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Weickert TW, Ji E, Galletly C, Boerrigter D, Morishima Y, Bruggemann J, Balzan R, O’Donnell M, Liu D, Lenroot R, Weickert CS, Kindler J. Toll-Like Receptor mRNA Levels in Schizophrenia: Association With Complement Factors and Cingulate Gyrus Cortical Thinning. Schizophr Bull 2024; 50:403-417. [PMID: 38102721 PMCID: PMC10919782 DOI: 10.1093/schbul/sbad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND AND HYPOTHESES Previous studies revealed innate immune system activation in people with schizophrenia (SZ), potentially mediated by endogenous pathogen recognition receptors, notably Toll-like receptors (TLR). TLRs are activated by pathogenic molecules like bacterial lipopolysaccharides (TLR1 and TLR4), viral RNA (TLR3), or both (TLR8). Furthermore, the complement system, another key component of innate immunity, has previously been linked to SZ. STUDY DESIGN Peripheral mRNA levels of TLR1, TLR3, TLR4, and TLR8 were compared between SZ and healthy controls (HC). We investigated their relationship with immune activation through complement expression and cortical thickness of the cingulate gyrus, a region susceptible to immunological hits. TLR mRNA levels and peripheral complement receptor mRNA were extracted from 86 SZ and 77 HC white blood cells; structural MRI scans were conducted on a subset. STUDY RESULTS We found significantly higher TLR4 and TLR8 mRNA levels and lower TLR3 mRNA levels in SZ compared to HC. TLRs and complemental factors were significantly associated in SZ and HC, with the strongest deviations of TLR mRNA levels in the SZ subgroup having elevated complement expression. Cortical thickness of the cingulate gyrus was inversely associated with TLR8 mRNA levels in SZ, and with TLR4 and TLR8 levels in HC. CONCLUSIONS The study underscores the role of innate immune activation in schizophrenia, indicating a coordinated immune response of TLRs and the complement system. Our results suggest there could be more bacterial influence (based on TLR 4 levels) as opposed to viral influence (based on TLR3 levels) in schizophrenia. Specific TLRs were associated with brain cortical thickness reductions of limbic brain structures.
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Affiliation(s)
- Thomas W Weickert
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031Australia
- Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210, USA
| | - Ellen Ji
- Psychiatric University Hospital Zurich, Zurich, Switzerland
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Ramsay Health Care (SA) Mental Health, Adelaide, Australia
- Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Danny Boerrigter
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
| | - Yosuke Morishima
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Jason Bruggemann
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031Australia
- Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Speciality of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ryan Balzan
- School of Psychology, Flinders University, Adelaide, SA, Australia
| | - Maryanne O’Donnell
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
- Kiloh Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Dennis Liu
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Ramsay Health Care (SA) Mental Health, Adelaide, Australia
- Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Rhoshel Lenroot
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031Australia
- Department of Psychiatry, University of New Mexico, Albuquerque, NM 87131-0001, USA
| | - Cynthia Shannon Weickert
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031Australia
- Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210, USA
| | - Jochen Kindler
- Neuroscience Research Australia, Schizophrenia Research Institute, Randwick, NSW 2031, Australia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
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Klar J, Slotboom J, Lerch S, Koenig J, Wiest R, Kaess M, Kindler J. Higher striatal glutamate in male youth with internet gaming disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:301-309. [PMID: 37505291 PMCID: PMC10914841 DOI: 10.1007/s00406-023-01651-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
Internet gaming disorder (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a research diagnosis, but little is known about its pathophysiology. Alterations in frontostriatal circuits appear to play a critical role in the development of addiction. Glutamate is considered an essential excitatory neurotransmitter in addictive disorders. This study's aim was to investigate striatal glutamate in youth with IGD compared to healthy controls (HC). Using a cross-sectional design, 25 adolescent male subjects fulfilling DSM-5 criteria for IGD and 26 HC, matched in age, education, handedness and smoking, were included in the analysis. A structural MPRAGE T1 sequence followed by a single-voxel magnetic resonance spectroscopy MEGA-PRESS sequence (TR = 1500 ms, TE = 68 ms, 208 averages) with a voxel size of 20 mm3 were recorded on 3 T Siemens Magnetom Prisma scanner. The voxel was placed in the left striatum. Group comparison of the relative glutamate and glutamine (Glx) was calculated using regression analysis. IGD subjects met an average of 6.5 of 9 DSM-5 IGD criteria and reported an average of 29 h of weekly gaming. Regression analysis showed a significant group effect for Glx, with higher Glx levels in IGD as compared to HC (coef. = .086, t (50) = 2.17, p = .035). Our study is the first to show higher levels of Glx in the striatum in youth with IGD. The elevation of Glx in the striatum may indicate hyperactivation of the reward system in IGD. Thus, results confirm that neurochemical alterations can be identified in early stages of behavioral addictions.
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Affiliation(s)
- Johanna Klar
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging (SCAN), Neuroradiology, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
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Liebrand M, Katsarakis A, Josi J, Diezig S, Michel C, Schultze-Lutter F, Rochas V, Mancini V, Kaess M, Hubl D, Koenig T, Kindler J. EEG microstate D as psychosis-specific correlate in adolescents and young adults with clinical high risk for psychosis and first-episode psychosis. Schizophr Res 2024; 264:49-57. [PMID: 38096659 DOI: 10.1016/j.schres.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/05/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024]
Abstract
Resting-state electroencephalography (EEG) microstates are brief periods (60-120 ms) of quasi-stable scalp field potentials, indicating simultaneous activity of large-scale networks. Microstates are assumed to reflect basic neuronal information processing. A common finding in psychosis spectrum disorders is that microstates classes C and D are altered. Whereas evidence in adults with schizophrenia is substantial, little is known about effects in underage patients, particularly in those at clinical high risk for psychosis (CHR) and first-episode psychosis (FEP). The present study used 74-channel EEG to investigate microstate effects in a large sample of patients with CHR (n = 100) and FEP (n = 33), clinical controls (CC, n = 18), as well as age-matched healthy controls (HC, n = 68). Subjects span an age range from 9 to 35 years, thus, covering underage patients as well as the most vulnerable period for the emergence of psychosis and its prodrome. Four EEG microstates classes were analyzed (A-D). In class D, CHR and FEP patients showed a decrease compared to HC, and CHR patients also to CC. An increase in class C was found in CHR and FEP compared to HC but not to CC. Results were independent of age and no differences were found between the psychosis spectrum groups. The findings suggest an age-independent decrease of microstate class D to be specific to the psychosis spectrum, whereas the increase in class C seems to reflect unspecific psychopathology. Overall, present data strengthens the role of microstate D as potential biomarker for psychosis, as early as in adolescence and already in CHR status.
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Affiliation(s)
- Matthias Liebrand
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Angelos Katsarakis
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Johannes Josi
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Sarah Diezig
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Vincent Rochas
- Department of Basic Neurosciences, University of Geneva, Campus Biotech, Switzerland
| | - Valentina Mancini
- Department of Basic Neurosciences, University of Geneva, Campus Biotech, Switzerland; Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
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Klaassen AL, Michel C, Stüble M, Kaess M, Morishima Y, Kindler J. Reduced anterior callosal white matter in risk for psychosis associated with processing speed as a fundamental cognitive impairment. Schizophr Res 2024; 264:211-219. [PMID: 38157681 DOI: 10.1016/j.schres.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/29/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Previous research in psychotic disorders discovered associations between reduced integrity of white matter (WM) in the corpus callosum (CC) and impaired cognitive functions, suggesting processing speed as a central construct. However, it is still largely unexplored to what extent disruption in callosal WM is related to cognitive deficits during the risk stage prior to psychosis. METHODS To address this gap, we measured the WM integrity in CC by fractional anisotropy (FA) and assessed cognition in 60 clinical-high risk for psychosis (CHR) patients during adolescence/young adulthood and 38 healthy control (HC) subjects. We employed tract based spatial statistics to examine group differences and associations between CC-FA and processing speed, executive function, and spatial working memory. RESULTS We revealed deficits in processing speed, executive function, and spatial working memory of CHR patients, and reductions in FA of the genu and the body of the CC (p < 0.05, corrected for multiple comparisons) compared to HC. A mediation analysis using the combined sample (CHR + HC) showed that processing speed mediates the associations between the impaired CC structure and executive function and spatial working memory, respectively. Exploratory analyses between CC-FA and the cognitive domains located associations of processing speed in the genu and the body of CC with distinct spatial distributions of executive function and spatial working memory. CONCLUSION We suggest processing speed as a subordinate cognitive factor contributing to the associations between callosal WM, executive function and working memory. These results extend findings in psychotic disorders to the prior risk stage.
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Affiliation(s)
- Arndt-Lukas Klaassen
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy Bern, University of Bern, Switzerland.
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy Bern, University of Bern, Switzerland
| | - Miriam Stüble
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy Bern, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy Bern, University of Bern, Switzerland; University Hospital Heidelberg, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany
| | - Yosuke Morishima
- University Hospital of Psychiatry Bern, Department of Psychiatric Neurophysiology, University of Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy Bern, University of Bern, Switzerland
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5
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Haas SS, Ge R, Agartz I, Amminger GP, Andreassen OA, Bachman P, Baeza I, Choi S, Colibazzi T, Cropley VL, de la Fuente-Sandoval C, Ebdrup BH, Fortea A, Fusar-Poli P, Glenthøj BY, Glenthøj LB, Haut KM, Hayes RA, Heekeren K, Hooker CI, Hwang WJ, Jahanshad N, Kaess M, Kasai K, Katagiri N, Kim M, Kindler J, Koike S, Kristensen TD, Kwon JS, Lawrie SM, Lebedeva I, Lee J, Lemmers-Jansen ILJ, Lin A, Ma X, Mathalon DH, McGuire P, Michel C, Mizrahi R, Mizuno M, Møller P, Mora-Durán R, Nelson B, Nemoto T, Nordentoft M, Nordholm D, Omelchenko MA, Pantelis C, Pariente JC, Raghava JM, Reyes-Madrigal F, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Smigielski L, Sugranyes G, Suzuki M, Takahashi T, Tamnes CK, Theodoridou A, Thomopoulos SI, Thompson PM, Tomyshev AS, Uhlhaas PJ, Værnes TG, van Amelsvoort TAMJ, van Erp TGM, Waltz JA, Wenneberg C, Westlye LT, Wood SJ, Zhou JH, Hernaus D, Jalbrzikowski M, Kahn RS, Corcoran CM, Frangou S. Normative Modeling of Brain Morphometry in Clinical High Risk for Psychosis. JAMA Psychiatry 2024; 81:77-88. [PMID: 37819650 PMCID: PMC10568447 DOI: 10.1001/jamapsychiatry.2023.3850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/25/2023] [Indexed: 10/13/2023]
Abstract
Importance The lack of robust neuroanatomical markers of psychosis risk has been traditionally attributed to heterogeneity. A complementary hypothesis is that variation in neuroanatomical measures in individuals at psychosis risk may be nested within the range observed in healthy individuals. Objective To quantify deviations from the normative range of neuroanatomical variation in individuals at clinical high risk for psychosis (CHR-P) and evaluate their overlap with healthy variation and their association with positive symptoms, cognition, and conversion to a psychotic disorder. Design, Setting, and Participants This case-control study used clinical-, IQ-, and neuroimaging software (FreeSurfer)-derived regional measures of cortical thickness (CT), cortical surface area (SA), and subcortical volume (SV) from 1340 individuals with CHR-P and 1237 healthy individuals pooled from 29 international sites participating in the Enhancing Neuroimaging Genetics Through Meta-analysis (ENIGMA) Clinical High Risk for Psychosis Working Group. Healthy individuals and individuals with CHR-P were matched on age and sex within each recruitment site. Data were analyzed between September 1, 2021, and November 30, 2022. Main Outcomes and Measures For each regional morphometric measure, deviation scores were computed as z scores indexing the degree of deviation from their normative means from a healthy reference population. Average deviation scores (ADS) were also calculated for regional CT, SA, and SV measures and globally across all measures. Regression analyses quantified the association of deviation scores with clinical severity and cognition, and 2-proportion z tests identified case-control differences in the proportion of individuals with infranormal (z < -1.96) or supranormal (z > 1.96) scores. Results Among 1340 individuals with CHR-P, 709 (52.91%) were male, and the mean (SD) age was 20.75 (4.74) years. Among 1237 healthy individuals, 684 (55.30%) were male, and the mean (SD) age was 22.32 (4.95) years. Individuals with CHR-P and healthy individuals overlapped in the distributions of the observed values, regional z scores, and all ADS values. For any given region, the proportion of individuals with CHR-P who had infranormal or supranormal values was low (up to 153 individuals [<11.42%]) and similar to that of healthy individuals (<115 individuals [<9.30%]). Individuals with CHR-P who converted to a psychotic disorder had a higher percentage of infranormal values in temporal regions compared with those who did not convert (7.01% vs 1.38%) and healthy individuals (5.10% vs 0.89%). In the CHR-P group, only the ADS SA was associated with positive symptoms (β = -0.08; 95% CI, -0.13 to -0.02; P = .02 for false discovery rate) and IQ (β = 0.09; 95% CI, 0.02-0.15; P = .02 for false discovery rate). Conclusions and Relevance In this case-control study, findings suggest that macroscale neuromorphometric measures may not provide an adequate explanation of psychosis risk.
