1
|
Fazio G, Olivo D, Wolf ND, Hirjak D, Schmitgen MM, Werler F, Witteman M, Kubera KM, Calhoun VD, Reith W, Wolf RC, Sambataro F. The risk of cannabis use disorder is mediated by altered brain connectivity: A chronnectome study. Addict Biol 2024; 29:e13395. [PMID: 38709211 PMCID: PMC11072977 DOI: 10.1111/adb.13395] [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] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/05/2024] [Accepted: 03/26/2024] [Indexed: 05/07/2024]
Abstract
The brain mechanisms underlying the risk of cannabis use disorder (CUD) are poorly understood. Several studies have reported changes in functional connectivity (FC) in CUD, although none have focused on the study of time-varying patterns of FC. To fill this important gap of knowledge, 39 individuals at risk for CUD and 55 controls, stratified by their score on a self-screening questionnaire for cannabis-related problems (CUDIT-R), underwent resting-state functional magnetic resonance imaging. Dynamic functional connectivity (dFNC) was estimated using independent component analysis, sliding-time window correlations, cluster states and meta-state indices of global dynamics and were compared among groups. At-risk individuals stayed longer in a cluster state with higher within and reduced between network dFNC for the subcortical, sensory-motor, visual, cognitive-control and default-mode networks, relative to controls. More globally, at-risk individuals had a greater number of meta-states and transitions between them and a longer state span and total distance between meta-states in the state space. Our findings suggest that the risk of CUD is associated with an increased dynamic fluidity and dynamic range of FC. This may result in altered stability and engagement of the brain networks, which can ultimately translate into altered cortical and subcortical function conveying CUD risk. Identifying these changes in brain function can pave the way for early pharmacological and neurostimulation treatment of CUD, as much as they could facilitate the stratification of high-risk individuals.
Collapse
Affiliation(s)
- Giovanni Fazio
- Department of Neuroscience, Padua Neuroscience CenterUniversity of PaduaPaduaItaly
| | - Daniele Olivo
- Department of Neuroscience, Padua Neuroscience CenterUniversity of PaduaPaduaItaly
| | - Nadine D. Wolf
- Department of General Psychiatry at the Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Mike M. Schmitgen
- Department of General Psychiatry at the Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Miriam Witteman
- Department of Psychiatry and PsychotherapySaarland UniversitySaarbrückenGermany
| | - Katharina M. Kubera
- Department of General Psychiatry at the Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Vince D. Calhoun
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of TechnologyEmory UniversityAtlantaGeorgiaUSA
| | - Wolfgang Reith
- Department of NeuroradiologySaarland UniversitySaarbrückenGermany
| | - Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Fabio Sambataro
- Department of Neuroscience, Padua Neuroscience CenterUniversity of PaduaPaduaItaly
| |
Collapse
|
2
|
Kubera KM, Rashidi M, Schmitgen MM, Barth A, Hirjak D, Otte ML, Sambataro F, Calhoun VD, Wolf RC. Functional network interactions in patients with schizophrenia with persistent auditory verbal hallucinations: A multimodal MRI fusion approach using three-way pICA. Schizophr Res 2024; 265:20-29. [PMID: 37024417 DOI: 10.1016/j.schres.2023.03.001] [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: 10/23/2022] [Revised: 02/18/2023] [Accepted: 03/03/2023] [Indexed: 04/08/2023]
Abstract
Over the last decade, there have been an increasing number of functional magnetic resonance imaging (fMRI) studies examining brain activity in schizophrenia (SZ) patients with persistent auditory verbal hallucinations (AVH) using either task-based or resting-state fMRI (rs-fMRI) paradigms. Such data have been conventionally collected and analyzed as distinct modalities, disregarding putative crossmodal interactions. Recently, it has become possible to incorporate two or more modalities in one comprehensive analysis to uncover hidden patterns of neural dysfunction not sufficiently captured by separate analysis. A novel multivariate fusion approach to multimodal data analysis, i.e., parallel independent component analysis (pICA), has been previously shown to be a powerful tool in this regard. We utilized three-way pICA to study covarying components among fractional amplitude of low-frequency fluctuations (fALFF) for rs-MRI and task-based activation computed from an alertness and a working memory (WM) paradigm of 15 SZ patients with AVH, 16 non-hallucinating SZ patients (nAVH), and 19 healthy controls (HC). The strongest connected triplet (false discovery rate (FDR)-corrected pairwise correlations) comprised a frontostriatal/temporal network (fALFF), a temporal/sensorimotor network (alertness task), and a frontoparietal network (WM task). Frontoparietal and frontostriatal/temporal network strength significantly differed between AVH patients and HC. Phenomenological features such as omnipotence and malevolence of AVH were associated with temporal/sensorimotor and frontoparietal network strength. The transmodal data confirm a complex interplay of neural systems subserving attentional processes and cognitive control interacting with speech and language processing networks. In addition, the data emphasize the importance of sensorimotor regions modulating specific symptom dimensions of AVH.
