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Yang G, Zhang S, Zhou Y, Song Y, Hu W, Peng Y, Shi H, Zhang Y. Increased resting-state interhemispheric functional connectivity of striatum in first-episode drug-naive adolescent-onset schizophrenia. Asian J Psychiatr 2022; 76:103134. [PMID: 35551877 DOI: 10.1016/j.ajp.2022.103134] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/25/2022] [Accepted: 04/20/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Compared to adult-onset schizophrenia, relatively few neuroimaging studies have examined functional connectivity (FC) abnormalities in adolescent-onset schizophrenia (AOS). The present study was designed to investigate resting-state interhemispheric connectivity patterns among drug-naive first-episode AOS patients and potential changes following short-term antipsychotic drug treatment. METHODS This study included 107 drug-naïve, first-episode AOS patients (age: 15.33 ± 1.62, 45 males) and 67 matched healthy controls (age: 15.43 ± 1.86, 30 males). All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans, and 34 AOS patients (age: 15.12 ± 1.68, 12 males) also underwent a follow-up scan after 8 weeks of antipsychotic drug treatment. Interhemispheric functional connectivity was measured by voxel-mirrored homotopic connectivity (VMHC). RESULTS Compared to healthy controls, AOS patients showed increased VMHC values in putamen and caudate. No significant differences were observed between the patients at baseline and after 8 weeks of treatment. CONCLUSIONS First-episode, drug-naive AOS patients demonstrate abnormalities in interhemispheric FC, and these are not mitigated by short-term antipsychotic treatment.
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Affiliation(s)
- Ge Yang
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Sen Zhang
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Youqi Zhou
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Yichen Song
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Wenyan Hu
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Yue Peng
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Han Shi
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Yan Zhang
- Henan Mental Hospital, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
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Increased Homotopic Connectivity in the Prefrontal Cortex Modulated by Olanzapine Predicts Therapeutic Efficacy in Patients with Schizophrenia. Neural Plast 2021; 2021:9954547. [PMID: 34512748 PMCID: PMC8429031 DOI: 10.1155/2021/9954547] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/08/2021] [Accepted: 08/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies have revealed the abnormalities in homotopic connectivity in schizophrenia. However, the relationship of these deficits to antipsychotic treatment in schizophrenia remains unclear. This study explored the effects of antipsychotic therapy on brain homotopic connectivity and whether the homotopic connectivity of these regions might predict individual treatment response in schizophrenic patients. Methods A total of 21 schizophrenic patients and 20 healthy controls were scanned by the resting-state functional magnetic resonance imaging. The patients received olanzapine treatment and were scanned at two time points. Voxel-mirrored homotopic connectivity (VMHC) and pattern classification techniques were applied to analyze the imaging data. Results Schizophrenic patients presented significantly decreased VMHC in the temporal and inferior frontal gyri, medial prefrontal cortex (MPFC), and motor and low-level sensory processing regions (including the fusiform gyrus and cerebellum lobule VI) relative to healthy controls. The VMHC in the superior/middle MPFC was significantly increased in the patients after eight weeks of treatment. Support vector regression (SVR) analyses revealed that VMHC in the superior/middle MPFC at baseline can predict the symptomatic improvement of the positive and negative syndrome scale after eight weeks of treatment. Conclusions This study demonstrated that olanzapine treatment may normalize decreased homotopic connectivity in the superior/middle MPFC in schizophrenic patients. The VMHC in the superior/middle MPFC may predict individual response for antipsychotic therapy. The findings of this study conduce to the comprehension of the therapy effects of antipsychotic medications on homotopic connectivity in schizophrenia.
