time scales were generated using the Complexity Toolbox. One-way analysis of variance (ANOVA) analysis on the MSE maps of four groups revealed significant differences in the thalamus, insula, lingual gyrus and inferior occipital gyrus, superior frontal gyrus and olfactory cortex, supramarginal gyrus, superior temporal gyrus, and middle temporal gyrus on multiple time scales. Compared with the NC group, MCI and AD patients had significant reductions in the complexity of BOLD signals and AD patients demonstrated lower complexity than that of the MCI subjects. Additionally, the complexity of BOLD signals from the regions of interest (ROIs) was found to be significantly associated with cognitive decline in patient groups on multiple time scales. Consequently, the complexity or MSE of BOLD signals may provide an imaging biomarker of cognitive impairments in MCI and AD.

Local functional connectivity alterations in schizophrenia, bipolar disorder, and major depressive disorder

BACKGROUND

Local functional connectivity (FC) indicates local or short-distance functional interactions and may serve as a neuroimaging marker to investigate the human brain connectome. Local FC alterations suggest a disrupted balance in the local functionality of the whole brain network and are increasingly implicated in schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD).

METHODS

We aim to examine the similarities and differences in the local FC across SZ, BD, and MDD. In total, 537 participants (SZ, 126; BD, 97; MDD, 126; and healthy controls, 188) completed resting-state functional magnetic resonance imaging at a single site. The local FC at resting state was calculated and compared across SZ, BD, and MDD.

RESULTS

The local FC increased across SZ, BD, and MDD within the bilateral orbital frontal cortex (OFC) and additional region in the left OFC extending to putamen and decreased in the primary visual, auditory, and motor cortices, right supplemental motor area, and bilateral thalami. There was a gradient in the extent of alterations such that SZ > BD > MDD.

LIMITATIONS

This cross-sectional study cannot consider medications and other clinical variables.

CONCLUSIONS

These findings indicate a disrupted balance between network integration and segregation in SZ, BD, and MDD, including over-integration via increased local FC in the OFC and diminished segregation of neural processing with the weakening of the local FC in the primary sensory cortices and thalamus. The shared local FC abnormalities across SZ, BD, and MDD may shed new light on the potential biological mechanisms underlying these disorders.

Resting-State Functional MRI: Everything That Nonexperts Have Always Wanted to Know

Resting-state fMRI was first described by Biswal et al in 1995 and has since then been widely used in both healthy subjects and patients with various neurologic, neurosurgical, and psychiatric disorders. As opposed to paradigm- or task-based functional MR imaging, resting-state fMRI does not require subjects to perform any specific task. The low-frequency oscillations of the resting-state fMRI signal have been shown to relate to the spontaneous neural activity. There are many ways to analyze resting-state fMRI data. In this review article, we will briefly describe a few of these and highlight the advantages and limitations of each. This description is to facilitate the adoption and use of resting-state fMRI in the clinical setting, helping neuroradiologists become familiar with these techniques and applying them for the care of patients with neurologic and psychiatric diseases.

Abnormal dynamic functional connectivity between speech and auditory areas in schizophrenia patients with auditory hallucinations

Purpose

Auditory hallucinations (AH), typically hearing voices, are a core symptom in schizophrenia. They may result from deficits in dynamic functional connectivity (FC) between cortical regions supporting speech production and language perception that interfere with the ability to recognize self-generated speech as not coming from external sources. We tested this hypothesis by investigating dynamic connectivity between the frontal cortex region related to language production and the temporal cortex region related to auditory processing.

Methods

Resting-state fMRI scans were acquired from 18 schizophrenia patients with AH (AH+), 17 schizophrenia patients without AH (AH-) and 22 healthy controls. A multiband sequence with TR = 427 ms was adopted to provide relatively high temporal resolution data for characterizing dynamic FC. Analysis focused on connectivity between speech production and language comprehension areas, eloquent language cortex in the left hemisphere. Two frequency bands of brain oscillatory activity were evaluated (0.01–0.027 Hz, 0.027–0.08 Hz) in which differential alterations that have been previously linked to schizophrenia. Conventional static FC maps of these seeds were also calculated.

Results

Dynamic connectivity analysis indicated that AH+ patients showed not only less temporal variability but transient lower strength in connectivity between speech and auditory areas than healthy controls, while AH- patients not. These findings were restricted to 0.027–0.08 Hz activity. In static connectivity analysis, no significant differences were observed in connectivity between speech production and language comprehension areas in either frequency band.

