1
|
Mariano M, Rossetti I, Maravita A, Paulesu E, Zapparoli L. Sensory Attenuation Deficit and Auditory Hallucinations in Schizophrenia: A Causal Mechanism or a Risk Factor? Evidence From Meta-Analyses on the N1 Event-Related Potential Component. Biol Psychiatry 2024; 96:207-221. [PMID: 38246250 DOI: 10.1016/j.biopsych.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/06/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Sensory attenuation (SA), the dampened perception of self-generated sensory information, is typically associated with reduced event-related potential signals, such as for the N1 component of auditory event-related potentials. SA, together with efficient monitoring of intentions and actions, should facilitate the distinction between self-generated and externally generated sensory events, thereby optimizing interaction with the world. According to many, SA is deficient in schizophrenia. The question arises whether altered SA reflects a sufficient mechanism to explain positive symptoms such as auditory hallucinations. A systematic association of reduced auditory SA in hallucinating patients would support this hypothesis. METHODS We conducted a series of meta-analyses on 15 studies on auditory SA in which the N1 component of event-related potential-electroencephalogram signals was measured during talking (self-generated sensory signals condition) or when listening to prerecorded vocalizations (externally generated sensory signals condition). RESULTS We found that individuals with schizophrenia did show some auditory SA because their N1 signal was significantly attenuated in talking conditions compared with listening conditions. However, the magnitude of such attenuation was reduced in individuals with schizophrenia compared to healthy control participants. This phenomenon generalizes independently from the stage of the disease, the severity of positive symptoms, and whether patients have auditory hallucinations or not. CONCLUSIONS These findings suggest that reduced SA cannot be a sufficient mechanism for explaining positive symptoms such as auditory hallucinations in schizophrenia. Because reduced SA was also present in participants at risk of schizophrenia, reduced SA may represent a risk factor for the disorder. We discuss the implications of these results for clinical-cognitive models of schizophrenia.
Collapse
Affiliation(s)
- Marika Mariano
- Psychology Department and NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy.
| | - Ileana Rossetti
- Psychology Department and NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Angelo Maravita
- Psychology Department and NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Eraldo Paulesu
- Psychology Department and NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy; IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Laura Zapparoli
- Psychology Department and NeuroMi, Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy; IRCCS Orthopedic Institute Galeazzi, Milan, Italy.
| |
Collapse
|
2
|
Kotov R, Carpenter WT, Cicero DC, Correll CU, Martin EA, Young JW, Zald DH, Jonas KG. Psychosis superspectrum II: neurobiology, treatment, and implications. Mol Psychiatry 2024; 29:1293-1309. [PMID: 38351173 DOI: 10.1038/s41380-024-02410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024]
Abstract
Alternatives to traditional categorical diagnoses have been proposed to improve the validity and utility of psychiatric nosology. This paper continues the companion review of an alternative model, the psychosis superspectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP). The superspectrum model aims to describe psychosis-related psychopathology according to data on distributions and associations among signs and symptoms. The superspectrum includes psychoticism and detachment spectra as well as narrow subdimensions within them. Auxiliary domains of cognitive deficit and functional impairment complete the psychopathology profile. The current paper reviews evidence on this model from neurobiology, treatment response, clinical utility, and measure development. Neurobiology research suggests that psychopathology included in the superspectrum shows similar patterns of neural alterations. Treatment response often mirrors the hierarchy of the superspectrum with some treatments being efficacious for psychoticism, others for detachment, and others for a specific subdimension. Compared to traditional diagnostic systems, the quantitative nosology shows an approximately 2-fold increase in reliability, explanatory power, and prognostic accuracy. Clinicians consistently report that the quantitative nosology has more utility than traditional diagnoses, but studies of patients with frank psychosis are currently lacking. Validated measures are available to implement the superspectrum model in practice. The dimensional conceptualization of psychosis-related psychopathology has implications for research, clinical practice, and public health programs. For example, it encourages use of the cohort study design (rather than case-control), transdiagnostic treatment strategies, and selective prevention based on subclinical symptoms. These approaches are already used in the field, and the superspectrum provides further impetus and guidance for their implementation. Existing knowledge on this model is substantial, but significant gaps remain. We identify outstanding questions and propose testable hypotheses to guide further research. Overall, we predict that the more informative, reliable, and valid characterization of psychopathology offered by the superspectrum model will facilitate progress in research and clinical care.
Collapse
Affiliation(s)
- Roman Kotov
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
| | | | - David C Cicero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - David H Zald
- Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Katherine G Jonas
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
3
|
Hamilton HK, Mathalon DH, Ford JM. P300 in schizophrenia: Then and now. Biol Psychol 2024; 187:108757. [PMID: 38316196 DOI: 10.1016/j.biopsycho.2024.108757] [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: 08/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
The 1965 discovery of the P300 component of the electroencephalography (EEG)-based event-related potential (ERP), along with the subsequent identification of its alteration in people with schizophrenia, initiated over 50 years of P300 research in schizophrenia. Here, we review what we now know about P300 in schizophrenia after nearly six decades of research. We describe recent efforts to expand our understanding of P300 beyond its sensitivity to schizophrenia itself to its potential role as a biomarker of risk for psychosis or a heritable endophenotype that bridges genetic risk and psychosis phenomenology. We also highlight efforts to move beyond a syndrome-based approach to understand P300 within the context of the clinical, cognitive, and presumed pathophysiological heterogeneity among people diagnosed with schizophrenia. Finally, we describe several recent approaches that extend beyond measuring the traditional P300 ERP component in people with schizophrenia, including time-frequency analyses and pharmacological challenge studies, that may help to clarify specific cognitive mechanisms that are disrupted in schizophrenia. Moreover, we discuss several promising areas for future research, including studies of animal models that can be used for treatment development.
Collapse
Affiliation(s)
- Holly K Hamilton
- University of Minnesota, Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA; Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA; University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Daniel H Mathalon
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Judith M Ford
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| |
Collapse
|
4
|
Yang X, Song Y, Zou Y, Li Y, Zeng J. Neural correlates of prediction error in patients with schizophrenia: evidence from an fMRI meta-analysis. Cereb Cortex 2024; 34:bhad471. [PMID: 38061699 DOI: 10.1093/cercor/bhad471] [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: 07/24/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/19/2024] Open
Abstract
Abnormal processes of learning from prediction errors, i.e. the discrepancies between expectations and outcomes, are thought to underlie motivational impairments in schizophrenia. Although dopaminergic abnormalities in the mesocorticolimbic reward circuit have been found in patients with schizophrenia, the pathway through which prediction error signals are processed in schizophrenia has yet to be elucidated. To determine the neural correlates of prediction error processing in schizophrenia, we conducted a meta-analysis of whole-brain neuroimaging studies that investigated prediction error signal processing in schizophrenia patients and healthy controls. A total of 14 studies (324 schizophrenia patients and 348 healthy controls) using the reinforcement learning paradigm were included. Our meta-analysis showed that, relative to healthy controls, schizophrenia patients showed increased activity in the precentral gyrus and middle frontal gyrus and reduced activity in the mesolimbic circuit, including the striatum, thalamus, amygdala, hippocampus, anterior cingulate cortex, insula, superior temporal gyrus, and cerebellum, when processing prediction errors. We also found hyperactivity in frontal areas and hypoactivity in mesolimbic areas when encoding prediction error signals in schizophrenia patients, potentially indicating abnormal dopamine signaling of reward prediction error and suggesting failure to represent the value of alternative responses during prediction error learning and decision making.
Collapse
Affiliation(s)
- Xun Yang
- School of Public Policy and Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yuan Song
- School of Public Policy and Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yuhan Zou
- School of Economics and Business Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yilin Li
- Psychology and Neuroscience Department, University of St Andrews, Forbes 1 DRA, Buchanan Garden, St Andrews, Fife, United Kingdom
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| |
Collapse
|
5
|
du Plessis S, Chand GB, Erus G, Phahladira L, Luckhoff HK, Smit R, Asmal L, Wolf DH, Davatzikos C, Emsley R. Two Neuroanatomical Signatures in Schizophrenia: Expression Strengths Over the First 2 Years of Treatment and Their Relationships to Neurodevelopmental Compromise and Antipsychotic Treatment. Schizophr Bull 2023; 49:1067-1077. [PMID: 37043772 PMCID: PMC10318886 DOI: 10.1093/schbul/sbad040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND AND HYPOTHESIS Two machine learning derived neuroanatomical signatures were recently described. Signature 1 is associated with widespread grey matter volume reductions and signature 2 with larger basal ganglia and internal capsule volumes. We hypothesized that they represent the neurodevelopmental and treatment-responsive components of schizophrenia respectively. STUDY DESIGN We assessed the expression strength trajectories of these signatures and evaluated their relationships with indicators of neurodevelopmental compromise and with antipsychotic treatment effects in 83 previously minimally treated individuals with a first episode of a schizophrenia spectrum disorder who received standardized treatment and underwent comprehensive clinical, cognitive and neuroimaging assessments over 24 months. Ninety-six matched healthy case-controls were included. STUDY RESULTS Linear mixed effect repeated measures models indicated that the patients had stronger expression of signature 1 than controls that remained stable over time and was not related to treatment. Stronger signature 1 expression showed trend associations with lower educational attainment, poorer sensory integration, and worse cognitive performance for working memory, verbal learning and reasoning and problem solving. The most striking finding was that signature 2 expression was similar for patients and controls at baseline but increased significantly with treatment in the patients. Greater increase in signature 2 expression was associated with larger reductions in PANSS total score and increases in BMI and not associated with neurodevelopmental indices. CONCLUSIONS These findings provide supporting evidence for two distinct neuroanatomical signatures representing the neurodevelopmental and treatment-responsive components of schizophrenia.
Collapse
Affiliation(s)
- Stefan du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| | - Ganesh B Chand
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Radiology and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Lebogang Phahladira
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| | - Hilmar K Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| | - Retha Smit
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| | - Daniel H Wolf
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Robin Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
| |
Collapse
|
6
|
Fryer SL, Marton TF, Roach BJ, Holroyd CB, Abram SV, Lau KJ, Ford JM, McQuaid JR, Mathalon DH. Alpha Event-Related Desynchronization During Reward Processing in Schizophrenia. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:551-559. [PMID: 37045705 DOI: 10.1016/j.bpsc.2022.12.015] [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: 08/11/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Alterations in the brain's reward system may underlie motivation and pleasure deficits in schizophrenia (SZ). Neuro-oscillatory desynchronization in the alpha band is thought to direct resource allocation away from the internal state, to prioritize processing salient environmental events, including reward feedback. We hypothesized reduced reward-related alpha event-related desynchronization (ERD) in SZ, consistent with less externally focused processing during reward feedback. METHODS Electroencephalography was recorded while participants with SZ (n = 54) and healthy control participants (n = 54) played a simple slot machine task. Total alpha band power (8-14 Hz), a measure of neural oscillation magnitude, was extracted via principal component analysis and compared between groups and reward outcomes. The clinical relevance of hypothesized alpha power alterations was examined by testing associations with negative symptoms within the SZ group and with trait rumination, dimensionally, across groups. RESULTS A group × reward outcome interaction (p = .018) was explained by healthy control participants showing significant posterior-occipital alpha power suppression to wins versus losses (p < .001), in contrast to participants with SZ (p > .1). Among participants with SZ, this alpha ERD was unrelated to negative symptoms (p > .1). Across all participants, less alpha ERD to reward outcomes covaried with greater trait rumination for both win (p = .005) and loss (p = .002) outcomes, with no group differences in slope. CONCLUSIONS These findings demonstrate alpha ERD alterations in SZ during reward outcome processing. Additionally, higher trait rumination was associated with less alpha ERD during reward feedback, suggesting that individual differences in rumination covary with external attention to reward processing, regardless of reward outcome valence or group membership.