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Affiliation(s)
- Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ruiyang Ge
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - G Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
| | - Ole A Andreassen
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Bachman
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
| | - Inmaculada Baeza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Madrid Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sunah Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York, New York
- New York State Psychiatric Institute, New York
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Western Health, Carlton South, VIC, Australia
| | | | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Madrid Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-Detection Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Birte Yding Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Rebecca A Hayes
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
| | - Karsten Heekeren
- Department of Psychiatry and Psychotherapy, LVR-Hospital Cologne, Cologne, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Shinsuke Koike
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Tina D Kristensen
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Irina Lebedeva
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Imke L J Lemmers-Jansen
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Xiaoqian Ma
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Romina Mizrahi
- Douglas Research Center, McGill Univesity, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ricardo Mora-Durán
- Emergency Department, Hospital Fray Bernardino Álvarez, Mexico City, Mexico
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Maria A Omelchenko
- Department of Youth Psychiatry, Mental Health Research Center, Moscow, Russian Federation
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Western Health, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Center for Mental Health, Parkville, Victoria, Australia
| | - Jose C Pariente
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Jayachandra M Raghava
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Jan I Røssberg
- Oslo University Hospital and University of Oslo, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, New South Wales, Australia
- Priority Research Centre Grow Up Well, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gisela Sugranyes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Madrid Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey
| | - Alexander S Tomyshev
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Tor G Værnes
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Therese A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore
| | - Christina Wenneberg
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Lars T Westlye
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Juan H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, New York, New York
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Weickert TW, Jacomb I, Lenroot R, Lappin J, Weinberg D, Brooks WS, Brown D, Pellen D, Kindler J, Mohan A, Wakefield D, Lloyd AR, Stanton C, O'Donnell M, Liu D, Galletly C, Shannon Weickert C. Adjunctive canakinumab reduces peripheral inflammation markers and improves positive symptoms in people with schizophrenia and inflammation: A randomized control trial. Brain Behav Immun 2024; 115:191-200. [PMID: 37848096 DOI: 10.1016/j.bbi.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Clinical trials of anti-inflammatories in schizophrenia do not show clear and replicable benefits, possibly because patients were not recruited based on elevated inflammation status. Interleukin 1-beta (IL-1β) mRNA and protein levels are increased in serum, plasma, cerebrospinal fluid, and brain of some chronically ill patients with schizophrenia, first episode psychosis, and clinical high-risk individuals. Canakinumab, an approved anti-IL-1β monoclonal antibody, interferes with the bioactivity of IL-1β and interrupts downstream signaling. However, the extent to which canakinumab reduces peripheral inflammation markers, such as, high sensitivity C-reactive protein (hsCRP) and symptom severity in schizophrenia patients with inflammation is unknown. TRIAL DESIGN We conducted a randomized, placebo-controlled, double-blind, parallel groups, 8-week trial of canakinumab in chronically ill patients with schizophrenia who had elevated peripheral inflammation. METHODS Twenty-seven patients with schizophrenia or schizoaffective disorder and elevated peripheral inflammation markers (IL-1β, IL-6, hsCRP and/or neutrophil to lymphocyte ratio: NLR) were randomized to a one-time, subcutaneous injection of canakinumab (150 mg) or placebo (normal saline) as an adjunctive antipsychotic treatment. Peripheral blood hsCRP, NLR, IL-1β, IL-6, IL-8 levels were measured at baseline (pre injection) and at 1-, 4- and 8-weeks post injection. Symptom severity was assessed at baseline and 4- and 8-weeks post injection. RESULTS Canakinumab significantly reduced peripheral hsCRP over time, F(3, 75) = 5.16, p = 0.003. Significant hsCRP reductions relative to baseline were detected only in the canakinumab group at weeks 1, 4 and 8 (p's = 0.0003, 0.000002, and 0.004, respectively). There were no significant hsCRP changes in the placebo group. Positive symptom severity scores were significantly reduced at week 8 (p = 0.02) in the canakinumab group and week 4 (p = 0.02) in the placebo group. The change in CRP between week 8 and baseline (b = 1.9, p = 0.0002) and between week 4 and baseline (b = 6.0, p = 0.001) were highly significant predictors of week 8 change in PANSS Positive Symptom severity scores. There were no significant changes in negative symptoms, general psychopathology or cognition in either group. Canakinumab was well tolerated and only 7 % discontinued. CONCLUSIONS Canakinumab quickly reduces peripheral hsCRP serum levels in patients with schizophrenia and inflammation; after 8 weeks of canakinumab treatment, the reductions in hsCRP are related to reduced positive symptom severity. Future studies should consider increased doses or longer-term treatment to confirm the potential benefits of adjunctive canakinumab in schizophrenia. Australian and New Zealand Clinical Trials Registry number: ACTRN12615000635561.
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Affiliation(s)
- Thomas W Weickert
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia.
| | - Isabella Jacomb
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Rhoshel Lenroot
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Julia Lappin
- School of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - William S Brooks
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - David Brown
- NSW Health Pathology-ICPMR, Centre for Immunology and Allergy Research, Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Pellen
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Jochen Kindler
- Neuroscience Research Australia, Sydney, New South Wales, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Adith Mohan
- School of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Denis Wakefield
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew R Lloyd
- Viral Immunology Systems Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Clive Stanton
- Neuroscience Research Australia, Sydney, New South Wales, Australia; Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Maryanne O'Donnell
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia; Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Dennis Liu
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Northern Adelaide Locah Health Network, Adelaide, South Australia, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Northern Adelaide Locah Health Network, Adelaide, South Australia, Australia
| | - Cynthia Shannon Weickert
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
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Kindler J, Ishida T, Michel C, Klaassen AL, Stüble M, Zimmermann N, Wiest R, Kaess M, Morishima Y. Aberrant brain dynamics in individuals with clinical high risk of psychosis. Schizophr Bull Open 2024; 5:sgae002. [PMID: 38605980 PMCID: PMC7615822 DOI: 10.1093/schizbullopen/sgae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Background Resting-state network (RSN) functional connectivity analyses have profoundly influenced our understanding of the pathophysiology of psychoses and their clinical high risk (CHR) states. However, conventional RSN analyses address the static nature of large-scale brain networks. In contrast, novel methodological approaches aim to assess the momentum state and temporal dynamics of brain network interactions. Methods Fifty CHR individuals and 33 healthy controls (HC) completed a resting-state functional MRI scan. We performed an Energy Landscape analysis, a data-driven method using the pairwise maximum entropy model, to describe large-scale brain network dynamics such as duration and frequency of, and transition between, different brain states. We compared those measures between CHR and HC, and examined the association between neuropsychological measures and neural dynamics in CHR. Results Our main finding is a significantly increased duration, frequency, and higher transition rates to an infrequent brain state with coactivation of the salience, limbic, default mode and somatomotor RSNs in CHR as compared to HC. Transition of brain dynamics from this brain state was significantly correlated with processing speed in CHR. Conclusion In CHR, temporal brain dynamics are attracted to an infrequent brain state, reflecting more frequent and longer occurrence of aberrant interactions of default mode, salience, and limbic networks. Concurrently, more frequent and longer occurrence of the brain state is associated with core cognitive dysfunctions, predictors of future onset of full-blown psychosis.
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Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Takuya Ishida
- Department of Neuropsychiatry, Graduate School of Wakayama Medical University, Kimiidera, Japan
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Arndt-Lukas Klaassen
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Miriam Stüble
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Nadja Zimmermann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Roland Wiest
- University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Yosuke Morishima
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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Rinaldi G, Osman N, Kaess M, Schimmelmann BG, Kindler J, Schultze-Lutter F, Michel C. Exploring the complex relationships between coping strategies, locus of control and self-esteem with psychopathology: structural equation modeling with a special focus on clinical high-risk of psychosis. Eur Psychiatry 2023; 66:e88. [PMID: 37848406 PMCID: PMC10755569 DOI: 10.1192/j.eurpsy.2023.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Coping strategies, competence, and locus of control (LOC) beliefs are important predictors of mental health (MH). However, research into their complex interactions has produced mixed results. Our study investigated them further in the previously unexplored context of clinical high-risk (CHR) of psychosis. METHODS We tested six alternative structural equation models in a community sample (N = 523), hypothesizing a mediating role of coping and treating CHR symptoms as (i) an additional mediator or (ii) a specific outcome. Our measurement model included two latent factors of MH: (1) psychopathology (PP), consisting of presence of mental disorders, global and psychosocial functioning, and (2) self-rated health (SRH) status. RESULTS In the model with the best Akaike Information Criterion and the latent factors as outcome variables, maladaptive coping completely mediated the impact of maladaptive LOC on PP and SRH. Additionally, CHR symptoms partially mediated the effect of maladaptive coping on PP and SRH in the community sample, as long as sex was not entered into the model. In the clinical sample (N = 371), the model did not support a mediation by CHR symptoms, despite significant pathways with both coping and MH outcomes; further, competence beliefs directly impacted SRH. CONCLUSIONS Coping strategies are an important intervention target for MH promotion, especially in the community. In clinical populations, interventions focusing on coping strategies may improve CHR symptoms, thus potentially supporting better MH, especially SRH. Additionally, due to their mostly cascading effects on MH, improving competence and LOC beliefs may also promote psychological well-being.
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Affiliation(s)
- Giulia Rinaldi
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Naweed Osman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Benno G. Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Kindler J, Kaess M, Eliez S, Cosentino M, Liebrand M, Klauser P. Research training in child and adolescent psychiatry: lack of motivation or a structural problem? Eur Child Adolesc Psychiatry 2023; 32:1817-1820. [PMID: 37740094 PMCID: PMC10533604 DOI: 10.1007/s00787-023-02293-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephan Eliez
- Fondation Pôle Autisme, Département de psychiatrie, Faculté de Médecine, Université de Genève, Genève, Switzerland
| | - Maya Cosentino
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Matthias Liebrand
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Paul Klauser
- Department of Psychiatry, Service of Child and Adolescent Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
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Dadush Azuz R, Kindler J, Gal O, Limon D, Fredman ET, Bragilovski DN. Application of a Novel Methodology for Efficient Optimization of Hippocampal Avoidance Whole-Brain Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e658. [PMID: 37785950 DOI: 10.1016/j.ijrobp.2023.06.2090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A growing awareness of the long-term neurocognitive toxicity associated with whole-brain radiotherapy (WBRT) has led to the development of newer delivery methods to achieve relative hippocampal sparing. In order to accomplish the required target coverage and dose constraints, however, hippocampal-avoidance WBRT (HA-WBRT) can prove labor intensive and time-consuming. We therefore developed a simplified and efficient planning model for generating optimized HA-WBRT treatment. MATERIALS/METHODS Target volumes and organs at risk (OARs) were contoured per the NRG-CC001 protocol, including the whole-brain parenchyma, bilateral hippocampi, and optic apparatus. Treatment was planned using Eclipse 16.1 for a TrueBeam STx 2.7 LINAC, applying customizable optimization and clinical goals templates to rapidly generate uniform plans. An isocenter was placed at the point corresponding to the center of mass between the bilateral contoured 3-dimensional hippocampi. Volumetric modulated arc therapy (VMAT) using 6MV photons was designed using two sets of bi-directional full arcs, with collimator rotations of 85° and 95°. The two paired sets independently covered the superior and inferior portions of the treatment volume, respectively. Arcs shared a total 2cm overlap in the superior-inferior (X Jaws) direction. RESULTS A total of 10 consecutive cases of HA-WBRT were retrospectively re-optimized using the described planning model. All plans were normalized to cover 95% of the treatment volume with prescription dose (V30Gy = 95%). The model achieved favorable dosimetry relative to NRG-CC001 per protocol constraints. Average maximal dose to the hottest 2% and minimal dose to 98% of the volume were 32.22 ± 0.26 Gy and 29.82 ± 1.46 Gy, well within protocol limits of 37.5 Gy and 25 Gy, respectively. The average maximal dose to 100% of the hippocampi (D100%) and to its hottest 0.03cc (Dmax) were 8.50 ± 0.34 Gy and 12.85 ± 0.70 Gy, compared to protocol limits of 9Gy and 16Gy, respectively. Mean Dmax to the total optic apparatus was 29.67 ± 0.52 Gy, with a maximum value within the cohort of 30 Gy, matching protocol constraints. CONCLUSION The above presented methodology for optimizing HA-WBRT can consistently and efficiently generate plans with excellent target coverage and strict hippocampal avoidance per current collaborative group constraints. This method can be broadly applied to decrease the burden and heterogeneity across HA-WBRT planning.
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Affiliation(s)
- R Dadush Azuz
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - J Kindler
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - O Gal
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - D Limon
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - E T Fredman
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - D N Bragilovski
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
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11
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Michel C, Lerch S, Büetiger JR, Flückiger R, Cavelti M, Koenig J, Kaess M, Kindler J. An ecological momentary assessment study of age effects on perceptive and non-perceptive clinical high-risk symptoms of psychosis. Eur Child Adolesc Psychiatry 2023; 32:1841-1852. [PMID: 35585271 PMCID: PMC9116495 DOI: 10.1007/s00787-022-02003-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/01/2021] [Accepted: 04/30/2022] [Indexed: 11/15/2022]
Abstract
Among individuals with clinical high risk for psychosis (CHR), perceptive symptoms are more frequent but have less clinical significance in children/adolescents compared to adults. However, findings are based on clinical interviews relying on patient's recall capacity. Ecological momentary assessment (EMA) can be used to explore experiences in real-time in the subject's daily life. The aim of this study was to assess frequency and stability of (perceptive and non-perceptive) CHR symptoms and to explore potential age effects. EMA was used in a sample of an early detection for psychosis service in Bern, Switzerland (N = 66; 11-36 years). CHR symptoms were recorded in random time intervals for seven days: eight assessments per day per subject, minimum time between prompts set at 25 min. CHR symptoms were additionally assessed with semi-structured interviews including the 'Structured Interview for Psychosis-Risk Syndromes' and the 'Schizophrenia Proneness Instruments'. Mixed-effects linear regression analysis on the frequency of CHR symptoms revealed a significant effect of age group, and the interaction CHR symptoms x age group for both perceptive and non-perceptive symptoms. Further, regarding stability of CHR symptoms, there was a significant effect of the interaction CHR symptoms x age group for perceptive symptoms only. Based on EMA, perceptive CHR symptoms were more frequently reported but less stable in children/adolescents compared with adults. Together with previous findings, our finding of higher instability/variability of perceptive symptoms in younger persons might suggest that with advancing age and more stability of CHR symptoms, clinical relevance (reduced psychosocial functioning) may increase.
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Affiliation(s)
- C Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - S Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - J R Büetiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - R Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - M Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - J Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - M Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - J Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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12
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Liebrand M, Rebsamen M, Nakamura-Utsunomiya A, von den Driesch L, Köck P, Caccia J, Hamann C, Wiest R, Kaess M, Walther S, Tschumi S, Hiyama TY, Kindler J. Case report: Psychosis and catatonia in an adolescent patient with adipsic hypernatremia and autoantibodies against the subfornical organ. Front Psychiatry 2023; 14:1206226. [PMID: 37539324 PMCID: PMC10396436 DOI: 10.3389/fpsyt.2023.1206226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
This is the first description of a patient in which adipsic hypernatremia, a rare autoimmune encephalitis, presented in combination with complex psychiatric symptomatology, including psychosis and catatonia. Adipsic hypernatremia is characterized by autoantibodies against the thirst center of the brain. These autoantibodies cause inflammation and apoptosis in key regions of water homeostasis, leading to lack of thirst and highly increased serum sodium. To date, the symptoms of weakness, fatigue and drowsiness have been associated with adipsic hypernatremia, but no psychiatric symptomatology. Here, we showcase the first description of an adolescent patient, in which severe and complex psychiatric symptoms presented along with adipsic hypernatremia. The patient experienced delusion, hallucinations, restlessness and pronounced depression. Further, he showed ritualized, aggressive, disinhibited and sexualized behavior, as well as self-harm and psychomotor symptoms. Due to his severe condition, he was hospitalized on the emergency unit of the child and adolescent psychiatry for 8 months. Key symptoms of the presented clinical picture are: childhood-onset complex and treatment-resistant psychosis/catatonia, pronounced behavioral problems, fatigue, absent thirst perception, hypernatremia and elevated prolactin levels. This case report renders first evidence speaking for a causal link between the autoimmune adipsic hypernatremia and the psychotic disorder. Moreover, it sheds light on a new form of autoimmune psychosis.