Collapse
Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Mahmoud Rashidi
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Anja Barth
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marie-Luise Otte
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padua, Padua, Italy; Padua Neuroscience Center, University of Padua, Padua, Italy
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany.
| |
Collapse
|
3
|
Fritze S, Brandt GA, Kubera KM, Schmitgen MM, Northoff G, Geiger-Primo LS, Tost H, Meyer-Lindenberg A, Wolf RC, Hirjak D. Structural alterations of amygdala and hypothalamus contribute to catatonia. Schizophr Res 2024; 263:122-130. [PMID: 35597738 DOI: 10.1016/j.schres.2022.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/29/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 12/12/2022]
Abstract
At present, current diagnostic criteria and systems neglect affective symptom expression in catatonia. This potentially serious omission could explain why putative contributions of limbic system structures, such as amygdala, hippocampus or hypothalamus, to catatonia in schizophrenia spectrum disorders (SSD) have been scarcely investigated so far. To determine whether topographical alterations of the amygdala, hippocampus and hypothalamus contribute to catatonia in SSD patients, we conducted structural magnetic resonance imaging (MRI) of SSD patients with (SSD-Cat, n = 30) and without (SSD-nonCat, n = 28) catatonia as defined by a Northoff Catatonia Rating Scale (NCRS) total score of ≥3 and =0, respectively, in comparison with healthy controls (n = 20). FreeSurfer v7.2 was used for automated segmentation of the amygdala and its 9 nuclei, hippocampus and its 21 subfields and hypothalamus and its associated 5 subunits. SSD-Cat had significantly smaller anterior inferior hypothalamus, cortical nucleus of amygdala, and hippocampal fimbria volumes when compared to SSD-nonCat. SSD-Cat had significantly smaller amygdala, hippocampus and hypothalamus whole and subunit volumes when compared to healthy controls. In SSD-Cat according to DSM-IV-TR (n = 44), we identified positive correlations between Brief Psychiatric Rating Scale (BPRS) item #2 (reflecting anxiety) and respective amygdala nuclei as well as negative correlation between NCRS behavioral score and hippocampus subiculum head. The lower volumes of respective limbic structures involved in affect regulation may point towards central affective pathomechanisms in catatonia.
Collapse
Affiliation(s)
- Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Geva A Brandt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Lena S Geiger-Primo
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| |
Collapse
|
4
|
Otte ML, Schmitgen MM, Wolf ND, Kubera KM, Calhoun VD, Fritze S, Geiger LS, Tost H, Seidl UW, Meyer-Lindenberg A, Hirjak D, Wolf RC. Structure/function interrelationships and illness insight in patients with schizophrenia: a multimodal MRI data fusion study. Eur Arch Psychiatry Clin Neurosci 2023; 273:1703-1713. [PMID: 36806586 PMCID: PMC10713778 DOI: 10.1007/s00406-023-01566-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Illness insight in schizophrenia (SZ) has an important impact on treatment outcome, integration into society and can vary over the course of the disorder. To deal with and treat reduced or absent illness insight, we need to better understand its functional and structural correlates. Previous studies showed regionally abnormal brain volume in brain areas related to cognitive control and self-reference. However, little is known about associations between illness insight and structural and functional network strength in patients with SZ. This study employed a cross-sectional design to examine structural and functional differences between patients with SZ (n = 74) and healthy controls (n = 47) using structural and resting-state functional magnetic resonance imaging (MRI). Voxel-based morphometry was performed on structural data, and the amplitude of low frequency fluctuations (ALFF) was calculated for functional data. To investigate abnormal structure/function interrelationships and their association with illness insight, we used parallel independent component analysis (pICA). Significant group (SZ vs. HC) differences were detected in distinct structural and functional networks, predominantly comprising frontoparietal, temporal and cerebellar regions. Significant associations were found between illness insight and two distinct structural networks comprising frontoparietal (pre- and postcentral gyrus, inferior parietal lobule, thalamus, and precuneus) and posterior cortical regions (cuneus, precuneus, lingual, posterior cingulate, and middle occipital gyrus). Finally, we found a significant relationship between illness insight and functional network comprising temporal regions (superior temporal gyrus). This study suggests that aberrant structural and functional integrity of neural systems subserving cognitive control, memory and self-reference are tightly coupled to illness insight in SZ.