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Liang S, Wang Q, Greenshaw AJ, Li X, Deng W, Ren H, Zhang C, Yu H, Wei W, Zhang Y, Li M, Zhao L, Du X, Meng Y, Ma X, Yan CG, Li T. Aberrant triple-network connectivity patterns discriminate biotypes of first-episode medication-naive schizophrenia in two large independent cohorts. Neuropsychopharmacology 2021; 46:1502-1509. [PMID: 33408329 PMCID: PMC8208970 DOI: 10.1038/s41386-020-00926-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/07/2020] [Accepted: 11/12/2020] [Indexed: 02/05/2023]
Abstract
Schizophrenia is a complex disorder associated with aberrant brain functional connectivity. This study aims to demonstrate the relation of heterogeneous symptomatology in this disorder to distinct brain connectivity patterns within the triple-network model. The study sample comprised 300 first-episode antipsychotic-naive patients with schizophrenia (FES) and 301 healthy controls (HCs). At baseline, resting-state functional magnetic resonance imaging data were captured for each participant, and concomitant neurocognitive functions were evaluated outside the scanner. Clinical information of 49 FES in the discovery dataset were reevaluated at a 6-week follow-up. Differential features between FES and HCs were selected from triple-network connectivity profiles. Cutting-edge unsupervised machine learning algorithms were used to define patient subtypes. Clinical and cognitive variables were compared between patient subgroups. Two FES subgroups with differing triple-network connectivity profiles were identified in the discovery dataset and confirmed in an independent hold-out cohort. One patient subgroup appearing to have more severe clinical symptoms was distinguished by salience network (SN)-centered hypoconnectivity, which was associated with greater impairments in sustained attention. The other subgroup exhibited hyperconnectivity and manifested greater deficits in cognitive flexibility. The SN-centered hypoconnectivity subgroup had more persistent negative symptoms at the 6-week follow-up than the hyperconnectivity subgroup. The present study illustrates that clinically relevant cognitive subtypes of schizophrenia may be associated with distinct differences in connectivity in the triple-network model. This categorization may foster further analysis of the effects of therapy on these network connectivity patterns, which may help to guide therapeutic choices to effectively reach personalized treatment goals.
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Affiliation(s)
- Sugai Liang
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Brain Research Centre, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Qiang Wang
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Andrew J. Greenshaw
- grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
| | - Xiaojing Li
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Wei Deng
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Brain Research Centre, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Hongyan Ren
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Chengcheng Zhang
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Hua Yu
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Wei Wei
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Yamin Zhang
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Mingli Li
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Liansheng Zhao
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Xiangdong Du
- grid.263761.70000 0001 0198 0694Suzhou Psychiatry Hospital, Affiliated Guangji Hospital of Soochow University, 215137 Suzhou, Jiangsu China
| | - Yajing Meng
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Xiaohong Ma
- grid.13291.380000 0001 0807 1581Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Chao-Gan Yan
- grid.454868.30000 0004 1797 8574CAS Key Laboratory of Behavioral Science, Institute of Psychology, 100101 Beijing, China ,grid.410726.60000 0004 1797 8419Department of Psychology, University of Chinese Academy of Sciences, 100101 Beijing, China
| | - Tao Li
- Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan, China. .,West China Brain Research Centre, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan, China.
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Chen J, Müller VI, Dukart J, Hoffstaedter F, Baker JT, Holmes AJ, Vatansever D, Nickl-Jockschat T, Liu X, Derntl B, Kogler L, Jardri R, Gruber O, Aleman A, Sommer IE, Eickhoff SB, Patil KR. Intrinsic Connectivity Patterns of Task-Defined Brain Networks Allow Individual Prediction of Cognitive Symptom Dimension of Schizophrenia and Are Linked to Molecular Architecture. Biol Psychiatry 2021; 89:308-319. [PMID: 33357631 PMCID: PMC7770333 DOI: 10.1016/j.biopsych.2020.09.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the marked interindividual variability in the clinical presentation of schizophrenia, the extent to which individual dimensions of psychopathology relate to the functional variability in brain networks among patients remains unclear. Here, we address this question using network-based predictive modeling of individual psychopathology along 4 data-driven symptom dimensions. Follow-up analyses assess the molecular underpinnings of predictive networks by relating them to neurotransmitter-receptor distribution patterns. METHODS We investigated resting-state functional magnetic resonance imaging data from 147 patients with schizophrenia recruited at 7 sites. Individual expression along negative, positive, affective, and cognitive symptom dimensions was predicted using a relevance vector machine based on functional connectivity within 17 meta-analytic task networks following repeated 10-fold cross-validation and leave-one-site-out analyses. Results were validated in an independent sample. Networks robustly predicting individual symptom dimensions were spatially correlated with density maps of 9 receptors/transporters from prior molecular imaging in healthy populations. RESULTS Tenfold and leave-one-site-out analyses revealed 5 predictive network-symptom associations. Connectivity within theory of mind, cognitive reappraisal, and mirror neuron networks predicted negative, positive, and affective symptom dimensions, respectively. Cognitive dimension was predicted by theory of mind and socioaffective default networks. Importantly, these predictions generalized to the independent sample. Intriguingly, these two networks were positively associated with D1 receptor and serotonin reuptake transporter densities as well as dopamine synthesis capacity. CONCLUSIONS We revealed a robust association between intrinsic functional connectivity within networks for socioaffective processes and the cognitive dimension of psychopathology. By investigating the molecular architecture, this work links dopaminergic and serotonergic systems with the functional topography of brain networks underlying cognitive symptoms in schizophrenia.
