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Wang Y, Fan L, He Y, Yuan L, Li Z, Zheng W, Tang J, Li C, Jin K, Liu W, Chen X, Ouyang L, Ma X. Compensatory thickening of cortical thickness in early stage of schizophrenia. Cereb Cortex 2024; 34:bhae255. [PMID: 38897816 DOI: 10.1093/cercor/bhae255] [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: 04/08/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Brain structural abnormality has been observed in the prodromal and early stages of schizophrenia, but the mechanism behind it is not clear. In this study, to explore the association between cortical abnormalities, metabolite levels, inflammation levels and clinical symptoms of schizophrenia, 51 drug-naive first-episode schizophrenia (FES) patients, 51 ultra-high risk for psychosis (UHR), and 51 healthy controls (HC) were recruited. We estimated gray matter volume (GMV), cortical thickness (CT), concentrations of different metabolites, and inflammatory marks among four groups (UHR converted to psychosis [UHR-C], UHR unconverted to psychosis [UHR-NC], FES, HC). UHR-C group had more CT in the right lateral occipital cortex and the right medial orbito-frontal cortex (rMOF), while a significant reduction in CT of the right fusiform cortex was observed in FES group. UHR-C group had significantly higher concentration of IL-6, while IL-17 could significantly predict CT of the right fusiform and IL-4 and IL-17 were significant predictors of CT in the rMOF. To conclude, it is reasonable to speculate that the increased CT in UHR-C group is related to the inflammatory response, and may participate in some compensatory mechanism, but might become exhaustive with the progress of the disease due to potential neurotoxic effects.
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Affiliation(s)
- Yujue Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Lejia Fan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada
| | - Ying He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- China National Technology Institute on Mental Disorders, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Institute of Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Hunan Medical Center for Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Liu Yuan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Zongchang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Wenxiao Zheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Jinsong Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Chunwang Li
- Department of Radiology, Hunan Children's Hospital, Yuhua District catalpa garden road 86, Changsha 410007, Hunan, China
| | - Ke Jin
- Department of Radiology, Hunan Children's Hospital, Yuhua District catalpa garden road 86, Changsha 410007, Hunan, China
| | - Weiqing Liu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, #165 Sanlin road, Pudong New Area,Shanghai 200124, China
- Laboratory for Molecular Mechanisms of Brain Development, Center for Brain Science (CBS), 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Xiaogang Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- China National Technology Institute on Mental Disorders, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Institute of Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Hunan Medical Center for Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Lijun Ouyang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
| | - Xiaoqian Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- China National Technology Institute on Mental Disorders, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Institute of Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
- Hunan Medical Center for Mental Health, Furong District No. 139 Renmin Road, Changsha 410011, Hunan, China
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Smesny S, Gussew A, Schack S, Langbein K, Wagner G, Reichenbach JR. Neurometabolic patterns of an "at risk for mental disorders" syndrome involve abnormalities in the thalamus and anterior midcingulate cortex. Schizophr Res 2022; 243:285-295. [PMID: 32444202 DOI: 10.1016/j.schres.2020.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/03/2020] [Accepted: 04/19/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The ultra-high risk (UHR) paradigm allows the investigation of individuals at increased risk of developing psychotic or other mental disorders with the aim of making prevention and early intervention as specific as possible in terms of the individual outcome. METHODS Single-session 1H-/31P-Chemical Shift Imaging of thalamus, prefrontal (DLPFC) and anterior midcingulate (aMCC) cortices was applied to 69 UHR patients for psychosis and 61 matched healthy controls. N-acetylaspartate (NAA), glutamate/glutamine complex (Glx), energy (PCr, ATP) and phospholipid metabolites were assessed, analysed by ANOVA (or ANCOVA [with covariates]) and correlated with symptomatology (SCL-90R). RESULTS The thalamus showed decreased NAA, inversely correlated with self-rated aggressiveness, as well as increased PCr, and altered phospholipid breakdown. While the aMCC showed a pattern of NAA decrease and PCr increase, the DLPFC showed PCr increase only in the close-to-psychosis patient subgroup. There were no specific findings in transition patients. CONCLUSION The results do not support the notion of a specific pre-psychotic neurometabolic pattern, but likely reflect correlates of an "at risk for mental disorders syndrome". This includes disturbed neuronal (mitochondrial) metabolism in the thalamus and aMCC, with emphasis on left-sided structures, and altered PL remodeling across structures.
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Affiliation(s)
- Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany.
| | - Alexander Gussew
- Department of Radiology, Halle University Hospital, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Stephan Schack
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Gerd Wagner
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
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Meller T, Schmitt S, Ettinger U, Grant P, Stein F, Brosch K, Grotegerd D, Dohm K, Meinert S, Förster K, Hahn T, Jansen A, Dannlowski U, Krug A, Kircher T, Nenadić I. Brain structural correlates of schizotypal signs and subclinical schizophrenia nuclear symptoms in healthy individuals. Psychol Med 2022; 52:342-351. [PMID: 32578531 PMCID: PMC8842196 DOI: 10.1017/s0033291720002044] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/23/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Subclinical psychotic-like experiences (PLE), resembling key symptoms of psychotic disorders, are common throughout the general population and possibly associated with psychosis risk. There is evidence that such symptoms are also associated with structural brain changes. METHODS In 672 healthy individuals, we assessed PLE and associated distress with the symptom-checklist-90R (SCL-90R) scales 'schizotypal signs' (STS) and 'schizophrenia nuclear symptoms' (SNS) and analysed associations with voxel- and surfaced-based brain structural parameters derived from structural magnetic resonance imaging at 3 T with CAT12. RESULTS For SNS, we found a positive correlation with the volume in the left superior parietal lobule and the precuneus, and a negative correlation with the volume in the right inferior temporal gyrus [p < 0.05 cluster-level Family Wise Error (FWE-corrected]. For STS, we found a negative correlation with the volume of the left and right precentral gyrus (p < 0.05 cluster-level FWE-corrected). Surface-based analyses did not detect any significant clusters with the chosen statistical threshold of p < 0.05. However, in exploratory analyses (p < 0.001, uncorrected), we found a positive correlation of SNS with gyrification in the left insula and rostral middle frontal gyrus and of STS with the left precuneus and insula, as well as a negative correlation of STS with gyrification in the left temporal pole. CONCLUSIONS Our results show that brain structures in areas implicated in schizophrenia are also related to PLE and its associated distress in healthy individuals. This pattern supports a dimensional model of the neural correlates of symptoms of the psychotic spectrum.