Conclusions

Reduced temporal variability and connectivity strength between key regions of eloquent language cortex may represent a mechanism for AH in schizophrenia.

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Abnormal dynamic functional connectivity in schizophrenia with auditory hallucinations.

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The dynamic connectivity goes wrong between expressive and receptive language regions.

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The abnormality was restricted to the left hemisphere.

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This abnormal dynamic connectivity was limited to a specific frequency band.

Changes in Gray Matter Density, Regional Homogeneity, and Functional Connectivity in Methamphetamine-Associated Psychosis: A Resting-State Functional Magnetic Resonance Imaging (fMRI) Study

Background

Using regional homogeneity (ReHo) blood oxygen level-dependent functional MR (BOLD-fMRI), we investigated the structural and functional alterations of brain regions among patients with methamphetamine-associated psychosis (MAP).

Material/Methods

This retrospective study included 17 MAP patients, 16 schizophrenia (SCZ) patients, and 18 healthy controls. Informed consent was obtained from all patients before the clinical assessment, the severity of clinical symptoms was evaluated prior to the fMRI scanning, and then images were acquired and preprocessed after each participant received 6-min fRMI scanning. The participants all underwent BOLD-fMRI scanning. Voxel-based morphometry was used to measure gray matter density (GMD). Resting-state fMRI (rs-fMRI) was conducted to analyze functional MR, ReHo, and functional connectivity (FC).

Results

GMD analysis results suggest that MAP patients, SCZ patients, and healthy volunteers show different GMDs within different brain regions. Similarly, the ReHo analysis results suggest that MAP patients, SCZ patients, and healthy volunteers have different GMDs within different brain regions. Negative correlations were found between ReHo- and the PANSS-positive scores within the left orbital interior frontal gyrus (L-orb-IFG) of MAP patients. ReHo- and PANSS-negative scores of R-SFG were negatively correlated among SCZ patients. The abnormal FC of R-MFG showed a negative correlation with the PANSS score among MAP patients.

Conclusions

The abnormalities in brain structure and FC were associated with the development of MAP.

Aberrant patterns of local and long-range functional connectivity densities in schizophrenia

Schizophrenia is a disorder of brain dysconnectivity, and both the connection strength and connection number are disrupted in patients with schizophrenia. The functional connectivity density (FCD) can reflect alterations in the connection number. Alterations in the global FCD (gFCD) in schizophrenia were previously demonstrated; however, alterations in two other indices of the pathological characteristics of the brain, local FCD (lFCD) and long-range FCD (lrFCD), have not been revealed. To investigate lFCD and lrFCD alterations in patients with schizophrenia, 95 patients and 93 matched healthy controls were examined using structural and resting-state functional magnetic resonance imaging scanning. lFCD and lrFCD were measured using FCD mapping, and differences were identified using a two-sample t-test in a voxel-wise manner, with age and gender considered to increase variability. Multiple comparisons were performed using a false discovery rate method with a corrected threshold of P<0.05. Our analysis showed that lFCD was primarily decreased in the postcentral gyrus, right calcarine sulcus, and inferior occipital gyrus lobule, but increased in the bilateral subcortical regions. The differences in lFCD were more pronounced and complicated than those in lrFCD. In summary, in contrast with previous studies that focused on the connection strength, our findings, from the perspective of connection number, indicate that schizophrenia is a disorder of brain dysconnectivity, particularly affecting the local functional connectivity network, and support the hypothesis that schizophrenia is associated with a widespread cortical functional connectivity/activity deficit, with hyper- and/or hypo-connectivity/activity coexisting in some cortical or subcortical regions.

Variability in Resting State Network and Functional Network Connectivity Associated With Schizophrenia Genetic Risk: A Pilot Study

Imaging genetics posits a valuable strategy for elucidating genetic influences on brain abnormalities in psychiatric disorders. However, association analysis between 2D genetic data (subject × genetic variable) and 3D first-level functional magnetic resonance imaging (fMRI) data (subject × voxel × time) has been challenging given the asymmetry in data dimension. A summary feature needs to be derived for the imaging modality to compute inter-modality association at subject level. In this work, we propose to use variability in resting state networks (RSNs) and functional network connectivity (FNC) as potential features for purpose of association analysis. We conducted a pilot study to investigate the proposed features in a dataset of 171 healthy controls and 134 patients with schizophrenia (SZ). We computed variability in RSN and FNC in a group independent component analysis framework and tested three types of variability metrics, namely Euclidean distance, Pearson correlation and Kullback-Leibler (KL) divergence. Euclidean distance and Pearson correlation metrics more effectively discriminated controls from patients than KL divergence. The group differences observed with variability in RSN and FNC were highly consistent, indicating patients presenting increased deviation from the cohort-common pattern of RSN and FNC than controls. The variability in RSN and FNC showed significant associations with network global efficiency, the more the deviation, the lower the efficiency. Furthermore, the RSN and FNC variability were found to associate with individual SZ risk SNPs as well as cumulative polygenic risk score for SZ. Collectively the current findings provide preliminary evidence for variability in RSN and FNC being promising imaging features that may find applications as biomarkers and in imaging genetic association analysis.

