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Herkströter F, Zahedi A, Standke I, Dannlowski U, Lencer R, Schubotz RI, Trempler I. Gray matter matters: Cognitive stability and flexibility in schizophrenia spectrum disorder. Psychophysiology 2024:e14596. [PMID: 38691383 DOI: 10.1111/psyp.14596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/12/2024] [Accepted: 04/10/2024] [Indexed: 05/03/2024]
Abstract
Cognitive dysfunction constitutes a core characteristic of schizophrenia spectrum disorders (SZ). Specifically, deficits in updating generative models (i.e., cognitive flexibility) and shielding against distractions (i.e., cognitive stability) are considered critical contributors to cognitive impairment in these patients. Here, we examined the structural integrity of frontostriatal networks and their associations with reduced cognitive stability and flexibility in SZ patients. In a sample of 21 patients diagnosed with SZ and 22 healthy controls, we measured gray matter volume (GMV) using structural MRI. Further, cognitive stability and flexibility were assessed using a switch-drift paradigm, quantifying the successful ignoring of distracters and detection of rule switches. Compared to controls, patients showed significantly smaller GMV in the whole brain and three predefined regions of interest: the medial prefrontal cortex (mPFC), inferior frontal gyrus (IFG), and caudate nucleus (CN). Notably, GMV in these areas positively correlated with correct rule-switch detection but not with ignoring rule-compatible drifts. Further, the volumetric differences between SZ patients and controls were statistically explainable by considering the behavioral performance in the switch-drift task. Our results indicate that morphological abnormalities in frontostriatal networks are associated with deficient flexibility in SZ patients and highlight the necessity of minimizing neurodevelopmental and progressive brain atrophy in this population.
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Affiliation(s)
- Florentine Herkströter
- Department of Neurology, Niels-Stensen-Kliniken, Marienhospital Osnabrück-Standort Natruper Holz, Osnabrueck, Germany
| | - Anoushiravan Zahedi
- Institute of Psychology, University of Muenster, Muenster, Germany
- Otto Creutzfeldt-Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
| | - Isabel Standke
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Udo Dannlowski
- Institute of Psychology, University of Muenster, Muenster, Germany
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Ricarda I Schubotz
- Institute of Psychology, University of Muenster, Muenster, Germany
- Otto Creutzfeldt-Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
| | - Ima Trempler
- Institute of Psychology, University of Muenster, Muenster, Germany
- Otto Creutzfeldt-Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
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2
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Chen C, Khanthiyong B, Charoenlappanit S, Roytrakul S, Reynolds GP, Thanoi S, Nudmamud-Thanoi S. Cholinergic-estrogen interaction is associated with the effect of education on attenuating cognitive sex differences in a Thai healthy population. PLoS One 2023; 18:e0278080. [PMID: 37471329 PMCID: PMC10358962 DOI: 10.1371/journal.pone.0278080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/30/2023] [Indexed: 07/22/2023] Open
Abstract
The development of human brain is shaped by both genetic and environmental factors. Sex differences in cognitive function have been found in humans as a result of sexual dimorphism in neural information transmission. Numerous studies have reported the positive effects of education on cognitive functions. However, little work has investigated the effect of education on attenuating cognitive sex differences and the neural mechanisms behind it based on healthy population. In this study, the Wisconsin Card Sorting Test (WCST) was employed to examine sex differences in cognitive function in 135 Thai healthy subjects, and label-free quantitative proteomic method and bioinformatic analysis were used to study sex-specific neurotransmission-related protein expression profiles. The results showed sex differences in two WCST sub-scores: percentage of Total corrects and Total errors in the primary education group (Bayes factor>100) with males performed better, while such differences eliminated in secondary and tertiary education levels. Moreover, 11 differentially expressed proteins (DEPs) between men and women (FDR<0.1) were presented in both education groups, with majority of them upregulated in females. Half of those DEPs interacted directly with nAChR3, whereas the other DEPs were indirectly connected to the cholinergic pathways through interaction with estrogen. These findings provided a preliminary indication that a cholinergic-estrogen interaction relates to, and might underpin, the effect of education on attenuating cognitive sex differences in a Thai healthy population.
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Affiliation(s)
- Chen Chen
- Medical Science Graduate Program, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
- Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | | | - Sawanya Charoenlappanit
- Functional Proteomics Technology Laboratory, National Centre for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Sittiruk Roytrakul
- Functional Proteomics Technology Laboratory, National Centre for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Gavin P. Reynolds
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Samur Thanoi
- School of Medical Sciences, University of Phayao, Mae Ka, Phayao, Thailand
| | - Sutisa Nudmamud-Thanoi
- Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
- Department of Anatomy, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
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3
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Zakowicz P, Pawlak J, Kapelski P, Wiłkość-Dębczyńska M, Szałkowska A, Twarowska-Hauser J, Rybakowski J, Skibińska M. Genetic association study reveals impact of interleukin 10 polymorphisms on cognitive functions in schizophrenia. Behav Brain Res 2022; 419:113706. [PMID: 34875307 DOI: 10.1016/j.bbr.2021.113706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/16/2021] [Accepted: 12/03/2021] [Indexed: 12/15/2022]
Abstract
AIM Cognitive deficits are the core factors impacting quality of life among patients diagnosed with schizophrenia. Effective method of treatment for this domain of symptoms remains lacking. Recent evidence suggests the link between impaired cognition and aberrant inflammatory response. Severity of symptoms might be linked to individual genetic predispositions and single-nucleotide polymorphisms (SNPs) in genes encoding interleukins and their receptors. Current genetic association studies include anti-inflammatory interleukins, such as IL10. Functional polymorphisms of IL10 (rs1800871, rs18008729) have been indicated to affect information processing in schizophrenia. MATERIALS AND METHODS In this study, we analyzed the potential impact of 27 functional SNPs in 8 cytokine genes on cognitive parameters measured by Wisconsin card-sorting test (WCST) in schizophrenia group (n = 150) and healthy controls (n = 152). RESULTS We found significant associations of two functional polymorphisms of IL10 (rs1800871, rs1800872) and WCST results. Allele A carriers in rs1800871 performed significantly better in Percent of Conceptual Level Responses (CLR%). Allele A carriers in rs1800871 and allele T carriers in rs1800872 obtained better results in Completed Categories (CC). The impact of illness duration was observed, with better performance of recent-onset patients. CONCLUSIONS Results of this study indicate that genetic variants of inflammatory response are associated with cognitive deficits in schizophrenia. The role of cytokines in schizophrenia need to be investigated in the aspect of pro-/anti-inflammatory imbalance. Altered inflammatory response promote chronic mild inflammation in the brain and aberrant synaptic plasticity.
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Affiliation(s)
- Przemysław Zakowicz
- Psychiatric Genetics Department, Poznań University of Medical Sciences, Poznań, Poland; Children and Adolescent Treatment Center, Zabór, Zielona Góra, Poland.
| | - Joanna Pawlak
- Psychiatric Genetics Department, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Kapelski
- Psychiatric Genetics Department, Poznań University of Medical Sciences, Poznań, Poland
| | | | - Agnieszka Szałkowska
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | | | - Janusz Rybakowski
- Department of Adult Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
| | - Maria Skibińska
- Psychiatric Genetics Department, Poznań University of Medical Sciences, Poznań, Poland
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4
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Villalobos D, Pacios J, Vázquez C. Cognitive Control, Cognitive Biases and Emotion Regulation in Depression: A New Proposal for an Integrative Interplay Model. Front Psychol 2021; 12:628416. [PMID: 33995183 PMCID: PMC8119761 DOI: 10.3389/fpsyg.2021.628416] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Research traditions on cognition and depression focus on relatively unconnected aspects of cognitive functioning. On one hand, the neuropsychological perspective has concentrated on cognitive control difficulties as a prominent feature of this condition. On the other hand, the clinical psychology perspective has focused on cognitive biases and repetitive negative patterns of thinking (i.e., rumination) for emotional information. A review of the literature from both fields reveals that difficulties are more evident for mood-congruent materials, suggesting that cognitive control difficulties interact with cognitive biases to hinder cognitive switching, working memory updating, and inhibition of irrelevant information. Connecting research from these two traditions, we propose a novel integrative cognitive model of depression in which the interplay between mood-congruent cognitive control difficulties, cognitive biases, and rumination may ultimately lead to ineffective emotion-regulation strategies to downregulate negative mood and upregulate positive mood.
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Affiliation(s)
- Dolores Villalobos
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain
| | - Javier Pacios
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain
| | - Carmelo Vázquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
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5
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Affiliation(s)
- Quenten Highgate
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Susan Schenk
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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6
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Wenneberg C, Nordentoft M, Rostrup E, Glenthøj LB, Bojesen KB, Fagerlund B, Hjorthøj C, Krakauer K, Kristensen TD, Schwartz C, Edden RAE, Broberg BV, Glenthøj BY. Cerebral Glutamate and Gamma-Aminobutyric Acid Levels in Individuals at Ultra-high Risk for Psychosis and the Association With Clinical Symptoms and Cognition. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:569-579. [PMID: 32008981 DOI: 10.1016/j.bpsc.2019.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Studies examining glutamate or gamma-aminobutyric acid (GABA) in ultra-high risk for psychosis (UHR) and the association with pathophysiology and cognition have shown conflicting results. We aimed to determine whether perturbed glutamate and GABA levels in the anterior cingulate cortex and glutamate levels in the left thalamus were present in UHR individuals and to investigate associations between metabolite levels and clinical symptoms and cognition. METHODS We included 122 UHR individuals and 60 healthy control subjects. Participants underwent proton magnetic resonance spectroscopy to estimate glutamate and GABA levels and undertook clinical and cognitive assessments. RESULTS We found no differences in metabolite levels between UHR individuals and healthy control subjects. In UHR individuals, we found negative correlations in the anterior cingulate cortex between the composite of glutamate and glutamine (Glx) and the Comprehensive Assessment of At-Risk Mental States composite score (p = .04) and between GABA and alogia (p = .01); positive associations in the anterior cingulate cortex between glutamate (p = .01) and Glx (p = .01) and spatial working memory and between glutamate (p = .04), Glx (p = .04), and GABA (p = .02) and set-shifting; and a positive association in the thalamus between glutamate and attention (p = .04). No associations between metabolites and clinical or cognitive scores were found in the healthy control subjects. CONCLUSIONS An association between glutamate and GABA levels and clinical symptoms and cognition found only in UHR individuals suggests a loss of the normal relationship between metabolite levels and cognitive function. Longitudinal studies with investigation of clinical and cognitive outcome and the association with baseline levels of glutamate and GABA could illuminate whether glutamatergic and GABAergic dysfunction predicts clinical outcome.