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Affiliation(s)
- Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111Bonn, Germany
| | - Phillip Grant
- Psychology School, Fresenius University of Applied Sciences, Marienburgstr. 6, 60528Frankfurt am Main, Germany
- Faculty of Life Science Engineering, Technische Hochschule Mittelhessen University of Applied Sciences, Giessen, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Dominik Grotegerd
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Katharina Dohm
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Susanne Meinert
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Katharina Förster
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Tim Hahn
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Core-Facility BrainImaging, Faculty of Medicine, Philipps-Universität, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Marburg University Hospital – UKGM, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Marburg University Hospital – UKGM, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Marburg University Hospital – UKGM, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
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Hubl D, Michel C, Schultze-Lutter F, Hauf M, Schimmelmann BG, Kaess M, Kindler J. Basic symptoms and gray matter volumes of patients at clinical high risk for psychosis. Psychol Med 2021; 51:2666-2674. [PMID: 32404212 DOI: 10.1017/s0033291720001282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Clinical high-risk (CHR) for psychosis is indicated by ultra-high risk (UHR) and basic symptom (BS) criteria; however, conversion rates are highest when both UHR and BS criteria are fulfilled (UHR&BS). While BSs are considered the most immediate expression of neurobiological aberrations underlying the development of psychosis, research on neurobiological correlates of BS is scarce. METHODS We investigated gray matter volumes (GMV) of 20 regions of interest (ROI) previously associated with UHR criteria in 90 patients from the Bern early detection service: clinical controls (CC), first-episode psychosis (FEP), UHR, BS and UHR&BS. We expected lowest GMV in FEP and UHR&BS, and highest volume in CC with UHR and BS in-between. RESULTS Significantly, lower GMV was detected in FEP and UHR&BS patients relative to CC with no other significant between-group differences. When ROIs were analyzed separately, seven showed a significant group effect (FDR corrected), with five (inferior parietal, medial orbitofrontal, lateral occipital, middle temporal, precuneus) showing significantly lower GM volume in the FEP and/or UHR&BS groups than in the CC group (Bonferroni corrected). In the CHR group, only COGDIS scores correlated negatively with cortical volumes. CONCLUSIONS This is the first study to demonstrate that patients who fulfill both UHR and BS criteria - a population that has been associated with higher conversion rates - exhibit more severe GMV reductions relative to those who satisfy BS or UHR criteria alone. This result was mediated by the BS in the UHR&BS group, as only the severity of BS was linked to GMV reductions.
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Affiliation(s)
- Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
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Sasabayashi D, Takayanagi Y, Takahashi T, Katagiri N, Sakuma A, Obara C, Katsura M, Okada N, Koike S, Yamasue H, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State. Schizophr Bull 2020; 46:834-845. [PMID: 32162659 PMCID: PMC7342178 DOI: 10.1093/schbul/sbaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan; tel: +81-76-434-7323, fax: +81-76-434-5030, e-mail:
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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Abstract
Developing disease-modifying treatments for Alzheimer dementia requires innovative approaches to identify novel biological targets during the course of the disease. Treatment development for the neuropsychiatric symptoms of Alzheimer may benefit from a mechanistic approach to treatment. There has been progress in identifying mild forms of behavioral impairment along the Alzheimer spectrum that may lead to additional insights into progression to dementia as well as the fundamental mechanisms of the symptoms. Developing therapies for complex neurobehavioral syndromes may require the translation of mechanistic insights into therapy, which may both improve the symptoms and delay progression to dementia in certain patients.
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Affiliation(s)
- Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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7
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Buechler R, Wotruba D, Michels L, Theodoridou A, Metzler S, Walitza S, Hänggi J, Kollias S, Rössler W, Heekeren K. Cortical Volume Differences in Subjects at Risk for Psychosis Are Driven by Surface Area. Schizophr Bull 2020; 46:1511-1519. [PMID: 32463880 PMCID: PMC7846193 DOI: 10.1093/schbul/sbaa066] [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: 01/10/2023]
Abstract
In subjects at risk for psychosis, the studies on gray matter volume (GMV) predominantly reported volume loss compared with healthy controls (CON). However, other important morphological measurements such as cortical surface area (CSA) and cortical thickness (CT) were not systematically compared. So far, samples mostly comprised subjects at genetic risk or at clinical risk fulfilling an ultra-high risk (UHR) criterion. No studies comparing UHR subjects with at-risk subjects showing only basic symptoms (BS) investigated the differences in CSA or CT. Therefore, we aimed to unravel the contribution of the 2 morphometrical measures constituting the cortical volume (CV) and to test whether these groups inhere different morphometric features. We conducted a surface-based morphometric analysis in 34 CON, 46 BS, and 39 UHR to examine between-group differences in CV, CSA, and CT vertex-wise across the whole cortex. Compared with BS and CON, UHR individuals presented increased CV in frontal and parietal regions, which was driven by larger CSA. These groups did not differ in CT. Yet, at-risk subjects who later developed schizophrenia showed thinning in the occipital cortex. Furthermore, BS presented increased CSA compared with CON. Our results suggest that volumetric differences in UHR subjects are driven by CSA while CV loss in converters seems to be based on cortical thinning. We attribute the larger CSA in UHR to aberrant pruning representing a vulnerability to develop psychotic symptoms reflected in different levels of vulnerability for BS and UHR, and cortical thinning to a presumably stress-related cortical decomposition.
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Affiliation(s)
- Roman Buechler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland,To whom correspondence should be addressed; UniversitätsSpital Zürich Klinik für Neuroradiologie Frauenklinikstrasse 10, Zurich 8091, Switzerland; tel: +41-44-255-56-00, fax +41-44-255-45-04, e-mail:
| | - Diana Wotruba
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | - Lars Michels
- Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Sibylle Metzler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
| | - Jürgen Hänggi
- Department of Psychology, Division of Neuropsychology, University of Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland,Laboratory of Neuroscience (LIM-27), Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland,Department of Psychiatry and Psychotherapy I, LVR-Hospital, Cologne, Germany
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8
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Hinney B, Walter A, Aghlmandi S, Andreou C, Borgwardt S. Does Hippocampal Volume Predict Transition to Psychosis in a High-Risk Group? A Meta-Analysis. Front Psychiatry 2020; 11:614659. [PMID: 33519555 PMCID: PMC7840882 DOI: 10.3389/fpsyt.2020.614659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/14/2020] [Indexed: 01/11/2023] Open
Abstract
Schizophrenia has a prodromal phase of several years in most patients, making it possible to identify patients at clinical high risk (CHR) for developing the disorder. So far, these individuals are identified based on clinical criteria alone, and there is no reliable biomarker for predicting the transition to psychosis. It is well-established that reductions in brain volume, especially in the hippocampus, are associated with schizophrenia. Therefore, hippocampal volume may serve as a biomarker for psychosis. Several studies have already investigated hippocampal volume in CHR groups. Based on these studies, the present meta-analysis compares the baseline left and right hippocampal volume of CHR patients who developed a psychosis with that of CHR patients without such a transition. Our results show no statistically significant effect of the hippocampal volume on the transition risk for psychosis.
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Affiliation(s)
- Bernd Hinney
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Anna Walter
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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9
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Zhu F, Liu Y, Liu F, Yang R, Li H, Chen J, Kennedy DN, Zhao J, Guo W. Functional asymmetry of thalamocortical networks in subjects at ultra-high risk for psychosis and first-episode schizophrenia. Eur Neuropsychopharmacol 2019; 29:519-528. [PMID: 30770234 DOI: 10.1016/j.euroneuro.2019.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 01/18/2023]
Abstract
Disrupted functional asymmetry has been implicated in schizophrenia. However, it remains unknown whether disrupted functional asymmetry originates from intra-hemispheric and/or inter-hemispheric functional connectivity (FC) in the patients, and whether it starts at very early stage of psychosis. Seventy-six patients with first-episode, drug-naive schizophrenia, 74 subjects at ultra-high risk for psychosis (UHR), and 71 healthy controls underwent resting-state functional magnetic resonance imaging. The 'Parameter of asymmetry' (PAS) metric was calculated and support vector machine (SVM) classification analysis was applied to analyze the data. Compared with healthy controls, patients exhibited decreased PAS in the left thalamus/pallidum, right hippocampus/parahippocampus, right inferior frontal gyrus/insula, right thalamus, and left inferior parietal lobule, and increased PAS in the left calcarine, right superior occipital gyrus/middle occipital gyrus, and right precentral gyrus/postcentral gyrus. By contrast, UHR subjects showed decreased PAS in the left thalamus relative to healthy controls. A negative correlation was observed between decreased PAS in the right hippocampus/parahippocampus and Brief Visuospatial Memory Test-Revised (BVMT-R) scores in the patients (r = -0.364, p = 0.002). Moreover, the PAS values in the left thalamus could discriminate the patients/UHR subjects from the controls with acceptable sensitivities (68.42%/81.08%). First-episode patients and UHR subjects shared decreased PAS in the left thalamus. This observed pattern of functional asymmetry highlights the involvement of the thalamus in the pathophysiology of psychosis and may also be applied as a very early marker for psychosis.