Abnormal regional homogeneity as a potential imaging biomarker for adolescent-onset schizophrenia: A resting-state fMRI study and support vector machine analysis

OBJECTIVE

Structural and functional abnormalities have been reported in the brain of patients with adolescent-onset schizophrenia (AOS). The brain regional functional synchronization in patients with AOS remains unclear.

METHODS

We analyzed resting-state functional magnetic resonance scans in 48 drug-naive patients with AOS and 31 healthy controls by using regional homogeneity (ReHo), a measurement that reflects brain local functional connectivity or synchronization and indicates regional integration of information processing. Then, receiver operating characteristic curves and support vector machines were used to evaluate the effect of abnormal regional homogeneity in differentiating patients from controls.

RESULTS

Patients with AOS showed significantly increased ReHo values in the bilateral superior medial prefrontal cortex (MPFC) and significantly decreased ReHo values in the left superior temporal gyrus (STG), right precentral lobule, right inferior parietal lobule (IPL), and left paracentral lobule when compared with controls. A combination of the ReHo values in bilateral superior MPFC, left STG, and right IPL was able to discriminate patients from controls with the sensitivity of 88.24%, specificity of 91.89%, and accuracy of 90.14%.

CONCLUSION

The brain regional functional synchronization abnormalities exist in drug-naive patients with AOS. A combination of ReHo values in these abnormal regions might serve as potential imaging biomarker to identify patients with AOS.

Effects of DISC1 Polymorphisms on Resting-State Spontaneous Neuronal Activity in the Early-Stage of Schizophrenia

Background: Localized abnormalities in the synchrony of spontaneous neuronal activity, measured with regional homogeneity (ReHo), has been consistently reported in patients with schizophrenia (SCZ) and their unaffected siblings. To date, little is known about the genetic influences affecting the spontaneous neuronal activity in SCZ. DISC1, a strong susceptible gene for SCZ, has been implicated in neuronal excitability and synaptic function possibly associated with regional spontaneous neuronal activity. This study aimed to examine the effects of DISC1 variations on the regional spontaneous neuronal activity in SCZ. Methods: Resting-state fMRI data were obtained from 28 SCZ patients and 21 healthy controls (HC) for ReHo analysis. Six single nucleotide polymorphisms (SNPs) of DISC1 gene were genotyped using the PCR and direct sequencing. Results: Significant diagnosis × genotype interactions were noted for three SNPs (rs821616, rs821617, and rs2738880). For rs821617, the interactions were localized to the precuneus, basal ganglia and pre-/post-central regions. Significant interactive effects were identified at the temporal and post-central gyri for rs821616 (Ser704Cys) and the inferior temporal gyrus for rs2738880. Furthermore, post-hoc analysis revealed that the DISC1 variations on these SNPs exerted different influences on ReHo between SCZ patients and HC. Conclusion: To our knowledge this is the first study to unpick the influence of DISC1 variations on spontaneous neuronal activity in SCZ; Given the emerging evidence that ReHo is a stable inheritable phenotype for schizophrenia, our findings suggest the DISC1 variations are possibly an inheritable source for the altered ReHo in this disorder.