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Affiliation(s)
- Christina Wenneberg
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark; Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark; Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark
| | - Kirsten Borup Bojesen
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kristine Krakauer
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark; Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Tina Dam Kristensen
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark; Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark
| | - Camilla Schwartz
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Brian Villumsen Broberg
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark
| | - Birte Yding Glenthøj
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, University of Copenhagen, Glostrup, Denmark
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7
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Thuaire F, Rondepierre F, Bacon E, Vallet GT, Jalenques I, Izaute M. Executive functions in schizophrenia aging: Differential effects of age within specific executive functions. Cortex 2019; 125:109-121. [PMID: 31981891 DOI: 10.1016/j.cortex.2019.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/19/2019] [Accepted: 12/03/2019] [Indexed: 12/24/2022]
Abstract
There are common cognitive and brain abnormalities in schizophrenia and healthy aging which may cumulate in schizophrenia aging. However, the course of executive deficits in late-life schizophrenia is still controversial as it remains unclear whether schizophrenia patients show accelerated aging. The use of specific models of executive functions might help to shed new lights on this issue. The aim of this study was then to determine how each of the four specific executive functions (shifting, updating, inhibition and access to long-term memory) is affected by aging in schizophrenia compared to healthy aging. 20 younger (age 18-34), 17 middle-aged (age 35-49) and 25 older (age 59-76) schizophrenia patients and 62 healthy comparison participants matched for gender, age and education performed a neurocognitive battery evaluating the four specific executive functions. Schizophrenia patients performed worse than comparison participants on shifting, updating and access, whereas inhibition appeared preserved. Age affected the four functions with increased degradation of shifting and access in schizophrenia patients, whereas updating and inhibition showed a normal decline with age. These results suggest a vulnerability of prefrontal and cingulate cortexes in schizophrenia aging. Moreover, as age affected the specific executive functions differently, remediation programs should be adapted to older patients. Models of specific executive functions are useful for understanding the complexity of cognition in schizophrenia and its course during later life so that healthcare can be adapted accordingly.
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Affiliation(s)
- Flavien Thuaire
- Université Clermont Auvergne, CNRS, LAPSCO, 34 avenue Carnot - TSA 60401 - 63001 Clermont-Ferrand Cedex 1.
| | - Fabien Rondepierre
- Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Elisabeth Bacon
- INSERM U-1114, Fédération de Médecine Translationnelle de Strasbourg (FMTS), CHU de Strasbourg, Université de Strasbourg, France.
| | - Guillaume T Vallet
- Université Clermont Auvergne, CNRS, LAPSCO, 34 avenue Carnot - TSA 60401 - 63001 Clermont-Ferrand Cedex 1.
| | - Isabelle Jalenques
- Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, CHU Clermont-Ferrand, Institut de Psychiatrie-GDR 3557, Université Clermont Auvergne, Clermont-Ferrand, France.
| | - Marie Izaute
- Université Clermont Auvergne, CNRS, LAPSCO, 34 avenue Carnot - TSA 60401 - 63001 Clermont-Ferrand Cedex 1.
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8
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Shafritz KM, Ikuta T, Greene A, Robinson DG, Gallego J, Lencz T, DeRosse P, Kingsley PB, Szeszko PR. Frontal lobe functioning during a simple response conflict task in first-episode psychosis and its relationship to treatment response. Brain Imaging Behav 2019; 13:541-553. [PMID: 29744804 DOI: 10.1007/s11682-018-9876-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Prior functional magnetic resonance imaging (fMRI) studies have investigated the neural mechanisms underlying cognitive control in patients with psychosis with findings of both hypo- and hyperfrontality. One factor that may contribute to inconsistent findings is the use of complex and polyfactorial tasks to investigate frontal lobe functioning. In the current study we employed a simple response conflict task during fMRI to examine differences in brain activation between patients experiencing their first-episode of psychosis (n = 33) and age- and sex-matched healthy volunteers (n = 33). We further investigated whether baseline brain activation among patients predicted changes in symptom severity and treatment response following 12 weeks of controlled antipsychotic treatment. During the task subjects were instructed to press a response button on the same side or opposite side of a circle that appeared on either side of a central fixation point. Imaging data revealed that for the contrast of opposite-side vs. same-side, patients showed significantly greater activation compared with healthy volunteers in the anterior cingulate cortex and intraparietal sulcus. Among patients, greater baseline anterior cingulate cortex, temporal-parietal junction, and superior temporal cortex activation predicted greater symptom reduction and therapeutic response following treatment. All findings remained significant after covarying for task performance. Intact performance on this relatively parsimonious task was associated with frontal hyperactivity suggesting the need for patients to utilize greater neural resources to achieve task performance comparable to healthy individuals. Moreover, frontal hyperactivity observed using a simple fMRI task may provide a biomarker for predicting treatment response in first-episode psychosis.
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Affiliation(s)
- Keith M Shafritz
- Department of Psychology, Hofstra University, Hempstead, NY, USA. .,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, Oxford, MS, USA
| | - Allison Greene
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Delbert G Robinson
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Northwell Health System, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Departments of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Juan Gallego
- Weill Cornell Medical College, New York, NY, USA.,New York-Presbyterian Hospital/Westchester Division, White Plains, NY, USA
| | - Todd Lencz
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Northwell Health System, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Departments of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Pamela DeRosse
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Northwell Health System, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Departments of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Peter B Kingsley
- Department of Radiology, North Shore University Hospital, Manhasset, NY, USA
| | - Philip R Szeszko
- James J. Peters VA Medical Center, Mental Illness Research Education Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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9
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Exploring Heterogeneity on the Wisconsin Card Sorting Test in Schizophrenia Spectrum Disorders: A Cluster Analytical Investigation. J Int Neuropsychol Soc 2019; 25:750-760. [PMID: 31104647 DOI: 10.1017/s1355617719000420] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The Wisconsin Card Sorting Test (WCST) is a complex measure of executive function that is frequently employed to investigate the schizophrenia spectrum. The successful completion of the task requires the interaction of multiple intact executive processes, including attention, inhibition, cognitive flexibility, and concept formation. Considerable cognitive heterogeneity exists among the schizophrenia spectrum population, with substantive evidence to support the existence of distinct cognitive phenotypes. The within-group performance heterogeneity of individuals with schizophrenia spectrum disorder (SSD) on the WCST has yet to be investigated. A data-driven cluster analysis was performed to characterise WCST performance heterogeneity. METHODS Hierarchical cluster analysis with k-means optimisation was employed to identify homogenous subgroups in a sample of 210 schizophrenia spectrum participants. Emergent clusters were then compared to each other and a group of 194 healthy controls (HC) on WCST performance and demographic/clinical variables. RESULTS Three clusters emerged and were validated via altered design iterations. Clusters were deemed to reflect a relatively intact patient subgroup, a moderately impaired patient subgroup, and a severely impaired patient subgroup. CONCLUSIONS Considerable within-group heterogeneity exists on the WCST. Identification of subgroups of patients who exhibit homogenous performance on measures of executive functioning may assist in optimising cognitive interventions. Previous associations found using the WCST among schizophrenia spectrum participants should be reappraised. (JINS, 2019, 25, 750-760).
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10
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Faria AV, Crawford J, Ye C, Hsu J, Kenkare A, Scheretlen D, Sawa A. Relationship between neuropsychological behavior and brain white matter in first-episode psychosis. Schizophr Res 2019; 208:49-54. [PMID: 30987924 PMCID: PMC6544495 DOI: 10.1016/j.schres.2019.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/27/2019] [Accepted: 04/05/2019] [Indexed: 01/14/2023]
Abstract
We addressed the relationship between white matter architecture, represented by MRI fractional anisotropy (FA), and cognition in individuals with first-episode psychosis (FEP) by applying for a new methodology that allows whole brain parcellation of core and peripheral white matter in a biologically meaningful fashion. Regionally specific correlations were found in FEP between three specific domains of cognition (processing speed, attention/working memory, and executive functioning) and FA at the deep (cerebral peduncles, sagittal striatum, uncinate, internal/external capsule, cingulum) and peripheral white matter (adjacent to inferior temporal, angular, supramarginal, insula, occipital, rectus gyrus).
