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Berthet P, Haatveit BC, Kjelkenes R, Worker A, Kia SM, Wolfers T, Rutherford S, Alnaes D, Dinga R, Pedersen ML, Dahl A, Fernandez-Cabello S, Dazzan P, Agartz I, Nesvåg R, Ueland T, Andreassen OA, Simonsen C, Westlye LT, Melle I, Marquand A. A 10-Year Longitudinal Study of Brain Cortical Thickness in People with First-Episode Psychosis Using Normative Models. Schizophr Bull 2024; 51:95-107. [PMID: 38970378 PMCID: PMC11661960 DOI: 10.1093/schbul/sbae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2024]
Abstract
BACKGROUND Clinical forecasting models have potential to optimize treatment and improve outcomes in psychosis, but predicting long-term outcomes is challenging and long-term follow-up data are scarce. In this 10-year longitudinal study, we aimed to characterize the temporal evolution of cortical correlates of psychosis and their associations with symptoms. DESIGN Structural magnetic resonance imaging (MRI) from people with first-episode psychosis and controls (n = 79 and 218) were obtained at enrollment, after 12 months (n = 67 and 197), and 10 years (n = 23 and 77), within the Thematically Organized Psychosis (TOP) study. Normative models for cortical thickness estimated on public MRI datasets (n = 42 983) were applied to TOP data to obtain deviation scores for each region and timepoint. Positive and Negative Syndrome Scale (PANSS) scores were acquired at each timepoint along with registry data. Linear mixed effects models assessed effects of diagnosis, time, and their interactions on cortical deviations plus associations with symptoms. RESULTS LMEs revealed conditional main effects of diagnosis and time × diagnosis interactions in a distributed cortical network, where negative deviations in patients attenuate over time. In patients, symptoms also attenuate over time. LMEs revealed effects of anterior cingulate on PANSS total, and insular and orbitofrontal regions on PANSS negative scores. CONCLUSIONS This long-term longitudinal study revealed a distributed pattern of cortical differences which attenuated over time together with a reduction in symptoms. These findings are not in line with a simple neurodegenerative account of schizophrenia, and deviations from normative models offer a promising avenue to develop biomarkers to track clinical trajectories over time.
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Affiliation(s)
- Pierre Berthet
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Beathe C Haatveit
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Rikka Kjelkenes
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Amanda Worker
- Department of Psychosis Studies, Institute of Psychiatry, King’s College, London, UK
| | - Seyed Mostafa Kia
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Psychiatry, Utrecht University Medical Center, Utrecht, the Netherlands
- Department Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - Thomas Wolfers
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Saige Rutherford
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Dag Alnaes
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Richard Dinga
- Department Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - Mads L Pedersen
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Andreas Dahl
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Sara Fernandez-Cabello
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, King’s College, London, UK
| | - Ingrid Agartz
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Torill Ueland
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Carmen Simonsen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Andre Marquand
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
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2
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Xu R, Zhang X, Zhou S, Guo L, Mo F, Ma H, Zhu J, Qian Y. Brain structural damage networks at different stages of schizophrenia. Psychol Med 2024:1-11. [PMID: 39660416 DOI: 10.1017/s0033291724003088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2024]
Abstract
BACKGROUND Neuroimaging studies have documented brain structural changes in schizophrenia at different stages of the illness, including clinical high-risk (cHR), genetic high-risk (gHR), first-episode schizophrenia (FES), and chronic schizophrenia (ChS). There is growing awareness that neuropathological processes associated with a disease fail to map to a specific brain region but do map to a specific brain network. We sought to investigate brain structural damage networks across different stages of schizophrenia. METHODS We initially identified gray matter alterations in 523 cHR, 855 gHR, 2162 FES, and 2640 ChS individuals relative to 6963 healthy controls. By applying novel functional connectivity network mapping to large-scale discovery and validation resting-state functional magnetic resonance imaging datasets, we mapped these affected brain locations to four specific networks. RESULTS Brain structural damage networks of cHR and gHR had limited and non-overlapping spatial distributions, with the former mainly involving the frontoparietal network and the latter principally implicating the subcortical network, indicative of distinct neuropathological mechanisms underlying cHR and gHR. By contrast, brain structural damage networks of FES and ChS manifested as similar patterns of widespread brain areas predominantly involving the somatomotor, ventral attention, and subcortical networks, suggesting an emergence of more prominent brain structural abnormalities with illness onset that have trait-like stability over time. CONCLUSIONS Our findings may not only provide a refined picture of schizophrenia neuropathology from a network perspective, but also potentially contribute to more targeted and effective intervention strategies for individuals at different schizophrenia stages.
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Affiliation(s)
- Ruoxuan Xu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Xiaohan Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Shanlei Zhou
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Lixin Guo
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Fan Mo
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Haining Ma
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Research Center of Clinical Medical Imaging, Hefei 230032, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei 230032, China
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3
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Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404:572-628. [PMID: 39096926 DOI: 10.1016/s0140-6736(24)01296-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/08/2024] [Accepted: 06/16/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Ames
- National Ageing Research Institute, Melbourne, VIC, Australia; University of Melbourne Academic Unit for Psychiatry of Old Age, Melbourne, VIC, Australia
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Nick C Fox
- The Dementia Research Centre, Department of Neurodegenerative Disease, University College London, London, UK
| | - Cleusa P Ferri
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Laura N Gitlin
- College of Nursing and Health Professions, AgeWell Collaboratory, Drexel University, Philadelphia, PA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Noeline Nakasujja
- Department of Psychiatry College of Health Sciences, Makerere University College of Health Sciences, Makerere University, Kampala City, Uganda
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Kokoro Shirai
- Graduate School of Social and Environmental Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK; Université Paris Cité, Inserm U1153, Paris, France
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Yao Yao
- China Center for Health Development Studies, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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4
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Panikratova YR, Tomyshev AS, Abdullina EG, Rodionov GI, Arkhipov AY, Tikhonov DV, Bozhko OV, Kaleda VG, Strelets VB, Lebedeva IS. Resting-state functional connectivity correlates of brain structural aging in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01837-5. [PMID: 38914851 DOI: 10.1007/s00406-024-01837-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/27/2024] [Indexed: 06/26/2024]
Abstract
A large body of research has shown that schizophrenia patients demonstrate increased brain structural aging. Although this process may be coupled with aberrant changes in intrinsic functional architecture of the brain, they remain understudied. We hypothesized that there are brain regions whose whole-brain functional connectivity at rest is differently associated with brain structural aging in schizophrenia patients compared to healthy controls. Eighty-four male schizophrenia patients and eighty-six male healthy controls underwent structural MRI and resting-state fMRI. The brain-predicted age difference (b-PAD) was a measure of brain structural aging. Resting-state fMRI was applied to obtain global correlation (GCOR) maps comprising voxelwise values of the strength and sign of functional connectivity of a given voxel with the rest of the brain. Schizophrenia patients had higher b-PAD compared to controls (mean between-group difference + 2.9 years). Greater b-PAD in schizophrenia patients, compared to controls, was associated with lower whole-brain functional connectivity of a region in frontal orbital cortex, inferior frontal gyrus, Heschl's Gyrus, plana temporale and polare, insula, and opercular cortices of the right hemisphere (rFTI). According to post hoc seed-based correlation analysis, decrease of functional connectivity with the posterior cingulate gyrus, left superior temporal cortices, as well as right angular gyrus/superior lateral occipital cortex has mainly driven the results. Lower functional connectivity of the rFTI was related to worse verbal working memory and language production. Our findings demonstrate that well-established frontotemporal functional abnormalities in schizophrenia are related to increased brain structural aging.
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Affiliation(s)
| | | | | | - Georgiy I Rodionov
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Moscow, Russia
| | - Andrey Yu Arkhipov
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Moscow, Russia
| | | | | | | | - Valeria B Strelets
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Moscow, Russia
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5
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Wilson JC, Liu KY, Jones K, Mahmood J, Arya U, Howard R. Biomarkers of neurodegeneration in schizophrenia: systematic review and meta-analysis. BMJ MENTAL HEALTH 2024; 27:e301017. [PMID: 38796179 PMCID: PMC11129036 DOI: 10.1136/bmjment-2024-301017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/07/2024] [Indexed: 05/28/2024]
Abstract
QUESTION Does neurodegenerative disease underlie the increased rate of dementia observed in older people with schizophrenia? Several studies have reported a higher prevalence of dementia in people with schizophrenia compared with the general population. This may reflect a higher risk of developing neurodegenerative diseases such as vascular dementia or Alzheimer's disease (AD). Alternatively, this may reflect non-pathological, age-related cognitive decline in a population with low cognitive reserve. STUDY SELECTION AND ANALYSIS We reviewed papers that compared postmortem findings, hippocampal MRI volume or cerebrospinal fluid (CSF) markers of AD, between patients with schizophrenia with evidence of cognitive impairment (age ≥45 years) with controls. We subsequently performed a meta-analysis of postmortem studies that compared amyloid-β plaques (APs) or neurofibrillary tangles (NFTs) in cognitively impaired patients with schizophrenia to normal controls or an AD group. FINDINGS No studies found a significant increase of APs or NFTs in cognitively impaired patients with schizophrenia compared with controls. All postmortem studies that compared APs or NFTs in patients with schizophrenia to an AD group found significantly more APs or NFTs in AD. No studies found a significant differences in CSF total tau or phosphorylated tau between patients with schizophrenia and controls. The two studies which compared CSF Aβ42 between patients with schizophrenia and controls found significantly decreased CSF Aβ42 in schizophrenia compared with controls. Hippocampal volume findings were mixed. CONCLUSIONS Studies have not found higher rates of AD-related pathology in cognitively impaired individuals with schizophrenia compared with controls. Higher rates of dementia identified in population studies may reflect a lack of specificity in clinical diagnostic tools used to diagnose dementia.
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Affiliation(s)
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Katherine Jones
- Camden and Islington NHS Foundation Trust, London, London, UK
| | | | - Utkarsh Arya
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Rob Howard
- Division of Psychiatry, University College London, London, UK
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6
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Howes OD, Bukala BR, Beck K. Schizophrenia: from neurochemistry to circuits, symptoms and treatments. Nat Rev Neurol 2024; 20:22-35. [PMID: 38110704 DOI: 10.1038/s41582-023-00904-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/20/2023]
Abstract
Schizophrenia is a leading cause of global disability. Current pharmacotherapy for the disease predominantly uses one mechanism - dopamine D2 receptor blockade - but often shows limited efficacy and poor tolerability. These limitations highlight the need to better understand the aetiology of the disease to aid the development of alternative therapeutic approaches. Here, we review the latest meta-analyses and other findings on the neurobiology of prodromal, first-episode and chronic schizophrenia, and the link to psychotic symptoms, focusing on imaging evidence from people with the disorder. This evidence demonstrates regionally specific neurotransmitter alterations, including higher glutamate and dopamine measures in the basal ganglia, and lower glutamate, dopamine and γ-aminobutyric acid (GABA) levels in cortical regions, particularly the frontal cortex, relative to healthy individuals. We consider how dysfunction in cortico-thalamo-striatal-midbrain circuits might alter brain information processing to underlie psychotic symptoms. Finally, we discuss the implications of these findings for developing new, mechanistically based treatments and precision medicine for psychotic symptoms, as well as negative and cognitive symptoms.