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Affiliation(s)
- Ji Chen
- Institute of Neuroscience and Medicine: Brain and Behavior (INM-7), Research Center Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Veronika I. Müller
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Justin T. Baker
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA 02478,Department of Psychiatry, Harvard Medical School, Boston, MA 02114
| | - Avram J. Holmes
- Department of Psychology, Yale University, New Haven, CT 06520
| | - Deniz Vatansever
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, 200433, Shanghai, PR China
| | - Thomas Nickl-Jockschat
- Iowa Neuroscience Institute & Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Xiaojin Liu
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Germany
| | - Lydia Kogler
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Germany
| | - Renaud Jardri
- Univ Lille, INSERM U1172, Lille Neuroscience & Cognition Centre, Plasticity & SubjectivitY team & CHU Lille, Fontan Hospital, CURE platform, Lille, France
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Germany
| | - André Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Iris E. Sommer
- Department of Biomedical Science of Cells and Systems, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Simon B. Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Correspondence should be addressed to: Simon B. Eickhoff, Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany & Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, 52428 Jülich, Germany. Tel: +49 2461 61 1791; .; Ji Chen, Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany & Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, 52428 Jülich, Germany. Tel: +49 2461 61 85334;
| | - Kaustubh R. Patil
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Reduced connectivity in anterior cingulate cortex as an early predictor for treatment response in drug-naive, first-episode schizophrenia: A global-brain functional connectivity analysis. Schizophr Res 2020; 215:337-343. [PMID: 31522869 DOI: 10.1016/j.schres.2019.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/27/2019] [Accepted: 09/02/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Antipsychotic medications may have acute effect on brain functional connectivity (FC) after only a few days of treatment. It is unclear if early changes in FC can predict treatment response in patients with schizophrenia. METHODS The study included 32 patients with drug-naive, first-episode schizophrenia and 32 healthy controls. Resting-state functional magnetic resonance imaging was obtained from the patients at two time-points (pre-treatment baseline and 1 week after treatment) and healthy controls at baseline. Patients were treated with olanzapine for 8 weeks, and clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) at three time points (baseline, 1 week and 8 weeks after treatment). Imaging data were analyzed using global-brain FC (GFC) and support vector regression (SVR). RESULTS At baseline, an increased GFC was observed in bilateral anterior cingulate cortex (ACC) in patients compared with healthy controls. After 1 week of olanzapine treatment, patients showed decreased GFC in bilateral ACC compared to the baseline values. SVR analysis suggested a positive relationship between GFC changes in bilateral ACC at week 1 and improvement in negative symptoms at week 8 (r = 0.957, p < 0.001). CONCLUSION An early decrease in GFC in bilateral ACC may serve as a predictor for treatment response in patients with schizophrenia. If further confirmed, our finding may be able to help clinicians decide, during the early treatment course, whether the patient should stay on the chosen antipsychotic medication or switch to a different one.
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Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Treatment effects of olanzapine on homotopic connectivity in drug-free schizophrenia at rest. World J Biol Psychiatry 2019. [PMID: 28649941 DOI: 10.1080/15622975.2017.1346280] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Deficits in homotopic connectivity have been implicated in schizophrenia. However, alterations in homotopic connectivity associated with antipsychotic treatments in schizophrenia remain unclear due to lack of longitudinal studies. METHODS Seventeen drug-free patients with recurrent schizophrenia and 24 healthy controls underwent resting-state functional magnetic resonance imaging scans. The patients were scanned at three time points (baseline, at 6 weeks of treatment, and at 6 months of treatment). Voxel-mirrored homotopic connectivity (VMHC) was applied to analyse the imaging data to examine alterations in VMHC associated with antipsychotic treatment. RESULTS The results showed that patients with schizophrenia exhibited decreased VMHC in the default-mode network (such as the precuneus and inferior parietal lobule) and the motor and sensory processing regions (such as the lingual gyrus, fusiform gyrus and cerebellum lobule VI), which could be normalised or denormalised by olanzapine treatment. In addition, negative correlations were found between decreased VMHC and symptom severity in the patients at baseline. CONCLUSIONS The present study shows that olanzapine treatment can normalise or denormalise decreased homotopic connectivity in schizophrenia. The findings also provide a new perspective to understand treatment effects of antipsychotic drugs on homotopic connectivity in schizophrenia that contribute to the disconnection hypothesis of this disease.