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Affiliation(s)
- Andreia V. Faria
- Department of Radiology, The Johns Hopkins University
School of Medicine, Baltimore, MD, USA;,Correspondence to: Andreia V. Faria, M.D.,PhD.,
Associate Professor, Magnetic Resonance Research Division, Department of
Radiology, The Johns Hopkins University School of Medicine., 217B Traylor Bldg.,
720 Rutland Ave., Baltimore, MD 21205., Phone: (410) 4109554215, Fax: (410)
614-1948,
| | - Jeffrey Crawford
- Department Psychiatry, The Johns Hopkins University School
of Medicine, Baltimore, MD, USA
| | - Chenfei Ye
- Department of Electronics and Information, Harbin Institute
of Technology Shenzhen Graduate School, Guangdong, China, 518055
| | - John Hsu
- Department of Radiology, The Johns Hopkins University
School of Medicine, Baltimore, MD, USA
| | - Anshel Kenkare
- Department Psychiatry, The Johns Hopkins University School
of Medicine, Baltimore, MD, USA
| | - David Scheretlen
- Department Psychiatry, The Johns Hopkins University School
of Medicine, Baltimore, MD, USA
| | - Akira Sawa
- Department Psychiatry, The Johns Hopkins University School
of Medicine, Baltimore, MD, USA;,Department of Biomedical Engineering, The Johns Hopkins
University School of Medicine, Baltimore, MD, USA;,Department of Neuroscience, The Johns Hopkins University
School of Medicine, Baltimore, MD, USA;,Department of Mental Health, The Johns Hopkins University
Bloomberg School of Public Health Baltimore, MD, USA
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11
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Neuroimaging Studies of Cognitive Function in Schizophrenia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1118:117-134. [PMID: 30747420 DOI: 10.1007/978-3-030-05542-4_6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Persons suffering from schizophrenia present cognitive impairments that have a major functional impact on their lives. Particularly, executive functions and episodic memory are consistently found to be impaired. Neuroimaging allows the investigation of affected areas of the brain associated with these impairments and, moreover, the detection of brain functioning improvements after cognitive remediation interventions. For instance, executive function impairments have been associated with prefrontal cortex volume and thickness; cognitive control impairments are correlated with an increased activation in the anterior cingulate cortex, and episodic memory impairments are linked to hippocampal reduction. Some findings suggest the presence of brain compensatory mechanisms in schizophrenia, e.g. recruiting broader cortical areas to perform identical tasks. Similarly, neuroimaging studies of cognitive remediation in schizophrenia focus differentially on structural, functional and connectivity changes. Cognitive remediation improvements have been reported in two main areas: the prefrontal and thalamic regions. It has been suggested that those changes imply a functional reorganisation of neural networks, and cognitive remediation interventions might have a neuroprotective effect. Future studies should use multimodal neuroimaging procedures and more complex theoretical models to identify, confirm and clarify these and newer outcomes. This chapter highlights neuroimaging findings in anatomical and functional brain correlates of schizophrenia, as well as its application and potential use for identifying brain changes after cognitive remediation.
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12
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Desai SJ, Allman BL, Rajakumar N. Infusions of Nerve Growth Factor Into the Developing Frontal Cortex Leads to Deficits in Behavioral Flexibility and Increased Perseverance. Schizophr Bull 2018; 44:1081-1090. [PMID: 29165654 PMCID: PMC6101573 DOI: 10.1093/schbul/sbx159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In the pursuit of further establishing a neurodevelopmental animal model to investigate the mechanisms underlying impaired executive function, a core and severely debilitating symptom of schizophrenia, we sought to characterize the deficits in behavioral flexibility in adult rats following neonatal infusions of nerve growth factor (NGF) into the medial part of the developing frontal cortex. Our previous studies using this neonatal frontal cortical lesion model have shown that it leads to adult-onset positive and negative symptom-like features, and several neuropathological abnormalities of schizophrenia. In the present study, we used operant conditioning-based paradigms to investigate set-shifting ability and reversal learning performance in adult rats that received infusions of NGF into the developing frontal cortex on post-natal day 1. NGF-infusion caused apoptosis of cells in the subplate layer. Adult rats that received neonatal infusions of NGF showed decreased grey matter thickness, and decreased levels of parvalbumin in prelimbic and infralimbic areas of the medial prefrontal cortex (mPFC). NGF-treated rats had difficulty completing the set-shifting and reversal learning tasks due to increased perseverance (ie, a failure to disengage from the previously-learned strategy once the rule contingencies were changed) compared to the control group. Collectively, these results identify the crucial role of the frontal cortical subplate layer in the structural and functional development of the mPFC relevant to schizophrenia. Furthermore, the present findings substantially advance the face and construct validity of this putative preclinical model of schizophrenia based on developmental disruption of the frontal cortical subplate.
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Affiliation(s)
- Sagar J Desai
- Department of Anatomy and Cell Biology, University of Western Ontario, London, ON, Canada
| | - Brian L Allman
- Department of Anatomy and Cell Biology, University of Western Ontario, London, ON, Canada
| | - Nagalingam Rajakumar
- Department of Anatomy and Cell Biology, University of Western Ontario, London, ON, Canada,Department of Psychiatry, University of Western Ontario, London, ON, Canada,To whom correspondence should be addressed; Department of Psychiatry and Anatomy & Cell Biology, The University of Western Ontario, London, ON N6A 5C1, Canada; tel: (1)-519-661-2111 ext. 80521, fax: (1)-519-661-3936, e-mail:
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13
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Li F, Wang J, Du B, Cao B. Electrophysiological Response to the Informative Value of Feedback Revealed in a Segmented Wisconsin Card Sorting Test. Front Psychol 2018; 9:57. [PMID: 29459841 PMCID: PMC5807434 DOI: 10.3389/fpsyg.2018.00057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/15/2018] [Indexed: 12/22/2022] Open
Abstract
Feedback has two main components. One is valence that indicates the wrong or correct behavior, and the other is the informative value that refers to what we can learn from feedback. Aimed to explore the neural distinction of these two components, we provided participants with a segmented Wisconsin Card Sorting Task, in which they received either positive or negative feedback at different steps. The informative value was manipulated in terms of the order of feedback presentation. The results of event-related potentials time-locked to the feedback presentation confirmed that valence of feedback was processed in a broad epoch, especially in the time window of feedback-related negativity (FRN), reflecting detection of correct or wrong card sorting behavior. In contrast, the informative value of positive and negative feedback was mainly processed in the P300, possibly reflecting information updating or hypothesis revision. These findings provide new evidence that informative values of feedback are processed by cognitive systems that differ from those of feedback valence.
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Affiliation(s)
- Fuhong Li
- Advanced Research Institute, Chengdu University, Chengdu, China.,School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Jing Wang
- School of Psychology, Southwest University, Chongqing, China
| | - Bin Du
- School of Psychology, Liaoning Normal University, Dalian, China
| | - Bihua Cao
- School of Psychology, Jiangxi Normal University, Nanchang, China
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14
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Moreira HS, Costa AS, Castro SL, Lima CF, Vicente SG. Assessing Executive Dysfunction in Neurodegenerative Disorders: A Critical Review of Brief Neuropsychological Tools. Front Aging Neurosci 2017; 9:369. [PMID: 29170636 PMCID: PMC5684643 DOI: 10.3389/fnagi.2017.00369] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/26/2017] [Indexed: 02/05/2023] Open
Abstract
Executive function (EF) has been defined as a multifaceted construct that involves a variety of high-level cognitive abilities such as planning, working memory, mental flexibility, and inhibition. Being able to identify deficits in EF is important for the diagnosis and monitoring of several neurodegenerative disorders, and thus their assessment is a topic of much debate. In particular, there has been a growing interest in the development of neuropsychological screening tools that can potentially provide a reliable quick measure of EF. In this review, we critically discuss the four screening tools of EF currently available in the literature: Executive Interview-25 (EXIT 25), Frontal Assessment Battery (FAB), INECO Frontal Screening (IFS), and FRONTIER Executive Screen (FES). We first describe their features, and then evaluate their psychometric properties, the existing evidence on their neural correlates, and the empirical work that has been conducted in clinical populations. We conclude that the four screening tools generally present appropriate psychometric properties, and are sensitive to impairments in EF in several neurodegenerative conditions. However, more research will be needed mostly with respect to normative data and neural correlates, and to determine the extent to which these tools add specific information to the one provided by global cognition screening tests. More research directly comparing the available tools with each other will also be important to establish in which conditions each of them can be most useful.
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Affiliation(s)
- Helena S Moreira
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| | - Ana S Costa
- Neurology Department, Hospital de Braga, Braga, Portugal
| | - São L Castro
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| | - César F Lima
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Selene G Vicente
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
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15
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Crocker CE, Purdon SE, Hanstock CC, Lakusta B, Seres P, Tibbo PG. Enduring changes in brain metabolites and executive functioning in abstinent cocaine users. Drug Alcohol Depend 2017; 178:435-442. [PMID: 28710968 DOI: 10.1016/j.drugalcdep.2017.04.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/27/2017] [Accepted: 04/27/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is a paucity of data connecting the metabolic and cognitive functioning of abstinent cocaine users. This is a pressing public health concern as approximately 1% of the Canadian population and 0.4% of the global population is estimated to have used cocaine in the past year. METHODS Our clinical study compared the in vivo neurochemical profiles in the prefrontal cortex to cognitive tests associated with the same region in 21 moderate term abstinent cocaine users (average 187days abstinent, range 15-1432days), and 30 healthy controls using 3T 1H MRS. RESULTS The abstinent cocaine users exhibited a 10% decrease in N-acetylaspartate (NAA) relative to healthy control subjects (p<0.01, Cohen's d=1.15). When subdivided by method of administration, a significant decrease in glutamate levels in former crack smokers compared to healthy controls (p<0.05) was observed, this decrease was not present in powder users. Abstinent users were significantly worse than healthy controls on the Trail Making Test B (p<0.05), and performance on this task was inversely related to NAA levels (p<0.05). Abstinent cocaine users showed deficits in the Wisconsin card sorting test with failures to maintain set (p<0.01). CONCLUSIONS Our work suggests that there are subtle but important changes in the brain that remain even with the moderate term cessation of cocaine use.