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Affiliation(s)
- Furong Zhu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yi Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Ru Yang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - David N Kennedy
- Department of Psychiatry, Division of Neuroinformatics, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605, United States
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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Bernardoni F, King JA, Geisler D, Birkenstock J, Tam FI, Weidner K, Roessner V, White T, Ehrlich S. Nutritional Status Affects Cortical Folding: Lessons Learned From Anorexia Nervosa. Biol Psychiatry 2018; 84:692-701. [PMID: 29910027 DOI: 10.1016/j.biopsych.2018.05.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/11/2018] [Accepted: 05/01/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cortical folding is thought to remain relatively invariant after birth. Therefore, differences seen in psychiatric disorders have been proposed as early biomarkers or used as intermediate phenotypes in imaging genetics studies. Anorexia nervosa (AN) is associated with drastic and rapid structural brain alterations and thus may be an ideal model disorder to study environmental influences on cortical folding. METHODS To date, the only two studies in AN applied different methods (local gyrification index and mean curvature) and found seemingly discordant results. We computed both vertexwise measures in a sizable sample of acutely underweight female AN patients (n = 87, mean age 16.5 years), long-term recovered patients (n = 58, mean age 22 years), and healthy control participants (n = 141, mean age 19.5 years). The majority of acutely ill patients were scanned longitudinally (n = 57) again after partial weight normalization (>14% body mass index increase). RESULTS While gyrification was broadly reduced in acutely ill patients, normal values were restored in most brain regions after partial weight restoration (≈3 months), and after full recovery no significant differences were evident relative to control participants. Increased gyrification was largely predicted by weight restoration alone. Results for absolute mean curvature analyses complemented those obtained using the local gyrification index. CONCLUSIONS Together, these findings indicate that nutritional status affects cortical folding and suggest that gyrification studies may need to better control for environmental factors. Moreover, they provide novel support for the likelihood that macroscopic changes in the cortical organization in AN are more reflective of nutritional state than premorbid trait markers or permanent scars.
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Affiliation(s)
- Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julian Birkenstock
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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11
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Takahashi T, Suzuki M. Brain morphologic changes in early stages of psychosis: Implications for clinical application and early intervention. Psychiatry Clin Neurosci 2018; 72:556-571. [PMID: 29717522 DOI: 10.1111/pcn.12670] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 12/20/2022]
Abstract
To date, a large number of magnetic resonance imaging (MRI) studies have been conducted in schizophrenia, which generally demonstrate gray matter reduction, predominantly in the frontal and temporo-limbic regions, as well as gross brain abnormalities (e.g., a deviated sulcogyral pattern). Although the causes as well as timing and course of these findings remain elusive, these morphologic changes (especially gross brain abnormalities and medial temporal lobe atrophy) are likely present at illness onset, possibly reflecting early neurodevelopmental abnormalities. In addition, longitudinal MRI studies suggest that patients with schizophrenia and related psychoses also have progressive gray matter reduction during the transition period from prodrome to overt psychosis, as well as initial periods after psychosis onset, while such changes may become almost stable in the chronic stage. These active brain changes during the early phases seem to be relevant to the development of clinical symptoms in a region-specific manner (e.g., superior temporal gyrus atrophy and positive psychotic symptoms), but may be at least partly ameliorated by antipsychotic medication. Recently, increasing evidence from MRI findings in individuals at risk for developing psychosis has suggested that those who subsequently develop psychosis have baseline brain changes, which could be at least partly predictive of later transition into psychosis. In this article, we selectively review previous MRI findings during the course of psychosis and also refer to the possible clinical applicability of these neuroimaging research findings, especially in the diagnosis of schizophrenia and early intervention for psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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12
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Vignapiano A, Mucci A, Merlotti E, Giordano GM, Amodio A, Palumbo D, Galderisi S. Impact of Reward and Loss Anticipation on Cognitive Control: An Event-Related Potential Study in Subjects With Schizophrenia and Healthy Controls. Clin EEG Neurosci 2018; 49:46-54. [PMID: 29243531 DOI: 10.1177/1550059417745935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Deficits of cognitive functions and motivation are core aspects of schizophrenia. The interaction of these deficits might contribute to impair the ability to flexibly adjust behavior in accordance with one's intentions and goals. Many studies have focused on the anterior N2 as a correlate of cognitive control based on motivational value. AIMS Given the key role of motivation impairment in schizophrenia as a predictor of functional outcome, we aimed to study the impact of reward- and avoidance-based motivation on cognitive control using N2. METHOD Event-related potentials were recorded during the execution of the "Monetary Incentive Delay (MID)" task in 34 patients with schizophrenia (SCZ) stabilized on second-generation antipsychotics and 22 healthy controls (HC). Cognitive domains were assessed using the MATRICS Consensus Cognitive Battery. Negative symptom domains (Avolition/apathy and Expressive deficit), as well as positive and disorganization dimensions were also assessed in SCZ. RESULTS We did not observe any group difference in N2 amplitude or latency. In HC, N2 amplitude was significantly larger for anticipation of large loss with regard to all reward conditions and for all incentive versus neutral conditions. In SCZ, N2 amplitude did not discriminate between large loss and reward or between incentive and neutral conditions. N2 amplitude was not correlated with psychopathological dimensions or MCCB-assessed cognitive deficits in SCZ. CONCLUSION Our data in HC are in line with the hypothesis that N2 amplitude reflects the impact of motivational salience on cognitive control. Our results in SCZ indicate a deficit in the discrimination of motivational salience to the service of cognitive control, independently of psychopathology and other cognitive deficits.