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Affiliation(s)
- Wenbin Guo
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Feng Liu
- f Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology , University of Electronic Science and Technology of China , Chengdu , Sichuan , China
| | - Jindong Chen
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Renrong Wu
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China.,f Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology , University of Electronic Science and Technology of China , Chengdu , Sichuan , China
| | - Lehua Li
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China
| | - Zhikun Zhang
- g Mental Health Center , The First Affiliated Hospital, Guangxi Medical University , Nanning , Guangxi , China
| | - Huafu Chen
- f Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology , University of Electronic Science and Technology of China , Chengdu , Sichuan , China
| | - Jingping Zhao
- a Department of Psychiatry , The Second Xiangya Hospital, Central South University , Changsha , Hunan , China.,b Mental Health Institute of the Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,c National Clinical Research Center on Mental Disorders , Changsha , Hunan , China.,d National Technology Institute on Mental Disorders , Changsha , Hunan , China.,e Hunan Key Laboratory of Psychiatry and Mental Health , Changsha , Hunan , China.,h Guangzhou Hui Ai Hospital , Affliated Brain Hospital of Guangzhou Medical University , Guangzhou , Guangdong , China
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Wu R, Ou Y, Liu F, Chen J, Li H, Zhao J, Guo W, Fan X. Reduced Brain Activity in the Right Putamen as an Early Predictor for Treatment Response in Drug-Naive, First-Episode Schizophrenia. Front Psychiatry 2019; 10:741. [PMID: 31649567 PMCID: PMC6791918 DOI: 10.3389/fpsyt.2019.00741] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/16/2019] [Indexed: 11/18/2022] Open
Abstract
Antipsychotic medications can have a significant effect on brain function after only several days of treatment. It is unclear whether such an acute effect can serve as an early predictor for treatment response in schizophrenia. Thirty-two patients with drug-naive, first-episode schizophrenia and 32 healthy controls underwent resting-state functional magnetic resonance imaging. Patients were treated with olanzapine and were scanned at baseline and 1 week of treatment. Healthy controls were scanned once at baseline. Symptom severity was assessed within the patient group using the Positive and Negative Syndrome Scale (PANSS) at three time points (baseline, 1 week of treatment, and 8 weeks of treatment). The fractional amplitude of low frequency fluctuation (fALFF) and support vector regression (SVR) methods were used to analyze the data. Compared with the control group, the patient group showed increased levels of fALFF in the bilateral putamen at baseline. After 1week of olanzapine treatment, the patient group showed decreased levels of fALFF in the right putamen relative to those at baseline. The SVR analysis found a significantly positive relationship between the reduction in fALFF after 1 week of treatment and the improvement in positive symptoms after 8 weeks of treatment (r = 0.431, p = 0.014). The present study provides evidence that early reduction and normalization of fALFF in the right putamen may serve as a predictor for treatment response in patients with schizophrenia.