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Affiliation(s)
- Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Faculty of Medicine, Institute of Clinical Sciences, Imperial College London, London, UK.
| | - Bernard R Bukala
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine Beck
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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7
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Zheng Y, Zhang Q, Zhou X, Yao L, Zhu Q, Fu Z. Altered levels of cytokine, T- and B-lymphocytes, and PD-1 expression rates in drug-naïve schizophrenia patients with acute phase. Sci Rep 2023; 13:21711. [PMID: 38066312 PMCID: PMC10709554 DOI: 10.1038/s41598-023-49206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
Many studies have investigated the changes of immune cells and proinflammatory cytokines in patients with acute schizophrenia, but few studies have investigated the functional phenotypes of immune cells and the expression rate of programmed cell death protein 1 (PD-1)/ programmed cell death-Ligand 1 (PD-L1). The aim of this study was to investigate the extent of immune cells activation, PD-1/PD-L1 expressions, and altered cytokine levels in drug-naïve schizophrenia patients with acute-phase. 23 drug-naïve schizophrenia patients in acute-phase and 23 healthy individuals were enrolled in this study as experimental and control groups, separately. Socio-demographic information including gender, age, duration of illness, and smoking status was collected for each subject. Beckman DXFLEX triple laser thirteen-color flow cytometer and self-contained software CytoFLEX flow cytometric analysis software were used to detect the expressions of PD-1/PD-L1 on CD4+/CD8+ T lymphocytes, B lymphocytes, monocytes and NK cells. BD Bioscience was used to examine the levels of cytokines including interferon (IFN)-γ, tumor necrosis factor (TNF)-α, Interleukin (IL)-2, IL-4, IL-6, and IL-10. Drug-naïve schizophrenia patients in acute-phase had higher levels of peripheral blood CD4+ T lymphocytes and B lymphocytes, higher PD-1 expression in B lymphocytes, and lower levels of CD8+ T lymphocytes. In addition, IL-6 levels of peripheral blood were higher in schizophrenia patients (all P < 0.05). Significant immune stress was present in schizophrenia patients with acute-phase.
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Affiliation(s)
- Yali Zheng
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Qi Zhang
- Hangzhou Normal University, Hangzhou, China
| | - Xianqin Zhou
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Linjuan Yao
- Hangzhou Di'an Medical Laboratory Center Co., Ltd, Hangzhou, China
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8
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Harikumar A, Solovyeva KP, Misiura M, Iraji A, Plis SM, Pearlson GD, Turner JA, Calhoun VD. Revisiting Functional Dysconnectivity: a Review of Three Model Frameworks in Schizophrenia. Curr Neurol Neurosci Rep 2023; 23:937-946. [PMID: 37999830 PMCID: PMC11126894 DOI: 10.1007/s11910-023-01325-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW Over the last decade, evidence suggests that a combination of behavioral and neuroimaging findings can help illuminate changes in functional dysconnectivity in schizophrenia. We review the recent connectivity literature considering several vital models, considering connectivity findings, and relationships with clinical symptoms. We reviewed resting state fMRI studies from 2017 to 2023. We summarized the role of two sets of brain networks (cerebello-thalamo-cortical (CTCC) and the triple network set) across three hypothesized models of schizophrenia etiology (neurodevelopmental, vulnerability-stress, and neurotransmitter hypotheses). RECENT FINDINGS The neurotransmitter and neurodevelopmental models best explained CTCC-subcortical dysfunction, which was consistently connected to symptom severity and motor symptoms. Triple network dysconnectivity was linked to deficits in executive functioning, and the salience network (SN)-default mode network dysconnectivity was tied to disordered thought and attentional deficits. This paper links behavioral symptoms of schizophrenia (symptom severity, motor, executive functioning, and attentional deficits) to various hypothesized mechanisms.
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Affiliation(s)
- Amritha Harikumar
- The Georgia State University/Georgia Institute of Technology/Emory University Center for Translational Research in Neuroimaging and Data Science (TReNDS Center), 55 Park Pl NE, Atlanta, GA, 30303, USA
| | - Kseniya P Solovyeva
- The Georgia State University/Georgia Institute of Technology/Emory University Center for Translational Research in Neuroimaging and Data Science (TReNDS Center), 55 Park Pl NE, Atlanta, GA, 30303, USA
| | - Maria Misiura
- The Georgia State University/Georgia Institute of Technology/Emory University Center for Translational Research in Neuroimaging and Data Science (TReNDS Center), 55 Park Pl NE, Atlanta, GA, 30303, USA
| | - Armin Iraji
- The Georgia State University/Georgia Institute of Technology/Emory University Center for Translational Research in Neuroimaging and Data Science (TReNDS Center), 55 Park Pl NE, Atlanta, GA, 30303, USA
| | - Sergey M Plis
- The Georgia State University/Georgia Institute of Technology/Emory University Center for Translational Research in Neuroimaging and Data Science (TReNDS Center), 55 Park Pl NE, Atlanta, GA, 30303, USA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Jessica A Turner
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Vince D Calhoun
- The Georgia State University/Georgia Institute of Technology/Emory University Center for Translational Research in Neuroimaging and Data Science (TReNDS Center), 55 Park Pl NE, Atlanta, GA, 30303, USA.
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9
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Wang R, Peterson Z, Balasubramanian N, Khan KM, Chimenti MS, Thedens D, Nickl-Jockschat T, Marcinkiewcz CA. Lateral Septal Circuits Govern Schizophrenia-Like Effects of Ketamine on Social Behavior. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.08.552372. [PMID: 37609170 PMCID: PMC10441349 DOI: 10.1101/2023.08.08.552372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Schizophrenia is marked by poor social functioning that can have a severe impact on quality of life and independence, but the underlying neural circuity is not well understood. Here we used a translational model of subanesthetic ketamine in mice to delineate neural pathways in the brain linked to social deficits in schizophrenia. Mice treated with chronic ketamine (30 mg/kg/day for 10 days) exhibit profound social and sensorimotor deficits as previously reported. Using three- dimensional c-Fos immunolabeling and volume imaging (iDISCO), we show that ketamine treatment resulted in hypoactivation of the lateral septum (LS) in response to social stimuli. Chemogenetic activation of the LS rescued social deficits after ketamine treatment, while chemogenetic inhibition of previously active populations in the LS (i.e. social engram neurons) recapitulated social deficits in ketamine-naïve mice. We then examined the translatome of LS social engram neurons and found that ketamine treatment dysregulated genes implicated in neuronal excitability and apoptosis, which may contribute to LS hypoactivation. We also identified 38 differentially expressed genes (DEGs) in common with human schizophrenia, including those involved in mitochondrial function, apoptosis, and neuroinflammatory pathways. Chemogenetic activation of LS social engram neurons induced downstream activity in the ventral part of the basolateral amygdala, subparafascicular nucleus of the thalamus, intercalated amygdalar nucleus, olfactory areas, and dentate gyrus, and it also reduces connectivity of the LS with the piriform cortex and caudate-putamen. In sum, schizophrenia-like social deficits may emerge via changes in the intrinsic excitability of a discrete subpopulation of LS neurons that serve as a central hub to coordinate social behavior via downstream projections to reward, fear extinction, motor and sensory processing regions of the brain.
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10
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Silva C, Rebelo M, Chendo I. Managing antipsychotic-related sexual dysfunction in patients with schizophrenia. Expert Rev Neurother 2023; 23:1147-1155. [PMID: 37941377 DOI: 10.1080/14737175.2023.2281399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Schizophrenia is a psychotic disorder and one of the most severe and impactful mental illnesses. Sexual dysfunction is highly prevalent in patients with schizophrenia but remains underdiagnosed and undertreated. Sexual dysfunction is frequently attributed to antipsychotics which may reduce medication adherence, but negative symptoms can also reduce sexual drive. AREAS COVERED This review provides an overview of the current knowledge about sexual dysfunction in patients with schizophrenia. The authors first review the literature concerning the mechanisms of sexual dysfunction and explore the impact of antipsychotics on sexual function. Finally, they present the available non-pharmacological and pharmacological treatment strategies for sexual dysfunction in patients with schizophrenia. EXPERT OPINION Sexual dysfunction in patients with schizophrenia is still underrated by clinicians despite having a negative impact on the quality of life and therapeutic adherence. Antipsychotic treatment is still perceived as a major cause of sexual impairment. Psychiatrists must be aware of this condition and actively question the patients. A comprehensive approach, addressing pharmacological and non-pharmacological aspects, is fundamental for managing sexual dysfunction in schizophrenia. Pharmacological strategies include (1) Serum-level adjustment of the antipsychotic dose, if possible (2) switching to a well-tolerable antipsychotic (aripiprazole, brexpiprazole) and (3) adding a coadjuvant drug (phosphodiesterase-5 inhibitors).
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Affiliation(s)
- Carlos Silva
- Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marta Rebelo
- Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal
| | - Inês Chendo
- Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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11
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Efficacy of Serotonin and Dopamine Activity Modulators in the Treatment of Negative Symptoms in Schizophrenia: A Rapid Review. Biomedicines 2023; 11:biomedicines11030921. [PMID: 36979900 PMCID: PMC10046337 DOI: 10.3390/biomedicines11030921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Schizophrenia is among the fifteen most disabling diseases worldwide. Negative symptoms (NS) are highly prevalent in schizophrenia, negatively affect the functional outcome of the disorder, and their treatment is difficult and rarely specifically investigated. Serotonin-dopamine activity modulators (SDAMs), of which aripiprazole, cariprazine, brexpiprazole, and lumateperone were approved for schizophrenia treatment, represent a possible therapy to reduce NS. The aim of this rapid review is to summarize the evidence on this topic to make it readily available for psychiatrists treating NS and for further research. We searched the PubMed database for original studies using SDAM, aripiprazole, cariprazine, brexpiprazole, lumateperone, schizophrenia, and NS as keywords. We included four mega-analyses, eight meta-analyses, two post hoc analyses, and 20 clinical trials. Aripiprazole, cariprazine, and brexpiprazole were more effective than placebo in reducing NS. Only six studies compared SDAMs with other classes of antipsychotics, demonstrating a superiority in the treatment of NS mainly for cariprazine. The lack of specific research and various methodological issues, related to the study population and the assessment of NS, may have led to these partial results. Here, we highlight the need to conduct new methodologically robust investigations with head-to-head treatment comparisons and long-term observational studies on homogeneous groups of patients evaluating persistent NS with first- and second-generation scales, namely the Brief Negative Symptom Scale and the Clinical Assessment Interview for Negative Symptoms. This rapid review can expand research on NS therapeutic strategies in schizophrenia, which is fundamental for the long-term improvement of patients’ quality of life.
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12
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Fu Y, Niu M, Gao Y, Dong S, Huang Y, Zhang Z, Zhuo C. Altered nonlinear Granger causality interactions in the large-scale brain networks of patients with schizophrenia. J Neural Eng 2022; 19. [PMID: 36579785 DOI: 10.1088/1741-2552/acabe7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Objective.It has been demonstrated that schizophrenia (SZ) is characterized by functional dysconnectivity involving extensive brain networks. However, the majority of previous studies utilizing resting-state functional magnetic resonance imaging (fMRI) to infer abnormal functional connectivity (FC) in patients with SZ have focused on the linear correlation that one brain region may influence another, ignoring the inherently nonlinear properties of fMRI signals.Approach. In this paper, we present a neural Granger causality (NGC) technique for examining the changes in SZ's nonlinear causal couplings. We develop static and dynamic NGC-based analyses of large-scale brain networks at several network levels, estimating complicated temporal and causal relationships in SZ patients.Main results. We find that the NGC-based FC matrices can detect large and significant differences between the SZ and healthy control groups at both the regional and subnetwork scales. These differences are persistent and significantly overlapped at various network sparsities regardless of whether the brain networks were built using static or dynamic techniques. In addition, compared to controls, patients with SZ exhibited extensive NGC confusion patterns throughout the entire brain.Significance. These findings imply that the NGC-based FCs may be a useful method for quantifying the abnormalities in the causal influences of patients with SZ, hence shedding fresh light on the pathophysiology of this disorder.