Collapse
Affiliation(s)
- Susanna L Fryer
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California.
| | - Tobias F Marton
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Brian J Roach
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California
| | - Clay B Holroyd
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Samantha V Abram
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Ken J Lau
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California
| | - Judith M Ford
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - John R McQuaid
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Daniel H Mathalon
- VA San Francisco Healthcare System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| |
Collapse
|
7
|
Hua JPY, Cummings J, Roach BJ, Fryer SL, Loewy RL, Stuart BK, Ford JM, Vinogradov S, Mathalon DH. Rich-club connectivity and structural connectome organization in youth at clinical high-risk for psychosis and individuals with early illness schizophrenia. Schizophr Res 2023; 255:110-121. [PMID: 36989668 PMCID: PMC10705845 DOI: 10.1016/j.schres.2023.03.016] [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] [Received: 04/14/2022] [Revised: 11/07/2022] [Accepted: 03/08/2023] [Indexed: 03/31/2023]
Abstract
Brain dysconnectivity has been posited as a biological marker of schizophrenia. Emerging schizophrenia connectome research has focused on rich-club organization, a tendency for brain hubs to be highly-interconnected but disproportionately vulnerable to dysconnectivity. However, less is known about rich-club organization in individuals at clinical high-risk for psychosis (CHR-P) and how it compares with abnormalities early in schizophrenia (ESZ). Combining diffusion tensor imaging (DTI) and magnetic resonance imaging (MRI), we examined rich-club and global network organization in CHR-P (n = 41) and ESZ (n = 70) relative to healthy controls (HC; n = 74) after accounting for normal aging. To characterize rich-club regions, we examined rich-club MRI morphometry (thickness, surface area). We also examined connectome metric associations with symptom severity, antipsychotic dosage, and in CHR-P specifically, transition to a full-blown psychotic disorder. ESZ had fewer connections among rich-club regions (ps < .024) relative to HC and CHR-P, with this reduction specific to the rich-club even after accounting for other connections in ESZ relative to HC (ps < .048). There was also cortical thinning of rich-club regions in ESZ (ps < .013). In contrast, there was no strong evidence of global network organization differences among the three groups. Although connectome abnormalities were not present in CHR-P overall, CHR-P converters to psychosis (n = 9) had fewer connections among rich-club regions (ps < .037) and greater modularity (ps < .037) compared to CHR-P non-converters (n = 19). Lastly, symptom severity and antipsychotic dosage were not significantly associated with connectome metrics (ps < .012). Findings suggest that rich-club and connectome organization abnormalities are present early in schizophrenia and in CHR-P individuals who subsequently transition to psychosis.
Collapse
Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center and the University of California, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Jennifer Cummings
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Brian J Roach
- San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Susanna L Fryer
- San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Barbara K Stuart
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Judith M Ford
- San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Daniel H Mathalon
- San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA.
| |
Collapse
|
8
|
Palaniyappan L, Homan P, Alonso-Sanchez MF. Language Network Dysfunction and Formal Thought Disorder in Schizophrenia. Schizophr Bull 2023; 49:486-497. [PMID: 36305160 PMCID: PMC10016399 DOI: 10.1093/schbul/sbac159] [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: 11/13/2022]
Abstract
BACKGROUND Pathophysiological inquiries into schizophrenia require a consideration of one of its most defining features: disorganization and impoverishment in verbal behavior. This feature, often captured using the term Formal Thought Disorder (FTD), still remains to be one of the most poorly understood and understudied dimensions of schizophrenia. In particular, the large-scale network level dysfunction that contributes to FTD remains obscure to date. STUDY DESIGN In this narrative review, we consider the various challenges that need to be addressed for us to move towards mapping FTD (construct) to a brain network level account (circuit). STUDY RESULTS The construct-to-circuit mapping goal is now becoming more plausible than it ever was, given the parallel advent of brain stimulation and the tools providing objective readouts of human speech. Notwithstanding this, several challenges remain to be overcome before we can decisively map the neural basis of FTD. We highlight the need for phenotype refinement, robust experimental designs, informed analytical choices, and present plausible targets in and beyond the Language Network for brain stimulation studies in FTD. CONCLUSIONS Developing a therapeutically beneficial pathophysiological model of FTD is a challenging endeavor, but holds the promise of improving interpersonal communication and reducing social disability in schizophrenia. Addressing the issues raised in this review will be a decisive step in this direction.
Collapse
Affiliation(s)
- Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Canada
| | - Philipp Homan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Maria F Alonso-Sanchez
- Robarts Research Institute, Western University, London, Ontario, Canada
- CIDCL, Fonoaudiología, Facultad de Medicina, Universidad de Valparaíso, Valparaiso, Chile
| |
Collapse
|
9
|
Roach BJ, Hirano Y, Ford JM, Spencer KM, Mathalon DH. Phase Delay of the 40 Hz Auditory Steady-State Response Localizes to Left Auditory Cortex in Schizophrenia. Clin EEG Neurosci 2022:15500594221130896. [PMID: 36213937 DOI: 10.1177/15500594221130896] [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: 11/16/2022]
Abstract
Background. The auditory steady state response (ASSR) is generated in bilateral auditory cortex and is the most used electroencephalographic (EEG) or magnetoencephalographic measure of gamma band abnormalities in schizophrenia. While the finding of reduced 40-Hz ASSR power and phase consistency in schizophrenia have been replicated many times, the 40-Hz ASSR phase locking angle (PLA), which assesses oscillation latency or phase delay, has rarely been examined. Furthermore, whether 40-Hz ASSR phase delay in schizophrenia is lateralized or common to left and right auditory cortical generators is unknown. Methods. Previously analyzed EEG data recorded from 24 schizophrenia patients and 24 healthy controls presented with 20-, 30-, and 40-Hz click trains to elicit ASSRs were re-analyzed to assess PLA in source space. Dipole moments in the right and left hemisphere were used to assess both frequency and hemisphere specificity of ASSR phase delay in schizophrenia. Results. Schizophrenia patients exhibited significantly reduced (ie, phase delayed) 40-Hz PLA in the left, but not the right, hemisphere, but their 20- and 30-Hz PLA values were normal. This left-lateralized 40-Hz phase delay was unrelated to symptoms or to previously reported left-lateralized PLF reductions in the schizophrenia patients. Conclusions. Consistent with sensor-based studies, the 40-Hz ASSR source-localized to left, but not right, auditory cortex was phase delayed in schizophrenia. Consistent with prior studies showing left temporal lobe volume deficits in schizophrenia, our findings suggest sluggish entrainment to 40-Hz auditory stimulation specific to left auditory cortex that are distinct from well-established deficits in gamma ASSR power and phase synchrony.
Collapse
Affiliation(s)
- Brian J Roach
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, USA.,Northern California Institute for Research and Education (NCIRE), San Francisco, USA
| | - Yoji Hirano
- Neural Dynamics Laboratory, Research Service, Veterans Affairs Boston Healthcare System, Boston, USA.,Department of Psychiatry, 1811Harvard Medical School, Boston, USA.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Judith M Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, USA.,Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA
| | - Kevin M Spencer
- Neural Dynamics Laboratory, Research Service, Veterans Affairs Boston Healthcare System, Boston, USA.,Department of Psychiatry, 1811Harvard Medical School, Boston, USA
| | - Daniel H Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, USA.,Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA
| |
Collapse
|
10
|
Diamond A, Silverstein SM, Keane BP. Visual system assessment for predicting a transition to psychosis. Transl Psychiatry 2022; 12:351. [PMID: 36038544 PMCID: PMC9424317 DOI: 10.1038/s41398-022-02111-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 01/19/2023] Open
Abstract
The field of psychiatry is far from perfect in predicting which individuals will transition to a psychotic disorder. Here, we argue that visual system assessment can help in this regard. Such assessments have generated medium-to-large group differences with individuals prior to or near the first psychotic episode or have shown little influence of illness duration in larger samples of more chronic patients. For example, self-reported visual perceptual distortions-so-called visual basic symptoms-occur in up to 2/3rds of those with non-affective psychosis and have already longitudinally predicted an impending onset of schizophrenia. Possibly predictive psychophysical markers include enhanced contrast sensitivity, prolonged backward masking, muted collinear facilitation, reduced stereoscopic depth perception, impaired contour and shape integration, and spatially restricted exploratory eye movements. Promising brain-based markers include visual thalamo-cortical hyperconnectivity, decreased occipital gamma band power during visual detection (MEG), and reduced visually evoked occipital P1 amplitudes (EEG). Potentially predictive retinal markers include diminished cone a- and b-wave amplitudes and an attenuated photopic flicker response during electroretinography. The foregoing assessments are often well-described mechanistically, implying that their findings could readily shed light on the underlying pathophysiological changes that precede or accompany a transition to psychosis. The retinal and psychophysical assessments in particular are inexpensive, well-tolerated, easy to administer, and brief, with few inclusion/exclusion criteria. Therefore, across all major levels of analysis-from phenomenology to behavior to brain and retinal functioning-visual system assessment could complement and improve upon existing methods for predicting which individuals go on to develop a psychotic disorder.
Collapse
Affiliation(s)
- Alexander Diamond
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA
- Center for Visual Science, University of Rochester, 601 Elmwood Ave, Rochester, NY, USA
- Department of Ophthalmology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA
| | - Brian P Keane
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA.
- Department of Neuroscience, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA.
- Center for Visual Science, University of Rochester, 601 Elmwood Ave, Rochester, NY, USA.
- Department of Brain & Cognitive Sciences, University of Rochester, 358 Meliora Hall, NY, Rochester, USA.
| |
Collapse
|
11
|
Hua JPY, Abram SV, Ford JM. Cerebellar stimulation in schizophrenia: A systematic review of the evidence and an overview of the methods. Front Psychiatry 2022; 13:1069488. [PMID: 36620688 PMCID: PMC9815121 DOI: 10.3389/fpsyt.2022.1069488] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cerebellar structural and functional abnormalities underlie widespread deficits in clinical, cognitive, and motor functioning that are observed in schizophrenia. Consequently, the cerebellum is a promising target for novel schizophrenia treatments. Here we conducted an updated systematic review examining the literature on cerebellar stimulation efficacy and tolerability for mitigating symptoms of schizophrenia. We discuss the purported mechanisms of cerebellar stimulation, current methods for implementing stimulation, and future directions of cerebellar stimulation for intervention development with this population. METHODS Two independent authors identified 20 published studies (7 randomized controlled trials, 7 open-label studies, 1 pilot study, 4 case reports, 1 preclinical study) that describe the effects of cerebellar circuitry modulation in patients with schizophrenia or animal models of psychosis. Published studies up to October 11, 2022 were identified from a search within PubMed, Scopus, and PsycInfo. RESULTS Most studies stimulating the cerebellum used transcranial magnetic stimulation or transcranial direct-current stimulation, specifically targeting the cerebellar vermis/midline. Accounting for levels of methodological rigor across studies, these studies detected post-cerebellar modulation in schizophrenia as indicated by the alleviation of certain clinical symptoms (mainly negative and depressive symptoms), as well as increased frontal-cerebellar connectivity and augmentation of canonical neuro-oscillations known to be abnormal in schizophrenia. In contrast to a prior review, we did not find consistent evidence for cognitive improvements following cerebellar modulation stimulation. Modern cerebellar stimulation methods appear tolerable for individuals with schizophrenia, with only mild and temporary side effects. CONCLUSION Cerebellar stimulation is a promising intervention for individuals with schizophrenia that may be more relevant to some symptom domains than others. Initial results highlight the need for continued research using more methodologically rigorous designs, such as additional longitudinal and randomized controlled trials. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022346667].