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Affiliation(s)
- Renrong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yangpan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Xiaoduo Fan
- University of Massachusetts Medical School, UMass Memorial Medical Center, One Biotech, Worcester, MA, United States
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Boksa P, Joober R. Who should be "controls" in studies on the neurobiology of psychiatric disorders? J Psychiatry Neurosci 2018; 43. [PMID: 30125246 PMCID: PMC6158024 DOI: 10.1503/jpn.180128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Patricia Boksa
- From the Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Que., Canada
| | - Ridha Joober
- From the Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Que., Canada
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Jing R, Huang J, Jiang D, Lin X, Ma X, Tian H, Li J, Zhuo C. Distinct pattern of cerebral blood flow alterations specific to schizophrenics experiencing auditory verbal hallucinations with and without insight: a pilot study. Oncotarget 2018; 9:6763-6770. [PMID: 29467926 PMCID: PMC5805512 DOI: 10.18632/oncotarget.23631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/29/2017] [Indexed: 12/24/2022] Open
Abstract
Schizophrenia is associated with widespread and complex cerebral blood flow (CBF) disturbance. Auditory verbal hallucinations (AVH) and insight are the core symptoms of schizophrenia. However, to the best of our knowledge, very few studies have assessed the CBF characteristics of the AVH suffered by schizophrenic patients with and without insight. Based on our previous findings, Using a 3D pseudo-continuous ASL (pcASL) technique, we investigated the differences in AVH-related CBF alterations in schizophrenia patients with and without insight. We used statistical parametric mapping (SPM8) and statistical non-parametric mapping (SnPM13) to perform the fMRI analysis. We found that AVH-schizophrenia patients without insight showed an increased CBF in the left temporal pole and a decreased CBF in the right middle frontal gyrus when compared to AVH-schizophrenia patients with insight. Our novel findings suggest that AVH-schizophrenia patients without insight possess a more complex CBF disturbance. Simultaneously, our findings also incline to support the idea that the CBF aberrant in some specific brain regions may be the common neural basis of insight and AVH. Our findings support the mostly current hypotheses regarding AVH to some extent. Although our findings come from a small sample, it provide the evidence that indicate us to conduct a larger study to thoroughly explore the mechanisms of schizophrenia, especially the core symptoms of AVHs and insight.
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Affiliation(s)
- Rixing Jing
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jiangjie Huang
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China
| | - Deguo Jiang
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China
| | - Xiaodong Lin
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China
| | - Xiaolei Ma
- Department of Psychological Medicine, Tianjin Anning Hospital, Tianjin, China
| | - Hongjun Tian
- Department of Psychological Medicine, Tianjin Anning Hospital, Tianjin, China
| | - Jie Li
- Department of Psychiatric Neuroimaging Laboratory, Tianjin Anding Hospital, Tianjin Mental Health Center, Teaching Hospital of Tianjin Medical University, Tianjin, China
| | - Chuanjun Zhuo
- Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, China.,Department of Psychiatric Neuroimaging Laboratory, Tianjin Anding Hospital, Tianjin Mental Health Center, Teaching Hospital of Tianjin Medical University, Tianjin, China
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10
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Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Olanzapine modulates the default-mode network homogeneity in recurrent drug-free schizophrenia at rest. Aust N Z J Psychiatry 2017; 51:1000-1009. [PMID: 28605934 DOI: 10.1177/0004867417714952] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous studies on brain function alterations associated with antipsychotic treatment for schizophrenia have produced conflicting results because they used short treatment periods and different designs. METHODS Resting-state functional magnetic resonance imaging scans were obtained from 17 drug-free patients with recurrent schizophrenia and 24 healthy controls. The patients were treated with olanzapine for 6 months and were scanned at three time points (baseline, 6 weeks of treatment and 6 months of treatment). Network homogeneity was used to analyze the imaging data to examine default-mode network homogeneity alterations associated with antipsychotic treatment. RESULTS Compared with the controls, the patients at baseline showed increased network homogeneity in the bilateral precuneus and decreased network homogeneity in the bilateral middle temporal gyrus. Network homogeneity values in the bilateral precuneus decreased, and network homogeneity values in the left superior medial prefrontal cortex and the right middle temporal gyrus increased in patients administered olanzapine as antipsychotic treatment. By contrast, network homogeneity values in the left middle temporal gyrus remained unchanged in patients after treatment. CONCLUSION This study provides evidence that antipsychotic treatment with olanzapine modulates the default-mode network homogeneity in schizophrenia. These findings contribute to the understanding of antipsychotic treatment effects on brain functions.