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Affiliation(s)
- Yu Fu
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Meng Niu
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, People's Republic of China
| | - Yuanhang Gao
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Shunjie Dong
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Yanyan Huang
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Zhe Zhang
- School of Physics, Hangzhou Normal University, Hangzhou, People's Republic of China.,Institute of Brain Science, Hangzhou Normal University, Hangzhou, People's Republic of China
| | - Cheng Zhuo
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, People's Republic of China.,Key Laboratory of Collaborative Sensing and Autonomous Unmanned Systems of Zhejiang Province, Hangzhou, People's Republic of China
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13
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Jutla A, Foss-Feig J, Veenstra-VanderWeele J. Autism spectrum disorder and schizophrenia: An updated conceptual review. Autism Res 2022; 15:384-412. [PMID: 34967130 PMCID: PMC8931527 DOI: 10.1002/aur.2659] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/08/2021] [Accepted: 12/12/2021] [Indexed: 12/19/2022]
Abstract
Autism spectrum disorder (ASD) and schizophrenia (SCZ) are separate disorders, with distinct clinical profiles and natural histories. ASD, typically diagnosed in childhood, is characterized by restricted or repetitive interests or behaviors and impaired social communication, and it tends to have a stable course. SCZ, typically diagnosed in adolescence or adulthood, is characterized by hallucinations and delusions, and tends to be associated with declining function. However, youth with ASD are three to six times more likely to develop SCZ than their neurotypical counterparts, and increasingly, research has shown that ASD and SCZ converge at several levels. We conducted a systematic review of studies since 2013 relevant to understanding this convergence, and present here a narrative synthesis of key findings, which we have organized into four broad categories: symptoms and behavior, perception and cognition, biomarkers, and genetic and environmental risk. We then discuss opportunities for future research into the phenomenology and neurobiology of overlap between ASD and SCZ. Understanding this overlap will allow for researchers, and eventually clinicians, to understand the factors that may make a child with ASD vulnerable to developing SCZ. LAY SUMMARY: Autism spectrum disorder and schizophrenia are distinct diagnoses, but people with autism and people with schizophrena share several characteristics. We review recent studies that have examined these areas of overlap, and discuss the kinds of studies we will need to better understand how these disorders are related. Understanding this will be important to help us identify which autistic children are at risk of developing schizophrenia.
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Affiliation(s)
- Amandeep Jutla
- Columbia University Vagelos College of Physicians and
Surgeons, 630 W 168th St, New York, NY 10032, United States
- New York State Psychiatric Institute, 1051 Riverside
Drive, Mail Unit 78, New York, NY 10032, United States
| | - Jennifer Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn
School of Medicine at Mount Sinai, Department of Psychiatry, 1 Gustave L. Levy
Place, Box 1230, New York, NY 10029, United States
| | - Jeremy Veenstra-VanderWeele
- Columbia University Vagelos College of Physicians and
Surgeons, 630 W 168th St, New York, NY 10032, United States
- New York State Psychiatric Institute, 1051 Riverside
Drive, Mail Unit 78, New York, NY 10032, United States
- Center for Autism and the Developing Brain, New
York-Presbyterian Westchester Behavioral Health Center, 21 Bloomingdale Road, White
Plains, NY 10605, United States
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14
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Zong X, Zhang Q, He C, Huang X, Zhang J, Wang G, Lv L, Sang D, Zou X, Chen H, Zheng J, Hu M. DNA Methylation Basis in the Effect of White Matter Integrity Deficits on Cognitive Impairments and Psychopathological Symptoms in Drug-Naive First-Episode Schizophrenia. Front Psychiatry 2021; 12:777407. [PMID: 34966308 PMCID: PMC8710603 DOI: 10.3389/fpsyt.2021.777407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mounting evidence from diffusion tensor imaging (DTI) and epigenetic studies, respectively, confirmed the abnormal alterations of brain white matter integrity and DNA methylation (DNAm) in schizophrenia. However, few studies have been carried out in the same sample to simultaneously explore the WM pathology relating to clinical behaviors, as well as the DNA methylation basis underlying the WM deficits. Methods: We performed DTI scans in 42 treatment-naïve first-episode schizophrenia patients and 38 healthy controls. Voxel-based method of fractional anisotropy (FA) derived from DTI was used to assess WM integrity. Participants' peripheral blood genomic DNAm status, quantified by using Infinium® Human Methylation 450K BeadChip, was examined in parallel with DTI scanning. Participants completed Digit Span test and Trail Making test, as well as Positive and Negative Syndrome Scale measurement. We acquired genes that are differentially expressed in the brain regions with abnormal FA values according to the Allen anatomically comprehensive atlas, obtained DNAm levels of the corresponding genes, and then performed Z-test to compare the differential epigenetic-imaging associations (DEIAs) between the two groups. Results: Significant decreases of FA values in the patient group were in the right middle temporal lobe WM, right cuneus WM, right anterior cingulate WM, and right inferior parietal lobe WM, while the significant increases were in the bilateral middle cingulate WM (Ps < 0.01, GRF correction). Abnormal FA values were correlated with patients' clinical symptoms and cognitive impairments. In the DEIAs, patients showed abnormal couple patterns between altered FA and DNAm components, for which the enriched biological processes and pathways could be largely grouped into three biological procedures: the neurocognition, immune, and nervous system. Conclusion: Schizophrenia may not cause widespread neuropathological changes, but subtle alterations affecting local cingulum WM, which may play a critical role in positive symptoms and cognitive impairments. This imaging-epigenetics study revealed for the first time that DNAm of genes enriched in neuronal, immunologic, and cognitive processes may serve as the basis in the effect of WM deficits on clinical behaviors in schizophrenia.
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Affiliation(s)
- Xiaofen Zong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qinran Zhang
- School of Mathematics and Statistics, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Computational Science, Wuhan University, Wuhan, China
| | - Changchun He
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyue Huang
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiangbo Zhang
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Deen Sang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xiufen Zou
- School of Mathematics and Statistics, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Computational Science, Wuhan University, Wuhan, China
| | - Huafu Chen
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Junjie Zheng
- Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
| | - Maolin Hu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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15
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Relationship of Corpus Callosum Integrity with Working Memory, Planning, and Speed of Processing in Patients with First-Episode and Chronic Schizophrenia. J Clin Med 2021; 10:jcm10143158. [PMID: 34300325 PMCID: PMC8304050 DOI: 10.3390/jcm10143158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022] Open
Abstract
There is a paucity of reports examining the relationship between the integrity of the corpus callosum (CC) and different aspects of cognitive functioning in patients with first-episode (FES) and chronic schizophrenia (CS) simultaneously; furthermore, what results exist are inconclusive. We used diffusion tensor imaging tractography to investigate differences in integrity in five regions of the CC between FES, CS, and healthy controls (HC). Additionally, we analyzed correlations between these regions' integrity and working memory, planning, and speed of processing. Eighteen patients with FES, 55 patients with CS, and 30 HC took part in the study. We assessed cognitive functions with four tasks from Measurement and Treatment Research to Improve Cognition in Schizophrenia. Patients with CS showed lower fractional anisotropy (FA) in Region 5 (statistical trend) and higher mean diffusivity (MD) in Regions 4 and 5 than HC, and patients with FES had higher MD in Region 3 (statistical trend) than HC. Both clinical groups performed worse on working memory and speed of processing tasks than HC, and patients with CS scored worse than HC on independent planning, and worse than FES and HC on dependent planning. Moreover, in patients with CS, MD in Region 3 was correlated with verbal working memory. Our results suggest that patients with FES and CS are characterized by impaired integrity of the middle and posterior CC, respectively. We confirmed that both clinical groups have cognitive impairments. Moreover, the integrity of the middle CC may influence planning in patients with CS.
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16
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Teetharatkul T, Vitayanont A, Liabsuetrakul T, Aunjitsakul W. Associations between symptom severity and well-being among Thai patients with schizophrenia: a cross-sectional analytical study. BMC Psychiatry 2021; 21:348. [PMID: 34253169 PMCID: PMC8276510 DOI: 10.1186/s12888-021-03358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/30/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Severity of symptoms in patients with schizophrenia is a determinant of patient's well-being, but evidence in low- and middle-income countries is limited. We aimed to measure the symptom severity using objective measurements, the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity scale (CGI-S), and their associations with well-being in patients with schizophrenia. METHODS Patients with schizophrenia aged ≥18 years, without active psychosis including no history of hospitalization within the last 6 months, were included. Symptom severity was measured by the clinicians using BPRS and CGI-S. The patients' well-being was assessed by self-report using the Subjective Well-being under Neuroleptic treatment scale (SWN) as continuous and binary outcomes (categorized into adequate or poor well-being). Correlations between symptom severity (BPRS and CGI-S scores) and well-being (SWN score) were analyzed using Pearson's correlation. Association between well-being status and BPRS was analyzed using multivariate logistic regression. RESULTS Of 150 patients, BPRS and CGI-S were inversely correlated with SWN score (r = - 0.47; p < 0.001 and - 0.21; p < 0.01, respectively). BPRS Affect domain had the highest correlation with SWN (r = - 0.51, p < 0.001). In multivariate logistic regression, BPRS score and being unemployed were associated with poor well-being status (adjusted OR 1.08; 95%CI 1.02-1.14; p = 0.006, and 4.01; 95%CI 1.38-11.7; p = 0.011, respectively). CONCLUSION Inverse relationships between symptom severity and well-being score were found. Higher BPRS Affect domain was significantly associated with lower patients' well-being. The use of BPRS tool into routine clinical practice could serve as an adjunct to physician's clinical evaluation of patients' symptoms and may help improve patient's well-being. Further research on negative symptoms associated with well-being is required.
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Affiliation(s)
- Teerapat Teetharatkul
- grid.7130.50000 0004 0470 1162Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Arnont Vitayanont
- grid.7130.50000 0004 0470 1162Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Tippawan Liabsuetrakul
- grid.7130.50000 0004 0470 1162Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110 Thailand
| | - Warut Aunjitsakul
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
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17
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Waszczuk K, Rek-Owodziń K, Tyburski E, Mak M, Misiak B, Samochowiec J. Disturbances in White Matter Integrity in the Ultra-High-Risk Psychosis State-A Systematic Review. J Clin Med 2021; 10:jcm10112515. [PMID: 34204171 PMCID: PMC8201371 DOI: 10.3390/jcm10112515] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/29/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022] Open
Abstract
Schizophrenia is a severe and disabling mental illness whose etiology still remains unclear. The available literature indicates that there exist white matter (WM) abnormalities in people with schizophrenia spectrum disorders. Recent developments in modern neuroimaging methods have enabled the identification of the structure, morphology, and function of the underlying WM fibers in vivo. The purpose of this paper is to review the existing evidence about WM abnormalities in individuals at ultra-high risk of psychosis (UHR) with the use of diffusion tensor imaging (DTI) available from the National Center for Biotechnology Information PubMed (Medline) and Health Source: Nursing/Academic Edition databases. Of 358 relevant articles identified, 25 papers published in the years 2008–2020 were ultimately included in the review. Most of them supported the presence of subtle aberrations in WM in UHR individuals, especially in the superior longitudinal fasciculus (SLF), the inferior longitudinal fasciculus (ILF), and the inferior fronto-occipital fasciculus (IFOF). These alterations may therefore be considered a promising neurobiological marker for the risk of psychosis. However, due to methodological discrepancies and the relative scarcity of evidence, further investigation is called for, especially into connectome analysis in UHR patients.
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Affiliation(s)
- Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland;
- Correspondence: ; Tel./Fax: +48-91-35-11-358
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.)
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Tadeusza Kutrzeby 10 Street, 61-719 Poznan, Poland;
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.)