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Affiliation(s)
- Candice E Crocker
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Diagnostic Radiology, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
| | - Scot E Purdon
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Bonnie Lakusta
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Peter Seres
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
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16
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Adaptive Encoding of Outcome Prediction by Prefrontal Cortex Ensembles Supports Behavioral Flexibility. J Neurosci 2017; 37:8363-8373. [PMID: 28729442 DOI: 10.1523/jneurosci.0450-17.2017] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/02/2017] [Accepted: 06/09/2017] [Indexed: 11/21/2022] Open
Abstract
The prefrontal cortex (PFC) is thought to play a critical role in behavioral flexibility by monitoring action-outcome contingencies. How PFC ensembles represent shifts in behavior in response to changes in these contingencies remains unclear. We recorded single-unit activity and local field potentials in the dorsomedial PFC (dmPFC) of male rats during a set-shifting task that required them to update their behavior, among competing options, in response to changes in action-outcome contingencies. As behavior was updated, a subset of PFC ensembles encoded the current trial outcome before the outcome was presented. This novel outcome-prediction encoding was absent in a control task, in which actions were rewarded pseudorandomly, indicating that PFC neurons are not merely providing an expectancy signal. In both control and set-shifting tasks, dmPFC neurons displayed postoutcome discrimination activity, indicating that these neurons also monitor whether a behavior is successful in generating rewards. Gamma-power oscillatory activity increased before the outcome in both tasks but did not differentiate between expected outcomes, suggesting that this measure is not related to set-shifting behavior but reflects expectation of an outcome after action execution. These results demonstrate that PFC neurons support flexible rule-based action selection by predicting outcomes that follow a particular action.SIGNIFICANCE STATEMENT Tracking action-outcome contingencies and modifying behavior when those contingencies change is critical to behavioral flexibility. We find that ensembles of dorsomedial prefrontal cortex neurons differentiate between expected outcomes when action-outcome contingencies change. This predictive mode of signaling may be used to promote a new response strategy at the service of behavioral flexibility.
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17
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Desai SJ, Allman BL, Rajakumar N. Combination of behaviorally sub-effective doses of glutamate NMDA and dopamine D 1 receptor antagonists impairs executive function. Behav Brain Res 2017; 323:24-31. [PMID: 28115219 DOI: 10.1016/j.bbr.2017.01.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/14/2017] [Accepted: 01/17/2017] [Indexed: 02/02/2023]
Abstract
Impairment of executive function is a core feature of schizophrenia. Preclinical studies indicate that injections of either N-methyl d-aspartate (NMDA) or dopamine D1 receptor blockers impair executive function. Despite the prevailing notion based on postmortem findings in schizophrenia that cortical areas have marked suppression of glutamate and dopamine, recent in vivo imaging studies suggest that abnormalities of these neurotransmitters in living patients may be quite subtle. Thus, we hypothesized that modest impairments in both glutamate and dopamine function can act synergistically to cause executive dysfunction. In the present study, we investigated the effect of combined administration of "behaviorally sub-effective" doses of NMDA and dopamine D1 receptor antagonists on executive function. An operant conditioning-based set-shifting task was used to assess behavioral flexibility in rats that were systemically injected with NMDA and dopamine D1 receptor antagonists individually or in combination prior to task performance. Separate injections of the NMDA receptor antagonist, MK-801, and the dopamine D1 receptor antagonist, SCH 23390, at low doses did not impair set-shifting; however, the combined administration of these same behaviorally sub-effective doses of the antagonists significantly impaired the performance during set-shifting without affecting learning, retrieval of the memory of the initial rule, latency of responses or the number of omissions. The combined treatment also produced an increased number of perseverative errors. Our results indicate that NMDA and D1 receptor blockade act synergistically to cause behavioral inflexibility, and as such, subtle abnormalities in glutamatergic and dopaminergic systems may act cooperatively to cause deficits in executive function.
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Affiliation(s)
- Sagar J Desai
- Department of Anatomy & Cell Biology, The University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Brian L Allman
- Department of Anatomy & Cell Biology, The University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Nagalingam Rajakumar
- Department of Anatomy & Cell Biology, The University of Western Ontario, London, Ontario, N6A 5C1, Canada; Department of Psychiatry, The University of Western Ontario, London, Ontario, N6A 5C1, Canada.
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18
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Kavanaugh BC, Gaudet CE, Dupont-Frechette JA, Tellock PP, Maher ID, Haisley LD, Holler KA. Failure to maintain set as a predictor of childhood depression within a children's psychiatric inpatient sample. Psychiatry Res 2016; 246:644-649. [PMID: 27825782 DOI: 10.1016/j.psychres.2016.10.074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 07/11/2016] [Accepted: 10/29/2016] [Indexed: 10/20/2022]
Abstract
Despite a wealth of studies in adults and adolescents, only a handful of studies have examined executive function in childhood depression. This study utilized retrospective chart review of a children's psychiatric inpatient program to evaluate executive function via Wisconsin Card Sorting Test (WCST) in 33 children (6-12 years old) with a depressive disorder and 61 age/sex-matched children without a depressive disorder referred for neuropsychological evaluation. WCST categories, perseverative errors, and failure to maintain set errors were examined as potential predictors of depressive disorder diagnosis and self-reported depressive symptoms. After controlling for age, length of hospital stay, and ADHD, failure to maintain set significantly predicted depressive disorder diagnosis. Failure to maintain set was also significantly associated with self-reported depressive symptoms. Current findings provide preliminary evidence to suggest that failure to maintain set may reflect a core deficit of childhood depression. While findings are preliminary, this may have important implications for the diagnosis and treatment of childhood depression.
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Affiliation(s)
- Brian C Kavanaugh
- E. P. Bradley Hospital, Children's Inpatient Treatment Program, Riverside, RI, USA; Alpert Medical School of Brown University, Department of Psychiatry & Human Behavior, Providence, RI, USA.
| | - Charles E Gaudet
- University of Rhode Island, Department of Psychology, Kingston, RI, USA
| | | | - Perrin P Tellock
- Antioch University New England, Department of Clinical Psychology, Keene, NH, USA
| | - Isolde D Maher
- Mount Holyoke College, Department of Biological Sciences, South Hadley, MA, USA
| | - Lauren D Haisley
- University of Connecticut, Department of Psychological Sciences, Storrs, CT, USA
| | - Karen A Holler
- E. P. Bradley Hospital, Children's Inpatient Treatment Program, Riverside, RI, USA; Alpert Medical School of Brown University, Department of Psychiatry & Human Behavior, Providence, RI, USA
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19
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Mazgaj R, Tal A, Goetz R, Lazar M, Rothman K, Messinger JW, Malaspina D, Gonen O. Hypo-metabolism of the rostral anterior cingulate cortex associated with working memory impairment in 18 cases of schizophrenia. Brain Imaging Behav 2016; 10:115-23. [PMID: 25804309 DOI: 10.1007/s11682-015-9372-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Working memory (Work-Mem), the capacity to hold and manipulate information, activates the anterior cingulate cortex (ACC), especially its caudal subregion. Impaired Work-Mem and structural and functional abnormalities of the ACC are reported in schizophrenia. This study aims to elucidate the pathogenesis of Work-Mem dysfunction in schizophrenia by comparing metabolite concentrations across ACC subregions. This retrospective study of 18 schizophrenia cases and 10 matched controls used proton magnetic resonance spectroscopic imaging ((1)H-MRSI, TR/TE = 1800/35 ms, 0.5 cm(3) spatial resolution) to test whether the Work-Mem Index of the Wechsler Adult Intelligence Scale, third edition is associated with differences in the rostral to caudal ACC ratios of N-acetylaspartate (NAA) and creatine (Cr). Higher caudal:rostral ACC Cr (but not NAA) concentrations were associated with decreased Work-Mem Index in cases (r = -0.6, p = 0.02), with a similar trend in controls (r = -0.56, p = 0.10), although caudal:rostral ACC Cr correlated with NAA in cases and controls (r = 0.67 and 0.62, p < 0.05 for both). NAA and Cr ratios did not correlate with myo-inositol, excluding gliosis as the underlying process. Subjects' sex and age had no effects on these relationships. The findings suggest that rostral ACC energy hypo-metabolism, possibly arising from neurodevelopmental processes, is associated with working memory impairment in schizophrenia. Changes in the rostral (not the expected caudal) subregion underscore the interconnections between the ACC subregions and may offer laboratory markers for treatment trials, etiology studies, and perhaps even enhanced identification of prodromal "at risk" subjects.
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Affiliation(s)
- Robert Mazgaj
- Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA
- Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA
| | - Assaf Tal
- Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY, 10016, USA
| | - Raymond Goetz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Mariana Lazar
- Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY, 10016, USA
| | - Karen Rothman
- Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA
- Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA
| | - Julie Walsh Messinger
- Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA
- Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Dolores Malaspina
- Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, Rm 222, New York, NY, 10016, USA.