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Affiliation(s)
- Matthias Liebrand
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Akari Nakamura-Utsunomiya
- Department of Medical Genetics and Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Luisa von den Driesch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Patrick Köck
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julien Caccia
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Hamann
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sibylle Tschumi
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Takeshi Y. Hiyama
- Department of Integrative Physiology, Graduate School and Faculty of Medicine, Tottori University, Tottori, Japan
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Kennedy E, Vadlamani S, Lindsey HM, Lei PW, Jo-Pugh M, Adamson M, Alda M, Alonso-Lana S, Ambrogi S, Anderson TJ, Arango C, Asarnow RF, Avram M, Ayesa-Arriola R, Babikian T, Banaj N, Bird LJ, Borgwardt S, Brodtmann A, Brosch K, Caeyenberghs K, Calhoun VD, Chiaravalloti ND, Cifu DX, Crespo-Facorro B, Dalrymple-Alford JC, Dams-O’Connor K, Dannlowski U, Darby D, Davenport N, DeLuca J, Diaz-Caneja CM, Disner SG, Dobryakova E, Ehrlich S, Esopenko C, Ferrarelli F, Frank LE, Franz C, Fuentes-Claramonte P, Genova H, Giza CC, Goltermann J, Grotegerd D, Gruber M, Gutierrez-Zotes A, Ha M, Haavik J, Hinkin C, Hoskinson KR, Hubl D, Irimia A, Jansen A, Kaess M, Kang X, Kenney K, Keřková B, Khlif MS, Kim M, Kindler J, Kircher T, Knížková K, Kolskår KK, Krch D, Kremen WS, Kuhn T, Kumari V, Kwon JS, Langella R, Laskowitz S, Lee J, Lengenfelder J, Liebel SW, Liou-Johnson V, Lippa SM, Løvstad M, Lundervold A, Marotta C, Marquardt CA, Mattos P, Mayeli A, McDonald CR, Meinert S, Melzer TR, Merchán-Naranjo J, Michel C, Morey RA, Mwangi B, Myall DJ, Nenadić I, Newsome MR, Nunes A, O’Brien T, Oertel V, Ollinger J, Olsen A, de la Foz VOG, Ozmen M, Pardoe H, Parent M, Piras F, Piras F, Pomarol-Clotet E, Repple J, Richard G, Rodriguez J, Rodriguez M, Rootes-Murdy K, Rowland J, Ryan NP, Salvador R, Sanders AM, Schmidt A, Soares JC, Spalleta G, Španiel F, Stasenko A, Stein F, Straube B, Thames A, Thomas-Odenthal F, Thomopoulos SI, Tone E, Torres I, Troyanskaya M, Turner JA, Ulrichsen KM, Umpierrez G, Vilella E, Vivash L, Walker WC, Werden E, Westlye LT, Wild K, Wroblewski A, Wu MJ, Wylie GR, Yatham LN, Zunta-Soares GB, Thompson PM, Tate DF, Hillary FG, Dennis EL, Wilde EA. Bridging Big Data: Procedures for Combining Non-equivalent Cognitive Measures from the ENIGMA Consortium. bioRxiv 2023:2023.01.16.524331. [PMID: 36712107 PMCID: PMC9882238 DOI: 10.1101/2023.01.16.524331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Investigators in neuroscience have turned to Big Data to address replication and reliability issues by increasing sample sizes, statistical power, and representativeness of data. These efforts unveil new questions about integrating data arising from distinct sources and instruments. We focus on the most frequently assessed cognitive domain - memory testing - and demonstrate a process for reliable data harmonization across three common measures. We aggregated global raw data from 53 studies totaling N = 10,505 individuals. A mega-analysis was conducted using empirical bayes harmonization to remove site effects, followed by linear models adjusting for common covariates. A continuous item response theory (IRT) model estimated each individual's latent verbal learning ability while accounting for item difficulties. Harmonization significantly reduced inter-site variance while preserving covariate effects, and our conversion tool is freely available online. This demonstrates that large-scale data sharing and harmonization initiatives can address reproducibility and integration challenges across the behavioral sciences.
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Affiliation(s)
- Eamonn Kennedy
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- Division of Epidemiology, University of Utah, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Shashank Vadlamani
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
| | - Hannah M Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Pui-Wa Lei
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA, 16801
| | - Mary Jo-Pugh
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- Division of Epidemiology, University of Utah, Salt Lake City, UT, 84132
| | - Maheen Adamson
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA, USA
- Neurosurgery, Stanford School of Medicine, Stanford, CA, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Silvia Alonso-Lana
- FIDMAG Research Foundation, Barcelona, Spain
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Tim J Anderson
- Department of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Neurology, Te Whatu Ora – Health New Zealand Waitaha Canterbury, Christchurch, New Zealand
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Robert F Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Brain Research Institute, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Laura J Bird
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Center of Brain, Behaviour and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Amy Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University University, Atlanta, GA, USA
| | - Nancy D Chiaravalloti
- Centers for Neuropsychology, Neuroscience & Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
| | - David X Cifu
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Virgen del Rocio University Hospital, School of Medicine, University of Seville, IBIS, Seville, Spain
| | - John C Dalrymple-Alford
- Department of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - David Darby
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Nicholas Davenport
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - John DeLuca
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Kessler Foundation, East Hanover, NJ, USA
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Seth G Disner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - Ekaterina Dobryakova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lea E Frank
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Carol Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Paola Fuentes-Claramonte
- FIDMAG Research Foundation, Barcelona, Spain
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Helen Genova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Autism Research, Kessler Foundation, East Hanover, NJ, USA
| | - Christopher C Giza
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
- Department of Pediatrics, Division of Neurology, UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Alfonso Gutierrez-Zotes
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Tarragona, Spain
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Charles Hinkin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH
- Section of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Daniela Hubl
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
- Department of Quantitative & Computational Biology, Dornsife College of Arts & Sciences, University of Southern California, Los Angeles CA, USA
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Xiaojian Kang
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA, USA
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | | | - Mohamed Salah Khlif
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Karolina Knížková
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Knut K Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Denise Krch
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Taylor Kuhn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Veena Kumari
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Roberto Langella
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Sarah Laskowitz
- Brain Imaging and Analysis Center, Duke University, Durham, NC
| | - Jungha Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Jean Lengenfelder
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ
| | - Spencer W Liebel
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | | | - Sara M Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Astri Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Cassandra Marotta
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
| | - Craig A Marquardt
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
- Minneapolis VA Health Care System, Minneapolis, MN
| | - Paulo Mattos
- Institute D’Or for Research and Education (IDOR), São Paulo, Brazil
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences and Psychiatry, UC San Diego, La Jolla, CA, USA
- Center for Multimodal Imaging and Genetics, UC San Diego, San Diego, CA, USA
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Tracy R Melzer
- Department of Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Jessica Merchán-Naranjo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rajendra A Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC
- VISN 6 MIRECC, Durham VA, Durham, NC
| | - Benson Mwangi
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Daniel J Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Mary R Newsome
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Terence O’Brien
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Neuroscience, The Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapiey, Frankfurt University, Frankfurt, Germany
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway
| | - Victor Ortiz García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Mustafa Ozmen
- Department of Electrical and Electronics Engineering, Antalya Bilim University, Antalya, Turkey
| | - Heath Pardoe
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Marise Parent
- Neuroscience Institute & Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | | | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Jonathan Rodriguez
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic
| | - Kelly Rootes-Murdy
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University University, Atlanta, GA, USA
| | - Jared Rowland
- W.G. (Bill) Hefner VA Medical Center, Salisbury, NC
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MA-MIRECC), Durham, NC
| | - Nicholas P Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Raymond Salvador
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Anne-Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Andre Schmidt
- University of Basel, Department of Psychiatry (UPK), Basel, Switzerland
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Filip Španiel
- National Institute of Mental Health, Klecany, Czech Republic
- 3rd Faculty of Medicine Charles University, Prague, Czech Republic
| | - Alena Stasenko
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for Multimodal Imaging and Genetics, UC San Diego, San Diego, CA, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - April Thames
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | | | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, 90007
| | - Erin Tone
- Department of Psychology, Georgia State University, Atlanta, GA
| | - Ivan Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Maya Troyanskaya
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Jessica A Turner
- Psychiatry and Behavioral Health, Ohio State Wexner Medical Center, Columbus, OH, USA
| | - Kristine M Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Guillermo Umpierrez
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA
| | - Elisabet Vilella
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Tarragona, Spain
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, Australia
| | - William C Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
- Richmond Veterans Affairs (VA) Medical Center, Central Virginia VA Health Care System , Richmond, VA
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Krista Wild
- Department of Psychology, Phoenix VA Health Care System, Phoenix, AZ, USA
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Mon-Ju Wu
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Glenn R Wylie
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, USA
- Rocco Ortenzio Neuroimaging Center, Kessler Foundation, East Hanover, NJ, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Giovana B Zunta-Soares
- Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, 90007
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, 90007
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Frank G Hillary
- Department of Psychology, Penn State University, State College, PA, 16801
- Department of Neurology, Hershey Medical Center, State College, PA, 16801
- Social Life and Engineering Science Imaging Center, Penn State University, State College, PA, 16801
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84132
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Graf D, Lerch S, Böhnke U, Reichl C, Kindler J, Koenig J, Kaess M. Treatment outcome of an intensive psychiatric home treatment for children and adolescents: a non-randomized controlled pilot evaluation. Eur Child Adolesc Psychiatry 2023; 32:685-695. [PMID: 34853908 PMCID: PMC8635478 DOI: 10.1007/s00787-021-01919-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/19/2021] [Indexed: 12/29/2022]
Abstract
Home treatment (HT) may offer an effective and cost-efficient alternative to inpatient treatment for children and adolescents with acute mental disorders. This study introduces and evaluates a pilot HT project from Bern, Switzerland, with HT completely replacing an inpatient treatment. A total of n = 133 children and adolescents with acute mental disorders and inpatient treatment needs were treated either in the new HT program (n = 37) or in an active control group with inpatient treatment as usual (I-TAU, n = 96). Psychopathological burden was assessed by the Health of the Nation Outcome Scale for Children and Adolescents clinician-rated (HoNOSCA) and self-rated (HoNOSCA-SR) at the time of admission and at discharge. Treatment effects were assessed and compared using Augmented Inverse Probability Weights to adjust for baseline differences and to control for treatment duration. Participants ranged in age from 6 to 17 years (M = 13.71 years, SD = 2.93), 54% were female. HT resulted in significant improvements in the HoNOSCA (d = 0.79, p < .001) and HoNOSCA-SR (d = 0.63, p = .006). No significant differences on treatment effects were observed between HT and the reference group I-TAU in the HoNOSCA (d = 0.01, p = .96) or the HoNOSCA-SR (d = 0.11, p = .63). Overall, results indicate HT to be an effective alternative for children and adolescents with acute mental health disorders instead of hospitalization. Further evaluation with random group allocation and long-term follow-up should attempt to replicate and extend the current findings.
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Affiliation(s)
- Daniel Graf
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ulrich Böhnke
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
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15
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Haas SS, Ge R, Agartz I, Amminger GP, Andreassen OA, Bachman P, Baeza I, Choi S, Colibazzi T, Cropley VL, de la Fuente-Sandoval C, Ebdrup BH, Fortea A, Fusar-Poli P, Glenthøj BY, Glenthøj LB, Haut KM, Hayes RA, Heekeren K, Hooker CI, Hwang WJ, Jahanshad N, Kaess M, Kasai K, Katagiri N, Kim M, Kindler J, Koike S, Kristensen TD, Kwon JS, Lawrie SM, Lee J, Lemmers-Jansen ILJ, Lin A, Ma X, Mathalon DH, McGuire P, Michel C, Mizrahi R, Mizuno M, Møller P, Mora-Durán R, Nelson B, Nemoto T, Nordentoft M, Nordholm D, Omelchenko MA, Pantelis C, Pariente JC, Raghava JM, Reyes-Madrigal F, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Smigielski L, Sugranyes G, Suzuki M, Takahashi T, Tamnes CK, Theodoridou A, Thomopoulos SI, Thompson PM, Tomyshev AS, Uhlhaas PJ, Værnes TG, van Amelsvoort TAMJ, van Erp TGM, Waltz JA, Wenneberg C, Westlye LT, Wood SJ, Zhou JH, Hernaus D, Jalbrzikowski M, Kahn RS, Corcoran CM, Frangou S. Normative modeling of brain morphometry in Clinical High-Risk for Psychosis. bioRxiv 2023:2023.01.17.523348. [PMID: 36711551 PMCID: PMC9882206 DOI: 10.1101/2023.01.17.523348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Importance The lack of robust neuroanatomical markers of psychosis risk has been traditionally attributed to heterogeneity. A complementary hypothesis is that variation in neuroanatomical measures in the majority of individuals at psychosis risk may be nested within the range observed in healthy individuals. Objective To quantify deviations from the normative range of neuroanatomical variation in individuals at clinical high-risk for psychosis (CHR-P) and evaluate their overlap with healthy variation and their association with positive symptoms, cognition, and conversion to a psychotic disorder. Design Setting and Participants Clinical, IQ and FreeSurfer-derived regional measures of cortical thickness (CT), cortical surface area (SA), and subcortical volume (SV) from 1,340 CHR-P individuals [47.09% female; mean age: 20.75 (4.74) years] and 1,237 healthy individuals [44.70% female; mean age: 22.32 (4.95) years] from 29 international sites participating in the ENIGMA Clinical High Risk for Psychosis Working Group. Main Outcomes and Measures For each regional morphometric measure, z-scores were computed that index the degree of deviation from the normative means of that measure in a healthy reference population (N=37,407). Average deviation scores (ADS) for CT, SA, SV, and globally across all measures (G) were generated by averaging the respective regional z-scores. Regression analyses were used to quantify the association of deviation scores with clinical severity and cognition and two-proportion z-tests to identify case-control differences in the proportion of individuals with infranormal (z<-1.96) or supranormal (z>1.96) scores. Results CHR-P and healthy individuals overlapped in the distributions of the observed values, regional z-scores, and all ADS vales. The proportion of CHR-P individuals with infranormal or supranormal values in any metric was low (<12%) and similar to that of healthy individuals. CHR-P individuals who converted to psychosis compared to those who did not convert had a higher percentage of infranormal values in temporal regions (5-7% vs 0.9-1.4%). In the CHR-P group, only the ADSSA showed significant but weak associations (|β|<0.09; PFDR<0.05) with positive symptoms and IQ. Conclusions and Relevance The study findings challenge the usefulness of macroscale neuromorphometric measures as diagnostic biomarkers of psychosis risk and suggest that such measures do not provide an adequate explanation for psychosis risk.