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, K. Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland;
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland;
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18
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Wang P, Li M, Zhao A, Ma J. Application of animal experimental models in the research of schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2021; 186:209-227. [PMID: 34155806 DOI: 10.1002/ajmg.b.32863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/04/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022]
Abstract
Schizophrenia is a relatively common but serious mental illness that results in a heavy burden to patients, their families, and society. The disease can be triggered by multiple factors, while the specific pathogenesis remains unclear. The development of effective therapeutic drugs for schizophrenia relies on a comprehensive understanding of the basic biology and pathophysiology of the disease. Therefore, effective animal experimental models play a vital role in the study of schizophrenia. Based on different molecular mechanisms and modeling methods, the currently used experimental animal experimental models of schizophrenia can be divided into four categories that can better simulate the clinical symptoms and the interplay between susceptible genes and the environment: neurodevelopmental, drug-induced, genetic-engineering, and genetic-environmental interaction of animal experimental models. Each of these categories contains multiple subtypes, which has its own advantages and disadvantages and therefore requires careful selection in a research application. The emergence and utilization of these models are promising in the prediction of the risk of schizophrenia at the molecular level, which will shed light on effective and targeted treatment at the genetic level.
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Affiliation(s)
- Pengjie Wang
- Medical Research Center, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China.,Department of Electron Microscope, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Manling Li
- School of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Gui Yang, Guizhou, China
| | - Aizhen Zhao
- Medical Research Center, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Jie Ma
- Medical Research Center, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China.,Department of Electron Microscope, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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19
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Kochunov P, Zavaliangos-Petropulu A, Jahanshad N, Thompson PM, Ryan MC, Chiappelli J, Chen S, Du X, Hatch K, Adhikari B, Sampath H, Hare S, Kvarta M, Goldwaser E, Yang F, Olvera RL, Fox PT, Curran JE, Blangero J, Glahn DC, Tan Y, Hong LE. A White Matter Connection of Schizophrenia and Alzheimer's Disease. Schizophr Bull 2021; 47:197-206. [PMID: 32681179 PMCID: PMC7825012 DOI: 10.1093/schbul/sbaa078] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Schizophrenia (SZ) is a severe psychiatric illness associated with an elevated risk for developing Alzheimer's disease (AD). Both SZ and AD have white matter abnormalities and cognitive deficits as core disease features. We hypothesized that aging in SZ patients may be associated with the development of cerebral white matter deficit patterns similar to those observed in AD. We identified and replicated aging-related increases in the similarity between white matter deficit patterns in patients with SZ and AD. The white matter "regional vulnerability index" (RVI) for AD was significantly higher in SZ patients compared with healthy controls in both the independent discovery (Cohen's d = 0.44, P = 1·10-5, N = 173 patients/230 control) and replication (Cohen's d = 0.78, P = 9·10-7, N = 122 patients/64 controls) samples. The degree of overlap with the AD deficit pattern was significantly correlated with age in patients (r = .21 and .29, P < .01 in discovery and replication cohorts, respectively) but not in controls. Elevated RVI-AD was significantly associated with cognitive measures in both SZ and AD. Disease and cognitive specificities were also tested in patients with mild cognitive impairment and showed intermediate overlap. SZ and AD have diverse etiologies and clinical courses; our findings suggest that white matter deficits may represent a key intersecting point for these 2 otherwise distinct diseases. Identifying mechanisms underlying this white matter deficit pattern may yield preventative and treatment targets for cognitive deficits in both SZ and AD patients.
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Affiliation(s)
- Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Artemis Zavaliangos-Petropulu
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California of USC, Marina del Rey, CA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California of USC, Marina del Rey, CA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California of USC, Marina del Rey, CA
| | - Meghann C Ryan
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Joshua Chiappelli
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Shuo Chen
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Xiaoming Du
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Kathryn Hatch
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Bhim Adhikari
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Hemalatha Sampath
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Stephanie Hare
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Mark Kvarta
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Eric Goldwaser
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Rene L Olvera
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Joanne E Curran
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX
| | - David C Glahn
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
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20
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Liloia D, Brasso C, Cauda F, Mancuso L, Nani A, Manuello J, Costa T, Duca S, Rocca P. Updating and characterizing neuroanatomical markers in high-risk subjects, recently diagnosed and chronic patients with schizophrenia: A revised coordinate-based meta-analysis. Neurosci Biobehav Rev 2021; 123:83-103. [PMID: 33497790 DOI: 10.1016/j.neubiorev.2021.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 01/10/2023]
Abstract
Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess pathophysiological models of how the disorder develops is an important target for the clinical practice. We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization. Results reveal a cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region found altered among c-HR, RDSZ and ChSZ. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ. These findings support the current neuroprogressive models of SZ and integrate this deterioration with the clinical evolution of the disease.
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Affiliation(s)
- Donato Liloia
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Claudio Brasso
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
| | - Franco Cauda
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
| | - Lorenzo Mancuso
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Andrea Nani
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Jordi Manuello
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Tommaso Costa
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
| | - Paola Rocca
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy.
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21
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Cauda F, Nani A, Liloia D, Manuello J, Premi E, Duca S, Fox PT, Costa T. Finding specificity in structural brain alterations through Bayesian reverse inference. Hum Brain Mapp 2020; 41:4155-4172. [PMID: 32829507 PMCID: PMC7502845 DOI: 10.1002/hbm.25105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/19/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022] Open
Abstract
In the field of neuroimaging reverse inferences can lead us to suppose the involvement of cognitive processes from certain patterns of brain activity. However, the same reasoning holds if we substitute "brain activity" with "brain alteration" and "cognitive process" with "brain disorder." The fact that different brain disorders exhibit a high degree of overlap in their patterns of structural alterations makes forward inference-based analyses less suitable for identifying brain areas whose alteration is specific to a certain pathology. In the forward inference-based analyses, in fact, it is impossible to distinguish between areas that are altered by the majority of brain disorders and areas that are specifically affected by certain diseases. To address this issue and allow the identification of highly pathology-specific altered areas we used the Bayes' factor technique, which was employed, as a proof of concept, on voxel-based morphometry data of schizophrenia and Alzheimer's disease. This technique allows to calculate the ratio between the likelihoods of two alternative hypotheses (in our case, that the alteration of the voxel is specific for the brain disorder under scrutiny or that the alteration is not specific). We then performed temporal simulations of the alterations' spread associated with different pathologies. The Bayes' factor values calculated on these simulated data were able to reveal that the areas, which are more specific to a certain disease, are also the ones to be early altered. This study puts forward a new analytical instrument capable of innovating the methodological approach to the investigation of brain pathology.
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Affiliation(s)
- Franco Cauda
- GCS‐fMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Department of PsychologyUniversity of TurinTurinItaly
- FOCUS Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Andrea Nani
- GCS‐fMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Department of PsychologyUniversity of TurinTurinItaly
- FOCUS Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Donato Liloia
- GCS‐fMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Department of PsychologyUniversity of TurinTurinItaly
- FOCUS Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Jordi Manuello
- GCS‐fMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Department of PsychologyUniversity of TurinTurinItaly
- FOCUS Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Enrico Premi
- Stroke Unit, Azienda Socio Sanitaria Territoriale Spedali CiviliSpedali Civili HospitalBresciaItaly
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Sergio Duca
- GCS‐fMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
| | - Peter T. Fox
- Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
- South Texas Veterans Health Care SystemSan AntonioTexasUSA
| | - Tommaso Costa
- GCS‐fMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Department of PsychologyUniversity of TurinTurinItaly
- FOCUS Lab, Department of PsychologyUniversity of TurinTurinItaly
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22
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Kochunov P, Fan F, Ryan MC, Hatch KS, Tan S, Jahanshad N, Thompson PM, van Erp TGM, Turner JA, Chen S, Du X, Adhikari B, Bruce H, Hare S, Goldwaser E, Kvarta M, Huang J, Tong J, Cui Y, Cao B, Tan Y, Hong LE. Translating ENIGMA schizophrenia findings using the regional vulnerability index: Association with cognition, symptoms, and disease trajectory. Hum Brain Mapp 2020; 43:566-575. [PMID: 32463560 PMCID: PMC8675428 DOI: 10.1002/hbm.25045] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022] Open
Abstract
Patients with schizophrenia have patterns of brain deficits including reduced cortical thickness, subcortical gray matter volumes, and cerebral white matter integrity. We proposed the regional vulnerability index (RVI) to translate the results of Enhancing Neuro Imaging Genetics Meta-Analysis studies to the individual level. We calculated RVIs for cortical, subcortical, and white matter measurements and a multimodality RVI. We evaluated RVI as a measure sensitive to schizophrenia-specific neuroanatomical deficits and symptoms and studied the timeline of deficit formations in: early (≤5 years since diagnosis, N = 45, age = 28.8 ± 8.5); intermediate (6-20 years, N = 30, age 43.3 ± 8.6); and chronic (21+ years, N = 44, age = 52.5 ± 5.2) patients and healthy controls (N = 76, age = 38.6 ± 12.4). All RVIs were significantly elevated in patients compared to controls, with the multimodal RVI showing the largest effect size, followed by cortical, white matter and subcortical RVIs (d = 1.57, 1.23, 1.09, and 0.61, all p < 10-6 ). Multimodal RVI was significantly correlated with multiple cognitive variables including measures of visual learning, working memory and the total score of the MATRICS consensus cognitive battery, and with negative symptoms. The multimodality and white matter RVIs were significantly elevated in the intermediate and chronic versus early diagnosis group, consistent with ongoing progression. Cortical RVI was stable in the three disease-duration groups, suggesting neurodevelopmental origins of cortical deficits. In summary, neuroanatomical deficits in schizophrenia affect the entire brain; the heterochronicity of their appearance indicates both the neurodevelopmental and progressive nature of this illness. These deficit patterns may be useful for early diagnosis and as quantitative targets for more effective treatment strategies aiming to alter these neuroanatomical deficit patterns.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Fengmei Fan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, People's Republic of China
| | - Meghann C Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kathryn S Hatch
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shuping Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, People's Republic of China
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Theo G M van Erp
- Department of Psychiatry, University of California Irvine, Irvine, California, USA
| | - Jessica A Turner
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bhim Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Stephanie Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Eric Goldwaser
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mark Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Junchao Huang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, People's Republic of China
| | - Jinghui Tong
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, People's Republic of China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Baopeng Cao
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, People's Republic of China
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, People's Republic of China
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
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23
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Abstract
IMPORTANCE Schizophrenia is a common, severe mental illness that most clinicians will encounter regularly during their practice. This report provides an overview of the clinical characteristics, epidemiology, genetics, neuroscience, and psychopharmacology of schizophrenia to provide a basis to understand the disorder and its treatment. This educational review is integrated with a clinical case to highlight how recent research findings can inform clinical understanding. OBSERVATIONS The first theme considered is the role of early-life environmental and genetic risk factors in altering neurodevelopmental trajectories to predispose an individual to the disorder and leading to the development of prodromal symptoms. The second theme is the role of cortical excitatory-inhibitory imbalance in the development of the cognitive and negative symptoms of the disorder. The third theme considers the role of psychosocial stressors, psychological factors, and subcortical dopamine dysfunction in the onset of the positive symptoms of the disorder. The final theme considers the mechanisms underlying treatment for schizophrenia and common adverse effects of treatment. CONCLUSIONS AND RELEVANCE Schizophrenia has a complex presentation with a multifactorial cause. Nevertheless, advances in neuroscience have identified roles for key circuits, particularly involving frontal, temporal, and mesostriatal brain regions, in the development of positive, negative, and cognitive symptoms. Current pharmacological treatments operate using the same mechanism, blockade of dopamine D2 receptor, which contribute to their adverse effects. However, the circuit mechanisms discussed herein identify novel potential treatment targets that may be of particular benefit in symptom domains not well served by existing medications.