- Creedmoor State Psychiatric Center, Queens Village, New York, NY, 11427, USA.
| | - Oded Gonen
- Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY, 10016, USA
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20
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Wang C, Ji F, Hong Z, Poh JS, Krishnan R, Lee J, Rekhi G, Keefe RSE, Adcock RA, Wood SJ, Fornito A, Pasternak O, Chee MWL, Zhou J. Disrupted salience network functional connectivity and white-matter microstructure in persons at risk for psychosis: findings from the LYRIKS study. Psychol Med 2016; 46:2771-2783. [PMID: 27396386 PMCID: PMC5358474 DOI: 10.1017/s0033291716001410] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Salience network (SN) dysconnectivity has been hypothesized to contribute to schizophrenia. Nevertheless, little is known about the functional and structural dysconnectivity of SN in subjects at risk for psychosis. We hypothesized that SN functional and structural connectivity would be disrupted in subjects with At-Risk Mental State (ARMS) and would be associated with symptom severity and disease progression. METHOD We examined 87 ARMS and 37 healthy participants using both resting-state functional magnetic resonance imaging and diffusion tensor imaging. Group differences in SN functional and structural connectivity were examined using a seed-based approach and tract-based spatial statistics. Subject-level functional connectivity measures and diffusion indices of disrupted regions were correlated with CAARMS scores and compared between ARMS with and without transition to psychosis. RESULTS ARMS subjects exhibited reduced functional connectivity between the left ventral anterior insula and other SN regions. Reduced fractional anisotropy (FA) and axial diffusivity were also found along white-matter tracts in close proximity to regions of disrupted functional connectivity, including frontal-striatal-thalamic circuits and the cingulum. FA measures extracted from these disrupted white-matter regions correlated with individual symptom severity in the ARMS group. Furthermore, functional connectivity between the bilateral insula and FA at the forceps minor were further reduced in subjects who transitioned to psychosis after 2 years. CONCLUSIONS Our findings support the insular dysconnectivity of the proximal SN hypothesis in the early stages of psychosis. Further developed, the combined structural and functional SN assays may inform the prognosis of persons at-risk for psychosis.
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Affiliation(s)
- C. Wang
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - F. Ji
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - Z. Hong
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. S. Poh
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - R. Krishnan
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Lee
- Research Division,
Institute of Mental Health, Singapore
- Office of Clinical Sciences,
Duke-NUS Medical School, Singapore
| | - G. Rekhi
- Research Division,
Institute of Mental Health, Singapore
| | - R. S. E. Keefe
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
| | - R. A. Adcock
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
- Center for Cognitive Neuroscience,
Duke University, Durham, NC,
USA
| | - S. J. Wood
- School of Psychology,
University of Birmingham, Edgbaston,
UK
- Department of Psychiatry,
Melbourne Neuropsychiatry Centre, University of
Melbourne and Melbourne Health, Victoria,
Australia
| | - A. Fornito
- Monash Clinical and Imaging
Neuroscience, School of Psychology and Psychiatry & Monash
Biomedical Imaging, Monash University,
Australia
| | - O. Pasternak
- Departments of Psychiatry and Radiology,
Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, USA
| | - M. W. L. Chee
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Zhou
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
- Clinical Imaging Research Centre, the Agency for
Science, Technology and Research and National University of
Singapore, Singapore
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21
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Sasabayashi D, Takayanagi Y, Nishiyama S, Takahashi T, Furuichi A, Kido M, Nishikawa Y, Nakamura M, Noguchi K, Suzuki M. Increased Frontal Gyrification Negatively Correlates with Executive Function in Patients with First-Episode Schizophrenia. Cereb Cortex 2016; 27:2686-2694. [DOI: 10.1093/cercor/bhw101] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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22
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Pang EW, Dunkley BT, Doesburg SM, da Costa L, Taylor MJ. Reduced brain connectivity and mental flexibility in mild traumatic brain injury. Ann Clin Transl Neurol 2015; 3:124-31. [PMID: 26900581 PMCID: PMC4748313 DOI: 10.1002/acn3.280] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 11/24/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE A mild traumatic brain injury (mTBI), or concussion, has known neuropsychological sequelae, and neuroimaging shows disturbed brain connectivity during the resting state. We hypothesized that task-based functional connectivity measures, using magnetoencephalography (MEG), would better link the neurobiological underpinnings of cognitive deficits to specific brain damage. METHODS We used a mental flexibility task in the MEG and compared brain connectivity between adults with and without mTBI. RESULTS Affected individuals showed significant reductions in connectivity. When challenged with a more difficult task, these individuals were not able to "boost" their connectivity, and as such, showed deterioration in performance. INTERPRETATION We discuss these findings in the context of limitations in cognitive reserve as a consequence of a mTBI.
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Affiliation(s)
- Elizabeth W Pang
- Division of Neurology Hospital for Sick Children Toronto Ontario Canada; Program in Neurosciences and Mental Health Sick Kids Research Institute Toronto Ontario Canada; Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Benjamin T Dunkley
- Faculty of Medicine University of Toronto Toronto Ontario Canada; Diagnostic Imaging Hospital for Sick Children Toronto Ontario Canada
| | | | - Leodante da Costa
- Faculty of Medicine University of Toronto Toronto Ontario Canada; Sunnybrook Health Sciences Centre Toronto Ontario Canada
| | - Margot J Taylor
- Program in Neurosciences and Mental Health Sick Kids Research Institute Toronto Ontario Canada; Faculty of Medicine University of Toronto Toronto Ontario Canada; Department of Psychology University of Toronto Toronto Ontario Canada
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23
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Nowrangi MA, Okonkwo O, Lyketsos C, Oishi K, Mori S, Albert M, Mielke MM. Atlas-based diffusion tensor imaging correlates of executive function. J Alzheimers Dis 2015; 44:585-98. [PMID: 25318544 DOI: 10.3233/jad-141937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Impairment in executive function (EF) is commonly found in Alzheimer's disease (AD) and mild cognitive impairment (MCI). Atlas-based diffusion tensor imaging (DTI) methods may be useful in relating regional integrity to EF measures in MCI and AD. Sixty-six participants (25 normal controls, 22 MCI, and 19 AD) received DTI scans and clinical evaluation. DTI scans were applied to a pre-segmented atlas and fractional anisotropy (FA) and mean diffusivity (MD) were calculated. ANOVA was used to assess group differences in frontal, parietal, and cerebellar regions. For regions differing between groups (p < 0.01), linear regression examined the relationship between EF scores and regional FA and MD. Anisotropy and diffusivity in frontal and parietal lobe white matter structures were associated with EF scores in MCI and only frontal lobe structures in AD. EF was more strongly associated with FA than MD. The relationship between EF and anisotropy and diffusivity was strongest in MCI. These results suggest that regional white matter integrity is compromised in MCI and AD and that FA may be a better correlate of EF than MD.
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Affiliation(s)
- Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Ozioma Okonkwo
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Constantine Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Kenichi Oishi
- Department of Radiology Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Susumu Mori
- Department of Radiology Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Michelle M Mielke
- Department of Health Sciences Research, Division of Epidemiology and Department of Neurology, Mayo Clinic, Rochester, MN, USA
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24
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Abstract
Attentional set-shifting, as a measure of executive flexibility, has been a staple of investigations into human cognition for over six decades. Mediated by the frontal cortex in mammals, the cognitive processes involved in forming, maintaining and shifting an attentional set are vulnerable to dysfunction arising from a number of human neurodegenerative diseases (such as Alzheimer's, Parkinson's and Huntington's diseases) and other neurological disorders (such as schizophrenia, depression, and attention deficit/hyperactivity disorder). Our understanding of these diseases and disorders, and the cognitive impairments induced by them, continues to advance, in tandem with an increasing number of tools at our disposal. In this chapter, we review and compare commonly used attentional set-shifting tasks (the Wisconsin Card Sorting Task and Intradimensional/Extradimensional tasks) and their applicability across species. In addition to humans, attentional set-shifting has been observed in a number of other animals, with a substantial body of literature describing performance in monkeys and rodents. We consider the task designs used to investigate attentional set-shifting in these species and the methods used to model human diseases and disorders, and ultimately the comparisons and differences between species-specific tasks, and between performance across species.
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Motivational Deficits in Schizophrenia and the Representation of Expected Value. Curr Top Behav Neurosci 2015; 27:375-410. [PMID: 26370946 DOI: 10.1007/7854_2015_385] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Motivational deficits (avolition and anhedonia) have historically been considered important negative symptoms of schizophrenia (SZ). Numerous studies have attempted to identify the neural substrates of avolition and anhedonia in schizophrenia , but these studies have not produced much agreement. Deficits in various aspects of reinforcement processing have been observed in individuals with schizophrenia, but it is not exactly clear which of these deficits actually engender motivational impairments in SZ. The purpose of this chapter is to examine how various reinforcement-related behavioral and neural signals could contribute to motivational impairments in both schizophrenia and psychiatric illness, in general. In particular, we describe different aspects of the concept of expected value (EV), such as the distinction between the EV of stimuli and the expected value of actions, the acquisition of value versus the estimation of value, and the discounting of value as a consequence of time or effort required. We conclude that avolition and anhedonia in SZ are most commonly tied to aberrant signals for expected value, in the context of learning. We discuss implications for further research on the neural substrates of motivational impairments in psychiatric illness.
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Pender S, Gilbert SJ, Serpell L. The neuropsychology of starvation: set-shifting and central coherence in a fasted nonclinical sample. PLoS One 2014; 9:e110743. [PMID: 25338075 PMCID: PMC4206438 DOI: 10.1371/journal.pone.0110743] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 09/19/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Recent research suggests certain neuropsychological deficits occur in anorexia nervosa (AN). The role of starvation in these deficits remains unclear. Studies of individuals without AN can elucidate our understanding of the effect of short-term starvation on neuropsychological performance. METHODS Using a within-subjects repeated measures design, 60 healthy female participants were tested once after fasting for 18 hours, and once when satiated. Measures included two tasks to measure central coherence and a set-shifting task. RESULTS Fasting exacerbated set-shifting difficulties on a rule-change task. Fasting was associated with stronger local and impaired global processing, indicating weaker central coherence. CONCLUSIONS Models of AN that propose a central role for set-shifting difficulties or weak central coherence should also consider the impact of short-term fasting on these processes.