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Affiliation(s)
- Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruiyang Ge
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - G. Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
| | - Ole A Andreassen
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Bachman
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Sunah Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | | | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Birte Yding Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Rebecca A Hayes
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
| | - Karsten Heekeren
- Department of Psychiatry and Psychotherapy, LVR-Hospital Cologne, Cologne, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Shinsuke Koike
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Tina D Kristensen
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Imke LJ Lemmers-Jansen
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Xiaoqian Ma
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Romina Mizrahi
- Douglas Research Center, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ricardo Mora-Durán
- Emergency Department, Hospital Fray Bernardino Álvarez, Mexico City, Mexico
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Maria A Omelchenko
- Department of Youth Psychiatry, Mental Health Research Center, Moscow, Russian Federation
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Center for Mental Health, Parkville, VIC, Australia
| | - Jose C Pariente
- Magnetic Resonance Imaging Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Jayachandra M Raghava
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Jan I Røssberg
- Oslo University Hospital and University of Oslo, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre Grow Up Well, The University of Newcastle, Newcastle, NSW, Australia
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Alexander S Tomyshev
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Tor G Værnes
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Therese AMJ van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Theo GM van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christina Wenneberg
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Lars T Westlye
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Juan H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, New York, NY, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Büetiger JR, Michel C, Kaess M, Kindler J. Childhood Maltreatment and Its Association with Cognitive Ability in Young People Suspected to Be at Clinical High Risk of Psychosis. Psychopathology 2023; 56:17-28. [PMID: 35660706 DOI: 10.1159/000524947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/25/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Childhood maltreatment is associated with both reduced cognitive functioning and the development of psychotic symptoms. However, the specific relationship between childhood maltreatment, cognitive abilities and (pre)psychotic symptoms remains unclear. Therefore, the aim of this study was to investigate the association between childhood maltreatment and tasks of verbal memory and processing speed in a help-seeking sample of an early detection of psychosis service. METHODS A total of 274 participants consisting of 177 clinical high risk (CHR) for psychosis subjects and 97 clinical controls (CC) with subthreshold CHR underwent a battery of neurocognitive assessments measuring the latent variables verbal memory and processing speed. Additionally, the Trauma and Distress Scale (TADS) was administered to assess varying childhood maltreatment subtypes. Structural equation modeling (SEM) was used to examine associations between verbal memory, processing speed, and maltreatment subtypes. Other factors in the model were age, gender, clinical group (CHR or CC), and the presence of different CHR criteria. RESULTS Physical abuse was associated with lower scores in verbal memory and processing speed. The explained variance in the SEM reached up to 9.5% for verbal memory and 24.9% for processing speed. Both latent variables were each associated with the presence of cognitive-perceptive basic symptoms. Lower verbal memory was additionally associated with the clinical high-risk group, and processing speed capacity was associated with higher age and female gender. CONCLUSION Childhood physical abuse in particular was associated with poorer performance on verbal memory and processing speed across both groups of CHR and CC with subthreshold CHR symptoms. This adds to the current literature on reduced cognitive abilities when childhood maltreatment had occurred, albeit subtype dependent. Our findings, together with high prevalence rates of childhood maltreatment in patients with psychosis or CHR states, along with the presence of cognitive deficits in these patients, highlight the importance of not only assessing cognition but also childhood maltreatment in managing these patients. Future research should investigate the specific biological mechanisms of childhood maltreatment on verbal memory and processing speed in CHR subjects, as neurobiological alterations might explain the underlying mechanisms.
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Affiliation(s)
- Jessica R Büetiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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17
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Kindler J, Koenig J, Lerch S, van der Venne P, Resch F, Kaess M. Increased immunological markers in female adolescents with non-suicidal self-injury. J Affect Disord 2022; 318:191-195. [PMID: 36057292 DOI: 10.1016/j.jad.2022.08.125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/03/2022] [Accepted: 08/28/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a prevalent health problem among adolescents and commonly associated with psychological stressors such as childhood maltreatment and comorbid psychiatric disorders (e.g., depression). There is evidence that alterations of immunological markers may occur in the context of both environmental stress and psychopathological development. METHOD Here, we investigated differences in plasma/serum leukocytes, cortisol, c-reactive protein and interleukin-6 in a large sample of female adolescents with NSSI (n = 155) and healthy controls (HC, n = 42). Further, we assessed correlations between inflammatory markers, depression severity and the severity of childhood maltreatment. RESULTS The absolute number of leukocytes and the leukocyte/cortisol ratio (adjusted for body mass index and smoking) were significantly higher in NSSI as compared to HC, whereas interleukin-6 and CRP levels did not differ significantly between groups. Childhood maltreatment scores were significantly correlated with the leukocyte/cortisol ratio and depression severity was significantly correlated with both, absolute leukocyte numbers and the leukocyte/cortisol ratio. CONCLUSIONS Our results suggest that an immune activation can be detected in female adolescents with NSSI. Depression and childhood maltreatment, which are commonly reported in NSSI, may potentially underlie immune activation and partially explain group differences.
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Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Patrice van der Venne
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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18
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Michel C, Kaess M, Flückiger R, Büetiger JR, Schultze-Lutter F, Schimmelmann BG, Gekle W, Jandl M, Hubl D, Kindler J. The Bern Early Recognition and Intervention Centre for mental crisis (FETZ Bern)-An 8-year evaluation. Early Interv Psychiatry 2022; 16:289-301. [PMID: 33960114 DOI: 10.1111/eip.13160] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/12/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
AIM Early detection of, and intervention for, psychosis during its prodromal phase has the potential to alter the course of the disease and has therefore become a major objective of modern clinical psychiatry. An increasing number of early detection and intervention services have been established in Europe and worldwide. This study aims to describe and evaluate an early detection and intervention service for children, adolescents and adults (FETZ Bern) aged from eight to 40 years with a population catchment area of 1.035 million in Bern, Switzerland. METHODS Routine demographic, diagnostic and service usage data were collected upon admission to the service. Using a retrospective, descriptive and naturalistic study design, data was analysed for different age groups (children, adolescents and adults) and where available, outcome data after 12 and 24 months was evaluated. RESULTS The FETZ Bern has received 827 referrals with full diagnostic data available for 353 patients. The majority of the assessed patients were young males. While 40% met criteria for a clinical high-risk state of psychosis, 20% were diagnosed with fully manifest psychosis at time of admission, and another 40% had one or more non-psychotic axis-I diagnoses. CONCLUSIONS The FETZ Bern is the first early detection centre worldwide assessing children aged younger than 12 years, as well as adolescents and young adults in one service. Given that developmental peculiarities are important in understanding and ultimately treating psychosis, the FETZ Bern, with its emphasis on developmental peculiarities, should be considered as a model for other similar services.
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Affiliation(s)
- Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Section for Translational Psychobiology in Child and Adolescent Psychiatry, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jessica R Büetiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Walter Gekle
- Soteria Bern, Centre for Psychiatric Rehabilitation, Bern, Switzerland
| | - Martin Jandl
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Daniela Hubl
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Kindler J, Zhan D, Sattler ELP, Ishikawa Y, Chen X, Gallo S. Bone density in youth with prediabetes: results from the National Health and Nutrition Examination Survey, 2005-2006. Osteoporos Int 2022; 33:467-474. [PMID: 34523010 DOI: 10.1007/s00198-021-06148-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
UNLABELLED Youth with type 2 diabetes might have suboptimal peak bone mass, but it is unknown whether similar effects are evident in youth with prediabetes. Results from this study suggest that diabetes-related effects on peak bone mass likely occur before disease onset, and involve the muscle-bone unit. INTRODUCTION Type 2 diabetes might adversely influence bone health around the age of peak bone mass, but it is unknown whether diabetes-related effects on areal bone mineral density (aBMD) are evident in youth with prediabetes. We compared age-related trends in aBMD and associations between lean body mass (LBM) and aBMD between children and adolescents with prediabetes vs. normal glucose regulation. METHODS Cross-sectional analysis of data from the National Health and Nutrition Examination Survey (2005-2006) in youth ages 12-20 years (49% female, 34% black) with prediabetes (n = 267) and normal glucose regulation (n = 1664). Whole body aBMD and LBM were assessed via DXA. LBM index (LBMI) and Z-scores for aBMD and LBMI were computed. RESULTS Unadjusted between-group comparisons revealed greater mean weight and LBMI Z-scores in youth with prediabetes vs. normal glucose regulation, but similar bone Z-scores between the two groups. While accounting for differences in BMI Z-score, there was a significant interaction between prediabetes status and age with respect to whole body aBMD Z-score (P < 0.05), such that children with prediabetes tended to have increased aBMD but adolescents and young adults with prediabetes tended have lower aBMD. Furthermore, the positive association between LBMI and whole body aBMD was moderated in youth with prediabetes (P < 0.001), who had slightly lower whole body aBMD for a given LBMI (P = 0.068). Lumbar spine bone measures did not differ between the two groups. CONCLUSIONS Type 2 diabetes-related threats to peak bone mass might occur prior to disease onset, therefore potentially impacting a considerable proportion of US youth.
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Affiliation(s)
- J Kindler
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA.
| | - D Zhan
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - E L P Sattler
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, USA
| | - Y Ishikawa
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
| | - X Chen
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - S Gallo
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
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Affiliation(s)
- Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland. .,Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
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21
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Flückiger R, Schmidt SJ, Michel C, Kindler J, Kaess M. Introducing a Group Therapy Program (PLAN D) for Young Outpatients with Derealization and Depersonalization: A Pilot Study. Psychopathology 2022; 55:62-68. [PMID: 34818653 DOI: 10.1159/000520008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
Depersonalization and derealization (DD) cause significant distress and are associated with poor role and social functional outcomes. Despite the relatively high prevalence of DD symptoms and the chronic course in those suffering from a DD disorder, there still exists a need for effective interventions. Preliminary evidence indicates that cognitive behavioral therapy (CBT) delivered in an individual setting demonstrates some positive intervention effects for patients with DD regarding their symptom levels. By considering DD-specific treatment needs, a group therapy program was developed as an add-on therapy based on CBT techniques called PLAN D comprising the following elements: psychoeducation, lifestyle interventions, acceptance and mindfulness training, and new patterns of DD-related cognitions. In a pilot study, we present an 8-week group intervention for adolescents and young adults with DD disorder. To our knowledge, no standardized group intervention program for DD exists so far. Thus, this novel intervention represents a promising opportunity to positively influence long-term outcomes and course of DD.
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Affiliation(s)
- Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefanie J Schmidt
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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22
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Schultze-Lutter F, Kindler J, Ambarini TK, Michel C. Positive psychotic symptoms in childhood and adolescence. Curr Opin Psychol 2021; 45:101287. [PMID: 35016089 DOI: 10.1016/j.copsyc.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/21/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
Based on the assumption of a universal neurodevelopmental model of psychosis, especially of the schizophrenia spectrum, the diagnosis (and treatment) of psychosis in minors commonly follows those in adults. Yet, as our review demonstrates, recent years have seen an emergence of studies of minors indicating that developmental aspects may play a crucial role in the prevalence and appraisal of diagnostically relevant positive psychotic symptoms in their full-blown and subthreshold forms, including neurobiogenetic and other risk factors, such as migration. Thus, caution is advised to not overpathologize potentially transient and clinically irrelevant occurrence of (subthreshold) positive psychotic symptoms in the diagnosis and treatment of psychotic disorders and their clinical high-risk states in minors. More studies on developmental aspects are urgently needed.
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Affiliation(s)
- Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Bergische Landstraße 2, 40470 Düsseldorf, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland; Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga 4-6, Surabaya 60286, Indonesia.
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland
| | - Tri Kurniati Ambarini
- Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga 4-6, Surabaya 60286, Indonesia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland
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Kaess M, Klar J, Kindler J, Parzer P, Brunner R, Carli V, Sarchiapone M, Hoven CW, Apter A, Balazs J, Barzilay S, Bobes J, Cozman D, Gomboc V, Haring C, Kahn JP, Keeley H, Meszaros G, Musa GJ, Postuvan V, Saiz P, Sisask M, Varnik P, Resch F, Wasserman D. Excessive and pathological Internet use - Risk-behavior or psychopathology? Addict Behav 2021; 123:107045. [PMID: 34332272 DOI: 10.1016/j.addbeh.2021.107045] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/10/2021] [Accepted: 07/06/2021] [Indexed: 12/29/2022]
Abstract
Pathological Internet use (but only with respect to gaming) is classified as mental disorder in the ICD-11. However, there is a large group of adolescents showing excessive Internet use, which may rather be considered adolescent risk-behavior. The aim was to test whether pathological and excessive Internet use should be considered as "psychopathology" or "risk-behavior". A representative, cross-sectional sample of 11.110 students from 10 European Union countries was analyzed. Structural equation models, including the factors "risk-behavior" and "psychopathology" and the variables excessive and pathological Internet use, were tested against each other. "Risk-behavior" was operationalized by several risk-behaviors (e.g. drug abuse, truancy, etc). "Psychopathology" included measures of several mental disorders (e.g. depression, hyperactivity, etc). Excessive Internet use was assessed as the duration and frequency of Internet use. Pathological Internet use was assessed with the Young Diagnostic Questionnaire (i.e., presence of addiction criteria). Excessive Internet use loaded on "risk-behavior" (λ = 0.484, p < .001) and on "psychopathology" (λ = 0.071, p < .007). Pathological Internet use loaded on "risk-behavior" (λ = 0.333, p < .001) and on "psychopathology" (λ = 0.852, p < .001). Chi-square tests determined that the loadings of excessive Internet use (χ2 (1) = 81.98, p < .001) were significantly stronger on "risk-behavior" than "psychopathology". Vice versa, pathological Internet use loaded significantly stronger on "psychopathology" (χ2 (1) = 107.10, p < .001). The results indicate that pathological Internet use should rather be considered as psychopathology. Excessive Internet use on the other hand, should be classified as adolescent risk-behavior.