Collapse
Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States.,San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Samantha V Abram
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Judith M Ford
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
12
|
Barros C, Silva CA, Pinheiro AP. Advanced EEG-based learning approaches to predict schizophrenia: Promises and pitfalls. Artif Intell Med 2021; 114:102039. [PMID: 33875158 DOI: 10.1016/j.artmed.2021.102039] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/11/2020] [Accepted: 02/16/2021] [Indexed: 01/10/2023]
Abstract
The complexity and heterogeneity of schizophrenia symptoms challenge an objective diagnosis, which is typically based on behavioral and clinical manifestations. Moreover, the boundaries of schizophrenia are not precisely demarcated from other nosologic categories, such as bipolar disorder. The early detection of schizophrenia can lead to a more effective treatment, improving patients' quality of life. Over the last decades, hundreds of studies aimed at specifying the neurobiological mechanisms that underpin clinical manifestations of schizophrenia, using techniques such as electroencephalography (EEG). Changes in event-related potentials of the EEG have been associated with sensory and cognitive deficits and proposed as biomarkers of schizophrenia. Besides contributing to a more effective diagnosis, biomarkers can be crucial to schizophrenia onset prediction and prognosis. However, any proposed biomarker requires substantial clinical research to prove its validity and cost-effectiveness. Fueled by developments in computational neuroscience, automatic classification of schizophrenia at different stages (prodromal, first episode, chronic) has been attempted, using brain imaging pattern recognition methods to capture differences in functional brain activity. Advanced learning techniques have been studied for this purpose, with promising results. This review provides an overview of recent machine learning-based methods for schizophrenia classification using EEG data, discussing their potentialities and limitations. This review is intended to serve as a starting point for future developments of effective EEG-based models that might predict the onset of schizophrenia, identify subjects at high-risk of psychosis conversion or differentiate schizophrenia from other disorders, promoting more effective early interventions.
Collapse
Affiliation(s)
- Carla Barros
- Center for Research in Psychology (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Carlos A Silva
- Center for Microelectromechanical Systems (CMEMS), School of Engineering, University of Minho, Guimarães, Portugal
| | - Ana P Pinheiro
- Center for Research in Psychology (CIPsi), School of Psychology, University of Minho, Braga, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal.
| |
Collapse
|
13
|
Fryer SL, Roach BJ, Hamilton HK, Bachman P, Belger A, Carrión RE, Duncan E, Johannesen J, Light GA, Niznikiewicz M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman L, Tsuang M, Walker EF, Woods SW, Mathalon DH. Deficits in auditory predictive coding in individuals with the psychosis risk syndrome: Prediction of conversion to psychosis. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 129:599-611. [PMID: 32757603 DOI: 10.1037/abn0000513] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The mismatch negativity (MMN) event-related potential (ERP) component is increasingly viewed as a prediction error signal elicited when a deviant sound violates the prediction that a frequent "standard" sound will repeat. Support for this predictive coding framework emerged with the identification of the repetition positivity (RP), a standard stimulus ERP component that increases with standard repetition and is thought to reflect strengthening of the standard's memory trace and associated predictive code. Using electroencephalographic recordings, we examined the RP elicited by repeating standard tones presented during a traditional "constant standard" MMN paradigm in individuals with the psychosis risk syndrome (PRS; n = 579) and healthy controls (HC; n = 241). Clinical follow-up assessments identified PRS participants who converted to a psychotic disorder (n = 77) and PRS nonconverters who were followed for the entire 24-month clinical follow-up period and either remained symptomatic (n = 144) or remitted from the PRS (n = 94). In HC, RP linearly increased from early- to late-appearing standards within local trains of repeating standards (p < .0001), consistent with auditory predictive code/memory trace strengthening. Relative to HC, PRS participants showed a reduced RP across standards (p = .0056). PRS converters showed a relatively small RP deficit for early appearing standards relative to HC (p = .0.0107) and a more prominent deficit for late-appearing standards (p = .0006) relative to both HC and PRS-remitted groups. Moreover, greater RP deficits predicted shorter time to conversion in a subsample of unmedicated PRS individuals (p = .02). Thus, auditory predictive coding/memory trace deficits precede psychosis onset and predict future psychosis risk in PRS individuals. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | | | | | - Aysenil Belger
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System
| | | | | | - Gregory A Light
- Department of Psychiatry, University of California, San Diego
| | - Margaret Niznikiewicz
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center
| | - Jean Addington
- Hotchkiss Brain Institute Department of Psychiatry, University of Calgary
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | | | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Larry Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center
| | - Ming Tsuang
- Department of Psychiatry, University of California, San Diego
| | | | - Scott W Woods
- Department of Psychiatry, Yale University, School of Medicine
| | | |
Collapse
|
14
|
Effects of Transcranial Direct Current Stimulation (tDCS) in the Normalization of Brain Activation in Patients with Neuropsychiatric Disorders: A Systematic Review of Neurophysiological and Neuroimaging Studies. Neural Plast 2020; 2020:8854412. [PMID: 33424961 PMCID: PMC7773462 DOI: 10.1155/2020/8854412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/23/2020] [Accepted: 12/03/2020] [Indexed: 11/17/2022] Open
Abstract
Background People with neuropsychiatric disorders have been found to have abnormal brain activity, which is associated with the persistent functional impairment found in these patients. Recently, transcranial direct current stimulation (tDCS) has been shown to normalize this pathological brain activity, although the results are inconsistent. Objective We explored whether tDCS alters and normalizes brain activity among patients with neuropsychiatric disorders. Moreover, we examined whether these changes in brain activity are clinically relevant, as evidenced by brain-behavior correlations. Methods A systematic review was conducted according to PRISMA guidelines. Randomized controlled trials that studied the effects of tDCS on brain activity by comparing experimental and sham control groups using either electrophysiological or neuroimaging methods were included. Results With convergent evidence from 16 neurophysiological/neuroimaging studies, active tDCS was shown to be able to induce changes in brain activation patterns in people with neuropsychiatric disorders. Importantly, anodal tDCS appeared to normalize aberrant brain activation in patients with schizophrenia and substance abuse, and the effect was selectively correlated with reaction times, task-specific accuracy performance, and some symptom severity measures. Limitations and Conclusions. Due to the inherent heterogeneity in brain activity measurements for tDCS studies among people with neuropsychiatric disorders, no meta-analysis was conducted. We recommend that future studies investigate the effect of repeated cathodal tDCS on brain activity. We suggest to clinicians that the prescription of 1-2 mA anodal stimulation for patients with schizophrenia may be a promising treatment to alleviate positive symptoms. This systematic review is registered with registration number CRD42020183608.
Collapse
|
15
|
Abram SV, Roach BJ, Holroyd CB, Paulus MP, Ford JM, Mathalon DH, Fryer SL. Reward processing electrophysiology in schizophrenia: Effects of age and illness phase. Neuroimage Clin 2020; 28:102492. [PMID: 33395983 PMCID: PMC7695886 DOI: 10.1016/j.nicl.2020.102492] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND Reward processing abnormalities may underlie characteristic pleasure and motivational impairments in schizophrenia. Some neural measures of reward processing show age-related modulation, highlighting the importance of considering age effects on reward sensitivity. We compared event-related potentials (ERPs) reflecting reward anticipation (stimulus-preceding negativity, SPN) and evaluation (reward positivity, RewP; late positive potential, LPP) across individuals with schizophrenia (SZ) and healthy controls (HC), with an emphasis on examining the effects of chronological age, brain age (i.e., predicted age based on neurobiological measures), and illness phase. METHODS Subjects underwent EEG while completing a slot-machine task for which rewards were not dependent on performance accuracy, speed, or response preparation. Slot-machine task EEG responses were compared between 54 SZ and 54 HC individuals, ages 19 to 65. Reward-related ERPs were analyzed with respect to chronological age, categorically-defined illness phase (early; ESZ versus chronic schizophrenia; CSZ), and were used to model brain age relative to chronological age. RESULTS Illness phase-focused analyses indicated there were no group differences in average SPN or RewP amplitudes. However, a group × reward outcome interaction revealed that ESZ differed from HC in later outcome processing, reflected by greater LPP responses following loss versus reward (a reversal of the HC pattern). While brain age estimates did not differ among groups, depressive symptoms in SZ were associated with older brain age estimates while controlling for negative symptoms. CONCLUSIONS ESZ and CSZ did not differ from HC in reward anticipation or early outcome processing during a cognitively undemanding reward task, highlighting areas of preserved functioning. However, ESZ showed altered later reward outcome evaluation, pointing to selective reward deficits during the early illness phase of schizophrenia. Further, an association between ERP-derived brain age and depressive symptoms in SZ extends prior findings linking depression with reward-related ERP blunting. Taken together, both illness phase and age may impact reward processing among SZ, and brain aging may offer a promising, novel marker of reward dysfunction that warrants further study.
Collapse
Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, and the University of California, San Francisco, CA, USA; Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brian J Roach
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Clay B Holroyd
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | | | - Judith M Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Daniel H Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Susanna L Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
16
|
Sheffield JM, Huang AS, Rogers BP, Giraldo-Chica M, Landman BA, Blackford JU, Heckers S, Woodward ND. Thalamocortical Anatomical Connectivity in Schizophrenia and Psychotic Bipolar Disorder. Schizophr Bull 2020; 46:1062-1071. [PMID: 32219397 PMCID: PMC7505173 DOI: 10.1093/schbul/sbaa022] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anatomical connectivity between the thalamus and cortex, including the prefrontal cortex (PFC), is abnormal in schizophrenia. Overlapping phenotypes, including deficits in executive cognitive abilities dependent on PFC-thalamic circuitry, suggest dysrupted thalamocortical anatomical connectivity may extend to psychotic bipolar disorder. We tested this hypothesis and examined the impact of illness stage to inform when in the illness course thalamocortical dysconnectivity emerges. METHODS Diffusion-weighted imaging data were collected on 70 healthy individuals and 124 people with a psychotic disorder (schizophrenia spectrum = 75; psychotic bipolar disorder = 49), including 62 individuals in the early stage of psychosis. Anatomical connectivity between major divisions of the cortex and thalamus was quantified using probabilistic tractography and compared between groups. Associations between PFC-thalamic anatomical connectivity and executive cognitive abilities were examined using regression analysis. RESULTS Psychosis was associated with lower PFC-thalamic and elevated somatosensory-thalamic anatomical connectivity. Follow-up analyses established that lower PFC-thalamic and elevated somatosensory-thalamic anatomical connectivity were present in both schizophrenia and psychotic bipolar disorder. Lower PFC-thalamic anatomical connectivity was also present in early-stage and chronic psychosis. Contrary to expectations, lower PFC-thalamic anatomical connectivity was not associated with impaired executive cognitive abilities. CONCLUSIONS Altered thalamocortical anatomical connectivity, especially reduced PFC-thalamic connectivity, is a transdiagnostic feature of psychosis detectable in the early stage of illness. Further work is required to elucidate the functional consequences of the full spectrum of thalamocortical connectivity abnormalities in psychosis.