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Affiliation(s)
- Wenbin Guo
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Feng Liu
- 6 Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jindong Chen
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Renrong Wu
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Lehua Li
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zhikun Zhang
- 7 Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Huafu Chen
- 6 Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingping Zhao
- 1 Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China.,2 Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.,3 National Clinical Research Center on Mental Disorders, Changsha, China.,4 National Technology Institute on Mental Disorders, Changsha, China.,5 Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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11
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Nelson BG, Bassett DS, Camchong J, Bullmore ET, Lim KO. Comparison of large-scale human brain functional and anatomical networks in schizophrenia. NEUROIMAGE-CLINICAL 2017; 15:439-448. [PMID: 28616384 PMCID: PMC5459352 DOI: 10.1016/j.nicl.2017.05.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/27/2017] [Accepted: 05/13/2017] [Indexed: 01/04/2023]
Abstract
Schizophrenia is a disease with disruptions in thought, emotion, and behavior. The dysconnectivity hypothesis suggests these disruptions are due to aberrant brain connectivity. Many studies have identified connectivity differences but few have been able to unify gray and white matter findings into one model. Here we develop an extension of the Network-Based Statistic (NBS) called NBSm (Multimodal Network-based statistic) to compare functional and anatomical networks in schizophrenia. Structural, resting functional, and diffusion magnetic resonance imaging data were collected from 29 chronic patients with schizophrenia and 29 healthy controls. Images were preprocessed, and average time courses were extracted for 90 regions of interest (ROI). Functional connectivity matrices were estimated by pairwise correlations between wavelet coefficients of ROI time series. Following diffusion tractography, anatomical connectivity matrices were estimated by white matter streamline counts between each pair of ROIs. Global and regional strength were calculated for each modality. NBSm was used to find significant overlap between functional and anatomical components that distinguished health from schizophrenia. Global strength was decreased in patients in both functional and anatomical networks. Regional strength was decreased in all regions in functional networks and only one region in anatomical networks. NBSm identified a distinguishing functional component consisting of 46 nodes with 113 links (p < 0.001), a distinguishing anatomical component with 47 nodes and 50 links (p = 0.002), and a distinguishing intermodal component with 26 nodes (p < 0.001). NBSm is a powerful technique for understanding network-based group differences present in both anatomical and functional data. In light of the dysconnectivity hypothesis, these results provide compelling evidence for the presence of significant overlapping anatomical and functional disruption in people with schizophrenia. A novel method for the unified analysis of functional and anatomical networks in schizophrenia is proposed. The methodology extends existing networkbased analyses to test brain network differences across imaging modalities. A fundamental disrupted network was found in those with schizophrenia when compared to healthy, agematched controls.
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Affiliation(s)
- Brent G Nelson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA.
| | - Danielle S Bassett
- Department of Physics, University of California, Santa Barbara, CA 93106, USA; Sage Center for the Study of the Mind, University of California, Santa Barbara, CA 93106, USA; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jazmin Camchong
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Edward T Bullmore
- Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK; GlaxoSmithKline R&D, Cambridge, UK
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
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12
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Lang X, Wang L, Zhuo CJ, Jia F, Wang LN, Wang CL. Reduction of Interhemispheric Functional Connectivity in Sensorimotor and Visual Information Processing Pathways in Schizophrenia. Chin Med J (Engl) 2017; 129:2422-2426. [PMID: 27748333 PMCID: PMC5072253 DOI: 10.4103/0366-6999.191758] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have demonstrated interhemispheric functional connectivity alterations in schizophrenia. However, the relationship between these alterations and the disease state of schizophrenia is largely unknown. Therefore, we aimed to investigate this relationship using voxel-mirrored homotopic connectivity (VMHC) method. Methods: This study enrolled 36 schizophrenia patients with complete remission, 58 schizophrenia patients with incomplete remission and 55 healthy controls. The VMHC was calculated based on resting-state functional magnetic resonance imaging data. Differences in VMHC among three groups were compared using one-way analysis of variance. A brain region with a significant difference in VMHC was defined as a region of interest (ROI), and the mean VMHC value in the ROI was extracted for the post hoc analysis, i.e., pair-wise comparisons across the three groups. Results: VMHC in the visual region (inferior occipital and fusiform gyri) and the sensorimotor region (paracentral lobule) showed significant differences among the three groups (P < 0.05, a false discovery rate method corrected). Pair-wise comparisons in the post hoc analysis showed that VMHC of the visual and sensorimotor regions in schizophrenia patients with complete remission and incomplete remission was lower than that in healthy controls (P < 0.05, Bonferroni corrected); however, there was no significant difference between the two patient subgroups. Conclusions: Interhemispheric functional connectivity in the sensorimotor and visual processing pathways was reduced in patients with schizophrenia, but this reduction was unrelated to the disease state; thus, this reduction may serve as a trait marker of schizophrenia.