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Yariv O, Kindler J, Weinstock M, Ben-Hur R, Icht O, Reinhorn D, Arad N, Shochat T, Kundel Y. Preoperative Chemoradiotherapy Utilizing Intensity Modulated Radiation Therapy (IMRT) Compared With 3D Conformal Radiotherapy (3DCRT) for Patients With Locally Advanced Rectal Cancer: Prospective Phase II Study. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Yariv O, Kindler J, Weinstock- Sabbah M, Ben-Hur R, Icht O, Reinhorn D, Arad N, Shochat T, Kundel Y. PO-1245 Intensity Modulated Radiotherapy versus 3D radiotherapy for rectal cancer: prospective phase 2 study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jalbrzikowski M, Hayes RA, Wood SJ, Nordholm D, Zhou JH, Fusar-Poli P, Uhlhaas PJ, Takahashi T, Sugranyes G, Kwak YB, Mathalon DH, Katagiri N, Hooker CI, Smigielski L, Colibazzi T, Via E, Tang J, Koike S, Rasser PE, Michel C, Lebedeva I, Hegelstad WTV, de la Fuente-Sandoval C, Waltz JA, Mizrahi R, Corcoran CM, Resch F, Tamnes CK, Haas SS, Lemmers-Jansen ILJ, Agartz I, Allen P, Amminger GP, Andreassen OA, Atkinson K, Bachman P, Baeza I, Baldwin H, Bartholomeusz CF, Borgwardt S, Catalano S, Chee MWL, Chen X, Cho KIK, Cooper RE, Cropley VL, Dolz M, Ebdrup BH, Fortea A, Glenthøj LB, Glenthøj BY, de Haan L, Hamilton HK, Harris MA, Haut KM, He Y, Heekeren K, Heinz A, Hubl D, Hwang WJ, Kaess M, Kasai K, Kim M, Kindler J, Klaunig MJ, Koppel A, Kristensen TD, Kwon JS, Lawrie SM, Lee J, León-Ortiz P, Lin A, Loewy RL, Ma X, McGorry P, McGuire P, Mizuno M, Møller P, Moncada-Habib T, Muñoz-Samons D, Nelson B, Nemoto T, Nordentoft M, Omelchenko MA, Oppedal K, Ouyang L, Pantelis C, Pariente JC, Raghava JM, Reyes-Madrigal F, Roach BJ, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Schiffman J, Schlagenhauf F, Schmidt A, Sørensen ME, Suzuki M, Theodoridou A, Tomyshev AS, Tor J, Værnes TG, Velakoulis D, Venegoni GD, Vinogradov S, Wenneberg C, Westlye LT, Yamasue H, Yuan L, Yung AR, van Amelsvoort TAMJ, Turner JA, van Erp TGM, Thompson PM, Hernaus D. Association of Structural Magnetic Resonance Imaging Measures With Psychosis Onset in Individuals at Clinical High Risk for Developing Psychosis: An ENIGMA Working Group Mega-analysis. JAMA Psychiatry 2021; 78:753-766. [PMID: 33950164 PMCID: PMC8100913 DOI: 10.1001/jamapsychiatry.2021.0638] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/04/2021] [Indexed: 01/10/2023]
Abstract
Importance The ENIGMA clinical high risk (CHR) for psychosis initiative, the largest pooled neuroimaging sample of individuals at CHR to date, aims to discover robust neurobiological markers of psychosis risk. Objective To investigate baseline structural neuroimaging differences between individuals at CHR and healthy controls as well as between participants at CHR who later developed a psychotic disorder (CHR-PS+) and those who did not (CHR-PS-). Design, Setting, and Participants In this case-control study, baseline T1-weighted magnetic resonance imaging (MRI) data were pooled from 31 international sites participating in the ENIGMA Clinical High Risk for Psychosis Working Group. CHR status was assessed using the Comprehensive Assessment of At-Risk Mental States or Structured Interview for Prodromal Syndromes. MRI scans were processed using harmonized protocols and analyzed within a mega-analysis and meta-analysis framework from January to October 2020. Main Outcomes and Measures Measures of regional cortical thickness (CT), surface area, and subcortical volumes were extracted from T1-weighted MRI scans. Independent variables were group (CHR group vs control group) and conversion status (CHR-PS+ group vs CHR-PS- group vs control group). Results Of the 3169 included participants, 1428 (45.1%) were female, and the mean (SD; range) age was 21.1 (4.9; 9.5-39.9) years. This study included 1792 individuals at CHR and 1377 healthy controls. Using longitudinal clinical information, 253 in the CHR-PS+ group, 1234 in the CHR-PS- group, and 305 at CHR without follow-up data were identified. Compared with healthy controls, individuals at CHR exhibited widespread lower CT measures (mean [range] Cohen d = -0.13 [-0.17 to -0.09]), but not surface area or subcortical volume. Lower CT measures in the fusiform, superior temporal, and paracentral regions were associated with psychosis conversion (mean Cohen d = -0.22; 95% CI, -0.35 to 0.10). Among healthy controls, compared with those in the CHR-PS+ group, age showed a stronger negative association with left fusiform CT measures (F = 9.8; P < .001; q < .001) and left paracentral CT measures (F = 5.9; P = .005; q = .02). Effect sizes representing lower CT associated with psychosis conversion resembled patterns of CT differences observed in ENIGMA studies of schizophrenia (ρ = 0.35; 95% CI, 0.12 to 0.55; P = .004) and individuals with 22q11.2 microdeletion syndrome and a psychotic disorder diagnosis (ρ = 0.43; 95% CI, 0.20 to 0.61; P = .001). Conclusions and Relevance This study provides evidence for widespread subtle, lower CT measures in individuals at CHR. The pattern of CT measure differences in those in the CHR-PS+ group was similar to those reported in other large-scale investigations of psychosis. Additionally, a subset of these regions displayed abnormal age associations. Widespread disruptions in CT coupled with abnormal age associations in those at CHR may point to disruptions in postnatal brain developmental processes.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca A Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Juan H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- EPIC Lab, Department of Psychosis Studies, King's College London, London, United Kingdom
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lukasz Smigielski
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York, New York
- New York State Psychiatric Institute, New York
| | - Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Zhejiang Province, School of Medicine, Zhejiang University Hangzhou, Hangzhou, China
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan
| | - Paul E Rasser
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, Australia
- Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Newcastle, Australia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Wenche Ten Velden Hegelstad
- Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | | | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore
| | - Romina Mizrahi
- Douglas Research Center, Montreal, Quebec, Canada
- McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, New York, New York
| | - Franz Resch
- Clinic for Child and Adolescent Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Imke L J Lemmers-Jansen
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - G Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kimberley Atkinson
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter Bachman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Helen Baldwin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Cali F Bartholomeusz
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Sabrina Catalano
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael W L Chee
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xiaogang Chen
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rebecca E Cooper
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Bjørn H Ebdrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Birte Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centre, Amsterdam, the Netherlands
- Arkin, Amsterdam, the Netherlands
| | - Holly K Hamilton
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Mathew A Harris
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Ying He
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Karsten Heekeren
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy I, LVR-Hospital Cologne, Cologne, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Kiyoto Kasai
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Mallory J Klaunig
- Department of Psychology, University of Maryland, Baltimore County, Baltimore
| | - Alex Koppel
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Tina D Kristensen
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Pablo León-Ortiz
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Xiaoqian Ma
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Lier, Norway
| | - Tomas Moncada-Habib
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Ketil Oppedal
- Stavanger Medical Imaging Laboratory, Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | - Lijun Ouyang
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Jose C Pariente
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Jayachandra M Raghava
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Physiology, Nuclear Medicine and PET, Functional Imaging Unit, University of Copenhagen, Glostrup, Denmark
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Brian J Roach
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Jan I Røssberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, Australia
- Priority Research Centre Grow Up Well, The University of Newcastle, Newcastle, Australia
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, Baltimore
- Department of Psychological Science, University of California, Irvine
| | - Florian Schlagenhauf
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Andre Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Mikkel E Sørensen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Tor G Værnes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Neuropsychiatry, The Royal Melbourne Hospital, Melbourne, Australia
| | - Gloria D Venegoni
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Christina Wenneberg
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Liu Yuan
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Alison R Yung
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Thérèse A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | | | - Theo G M van Erp
- Center for the Neurobiology of Learning and Memory, Irvine, California
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Los Angeles
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Michel C, Berger M, Mossaheb N, Kindler J. Editorial: Clinical High Risk for Psychosis: From Epidemiological Findings to Neurobiological Underpinnings of Treatment Response and Outcome. Front Psychiatry 2021; 12:790810. [PMID: 34867565 PMCID: PMC8639025 DOI: 10.3389/fpsyt.2021.790810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Maximus Berger
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Nilufar Mossaheb
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Munsar Z, Zysman-Colman Z, Kindler J, Zemel B, Stallings V, Kelly A. P262 Height-adjustment methods for lumbar spine bone density in youth with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30594-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hubl D, Moor N, Kindler J, Kottlow M, Dierks T, Koenig T. Speed, Accuracy, and Efficiency of Judgements of Coincidence between Speech Acts and Auditory Perception during a Delayed Auditory Feedback Paradigm: A Behavioral Study in Patients with Schizophrenia. Timing Time Percept 2020. [DOI: 10.1163/22134468-20191163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The inability to differentiate between one’s actions and their consequences from sensory inputs originating from an alien source might cause classical first-rank symptoms in schizophrenia, such as audio-verbal hallucinations (AVH). We aimed to determine whether patients with or without AVH perform differently in a task challenging the audio-verbal self-monitoring system compared to controls. Controls (n = 21) and schizophrenia patients with (AH, n = 11) and without AVH (NH, n = 9) participated. Subjects had to discern whether they heard a sound they had just uttered with or without delay. Reaction time, accuracy as well as sensitivity and response bias were compared between groups. There were no group effects in reaction time. Controls were significantly more accurate in the detection of delays compared to AH and to NH. However, the most salient observation was that these deficits were not uniformly present, but were selectively elicited by the delay, reducing patients’ response accuracy to chance level. The analysis of the data based on signal detection theory revealed a significant drop in sensitivity in both patient groups compared to the controls, and a response bias: Particularly the patients with AVH seemed to be biased not to consider a delay, rather than falsely signaling a delay. Such a deficit may blur the distinction between external events and self-initiated actions, thus eventually interfering with the patients’ sense of agency.
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Affiliation(s)
- Daniela Hubl
- 1 Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Nicolas Moor
- 1 Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jochen Kindler
- 2 University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Mara Kottlow
- 1 Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Thomas Dierks
- 1 Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Thomas Koenig
- 1 Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
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Büetiger JR, Hubl D, Kupferschmid S, Schultze-Lutter F, Schimmelmann BG, Federspiel A, Hauf M, Walther S, Kaess M, Michel C, Kindler J. Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization-Derealization Disorder. Front Psychiatry 2020; 11:535652. [PMID: 33024435 PMCID: PMC7516266 DOI: 10.3389/fpsyt.2020.535652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depersonalization (DP) and derealization (DR) are symptoms of a disruption of perceptual integration leading to an altered quality of subjective experiences such as feelings of unreality and detachment from the self (DP) or the surroundings (DR). Both DP and DR often occur in concert with other symptoms, for example in subjects at clinical high-risk (CHR) for psychosis, but also appear isolated in the form of DP/DR disorder. Despite evidence that DP/DR causes immense distress, little is known about their neurobiological underpinnings. Therefore, we investigated the neural correlates of DP/DR using pseudo-continuous arterial spin labeling MRI. METHODS We evaluated the frequency of DP/DR symptoms in a clinical sample (N = 217) of help-seeking individuals from the Early Detection and Intervention Centre for Mental Crisis (CHR, n = 97; clinical controls (CC), n = 91; and first-episode psychosis (FEP), n = 29). Further, in a subsample of those CHR subjects who underwent MRI, we investigated the resting-state regional cerebral blood flow (rCBF). Here, individuals with (n = 21) and without (n = 23) DP/DR were contrasted. Finally, rCBF was measured in a small independent second sample of patients with DP/DR disorder (n = 6) and healthy controls (HC, n = 6). RESULTS In the complete clinical sample, significantly higher frequency of DP/DR was found in CHR compared to CC (50.5 vs. 16.5%; χ2 (2) = 24.218, p ≤ 0.001, Cramer's V = 0.359) as well as in FEP compared to CC (37.9 vs. 16.5%; χ2 (2) = 5.960, p = 0.015, Cramer's V = 0.223). In MRI, significantly lower rCBF was detected in the left orbitofrontal cortex in CHR with vs. without DP/DR (x/y/z = -16/42/-22, p < 0.05, FWE corrected). In patients with DP/DR disorder, significantly higher rCBF was detected in the left caudate nucleus (x/y/z = -18/-32/18, p < 0.05) compared to HC. CONCLUSIONS This study shows that DP/DR symptoms are frequently found in CHR subjects. Investigating two separate DP/DR populations with an identical neuroimaging technique, our study also indicates that there may be divergent pathophysiological mechanisms-decreased neuronal activity in the orbitofrontal cortex, but increased activity within the caudate nucleus-leading to a final common pathway with similar psychopathological symptoms. This suggests that both top-down (orbitofrontal cortex) and bottom-up (caudate nucleus) mechanisms could contribute to the emergence of DP/DR.
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Affiliation(s)
- Jessica R Büetiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Daniela Hubl
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephan Kupferschmid
- Integrated Psychiatric Services of Winterthur and Zurich Unterland (ipw), Winterthur , Switzerland
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Federspiel
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Schultze-Lutter F, Ruhrmann S, Michel C, Kindler J, Schimmelmann BG, Schmidt SJ. Age effects on basic symptoms in the community: A route to gain new insight into the neurodevelopment of psychosis? Eur Arch Psychiatry Clin Neurosci 2020; 270:311-324. [PMID: 30361925 PMCID: PMC7069926 DOI: 10.1007/s00406-018-0949-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/19/2018] [Indexed: 02/06/2023]
Abstract
Reports of limited clinical significance of attenuated psychotic symptoms before age 15/16 indicate an important role of neurodevelopment in the early detection of psychoses. Therefore, we examined if age also exerts an influence on the prevalence and clinical significance of the 14 cognitive and perceptive basic symptoms (BS) used in psychosis-risk criteria and conceptualized as the most direct self-experienced expression of neurobiological aberrations. A random representative general population sample of the Swiss canton Bern (N = 689, age 8-40 years, 06/2011-05/2014) was interviewed for BS, psychosocial functioning, and current mental disorder. BS were reported by 18% of participants, mainly cognitive BS (15%). In regression analyses, age affected perceptive and cognitive BS differently, indicating an age threshold for perceptive BS in late adolescence (around age 18) and for cognitive BS in young adulthood (early twenties)-with higher prevalence, but a lesser association with functional deficits and the presence of mental disorder in the below-threshold groups. Thereby, interaction effects between age and BS on functioning and mental disorder were commonly stronger than individual effects of age and BS. Indicating support of the proposed "substrate-closeness" of BS, differential age effects of perceptual and cognitive BS seem to follow normal brain maturation processes, in which they might occur as infrequent and temporary non-pathological disturbances. Their persistence or occurrence after conclusion of main brain maturation processes, however, might signify aberrant maturation or neurodegenerative processes. Thus, BS might provide important insight into the pathogenesis of psychosis and into differential neuroprotective or anti-inflammatory targets.
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Affiliation(s)
- Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. .,Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Bergische Landstrasse 2, 40629, Düsseldorf, Germany.
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Benno G. Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland ,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie J. Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland ,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany ,Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
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33
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Weickert TW, Salimuddin H, Lenroot RK, Bruggemann J, Loo C, Vercammen A, Kindler J, Weickert CS. Preliminary findings of four-week, task-based anodal prefrontal cortex transcranial direct current stimulation transferring to other cognitive improvements in schizophrenia. Psychiatry Res 2019; 280:112487. [PMID: 31376788 DOI: 10.1016/j.psychres.2019.112487] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 02/07/2023]
Abstract
Most transcranial Direct Current Stimulation (tDCS) trials of schizophrenia administer few sessions and do not assess transfer effects to other cognitive domains. In a randomized, double-blind, sham-controlled, parallel groups trial, we determined the extent to which 4-weeks of 2 mA tDCS at 20 min/day totalling 20 tDCS sessions administered during a spatial working memory test, with anodal right dorsolateral prefrontal cortex (DLPFC) and cathodal left tempo-parietal junction (TPJ) placement, as an adjunct to antipsychotics reduced auditory hallucinations and improved cognition in 12 outpatients with schizophrenia. Anodal tDCS significantly improved language-based working memory after 2 weeks and verbal fluency after 2 and 4 weeks. Thus, four weeks of tDCS appears to be safe and elicits transfer benefits to other prefrontal-dependent cognitive abilities in schizophrenia.