Collapse
Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Anna S Huang
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Baxter P Rogers
- Vanderbilt University Institute of Imaging Science, Nashville, TN
| | | | - Bennett A Landman
- Vanderbilt University Institute of Imaging Science, Nashville, TN
- Vanderbilt University School of Engineering, Nashville, TN
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
- Research and Development, Department of Veterans Affairs Medical Center, Nashville, TN
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN
| |
Collapse
|
17
|
Ford JM, Mathalon DH. Efference Copy, Corollary Discharge, Predictive Coding, and Psychosis. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 4:764-767. [PMID: 31495399 DOI: 10.1016/j.bpsc.2019.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Judith M Ford
- Veterans Affairs San Francisco Healthcare System and the University of California, San Francisco, San Francisco, California.
| | - Daniel H Mathalon
- Veterans Affairs San Francisco Healthcare System and the University of California, San Francisco, San Francisco, California
| |
Collapse
|
18
|
Abram SV, De Coster L, Roach BJ, Mueller BA, van Erp TGM, Calhoun VD, Preda A, Lim KO, Turner JA, Ford JM, Mathalon DH, Woolley JD. Oxytocin Enhances an Amygdala Circuit Associated With Negative Symptoms in Schizophrenia: A Single-Dose, Placebo-Controlled, Crossover, Randomized Control Trial. Schizophr Bull 2020; 46:661-669. [PMID: 31595302 PMCID: PMC7147578 DOI: 10.1093/schbul/sbz091] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Negative symptoms are core contributors to vocational and social deficits in schizophrenia (SZ). Available antipsychotic medications typically fail to reduce these symptoms. The neurohormone oxytocin (OT) is a promising treatment for negative symptoms, given its role in complex social behaviors mediated by the amygdala. In sample 1, we used a double-blind, placebo-controlled, crossover design to test the effects of a single dose of intranasal OT on amygdala resting-state functional connectivity (rsFC) in SZ (n = 22) and healthy controls (HC, n = 24) using a whole-brain corrected approach: we identified regions for which OT modulated SZ amygdala rsFC, assessed whether OT-modulated circuits were abnormal in SZ relative to HC on placebo, and evaluated whether connectivity on placebo and OT-induced connectivity changes correlated with baseline negative symptoms in SZ. Given our modest sample size, we used a second SZ (n = 183) and HC (n = 178) sample to replicate any symptom correlations. In sample 1, OT increased rsFC between the amygdala and left middle temporal gyrus, superior temporal sulcus, and angular gyrus (MTG/STS/AngG) in SZ compared to HC. Further, SZ had hypo-connectivity in this circuit compared to HC on placebo. More severe negative symptoms correlated with less amygdala-to-left-MTG/STS/AngG connectivity on placebo and with greater OT-induced connectivity increases. In sample 2, we replicated the correlation between amygdala-left-MTG/STS/AngG hypo-connectivity and negative symptoms, finding a specific association with expressive negative symptoms. These data suggest intranasal OT can normalize functional connectivity in an amygdala-to-left-MTG/STS/AngG circuit that contributes to negative symptoms in SZ.
Collapse
Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center, and the University of California, San Francisco, CA,Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Lize De Coster
- Department of Computer Science, Universidad Carlos III de Madrid, Madrid, Spain
| | - Brian J Roach
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Bryon A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM,Department of Psychiatry, University of New Mexico, Albuquerque, NM,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | - Judith M Ford
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Daniel H Mathalon
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Joshua D Woolley
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA,Department of Psychiatry, University of California San Francisco, San Francisco, CA,To whom correspondence should be addressed; 4150 Clement Street, Box (116C-1 [Joshua Woolley]), San Francisco, CA 94121, US; tel: 415-221-4810-x24117; fax: 415-379-5667, e-mail:
| |
Collapse
|
19
|
Leonard CJ, Robinson BM, Hahn B, Luck SJ, Gold JM. Altered spatial profile of distraction in people with schizophrenia. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 126:1077-1086. [PMID: 29154568 DOI: 10.1037/abn0000314] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Attention is critical for effective processing of incoming information and has long been identified as a potential area of dysfunction in people with schizophrenia (PSZ). In the realm of visual processing, both spatial attention and feature-based attention are involved in biasing selection toward task-relevant stimuli and avoiding distraction. Evidence from multiple paradigms has suggested that PSZ may hyperfocus and have a narrower "spotlight" of spatial attention. In contrast, feature-based attention seems largely preserved, with some suggestion of increased processing of stimuli sharing the target-defining feature. In the current study, we examined the spatial profile of feature-based distraction using a task in which participants searched for a particular color target and attempted to ignore distractors that varied in distance from the target location and either matched or mismatched the target color. PSZ differed from healthy controls in terms of interference from peripheral distractors that shared the target-color presented 200 ms before a central target. Specifically, PSZ showed an amplified gradient of spatial attention, with increased distraction to near distractors and less interference to far distractors. Moreover, consistent with hyperfocusing, individual differences in this spatial profile were correlated with positive symptoms, such that those with greater positive symptoms showed less distraction by target-colored distractors near the task-relevant location. (PsycINFO Database Record
Collapse
Affiliation(s)
| | - Benjamin M Robinson
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| |
Collapse
|
20
|
Whitford TJ. Speaking-Induced Suppression of the Auditory Cortex in Humans and Its Relevance to Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:791-804. [PMID: 31399393 DOI: 10.1016/j.bpsc.2019.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 01/13/2023]
Abstract
Speaking-induced suppression (SIS) is the phenomenon that the sounds one generates by overt speech elicit a smaller neurophysiological response in the auditory cortex than comparable sounds that are externally generated. SIS is a specific example of the more general phenomenon of self-suppression. SIS has been well established in nonhuman animals and is believed to involve the action of corollary discharges. This review summarizes, first, the evidence for SIS in heathy human participants, where it has been most commonly assessed with electroencephalography and/or magnetoencephalography using an experimental paradigm known as "Talk-Listen"; and second, the growing number of Talk-Listen studies that have reported subnormal levels of SIS in patients with schizophrenia. This result is theoretically significant, as it provides a plausible explanation for some of the most distinctive and characteristic symptoms of schizophrenia, namely the first-rank symptoms. In particular, while the failure to suppress the neural consequences of self-generated movements (such as those associated with overt speech) provides a prima facie explanation for delusions of control, the failure to suppress the neural consequences of self-generated inner speech provides a plausible explanation for certain classes of auditory-verbal hallucinations, such as audible thoughts. While the empirical evidence for a relationship between SIS and the first-rank symptoms is currently limited, I predict that future studies with more sensitive experimental designs will confirm its existence. Establishing the existence of a causal, mechanistic relationship would represent a major step forward in our understanding of schizophrenia, which is a necessary precursor to the development of novel treatments.
Collapse
Affiliation(s)
- Thomas J Whitford
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia.
| |
Collapse
|
21
|
Ferri J, Ford JM, Roach BJ, Turner JA, van Erp TG, Voyvodic J, Preda A, Belger A, Bustillo J, O'Leary D, Mueller BA, Lim KO, McEwen SC, Calhoun VD, Diaz M, Glover G, Greve D, Wible CG, Vaidya JG, Potkin SG, Mathalon DH. Resting-state thalamic dysconnectivity in schizophrenia and relationships with symptoms. Psychol Med 2018; 48:2492-2499. [PMID: 29444726 DOI: 10.1017/s003329171800003x] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizophrenia (SZ) is a severe neuropsychiatric disorder associated with disrupted connectivity within the thalamic-cortico-cerebellar network. Resting-state functional connectivity studies have reported thalamic hypoconnectivity with the cerebellum and prefrontal cortex as well as thalamic hyperconnectivity with sensory cortical regions in SZ patients compared with healthy comparison participants (HCs). However, fundamental questions remain regarding the clinical significance of these connectivity abnormalities. METHOD Resting state seed-based functional connectivity was used to investigate thalamus to whole brain connectivity using multi-site data including 183 SZ patients and 178 matched HCs. Statistical significance was based on a voxel-level FWE-corrected height threshold of p < 0.001. The relationships between positive and negative symptoms of SZ and regions of the brain demonstrating group differences in thalamic connectivity were examined. RESULTS HC and SZ participants both demonstrated widespread positive connectivity between the thalamus and cortical regions. Compared with HCs, SZ patients had reduced thalamic connectivity with bilateral cerebellum and anterior cingulate cortex. In contrast, SZ patients had greater thalamic connectivity with multiple sensory-motor regions, including bilateral pre- and post-central gyrus, middle/inferior occipital gyrus, and middle/superior temporal gyrus. Thalamus to middle temporal gyrus connectivity was positively correlated with hallucinations and delusions, while thalamus to cerebellar connectivity was negatively correlated with delusions and bizarre behavior. CONCLUSIONS Thalamic hyperconnectivity with sensory regions and hypoconnectivity with cerebellar regions in combination with their relationship to clinical features of SZ suggest that thalamic dysconnectivity may be a core neurobiological feature of SZ that underpins positive symptoms.
Collapse
Affiliation(s)
- J Ferri
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| | - J M Ford
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| | - B J Roach
- San Francisco VA Health Care System,San Francisco, CA,USA
| | - J A Turner
- The Mind Research Network,Albuquerque, NM,USA
| | - T G van Erp
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - J Voyvodic
- Department of Psychiatry,Duke University,Raleigh-Durham, NC,USA
| | - A Preda
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - A Belger
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
| | - J Bustillo
- Department of Psychiatry,University of New Mexico,Albuquerque, NM,USA
| | - D O'Leary
- Department of Psychiatry,University of Iowa,Iowa City, IA,USA
| | - B A Mueller
- Department of Psychiatry,University of Minnesota,Minneapolis, MN,USA
| | - K O Lim
- Department of Psychiatry,University of Minnesota,Minneapolis, MN,USA
| | - S C McEwen
- Department of Psychiatry,University of California,Los Angeles, Los Angeles, CA,USA
| | - V D Calhoun
- The Mind Research Network,Albuquerque, NM,USA
| | - M Diaz
- Department of Psychiatry,Duke University,Raleigh-Durham, NC,USA
| | - G Glover
- Department of Radiology,Stanford University,Stanford, CA,USA
| | - D Greve
- Department of Radiology,Massachusetts General Hospital,Boston, MA,USA
| | - C G Wible
- Department of Psychiatry,Harvard University,Boston, MA,USA
| | - J G Vaidya
- Department of Psychiatry,University of Iowa,Iowa City, IA,USA
| | - S G Potkin
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - D H Mathalon
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| |
Collapse
|
22
|
Keane BP, Paterno D, Kastner S, Krekelberg B, Silverstein SM. Intact illusory contour formation but equivalently impaired visual shape completion in first- and later-episode schizophrenia. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 128:57-68. [PMID: 30346202 DOI: 10.1037/abn0000384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Visual shape completion is a fundamental process that constructs contours and shapes on the basis of the geometric relations between spatially separated edge elements. People with schizophrenia are impaired at distinguishing visually completed shapes, but when does the impairment emerge and how does it evolve with illness duration? The question bears on the debate as to whether cognition declines after illness onset. To address the issue, we tested healthy controls (n = 48), first-episode psychosis patients (n = 23), and chronic schizophrenia patients (n = 49) on a classic psychophysical task in which subjects discriminated the relative orientations of four sectored circles that either formed or did not form visually completed shapes (illusory and fragmented conditions, respectively). Visual shape completion was quantified as the extent to which performance in the illusory condition exceeded that of the fragmented. Half of the trials incorporated wire edge elements, which augment contour salience and improve shape completion. Each patient group exhibited large visual shape completion deficits that could not be explained by differences in age, motivation, or orientation tuning. Patients responded normally to changes in illusory contour salience, indicating that they were forming but not adequately employing such contours for discriminating shapes. Shape completion deficits were most apparent for patients with cognitive disorganization, poor premorbid early adolescent functioning, and normal orientation discrimination. Visual shape completion deficits emerge maximally by the first psychotic episode and arise from higher-level disturbances that are related to premorbid functioning and disorganization. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
- Brian P Keane
- Department of Psychiatry, Robert Wood Johnson Medical School, University Behavioral Health Care, Rutgers Biomedical and Health Sciences, Rutgers University
| | | | | | - Bart Krekelberg
- Center for Molecular and Behavioral Neuroscience, Rutgers University
| | - Steven M Silverstein
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University
| |
Collapse
|
23
|
Knolle F, Ermakova AO, Justicia A, Fletcher PC, Bunzeck N, Düzel E, Murray GK. Brain responses to different types of salience in antipsychotic naïve first episode psychosis: An fMRI study. Transl Psychiatry 2018; 8:196. [PMID: 30242202 PMCID: PMC6154975 DOI: 10.1038/s41398-018-0250-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/16/2018] [Accepted: 07/24/2018] [Indexed: 02/07/2023] Open
Abstract
Abnormal salience processing has been suggested to contribute to the formation of positive psychotic symptoms in schizophrenia and related conditions. Previous research utilising reward learning or anticipation paradigms has demonstrated cortical and subcortical abnormalities in people with psychosis, specifically in the prefrontal cortex, the dopaminergic midbrain and the striatum. In these paradigms, reward prediction errors attribute motivational salience to stimuli. However, little is known about possible abnormalities across different forms of salience processing in psychosis patients, and whether any such abnormalities involve the dopaminergic midbrain. The aim of our study was, therefore, to investigate possible alterations in psychosis in neural activity in response to various forms of salience: novelty, negative emotion, targetness (task-driven salience) and rareness/deviance. We studied 14 antipsychotic naïve participants with first episode psychosis, and 37 healthy volunteers. During fMRI scanning, participants performed a visual oddball task containing these four forms of salience. Psychosis patients showed abnormally reduced signalling in the substantia nigra/ventral tegmental area (SN/VTA) for novelty, negative emotional salience and targetness; reduced striatal and occipital (lingual gyrus) signalling to novelty and negative emotional salience, reduced signalling in the amygdala, anterior cingulate cortex and parahippocamal gyrus to negative emotional salience, and reduced cerebellar signalling to novelty and negative emotional salience. Our results indicate alterations of several forms of salience processing in patients with psychosis in the midbrain SN/VTA, with additional subcortical and cortical regions also showing alterations in salience signalling, the exact pattern of alterations depending on the form of salience in question.