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Affiliation(s)
- Xu Lang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Le Wang
- Department of Radiology, First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Chuan-Jun Zhuo
- Tianjin Anning Hospital, Tianjin 300300; Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin 300070, China
| | - Feng Jia
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin 300070, China
| | - Li-Na Wang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin 300070, China
| | - Chun-Li Wang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin 300070, China
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13
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Olanzapine modulation of long- and short-range functional connectivity in the resting brain in a sample of patients with schizophrenia. Eur Neuropsychopharmacol 2017; 27:48-58. [PMID: 27887859 DOI: 10.1016/j.euroneuro.2016.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/24/2016] [Accepted: 11/08/2016] [Indexed: 01/12/2023]
Abstract
Treatment effects of antipsychotic drugs on cerebral function are seldom examined. Exploring functional connectivity (FC) in drug-free schizophrenia patients before and after antipsychotic treatment can improve the understanding of antipsychotic drug mechanisms. A total of 17 drug-free patients with recurrent schizophrenia and 24 healthy controls underwent resting-state functional magnetic resonance imaging scans. Long- and short-range FC strengths (FCS) were calculated for each participant. Compared with the controls, the patients at baseline exhibited increased long-range positive FCS (lpFCS) in the bilateral inferior parietal lobule (IPL) and decreased lpFCS in the brain regions of the default-mode network (DMN) regions and sensorimotor circuits of the brain. By contrast, increased short-range positive FCS was observed in the right IPL of the patients at baseline compared with the controls. After treatment with olanzapine, increased FC in the DMN and sensorimotor circuits of the brain was noted, whereas decreased FC was observed in the left superior temporal gyrus (STG). Moreover, the alterations of the FCS values and the reductions in symptom severity among the patients after treatment were correlated. The present study provides evidence that olanzapine normalizes the abnormalities of long- and short-range FCs in schizophrenia. FC reductions in the right IPL may be associated with early treatment response, whereas those in the left STG may be related to poor treatment outcome.
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14
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Bai Y, Wang W, Xu J, Zhang F, Yu H, Luo C, Wang L, Chen X, Shan B, Xu L, Xu X, Cheng Y. Altered resting-state regional homogeneity after 13 weeks of paliperidone injection treatment in schizophrenia patients. Psychiatry Res Neuroimaging 2016; 258:37-43. [PMID: 27837680 DOI: 10.1016/j.pscychresns.2016.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 12/22/2022]
Abstract
This study aimed to explore the effects of the long-acting antipsychotic drug palmitate paliperidone in resting-state brain activity of schizophrenia patients. Seventeen schizophrenia outpatients were included and received palmitate paliperidone injection (PAL) treatment for 13 weeks. These patients were compared to seventeen matched healthy controls. All subjects underwent two scan sessions of resting-state magnetic resonance imaging (baseline and the 13th week) and regional homogeneity (ReHo) at resting-state where compared. After 13 weeks of treatment, PAL increased ReHo of the prefrontal cortex, anterior cingulate gyrus and orbital frontal gyrus, while PAL decreased ReHo of the thalamus, parahippocampal gyrus and superior temporal gyrus. Furthermore, improvement of psychiatric symptoms correlated with changing amplitude of ReHo: positively correlated with postcentral gyrus and negatively correlated with the occipital cortex. Baseline ReHo values of the middle occipital gyrus were positively correlated with the rate of reduction of psychiatric symptoms and improvement of social function. These results suggested that PAL might achieve its clinical effect in schizophrenia by influencing the resting-state function of the occipital cortex, lateral prefrontal cortex and temporal lobe. Baseline function of the inferior occipital gyrus might potentially predict the short-term effect of PAL in schizophrenia.
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Affiliation(s)
- Yan Bai
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Weixin Wang
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fengrui Zhang
- Magnetic Resonance Imaging Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongjun Yu
- Magnetic Resonance Imaging Center, First Hospital of Kunming City, Kunming, China
| | - Chunrong Luo
- Magnetic Resonance Imaging Center, First Hospital of Kunming City, Kunming, China
| | - Lianzhang Wang
- School of Life Sciences, Tsinghua University, Beijing, China
| | - Xianyu Chen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Baoci Shan
- Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Lin Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms, Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China.
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