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Affiliation(s)
- T W Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
| | - H Salimuddin
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - R K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - J Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - C Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - A Vercammen
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Faculty of Natural Sciences, Imperial College London, London, UK
| | - J Kindler
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - C S Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
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Kindler J, Michel C, Schultze-Lutter F, Felber G, Hauf M, Schimmelmann BG, Kaess M, Hubl D, Walther S. Functional and structural correlates of abnormal involuntary movements in psychosis risk and first episode psychosis. Schizophr Res 2019; 212:196-203. [PMID: 31405623 DOI: 10.1016/j.schres.2019.07.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Abnormal involuntary movements (AIM) may occur throughout the course of psychosis. While AIM are thought to indicate striatal abnormalities, the functional and structural correlates of increased AIM remain elusive. Here, we examined the prevalence of AIM in patients with clinical high risk for psychosis (CHR), first episode psychosis (FEP) and clinical controls (CC). Furthermore, we tested the association of AIM with regional cerebral blood flow (rCBF), grey matter volume (GMV), and premorbid IQ. METHODS We conducted a video-based analysis of AIM in patients with CHR (n = 45), FEP (n = 10) and CC (n = 39), recruited in the Early Detection and Intervention Center, Bern. Premorbid intelligence was evaluated using the Peabody Picture Vocabulary test. Additionally, arterial spin labeling MRIs and structural MRIs were acquired in a subgroup of the sample to investigate the association of AIM with rCBF and GMV. RESULTS Higher total AIM scores were detected in CHR (p = 0.02) and FEP (p = 0.04) as compared to CC. When separated for different muscle groups, lips and perioral movements were significantly increased in CHR patients as compared to CC (p = 0.009). AIM scores correlated positively with rCBF in the premotor cortex, Brodmann area 6 (p < 0.05, FWE corrected). Negative correlations were found between AIM and GMV of the corresponding caudal middle frontal gyrus (p = 0.04, FWE corrected) and premorbid intelligence (p = 0.02). CONCLUSIONS AIM were more frequent in the psychosis spectrum than in clinical controls. Neuroimaging findings indicate an involvement of cortical motor areas in abnormal motor behavior, instead of pure basal ganglia pathology.
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Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland.
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Gwendolin Felber
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - 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, Clinic for Child and Adolescent Psychiatry, University Hospital Heidelberg, Germany
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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Michel C, Flückiger R, Kindler J, Hubl D, Kaess M, Schultze‐Lutter F. The trait-state distinction between schizotypy and clinical high risk: results from a one-year follow-up. World Psychiatry 2019; 18:108-109. [PMID: 30600631 PMCID: PMC6313228 DOI: 10.1002/wps.20595] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Frauke Schultze‐Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,Department of Psychiatry and Psychotherapy, Heinrich‐Heine‐University, Düsseldorf, Germany
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Kindler J, Schultze-Lutter F, Hauf M, Dierks T, Federspiel A, Walther S, Schimmelmann BG, Hubl D. Increased Striatal and Reduced Prefrontal Cerebral Blood Flow in Clinical High Risk for Psychosis. Schizophr Bull 2018; 44:182-192. [PMID: 28575528 PMCID: PMC5768043 DOI: 10.1093/schbul/sbx070] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Increased striatal dopaminergic activity and decreased prefrontal functioning have been reported in individuals at clinical high risk (CHR) for psychosis. Abnormal metabolic rate might affect resting-state cerebral blood flow (rCBF) in the respective regions. Here, we examined if striatal and prefrontal rCBF differ between patients with CHR, first-episode psychosis (FEP), chronic schizophrenia-spectrum disorder (SZ) and controls. Two cohorts with a total of 122 participants were included and analyzed separately: 32 patients with SZ and 31 healthy controls (HC) from the University Hospital of Psychiatry, and 59 patients from the Bern Early Recognition and Intervention Center (29 with CHR, 12 with FEP, and 18 clinical controls [CC]). Ultra-high risk criteria were assessed with the Structured Interview for Psychosis-Risk Syndromes, basic symptom criteria with the Schizophrenia Proneness Instrument. rCBF was measured with pseudo-continuous arterial spin labeling 3T-Magnetic Resonance Imaging. Striatal rCBF was significantly increased and prefrontal rCBF significantly decreased in the SZ group compared to HC group and in the CHR and FEP groups compared to CC group. Striatal rCBF correlated significantly with positive symptom scores in SZ and CHR. An inverse correlation between striatal and frontal rCBF was found in controls (HC, CC), but not in patient groups (SZ, FEP, CHR). This is the first study to demonstrate increased neuronal activity within the striatum, but reduced prefrontal activity in patients with CHR, FEP, and SZ compared to the respective controls. Our results indicate that alterations in striatal and prefrontal rCBF are reflecting metabolic abnormalities preceding the onset of frank psychosis.
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Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,To whom correspondence should be addressed; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; tel: +41319328554, fax: +41319328569, e-mail:
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Thomas Dierks
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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Kindler J, Weickert CS, Schofield PR, Lenroot R, Weickert TW. Raloxifene increases prefrontal activity during emotional inhibition in schizophrenia based on estrogen receptor genotype. Eur Neuropsychopharmacol 2016; 26:1930-1940. [PMID: 27842943 DOI: 10.1016/j.euroneuro.2016.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 09/23/2016] [Accepted: 10/29/2016] [Indexed: 12/16/2022]
Abstract
People with schizophrenia show decreased prefrontal cortex (PFC) activity during emotional response inhibition, a cognitive process sensitive to hormonal influences. Raloxifene, a selective estrogen receptor modulator, binds estrogen receptor alpha (ESR-α), improves memory, attention and normalizes cortical and hippocampal activity during learning and emotional face recognition in schizophrenia. Here, we tested the extent to which raloxifene restores neuronal activity during emotional response inhibition in schizophrenia. Since genetic variation in estrogen receptor alpha (ESR-1) determines cortical ESR-α production and correlates with cognition, we also predicted that genetic ESR-1 variation would differentially relate to increased cortical activity by raloxifene administration. Thirty people with schizophrenia participated in a thirteen-week randomized, double-blind, placebo-controlled, cross-over adjunctive treatment trial of raloxifene administered at 120mg/day. Effects of raloxifene on brain activation were assessed based on ESR-1 genotype using functional magnetic resonance imaging during emotional word inhibition. Raloxifene increased PFC activity during inhibition of response to negative words and the raloxifene related increased PFC activity was greater in patients homozygous for ESR-1 rs9340799 AA relative to G carriers. Comparison to 23 healthy controls demonstrated that PFC activity of people with schizophrenia receiving raloxifene was more similar to controls than to their own brain activity during placebo. Estrogen receptor modulation by raloxifene restores PFC activity during emotional response inhibition in schizophrenia and ESR-1 genotype predicts degree of increased neural activity in response to raloxifene. While these preliminary results require replication, they suggest the potential for personalized pharmacotherapy using ESR-1 and estrogen receptor targeting compounds in schizophrenia.
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Affiliation(s)
- Jochen Kindler
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031 Australia; Neuroscience Research Australia, Randwick, NSW 2031, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern 60, Switzerland
| | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031 Australia; Neuroscience Research Australia, Randwick, NSW 2031, Australia; Schizophrenia Research Institute, Randwick, NSW 2031 Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Randwick, NSW 2031, Australia; Schizophrenia Research Institute, Randwick, NSW 2031 Australia; School of Medical Sciences, University of New South Wales, Randwick, Australia
| | - Rhoshel Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031 Australia; Neuroscience Research Australia, Randwick, NSW 2031, Australia; Schizophrenia Research Institute, Randwick, NSW 2031 Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW 2031 Australia; Neuroscience Research Australia, Randwick, NSW 2031, Australia; Schizophrenia Research Institute, Randwick, NSW 2031 Australia.
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Kindler J, Schultze-Lutter F, Michel C, Martz-Irngartinger A, Linder C, Schmidt SJ, Stegmayer K, Schimmelmann BG, Walther S. Abnormal involuntary movements are linked to psychosis-risk in children and adolescents: Results of a population-based study. Schizophr Res 2016; 174:58-64. [PMID: 27160790 DOI: 10.1016/j.schres.2016.04.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Altered motor behavior has consistently been reported in medication-naive adult patients with schizophrenia and first episode psychosis and adults at clinical high risk for psychosis (CHR). This study is the first to evaluate the prevalence of abnormal involuntary movements in a community sample of children and adolescents with and without CHR. METHODS We examined CHR in 102 children and adolescents aged 8-17years from the general population of the Canton Bern. Attenuated and brief intermittent psychotic symptoms, as well as basic symptoms, were assessed using the Structured Interview for Psychosis Risk Syndromes and the Schizophrenia Proneness Instrument, Child & Youth Version. Motor symptoms were assessed using the Abnormal Involuntary Movement Scale (AIMS). Additionally, psychosocial functioning, a neurocognitive test battery, and DSM-IV Axis I disorders were examined. RESULTS Eleven (10.8%) participants met CHR criteria, 13 (12.7%, 5 with and 8 without CHR) met criteria for increased abnormal involuntary movements (AIMS≥2). Both AIMS total scores and the percentage of children with AIMS≥2 were significantly higher in the CHR group. Psychosocial functioning was reduced in subjects with abnormal involuntary movements, and movement abnormalities were linked to deficits in attention and perception but not to the presence of non-psychotic mental disorders. CONCLUSIONS Our findings suggest that abnormal involuntary movements are linked to psychosis risk in children and adolescents from the general population. Thus, abnormal involuntary movements might represent an additional useful and easily accessible predictor of psychosis.
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Affiliation(s)
- Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Alexandra Martz-Irngartinger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Caroline Linder
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Stefanie J Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
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Koren S, Kindler J, Tafo AG, Cohen G, Reich E. SU-F-T-21: A Novel Beam-Light View, Collimating Applicator for HDR Ocular Conjunctiva Brachytherapy-Treatments. Med Phys 2016. [DOI: 10.1118/1.4956156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Schultze-Lutter F, Debbané M, Theodoridou A, Wood SJ, Raballo A, Michel C, Schmidt SJ, Kindler J, Ruhrmann S, Uhlhaas PJ. Revisiting the Basic Symptom Concept: Toward Translating Risk Symptoms for Psychosis into Neurobiological Targets. Front Psychiatry 2016; 7:9. [PMID: 26858660 PMCID: PMC4729935 DOI: 10.3389/fpsyt.2016.00009] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/14/2016] [Indexed: 12/31/2022] Open
Abstract
In its initial formulation, the concept of basic symptoms (BSs) integrated findings on the early symptomatic course of schizophrenia and first in vivo evidence of accompanying brain aberrations. It argued that the subtle subclinical disturbances in mental processes described as BSs were the most direct self-experienced expression of the underlying neurobiological aberrations of the disease. Other characteristic symptoms of psychosis (e.g., delusions and hallucinations) were conceptualized as secondary phenomena, resulting from dysfunctional beliefs and suboptimal coping styles with emerging BSs and/or concomitant stressors. While BSs can occur in many mental disorders, in particular affective disorders, a subset of perceptive and cognitive BSs appear to be specific to psychosis and are currently employed in two alternative risk criteria. However, despite their clinical recognition in the early detection of psychosis, neurobiological research on the aetiopathology of psychosis with neuroimaging methods has only just begun to consider the neural correlate of BSs. This perspective paper reviews the emerging evidence of an association between BSs and aberrant brain activation, connectivity patterns, and metabolism, and outlines promising routes for the use of BSs in aetiopathological research on psychosis.
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Affiliation(s)
- Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern , Bern , Switzerland
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry , Zurich , Switzerland
| | - Stephen J Wood
- School of Psychology, University of Birmingham , Birmingham , UK
| | - Andrea Raballo
- Norwegian Centre for Mental Disorders Research (NORMENT), Faculty of Medicine, University of Oslo , Oslo , Norway
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern , Bern , Switzerland
| | - Stefanie J Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern , Bern , Switzerland
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern , Bern , Switzerland
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne , Cologne , Germany
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow , Glasgow , UK
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Kindler J, Weickert CS, Skilleter AJ, Catts SV, Lenroot R, Weickert TW. Selective Estrogen Receptor Modulation Increases Hippocampal Activity during Probabilistic Association Learning in Schizophrenia. Neuropsychopharmacology 2015; 40:2388-97. [PMID: 25829142 PMCID: PMC4538353 DOI: 10.1038/npp.2015.88] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/14/2015] [Accepted: 03/09/2015] [Indexed: 02/06/2023]
Abstract
People with schizophrenia show probabilistic association learning impairment in conjunction with abnormal neural activity. The selective estrogen receptor modulator (SERM) raloxifene preserves neural activity during memory in healthy older men and improves memory in schizophrenia. Here, we tested the extent to which raloxifene modifies neural activity during learning in schizophrenia. Nineteen people with schizophrenia participated in a twelve-week randomized, double-blind, placebo-controlled, cross-over adjunctive treatment trial of the SERM raloxifene administered orally at 120 mg daily to assess brain activity during probabilistic association learning using functional magnetic resonance imaging (fMRI). Raloxifene improved probabilistic association learning and significantly increased fMRI BOLD activity in the hippocampus and parahippocampal gyrus relative to placebo. A separate region of interest confirmatory analysis in 21 patients vs 36 healthy controls showed a positive association between parahippocampal neural activity and learning in patients, but no such relationship in the parahippocampal gyrus of healthy controls. Thus, selective estrogen receptor modulation by raloxifene concurrently increases activity in the parahippocampal gyrus and improves probabilistic association learning in schizophrenia. These results support a role for estrogen receptor modulation of mesial temporal lobe neural activity in the remediation of learning disabilities in both men and women with schizophrenia.