Collapse
Affiliation(s)
- Franziska Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
| | - Anna O Ermakova
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
| | - Azucena Justicia
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
- IMIM (Hospital del Mar Medical Research Institute)., Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Paul C Fletcher
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Nico Bunzeck
- Institute of Psychology, University of Lübeck, Lübeck, Germany
| | - Emrah Düzel
- Otto-von-Guericke University Magdeburg, Institute of Cognitive Neurology and Dementia Research, Magdeburg, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Graham K Murray
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
24
|
Roach BJ, Ford JM, Mathalon DH. Gamma Band Phase Delay in Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:131-139. [PMID: 30314905 DOI: 10.1016/j.bpsc.2018.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/15/2018] [Accepted: 08/15/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND In 1999, Kwon et al. reported several electroencephalographic gamma band auditory steady-state response (ASSR) abnormalities in schizophrenia, spawning approximately 100 subsequent studies. While many studies replicated the finding of reduced 40-Hz ASSR power in schizophrenia and extended this by showing that 40-Hz phase synchrony (phase-locking factor [PLF]) was also reduced, none attempted to replicate the original phase delay finding of Kwon et al. Accordingly, we measured the 40-Hz ASSR phase-locking angle (PLA) to assess phase delay and examined its differential sensitivity to schizophrenia, relative to power and PLF measures. METHODS To obtain ASSRs, electroencephalography data were recorded from 28 patients with schizophrenia and 25 healthy control subjects listening to repeated 40-Hz 500-ms click trains. Evoked power, total power, PLF, and PLA were calculated after Morlet wavelet time-frequency decomposition of single trial data from electrode Fz. RESULTS In patients with schizophrenia, 40-Hz PLA was significantly reduced (i.e., phase delayed) (p < .0001) and was unrelated to reductions in their 40-Hz power or PLF. PLA discriminated patients from healthy control subjects with 85% accuracy compared with 67% for power and 65% for PLF. CONCLUSIONS Consistent with the original Kwon et al. study, 40-Hz click train-driven gamma oscillations were phase delayed in schizophrenia. Importantly, this phase delay abnormality was substantially larger than the gamma power and phase synchrony abnormalities that have been the focus of prior 40-Hz ASSR studies in schizophrenia. PLA provides a unique neurobiological measure of gamma band abnormalities in schizophrenia, likely reflecting a distinct pathophysiological mechanism from those underlying PLF and power abnormalities.
Collapse
Affiliation(s)
- Brian J Roach
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, San Francisco, California; Northern California Institute for Research and Education, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, California
| | - Judith M Ford
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, San Francisco, California; Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Daniel H Mathalon
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, San Francisco, California; Department of Psychiatry, University of California, San Francisco, San Francisco, California.
| |
Collapse
|
25
|
Cariaga-Martinez A, Gutiérrez K, Alelú-Paz R. Rethinking schizophrenia through the lens of evolution: shedding light on the enigma. RESEARCH IDEAS AND OUTCOMES 2018. [DOI: 10.3897/rio.4.e28459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Schizophrenia refers to a complex psychiatric illness characterized by the heterogenic presence of positive, negative and cognitive symptoms occurring in all human societies. The fact that the disorder lacks a unifying neuropathology, presents a decreased fecundity of the affected individuals and has a cross-culturally stable incidence rate, makes it necessary for an evolutionary explanation that fully accounts for the preservation of “schizophrenic genes” in the global human genepool, explaining the potential sex differences and the heterogeneous cognitive symptomatology of the disorder and is consistent with the neuropsychological, developmental and evolutionary findings regarding the human brain. Here we proposed a new evolutionary framework for schizophrenia that is consistent with findings presented in different dimensions, considering the disorder as a form of brain functioning that allows us to adapt to the environment and, ultimately, maintain the survival of the species. We focus on the epigenetic regulation of thalamic interneurons as a major player involved in the development of the clinical picture characteristic of schizophrenia.
Collapse
|
26
|
Abnormal reward prediction-error signalling in antipsychotic naive individuals with first-episode psychosis or clinical risk for psychosis. Neuropsychopharmacology 2018; 43:1691-1699. [PMID: 29748629 PMCID: PMC6006166 DOI: 10.1038/s41386-018-0056-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/20/2022]
Abstract
Ongoing research suggests preliminary, though not entirely consistent, evidence of neural abnormalities in signalling prediction errors in schizophrenia. Supporting theories suggest mechanistic links between the disruption of these processes and the generation of psychotic symptoms. However, it is unknown at what stage in the pathogenesis of psychosis these impairments in prediction-error signalling develop. One major confound in prior studies is the use of medicated patients with strongly varying disease durations. Our study aims to investigate the involvement of the meso-cortico-striatal circuitry during reward prediction-error signalling in earliest stages of psychosis. We studied patients with first-episode psychosis (FEP) and help-seeking individuals at-risk for psychosis due to sub-threshold prodromal psychotic symptoms. Patients with either FEP (n = 14), or at-risk for developing psychosis (n = 30), and healthy volunteers (n = 39) performed a reinforcement learning task during fMRI scanning. ANOVA revealed significant (p < 0.05 family-wise error corrected) prediction-error signalling differences between groups in the dopaminergic midbrain and right middle frontal gyrus (dorsolateral prefrontal cortex, DLPFC). FEP patients showed disrupted reward prediction-error signalling compared to controls in both regions. At-risk patients showed intermediate activation in the midbrain that significantly differed from controls and from FEP patients, but DLPFC activation that did not differ from controls. Our study confirms that FEP patients have abnormal meso-cortical signalling of reward-prediction errors, whereas reward-prediction-error dysfunction in the at-risk patients appears to show a more nuanced pattern of activation with a degree of midbrain impairment but preserved cortical function.
Collapse
|
27
|
Evaluating accuracy of striatal, pallidal, and thalamic segmentation methods: Comparing automated approaches to manual delineation. Neuroimage 2018; 170:182-198. [DOI: 10.1016/j.neuroimage.2017.02.069] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/03/2017] [Accepted: 02/24/2017] [Indexed: 12/16/2022] Open
|
28
|
Keane BP, Cruz LN, Paterno D, Silverstein SM. Self-Reported Visual Perceptual Abnormalities Are Strongly Associated with Core Clinical Features in Psychotic Disorders. Front Psychiatry 2018; 9:69. [PMID: 29593580 PMCID: PMC5858532 DOI: 10.3389/fpsyt.2018.00069] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 02/19/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Past studies using the Bonn Scale for the Assessment of Basic Symptoms (hereafter, Bonn Scale) have shown that self-reported perceptual/cognitive disturbances reveal which persons have or will soon develop schizophrenia. Here, we focused specifically on the clinical value of self-reported visual perceptual abnormalities (VPAs) since they are underexplored and have been associated with suicidal ideation, negative symptoms, and objective visual dysfunction. METHOD Using the 17 Bonn Scale vision items, we cross-sectionally investigated lifetime occurrence of VPAs in 21 first-episode psychosis and 22 chronic schizophrenia/schizoaffective disorder (SZ/SA) patients. Relationships were probed between VPAs and illness duration, symptom severity, current functioning, premorbid functioning, diagnosis, and age of onset. RESULTS Increased VPAs were associated with: earlier age of onset; more delusions, hallucinations, bizarre behavior, and depressive symptoms; and worse premorbid social functioning, especially in the childhood and early adolescent phases. SZ/SA participants endorsed more VPAs as compared to those with schizophreniform or psychotic disorder-NOS, especially in the perception of color, bodies, faces, object movement, and double/reversed vision. The range of self-reported VPAs was strikingly similar between first-episode and chronic patients and did not depend on the type or amount of antipsychotic medication. As a comparative benchmark, lifetime occurrence of visual hallucinations did not depend on diagnosis and was linked only to poor premorbid social functioning. CONCLUSION A brief 17-item interview derived from the Bonn Scale is strongly associated with core clinical features in schizophrenia. VPAs hold promise for clarifying diagnosis, predicting outcome, and guiding neurocognitive investigations.
Collapse
Affiliation(s)
- Brian P. Keane
- University Behavioral Health Care, Rutgers University, Piscataway, NJ, United States
- Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, United States
- Center for Cognitive Science, Rutgers University, Piscataway, NJ, United States
| | - Lisa N. Cruz
- University Behavioral Health Care, Rutgers University, Piscataway, NJ, United States
| | - Danielle Paterno
- University Behavioral Health Care, Rutgers University, Piscataway, NJ, United States
| | - Steven M. Silverstein
- University Behavioral Health Care, Rutgers University, Piscataway, NJ, United States
- Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, United States
- Center for Cognitive Science, Rutgers University, Piscataway, NJ, United States
| |
Collapse
|
29
|
Takahashi T, Goto T, Nobukawa S, Tanaka Y, Kikuchi M, Higashima M, Wada Y. Abnormal functional connectivity of high-frequency rhythms in drug-naïve schizophrenia. Clin Neurophysiol 2018; 129:222-231. [DOI: 10.1016/j.clinph.2017.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 01/15/2023]
|
30
|
Abstract
It has been surprisingly difficult to find associations between neural signatures of schizophrenia and the symptoms that define it. That is, many of the legacy components of the event-related potential (ERP)- P50, N100, P200, P300-are reduced in patients with schizophrenia, in first-degree relatives of patients with schizophrenia, in schizophrenia patients early in their illness, and even in people at clinical high risk for schizophrenia. Nevertheless, these ERP components tend to be relatively insensitive to symptoms. This might be due to a number of reasons. First, this could reflect a lack of relationship, a failure to report disappointing findings, or a failure to test for relationships. Second, many ERP studies were not designed to be sensitive to symptoms or to the mechanisms that might underlie them. Third, assessing symptoms is sometimes dependent on the patients' ability to describe unfathomable experiences and the clinicians' ability to understand and interpret them. Fourth, medications and comorbidities may decouple the symptoms from the neurobiology. Finally, we must also consider the possibility that the schizophrenia diagnosis breeds truer than the symptoms it comprises.