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Affiliation(s)
- Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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24
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Rivas-Grajales AM, Savadjiev P, Kubicki M, Nestor PG, Niznikiewicz M, McCarley RW, Westin CF, Shenton ME, Levitt JJ. Striato-nigro-striatal tract dispersion abnormalities in patients with chronic schizophrenia. Brain Imaging Behav 2020; 13:1236-1245. [PMID: 30109597 DOI: 10.1007/s11682-018-9934-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The white matter connections between the midbrain dopamine neurons and the striatum are part of a neural system involved in reward-based learning, a process that is impaired in patients with schizophrenia. The striato-nigro-striatal (SNS) tract, which participates in this process, has not as yet been explored. The present study aimed to use diffusion MRI (dMRI) to delineate the SNS tract, and to compare the application of two dMRI measures, Tract Dispersion (TD), an index of white matter morphology, and Fractional Anisotropy (FA), an index of white matter integrity, to detect group differences between patients with chronic schizophrenia (CSZ) and healthy controls (HC). dMRI scans were acquired in 22 male patients with CSZ and 23 age-matched HC. Two-tensor tractography was used in addition to manually-delineated regions of interest to extract the SNS tract. A mixed-model analysis of variance was used to investigate differences in TD and FA between CSZ patients and HC. The associations between TD and behavioral measures were also explored. Patients and controls differed significantly in TD (P = 0.04), but not in FA (P = 0.69). The group differences in TD were driven by a higher TD in the right hemisphere in the CSZ group. Higher TD correlated significantly with poorer performance in the Iowa Gambling Task (IGT) when combining the scores of both groups. The findings suggest that dysconnectiviy of the SNS tract which is associated with schizophrenia, could arise from abnormalities in white matter morphology. These abnormalities may potentially reflect irregularities in brain development.
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Affiliation(s)
- Ana María Rivas-Grajales
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Peter Savadjiev
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul G Nestor
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Margaret Niznikiewicz
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Robert W McCarley
- Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Carl-Fredrik Westin
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - James J Levitt
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Psychiatry, VA Boston Healthcare System, Brockton Division, Brockton, MA, USA.
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25
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Matsuda Y, Makinodan M, Morimoto T, Kishimoto T. Neural changes following cognitive remediation therapy for schizophrenia. Psychiatry Clin Neurosci 2019; 73:676-684. [PMID: 31278805 DOI: 10.1111/pcn.12912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/13/2019] [Accepted: 07/01/2019] [Indexed: 01/15/2023]
Abstract
Patients with schizophrenia experience cognitive impairments that relate to poorer social functioning even after amelioration of positive symptoms. Pharmacological treatment and cognitive remediation are the two important therapeutic approaches for cognitive impairment in schizophrenia. Cognitive remediation therapy (CRT) for schizophrenia improves cognitive functioning and induces neuroplasticity, but different approaches and durations of CRT and different neuroimaging devices have led to varying results in meta-analyses. The objective of this review was to explore the impact of CRT on neurobiology. Several studies have provided evidence of increased activation in the frontal brain regions, such as the prefrontal cortex, anterior cingulate cortex, and parietal and occipital regions during working memory or executive function tasks after CRT. Two studies have shown alterations in resting-state connectivity between the prefrontal cortex and temporal regions. Two studies have reported that CRT induces changes in gray matter volume in the hippocampus. Further, one study observed that patients who had received CRT had elevated fractional anisotropy in the basal ganglia. We conclude that neuroimaging studies assessing CRT in patients with schizophrenia showed functional, structural, and connectivity changes that were positively correlated with cognitive improvements despite heterogeneous CRT approaches. Future studies that combine multiple modalities are required to address the differences, effects of intrinsic motivation, and pharmacological augmentation of CRT. Further understanding of the biological basis might lead to predictions of the CRT response in patients with schizophrenia and contribute to identification of schizophrenia patients for future interventions.
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Affiliation(s)
- Yasuhiro Matsuda
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Tsubasa Morimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Nara, Japan
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26
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Rabanea-Souza T, Cirigola SMC, Noto C, Gomes JS, Azevedo CC, Gadelha A, Cordeiro Q, Dias ÁM, Lacerda ALT. Evaluation of the efficacy of transcranial direct current stimulation in the treatment of cognitive symptomatology in the early stages of psychosis: study protocol for a double-blind randomized controlled trial. Trials 2019; 20:199. [PMID: 30953544 PMCID: PMC6451248 DOI: 10.1186/s13063-019-3288-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 03/13/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cognitive deficits are core symptoms of schizophrenia that occur from the early stages of the disorder. There is reliable evidence that cognitive deficits are associated with outcomes in schizophrenia; thus, early treatment could be particularly important. Studies with different neuromodulation techniques involving subjects with schizophrenia suggest that application of transcranial direct current stimulation (tDCS) with inhibitory stimulation over the left temporo-parietal cortex and excitatory stimulation over the left dorsolateral prefrontal cortex could ameliorate positive, negative, and cognitive symptoms. The aim of the present study protocol is to evaluate the efficacy of tDCS in the treatment of cognitive symptomatology in the early stages of psychosis. METHODS/DESIGN Seventy patients in the early stages of psychosis will be randomly allocated to receive 20 min of active 2-mA tDCS or sham stimulation once a day for 10 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporo-parietal cortex. Neuropsychological and psychiatric assessments will be performed at baseline and at 1 and 3 months following the end of the intervention (sustained effect). DISCUSSION The development and utilization of potentially effective neuroenhancement tools such as the non-invasive brain stimulation technique tDCS for the treatment and rehabilitation of cognitive impairment in the early stages of schizophrenia may contribute to improving outcomes of the disorder and eventually provide a further understanding of the nature of the complex and dynamic neural processes underlying those abnormalities. TRIAL REGISTRATION ClinicalTrials.gov, NCT03071484 . Registered on 7 March 2017.
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Affiliation(s)
- Thais Rabanea-Souza
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil. .,Center for Neuromodulation Studies, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil.
| | - Sheila M C Cirigola
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Cristiano Noto
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - July S Gomes
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Center for Neuromodulation Studies, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Caroline C Azevedo
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Center for Neuromodulation Studies, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Ary Gadelha
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Sao Paulo, Brazil
| | - Álvaro M Dias
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Center for Neuromodulation Studies, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Acioly L T Lacerda
- LiNC - Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Center for Neuromodulation Studies, Department of Psychiatry, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil
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27
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Serati M, Delvecchio G, Orsenigo G, Mandolini GM, Lazzaretti M, Scola E, Triulzi F, Brambilla P. The Role of the Subplate in Schizophrenia and Autism: A Systematic Review. Neuroscience 2019; 408:58-67. [PMID: 30930130 DOI: 10.1016/j.neuroscience.2019.03.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
The subplate (SP) represents a transitory cytoarchitectural fetal compartment containing most subcortical and cortico-cortical afferents, and has a fundamental role in the structural development of the healthy adult brain. There is evidence that schizophrenia and autism may be determined by developmental defects in the cortex or cortical circuitry during the earliest stages of pregnancy. This article provides an overview on fetal SP development, considering its role in schizophrenia and autism, as supported by a systematic review of the main databases. The SP has been described as a cortical amplifier with a role in the coordination of cortical activity, and sensitive growth and migration windows have crucial consequences with respect to cognitive functioning. Although there are not enough studies to draw final conclusions, improved knowledge of the SP's role in schizophrenia and autism spectrum disorders may help to elucidate and possibly prevent the onset of these two severe disorders.
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Affiliation(s)
- Marta Serati
- Department of Mental Health, ASST Rhodense, Rho, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Orsenigo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Elisa Scola
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA
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28
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Lyne J, O'Donoghue B, Roche E, Renwick L, Cannon M, Clarke M. Negative symptoms of psychosis: A life course approach and implications for prevention and treatment. Early Interv Psychiatry 2018; 12:561-571. [PMID: 29076240 DOI: 10.1111/eip.12501] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 07/29/2017] [Accepted: 08/20/2017] [Indexed: 01/09/2023]
Abstract
AIM Negative symptoms are a cause of enduring disability in serious mental illness. In spite of this, the development of effective treatments for negative symptoms has remained slow. The challenge of improving negative symptom outcomes is compounded by our limited understanding of their aetiology and longitudinal development. METHODS A literature search was conducted for life course approach of negative symptoms using PubMed. Further articles were included following manual checking of reference lists and other search strategies. The paper contains a theoretical synthesis of the literature, summarized using conceptual models. RESULTS Negative symptom definitions are compared and considered within a context of the life course. Previous studies suggest that several illness phases may contribute to negative symptoms, highlighting our uncertainty in relation to the origin of negative symptoms. CONCLUSIONS Similar to other aspects of schizophrenia, negative symptoms likely involve a complex interplay of several risk and protective factors at different life phases. Concepts suggested in this article, such as "negative symptom reserve" theory, require further research, which may inform future prevention and treatment strategies.
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Affiliation(s)
- John Lyne
- Royal College of Surgeons in Ireland, North Dublin Mental Health Service, Ashlin Centre, Dublin, Ireland.,Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Brian O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre of Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Eric Roche
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Laoise Renwick
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.,Saint John of God Community Services Ltd, Blackrock, Co., Dublin, Ireland
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Ntouros E, Karanikas E, Floros G, Andreou C, Tsoura A, Garyfallos G, Bozikas VP. Social cognition in the course of psychosis and its correlation with biomarkers in a male cohort. Cogn Neuropsychiatry 2018; 23:103-115. [PMID: 29447074 DOI: 10.1080/13546805.2018.1440201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Patients diagnosed with schizophrenia display deficits in Theory of Mind (ToM) and Emotion Perception (EP) even before the appearance of full-blown symptomatology. METHODS We evaluated ToM and EP in a male cohort consisting of 25 First Episode Psychosis (FEP) and 16 relapsed schizophrenic patients (CHRON) compared to 12 subjects in Ultra-high Risk (UHR) and 23 healthy controls (CTR). Furthermore, we measured the levels of Cortisol, Insulin like Growth Factor (IGF-1), TNF-a, TNF-b and several interleukins as potential biomarkers. RESULTS Deficits in EP and ToM were found in FEP, CHRON patients and UHR subjects compared to CTR. The impairments in these two domains seem to follow different patterns in the course of psychosis. EP was more impaired in subjects with a longer history of symptomatology whereas there was no statistically significant difference regarding ToM. On the other hand IL-4 was the only biomarker correlated to ToM and EP scores in two different samples of our study. CONCLUSION Social Cognition (SC) domains are impaired in patients with psychosis as well as in UHR subjects compared to healthy controls. There are differences in the progress of ToM and EP deficits in the course of psychosis. Interleukins as IL-4 could correlate to SC.
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Affiliation(s)
- Evangelos Ntouros
- a Psychiatric Department , 424 General Military Hospital of Thessaloniki , Thessaloniki , Greece
| | - Evangelos Karanikas
- a Psychiatric Department , 424 General Military Hospital of Thessaloniki , Thessaloniki , Greece.,e The University of Queensland, Rural Clinical School, School of Medicine , Toowoomba , Australia
| | - Georgios Floros
- b 2nd Department of Psychiatry , Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece
| | - Christina Andreou
- c University Psychiatric Clinics, University of Basel , Basel , Switzerland
| | - Aikaterini Tsoura
- b 2nd Department of Psychiatry , Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece
| | - Georgios Garyfallos
- b 2nd Department of Psychiatry , Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece
| | - Vasilios P Bozikas
- d 1st Department of Psychiatry , Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Thessaloniki , Greece
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30
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Seitz J, Rathi Y, Lyall A, Pasternak O, Del Re EC, Niznikiewicz M, Nestor P, Seidman LJ, Petryshen TL, Mesholam-Gately RI, Wojcik J, McCarley RW, Shenton ME, Koerte IK, Kubicki M. Alteration of gray matter microstructure in schizophrenia. Brain Imaging Behav 2018; 12:54-63. [PMID: 28102528 PMCID: PMC5517358 DOI: 10.1007/s11682-016-9666-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Neuroimaging studies demonstrate gray matter (GM) macrostructural abnormalities in patients with schizophrenia (SCZ). While ex-vivo and genetic studies suggest cellular pathology associated with abnormal neurodevelopmental processes in SCZ, few in-vivo measures have been proposed to target microstructural GM organization. Here, we use diffusion heterogeneity- to study GM microstructure in SCZ. Structural and diffusion magnetic resonance imaging (MRI) were acquired on a 3 Tesla scanner in 46 patients with SCZ and 37 matched healthy controls (HC). After correction for free water, diffusion heterogeneity as well as commonly used diffusion measures FA and MD and volume were calculated for the four cortical lobes on each hemisphere, and compared between groups. Patients with early course SCZ exhibited higher diffusion heterogeneity in the GM of the frontal lobes compared to controls. Diffusion heterogeneity of the frontal lobe showed excellent discrimination between patients and HC, while none of the commonly used diffusion measures such as FA or MD did. Higher diffusion heterogeneity in the frontal lobes in early SCZ may be due to abnormal brain maturation (migration, pruning) before and during adolescence and early adulthood. Further studies are needed to investigate the role of heterogeneity as potential biomarker for SCZ risk.