Collapse
Affiliation(s)
- Marie-Luise Otte
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Nadine D Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany
| | - 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, Atlanta, GA, USA
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lena S Geiger
- Department of Psychiatry and Psychotherapy, Research Group Systems Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group Systems Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrich W Seidl
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany
- Department of Psychiatry and Psychotherapy, SHG-Kliniken Saarbrücken, Saarbrücken, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Research Group Systems Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany.
| |
Collapse
|
5
|
Jeung-Maarse H, Schmitgen MM, Schmitt R, Bertsch K, Herpertz SC. Oxytocin effects on amygdala reactivity to angry faces in males and females with antisocial personality disorder. Neuropsychopharmacology 2023; 48:946-953. [PMID: 36941365 PMCID: PMC10156793 DOI: 10.1038/s41386-023-01549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 03/23/2023]
Abstract
The amygdala is a key region in current neurocircuitry models of reactive aggression as it is crucially involved in detecting social threat and provocation. An increased amygdala reactivity to angry faces has been reported in aggression-prone individuals and the neuropeptide oxytocin (OT) could dampen anger-related amygdala reactivity in a number of mental disorders. One example is the antisocial personality disorder (ASPD) which has so far only been studied in limited numbers. To address the question whether OT can normalize amygdala hyperreactivity to emotional faces, we conducted a functional magnetic resonance imaging experiment with 20 men and 18 women with ASPD and 20 male and 20 female healthy control (HC) participants in a double-blind, randomized, placebo (PLC)-controlled within-subject design. Participants were exposed to an emotion classification task (fearful, angry, and happy faces) after receiving an intranasal dose (24 IU) of synthetic OT or PLC. We found OT to attenuate right amygdala hyperactivity to angry faces in participants with ASPD to such an extent that the intensity of amygdala activity in the ASPD group in the OT condition decreased to the level of amygdala activity in the PLC condition in the HC group. There was also a trend that OT effects were generally larger in women than in men. These findings suggest that OT differentially modulates the amygdala following social threatening or provoking cues in dependence of psychopathology (ASPD vs. HC) and sex (male vs. female). Particularly female ASPD patients could benefit from OT in the treatment of reactive aggression.
Collapse
Affiliation(s)
- Haang Jeung-Maarse
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld University, Bielefeld, Germany.
- Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany.
| | - Mike M Schmitgen
- Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Ruth Schmitt
- Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
- Department of Psychology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
6
|
Wolf RC, Werler F, Schmitgen MM, Wolf ND, Wittemann M, Reith W, Hirjak D. Functional correlates of neurological soft signs in heavy cannabis users. Addict Biol 2023; 28:e13270. [PMID: 36825488 DOI: 10.1111/adb.13270] [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: 08/10/2022] [Revised: 12/03/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023]
Abstract
Sensorimotor dysfunction has been previously reported in persons with cannabis dependence. Such individuals can exhibit increased levels of neurological soft signs (NSS), particularly involving motor coordination, sensorimotor integration and complex motor task performance. Abnormal NSS levels can also be detected in non-dependent individuals with heavy cannabis use (HCU), yet very little is known about the functional correlates underlying such deficits. Here, we used resting-state functional magnetic resonance imaging (MRI) to investigate associations between NSS and intrinsic neural activity (INA) in HCU (n = 21) and controls (n = 26). Compared with controls, individuals with HCU showed significantly higher NSS across all investigated subdomains. Three of these subdomains, that is, motor coordination, sensorimotor integration and complex motor task behaviour, were associated with specific use-dependent variables, particularly age of onset of cannabis use and current cannabis use. Between-group comparisons of INA revealed lower regional homogeneity (ReHo) in left precentral gyrus, left inferior occipital gyrus, right triangular pat of the inferior frontal gyrus and right precentral gyrus in HCU compared with controls. In addition, HCU showed also higher ReHo in right cerebellum and left postcentral gyrus compared with controls. Complex motor task behaviour in HCU was significantly related to INA in postcentral, inferior frontal and occipital cortices. Our findings indicate abnormal ReHo in HCU in regions associated with sensorimotor, executive control and visuomotor-integration processes. Importantly, we show associations between ReHo, cannabis-use behaviour and execution of complex motor tasks. Given convergent findings in manifest psychotic disorders, this study suggests an HCU endophenotype that may present with a cumulative risk for psychosis.