Collapse
Affiliation(s)
- Judith M Ford
- 1 San Francisco Veterans Administration Medical Center, San Francisco, CA, USA.,2 University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
31
|
Stegmayer K, Strik W, Federspiel A, Wiest R, Bohlhalter S, Walther S. Specific cerebral perfusion patterns in three schizophrenia symptom dimensions. Schizophr Res 2017; 190:96-101. [PMID: 28320578 DOI: 10.1016/j.schres.2017.03.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 12/18/2022]
Abstract
Dimensional concepts such as the Research Domain Criteria initiative have been proposed to disentangle the heterogeneity of schizophrenia. One model introduced three neurobiologically informed behavioral dimensions: language, affectivity and motor behavior. To study the brain-behavior associations of these three dimensions, we investigated whether current behavioral alterations were linked to resting state perfusion in distinct brain circuits in schizophrenia. In total, 47 patients with schizophrenia spectrum disorders and 44 healthy controls were included. Psychopathology was assessed with the Positive And Negative Syndrome Scale and the Bern Psychopathology scale (BPS). The BPS provides severity ratings of three behavioral dimensions (language, affectivity and motor). Patients were classified according to the severity of alterations (severe, mild, no) in each dimension. Whole brain resting state cerebral blood flow (CBF) was compared between patient subgroups and controls. Two symptom dimensions were associated with distinct CBF changes. Behavioral alterations in the language dimension were linked to increased CBF in Heschl's gyrus. Altered affectivity was related to increased CBF in amygdala. The ratings of motor behavior instead were not specifically associated with CBF. Investigating behavioral alterations in three schizophrenia symptom dimensions identified distinct regional CBF changes in the language and limbic brain circuits. The results demonstrate a hitherto unknown segregation of pathophysiological pathways underlying a limited number of specific symptom dimensions in schizophrenia.
Collapse
Affiliation(s)
- Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland.
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Lucerne, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| |
Collapse
|
32
|
Kimhy D, Wall MM, Hansen MC, Vakhrusheva J, Choi CJ, Delespaul P, Tarrier N, Sloan RP, Malaspina D. Autonomic Regulation and Auditory Hallucinations in Individuals With Schizophrenia: An Experience Sampling Study. Schizophr Bull 2017; 43:754-763. [PMID: 28177507 PMCID: PMC5472124 DOI: 10.1093/schbul/sbw219] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Auditory Hallucinations (AH) cause substantial suffering and dysfunction, yet remain poorly understood and modeled. Previous reports have linked AH to increases in negative emotions, suggesting a role for the autonomic nervous system (ANS) in underlying this link. Employing an Experience Sampling Method (ESM) approach, 40 individuals with schizophrenia completed a 36-hour ambulatory assessment of AH and cardiac autonomic regulation. Participants carried mobile electronic devices that prompted them to report 10 times/d the severity of their momentary AH, along with a Holter monitor that continuously recorded their cardiac autonomic regulation. The clocks of the devices and monitors were synchronized, allowing for high time-resolution temporal linking of the AH and concurrent autonomic data. Power spectral analysis was used to determine the relative vagal (parasympathetic) contribution to autonomic regulation during 5 minutes prior to each experience sample. The participants also completed interview-based measures of AH (SAPS; PSYRATS). The ESM-measured severity of AH was significantly correlated with the overall SAPS-indexed AH severity, along with the PSYRATS-indexed AH frequency, duration, loudness, degree of negative content, and associated distress. A mixed-effect regression model indicated that momentary increases in autonomic arousal, characterized by decreases in vagal input, significantly predicted increases in ESM-measured AH severity. Vagal input averaged over the 36-hour assessment displayed a small but significant inverse correlation with the SAPS-indexed AH. The results provide preliminary support for a link between ANS regulation and AH. The findings also underscore the highly dynamic nature of AH and the need to utilize high time-resolution methodologies to investigate AH.
Collapse
Affiliation(s)
- David Kimhy
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Melanie M. Wall
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | | | | | - C. Jean Choi
- New York State Psychiatric Institute, New York, NY
| | - Philippe Delespaul
- Departments of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Nicholas Tarrier
- Department of Psychology, University of Manchester, Manchester, UK
| | - Richard P. Sloan
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Dolores Malaspina
- Department of Psychiatry & Child Psychiatry, New York University Medical Center, New York, NY
| |
Collapse
|
33
|
The ability to tickle oneself is associated with level of psychometric schizotypy in non-clinical individuals. Conscious Cogn 2017; 52:93-103. [PMID: 28500871 DOI: 10.1016/j.concog.2017.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 04/04/2017] [Accepted: 04/25/2017] [Indexed: 11/21/2022]
Abstract
A recent study (Lemaitre et al., 2016, Consciousness and Cognition, 41, 64-71) found that non-clinical individuals who scored highly on a psychometric scale of schizotypy were able to tickle themselves. The present study aimed to extend this finding by investigating whether the ability to tickle oneself was associated with level of psychometric schizotypy considered as a continuous variable. One hundred and eleven students completed the Schizotypal Personality Questionnaire (SPQ). A mechanical device delivered tactile stimulation to participants' palms. The device was operated by the experimenter (External) or the participant (Self). Participants were asked to rate the intensity, ticklishness and pleasantness of the stimulation. A significant association was observed between participants' tactile self-suppression (External minus Self) and their score on the SPQ. These results suggest that the ability to suppress the tactile consequences of self-generated movements varies across the general population, and maps directly onto the personality dimension of schizotypy.
Collapse
|
34
|
Edgar JC, Fisk CL, Chen YH, Stone-Howell B, Hunter MA, Huang M, Bustillo JR, Cañive JM, Miller GA. By our bootstraps: Comparing methods for measuring auditory 40 Hz steady-state neural activity. Psychophysiology 2017; 54:1110-1127. [PMID: 28421620 DOI: 10.1111/psyp.12876] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/10/2017] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
Although the 40 Hz auditory steady-state response (ASSR) is of clinical interest, the construct validity of EEG and MEG measures of 40 Hz ASSR cortical microcircuits is unclear. This study evaluated several MEG and EEG metrics by leveraging findings of (a) an association between the 40 Hz ASSR and age in the left but not right hemisphere, and (b) right- > left-hemisphere differences in the strength of the 40 Hz ASSR. The contention is that, if an analysis method does not demonstrate a left 40 Hz ASSR and age relationship or hemisphere differences, then the obtained measures likely have low validity. Fifty-three adults were presented 500 Hz stimuli modulated at 40 Hz while MEG and EEG were collected. ASSR activity was examined as a function of phase similarity (intertrial coherence) and percent change from baseline (total power). A variety of head models (spherical and realistic) and a variety of dipole source modeling strategies (dipole source localization and dipoles fixed to Heschl's gyri) were compared. Several sensor analysis strategies were also tested. EEG sensor measures failed to detect left 40 Hz ASSR and age associations or hemisphere differences. A comparison of MEG and EEG head-source models showed similarity in the 40 Hz ASSR measures and in estimating age and left 40 Hz ASSR associations, indicating good construct validity across models. Given a goal of measuring the 40 Hz ASSR cortical microcircuits, a source-modeling approach was shown to be superior in measuring this construct versus methods that rely on EEG sensor measures.
Collapse
Affiliation(s)
- J Christopher Edgar
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Charles L Fisk
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yu-Han Chen
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Breannan Stone-Howell
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico.,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, New Mexico
| | - Michael A Hunter
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico.,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, New Mexico
| | - Mingxiong Huang
- University of California, San Diego, Department of Radiology, San Diego, California.,San Diego VA Healthcare System, Department of Radiology, San Diego, California
| | - Juan R Bustillo
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico
| | - José M Cañive
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico.,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, New Mexico
| | - Gregory A Miller
- University of California, Los Angeles, Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California
| |
Collapse
|
35
|
Abram SV, Wisner KM, Fox JM, Barch DM, Wang L, Csernansky JG, MacDonald AW, Smith MJ. Fronto-temporal connectivity predicts cognitive empathy deficits and experiential negative symptoms in schizophrenia. Hum Brain Mapp 2017; 38:1111-1124. [PMID: 27774734 PMCID: PMC6866816 DOI: 10.1002/hbm.23439] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/03/2016] [Accepted: 10/05/2016] [Indexed: 01/10/2023] Open
Abstract
Impaired cognitive empathy is a core social cognitive deficit in schizophrenia associated with negative symptoms and social functioning. Cognitive empathy and negative symptoms have also been linked to medial prefrontal and temporal brain networks. While shared behavioral and neural underpinnings are suspected for cognitive empathy and negative symptoms, research is needed to test these hypotheses. In two studies, we evaluated whether resting-state functional connectivity between data-driven networks, or components (referred to as, inter-component connectivity), predicted cognitive empathy and experiential and expressive negative symptoms in schizophrenia subjects. Study 1: We examined associations between cognitive empathy and medial prefrontal and temporal inter-component connectivity at rest using a group-matched schizophrenia and control sample. We then assessed whether inter-component connectivity metrics associated with cognitive empathy were also related to negative symptoms. Study 2: We sought to replicate the connectivity-symptom associations observed in Study 1 using an independent schizophrenia sample. Study 1 results revealed that while the groups did not differ in average inter-component connectivity, a medial-fronto-temporal metric and an orbito-fronto-temporal metric were related to cognitive empathy. Moreover, the medial-fronto-temporal metric was associated with experiential negative symptoms in both schizophrenia samples. These findings support recent models that link social cognition and negative symptoms in schizophrenia. Hum Brain Mapp 38:1111-1124, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Samantha V. Abram
- Department of PsychologyUniversity of Minnesota, Twin Cities75 East River ParkwayMinneapolisMinnesota
| | - Krista M. Wisner
- Department of PsychologyUniversity of Minnesota, Twin Cities75 East River ParkwayMinneapolisMinnesota
| | - Jaclyn M. Fox
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of Medicine710 North Lakeshore DriveChicagoIllinois
| | - Deanna M. Barch
- Department of PsychologyWashington University School of MedicineSt. LouisMissouri
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouri
- Department of RadiologyWashington University School of MedicineSt. LouisMissouri
| | - Lei Wang
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of Medicine710 North Lakeshore DriveChicagoIllinois
| | - John G. Csernansky
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of Medicine710 North Lakeshore DriveChicagoIllinois
| | - Angus W. MacDonald
- Department of PsychologyUniversity of Minnesota, Twin Cities75 East River ParkwayMinneapolisMinnesota
- Department of PsychiatryUniversity of Minnesota, Twin CitiesMinneapolisMinnesota
| | - Matthew J. Smith
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of Medicine710 North Lakeshore DriveChicagoIllinois
| |
Collapse
|
36
|
Ford JM. Studying auditory verbal hallucinations using the RDoC framework. Psychophysiology 2017; 53:298-304. [PMID: 26877116 DOI: 10.1111/psyp.12457] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/05/2015] [Indexed: 01/23/2023]
Abstract
In this paper, I explain why I adopted a Research Domain Criteria (RDoC) approach to study the neurobiology of auditory verbal hallucinations (AVH), or voices. I explain that the RDoC construct of "agency" fits well with AVH phenomenology. To the extent that voices sound nonself, voice hearers lack a sense of agency over the voices. Using a vocalization paradigm like those used with nonhuman primates to study mechanisms subserving the sense of agency, we find that the auditory N1 ERP is suppressed during vocalization, that EEG synchrony preceding speech onset is related to N1 suppression, and that both are reduced in patients with schizophrenia. Reduced cortical suppression is also seen across multiple psychotic disorders and in clinically high-risk youth, but it is not related to AVH. The motor activity preceding talking and connectivity between frontal and temporal lobes during talking have both proved sensitive to AVH, suggesting neural activity and connectivity associated with intentions to act may be a better way to study agency and predictions based on agency.
