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Wang C, Ji F, Hong Z, Poh JS, Krishnan R, Lee J, Rekhi G, Keefe RSE, Adcock RA, Wood SJ, Fornito A, Pasternak O, Chee MWL, Zhou J. Disrupted salience network functional connectivity and white-matter microstructure in persons at risk for psychosis: findings from the LYRIKS study. Psychol Med 2016; 46:2771-2783. [PMID: 27396386 PMCID: PMC5358474 DOI: 10.1017/s0033291716001410] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Salience network (SN) dysconnectivity has been hypothesized to contribute to schizophrenia. Nevertheless, little is known about the functional and structural dysconnectivity of SN in subjects at risk for psychosis. We hypothesized that SN functional and structural connectivity would be disrupted in subjects with At-Risk Mental State (ARMS) and would be associated with symptom severity and disease progression. METHOD We examined 87 ARMS and 37 healthy participants using both resting-state functional magnetic resonance imaging and diffusion tensor imaging. Group differences in SN functional and structural connectivity were examined using a seed-based approach and tract-based spatial statistics. Subject-level functional connectivity measures and diffusion indices of disrupted regions were correlated with CAARMS scores and compared between ARMS with and without transition to psychosis. RESULTS ARMS subjects exhibited reduced functional connectivity between the left ventral anterior insula and other SN regions. Reduced fractional anisotropy (FA) and axial diffusivity were also found along white-matter tracts in close proximity to regions of disrupted functional connectivity, including frontal-striatal-thalamic circuits and the cingulum. FA measures extracted from these disrupted white-matter regions correlated with individual symptom severity in the ARMS group. Furthermore, functional connectivity between the bilateral insula and FA at the forceps minor were further reduced in subjects who transitioned to psychosis after 2 years. CONCLUSIONS Our findings support the insular dysconnectivity of the proximal SN hypothesis in the early stages of psychosis. Further developed, the combined structural and functional SN assays may inform the prognosis of persons at-risk for psychosis.
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Affiliation(s)
- C. Wang
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - F. Ji
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - Z. Hong
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. S. Poh
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - R. Krishnan
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Lee
- Research Division,
Institute of Mental Health, Singapore
- Office of Clinical Sciences,
Duke-NUS Medical School, Singapore
| | - G. Rekhi
- Research Division,
Institute of Mental Health, Singapore
| | - R. S. E. Keefe
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
| | - R. A. Adcock
- Department of Psychiatry and Behavioral
Sciences, Duke University, Durham,
NC, USA
- Center for Cognitive Neuroscience,
Duke University, Durham, NC,
USA
| | - S. J. Wood
- School of Psychology,
University of Birmingham, Edgbaston,
UK
- Department of Psychiatry,
Melbourne Neuropsychiatry Centre, University of
Melbourne and Melbourne Health, Victoria,
Australia
| | - A. Fornito
- Monash Clinical and Imaging
Neuroscience, School of Psychology and Psychiatry & Monash
Biomedical Imaging, Monash University,
Australia
| | - O. Pasternak
- Departments of Psychiatry and Radiology,
Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, USA
| | - M. W. L. Chee
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
| | - J. Zhou
- Center for Cognitive Neuroscience,
Neuroscience and Behavioral Disorder Program, Duke-NUS
Medical School, National University of Singapore,
Singapore
- Clinical Imaging Research Centre, the Agency for
Science, Technology and Research and National University of
Singapore, Singapore
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