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Affiliation(s)
- Sarah Pender
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Sam J. Gilbert
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Lucy Serpell
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
- Eating Disorders Service, North East London Foundation Trust, Essex, United Kingdom
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Nowrangi MA, Lyketsos C, Rao V, Munro CA. Systematic review of neuroimaging correlates of executive functioning: converging evidence from different clinical populations. J Neuropsychiatry Clin Neurosci 2014; 26:114-25. [PMID: 24763759 PMCID: PMC5171230 DOI: 10.1176/appi.neuropsych.12070176] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Executive functioning (EF) is an important cognitive domain that is negatively affected in a number of neuropsychiatric conditions. Neuroimaging methods have led to insights into the anatomical and functional nature of EF. The authors conducted a systematic review of the recent cognitive and neuroimaging literature to investigate how the neuroimaging correlates of EF compare between different diagnostic groups. The authors found that the frontal, parietal, and cerebellar lobes were most frequently associated with EF when comparing results from different clinical populations; the occipital lobe was not correlated with EF in any group. These findings suggest that individual disease processes affect circuits within an identifiable distributed network rather than isolated regions.
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Zhang R, Wei Q, Kang Z, Zalesky A, Li M, Xu Y, Li L, Wang J, Zheng L, Wang B, Zhao J, Zhang J, Huang R. Disrupted brain anatomical connectivity in medication-naïve patients with first-episode schizophrenia. Brain Struct Funct 2014; 220:1145-59. [PMID: 24449342 DOI: 10.1007/s00429-014-0706-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 01/04/2014] [Indexed: 01/16/2023]
Abstract
Previous studies suggested that the topological properties of brain anatomical networks may be aberrant in schizophrenia (SCZ), and most of them focused on the chronic and antipsychotic-medicated SCZ patients which may introduce various confounding factors due to antipsychotic medication and duration of illness. To avoid those potential confounders, a desirable approach is to select medication-naïve, first-episode schizophrenia (FE-SCZ) patients. In this study, we acquired diffusion tensor imaging datasets from 30 FE-SCZ patients and 34 age- and gender-matched healthy controls. Taking a distinct gray matter region as a node, inter-regional connectivity as edge and the corresponding streamline counts as edge weight, we constructed whole-brain anatomical networks for both groups, calculated their topological parameters using graph theory, and compared their between-group differences using nonparametric permutation tests. In addition, network-based statistic method was utilized to identify inter-regional connections which were impaired in the FE-SCZ patients. We detected only significantly decreased inter-regional connections in the FE-SCZ patients compared to the controls. These connections were primarily located in the frontal, parietal, occipital, and subcortical regions. Although small-worldness was conserved in the FE-SCZ patients, we found that the network strength and global efficiency as well as the degree were significantly decreased, and shortest path length was significantly increased in the FE-SCZ patients compared to the controls. Most of the regions that showed significantly decreased nodal parameters belonged to the top-down control, sensorimotor, basal ganglia, and limbic-visual system systems. Correlation analysis indicated that the nodal efficiency in the sensorimotor system was negatively correlated with the severity of psychosis symptoms in the FE-SCZ patients. Our results suggest that the network organization is changed in the early stages of the SCZ disease process. Our findings provide useful information for further understanding the brain white matter dysconnectivity of schizophrenia.
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Affiliation(s)
- Ruibin Zhang
- Brain Imaging Center, Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for the Study of Applied Psychology, School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
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Merritt K, McGuire P, Egerton A. Relationship between Glutamate Dysfunction and Symptoms and Cognitive Function in Psychosis. Front Psychiatry 2013; 4:151. [PMID: 24324444 PMCID: PMC3840324 DOI: 10.3389/fpsyt.2013.00151] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 11/07/2013] [Indexed: 11/13/2022] Open
Abstract
The glutamate hypothesis of schizophrenia, proposed over two decades ago, originated following the observation that administration of drugs that block NMDA glutamate receptors, such as ketamine, could induce schizophrenia-like symptoms. Since then, this hypothesis has been extended to describe how glutamate abnormalities may disturb brain function and underpin psychotic symptoms and cognitive impairments. The glutamatergic system is now a major focus for the development of new compounds in schizophrenia. Relationships between regional brain glutamate function and symptom severity can be investigated using proton magnetic resonance spectroscopy (1H-MRS) to estimate levels of glutamatergic metabolites in vivo. Here we briefly review the 1H-MRS studies that have explored relationships between glutamatergic metabolites, symptoms, and cognitive function in clinical samples. While some of these studies suggest that more severe symptoms may be associated with elevated glutamatergic function in the anterior cingulate, studies in larger patient samples selected on the basis of symptom severity are required.
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Affiliation(s)
- Kate Merritt
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
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30
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Impairments in set-shifting but not reversal learning in the neonatal ventral hippocampal lesion model of schizophrenia: Further evidence for medial prefrontal deficits. Behav Brain Res 2013; 256:405-13. [DOI: 10.1016/j.bbr.2013.08.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/15/2013] [Accepted: 08/19/2013] [Indexed: 01/16/2023]
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Schaefer J, Giangrande E, Weinberger DR, Dickinson D. The global cognitive impairment in schizophrenia: consistent over decades and around the world. Schizophr Res 2013; 150:42-50. [PMID: 23911259 PMCID: PMC4196267 DOI: 10.1016/j.schres.2013.07.009] [Citation(s) in RCA: 370] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/02/2013] [Accepted: 07/03/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Schizophrenia results in cognitive impairments as well as positive, negative, and disorganized symptomatology. The present study examines the extent to which these cognitive deficits are generalized across domains, potential moderator variables, and whether the pattern of cognitive findings reported in schizophrenia has remained consistent over time and across cultural and geographic variation. METHOD Relevant publications from 2006 to 2011 were identified through keyword searches in PubMed and an examination of reference lists. Studies were included if they (1) compared the cognitive performance of adult schizophrenia patients and healthy controls, (2) based schizophrenia diagnoses on contemporary diagnostic criteria, (3) reported information sufficient to permit effect size calculation, (4) were reported in English, and (5) reported data for neuropsychological tests falling into at least 3 distinct cognitive domains. A set of 100 non-overlapping studies was identified, and effect sizes (Hedge's g) were calculated for each cognitive variable. RESULTS Consistent with earlier analyses, patients with schizophrenia scored significantly lower than controls across all cognitive tests and domains (grand mean effect size, g=-1.03). Patients showed somewhat larger impairments in the domains of processing speed (g=-1.25) and episodic memory (g=-1.23). Our results also showed few inconsistencies when grouped by geographic region. CONCLUSIONS The present study extends findings from 1980 to 2006 of a substantial, generalized cognitive impairment in schizophrenia, demonstrating that this finding has remained robust over time despite changes in assessment instruments and alterations in diagnostic criteria, and that it manifests similarly in different regions of the world despite linguistic and cultural differences.
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Affiliation(s)
- Jonathan Schaefer
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA
| | - Evan Giangrande
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA
| | - Daniel R. Weinberger
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA,Lieber institute for Brain Development, Johns Hopkins University Medical Center 855 North Wolfe Street, Baltimore, Maryland 21205 USA
| | - Dwight Dickinson
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA
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Su TW, Lan TH, Hsu TW, Biswal BB, Tsai PJ, Lin WC, Lin CP. Reduced neuro-integration from the dorsolateral prefrontal cortex to the whole brain and executive dysfunction in schizophrenia patients and their relatives. Schizophr Res 2013; 148:50-8. [PMID: 23726722 DOI: 10.1016/j.schres.2013.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 04/13/2013] [Accepted: 05/04/2013] [Indexed: 11/16/2022]
Abstract
Executive dysfunction is one of the core symptoms of schizophrenia. Functional neuro-imaging studies have suggested an association between deficits in activating the dorsolateral prefrontal cortex (DLPFC) and executive dysfunction, but neuro-integration from the DLPFC to the whole brain remains unclear. Studies investigating the neuro-integration from the DLPFC to the whole brain in unaffected but genetically liable family members are scant. In this study, we report DLPFC neuro-integrative deficits correlated with executive dysfunction and family history of schizophrenia using resting-state functional magnetic resonance imaging (fMRI). Using seed regions in DLPFC, we examined resting-state functional connectivity in 25 patients with schizophrenia, 25 unaffected first-degree relatives (UR), and 25 healthy control (HC) persons. Schizophrenia patients and UR have impaired connectivity from DLPFC to its coordinated regions (ANOVA: F=7.316-10.974, p<0.001). These coordinated brain regions are distributed in the bilateral caudate, left middle/inferior frontal gyrus, left precentral gyrus, and right cerebellum. The individual functional connectivity strength between the left DLPFC and its coordinated regions was correlated with individual executive function performance among whole persons. (Pearson's r=0.244-0.366, p=0.035-0.008) Our findings support that distributed neuro-integrative DLPFC deficits reflect a genetic risk for schizophrenia and that these deficits are present, to a lesser degree, in unaffected first-degree relatives. Our findings also support that neuro-integration might correlate with a patient's executive function performance.