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Affiliation(s)
- Johanna Seitz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig- Maximilians- Universität, Munich, Germany
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
| | - Amanda Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
- Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Elisabetta C Del Re
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
- Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton, MA, USA
| | - Margaret Niznikiewicz
- Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton, MA, USA
| | - Paul Nestor
- Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton, MA, USA
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
- Beth Israel Deaconess Medical Center Public Psychiatry Division at the Massachusetts Mental Health Center Harvard Medical School, Boston, MA, USA
| | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetic Unit, Department of Psychiatry and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Raquelle I Mesholam-Gately
- Beth Israel Deaconess Medical Center Public Psychiatry Division at the Massachusetts Mental Health Center Harvard Medical School, Boston, MA, USA
| | - Joanne Wojcik
- Beth Israel Deaconess Medical Center Public Psychiatry Division at the Massachusetts Mental Health Center Harvard Medical School, Boston, MA, USA
| | - Robert W McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton, MA, USA
- VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
- Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
- VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig- Maximilians- Universität, Munich, Germany
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, 1249 Boylston St, Boston, MA, 02215, USA.
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
- Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
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Mohammadi A, Hesami E, Kargar M, Shams J. Detecting allocentric and egocentric navigation deficits in patients with schizophrenia and bipolar disorder using virtual reality. Neuropsychol Rehabil 2017; 28:398-415. [DOI: 10.1080/09602011.2017.1369888] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Alireza Mohammadi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ehsan Hesami
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Mahmoud Kargar
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamal Shams
- Behavioral Research Center, Department of Psychiatry, Shahid Beheshti University of Medical Science, Tehran, Iran
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32
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Progressive cortical reorganisation: A framework for investigating structural changes in schizophrenia. Neurosci Biobehav Rev 2017; 79:1-13. [DOI: 10.1016/j.neubiorev.2017.04.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
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Fisher M, Herman A, Stephens DB, Vinogradov S. Neuroscience-informed computer-assisted cognitive training in schizophrenia. Ann N Y Acad Sci 2017; 1366:90-114. [PMID: 27111135 DOI: 10.1111/nyas.13042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 01/09/2023]
Abstract
Schizophrenia is a heterogeneous psychiatric syndrome characterized by psychosis. It is also a neurodevelopmental disorder. In the earliest phases of the illness, at-risk individuals exhibit subtle, nonspecific symptoms, including cognitive dysfunction and progressive brain volumetric loss. Generally, schizophrenia is characterized by abnormal/inefficient neural system operations and neural oscillatory activity, as well as functional disconnectivity across frontal-temporo parietal and frontal-subcortical networks; it thus may best be described as a widespread neural oscillatory connectomopathy. Despite earlier views of schizophrenia as an inevitably progressive neurodegenerative disease, emerging evidence indicates that endogenous neuroplastic capacity is retained. An active area of research is directed at understanding how best to harness this learning-induced neuroplasticity to enhance neural system functioning, improve cognition, and prevent-and possibly even reverse-disease progression. In this review, we present an overview of results from the most widely used computer-assisted cognitive-training programs in schizophrenia, contrasting a broad neuropsychological rehabilitation approach with a targeted cognitive-training approach. We then review studies on the neurobiological effects of these two training methods. Finally, we discuss future directions with a focus on the "oscillatory connectome" as a key area of investigation for developing the most precise and scientifically informed treatment approaches for this illness.
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry, University of California, San Francisco, and San Francisco Department of Veterans Affairs Medical Center, San Francisco, California
| | - Alexander Herman
- School of Medicine, University of California, San Francisco, California
| | | | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco, and San Francisco Department of Veterans Affairs Medical Center, San Francisco, California
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Xu Y, Qin W, Zhuo C, Xu L, Zhu J, Liu X, Yu C. Selective functional disconnection of the orbitofrontal subregions in schizophrenia. Psychol Med 2017; 47:1637-1646. [PMID: 28183367 DOI: 10.1017/s0033291717000101] [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] [Indexed: 01/11/2023]
Abstract
BACKGROUND As a disconnection syndrome, schizophrenia has shown impaired resting-state functional connectivity (rsFC) in the orbitofrontal cortex (OFC); however, the OFC is a rather heterogeneous region and the rsFC changes in the OFC subregions remain unknown. METHOD A total of 98 schizophrenia patients and 102 healthy controls underwent resting-state functional MRI using a sensitivity-encoded spiral-in imaging sequence (SENSE-SPIRAL) to reduce susceptibility-induced signal loss and distortion. The OFC subregions were defined according to a previous parcellation study that divided the OFC into the anterior (OFCa), medial (OFCm), posterior (OFCp), intermediate (OFCi), and lateral (OFCl) subregions. The rsFC was compared using two-way repeated-measures ANOVA. RESULTS Whether or not global signal regression, compared with healthy controls, schizophrenia patients consistently exhibited decreased rsFC between the left OFCi and the left middle temporal gyrus and the right middle frontal gyrus (MFG), between the right OFCi and the right MFG and the left inferior frontal gyrus, between the right OFCm and the middle cingulate cortex and the left Rolandic operculum. These rsFC changes still remained significant even after cortical atrophy correction. CONCLUSIONS These findings suggest a selective functional disconnection of the OFC subregions in schizophrenia, and provide more precise information about the functional disconnections of the OFC in this disorder.
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Affiliation(s)
- Y Xu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - W Qin
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - C Zhuo
- Tianjin Anning Hospital,Tianjin,China
| | - L Xu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - J Zhu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - X Liu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - C Yu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
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Gildengers A. Commentary for "Steeper Slope of Age-Related Changes in White Matter Microstructure and Processing Speed in Bipolar Disorder". Am J Geriatr Psychiatry 2017; 25:753-754. [PMID: 28495468 DOI: 10.1016/j.jagp.2017.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 04/04/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Ariel Gildengers
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA.
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36
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Dietsche B, Kircher T, Falkenberg I. Structural brain changes in schizophrenia at different stages of the illness: A selective review of longitudinal magnetic resonance imaging studies. Aust N Z J Psychiatry 2017; 51:500-508. [PMID: 28415873 DOI: 10.1177/0004867417699473] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Schizophrenia is a devastating mental disorder accompanied by aberrant structural brain connectivity. The question whether schizophrenia is a progressive brain disorder is yet to be resolved. Thus, it is not clear when these structural alterations occur and how they develop over time. METHODS In our selective review, we summarized recent findings from longitudinal magnetic resonance imaging studies investigating structural brain alterations and its impact on clinical outcome at different stages of the illness: (1) subjects at ultra-high risk of developing psychosis, (2) patients with a first episode psychosis, and (3) chronically ill patients. Moreover, we reviewed studies examining the longitudinal effects of medication on brain structure in patients with schizophrenia. RESULTS (1) Studies from pre-clinical stages to conversion showed a more pronounced cortical gray matter loss (i.e. superior temporal and inferior frontal regions) in those individuals who later made transition to psychosis. (2) Studies investigating patients with a first episode psychosis revealed a decline in multiple gray matter regions (i.e. frontal regions and thalamus) over time as well as progressive cortical thinning in the superior and inferior frontal cortex. (3) Studies focusing on patients with chronic schizophrenia showed that gray matter decreased to a greater extent (i.e. frontal and temporal areas, thalamus, and cingulate cortices)-especially in poor-outcome patients. Very few studies reported effects on white matter microstructure in the longitudinal course of the illness. CONCLUSION There is adequate evidence to suggest that schizophrenia is associated with progressive gray matter abnormalities particularly during the initial stages of illness. However, causal relationships between structural changes and illness course-especially in chronically ill patients-should be interpreted with caution. Findings might be confounded by longer periods of treatment and higher doses of antipsychotics or epiphenomena related to the illness.
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Affiliation(s)
- Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
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37
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Domen P, Peeters S, Michielse S, Gronenschild E, Viechtbauer W, Roebroeck A, Os JV, Marcelis M. Differential Time Course of Microstructural White Matter in Patients With Psychotic Disorder and Individuals at Risk: A 3-Year Follow-up Study. Schizophr Bull 2017; 43:160-170. [PMID: 27190279 PMCID: PMC5216846 DOI: 10.1093/schbul/sbw061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although widespread reduced white matter (WM) integrity is a consistent finding in cross-sectional diffusion tensor imaging (DTI) studies of schizophrenia, little is known about the course of these alterations. This study examined to what degree microstructural WM alterations display differential trajectories over time as a function of level of psychosis liability. METHODS Two DTI scans with a 3-year time interval were acquired from 159 participants (55 patients with a psychotic disorder, 55 nonpsychotic siblings and 49 healthy controls) and processed with tract-based spatial statistics. The mean fractional anisotropy (FA) change over time was calculated. Main effects of group, as well as group × region interactions in the model of FA change were examined with multilevel (mixed-effects) models. RESULTS Siblings revealed a significant mean FA decrease over time compared to controls (B = -0.004, P = .04), resulting in a significant sibling-control difference at follow-up (B = -0.007, P = .03). Patients did not show a significant change over time, but their mean FA was lower than controls both at baseline and at follow-up. A significant group × region interaction (χ2 = 105.4, P = .01) revealed group differences in FA change in the right cingulum, left posterior thalamic radiation, right retrolenticular part of the internal capsule, and the right posterior corona radiata. CONCLUSION Whole brain mean FA remained stable over a 3-year period in patients with psychotic disorder and declined over time in nonaffected siblings, so that at follow-up both groups had lower FA with respect to controls. The results suggest that liability for psychosis may involve a process of WM alterations.
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Affiliation(s)
- Patrick Domen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands;
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ed Gronenschild
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alard Roebroeck
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
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Castillo-Morales A, Monzón-Sandoval J, de Sousa AA, Urrutia AO, Gutierrez H. Neocortex expansion is linked to size variations in gene families with chemotaxis, cell-cell signalling and immune response functions in mammals. Open Biol 2016; 6:160132. [PMID: 27707894 PMCID: PMC5090057 DOI: 10.1098/rsob.160132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 09/08/2016] [Indexed: 11/30/2022] Open
Abstract
Increased brain size is thought to have played an important role in the evolution of mammals and is a highly variable trait across lineages. Variations in brain size are closely linked to corresponding variations in the size of the neocortex, a distinct mammalian evolutionary innovation. The genomic features that explain and/or accompany variations in the relative size of the neocortex remain unknown. By comparing the genomes of 28 mammalian species, we show that neocortical expansion relative to the rest of the brain is associated with variations in gene family size (GFS) of gene families that are significantly enriched in biological functions associated with chemotaxis, cell-cell signalling and immune response. Importantly, we find that previously reported GFS variations associated with increased brain size are largely accounted for by the stronger link between neocortex expansion and variations in the size of gene families. Moreover, genes within these families are more prominently expressed in the human neocortex during early compared with adult development. These results suggest that changes in GFS underlie morphological adaptations during brain evolution in mammalian lineages.