Collapse
Affiliation(s)
- Judith M Ford
- San Francisco VA Medical Center, San Francisco, California, USA.,Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, California, USA
| |
Collapse
|
37
|
Abstract
Neuroscience and schizophrenia are densely entangled and mutually supporting, such that a critical evaluation of schizophrenia is, effectively, an evaluation of applied aspects of contemporary neuroscience. A critical historical account of the development of schizophrenia is therefore followed by an overview of current issues and debates. A summary of possible future research directions then identifies a range of extant research strategies which already undercut or exceed this diagnosis. It is concluded that the example of schizophrenia functions more generally to illustrate how neuroscience need not rely upon poorly supported psychiatric concepts of mental illness.
Collapse
|
38
|
Cromby J, Chung E, Papadopoulos D, Talbot C. Reviewing the epigenetics of schizophrenia. J Ment Health 2016; 28:71-79. [DOI: 10.1080/09638237.2016.1207229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Emma Chung
- Department of Cardiovascular Sciences, and
| | | | - Chris Talbot
- Department of Genetics, University of Leicester, Leicester, UK
| |
Collapse
|
39
|
Medial-Frontal Stimulation Enhances Learning in Schizophrenia by Restoring Prediction Error Signaling. J Neurosci 2015; 35:12232-40. [PMID: 26338333 DOI: 10.1523/jneurosci.1717-15.2015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Posterror learning, associated with medial-frontal cortical recruitment in healthy subjects, is compromised in neuropsychiatric disorders. Here we report novel evidence for the mechanisms underlying learning dysfunctions in schizophrenia. We show that, by noninvasively passing direct current through human medial-frontal cortex, we could enhance the event-related potential related to learning from mistakes (i.e., the error-related negativity), a putative index of prediction error signaling in the brain. Following this causal manipulation of brain activity, the patients learned a new task at a rate that was indistinguishable from healthy individuals. Moreover, the severity of delusions interacted with the efficacy of the stimulation to improve learning. Our results demonstrate a causal link between disrupted prediction error signaling and inefficient learning in schizophrenia. These findings also demonstrate the feasibility of nonpharmacological interventions to address cognitive deficits in neuropsychiatric disorders. SIGNIFICANCE STATEMENT When there is a difference between what we expect to happen and what we actually experience, our brains generate a prediction error signal, so that we can map stimuli to responses and predict outcomes accurately. Theories of schizophrenia implicate abnormal prediction error signaling in the cognitive deficits of the disorder. Here, we combine noninvasive brain stimulation with large-scale electrophysiological recordings to establish a causal link between faulty prediction error signaling and learning deficits in schizophrenia. We show that it is possible to improve learning rate, as well as the neural signature of prediction error signaling, in patients to a level quantitatively indistinguishable from that of healthy subjects. The results provide mechanistic insight into schizophrenia pathophysiology and suggest a future therapy for this condition.
Collapse
|
40
|
Palaniyappan L, Mahmood J, Balain V, Mougin O, Gowland PA, Liddle PF. Structural correlates of formal thought disorder in schizophrenia: An ultra-high field multivariate morphometry study. Schizophr Res 2015; 168:305-12. [PMID: 26232240 PMCID: PMC4604249 DOI: 10.1016/j.schres.2015.07.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 06/28/2015] [Accepted: 07/13/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND Persistent formal thought disorder (FTD) is one of the most characteristic features of schizophrenia. Several neuroimaging studies report spatially distinct neuroanatomical changes in association with FTD. Given that most studies so far have employed a univariate localisation approach that obscures the study of covarying interregional relationships, the present study focussed on the multivariate systemic pattern of anatomical changes that contribute to FTD. METHODS Speech samples from nineteen medicated clinically stable schizophrenia patients and 20 healthy controls were evaluated for subtle formal thought disorder. Ultra high-field (7T) anatomical Magnetic Resonance Imaging scans were obtained from all subjects. Multivariate morphometric patterns were identified using an independent component approach (source based morphometry). Using multiple regression analysis, the morphometric patterns predicting positive and negative FTD scores were identified. RESULTS Morphometric variations in grey matter predicted a substantial portion of inter-individual variance in negative but not positive FTD. A pattern of concomitant striato-insular/precuneus reduction along with frontocingular grey matter increase had a significant association with negative FTD. CONCLUSIONS These results suggest that concomitant increase and decrease in grey matter occur in association with persistent negative thought disorder in clinically stable individuals with schizophrenia.
Collapse
Affiliation(s)
- Lena Palaniyappan
- Translational Neuroimaging for Mental Health, Division of Psychiatry & Applied Psychology, Institute of Mental Health, University of Nottingham, UK; Early Intervention in Psychosis, Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
| | - Jenaid Mahmood
- Translational Neuroimaging for Mental Health, Division of Psychiatry & Applied Psychology, Institute of Mental Health, University of Nottingham, UK
| | - Vijender Balain
- Penticton Regional Hospital, Penticton, British Columbia, Canada
| | - Olivier Mougin
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics, University of Nottingham, UK
| | - Penny A. Gowland
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics, University of Nottingham, UK
| | - Peter F. Liddle
- Translational Neuroimaging for Mental Health, Division of Psychiatry & Applied Psychology, Institute of Mental Health, University of Nottingham, UK
| |
Collapse
|
41
|
|
42
|
Hay RA, Roach BJ, Srihari VH, Woods SW, Ford JM, Mathalon DH. Equivalent mismatch negativity deficits across deviant types in early illness schizophrenia-spectrum patients. Biol Psychol 2015; 105:130-7. [PMID: 25603283 DOI: 10.1016/j.biopsycho.2015.01.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 11/17/2022]
Abstract
Neurophysiological abnormalities in auditory deviance processing, as reflected by the mismatch negativity (MMN), have been observed across the course of schizophrenia. Studies in early schizophrenia patients have typically shown varying degrees of MMN amplitude reduction for different deviant types, suggesting that different auditory deviants are uniquely processed and may be differentially affected by duration of illness. To explore this further, we examined the MMN response to 4 auditory deviants (duration, frequency, duration+frequency "double deviant", and intensity) in 24 schizophrenia-spectrum patients early in the illness (ESZ) and 21 healthy controls. ESZ showed significantly reduced MMN relative to healthy controls for all deviant types (p<0.05), with no significant interaction with deviant type. No correlations with clinical symptoms were present (all ps>0.05). These findings support the conclusion that neurophysiological mechanisms underlying processing of auditory deviants are compromised early in illness, and these deficiencies are not specific to the type of deviant presented.
Collapse
Affiliation(s)
- Rachel A Hay
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Brian J Roach
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Vinod H Srihari
- Yale University School of Medicine, New Haven, CT, United States
| | - Scott W Woods
- Yale University School of Medicine, New Haven, CT, United States
| | - Judith M Ford
- University of California, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Daniel H Mathalon
- University of California, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States.
| |
Collapse
|
43
|
Ford JM, Palzes VA, Roach BJ, Potkin SG, van Erp TGM, Turner JA, Mueller BA, Calhoun VD, Voyvodic J, Belger A, Bustillo J, Vaidya JG, Preda A, McEwen SC, Mathalon DH. Visual hallucinations are associated with hyperconnectivity between the amygdala and visual cortex in people with a diagnosis of schizophrenia. Schizophr Bull 2015; 41:223-32. [PMID: 24619536 PMCID: PMC4266287 DOI: 10.1093/schbul/sbu031] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION While auditory verbal hallucinations (AH) are a cardinal symptom of schizophrenia, people with a diagnosis of schizophrenia (SZ) may also experience visual hallucinations (VH). In a retrospective analysis of a large sample of SZ and healthy controls (HC) studied as part of the functional magnetic resonance imaging (fMRI) Biomedical Informatics Research Network (FBIRN), we asked if SZ who endorsed experiencing VH during clinical interviews had greater connectivity between visual cortex and limbic structures than SZ who did not endorse experiencing VH. METHODS We analyzed resting state fMRI data from 162 SZ and 178 age- and gender-matched HC. SZ were sorted into groups according to clinical ratings on AH and VH: SZ with VH (VH-SZ; n = 45), SZ with AH but no VH (AH-SZ; n = 50), and SZ with neither AH nor VH (NoH-SZ; n = 67). Our primary analysis was seed based, extracting connectivity between visual cortex and the amygdala (because of its role in fear and negative emotion) and visual cortex and the hippocampus (because of its role in memory). RESULTS Compared with the other groups, VH-SZ showed hyperconnectivity between the amygdala and visual cortex, specifically BA18, with no differences in connectivity among the other groups. In a voxel-wise, whole brain analysis comparing VH-SZ with AH-SZ, the amygdala was hyperconnected to left temporal pole and inferior frontal gyrus in VH-SZ, likely due to their more severe thought broadcasting. CONCLUSIONS VH-SZ have hyperconnectivity between subcortical areas subserving emotion and cortical areas subserving higher order visual processing, providing biological support for distressing VH in schizophrenia.
Collapse
Affiliation(s)
- Judith M. Ford
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA;,*To whom correspondence should be addressed; Psychiatry Service (116D), San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, US; tel: 415-221-4810, ext. 4187, fax: 415-750-6622, e-mail:
| | - Vanessa A. Palzes
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
| | - Brian J. Roach
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
| | - Steven G. Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Theo G. M. van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Jessica A. Turner
- Mind Research Network, Albuquerque, NM;,Departments of Psychology and Neuroscience, Georgia State University, Atlanta GA
| | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota, Twin Cities, Minneapolis, MN
| | - Vincent D. Calhoun
- Mind Research Network, Albuquerque, NM;,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM
| | - Jim Voyvodic
- Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC
| | - Aysenil Belger
- Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC;,Department of Psychiatry, University of North Carolina, Durham, NC
| | - Juan Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | | | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Sarah C. McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | | | - Daniel H. Mathalon
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
| |
Collapse
|
44
|
Wolf DH, Satterthwaite TD, Kantrowitz JJ, Katchmar N, Vandekar L, Elliott MA, Ruparel K. Amotivation in schizophrenia: integrated assessment with behavioral, clinical, and imaging measures. Schizophr Bull 2014; 40:1328-37. [PMID: 24657876 PMCID: PMC4193711 DOI: 10.1093/schbul/sbu026] [Citation(s) in RCA: 141] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Motivational deficits play a central role in disability caused by schizophrenia and constitute a major unmet therapeutic need. Negative symptoms have previously been linked to hypofunction in ventral striatum (VS), a core component of brain motivation circuitry. However, it remains unclear to what extent this relationship holds for specific negative symptoms such as amotivation, and this question has not been addressed with integrated behavioral, clinical, and imaging measures. Here, 41 individuals with schizophrenia and 37 controls performed a brief, computerized progressive ratio task (PRT) that quantifies effort exerted in pursuit of monetary reward. Clinical amotivation was assessed using the recently validated Clinical Assessment Interview for Negative Symptoms (CAINS). VS function was probed during functional magnetic resonance imaging using a monetary guessing paradigm. We found that individuals with schizophrenia had diminished motivation as measured by the PRT, which significantly and selectively related to clinical amotivation as measured by the CAINS. Critically, lower PRT motivation in schizophrenia was also dimensionally related to VS hypofunction. Our results demonstrate robust dimensional associations between behavioral amotivation, clinical amotivation, and VS hypofunction in schizophrenia. Integrating behavioral measures such as the PRT will facilitate translational efforts to identify biomarkers of amotivation and to assess response to novel therapeutic interventions.