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Affiliation(s)
- Jochen Kindler
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,Department of Psychiatric Neurophysiology, University of Bern, Bern, Switzerland
| | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia
| | - Ashley J Skilleter
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia
| | - Stanley V Catts
- School of Medical Science, University of Queensland, Brisbane, QLD, Australia
| | - Rhoshel Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,Schizophrenia Research Institute, Darlinghurst, NSW, Australia,School of Psychiatry, University of New South Wales, Neuroscience Research Australia, Barker Street, Randwick, NSW 2031, Australia, Tel: +61 2 9399 1730, Fax: +61 2 9399 1034, E-mail:
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Jandeleit K, Ehmer B, Heintz B, Gross-Heitfeld E, Nelson K, Kirsten R, Scigalla P, Kindler J, Sieberth HG. Hormonal and electrolyte changes under regular therapy with recombinant human erythropoietin in hemodialysis patients. Contrib Nephrol 2015; 91:57-60. [PMID: 1839278 DOI: 10.1159/000420159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Kindler J, Moedder G, Sieberth HG. Tissue distribution of endralazine and its clinical effect in refractory hypertension. Contrib Nephrol 2015; 49:193-200. [PMID: 3830566 DOI: 10.1159/000411914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Kindler J, Jann K, Homan P, Hauf M, Walther S, Strik W, Dierks T, Hubl D. Static and dynamic characteristics of cerebral blood flow during the resting state in schizophrenia. Schizophr Bull 2015; 41:163-70. [PMID: 24327756 PMCID: PMC4266282 DOI: 10.1093/schbul/sbt180] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The cerebral network that is active during rest and is deactivated during goal-oriented activity is called the default mode network (DMN). It appears to be involved in self-referential mental activity. Atypical functional connectivity in the DMN has been observed in schizophrenia. One hypothesis suggests that pathologically increased DMN connectivity in schizophrenia is linked with a main symptom of psychosis, namely, misattribution of thoughts. METHODS A resting-state pseudocontinuous arterial spin labeling (ASL) study was conducted to measure absolute cerebral blood flow (CBF) in 34 schizophrenia patients and 27 healthy controls. Using independent component analysis (ICA), the DMN was extracted from ASL data. Mean CBF and DMN connectivity were compared between groups using a 2-sample t test. RESULTS Schizophrenia patients showed decreased mean CBF in the frontal and temporal regions (P < .001). ICA demonstrated significantly increased DMN connectivity in the precuneus (x/y/z = -16/-64/38) in patients than in controls (P < .001). CBF was not elevated in the respective regions. DMN connectivity in the precuneus was significantly correlated with the Positive and Negative Syndrome Scale scores (P < .01). CONCLUSIONS In schizophrenia patients, the posterior hub--which is considered the strongest part of the DMN--showed increased DMN connectivity. We hypothesize that this increase hinders the deactivation of the DMN and, thus, the translation of cognitive processes from an internal to an external focus. This might explain symptoms related to defective self-monitoring, such as auditory verbal hallucinations or ego disturbances.
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Affiliation(s)
- Jochen Kindler
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland;
| | - Kay Jann
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland;,Laboratory of Functional MRI Technology, Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA;,These authors contributed equally to the article
| | - Philipp Homan
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Werner Strik
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Thomas Dierks
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Daniela Hubl
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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Woodward TS, Jung K, Hwang H, Yin J, Taylor L, Menon M, Peters E, Kuipers E, Waters F, Lecomte T, Sommer IE, Daalman K, van Lutterveld R, Hubl D, Kindler J, Homan P, Badcock JC, Chhabra S, Cella M, Keedy S, Allen P, Mechelli A, Preti A, Siddi S, Erickson D. Symptom dimensions of the psychotic symptom rating scales in psychosis: a multisite study. Schizophr Bull 2014; 40 Suppl 4:S265-74. [PMID: 24936086 PMCID: PMC4141314 DOI: 10.1093/schbul/sbu014] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 11/26/2022]
Abstract
The Psychotic Symptom Rating Scales (PSYRATS) is an instrument designed to quantify the severity of delusions and hallucinations and is typically used in research studies and clinical settings focusing on people with psychosis and schizophrenia. It is comprised of the auditory hallucinations (AHS) and delusions subscales (DS), but these subscales do not necessarily reflect the psychological constructs causing intercorrelation between clusters of scale items. Identification of these constructs is important in some clinical and research contexts because item clustering may be caused by underlying etiological processes of interest. Previous attempts to identify these constructs have produced conflicting results. In this study, we compiled PSYRATS data from 12 sites in 7 countries, comprising 711 participants for AHS and 520 for DS. We compared previously proposed and novel models of underlying constructs using structural equation modeling. For the AHS, a novel 4-dimensional model provided the best fit, with latent variables labeled Distress (negative content, distress, and control), Frequency (frequency, duration, and disruption), Attribution (location and origin of voices), and Loudness (loudness item only). For the DS, a 2-dimensional solution was confirmed, with latent variables labeled Distress (amount/intensity) and Frequency (preoccupation, conviction, and disruption). The within-AHS and within-DS dimension intercorrelations were higher than those between subscales, with the exception of the AHS and DS Distress dimensions, which produced a correlation that approached the range of the within-scale correlations. Recommendations are provided for integrating these underlying constructs into research and clinical applications of the PSYRATS.
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Affiliation(s)
- Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada;
| | - Kwanghee Jung
- Department of Pediatrics, University of Texas Health Science Center, Houston, TX
| | - Heungsun Hwang
- Department of Psychology, McGill University, Montreal, Québec, Canada
| | - John Yin
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
| | - Laura Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emmanuelle Peters
- Department of Psychology, and the BRC of the South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, UK
| | - Elizabeth Kuipers
- Department of Psychology, and the BRC of the South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, UK
| | - Flavie Waters
- North Metro Health Service Mental Health, and School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, Australia
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
| | - Iris E Sommer
- Department of Psychiatry, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - Kirstin Daalman
- Department of Psychiatry, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - Remko van Lutterveld
- Department of Psychiatry, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - Daniela Hubl
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Philipp Homan
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Johanna C Badcock
- School of Psychology, University of Western Australia, Crawley, Western Australia, Australia
| | - Saruchi Chhabra
- School of Psychology, University of Western Australia, Crawley, Western Australia, Australia
| | - Matteo Cella
- Department of Psychology, and the BRC of the South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, UK
| | - Sarah Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Paul Allen
- Department of Psychosis Studies, King's College London, London, UK
| | - Andrea Mechelli
- Department of Psychosis Studies, King's College London, London, UK
| | - Antonio Preti
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Sara Siddi
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - David Erickson
- Fraser North Early Psychosis Program, Royal Columbian Hospital, New Westminster, British Columbia, Canada
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Hubl D, Schneider RC, Kottlow M, Kindler J, Strik W, Dierks T, Koenig T. Agency and Ownership are Independent Components of ‘Sensing the Self’ in the Auditory-Verbal Domain. Brain Topogr 2014; 27:672-82. [DOI: 10.1007/s10548-014-0351-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 01/11/2014] [Indexed: 10/25/2022]
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He BJ, Nolte G, Nagata K, Takano D, Yamazaki T, Fujimaki Y, Maeda T, Satoh Y, Heckers S, George MS, Lopes da Silva F, de Munck JC, Van Houdt PJ, Verdaasdonk RM, Ossenblok P, Mullinger K, Bowtell R, Bagshaw AP, Keeser D, Karch S, Segmiller F, Hantschk I, Berman A, Padberg F, Pogarell O, Scharnowski F, Karch S, Hümmer S, Keeser D, Paolini M, Kirsch V, Koller G, Rauchmann B, Kupka M, Blautzik J, Pogarell O, Razavi N, Jann K, Koenig T, Kottlow M, Hauf M, Strik W, Dierks T, Gotman J, Vulliemoz S, Lu Y, Zhang H, Yang L, Worrell G, He B, Gruber O, Piguet C, Hubl D, Homan P, Kindler J, Dierks T, Kim K, Steinhoff U, Wakai R, Koenig T, Kottlow M, Melie-García L, Mucci A, Volpe U, Prinster A, Salvatore M, Galderisi S, Linden DEJ, Brandeis D, Schroeder CE, Kayser C, Panzeri S, Kleinschmidt A, Ritter P, Walther S, Haueisen J, Lau S, Flemming L, Sonntag H, Maess B, Knösche TR, Lanfer B, Dannhauer M, Wolters CH, Stenroos M, Haueisen J, Wolters C, Aydin U, Lanfer B, Lew S, Lucka F, Ruthotto L, Vorwerk J, Wagner S, Ramon C, Guan C, Ang KK, Chua SG, Kuah WK, Phua KS, Chew E, Zhou H, Chuang KH, Ang BT, Wang C, Zhang H, Yang H, Chin ZY, Yu H, Pan Y, Collins L, Mainsah B, Colwell K, Morton K, Ryan D, Sellers E, Caves K, Throckmorton S, Kübler A, Holz EM, Zickler C, Sellers E, Ryan D, Brown K, Colwell K, Mainsah B, Caves K, Throckmorton S, Collins L, Wennberg R, Ahlfors SP, Grova C, Chowdhury R, Hedrich T, Heers M, Zelmann R, Hall JA, Lina JM, Kobayashi E, Oostendorp T, van Dam P, Oosterhof P, Linnenbank A, Coronel R, van Dessel P, de Bakker J, Rossion B, Jacques C, Witthoft N, Weiner KS, Foster BL, Miller KJ, Hermes D, Parvizi J, Grill-Spector K, Recanzone GH, Murray MM, Haynes JD, Richiardi J, Greicius M, De Lucia M, Müller KR, Formisano E, Smieskova R, Schmidt A, Bendfeldt K, Walter A, Riecher-Rössler A, Borgwardt S, Fusar-Poli P, Eliez S, Schmidt A, Sekihara K, Nagarajan SS, Schoffelen JM, Guggisberg AG, Nolte G, Balazs S, Kermanshahi K, Kiesenhofer W, Binder H, Rattay F, Antal A, Chaieb L, Paulus W, Bodis-Wollner I, Maurer K, Fein G, Camchong J, Johnstone J, Cardenas-Nicolson V, Fiederer LDJ, Lucka F, Yang S, Vorwerk J, Dümpelmann M, Cosandier-Rimélé D, Schulze-Bonhage A, Aertsen A, Speck O, Wolters CH, Ball T, Fuchs M, Wagner M, Kastner J, Tech R, Dinh C, Haueisen J, Baumgarten D, Hämäläinen MS, Lau S, Vogrin SJ, D'Souza W, Haueisen J, Cook MJ, Custo A, Van De Ville D, Vulliemoz S, Grouiller F, Michel CM, Malmivuo J, Aydin U, Vorwerk J, Küpper P, Heers M, Kugel H, Wellmer J, Kellinghaus C, Scherg M, Rampp S, Wolters C, Storti SF, Boscolo Galazzo I, Del Felice A, Pizzini FB, Arcaro C, Formaggio E, Mai R, Manganotti P, Koessler L, Vignal J, Cecchin T, Colnat-Coulbois S, Vespignani H, Ramantani G, Maillard L, Rektor I, Kuba R, Brázdil M, Chrastina J, Rektorova I, van Mierlo P, Carrette E, Strobbe G, Montes-Restrepo V, Vonck K, Vandenberghe S, Ahmed B, Brodely C, Carlson C, Kuzniecky R, Devinsky O, French J, Thesen T, Bénis D, David O, Lachaux JP, Seigneuret E, Krack P, Fraix V, Chabardès S, Bastin J, Jann K, Gee D, Kilroy E, Cannon T, Wang DJ, Hale JR, Mayhew SD, Przezdzik I, Arvanitis TN, Bagshaw AP, Plomp G, Quairiaux C, Astolfi L, Michel CM, Mayhew SD, Mullinger KJ, Bagshaw AP, Bowtell R, Francis ST, Schouten AC, Campfens SF, van der Kooij H, Koles Z, Lind J, Flor-Henry P, Wirth M, Haase CM, Villeneuve S, Vogel J, Jagust WJ, Kambeitz-Ilankovic L, Simon-Vermot L, Gesierich B, Duering M, Ewers M, Rektorova I, Krajcovicova L, Marecek R, Mikl M, Bracht T, Horn H, Strik W, Federspiel A, Schnell S, Höfle O, Stegmayer K, Wiest R, Dierks T, Müller TJ, Walther S, Surmeli T, Ertem A, Eralp E, Kos IH, Skrandies W, Flüggen S, Klein A, Britz J, Díaz Hernàndez L, Ro T, Michel CM, Lenartowicz A, Lau E, Rodriguez C, Cohen MS, Loo SK, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, La Porta P, Verardo AR, Niolu C, Fernandez I, Siracusano A, Flor-Henry P, Lind J, Koles Z, Bollmann S, Ghisleni C, O'Gorman R, Poil SS, Klaver P, Michels L, Martin E, Ball J, Eich-Höchli D, Brandeis D, Salisbury DF, Murphy TK, Butera CD, Mathalon DH, Fryer SL, Kiehl KA, Calhoun VC, Pearlson GD, Roach BJ, Ford JM, McGlashan TH, Woods SW, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Gonzalez Andino S, Grave de Peralta Menendez R, Grave de Peralta Menendez R, Sanchez Vives M, Rebollo B, Gonzalez Andino S, Frølich L, Andersen TS, Mørup M, Belfiore P, Gargiulo P, Ramon C, Vanhatalo S, Cho JH, Vorwerk J, Wolters CH, Knösche TR, Watanabe T, Kawabata Y, Ukegawa D, Kawabata S, Adachi Y, Sekihara K, Sekihara K, Nagarajan SS, Wagner S, Aydin U, Vorwerk J, Herrmann C, Burger M, Wolters C, Lucka F, Aydin U, Vorwerk J, Burger M, Wolters C, Bauer M, Trahms L, Sander T, Faber PL, Lehmann D, Gianotti LRR, Pascual-Marqui RD, Milz P, Kochi K, Kaneko S, Yamashita S, Yana K, Kalogianni K, Vardy AN, Schouten AC, van der Helm FCT, Sorrentino A, Luria G, Aramini R, Hunold A, Funke M, Eichardt R, Haueisen J, Gómez-Aguilar F, Vázquez-Olvera S, Cordova-Fraga T, Castro-López