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Affiliation(s)
- Atahualpa Castillo-Morales
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK School of Life Sciences, University of Lincoln, Lincoln LN6 7TS, UK Milner Centre for Evolution, University of Bath, Bath BA2 7YA, UK
| | - Jimena Monzón-Sandoval
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK School of Life Sciences, University of Lincoln, Lincoln LN6 7TS, UK Milner Centre for Evolution, University of Bath, Bath BA2 7YA, UK
| | | | - Araxi O Urrutia
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK Milner Centre for Evolution, University of Bath, Bath BA2 7YA, UK
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Isaac C, Januel D. Neural correlates of cognitive improvements following cognitive remediation in schizophrenia: a systematic review of randomized trials. SOCIOAFFECTIVE NEUROSCIENCE & PSYCHOLOGY 2016; 6:30054. [PMID: 26993787 PMCID: PMC4799394 DOI: 10.3402/snp.v6.30054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/31/2015] [Accepted: 02/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Cognitive impairments are a core feature in schizophrenia and are linked to poor social functioning. Numerous studies have shown that cognitive remediation can enhance cognitive and functional abilities in patients with this pathology. The underlying mechanism of these behavioral improvements seems to be related to structural and functional changes in the brain. However, studies on neural correlates of such enhancement remain scarce. OBJECTIVES We explored the neural correlates of cognitive enhancement following cognitive remediation interventions in schizophrenia and the differential effect between cognitive training and other therapeutic interventions or patients' usual care. METHOD We searched MEDLINE, PsycInfo, and ScienceDirect databases for studies on cognitive remediation therapy in schizophrenia that used neuroimaging techniques and a randomized design. Search terms included randomized controlled trial, cognitive remediation, cognitive training, rehabilitation, magnetic resonance imaging, positron emission tomography, electroencephalography, magnetoencephalography, near infrared spectroscopy, and diffusion tensor imaging. We selected randomized controlled trials that proposed multiple sessions of cognitive training to adult patients with a schizophrenia spectrum disorder and assessed its efficacy with imaging techniques. RESULTS In total, 15 reports involving 19 studies were included in the systematic review. They involved a total of 455 adult patients, 271 of whom received cognitive remediation. Cognitive remediation therapy seems to provide a neurobiological enhancing effect in schizophrenia. After therapy, increased activations are observed in various brain regions mainly in frontal - especially prefrontal - and also in occipital and anterior cingulate regions during working memory and executive tasks. Several studies provide evidence of an improved functional connectivity after cognitive training, suggesting a neuroplastic effect of therapy through mechanisms of functional reorganization. Neurocognitive and social-cognitive training may have a cumulative effect on neural networks involved in social cognition. The variety of proposed programs, imaging tasks, and techniques may explain the heterogeneity of observed neural improvements. Future studies would need to specify the effect of cognitive training depending on those variables.
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Affiliation(s)
- Clémence Isaac
- Unité de Recherche Clinique, EPS Ville Evrard, Neuilly-Sur-Marne, France;
| | - Dominique Januel
- Unité de Recherche Clinique, EPS Ville Evrard, Neuilly-Sur-Marne, France
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Hernandez K, Swiatkowski P, Patel MV, Liang C, Dudzinski NR, Brzustowicz LM, Firestein BL. Overexpression of Isoforms of Nitric Oxide Synthase 1 Adaptor Protein, Encoded by a Risk Gene for Schizophrenia, Alters Actin Dynamics and Synaptic Function. Front Cell Neurosci 2016; 10:6. [PMID: 26869880 PMCID: PMC4735351 DOI: 10.3389/fncel.2016.00006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/11/2016] [Indexed: 11/13/2022] Open
Abstract
Proper communication between neurons depends upon appropriate patterning of dendrites and correct distribution and structure of spines. Schizophrenia is a neuropsychiatric disorder characterized by alterations in dendrite branching and spine density. Nitric oxide synthase 1 adaptor protein (NOS1AP), a risk gene for schizophrenia, encodes proteins that are upregulated in the dorsolateral prefrontal cortex (DLPFC) of individuals with schizophrenia. To elucidate the effects of NOS1AP overexpression observed in individuals with schizophrenia, we investigated changes in actin dynamics and spine development when a long (NOS1AP-L) or short (NOS1AP-S) isoform of NOS1AP is overexpressed. Increased NOS1AP-L protein promotes the formation of immature spines when overexpressed in rat cortical neurons from day in vitro (DIV) 14 to DIV 17 and reduces the amplitude of miniature excitatory postsynaptic currents (mEPSCs). In contrast, increased NOS1AP-S protein increases the rate of actin polymerization and the number of immature and mature spines, which may be attributed to a decrease in total Rac1 expression and a reduction in the levels of active cofilin. The increase in the number of mature spines by overexpression of NOS1AP-S is accompanied by an increase in the frequency of mEPSCs. Our findings show that overexpression of NOS1AP-L or NOS1AP-S alters the actin cytoskeleton and synaptic function. However, the mechanisms by which these isoforms induce these changes are distinct. These results are important for understanding how increased expression of NOS1AP isoforms can influence spine development and synaptic function.
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Affiliation(s)
- Kristina Hernandez
- Department of Cell Biology and Neuroscience, Human Genetics Institute of New Jersey, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Przemyslaw Swiatkowski
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Mihir V. Patel
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Chen Liang
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Natasha R. Dudzinski
- Department of Cell Biology and Neuroscience, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Linda M. Brzustowicz
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers—The State University of New JerseyPiscataway, NJ, USA
| | - Bonnie L. Firestein
- Department of Cell Biology and Neuroscience, Human Genetics Institute of New Jersey, Rutgers—The State University of New JerseyPiscataway, NJ, USA
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Abstract
BACKGROUND An increasing number of studies identifies the duration of illness (DI) as an important predictor of outcome in patients affected by major psychoses (MP). The aim of the present paper was to revise medical literature about DI and its effects on MP, focusing in particular on the relationship between DI and outcome with particular reference to treatment response, suicidal risk, cognitive impairment and social functioning. METHODS A search in the main database sources has been performed to obtain a comprehensive overview. Studies with different methodologies (open and double-blinded) have been included, while papers considering other variables such as duration of untreated episode/illness were excluded. MP included the diagnoses of schizophrenia, bipolar disorder and major depressive disorder. RESULTS Available data show that DI influences treatment response, suicidal risk and loss of social functioning in schizophrenic patients, while results are more controversial with regard to cognitive impairment. In bipolar disorder, a long DI has been associated with less treatment response, more suicidal risk and cognitive impairment, but more data are needed to draw definitive conclusions. Finally, studies, regarding DI of illness and its predictive value of outcome in major depressive disorder show contradictory results. CONCLUSIONS DI appears a negative outcome factor particularly for schizophrenia, while with regard to mood disorders, more data are needed to draw definitive sound conclusions.
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Affiliation(s)
- Alfredo Carlo Altamura
- Alfredo C Altamura, Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , Via F. Sforza 35, 20122, Milan , Italy
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Genestine M, Lin L, Durens M, Yan Y, Jiang Y, Prem S, Bailoor K, Kelly B, Sonsalla PK, Matteson PG, Silverman J, Crawley JN, Millonig JH, DiCicco-Bloom E. Engrailed-2 (En2) deletion produces multiple neurodevelopmental defects in monoamine systems, forebrain structures and neurogenesis and behavior. Hum Mol Genet 2015. [PMID: 26220976 DOI: 10.1093/hmg/ddv301] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Many genes involved in brain development have been associated with human neurodevelopmental disorders, but underlying pathophysiological mechanisms remain undefined. Human genetic and mouse behavioral analyses suggest that ENGRAILED-2 (EN2) contributes to neurodevelopmental disorders, especially autism spectrum disorder. In mouse, En2 exhibits dynamic spatiotemporal expression in embryonic mid-hindbrain regions where monoamine neurons emerge. Considering their importance in neuropsychiatric disorders, we characterized monoamine systems in relation to forebrain neurogenesis in En2-knockout (En2-KO) mice. Transmitter levels of serotonin, dopamine and norepinephrine (NE) were dysregulated from Postnatal day 7 (P7) to P21 in En2-KO, though NE exhibited the greatest abnormalities. While NE levels were reduced ∼35% in forebrain, they were increased 40 -: 75% in hindbrain and cerebellum, and these patterns paralleled changes in locus coeruleus (LC) fiber innervation, respectively. Although En2 promoter was active in Embryonic day 14.5 -: 15.5 LC neurons, expression diminished thereafter and gene deletion did not alter brainstem NE neuron numbers. Significantly, in parallel with reduced NE levels, En2-KO forebrain regions exhibited reduced growth, particularly hippocampus, where P21 dentate gyrus granule neurons were decreased 16%, suggesting abnormal neurogenesis. Indeed, hippocampal neurogenic regions showed increased cell death (+77%) and unexpectedly, increased proliferation. Excess proliferation was restricted to early Sox2/Tbr2 progenitors whereas increased apoptosis occurred in differentiating (Dcx) neuroblasts, accompanied by reduced newborn neuron survival. Abnormal neurogenesis may reflect NE deficits because intra-hippocampal injections of β-adrenergic agonists reversed cell death. These studies suggest that disruption of hindbrain patterning genes can alter monoamine system development and thereby produce forebrain defects that are relevant to human neurodevelopmental disorders.
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Affiliation(s)
- Matthieu Genestine
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers
| | - Lulu Lin
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers, Graduate School of Biological Sciences, Rutgers
| | - Madel Durens
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers, Graduate School of Biological Sciences, Rutgers
| | - Yan Yan
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers, Graduate School of Biological Sciences, Rutgers
| | - Yiqin Jiang
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers
| | - Smrithi Prem
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers
| | - Kunal Bailoor
- Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Brian Kelly
- Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Patricia K Sonsalla
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, Rutgers
| | - Paul G Matteson
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Jill Silverman
- MIND Institute, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Jacqueline N Crawley
- MIND Institute, University of California Davis School of Medicine, Sacramento, CA, USA
| | - James H Millonig
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers, Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Emanuel DiCicco-Bloom
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Rutgers, Graduate School of Biological Sciences, Rutgers, Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA and
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43
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Altered Spontaneous Brain Activity in Schizophrenia: A Meta-Analysis and a Large-Sample Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:204628. [PMID: 26180786 PMCID: PMC4477065 DOI: 10.1155/2015/204628] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/05/2014] [Accepted: 10/26/2014] [Indexed: 11/18/2022]
Abstract
Altered spontaneous brain activity as measured by ALFF, fALFF, and ReHo has been reported in schizophrenia, but no consensus has been reached on alternations of these indexes in the disorder. We aimed to clarify the regional alterations in ALFF, fALFF, and ReHo in schizophrenia using a meta-analysis and a large-sample validation. A meta-analysis of activation likelihood estimation was conducted based on the abnormal foci of ten studies. A large sample of 86 schizophrenia patients and 89 healthy controls was compared to verify the results of the meta-analysis. Meta-analysis demonstrated that the alternations in ALFF and ReHo had similar distribution in schizophrenia patients. The foci with decreased ALFF/fALFF and ReHo in schizophrenia were mainly located in the somatosensory cortex, posterior parietal cortex, and occipital cortex; however, foci with increased ALFF/fALFF and ReHo were mainly located in the bilateral striatum, medial temporal cortex, and medial prefrontal cortex. The large-sample study showed consistent findings with the meta-analysis. These findings may expound the pathophysiological hypothesis and guide future research.