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Affiliation(s)
- Annarita Vignapiano
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Armida Mucci
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Eleonora Merlotti
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia Maria Giordano
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonella Amodio
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Davide Palumbo
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silvana Galderisi
- 1 Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Sasabayashi D, Takayanagi Y, Takahashi T, Koike S, Yamasue H, Katagiri N, Sakuma A, Obara C, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Increased Occipital Gyrification and Development of Psychotic Disorders in Individuals With an At-Risk Mental State: A Multicenter Study. Biol Psychiatry 2017; 82:737-745. [PMID: 28709499 DOI: 10.1016/j.biopsych.2017.05.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anomalies of brain gyrification have been reported in schizophrenia, possibly reflecting its neurodevelopmental pathology. However, it remains elusive whether individuals at risk for psychotic disorders exhibit deviated gyrification patterns, and whether such findings, if present, are predictive of transition to psychotic disorders. METHODS This multicenter magnetic resonance imaging study investigated brain gyrification and its relationship to later transition to psychotic disorders in a large sample of at-risk mental state (ARMS) individuals. T1-weighted magnetic resonance imaging scans were obtained from 104 ARMS individuals, of whom 21 (20.2%) exhibited the transition to psychotic disorders during clinical follow-up (mean = 4.9 years, SD = 2.6 years), and 104 healthy control subjects at 4 different sites. The local gyrification index (LGI) of the entire cortex was compared across the groups using FreeSurfer software. RESULTS Compared with the control subjects, ARMS individuals showed a significantly higher LGI in widespread cortical areas, including the bilateral frontal, temporal, parietal, and occipital regions, which was partly associated with prodromal symptomatology. ARMS individuals who exhibited the transition to psychotic disorders showed a significantly higher LGI in the left occipital region compared with individuals without transition. CONCLUSIONS These findings suggested that increased LGI in diverse cortical regions might represent vulnerability to psychopathology, while increased LGI in the left occipital cortex might be related to subsequent manifestation of florid psychotic disorders as a possible surrogate marker.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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14
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Cho KIK, Shenton ME, Kubicki M, Jung WH, Lee TY, Yun JY, Kim SN, Kwon JS. Altered Thalamo-Cortical White Matter Connectivity: Probabilistic Tractography Study in Clinical-High Risk for Psychosis and First-Episode Psychosis. Schizophr Bull 2016; 42:723-31. [PMID: 26598740 PMCID: PMC4838094 DOI: 10.1093/schbul/sbv169] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Disrupted thalamo-cortical connectivity is regarded as a core psychopathology in patients diagnosed with schizophrenia. However, whether the thalamo-cortical white matter connectivity is disrupted before the onset of psychosis is still unknown. To determine this gap in knowledge, the strength of thalamo-cortical white matter anatomical connectivity in subjects at clinical-high risk for psychosis (CHR) was compared to that of first-episode psychosis (FEP) and healthy controls. A total of 37 CHR, 21 FEP, and 37 matched healthy controls underwent diffusion-weighted magnetic resonance imaging to examine the number of probabilistic tractography "counts" representing thalamo-cortical white matter connectivity. We also investigated the relationship with psychopathology. For FEP, the connectivity between the thalamus and parietal cortex was significantly increased (F= 5.65,P< .05) compared to that of healthy controls. However, the connectivity between thalamus and orbitofrontal cortex was significantly reduced compared to both healthy controls (F= 11.86,P< .005) and CHR (F= 6.63,P< .05). Interestingly, CHR exhibited a similar pattern as FEP, albeit with slightly reduced magnitude. Compared to healthy controls, there was a significant decrease (F= 4.16,P< .05) in CHR thalamo-orbitofrontal connectivity. Also, the strength of the thalamo-orbitofrontal connectivity was correlated with the Global Assessment of Functioning score in CHR (r= .35,P< .05). This observed pattern of white matter connectivity disruptions in FEP and in CHR suggests that this pattern of disconnectivity not only highlights the involvement of thalamus but also might be useful as an early biomarker for psychosis.
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Affiliation(s)
- Kang Ik K. Cho
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea;,Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Martha E. Shenton
- Department of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,VA Boston Healthcare System, Brockton Campus, Brocton, MA
| | - Marek Kubicki
- Department of Psychiatry and Radiology, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Wi Hoon Jung
- Department of Psychology, University of Pennsylvania, Philadelphia, PA
| | - Tae Young Lee
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea;,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea;,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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15
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Zhang T, Tang Y, Cui H, Lu X, Xu L, Liu X, Li H, Chow A, Du Y, Li C, Jiang K, Xiao Z, Wang J. Theory of Mind Impairments in Youth at Clinical High Risk of Psychosis. Psychiatry 2016; 79:40-55. [PMID: 27187512 DOI: 10.1080/00332747.2015.1123592] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The normal maturational processes of theory of mind (ToM) capacity are ongoing during adolescence and even early adulthood. However, research has shown that ToM ability also declines among adults suffering from prodromal psychotic experiences. The goal of this study was to investigate the characteristics of ToM performance in youth with clinical high risk (CHR) of psychosis. METHODS The Reading Mind in Eyes Task (RMET), including own-race and other-race eyes, was administered to 40 CHR youth; 42 age-, gender-, and education-matched healthy controls (HCs); and 62 adult patients with schizophrenia (SZ). Nine-month follow-up data were collected from 31 CHR subjects, of whom 7 (22.6%) had made the transition to psychosis. RESULTS CHR youth showed significant impairment in RMET performance compared to HC youth but performed better than did SZ patients. Moreover, they were significantly slower than were HC youth in responding to the RMET, with a response time similar to that of SZ patients. In particular, they had significantly poorer accuracy in interpreting positive and neutral eye expressions compared to the HC group, but not in interpreting negative eye expressions. Preliminary follow-up data showed a trend toward significance (p = 0.079) for RMET performance between those who transitioned to psychosis and those who did not. CONCLUSIONS Our findings illustrate that deficits in ToM capacity, specifically the ability to interpret people's mental state from eye expressions, occur early on in prodromal psychosis in youth. Early interventions for CHR youth focusing on ToM enhancement may halt progress toward psychosis.
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16
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Vernon AC, So PW, Lythgoe DJ, Chege W, Cooper JD, Williams SCR, Kapur S. Longitudinal in vivo maturational changes of metabolites in the prefrontal cortex of rats exposed to polyinosinic-polycytidylic acid in utero. Eur Neuropsychopharmacol 2015; 25:2210-20. [PMID: 26475576 DOI: 10.1016/j.euroneuro.2015.09.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 08/28/2015] [Accepted: 09/29/2015] [Indexed: 01/10/2023]
Abstract
Proton magnetic resonance spectroscopy ((1)H MRS) studies in schizophrenia patients generally report decreased levels of N-acetyl-aspartate (NAA), glutamate and glutathione, particularly in frontal cortex. However, these data are inconsistent in part due to confounds associated with clinical samples. The lack of validated diagnostic biomarkers also hampers analysis of the neurodevelopmental trajectory of neurochemical abnormalities. Rodent models are powerful tools to address these issues, particularly when combined with (1)H MRS (clinically comparable technology). We investigated the trajectory of metabolic changes in the prefrontal cortex during brain maturation from adolescence to adulthood in vivo using (1)H MRS in rats exposed prenatally to polyinosinic-polycytidylic acid (POL), a rodent model of maternal immune activation (MIA), an epidemiological risk factor for several psychiatric disorders with a neurodevelopmental origin. Longitudinal in vivo (1)H MRS revealed a significant decrease in PFC levels of GSH and taurine in adult, but not adolescent rats. Significant age×MIA interactions for PFC levels of NAA were also observed. These data replicate some deficits observed in the PFC of patients with schizophrenia. There were no significant changes in the levels of glutamate or any other metabolite. These data suggest prenatal exposure to POL leads to subtle metabolic perturbations of the normal maturing PFC, which may be related to subsequent behavioural abnormalities. Further work is however required to examine any potential confound of shipping stress on the presumed imbalances in PFC metabolites in POL-exposed offspring. Testing the interactions between MIA with stress or genetic risk variants will also be an important advance.