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Affiliation(s)
- Tsung-Wei Su
- Brain Connectivity Lab., Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan, ROC
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Lutgen V, Qualmann K, Resch J, Kong L, Choi S, Baker DA. Reduction in phencyclidine induced sensorimotor gating deficits in the rat following increased system xc⁻ activity in the medial prefrontal cortex. Psychopharmacology (Berl) 2013; 226:531-40. [PMID: 23192314 PMCID: PMC3595356 DOI: 10.1007/s00213-012-2926-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/09/2012] [Indexed: 12/25/2022]
Abstract
RATIONALE Aspects of schizophrenia, including deficits in sensorimotor gating, have been linked to glutamate dysfunction and/or oxidative stress in the prefrontal cortex. System xc(-), a cystine-glutamate antiporter, is a poorly understood mechanism that contributes to both cellular antioxidant capacity and glutamate homeostasis. OBJECTIVES Our goal was to determine whether increased system xc(-) activity within the prefrontal cortex would normalize a rodent measure of sensorimotor gating. METHODS In situ hybridization was used to map messenger RNA (mRNA) expression of xCT, the active subunit of system xc(-), in the prefrontal cortex. Prepulse inhibition was used to measure sensorimotor gating; deficits in prepulse inhibition were produced using phencyclidine (0.3-3 mg/kg, sc). N-Acetylcysteine (10-100 μM) and the system xc(-) inhibitor (S)-4-carboxyphenylglycine (CPG, 0.5 μM) were used to increase and decrease system xc(-) activity, respectively. The uptake of (14)C-cystine into tissue punches obtained from the prefrontal cortex was used to assay system xc(-) activity. RESULTS The expression of xCT mRNA in the prefrontal cortex was most prominent in a lateral band spanning primarily the prelimbic cortex. Although phencyclidine did not alter the uptake of (14)C-cystine in prefrontal cortical tissue punches, intraprefrontal cortical infusion of N-acetylcysteine (10-100 μM) significantly reduced phencyclidine- (1.5 mg/kg, sc) induced deficits in prepulse inhibition. N-Acetylcysteine was without effect when coinfused with CPG (0.5 μM), indicating an involvement of system xc(-). CONCLUSIONS These results indicate that phencyclidine disrupts sensorimotor gating through system xc(-) independent mechanisms, but that increasing cystine-glutamate exchange in the prefrontal cortex is sufficient to reduce behavioral deficits produced by phencyclidine.
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Affiliation(s)
- Victoria Lutgen
- Department of Biomedical Sciences, Marquette University, Suite 446, 561 N. 15St, Milwaukee, WI 53233
| | - Krista Qualmann
- Department of Biomedical Sciences, Marquette University, Suite 446, 561 N. 15St, Milwaukee, WI 53233
| | - Jon Resch
- Department of Biomedical Sciences, Marquette University, Suite 446, 561 N. 15St, Milwaukee, WI 53233
| | - Linghai Kong
- Department of Biomedical Sciences, Marquette University, Suite 446, 561 N. 15St, Milwaukee, WI 53233
| | - SuJean Choi
- Department of Biomedical Sciences, Marquette University, Suite 446, 561 N. 15St, Milwaukee, WI 53233
| | - David A. Baker
- Department of Biomedical Sciences, Marquette University, Suite 446, 561 N. 15St, Milwaukee, WI 53233
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Chew LJ, Fusar-Poli P, Schmitz T. Oligodendroglial alterations and the role of microglia in white matter injury: relevance to schizophrenia. Dev Neurosci 2013; 35:102-29. [PMID: 23446060 PMCID: PMC4531048 DOI: 10.1159/000346157] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 11/07/2012] [Indexed: 12/12/2022] Open
Abstract
Schizophrenia is a chronic and debilitating mental illness characterized by a broad range of abnormal behaviors, including delusions and hallucinations, impaired cognitive function, as well as mood disturbances and social withdrawal. Due to the heterogeneous nature of the disease, the causes of schizophrenia are very complex; its etiology is believed to involve multiple brain regions and the connections between them, and includes alterations in both gray and white matter regions. The onset of symptoms varies with age and severity, and there is some debate over a degenerative or developmental etiology. Longitudinal magnetic resonance imaging studies have detected progressive gray matter loss in the first years of disease, suggesting neurodegeneration; but there is also increasing recognition of a temporal association between clinical complications at birth and disease onset that supports a neurodevelopmental origin. Presently, neuronal abnormalities in schizophrenia are better understood than alterations in myelin-producing cells of the brain, the oligodendrocytes, which are the predominant constituents of white matter structures. Proper white matter development and its structural integrity critically impacts brain connectivity, which affects sensorimotor coordination and cognitive ability. Evidence of defective white matter growth and compromised white matter integrity has been found in individuals at high risk of psychosis, and decreased numbers of mature oligodendrocytes are detected in schizophrenia patients. Inflammatory markers, including proinflammatory cytokines and chemokines, are also associated with psychosis. A relationship between risk of psychosis, white matter defects and prenatal inflammation is being established. Animal models of perinatal brain injury are successful in producing white matter damage in the brain, typified by hypomyelination and/or dysmyelination, impaired motor coordination and prepulse inhibition of the acoustic startle reflex, recapitulating structural and functional characteristics observed in schizophrenia. In addition, elevated expression of inflammation-related genes in brain tissue and increased production of cytokines by blood cells from patients with schizophrenia indicate immunological dysfunction and abnormal inflammatory responses, which are also important underlying features in experimental models. Microglia, resident immune defenders of the central nervous system, play important roles in the development and protection of neural cells, but can contribute to injury under pathological conditions. This article discusses oligodendroglial changes in schizophrenia and focuses on microglial activity in the context of the disease, in neonatal brain injury and in various experimental models of white matter damage. These include disorders associated with premature birth, and animal models of perinatal bacterial and viral infection, oxygen deprivation (hypoxia) and excess (hyperoxia), and elevated systemic proinflammatory cytokine levels. We briefly review the effects of treatment with antipsychotic and anti-inflammatory agents in models of perinatal brain injury, and comment on the therapeutic potential of these strategies. By understanding the neurobiological basis of oligodendroglial abnormalities in schizophrenia, it is hoped that patients will benefit from the availability of targeted and more efficacious treatment options.
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Affiliation(s)
- Li-Jin Chew
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA.
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Sridharan A, Willette AA, Bendlin BB, Alexander AL, Coe CL, Voytko ML, Colman RJ, Kemnitz JW, Weindruch RH, Johnson SC. Brain volumetric and microstructural correlates of executive and motor performance in aged rhesus monkeys. Front Aging Neurosci 2012; 4:31. [PMID: 23162464 PMCID: PMC3492760 DOI: 10.3389/fnagi.2012.00031] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 10/22/2012] [Indexed: 01/21/2023] Open
Abstract
The aged rhesus macaque exhibits brain atrophy and behavioral deficits similar to normal aging in humans. Here we studied the association between cognitive and motor performance and anatomic and microstructural brain integrity measured with 3T magnetic resonance imaging in aged monkeys. About half of these animals were maintained on moderate calorie restriction (CR), the only intervention shown to delay the aging process in lower animals. T1-weighted anatomic and diffusion tensor images were used to obtain gray matter (GM) volume and fractional anisotropy (FA) and mean diffusivity (MD), respectively. We tested the extent to which brain health indexed by GM volume, FA, and MD were related to executive and motor function, and determined the effect of the dietary intervention on this relationship. We hypothesized that fewer errors on the executive function test and faster motor response times would be correlated with higher volume, higher FA, and lower MD in frontal areas that mediate executive function, and in motor, premotor, subcortical, and cerebellar areas underlying goal-directed motor behaviors. Higher error percentage on a cognitive conceptual shift task was significantly associated with lower GM volume in frontal and parietal cortices, and lower FA in major association fiber bundles. Similarly, slower performance time on the motor task was significantly correlated with lower volumetric measures in cortical, subcortical, and cerebellar areas and decreased FA in several major association fiber bundles. Notably, performance during the acquisition phase of the hardest level of the motor task was significantly associated with anterior mesial temporal lobe volume. Finally, these brain-behavior correlations for the motor task were attenuated in CR animals compared to controls, indicating a potential protective effect of the dietary intervention.
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Affiliation(s)
- Aadhavi Sridharan
- Neuroscience Training Program, University of Wisconsin-Madison Madison, WI, USA ; Medical Scientist Training Program, University of Wisconsin-Madison Madison, WI, USA
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Aizawa E, Sato Y, Kochiyama T, Saito N, Izumiyama M, Morishita J, Kanazawa M, Shima K, Mushiake H, Hongo M, Fukudo S. Altered cognitive function of prefrontal cortex during error feedback in patients with irritable bowel syndrome, based on FMRI and dynamic causal modeling. Gastroenterology 2012; 143:1188-1198. [PMID: 22841782 DOI: 10.1053/j.gastro.2012.07.104] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 07/12/2012] [Accepted: 07/17/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Patients with irritable bowel syndrome (IBS) have increased activity in the insula and reduced activation of the dorsolateral prefrontal cortex (DLPFC) in response to visceral stimulation. We investigated whether they have latent impairments in cognitive flexibility because of dysfunction in the DLPFC and insula and altered connectivity between brain regions. METHODS We analyzed data from 30 individuals with IBS (15 men; age, 21.7 ± 3.0 y) diagnosed based on Rome III criteria, along with 30 individuals matched for age, sex, and education level (controls). Event-related functional magnetic resonance imaging of the brain was performed to evaluate cognitive flexibility and was assessed by the Wisconsin Card Sorting Test, in which subjects are allowed to change choice criteria, defined as set-shifting in response to error feedback. Brain images were analyzed with statistical parametric mapping 5 and 8 software and dynamic causal modeling. RESULTS Subjects with IBS had significantly more Nelson perseverative errors (P < .05) and set-maintenance difficulties (P < .05) than controls. They also showed significantly decreased activity of the right DLPFC (Brodmann's area 9; P < .001) and right hippocampus (P < .001), and significantly increased activity of the left posterior insula (P < .001) at error feedback during set-shifting. Dynamic causal modeling analysis during set-shifting revealed significantly less connectivity from the DLPFC to pre-supplementary motor area in subjects with IBS, compared with controls (P = .012). CONCLUSIONS Individuals with IBS have latent impairments in cognitive flexibility as a result of altered activity of the DLPFC, insula, and hippocampus, and impaired connectivity between the DLPFC and pre-supplementary motor area.