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Nour MM, Howes OD. Interpreting the neurodevelopmental hypothesis of schizophrenia in the context of normal brain development and ageing. Proc Natl Acad Sci U S A 2015; 112:E2745. [PMID: 25941415 PMCID: PMC4450386 DOI: 10.1073/pnas.1502170112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Matthew M Nour
- Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London SE5 8AF, United Kingdom; and
| | - Oliver D Howes
- Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London SE5 8AF, United Kingdom; and Psychiatric Imaging, Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, United Kingdom
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45
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Xiao Y, Lui S, Deng W, Yao L, Zhang W, Li S, Wu M, Xie T, He Y, Huang X, Hu J, Bi F, Li T, Gong Q. Altered cortical thickness related to clinical severity but not the untreated disease duration in schizophrenia. Schizophr Bull 2015; 41:201-10. [PMID: 24353097 PMCID: PMC4266280 DOI: 10.1093/schbul/sbt177] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Although previous studies have reported deficits in the gray matter volume of schizophrenic patients, it remains unclear whether these deficits occur at the onset of the disease, before treatment, and whether they are progressive over the duration of untreated disease. Furthermore, the gray matter volume represents the combinations of cortical thickness and surface area; these features are believed to be influenced by different genetic factors. However, cortical thickness and surface area in antipsychotic-naive first-episode schizophrenic patients have seldom been investigated. Here, the cortical thicknesses and surface areas of 128 antipsychotic-naive first-episode schizophrenic patients were compared with 128 healthy controls. The patients exhibited significantly lower cortical thickness, primarily in the bilateral prefrontal and parietal cortex, and increased thickness in the bilateral anterior temporal lobes, left medial orbitofrontal cortex, and left cuneus. Furthermore, decreased cortical thickness was related to positive schizophrenia symptoms but not to the severity of negative symptoms and the untreated disease duration. No significant difference of surface area was observed between the 2 groups. Thus, without the confounding factors of medication and illness progression, this study provides further evidence to support anatomical deficits in the prefrontal and parietal cortex early in course of the illness. The increased thicknesses of the bilateral anterior temporal lobes may represent a compensatory factor or may be an early-course neuronal pathology caused by preapoptotic osmotic changes or hypertrophy. Furthermore, these anatomical deficits are crucial to the pathogenesis of positive symptoms and relatively stable instead of progressing during the early stages of the disease.
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Affiliation(s)
- Yuan Xiao
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China;,These authors contributed equally to the article
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China;
| | - Wei Deng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China;,These authors contributed equally to the article
| | - Li Yao
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China;,These authors contributed equally to the article
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China
| | - Shiguang Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China
| | - Teng Xie
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China
| | - Junmei Hu
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Feng Bi
- Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Tao Li
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, 37 Guo Xuexiang, Chengdu, Sichuan, China
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46
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Neurocognition in schizophrenia: from prodrome to multi-episode illness. Psychiatry Res 2014; 220:129-34. [PMID: 25149131 DOI: 10.1016/j.psychres.2014.07.067] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 06/24/2014] [Accepted: 07/27/2014] [Indexed: 11/20/2022]
Abstract
Individuals with schizophrenia present a neuropsychological deficit throughout the course of the disorder. Few studies have addressed the progression of the deficit since the prodromal phase of the disorder. This investigation explored neurocognition in accordance with the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus recommendations. The aim of the study was to explore the presence of neurocognitive impairment in ultra-high-risk individuals and the stage of this impairment in samples at different phases of illness. Thirty-six individuals with a prodromal syndrome, 53 first-episode and 44 multi-episode schizophrenia patients were assessed to examine neuropsychological performance. ANCOVA analysis adjusted for possible confounder factors and planned contrasts with healthy controls were undertaken. The results revealed deficits in speed-of-processing, visual-learning and social-cognition in prodromal individuals, and of all other neuropsychological domains in both first-episode and multi-episode patients. Furthermore impairment was found in the first-episode and in the multi-episode group, respectively on working-memory and attention. Within the framework of the neurodevelopmental model of schizophrenia, our results suggest the presence of neuropsychological impairment before the onset of full-blown psychosis. Moreover, the deficits are larger in the more chronic groups, according to the theory of an ongoing neurodevelopmental alteration.
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47
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Gildengers AG, Chung KH, Huang SH, Begley A, Aizenstein HJ, Tsai SY. Neuroprogressive effects of lifetime illness duration in older adults with bipolar disorder. Bipolar Disord 2014; 16:617-23. [PMID: 24716786 PMCID: PMC4149863 DOI: 10.1111/bdi.12204] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 10/16/2013] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The aim of the present study was to examine the long-term effects of bipolar disorder (BD) on brain structure (gray matter volumes). METHODS Fifty-four adults with BD [mean (standard deviation) age = 64.4 (5.4) years] underwent brain MR imaging along with comprehensive clinical assessment. Total gray matter, hippocampal, and amygdala volumes were extracted using methods developed through the Geriatric Neuroimaging Laboratory at the University of Pittsburgh (Pittsburgh, PA, USA). RESULTS Lower total gray matter volumes were related to longer duration of BD, even when controlling for current age and cerebrovascular accident (CVA) risk/burden. Additionally, longer exposure to antipsychotic medication was related to lower gray matter volumes. Lower hippocampal volumes were related to total years of antipsychotic agent exposure and CVA risk/burden scores. Older age was related to lower total gray matter, hippocampal, and amgydala volumes. CONCLUSIONS Our study of older adults with BD supports the understanding that BD is a neuroprogressive disorder with a longer duration of illness and more antipsychotic agent exposure related to lower gray matter volume.
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Affiliation(s)
- Ariel G Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kuo-Hsuan Chung
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shou-Hung Huang
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Amy Begley
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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48
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Kochunov P, Hong LE. Neurodevelopmental and neurodegenerative models of schizophrenia: white matter at the center stage. Schizophr Bull 2014; 40:721-8. [PMID: 24870447 PMCID: PMC4059450 DOI: 10.1093/schbul/sbu070] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Schizophrenia is a disorder of cerebral disconnectivity whose lifetime course is modeled as both neurodevelopmental and neurodegenerative. The neurodevelopmental models attribute schizophrenia to alterations in the prenatal-to-early adolescent development. The neurodegenerative models identify progressive neurodegeneration as its core attribute. Historically, the physiology, pharmacology, and treatment targets in schizophrenia were conceptualized in terms of neurons, neurotransmitter levels, and synaptic receptors. Much of the evidence for both models was derived from studies of cortical and subcortical gray matter. We argue that the dynamics of the lifetime trajectory of white matter, and the consistency of connectivity deficits in schizophrenia, support white matter integrity as a promising phenotype to evaluate the competing evidence for and against neurodevelopmental and neurodegenerative heuristics. We develop this perspective by reviewing normal lifetime trajectories of white and gray matter changes. We highlighted the overlap between the age of peak of white matter development and the age of onset of schizophrenia and reviewed findings of white matter abnormalities prior to, at the onset, and at chronic stages of schizophrenia. We emphasized the findings of reduced white matter integrity at the onset and findings of accelerated decline in chronic stages, but the developmental trajectory that precedes the onset is largely unknown. We propose 4 probable lifetime white matter trajectory models that can be used as the basis for separation between the neurodevelopmental and neurodegenerative etiologies. We argue that a combination of the cross-sectional and longitudinal studies of white matter integrity in patients may be used to bridge the neurodevelopment and degeneration heuristics to advance schizophrenia research.
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Affiliation(s)
- Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD.
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49
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Cao L, Deng W, Guan L, Yang Z, Lin Y, Ma X, Li X, Liu Y, Ye B, Lao G, Chen Y, Liang H, Wu Y, Ou Y, Huang W, Liu W, Wang Q, Wang Y, Zhao L, Li T, Hu X. Association of the 3' region of the neuregulin 1 gene with bipolar I disorder in the Chinese Han population. J Affect Disord 2014; 162:81-8. [PMID: 24767010 DOI: 10.1016/j.jad.2014.03.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 03/17/2014] [Accepted: 03/18/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Based on the function of neuregulin 1 (NRG1) in neurodevelopment, susceptibility to bipolar disorder presumably involves this gene. The 3' region of NRG1 contains the majority of the coding exons, and transcripts from this region encode 8 of the 9 known NRG1 isoforms; therefore, this region is likely to be predominant versus the 5' region in terms of their relative contributions to NRG1 function. We investigated the association between the 3' region of the NRG1 gene and bipolar I disorder (BPI) in the Chinese Han population and performed further analyses depending on the presence or absence of psychotic features. METHODS A total of 385 BPI patients and 475 healthy controls were recruited for this study. Thirty tag single nucleotide polymorphisms (SNPs) across the 3' region of the NRG1 gene were genotyped for allelic and haplotypic associations with BPI and subgroups with psychotic features (BPI-P) or without psychotic features (BPI-NP). RESULTS Individual marker analysis showed that 2 SNPs (rs12547858 and rs6468121) in this region were significantly associated with BPI. Moreover, subgroup analyses showed significant but marginal associations of rs6468121 with BPI-P and rs3757933 with BPI-NP. Haplotype analyses showed that 6 haplotypes were associated with BPI only. LIMITATIONS The sample size was relatively small. The investigated tag SNPs only represented 83% of the information on the targeted region. There might be a retrospective bias in the subgroup analyses. CONCLUSION The results suggest that the 3' region of the NRG1 gene plays a role in BPI susceptibility in the Chinese Han population. In addition, the preliminary results show that BPI with psychotic features and BPI without psychotic features may constitute different sub-phenotypes; however, this finding should be confirmed in a larger population sample.
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Affiliation(s)
- Liping Cao
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China.
| | - Wenhao Deng
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Lijie Guan
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Zhenxing Yang
- Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yin Lin
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China; Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaohong Ma
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China; Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xuan Li
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Yuping Liu
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Biyu Ye
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Guohui Lao
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Yuwei Chen
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Huiwei Liang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Yuanfei Wu
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Yufen Ou
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Weijie Huang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Wentao Liu
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China
| | - Qiang Wang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China; Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yingcheng Wang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Brain Hospital, Guangzhou, Guangdong, PR China; Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Liansheng Zhao
- Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Tao Li
- Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xun Hu
- Psychiatric Laboratory and Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
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50
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Lotrich FE, Butters MA, Aizenstein H, Marron MM, Reynolds CF, Gildengers AG. The relationship between interleukin-1 receptor antagonist and cognitive function in older adults with bipolar disorder. Int J Geriatr Psychiatry 2014; 29:635-44. [PMID: 24273017 PMCID: PMC4013203 DOI: 10.1002/gps.4048] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 10/15/2013] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Cognitive impairments are a feature of bipolar disorder (BD) and could be worsened by inflammatory cytokines. We determined whether (i) serum interleukin-1 receptor antagonist (IL-1RA) was increased in elderly BD subjects; (ii) whether IL-1RA was associated with worse neurocognitive function; and (iii) whether IL-1RA was associated with white matter integrity. METHODS Twenty-one euthymic BD patients (65 +/- 9 years) with serum available for IL-1RA measures by enzyme-linked immunoassays were compared with 26 similarly aged control participants. Four factor analysis-derived z-scores and a global z-score were obtained from a battery of 21 neurocognitive tests. Diffusion tensor images were used to obtain fractional anisotropy (FA), and an automated labeling pathway algorithm was used to obtain white matter hyperintensity burden. RESULTS Interleukin-1 receptor antagonist was elevated in BD subjects compared with controls (439+/-326 pg/mL vs. 269+/-109 pg/mL; p = 0.004). Moreover, IL-1RA was inversely correlated with three cognitive function factors and global cognition (r = -0.37; p = 0.01). IL-1RA continued to correlate with global cognitive function even when covarying for either IL-6 or brain-derived neurotrophic factor. Although FA was lower in BD subjects (0.368 +/- 0.02 vs. 0.381 +/- 0.01; p = 0.02), IL-1RA was not associated with FA or white matter hyperintensity burden. CONCLUSION Elevated serum levels of IL-1RA in BD subjects, even during euthymic states, were associated with worse cognitive function. This association was not explained by co-occurring increases in IL-6, by decreased brain-derived neurotrophic factor, nor by measures of white matter integrity. These cross-sectional findings support the possibility that the IL-1 family may contribute to cognitive impairments in BD.
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Affiliation(s)
| | - Meryl A. Butters
- 3811 O’Hara Street, Pittsburgh, PA 15213, USA. Phone 412-246-5280
| | | | - Megan M. Marron
- 3811 O’Hara Street, Pittsburgh, PA 15213, USA. Phone 412-246-6442
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