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Affiliation(s)
- Anthony C Vernon
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, London SE5 8AF, UK.
| | - Po-Wah So
- King's College London, Institute of Psychiatry, Department of Neuroimaging, Centre for Neuroimaging Sciences, De Crespigny Park, London SE5 8AF, UK
| | - David J Lythgoe
- King's College London, Institute of Psychiatry, Department of Neuroimaging, Centre for Neuroimaging Sciences, De Crespigny Park, London SE5 8AF, UK
| | - Winfred Chege
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, London SE5 8AF, UK
| | - Jonathan D Cooper
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, The James Black Centre, 125 Coldharbour Lane, London SE5 9NU, UK
| | - Steven C R Williams
- King's College London, Institute of Psychiatry, Department of Neuroimaging, Centre for Neuroimaging Sciences, De Crespigny Park, London SE5 8AF, UK
| | - Shitij Kapur
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, London SE5 8AF, UK
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17
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Hong SB, Lee TY, Kwak YB, Kim SN, Kwon JS. Baseline putamen volume as a predictor of positive symptom reduction in patients at clinical high risk for psychosis: A preliminary study. Schizophr Res 2015; 169:178-185. [PMID: 26527246 DOI: 10.1016/j.schres.2015.10.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/13/2015] [Accepted: 10/20/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Illness course in individuals at clinical high risk (CHR) status for psychosis is heterogeneous, which limits effective treatment for all CHR subgroups. Baseline predictors of positive symptom trajectory in the CHR group will reduce such limitations. We singled out the putamen, thought to be involved in the generation of the key schizophrenia symptoms early in the course of disease, as a potential predictor of positive symptom trajectory in CHR patients. METHOD We recruited 45 CHR patients and 29 age- and gender-matched healthy controls (HC). The CHR group was divided into patients with positive symptom reduction (CHR-R) and patients without positive symptom reduction (CHR-NR) at 6 months. Comparisons were made between the baseline putamen volumes of CHR-R, CHR-NR and HC groups. The relationship between baseline putamen volumes and clinical measures was investigated. RESULTS Left putamen volumes of CHR-R patients were significantly smaller than those of HCs (p=0.002) and of CHR-NR patients (p=0.024). CHR-R patients had significantly reduced leftward laterality compared to HCs (p=0.007). In the CHR-R group, bilateral putamen volumes were correlated with positive symptom severity at baseline (r=-0.552, p=0.001) and at 6 months (r=-0.360, p=0.043), and predicted positive symptom score change in 6 months at a trend level (p=0.092). CONCLUSION Smaller left putamen volumes in CHR-R patients, and the correlation between positive symptom severity and putamen volumes suggest that putamen volume is a possible risk-stratifier and predictor of clinical course in the CHR population.
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Affiliation(s)
- Sang Bin Hong
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Yoo Bin Kwak
- Department of Brain & Cognitive Sciences, Seoul National University College of National Sciences, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain & Cognitive Sciences, Seoul National University College of National Sciences, Seoul, Republic of Korea
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Klauser P, Zhou J, Lim JK, Poh JS, Zheng H, Tng HY, Krishnan R, Lee J, Keefe RS, Adcock RA, Wood SJ, Fornito A, Chee MW. Lack of Evidence for Regional Brain Volume or Cortical Thickness Abnormalities in Youths at Clinical High Risk for Psychosis: Findings From the Longitudinal Youth at Risk Study. Schizophr Bull 2015; 41:1285-93. [PMID: 25745033 PMCID: PMC4601700 DOI: 10.1093/schbul/sbv012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is cumulative evidence that young people in an "at-risk mental state" (ARMS) for psychosis show structural brain abnormalities in frontolimbic areas, comparable to, but less extensive than those reported in established schizophrenia. However, most available data come from ARMS samples from Australia, Europe, and North America while large studies from other populations are missing. We conducted a structural brain magnetic resonance imaging study from a relatively large sample of 69 ARMS individuals and 32 matched healthy controls (HC) recruited from Singapore as part of the Longitudinal Youth At-Risk Study (LYRIKS). We used 2 complementary approaches: a voxel-based morphometry and a surface-based morphometry analysis to extract regional gray and white matter volumes (GMV and WMV) and cortical thickness (CT). At the whole-brain level, we did not find any statistically significant difference between ARMS and HC groups concerning total GMV and WMV or regional GMV, WMV, and CT. The additional comparison of 2 regions of interest, hippocampal, and ventricular volumes, did not return any significant difference either. Several characteristics of the LYRIKS sample like Asian origins or the absence of current illicit drug use could explain, alone or in conjunction, the negative findings and suggest that there may be no dramatic volumetric or CT abnormalities in ARMS.
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Affiliation(s)
- Paul Klauser
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,Monash Clinical and Imaging Neuroscience, School of Psychological Sciences & Monash Biomedical Imaging, Monash University, Clayton, Australia;,These authors contributed equally to the article
| | - Juan Zhou
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore;
| | - Joseph K.W. Lim
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Joann S. Poh
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Hui Zheng
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Han Ying Tng
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Ranga Krishnan
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Jimmy Lee
- Department of General Psychiatry 1 and Research Division, Institute of Mental Health, Singapore, Singapore;,Office of Clinical Sciences, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Richard S.E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - R. Alison Adcock
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC;,Center for Cognitive Neuroscience, Duke University, Durham, NC
| | - Stephen J. Wood
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alex Fornito
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,Monash Clinical and Imaging Neuroscience, School of Psychological Sciences & Monash Biomedical Imaging, Monash University, Clayton, Australia
| | - Michael W.L. Chee
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
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Associations of hippocampal metabolism and regional brain grey matter in neuroleptic-naïve ultra-high-risk subjects and first-episode schizophrenia. Eur Neuropsychopharmacol 2015; 25:1661-8. [PMID: 26088723 DOI: 10.1016/j.euroneuro.2015.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/06/2015] [Accepted: 05/13/2015] [Indexed: 01/21/2023]
Abstract
Hippocampal pathology has been shown to be central to the pathophysiology of schizophrenia and a putative risk marker for developing psychosis. We applied both (1)H MRS (proton magnetic resonance spectroscopy) at 3Tesla and voxel-based morphometry (VBM) of high-resolution brain structural images in order to study the association of the metabolites glutamate (Glu) and N-acetyl-aspartate (NAA) in the hippocampus with whole-brain morphometry in 31 persons at ultra-high-risk for psychosis (UHR), 18 first-episode schizophrenia patients (Sz), and 42 healthy controls (all subjects being neuroleptic-naïve). Significantly diverging associations emerged for UHR subjects hippocampal glutamate showed positive correlation with the left superior frontal cortex, not seen in Sz or controls, while in first-episode schizophrenia patients a negative correlation was significant between glutamate and a left prefrontal area. For NAA, we observed different associations for left prefrontal and caudate clusters bilaterally for both high-risk and first-episode schizophrenia subjects, diverging from the pattern seen in healthy subjects. Our results suggest that associations of hippocampal metabolites in key areas of schizophrenia might vary due to liability to or onset of the disorder.