J, Hernández-Gonzalez MA, Solorio-Meza S, Sosa-Aquino M, Bernal-Alvarado JJ, Vargas-Luna M, Vorwerk J, Magyari L, Ludewig J, Oostenveld R, Wolters CH, Vorwerk J, Engwer C, Ludewig J, Wolters C, Sato K, Nishibe T, Furuya M, Yamashiro K, Yana K, Ono T, Puthanmadam Subramaniyam N, Hyttinen J, Lau S, Güllmar D, Flemming L, Haueisen J, Sonntag H, Vorwerk J, Wolters CH, Grasedyck L, Haueisen J, Maeß B, Freitag S, Graichen U, Fiedler P, Strohmeier D, Haueisen J, Stenroos M, Hauk O, Grigutsch M, Felber M, Maess B, Herrmann B, Strobbe G, van Mierlo P, Vandenberghe S, Strobbe G, Cárdenas-Peña D, Montes-Restrepo V, van Mierlo P, Castellanos-Dominguez G, Vandenberghe S, Lanfer B, Paul-Jordanov I, Scherg M, Wolters CH, Ito Y, Sato D, Kamada K, Kobayashi T, Dalal SS, Rampp S, Willomitzer F, Arold O, Fouladi-Movahed S, Häusler G, Stefan H, Ettl S, Zhang S, Zhang Y, Li H, Kong X, Montes-Restrepo V, Strobbe G, van Mierlo P, Vandenberghe S, Wong DDE, Bidet-Caulet A, Knight RT, Crone NE, Dalal SS, Birot G, Spinelli L, Vulliémoz S, Seeck M, Michel CM, Emory H, Wells C, Mizrahi N, Vogrin SJ, Lau S, Cook MJ, Karahanoglu FI, Grouiller F, Caballero-Gaudes C, Seeck M, Vulliemoz S, Van De Ville D, Spinelli L, Megevand P, Genetti M, Schaller K, Michel C, Vulliemoz S, Seeck M, Genetti M, Tyrand R, Grouiller F, Vulliemoz S, Spinelli L, Seeck M, Schaller K, Michel CM, Grouiller F, Heinzer S, Delattre B, Lazeyras F, Spinelli L, Pittau F, Seeck M, Ratib O, Vargas M, Garibotto V, Vulliemoz S, Vogrin SJ, Bailey CA, Kean M, Warren AE, Davidson A, Seal M, Harvey AS, Archer JS, Papadopoulou M, Leite M, van Mierlo P, Vonck K, Boon P, Friston K, Marinazzo D, Ramon C, Holmes M, Koessler L, Rikir E, Gavaret M, Bartolomei F, Vignal JP, Vespignani H, Maillard L, Centeno M, Perani S, Pier K, Lemieux L, Clayden J, Clark C, Pressler R, Cross H, Carmichael DW, Spring A, Bessemer R, Pittman D, Aghakhani Y, Federico P, Pittau F, Grouiller F, Vulliémoz S, Gotman J, Badier JM, Bénar CG, Bartolomei F, Cruto C, Chauvel P, Gavaret M, Brodbeck V, van Leeuwen T, Tagliazzuchi E, Melloni L, Laufs H, Griskova-Bulanova I, Dapsys K, Klein C, Hänggi J, Jäncke L, Ehinger BV, Fischer P, Gert AL, Kaufhold L, Weber F, Marchante Fernandez M, Pipa G, König P, Sekihara K, Hiyama E, Koga R, Iannilli E, Michel CM, Bartmuss AL, Gupta N, Hummel T, Boecker R, Holz N, Buchmann AF, Blomeyer D, Plichta MM, Wolf I, Baumeister S, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M, Natahara S, Ueno M, Kobayashi T, Kottlow M, Bänninger A, Koenig T, Schwab S, Koenig T, Federspiel A, Dierks T, Jann K, Natsukawa H, Kobayashi T, Tüshaus L, Koenig T, Kottlow M, Achermann P, Wilson RS, Mayhew SD, Assecondi S, Arvanitis TN, Bagshaw AP, Darque A, Rihs TA, Grouiller F, Lazeyras F, Ha-Vinh Leuchter R, Caballero C, Michel CM, Hüppi PS, Hauser TU, Hunt LT, Iannaccone R, Stämpfli P, Brandeis D, Dolan RJ, Walitza S, Brem S, Graichen U, Eichardt R, Fiedler P, Strohmeier D, Freitag S, Zanow F, Haueisen J, Lordier L, Grouiller F, Van de Ville D, Sancho Rossignol A, Cordero I, Lazeyras F, Ansermet F, Hüppi P, Schläpfer A, Rubia K, Brandeis D, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, Verardo AR, La Porta P, Niolu C, Fernandez I, Siracusano A, Tamura K, Karube C, Mizuba T, Matsufuji M, Takashima S, Iramina K, Assecondi S, Ostwald D, Bagshaw AP, Marecek R, Brazdil M, Lamos M, Slavícek T, Marecek R, Jan J, Meier NM, Perrig W, Koenig T, Minami T, Noritake Y, Nakauchi S, Azuma K, Minami T, Nakauchi S, Rodriguez C, Lenartowicz A, Cohen MS, Rodriguez C, Lenartowicz A, Cohen MS, Iramina K, Kinoshita H, Tamura K, Karube C, Kaneko M, Ide J, Noguchi Y, Cohen MS, Douglas PK, Rodriguez CM, Xia HJ, Zimmerman EM, Konopka CJ, Epstein PS, Konopka LM, Giezendanner S, Fisler M, Soravia L, Andreotti J, Wiest R, Dierks T, Federspiel A, Razavi N, Federspiel A, Dierks T, Hauf M, Jann K, Kamada K, Sato D, Ito Y, Okano K, Mizutani N, Kobayashi T, Thelen A, Murray M, Pastena L, Formaggio E, Storti SF, Faralli F, Melucci M, Gagliardi R, Ricciardi L, Ruffino G, Coito A, Macku P, Tyrand R, Astolfi L, He B, Wiest R, Seeck M, Michel C, Plomp G, Vulliemoz S, Fischmeister FPS, Glaser J, Schöpf V, Bauer H, Beisteiner R, Deligianni F, Centeno M, Carmichael DW, Clayden J, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny S, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Dürschmid S, Zaehle T, Pannek H, Chang HF, Voges J, Rieger J, Knight RT, Heinze HJ, Hinrichs H, Tsatsishvili V, Cong F, Puoliväli T, Alluri V, Toiviainen P, Nandi AK, Brattico E, Ristaniemi T, Grieder M, Crinelli RM, Jann K, Federspiel A, Wirth M, Koenig T, Stein M, Wahlund LO, Dierks T, Atsumori H, Yamaguchi R, Okano Y, Sato H, Funane T, Sakamoto K, Kiguchi M, Tränkner A, Schindler S, Schmidt F, Strauß M, Trampel R, Hegerl U, Turner R, Geyer S, Schönknecht P, Kebets V, van Assche M, Goldstein R, van der Meulen M, Vuilleumier P, Richiardi J, Van De Ville D, Assal F, Wozniak-Kwasniewska A, Szekely D, Harquel S, Bougerol T, David O, Bracht T, Jones DK, Horn H, Müller TJ, Walther S, Sos P, Klirova M, Novak T, Brunovsky M, Horacek J, Bares M, Hoschl C C, Fellhauer I, Zöllner FG, Schröder J, Kong L, Essig M, Schad LR, Arrubla J, Neuner I, Hahn D, Boers F, Shah NJ, Neuner I, Arrubla J, Hahn D, Boers F, Jon Shah N, Suriya Prakash M, Sharma R, Kawaguchi H, Kobayashi T, Fiedler P, Griebel S, Biller S, Fonseca C, Vaz F, Zentner L, Zanow F, Haueisen J, Rochas V, Rihs T, Thut G, Rosenberg N, Landis T, Michel C, Moliadze V, Schmanke T, Lyzhko E, Bassüner S, Freitag C, Siniatchkin M, Thézé R, Guggisberg AG, Nahum L, Schnider A, Meier L, Friedrich H, Jann K, Landis B, Wiest R, Federspiel A, Strik W, Dierks T, Witte M, Kober SE, Neuper C, Wood G, König R, Matysiak A, Kordecki W, Sieluzycki C, Zacharias N, Heil P, Wyss C, Boers F, Arrubla J, Dammers J, Kawohl W, Neuner I, Shah NJ, Braboszcz C, Cahn RB, Levy J, Fernandez M, Delorme A, Rosas-Martinez L, Milne E, Zheng Y, Urakami Y, Kawamura K, Washizawa Y, Hiyoshi K, Cichocki A, Giroud N, Dellwo V, Meyer M, Rufener KS, Liem F, Dellwo V, Meyer M, Jones-Rounds JD, Raizada R, Staljanssens W, Strobbe G, van Mierlo P, Van Holen R, Vandenberghe S, Pefkou M, Becker R, Michel C, Hervais-Adelman A, He W, Brock J, Johnson B, Ohla K, Hitz K, Heekeren K, Obermann C, Huber T, Juckel G, Kawohl W, Gabriel D, Comte A, Henriques J, Magnin E, Grigoryeva L, Ortega JP, Haffen E, Moulin T, Pazart L, Aubry R, Kukleta M, Baris Turak B, Louvel J, Crespo-Garcia M, Cantero JL, Atienza M, Connell S, Kilborn K, Damborská A, Brázdil M, Rektor I, Kukleta M, Koberda JL, Bienkiewicz A, Koberda I, Koberda P, Moses A, Tomescu M, Rihs T, Britz J, Custo A, Grouiller F, Schneider M, Debbané M, Eliez S, Michel C, Wang GY, Kydd R, Wouldes TA, Jensen M, Russell BR, Dissanayaka N, Au T, Angwin A, O'Sullivan J, Byrne G, Silburn P, Marsh R, Mellic G, Copland D, Bänninger A, Kottlow M, Díaz Hernàndez L, Koenig T, Díaz Hernàndez L, Bänninger A, Koenig T, Hauser TU, Iannaccone R, Mathys C, Ball J, Drechsler R, Brandeis D, Walitza S, Brem S, Boeijinga PH, Pang EW, Valica T, Macdonald MJ, Oh A, Lerch JP, Anagnostou E, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Verardo AR, Giannoudas I, La Porta P, Niolu C, Fernandez I, Siracusano A, Shimada T, Matsuda Y, Monkawa A, Monkawa T, Hashimoto R, Watanabe K, Kawasaki Y, Matsuda Y, Shimada T, Monkawa T, Monkawa A, Watanabe K, Kawasaki Y, Stegmayer K, Horn H, Federspiel A, Razavi N, Bracht T, Laimböck K, Strik W, Dierks T, Wiest R, Müller TJ, Walther S, Koorenhof LJ, Swithenby SJ, Martins-Mourao A, Rihs TA, Tomescu M, Song KW, Custo A, Knebel JF, Murray M, Eliez S, Michel CM, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Laimboeck K, Jann K, Walther S, Federspiel A, Wiest R, Strik W, Horn H. Abstracts of Presentations at the International Conference on Basic and Clinical Multimodal Imaging (BaCI), a Joint Conference of the International Society for Neuroimaging in Psychiatry (ISNIP), the International Society for Functional Source Imaging (ISFSI), the International Society for Bioelectromagnetism (ISBEM), the International Society for Brain Electromagnetic Topography (ISBET), and the EEG and Clinical Neuroscience Society (ECNS), in Geneva, Switzerland, September 5-8, 2013. Clin EEG Neurosci 2013; 44:1550059413507209. [PMID: 24368763 DOI: 10.1177/1550059413507209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- B J He
- National Institutes of Health, Bethesda, MD, USA
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Kindler J, Homan P, Flury R, Strik W, Dierks T, Hubl D. Theta burst transcranial magnetic stimulation for the treatment of auditory verbal hallucinations: results of a randomized controlled study. Psychiatry Res 2013; 209:114-7. [PMID: 23648282 DOI: 10.1016/j.psychres.2013.03.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 03/10/2013] [Accepted: 03/17/2013] [Indexed: 10/26/2022]
Abstract
One Hertz (1 Hz) repetitive transcranial magnetic stimulation (rTMS) is an effective therapy for auditory verbal hallucinations (AVH). Theta burst protocols (TBS) show longer after-effects. This single-blind, randomized controlled study compared continuous TBS with 1Hz rTMS in a 10-day treatment. Patients were diagnosed with schizophrenia or schizoaffective disorder. TBS demonstrated equal clinical effects compared to 1Hz TMS.
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Affiliation(s)
- Jochen Kindler
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, CH-3000 Bern 60, Switzerland.
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Homan P, Kindler J, Hauf M, Walther S, Hubl D, Dierks T. Repeated measurements of cerebral blood flow in the left superior temporal gyrus reveal tonic hyperactivity in patients with auditory verbal hallucinations: a possible trait marker. Front Hum Neurosci 2013; 7:304. [PMID: 23805093 PMCID: PMC3691504 DOI: 10.3389/fnhum.2013.00304] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/06/2013] [Indexed: 01/12/2023] Open
Abstract
Background: The left superior temporal gyrus (STG) has been suggested to play a key role in auditory verbal hallucinations (AVH) in patients with schizophrenia. Methods: Eleven medicated subjects with schizophrenia and medication-resistant AVH and 19 healthy controls underwent perfusion magnetic resonance (MR) imaging with arterial spin labeling (ASL). Three additional repeated measurements were conducted in the patients. Patients underwent a treatment with transcranial magnetic stimulation (TMS) between the first 2 measurements. The main outcome measure was the pooled cerebral blood flow (CBF), which consisted of the regional CBF measurement in the left STG and the global CBF measurement in the whole brain. Results: Regional CBF in the left STG in patients was significantly higher compared to controls (p < 0.0001) and to the global CBF in patients (p < 0.004) at baseline. Regional CBF in the left STG remained significantly increased compared to the global CBF in patients across time (p < 0.0007), and it remained increased in patients after TMS compared to the baseline CBF in controls (p < 0.0001). After TMS, PANSS (p = 0.003) and PSYRATS (p = 0.01) scores decreased significantly in patients. Conclusions: This study demonstrated tonically increased regional CBF in the left STG in patients with schizophrenia and auditory hallucinations despite a decrease in symptoms after TMS. These findings were consistent with what has previously been termed a trait marker of AVH in schizophrenia.
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Affiliation(s)
- Philipp Homan
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern Bern, Switzerland
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Kindler J, Homan P, Jann K, Federspiel A, Flury R, Hauf M, Strik W, Dierks T, Hubl D. Reduced neuronal activity in language-related regions after transcranial magnetic stimulation therapy for auditory verbal hallucinations. Biol Psychiatry 2013; 73:518-24. [PMID: 22840762 DOI: 10.1016/j.biopsych.2012.06.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 06/07/2012] [Accepted: 06/08/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) is a novel therapeutic approach, used in patients with pharmacoresistant auditory verbal hallucinations (AVH). To investigate the neurobiological effects of TMS on AVH, we measured cerebral blood flow with pseudo-continuous magnetic resonance-arterial spin labeling 20 ± 6 hours before and after TMS treatment. METHODS Thirty patients with schizophrenia or schizoaffective disorder were investigated. Fifteen patients received a 10-day TMS treatment to the left temporoparietal cortex, and 15 received the standard treatment. The stimulation location was chosen according to an individually determined language region determined by a functional magnetic resonance imaging language paradigm, which identified the sensorimotor language area, area Spt (sylvian parietotemporal), as the target region. RESULTS TMS-treated patients showed positive clinical effects, which were indicated by a reduction in AVH scores (p ≤ .001). Cerebral blood flow was significantly decreased in the primary auditory cortex (p ≤ .001), left Broca's area (p ≤ .001), and cingulate gyrus (p ≤ .001). In control subjects, neither positive clinical effects nor cerebral blood flow decreases were detected. The decrease in cerebral blood flow in the primary auditory cortex correlated with the decrease in AVH scores (p ≤ .001). CONCLUSIONS TMS reverses hyperactivity of language regions involved in the emergence of AVH. Area Spt acts as a gateway to the hallucination-generating cerebral network. Successful therapy corresponded to decreased cerebral blood flow in the primary auditory cortex, supporting its crucial role in triggering AVH and contributing to the physical quality of the false perceptions.
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Affiliation(s)
- Jochen Kindler
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, Bern, Switzerland
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