Frequency-specific alteration of functional connectivity density in antipsychotic-naive adolescents with early-onset schizophrenia

Early-onset schizophrenia (EOS) is a severe mental illness associated with dysconnectivity that widespread in the brain. However, the functional dysconnectivity in EOS are still mixed. Recently, studies have identified that functional connectivity (FC) arises from a band-limited slow rhythmic mechanism and suggested that the dysconnectivity at specific frequency bands may provide more robust biomarkers for schizophrenia. The frequency-specific changes of FC pattern in EOS remain unclear. To address this issue, resting-state functional magnetic resonance imaging data scans from 39 EOS patients (drug-naive) and 31 healthy controls (HCs) were used to assess the FC density (FCD) across slow-4 (0.027-0.073 Hz) and slow-5 (0.01-0.027 Hz). Results revealed that a remarkable difference between the FCD of the two bands existed mainly in the default mode network (DMN) and subcortical areas. Compared with the HCs, EOS patients showed significantly altered FCD involved in audiovisual information processing, sensorimotor system, and social cognition. Importantly, a significant frequency-by-group interaction was observed in the left precuneus with significantly lower FCD in the slow-4 frequency band, but no significant effect in the slow-5 frequency band. In addition, decreased FC was found between the precuneus and other DMN regions in the slow-4 band. Furthermore, the change in FCD in precuneus was inversely proportional to the clinical symptom in slow-4 band, indicating the key role of precuneus in schizophrenia progress. Our findings demonstrated that the dysconnectivity pattern in EOS could be frequency-dependent.

Frequency-selective alteration in the resting-state corticostriatal-thalamo-cortical circuit correlates with symptoms severity in first-episode drug-naive patients with schizophrenia

Schizophrenia is a prototypical disorder of brain connectivity with altered neural activity in regions extending throughout the brain. Regions, including the subcortex and cortex, present activity mainly within a specific frequency band in resting-state. Whether these altered resting-state functional connections also present frequency specificity is unknown. In the present study, empirical mode decomposition, which is a pure data-driven method suitable for nonlinear and nonstationary signals, was used to decompose blood-oxygen-level-dependent (BOLD) signals into different intrinsic frequency bands. Our study included 42 first-episode drug-naive patients with schizophrenia and 38 controls. Significant aberration in functional connectivity was observed only at a higher frequency range (the peak spectral density power was 0.06Hz). In this frequency band, patients with schizophrenia showed significantly increased functional connections between the bilateral cuneus and right supplementary motor area, reduced connections within the basal ganglia, and reduced connections between the dorsal striatum and left supplementary motor area. The dysfunction of the frontal gyrus significantly correlated with the dysfunction of the basal ganglia. Notably, these altered connections were significantly correlated with symptom severity. Our results demonstrate that frequency-selective altered corticostriatal-thalamo-cortical circuits in patients with schizophrenia are associated with symptoms severity.

Frequency Clustering Analysis for Resting State Functional Magnetic Resonance Imaging Based on Hilbert-Huang Transform

Objective: Exploring resting-state functional networks using functional magnetic resonance imaging (fMRI) is a hot topic in the field of brain functions. Previous studies suggested that the frequency dependence between blood oxygen level dependent (BOLD) signals may convey meaningful information regarding interactions between brain regions. Methods: In this article, we introduced a novel frequency clustering analysis method based on Hilbert-Huang Transform (HHT) and a label-replacement procedure. First, the time series from multiple predefined regions of interest (ROIs) were extracted. Second, each time series was decomposed into several intrinsic mode functions (IMFs) by using HHT. Third, the improved k-means clustering method using a label-replacement method was applied to the data of each subject to classify the ROIs into different classes. Results: Two independent resting-state fMRI dataset of healthy subjects were analyzed to test the efficacy of method. The results show almost identical clusters when applied to different runs of a dataset or to different datasets, indicating a stable performance of our framework. Conclusions and Significance: Our framework provided a novel measure for functional segregation of the brain according to time-frequency characteristics of resting state BOLD activities.

Brain structural and functional dissociated patterns in schizophrenia

BACKGROUND

Although previous studies found that aberrations in gray matter volume (GMV) and global functional connectivity density (gFCD) are important characteristics of schizophrenia, to the best of our knowledge no study to date has investigated the associations between the spatial distribution patterns of GMV and gFCD alterations. We investigated pattern changes in gFCD and GMV among patients with schizophrenia and their associated spatial distributions.

METHODS

Ninety-five patients with schizophrenia and 93 matched healthy controls underwent structural and resting-state functional MRI scanning to assess gFCD and GMV.

RESULTS

We found that gFCD increased in the subcortical regions (caudate, pallidum, putamen, and thalami) and limbic system (left hippocampus and parahippocampus), and decreased in the posterior parieto-occipito-temporal cortices (postcentral gyri, occipital cortex, temporo-occipital conjunction, and inferior parietal lobule), in patients with schizophrenia. By contrast, we found decreased GMV in brain regions including the frontal, parietal, temporal, occipital, cingulate cortices, and the insular, striatum, thalamus in these patients. Increased gFCD primarily occurred in subcortical regions including the basal ganglia and some regions of the limbic system. Decreased gFCD appeared primarily in the cortical regions. There were no statistically significant correlations between changes in gFCD and GMV, and their spatial distribution patterns, in different regions.