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Mechelli A, Prata D, Kefford C, Kapur S. Predicting clinical response in people at ultra-high risk of psychosis: a systematic and quantitative review. Drug Discov Today 2015; 20:924-7. [DOI: 10.1016/j.drudis.2015.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/22/2015] [Accepted: 03/10/2015] [Indexed: 11/29/2022]
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Heinze K, Reniers RLEP, Nelson B, Yung AR, Lin A, Harrison BJ, Pantelis C, Velakoulis D, McGorry PD, Wood SJ. Discrete alterations of brain network structural covariance in individuals at ultra-high risk for psychosis. Biol Psychiatry 2015; 77:989-96. [PMID: 25524754 DOI: 10.1016/j.biopsych.2014.10.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 10/16/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Investigation of aberrant large-scale brain networks offers novel insight into the role these networks play in diverse psychiatric disorders such as schizophrenia. Although studies report altered functional brain connectivity in participants at ultra-high risk (UHR) for psychosis, it is unclear whether these alterations extend to structural brain networks. METHODS Whole-brain structural covariance patterns of 133 participants at UHR for psychosis (51 of whom subsequently developed psychosis) and 65 healthy control (HC) subjects were studied. Following data preprocessing (using VBM8 toolbox), the mean signal in seed regions relating to specific networks (visual, auditory, motor, speech, semantic, executive control, salience, and default-mode) were extracted, and voxel-wise analyses of covariance were conducted to compare the association between whole-brain signal and each seed region for UHR and HC individuals. The UHR participants who transitioned to psychosis were compared with the UHR participants who did not. RESULTS Significantly reduced structural covariance was observed in the UHR sample compared with the HC sample for the default-mode network, and increased covariance was observed for the motor and executive control networks. When the UHR participants who transitioned to psychosis were compared with the UHR participants who did not, aberrant structural covariance was observed in the salience, executive control, auditory, and motor networks. CONCLUSIONS Whole-brain structural covariance analyses revealed subtle changes of connectivity of the default-mode, executive control, salience, motor, and auditory networks in UHR individuals for psychosis. Although we found significant differences, these are small changes and tend to reflect largely intact structural networks.
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Affiliation(s)
- Kareen Heinze
- School of Psychology, University of Birmingham, Birmingham, United Kingdom.
| | | | - Barnaby Nelson
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - Alison R Yung
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia; Institute of Brain, Behavior and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Patrick D McGorry
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J Wood
- School of Psychology, University of Birmingham, Birmingham, United Kingdom; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
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Pettersson-Yeo W, Benetti S, Frisciata S, Catani M, Williams SC, Allen P, McGuire P, Mechelli A. Does neuroanatomy account for superior temporal dysfunction in early psychosis? A multimodal MRI investigation. J Psychiatry Neurosci 2015; 40:100-7. [PMID: 25338016 PMCID: PMC4354815 DOI: 10.1503/jpn.140082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Neuroimaging studies of ultra-high risk (UHR) and first-episode psychosis (FEP) have revealed widespread alterations in brain structure and function. Recent evidence suggests there is an intrinsic relationship between these 2 types of alterations; however, there is very little research linking these 2 modalities in the early stages of psychosis. METHODS To test the hypothesis that functional alteration in UHR and FEP articipants would be associated with corresponding structural alteration, we examined brain function and structure in these participants as well as in a group of healthy controls using multimodal MRI. The data were analyzed using statistical parametric mapping. RESULTS We included 24 participants in the FEP group, 18 in the UHR group and 21 in the control group. Patients in the FEP group showed a reduction in functional activation in the left superior temporal gyrus relative to controls, and the UHR group showed intermediate values. The same region showed a corresponding reduction in grey matter volume in the FEP group relative to controls. However, while the difference in grey matter volume remained significant after including functional activation as a covariate of no interest, the reduction in functional activation was no longer evident after including grey matter volume as a covariate of no interest. LIMITATIONS Our sample size was relatively small. All participants in the FEP group and 2 in the UHR group had received antipsychotic medication, which may have impacted neurofunction and/or neuroanatomy. CONCLUSION Our results suggest that superior temporal dysfunction in early psychosis is accounted for by a corresponding alteration in grey matter volume. This finding has important implications for the interpretation of functional alteration in early psychosis.
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Affiliation(s)
- William Pettersson-Yeo
- Correspondence to: W. Pettersson-Yeo, Department of Psychosis Studies, PO Box 67, Institute of Psychiatry, King’s College London, De Crespigny Park, London UK SE5 8AF;
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Lincoln SH, Hooker CI. Neural structure and social dysfunction in individuals at clinical high risk for psychosis. Psychiatry Res 2014; 224:152-8. [PMID: 25443177 DOI: 10.1016/j.pscychresns.2014.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 05/24/2014] [Accepted: 08/07/2014] [Indexed: 10/24/2022]
Abstract
Individuals at a clinical high risk (CHR) for psychosis have gray matter volume (GMV) abnormalities that are similar to, though less severe than, those in individuals with schizophrenia. Less GMV in schizophrenia is related to worse social cognition and social functioning, but the relationship between GMV and social functioning in CHR individuals has yet to be investigated. The aim of this study was to (1) investigate differences in GMV between healthy controls (HC) and CHR individuals, and (2) evaluate the relationship between GMV and social functioning in these two groups. Participants comprised 22 CHR and 21 HC individuals who completed a structural magnetic resonance imaging (MRI) scan as well as self-reported and interviewer-rated measures of social functioning. Processing and analysis of structural images were completed using voxel based morphometry (VBM). Results showed that the CHR group had less GMV in the left postcentral gyrus, bilateral parahippocampual gyri, and left anterior cingulate cortex. Reduced GMV in the postcentral gyrus and the anterior cingulate was related to self-reported social impairment across the whole group. This study has implications for the neurobiological basis of social dysfunction present before the onset of psychosis.
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Affiliation(s)
- Sarah Hope Lincoln
- Department of Psychology, Harvard University, William James Hall 1008, Cambridge, MA 02138, USA.
| | - Christine I'Lee Hooker
- Department of Psychology, Harvard University, William James Hall 1008, Cambridge, MA 02138, USA
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Keshavan MS, Giedd J, Lau JYF, Lewis DA, Paus T. Changes in the adolescent brain and the pathophysiology of psychotic disorders. Lancet Psychiatry 2014; 1:549-58. [PMID: 26361314 DOI: 10.1016/s2215-0366(14)00081-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 05/23/2014] [Indexed: 10/24/2022]
Abstract
Adolescence is a time of extensive neuroanatomical, functional, and chemical reorganisation of the brain which parallels substantial maturational changes in cognition and affect regulation. This period is characterised by stabilisation of synapses to diminish redundancy and increase efficiency of neural function, fine-tuning of excitatory and inhibitory neurotransmitter systems, beginning of integration between late maturing and early maturing brain structures, and development of effective connections. In effect, these so-called moving parts create a state of dynamic change that might underlie adolescent behaviours. Imbalances or changes in timing of these developmental processes clearly increase the risk for psychiatric disorders. Genetic, environmental, and epigenetic factors that shape brain development and hormonal changes that affect stress reactivity could be reasons why some, but not all, adolescents are at a heightened risk of developing a psychopathological disorder. In this Series paper, we assess the neurobiology of the changing adolescent brain, implications of this knowledge, and future research in major psychiatric disorders, particularly for psychotic disorders.
