1
|
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
|
2
|
Weilnhammer V, Röd L, Eckert AL, Stuke H, Heinz A, Sterzer P. Psychotic Experiences in Schizophrenia and Sensitivity to Sensory Evidence. Schizophr Bull 2020; 46:927-936. [PMID: 32090246 PMCID: PMC7345814 DOI: 10.1093/schbul/sbaa003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Perceptual inference depends on an optimal integration of current sensory evidence with prior beliefs about the environment. Alterations of this process have been related to the emergence of positive symptoms in schizophrenia. However, it has remained unclear whether delusions and hallucinations arise from an increased or decreased weighting of prior beliefs relative to sensory evidence. To investigate the relation of this prior-to-likelihood ratio to positive symptoms in schizophrenia, we devised a novel experimental paradigm which gradually manipulates perceptually ambiguous visual stimuli by disambiguating stimulus information. As a proxy for likelihood precision, we assessed the sensitivity of individual participants to sensory evidence. As a surrogate for the precision of prior beliefs in perceptual stability, we measured phase duration in ambiguity. Relative to healthy controls, patients with schizophrenia showed a stronger increment in congruent perceptual states for increasing levels of disambiguating stimulus evidence. Sensitivity to sensory evidence correlated positively with the individual patients' severity of perceptual anomalies and hallucinations. Moreover, the severity of such experiences correlated negatively with phase duration. Our results indicate that perceptual anomalies and hallucinations are associated with a shift of perceptual inference toward sensory evidence and away from prior beliefs. This reduced prior-to-likelihood ratio in sensory processing may contribute to the phenomenon of aberrant salience, which has been suggested to give rise to the false inferences underlying psychotic experiences.
Collapse
Affiliation(s)
- Veith Weilnhammer
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lukas Röd
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anna-Lena Eckert
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Heiner Stuke
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Philipp Sterzer
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| |
Collapse
|
3
|
Shoshina II, Sosnina IS, Zelenskiy KA, Karpinskaya VY, Lyakhovetskii VA, Pronin SV. The Contrast Sensitivity of the Visual System in “Dry” Immersion Conditions. Biophysics (Nagoya-shi) 2020. [DOI: 10.1134/s0006350920040211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
4
|
Demmin DL, Fradkin SI, Silverstein SM. Remediation of Visual Processing Impairments in Schizophrenia: Where We Are and Where We Need to Be. Curr Behav Neurosci Rep 2019. [DOI: 10.1007/s40473-019-00171-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|