CONCLUSIONS

Our findings indicate that gFCD and GMV are both perturbed in multiple brain regions in schizophrenia. gFCD and GMV consistently decreased in the cortical regions, with the exception of the Supplementary Motor Area (SMA). However, in the sub-cortical regions, the alterations of gFCD and GMV showed the opposite pattern, with increased gFCD and decreased GMV simultaneously observed in these regions. Overall, our findings suggest that structural and functional alterations appear to contribute independently to the neurobiology of schizophrenia.

Altered Hippocampo-Cerebello-Cortical Circuit in Schizophrenia by a Spatiotemporal Consistency and Causal Connectivity Analysis

In the current study, FOur-dimensional Consistency of local neural Activities (FOCA) analysis was used to investigate the local consistency by integrating the temporal and spatial information of the local region. In the current study, resting-state fMRI data of 69 schizophrenia patients and 70 healthy controls were collected. FOCA was utilized to investigate the local consistency. Moreover, Granger causal analysis was used to investigate causal functional connectivity among these areas, which exhibited significantly different local consistency between groups. Compared with the healthy controls, the schizophrenia patients exhibited increased local consistency in hippocampus, basal ganglia and cerebellum regions, and decreased local consistency in sensoriperceptual cortex. In addition, altered causal functional connectivity was observed in hippocampo–cerebello-cortical (occipital) circuit. These findings suggested that this circuit might play a role in the motor dysfunction in schizophrenia, and should be paid more attention in future.

Interhemispheric functional connectivity in anorexia and bulimia nervosa

The functional interplay between hemispheres is fundamental for behavioral, cognitive, and emotional control. Anorexia nervosa (AN) and bulimia nervosa (BN) have been largely studied with brain magnetic resonance imaging (MRI) in relation to the functional mechanisms of high-level processing, but not in terms of possible inter-hemispheric functional connectivity anomalies. Using resting-state functional MRI (fMRI), voxel-mirrored homotopic connectivity (VMHC) and regional inter-hemispheric spectral coherence (IHSC) were studied in 15 AN and 13 BN patients and 16 healthy controls (HC). Using T1-weighted and diffusion tensor imaging MRI scans, regional VMHC values were correlated with the left-right asymmetry of corresponding homotopic gray matter volumes and with the white matter callosal fractional anisotropy (FA). Compared to HC, AN patients exhibited reduced VMHC in cerebellum, insula, and precuneus, while BN patients showed reduced VMHC in dorso-lateral prefrontal and orbito-frontal cortices. The regional IHSC analysis highlighted that the inter-hemispheric functional connectivity was higher in the 'Slow-5' band in all regions except the insula. No group differences in left-right structural asymmetries and in VMHC vs. callosal FA correlations were significant in the comparisons between cohorts. These anomalies, not explained by structural changes, indicate that AN and BN, at least in their acute phase, are associated with a loss of inter-hemispheric connectivity in regions implicated in self-referential, cognitive control and reward processing. These findings may thus gather novel functional markers to explore aberrant features of these eating disorders.

Abnormalities of localized connectivity in schizophrenia patients and their unaffected relatives: a meta-analysis of resting-state functional magnetic resonance imaging studies

OBJECTIVE

The localized dysfunction of specialized brain regions in schizophrenia patients and their unaffected relatives has been identified in a large-scale brain network; however, evidence is inconsistent. We aimed to identify abnormalities in the localized connectivity in schizophrenia patients and their relatives by conducting a meta-analysis of regional homogeneity (ReHo) studies.

METHODS

Fourteen studies on resting-state functional magnetic resonance imaging, with 316 schizophrenia patients, 342 healthy controls, and 66 unaffected relatives, were included in the meta-analysis. This analysis was performed using anisotropic effect-size-based signed differential mapping software.

RESULTS

Schizophrenia patients showed increased ReHo in right superior frontal gyrus and right superior temporal gyrus, as well as decreased ReHo in left fusiform gyrus, left superior temporal gyrus, left postcentral gyrus, and right precentral gyrus. Unaffected relatives showed decreased ReHo in right insula and right superior temporal gyrus. These results remained widely unchanged in both sensitivity and subgroup analyses.