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Affiliation(s)
- Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
| | - Jay Giedd
- Brain Imaging Section, Child Psychiatry Branch, NIMH, Bethesda, MD, USA
| | | | - David A Lewis
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - Tomáš Paus
- Rotman Research Institute and Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
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25
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Pelletier-Baldelli A, Dean DJ, Lunsford-Avery JR, Smith Watts AK, Orr JM, Gupta T, Millman ZB, Mittal VA. Orbitofrontal cortex volume and intrinsic religiosity in non-clinical psychosis. Psychiatry Res 2014; 222:124-30. [PMID: 24746701 PMCID: PMC4073495 DOI: 10.1016/j.pscychresns.2014.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 02/16/2014] [Accepted: 03/26/2014] [Indexed: 11/30/2022]
Abstract
Research indicates that religiosity plays a complex role in mental illness. Despite this link, little work has been done to clarify the role of religiosity in persons exhibiting non-clinical psychosis (NCP, individuals experiencing fleeting psychotic-like symptoms in the absence of a formal psychotic disorder). Further, there are no NCP investigations into whether abnormalities exist in brain structures that are associated with religiosity. Understanding these relationships in NCP is important to clarify the role of religiosity and brain structural anomalies in psychosis. Twenty individuals experiencing NCP and twenty controls were assessed for intrinsic religiosity (IR; motivation/commitment to religious beliefs and/or practices) using a well-validated self-report scale. Structural magnetic resonance imaging was used to determine volumes of the orbitofrontal cortex (OFC), a critical region that has been associated with increased religiosity. Results indicate that IR is elevated in the NCP group, and that these individuals exhibit bilateral volume reduction in both the lateral and medial OFC. Sample-wide correlations are non-significant, but show notable relationships between smaller OFC regions and increased IR. Significant negative relationships were found between OFC volume and depressive and negative symptoms. Overall, results suggest that brain abnormalities associated with NCP may also confer a heightened susceptibility for religiosity.
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Affiliation(s)
- Andrea Pelletier-Baldelli
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Corresponding Author: Andrea Pelletier-Baldelli, Department of Psychology and Neuroscience, University of Colorado at Boulder, 345 UCB, Boulder, Colorado 80309-0345, Phone: 252.670.2571
| | - Derek J. Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | | | - Ashley K. Smith Watts
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Joseph M. Orr
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Tina Gupta
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Zachary B. Millman
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Vijay A. Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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Badcock JC, Hugdahl K. A synthesis of evidence on inhibitory control and auditory hallucinations based on the Research Domain Criteria (RDoC) framework. Front Hum Neurosci 2014; 8:180. [PMID: 24723879 PMCID: PMC3972475 DOI: 10.3389/fnhum.2014.00180] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 03/10/2014] [Indexed: 12/17/2022] Open
Abstract
The National Institute of Mental Health initiative called the Research Domain Criteria (RDoC) project aims to provide a new approach to understanding mental illness grounded in the fundamental domains of human behavior and psychological functioning. To this end the RDoC framework encourages researchers and clinicians to think outside the [diagnostic] box, by studying symptoms, behaviors or biomarkers that cut across traditional mental illness categories. In this article we examine and discuss how the RDoC framework can improve our understanding of psychopathology by zeroing in on hallucinations- now widely recognized as a symptom that occurs in a range of clinical and non-clinical groups. We focus on a single domain of functioning-namely cognitive [inhibitory] control-and assimilate key findings structured around the basic RDoC "units of analysis," which span the range from observable behavior to molecular genetics. Our synthesis and critique of the literature provides a deeper understanding of the mechanisms involved in the emergence of auditory hallucinations, linked to the individual dynamics of inhibitory development before and after puberty; favors separate developmental trajectories for clinical and non-clinical hallucinations; yields new insights into co-occurring emotional and behavioral problems; and suggests some novel avenues for treatment.
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Affiliation(s)
- Johanna C. Badcock
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western AustraliaCrawley, WA, Australia
- Clinical Research Centre, North Metropolitan Health Service-Mental HealthPerth, WA, Australia
| | - Kenneth Hugdahl
- Division of Psychiatry, Department of Biological and Medical Psychology, NORMENT Centre of Excellence (RCN # 223273), Haukeland University Hospital, University of BergenBergen, Norway
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Dean DJ, Bernard JA, Orr JM, Pelletier-Baldelli A, Gupta T, Carol EE, Mittal VA. Cerebellar Morphology and Procedural Learning Impairment in Neuroleptic-Naive Youth at Ultrahigh Risk of Psychosis. Clin Psychol Sci 2014; 2:152-164. [PMID: 25419496 PMCID: PMC4240519 DOI: 10.1177/2167702613500039] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Despite evidence suggesting a role for cerebellar abnormalities in the pathogenesis of psychosis, the structure has yet to receive attention in individuals at ultrahigh risk for psychosis (UHR). Accumulating research has suggested that the cerebellum helps modulate cognition and movement, domains in which UHR individuals show impairment; understanding putative markers of risk, such as structural abnormalities and behavioral correlates, is essential. In this study, participants underwent a high-resolution structural brain scan and participated in a pursuit rotor experiment. Cerebellar regions associated with movement (anterior cerebellum) and cognition (crus I) were subsequently analyzed. UHR participants showed impaired performance on the pursuit rotor task, learned at a slower rate, and showed smaller cerebellar volumes compared with control participants. Left crus I volume was significantly associated with poor rate of learning. The present results suggest that cerebellar abnormalities and their behavioral correlates (poor learning and motor control) precede the onset of psychosis.
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Affiliation(s)
- Derek J. Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Center for Neuroscience, University of Colorado Boulder
| | | | - Joseph M. Orr
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute for Cognitive Science, University of Colorado Boulder
| | - Andrea Pelletier-Baldelli
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Center for Neuroscience, University of Colorado Boulder
| | - Tina Gupta
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Emily E. Carol
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Vijay A. Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Center for Neuroscience, University of Colorado Boulder
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28
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Bernard JA, Dean DJ, Kent JS, Orr JM, Pelletier-Baldelli A, Lunsford-Avery JR, Gupta T, Mittal VA. Cerebellar networks in individuals at ultra high-risk of psychosis: impact on postural sway and symptom severity. Hum Brain Mapp 2014; 35:4064-78. [PMID: 24464473 DOI: 10.1002/hbm.22458] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 11/15/2013] [Accepted: 12/18/2013] [Indexed: 01/03/2023] Open
Abstract
Despite known deficits in postural control in patients with schizophrenia, this domain has not been investigated in youth at ultra high-risk (UHR) for psychosis. This is particularly relevant as postural control implicates dysfunction in the cerebellum-a region implicated in cognitive dysmetria conceptions of schizophrenia but poorly understood in the prodrome. Here, we extended our understanding of movement abnormalities in UHR individuals to include postural control, and have linked these deficits to both symptom severity and cerebello-cortical network connectivity. UHR and healthy control participants completed an instrumentally based balance task to quantify postural control along with a resting state brain imaging scan to investigate cerebellar networks. We also quantified positive and negative symptom severity with structured clinical interviews. The UHR group showed overall increased postural sway and decreased cerebello-cortical resting state connectivity, relative to controls. The decreased cerebello-cortical connectivity was seen across multiple networks. Postural sway was also correlated with cerebellar connectivity in this population and uniquely positively correlated with the severity of negative symptoms. Finally, symptom severity was also associated with cerebellar connectivity. Together, our results point to a potential deficit in sensory integration as an underlying contributor to the increased postural sway, and provide evidence of cerebellar abnormalities in UHR individuals. These results extend our understanding of the motor abnormalities of UHR individuals beyond striatum-based dyskinesias to include postural control and sensory integration deficits, and implicate the cerebellum as a distinct neural substrate preceding the onset of psychosis. Taken together, our results extend the cognitive dysmetria framework to UHR populations.