Collapse
Affiliation(s)
- Daniel H. Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA;,*To whom correspondence should be addressed; Department of Psychiatry, University of Pennsylvania, 10th Floor Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, US; tel: (215)-662-3692, fax: (215)-662-7903, e-mail:
| | | | | | - Natalie Katchmar
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Lillie Vandekar
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Mark A. Elliott
- Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
45
|
Source retrieval is not properly differentiated from object retrieval in early schizophrenia: an fMRI study using virtual reality. NEUROIMAGE-CLINICAL 2014; 7:336-46. [PMID: 25610794 PMCID: PMC4297883 DOI: 10.1016/j.nicl.2014.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 08/05/2014] [Accepted: 08/11/2014] [Indexed: 01/08/2023]
Abstract
Source memory, the ability to identify the context in which a memory occurred, is impaired in schizophrenia and has been related to clinical symptoms such as hallucinations. The neurobiological underpinnings of this deficit are not well understood. Twenty-five patients with recent onset schizophrenia (within the first 4.5 years of treatment) and twenty-four healthy controls completed a source memory task. Participants navigated through a 3D virtual city, and had 20 encounters of an object with a person at a place. Functional magnetic resonance imaging was performed during a subsequent forced-choice recognition test. Two objects were presented and participants were asked to either identify which object was seen (new vs. old object recognition), or identify which of the two old objects was associated with either the person or the place being presented (source memory recognition). Source memory was examined by contrasting person or place with object. Both patients and controls demonstrated significant neural activity to source memory relative to object memory, though activity in controls was much more widespread. Group differences were observed in several regions, including the medial parietal and cingulate cortex, lateral frontal lobes and right superior temporal gyrus. Patients with schizophrenia did not differentiate between source and object memory in these regions. Positive correlations with hallucination proneness were observed in the left frontal and right middle temporal cortices and cerebellum. Patients with schizophrenia have a deficit in the neural circuits which facilitate source memory, which may underlie both the deficits in this domain and be related to auditory hallucinations.
Collapse
|
46
|
Ford JM, Palzes VA, Roach BJ, Mathalon DH. Did I do that? Abnormal predictive processes in schizophrenia when button pressing to deliver a tone. Schizophr Bull 2014; 40:804-12. [PMID: 23754836 PMCID: PMC4059422 DOI: 10.1093/schbul/sbt072] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Motor actions are preceded by an efference copy of the motor command, resulting in a corollary discharge of the expected sensation in sensory cortex. These mechanisms allow animals to predict sensations, suppress responses to self-generated sensations, and thereby process sensations efficiently and economically. During talking, patients with schizophrenia show less evidence of pretalking activity and less suppression of the speech sound, consistent with dysfunction of efference copy and corollary discharge, respectively. We asked if patterns seen in talking would generalize to pressing a button to hear a tone, a paradigm translatable to less vocal animals. In 26 patients [23 schizophrenia, 3 schizoaffective (SZ)] and 22 healthy controls (HC), suppression of the N1 component of the auditory event-related potential was estimated by comparing N1 to tones delivered by button presses and N1 to those tones played back. The lateralized readiness potential (LRP) associated with the motor plan preceding presses to deliver tones was estimated by comparing right and left hemispheres' neural activity. The relationship between N1 suppression and LRP amplitude was assessed. LRP preceding button presses to deliver tones was larger in HC than SZ, as was N1 suppression. LRP amplitude and N1 suppression were correlated in both groups, suggesting stronger efference copies are associated with stronger corollary discharges. SZ have reduced N1 suppression, reflecting corollary discharge action, and smaller LRPs preceding button presses to deliver tones, reflecting the efference copy of the motor plan. Effects seen during vocalization largely extend to other motor acts more translatable to lab animals.
Collapse
Affiliation(s)
- Judith M. Ford
- Mental Health Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA,*To whom correspondence should be addressed; 4150 Clement Street, San Francisco, CA 94121; tel: 415-221-4810, ext. 4187, fax: 415-750-6622, e-mail:
| | - Vanessa A. Palzes
- Mental Health Service, San Francisco VA Medical Center, San Francisco, CA
| | - Brian J. Roach
- Mental Health Service, San Francisco VA Medical Center, San Francisco, CA
| | - Daniel H. Mathalon
- Mental Health Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
| |
Collapse
|
47
|
Goozée R, Handley R, Kempton MJ, Dazzan P. A systematic review and meta-analysis of the effects of antipsychotic medications on regional cerebral blood flow (rCBF) in schizophrenia: association with response to treatment. Neurosci Biobehav Rev 2014; 43:118-36. [PMID: 24690578 DOI: 10.1016/j.neubiorev.2014.03.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/27/2014] [Accepted: 03/20/2014] [Indexed: 11/25/2022]
Abstract
Evaluating the short- and long-term effects of antipsychotics on brain physiology is a key factor in advancing our understanding of neurophysiological changes in psychosis and improving prediction of treatment response. Understanding the nature of such changes is crucial to the interpretation of neuroimaging findings in patients with schizophrenia and psychoses in general. This review has systematically appraised existing evidence on resting cerebral blood flow (rCBF) in schizophrenia, before and after antipsychotic treatment, relating the findings to symptom severity. The review shows that antipsychotics exert regional effects on rCBF, particularly in frontal and basal ganglia regions, and that different antipsychotic generations have differential effects on rCBF. These findings are supported by an exploratory meta-analysis of a subset of studies. The review also highlights the relative lack of studies that use a priori definitions of treatment response, which is an important step in identifying testable hypotheses and ensuring clinical relevance of remission criteria. Finally, the review highlights important considerations for future psychopharmacological studies investigating the potential for rCBF to predict symptomatic improvement, which could inform the management of treatment in schizophrenia.
Collapse
Affiliation(s)
- Rhianna Goozée
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK.
| | - Rowena Handley
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
| | - Matthew J Kempton
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
| | - Paola Dazzan
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Kings College London, London, UK
| |
Collapse
|
48
|
Perez VB, Woods SW, Roach BJ, Ford JM, McGlashan TH, Srihari VH, Mathalon DH. Automatic auditory processing deficits in schizophrenia and clinical high-risk patients: forecasting psychosis risk with mismatch negativity. Biol Psychiatry 2014; 75:459-69. [PMID: 24050720 PMCID: PMC4028131 DOI: 10.1016/j.biopsych.2013.07.038] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 07/02/2013] [Accepted: 07/29/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Only about one third of patients at high risk for psychosis based on current clinical criteria convert to a psychotic disorder within a 2.5-year follow-up period. Targeting clinical high-risk (CHR) individuals for preventive interventions could expose many to unnecessary treatments, underscoring the need to enhance predictive accuracy with nonclinical measures. Candidate measures include event-related potential components with established sensitivity to schizophrenia. Here, we examined the mismatch negativity (MMN) component of the event-related potential elicited automatically by auditory deviance in CHR and early illness schizophrenia (ESZ) patients. We also examined whether MMN predicted subsequent conversion to psychosis in CHR patients. METHODS Mismatch negativity to auditory deviants (duration, frequency, and duration + frequency double deviant) was assessed in 44 healthy control subjects, 19 ESZ, and 38 CHR patients. Within CHR patients, 15 converters to psychosis were compared with 16 nonconverters with at least 12 months of clinical follow-up. Hierarchical Cox regression examined the ability of MMN to predict time to psychosis onset in CHR patients. RESULTS Irrespective of deviant type, MMN was significantly reduced in ESZ and CHR patients relative to healthy control subjects and in CHR converters relative to nonconverters. Mismatch negativity did not significantly differentiate ESZ and CHR patients. The duration + frequency double deviant MMN, but not the single deviant MMNs, significantly predicted the time to psychosis onset in CHR patients. CONCLUSIONS Neurophysiological mechanisms underlying automatic processing of auditory deviance, as reflected by the duration + frequency double deviant MMN, are compromised before psychosis onset and can enhance the prediction of psychosis risk among CHR patients.
Collapse
Affiliation(s)
- Veronica B. Perez
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| | | | - Brian J. Roach
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| | - Judith M. Ford
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| | | | | | - Daniel H. Mathalon
- University of California, San Francisco,San Francisco Veterans Administration Medical Center
| |
Collapse
|
49
|
Chiappelli J, Nugent KL, Thangavelu K, Searcy K, Hong LE. Assessment of trait and state aspects of depression in schizophrenia. Schizophr Bull 2014; 40:132-42. [PMID: 23686021 PMCID: PMC3885299 DOI: 10.1093/schbul/sbt069] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Depression and negative symptoms can be difficult to distinguish in schizophrenia. Assessments for negative symptoms usually account for the longitudinal nature of these symptoms, whereas instruments available to measure depression mainly assess current or recent symptoms. This construct difference may confound comparison of depressive and negative symptoms in schizophrenia because both domains may have trait-like aspects. We developed an instrument to measure both longitudinal "trait" as well as recent "state" symptoms of depression and tested this instrument (Maryland Trait and State Depression [MTSD] scale) in a sample of 98 individuals with schizophrenia or schizoaffective disorder and 115 community participants without psychotic illness. Exploratory factor analysis of the MTSD revealed 2 factors accounting for 73.4% of the variance; these 2 factors corresponded with "trait" and "state" depression inventory items. Neither MTSD-state nor MTSD-trait was correlated with negative symptoms as measured with the Brief Negative Symptom Scale (r = .07 and -.06, respectively) in schizophrenia patients. MTSD state and trait scores were significantly correlated with the Brief Psychiatric Rating Scale depression subscale (r = .58 and .53, respectively) as well as the Profile of Mood States depression subscale (r = .57 and .44). Persons with schizophrenia had significantly greater trait depressive symptoms than controls (P = .031). Individuals with schizoaffective disorder had significantly higher trait depression (P = .001), but not state depression (P = .146), compared with schizophrenia patients. Trait depressive symptoms are prominent in schizophrenia and are distinct from negative symptoms.
Collapse
Affiliation(s)
- Joshua Chiappelli
- *To whom correspondence should be addressed; Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228; tel: 410 402 6827, fax: 410 402 6023, e-mail:
| | | | | | | | | |
Collapse
|
50
|
Farooq S, Agid O, Foussias G, Remington G. Using treatment response to subtype schizophrenia: proposal for a new paradigm in classification. Schizophr Bull 2013; 39:1169-72. [PMID: 24045038 PMCID: PMC3796094 DOI: 10.1093/schbul/sbt137] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Saeed Farooq
- *To whom correspondence should be addressed; Complex Mental Illness Division-Schizophrenia Program, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, Canada M5T 1R8; tel: 416-535-8501, fax: 416-979-4292, e-mail:
| | - Ofer Agid
- Centre for Addiction and Mental Health, Toronto, Canada;,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Gary Remington
- *To whom correspondence should be addressed; Complex Mental Illness Division—Schizophrenia Program, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, Canada M5T 1R8; tel: 416-535-8501, fax: 416-979-4292, e-mail:
| |
Collapse
|