CONCLUSION

Schizophrenia patients and their unaffected relatives had extensive abnormal localized connectivity in cerebrum, especially in superior temporal gyrus, which were the potential diagnostic markers and expounded the pathophysiological hypothesis for the disorder.

Short-term Effects of Risperidone Monotherapy on Spontaneous Brain Activity in First-episode Treatment-naïve Schizophrenia Patients: A Longitudinal fMRI Study

It is unclear whether abnormal spontaneous neural activation patterns found in chronic schizophrenia patients (CSP) are part of the pathogenesis of disease, consequences of chronic illness, or effects of antipsychotic treatment. We performed a longitudinal resting-state functional magnetic resonance imaging (fMRI) study in 42 treatment-naïve first-episode schizophrenia patients (FESP) at baseline and then after 8-weeks of risperidone monotherapy, and compared the findings to 38 healthy volunteers. Spontaneous brain activity was quantified using the fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo) and compared between patients and controls. Pretreatment, patients exhibited higher fALFF in left caudate compared with controls. After treatment, patients had elevated fALFF in bilateral putamen and right caudate, and increased ReHo in right caudate and left putamen. Greater increase of fALFF in the left putamen correlated with less improvement in positive symptoms. Thus, abnormalities of spontaneous neural activity in chronic schizophrenia is at least partly due to a medication effect. The observed post-treatment increase in striatal intrinsic activity may reflect counter-therapeutic functional adaptation to dopamine D2 receptor occupancy required for medication effects on psychosis.

Regional homogeneity changes in amnestic mild cognitive impairment patients

OBJECTIVE

Regional Homogeneity (ReHo) measures the local coherence of spontaneous brain activity, and it is sensitive to detect aberrant local functional connectivity of brain region. We tried to explore the activity of brain network by ReHo method in amnestic mild cognitive impairment (aMCI) patients and examine the impact of regional brain atrophy on the functional results.

METHODS

Data of both structural magnetic resonance images (MRI) and resting-state functional MRI scans were collected from 36 aMCI patients and 46 age-matched healthy controls.

RESULTS

Compared with the HC subjects, the aMCI patients showed significant decreased ReHo areas in the right inferior parietal lobule (IPL), left posterior cingulate cortex/precuneus (PCC/PCu), left inferior temporal gyrus (ITG), right supramarginal gyrus (SMG), right fusiform gyrus (FG), bilateral lentiform nucleus (LN) and right cerebellum posterior lobe, with the right IPL being the most significant area. In addition, the aMCI group also had some significant increased ReHo areas in the right medial frontal gyrus (MFG), bilateral postcentral gyrus (PoCG), left cuneus and right lingual gyrus (LG), possibly reflective of some underlining compensatory mechanism. Furthermore, in the aMCI patients, we found the ReHo index of the left PCC was positively correlated with the AVLT-Immediate Recall scores, while the ReHo index of the left cuneus was negatively correlated with the MMSE scores. In addition, we found that after regressing out the identified regional brain atrophy, the significant correlations between fitted ReHo index and clinical variables still remained.

CONCLUSIONS

Our study indicated that aMCI patients showed significant abnormal local coherence of biological activity in resting state and ReHo could serve as a sensitive biomarker in functional imaging studies of aMCI.

Abnormal regional homogeneity as potential imaging biomarker for psychosis risk syndrome: a resting-state fMRI study and support vector machine analysis

Subjects with psychosis risk syndrome (PRS) have structural and functional abnormalities in several brain regions. However, regional functional synchronization of PRS has not been clarified. We recruited 34 PRS subjects and 37 healthy controls. Regional homogeneity (ReHo) of resting-state functional magnetic resonance scans was employed to analyze regional functional synchronization in these participants. Receiver operating characteristic curves and support vector machines were used to detect whether abnormal regional functional synchronization could be utilized to separate PRS subjects from healthy controls. We observed that PRS subjects showed significant ReHo decreases in the left inferior temporal gyrus and increases in the right inferior frontal gyrus and right putamen compared with the controls. No correlations between abnormal regional functional synchronization in these brain regions and clinical characteristics existed. A combination of the ReHo values in the three brain regions showed sensitivity, specificity, and accuracy of 88.24%, 91.89%, and 90.14%, respectively, for discriminating PRS subjects from healthy controls. We inferred that abnormal regional functional synchronization exists in the cerebrum of PRS subjects, and a combination of ReHo values in these abnormal regions could be applied as potential image biomarker to identify PRS subjects from healthy controls.