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Affiliation(s)
- Jessica A Bernard
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado
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29
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Edgar JC, Chen YH, Lanza M, Howell B, Chow VY, Heiken K, Liu S, Wootton C, Hunter MA, Huang M, Miller GA, Cañive JM. Cortical thickness as a contributor to abnormal oscillations in schizophrenia? NEUROIMAGE-CLINICAL 2013; 4:122-9. [PMID: 24371794 PMCID: PMC3871288 DOI: 10.1016/j.nicl.2013.11.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 11/06/2013] [Accepted: 11/12/2013] [Indexed: 11/25/2022]
Abstract
Introduction Although brain rhythms depend on brain structure (e.g., gray and white matter), to our knowledge associations between brain oscillations and structure have not been investigated in healthy controls (HC) or in individuals with schizophrenia (SZ). Observing function–structure relationships, for example establishing an association between brain oscillations (defined in terms of amplitude or phase) and cortical gray matter, might inform models on the origins of psychosis. Given evidence of functional and structural abnormalities in primary/secondary auditory regions in SZ, the present study examined how superior temporal gyrus (STG) structure relates to auditory STG low-frequency and 40 Hz steady-state activity. Given changes in brain activity as a function of age, age-related associations in STG oscillatory activity were also examined. Methods Thirty-nine individuals with SZ and 29 HC were recruited. 40 Hz amplitude-modulated tones of 1 s duration were presented. MEG and T1-weighted sMRI data were obtained. Using the sources localizing 40 Hz evoked steady-state activity (300 to 950 ms), left and right STG total power and inter-trial coherence were computed. Time–frequency group differences and associations with STG structure and age were also examined. Results Decreased total power and inter-trial coherence in SZ were observed in the left STG for initial post-stimulus low-frequency activity (~ 50 to 200 ms, ~ 4 to 16 Hz) as well as 40 Hz steady-state activity (~ 400 to 1000 ms). Left STG 40 Hz total power and inter-trial coherence were positively associated with left STG cortical thickness in HC, not in SZ. Left STG post-stimulus low-frequency and 40 Hz total power were positively associated with age, again only in controls. Discussion Left STG low-frequency and steady-state gamma abnormalities distinguish SZ and HC. Disease-associated damage to STG gray matter in schizophrenia may disrupt the age-related left STG gamma-band function–structure relationships observed in controls. Associations between brain oscillations and structure were investigated in SZ The present study examined how superior temporal gyrus (STG) structure and agerelate to auditory STG low-frequency and 40 Hz steady-state activity Decreased total power and inter-trial coherence in SZ were observed in the left STG for early low-frequency activity (~ 50 to 200 ms, ~ 4 to 16 Hz) as well as 40 Hz steady-state activity (~ 400 to 1000 ms) Left STG 40 Hz total power and inter-trial coherence were positively associated with left STG cortical thickness in HC, not in SZ Disease-associated damage to STG gray matter in schizophrenia may disrupt the age-related left STG function-structure relationships observed in controls.
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Affiliation(s)
- J Christopher Edgar
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Yu-Han Chen
- The University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, NM, USA ; New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, NM, USA
| | - Matthew Lanza
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Breannan Howell
- The University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, NM, USA ; New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, NM, USA
| | - Vivian Y Chow
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Kory Heiken
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Song Liu
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Cassandra Wootton
- The University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, NM, USA ; New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, NM, USA
| | - Michael A Hunter
- The University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, NM, USA ; New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, NM, USA
| | - Mingxiong Huang
- The University of California San Diego, Department of Radiology, San Diego, CA, USA ; San Diego VA Healthcare System, Department of Radiology, San Diego, CA, USA
| | - Gregory A Miller
- University of California, Los Angeles, Department of Psychology, USA
| | - José M Cañive
- The University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, NM, USA ; New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, NM, USA
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Kato TA, Watabe M, Kanba S. Neuron-glia interaction as a possible glue to translate the mind-brain gap: a novel multi-dimensional approach toward psychology and psychiatry. Front Psychiatry 2013; 4:139. [PMID: 24155727 PMCID: PMC3804762 DOI: 10.3389/fpsyt.2013.00139] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 10/07/2013] [Indexed: 12/28/2022] Open
Abstract
Neurons and synapses have long been the dominant focus of neuroscience, thus the pathophysiology of psychiatric disorders has come to be understood within the neuronal doctrine. However, the majority of cells in the brain are not neurons but glial cells including astrocytes, oligodendrocytes, and microglia. Traditionally, neuroscientists regarded glial functions as simply providing physical support and maintenance for neurons. Thus, in this limited role glia had been long ignored. Recently, glial functions have been gradually investigated, and increasing evidence has suggested that glial cells perform important roles in various brain functions. Digging up the glial functions and further understanding of these crucial cells, and the interaction between neurons and glia may shed new light on clarifying many unknown aspects including the mind-brain gap, and conscious-unconscious relationships. We briefly review the current situation of glial research in the field, and propose a novel translational research with a multi-dimensional model, combining various experimental approaches such as animal studies, in vitro & in vivo neuron-glia studies, a variety of human brain imaging investigations, and psychometric assessments.
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Affiliation(s)
- Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan ; Innovation Center for Medical Redox Navigation, Kyushu University , Fukuoka , Japan
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Brent BK, Thermenos HW, Keshavan MS, Seidman LJ. Gray Matter Alterations in Schizophrenia High-Risk Youth and Early-Onset Schizophrenia: A Review of Structural MRI Findings. Child Adolesc Psychiatr Clin N Am 2013; 22:689-714. [PMID: 24012081 PMCID: PMC3767930 DOI: 10.1016/j.chc.2013.06.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article reviews the literature on structural magnetic resonance imaging findings in pediatric and young adult populations at clinical or genetic high-risk for schizophrenia and early-onset schizophrenia. The implications of this research are discussed for understanding the pathophysiology of schizophrenia and for early intervention strategies. The evidence linking brain structural changes in prepsychosis development and early-onset schizophrenia with disruptions of normal neurodevelopmental processes during childhood or adolescence is described. Future directions are outlined for research to address knowledge gaps regarding the neurobiological basis of brain structural abnormalities in schizophrenia and to improve the usefulness of these abnormalities for preventative interventions.
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Affiliation(s)
- Benjamin K Brent
- Harvard Medical School, Boston, MA 02115, USA; Division of Public Psychiatry, Massachusetts Mental Health Center, 75 Fenwood Road, Boston, MA 02115, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
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Heritability of subcortical brain measures: a perspective for future genome-wide association studies. Neuroimage 2013; 83:98-102. [PMID: 23770413 DOI: 10.1016/j.neuroimage.2013.06.027] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/31/2013] [Accepted: 06/07/2013] [Indexed: 01/02/2023] Open
Abstract
Several large imaging-genetics consortia aim to identify genetic variants influencing subcortical brain volumes. We investigated the extent to which genetic variation accounts for the variation in subcortical volumes, including thalamus, amygdala, putamen, caudate nucleus, globus pallidus and nucleus accumbens and obtained the stability of these brain volumes over a five-year period. The heritability estimates for all subcortical regions were high, with the highest heritability estimates observed for the thalamus (.80) and caudate nucleus (.88) and lowest for the left nucleus accumbens (.44). Five-year stability was substantial and higher for larger [e.g., thalamus (.88), putamen (.86), caudate nucleus (.87)] compared to smaller [nucleus accumbens (.45)] subcortical structures. These results provide additional evidence that subcortical structures are promising starting points for identifying genetic variants that influence brain structure.
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