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Affiliation(s)
- Emiko Aizawa
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiro Sato
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | | | - Naohiro Saito
- Department of Clinical Neuroscience, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | | | - Joe Morishita
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Motoyori Kanazawa
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keisetsu Shima
- Department of Physiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hajime Mushiake
- Department of Physiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michio Hongo
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan; Department of Comprehensive Medicine, Tohoku University Hospital, Sendai, Japan
| | - Shin Fukudo
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan.
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Pedersen A, Wilmsmeier A, Wiedl KH, Bauer J, Kueppers K, Koelkebeck K, Kohl W, Kugel H, Arolt V, Ohrmann P. Anterior cingulate cortex activation is related to learning potential on the WCST in schizophrenia patients. Brain Cogn 2012; 79:245-51. [PMID: 22554566 DOI: 10.1016/j.bandc.2012.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
Abstract
The remediation of executive function in patients with schizophrenia is important in rehabilitation because these skills affect the patient's capacity to function in the community. There is evidence that instructional techniques can improve deficits in the Wisconsin Card Sorting Test (WCST) in some schizophrenia patients. We used a standard test/training phase/standard test format of the WCST to classify 36 schizophrenia patients as high-achievers, learners or non-retainers. All healthy controls performed as high-achievers. An event-related fMRI design assessed neural activation patterns during post-training WCST performance. Patients showed a linear trend between set-shifting related activation in the anterior cingulate cortex and learning potential, i.e. increased activation in high-achievers, a trend for increased activation in learners, and no activation in non-retainers compared to controls. In addition, activation in the temporoparietal cortex was highest in patients classified as learners, whereas in non-retainers activation was increased in the inferior frontal gyrus compared to controls and high-achieving patients. These results emphasize the relevance of the ACC's neural integrity in learning set-shifting strategies for patients with schizophrenia. Also, our results support the hypothesis that compensatory neural activation in patients with schizophrenia helps them to catch up with healthy controls on cognitive tasks.
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Affiliation(s)
- Anya Pedersen
- Department of Psychiatry, School of Medicine, University of Muenster, Germany
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El Haj M, Allain P. What do we know about the relationship between source monitoring deficits and executive dysfunction? Neuropsychol Rehabil 2012; 22:449-72. [PMID: 22324387 DOI: 10.1080/09602011.2012.658267] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
In clinical neuropsychology, source monitoring deficits have been classically attributed to executive dysfunction. Nevertheless, in this review we identified only 16 papers that provided statistical data about the relationships between source monitoring and executive processes. Surprisingly, they reported either a total, partial or non-existent relationship between source monitoring and executive tasks. In order to understand and explain these contradictions, we classified the source and executive tasks of the 16 papers according to two well-accepted definitions. Source tasks were classified using the Source Monitoring Framework (Johnson, Hashtroudi, & Lindsay, 1993 ) which specifies reality and external and internal source monitoring. Executive tasks were classified according to the model of Miyake Friedman, Emerson, Witzki, and Howerter (2000) which specifies complex, shifting, updating and inhibition tasks. We found that evaluation of reality and internal source monitoring was limited. Regarding executive functions, there was no assessment of updating and only a limited assessment of shifting and inhibition. Therefore, the relationship between source monitoring and executive functions remains an open question. Our findings point to the need for the simultaneous assessment of source monitoring and executive functions as defined by multidimensional theoretical frameworks. Such investigations would help in understanding the relationship between specific source monitoring deficits and specific executive decline in clinical populations.
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Affiliation(s)
- Mohamad El Haj
- Laboratoire de Psychologie EA 2646, Université d'Angers, France.
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Palaniyappan L, Liddle PF. Does the salience network play a cardinal role in psychosis? An emerging hypothesis of insular dysfunction. J Psychiatry Neurosci 2012; 37:17-27. [PMID: 21693094 PMCID: PMC3244495 DOI: 10.1503/jpn.100176] [Citation(s) in RCA: 366] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The insular cortex is one of the brain regions that show consistent abnormalities in both structural and functional neuroimaging studies of schizophrenia. In healthy individuals, the insula has been implicated in a myriad of physiologic functions. The anterior cingulate cortex (ACC) and insula together constitute the salience network, an intrinsic large-scale network showing strong functional connectivity. Considering the insula as a functional unit along with the ACC provides an integrated understanding of the role of the insula in information processing. In this review, we bring together evidence from imaging studies to understand the role of the salience network in schizophrenia and propose a model of insular dysfunction in psychosis.
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Affiliation(s)
- Lena Palaniyappan
- Division of Psychiatry, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.
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Hardy CJ, Tal A, Babb JS, Perry NN, Messinger JW, Antonius D, Malaspina D, Gonen O. Multivoxel proton MR spectroscopy used to distinguish anterior cingulate metabolic abnormalities in patients with schizophrenia. Radiology 2011; 261:542-50. [PMID: 21900615 DOI: 10.1148/radiol.11110675] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To test the hypothesis that anterior cingulate cortex (ACC) subregions in patients with schizophrenia are metabolically different from those in healthy control subjects. MATERIALS AND METHODS This institutional review board-approved study was HIPAA compliant, and all participants provided written informed consent. Twenty-two patients with schizophrenia (13 male, nine female; 39.4 years ± 10.6 [standard deviation]) and 11 age- and sex-matched control subjects (seven male, four female; 35.5 years ± 10.7) underwent magnetic resonance (MR) imaging and three-dimensional 3-T voxel proton MR spectroscopy to measure absolute rostral and caudal ACC N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) concentrations. Exact Mann-Whitney test was used to compare patient data with control data, paired-sample Wilcoxon signed rank test was used to compare subregions within groups, and receiver operating characteristic curve analysis was used to assess sensitivity and specificity in diagnosis of schizophrenia. RESULTS There were no significant metabolic differences between patients and control subjects or between ACC subregions in control subjects. In patients, rostral ACC NAA and Cr concentrations were significantly lower than those in caudal ACC (6.2 mM ± 1.3 vs 7.1 mM ± 1.3, P < .01; 5.7 mmol/L ± 1.4 vs 6.3 mmol/L ± 1.6, P < .01; respectively); however, this did not hold true for Cho concentrations (1.7 mmol/L ± 0.5 vs 1.8 mmol/L ± 0.5). For individual differences between caudal and rostral measurements, only NAA in patients was different from that in control subjects (0.9 mmol/L ± 1.3 vs -0.1 mmol/L ± 0.5, P < .01), enabling prediction of schizophrenia with 68% sensitivity and 91% specificity, for a difference of more than 0.4. CONCLUSION Significant differences between caudal and rostral NAA concentration are found in ACC of patients with schizophrenia but not in ACC of healthy control subjects, indicating that neuronal density or integrity differences between ACC subregions may be characteristic of the disease.
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Affiliation(s)
- Caitlin J Hardy
- Department of Radiology, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016, USA
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Lyche P, Jonassen R, Stiles TC, Ulleberg P, Landrø NI. Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder. Front Psychiatry 2010; 1:149. [PMID: 21423456 PMCID: PMC3059619 DOI: 10.3389/fpsyt.2010.00149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 11/24/2010] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Impaired cognitive control functions have been demonstrated in both major depression (MDD) and anxiety disorder (A), but few studies have systematically examined the impact of MDD with co-morbid A (MDDA), which is the main aim of this study. METHOD We compared patients with MDD with (MDDA; n = 24) and without co-morbid A (n = 37) to a group of healthy controls (HC; n = 92) on three subtests from the Cambridge Neuropsychological Test Automated Battery; intra-extra dimensional, stop signal task, and spatial working memory. These tasks correspond to a theoretical model consisting of three separable but interrelated executive control functions: Shifting, Inhibition, and Updating. A simple psychomotor speed measure was also included. RESULTS After controlling for age, gender, and education level, the results showed that the MDDA group displayed significantly impaired performance on the functions Shifting and Updating compared to HC. There emerged no significant differences between any of the patient groups and HC regarding Inhibition. The pure MDD group did not display dysfunctions relative to the HC group on the main executive control variables, but displayed slowed psychomotor speed. Contrary to expectation there were no significant differences between the MDDA and the MDD groups. CONCLUSION Co-morbid anxiety should be taken into account when studying cognitive control functions in major depression.
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Affiliation(s)
- Pia Lyche
- Department of Psychology, Center for the Study of Human Cognition, University of OsloOslo, Norway
| | - Rune Jonassen
- Department of Psychology, Center for the Study of Human Cognition, University of OsloOslo, Norway
- Akershus University Hospital Health AuthorityLørenskog, Norway
| | - Tore C. Stiles
- Department of Psychology, Norwegian University of Science and TechnologyTrondheim, Norway
| | - Pål Ulleberg
- Department of Psychology, Center for the Study of Human Cognition, University of OsloOslo, Norway
| | - Nils I. Landrø
- Department of Psychology, Center for the Study of Human Cognition, University of OsloOslo, Norway
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