Collapse
Affiliation(s)
- Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Nadine D Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Miriam Wittemann
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Wolfgang Reith
- Department of Neuroradiology, Saarland University, Saarbrücken, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
7
|
Henemann GM, Schmitgen MM, Wolf ND, Hirjak D, Kubera KM, Sambataro F, Bach P, Koenig J, Wolf RC. Cognitive domain-independent aberrant frontoparietal network strength in individuals with excessive smartphone use. Psychiatry Res Neuroimaging 2023; 329:111593. [PMID: 36724625 DOI: 10.1016/j.pscychresns.2023.111593] [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: 10/18/2022] [Revised: 11/30/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Excessive smartphone use (ESU) may fulfill criteria for addictive behavior. In contrast to other related behavioral addictions, particularly Internet Gaming Disorder, little is known about the neural correlates underlying ESU. In this study, we used functional magnetic resonance imaging (fMRI) to acquire task data from three distinct behavioral paradigms, i.e. cue-reactivity, inhibition, and working memory, in individuals with psychometrically defined ESU (n = 19) compared to controls (n-ESU; n = 20). The Smartphone Addiction Inventory (SPAI) was used to quantify ESU-severity according to a novel five-factor model (SPAI-I). A multivariate data fusion approach, i.e. joint Independent Component Analysis (jICA) was employed to analyze fMRI-data derived from three separate experimental conditions, but analyzed jointly to detect converging and domain-independent neural signatures that differ between persons with vs. those without ESU. Across the three functional tasks, jICA identified a predominantly frontoparietal system that showed lower network strength in individuals with ESU compared to n-ESU (p < 0.05 FDR-corrected). Furthermore, significant associations between frontoparietal network strength and SPAI-I's dimensions "time spent" and "craving" were found. The data suggest a frontoparietal cognitive control network as cognitive domain-independent neural signature of excessive and potentially addictive smartphone use.
Collapse
Affiliation(s)
- Gudrun M Henemann
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany
| | - Nadine D Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany
| | - Fabio Sambataro
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Patrick Bach
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany.
| |
Collapse
|
8
|
Kubera KM, Schmitgen MM, Hildebrandt V, Neukel C, Otte ML, Sicorello M, Steinmann S, Herpertz SC, Wolf RC. Structural Correlates of Lifetime Voice-Hearing in Patients with Borderline Personality Disorder: A Pilot Study. Neuropsychobiology 2023; 82:72-80. [PMID: 36634631 DOI: 10.1159/000528039] [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: 03/14/2022] [Accepted: 10/31/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Auditory verbal hallucinations (AVH) are transdiagnostic phenomena that can occur in several mental disorders, including borderline personality disorder (BPD). Despite the transdiagnostic relevance of these symptoms, very little is known about neural signatures of AVH in BPD. METHODS We used structural magnetic resonance imaging to investigate multiple markers of brain morphology in BPD patients presenting with a lifetime history of AVH (AVH, n = 6) versus BPD patients without AVH (nAVH, n = 10) and healthy controls (HC, n = 12). The Computational Anatomy Toolbox (CAT12) was used for surface-based morphometric analyses that considered cortical thickness (CTh), gyrification (CG), and complexity of cortical folding (CCF). Factorial models were used to explore differences between AVH patients and HC, as well as between the patient groups. RESULTS Compared to HC, AVH patients showed distinct abnormalities in key regions of the language network, i.e., aberrant CTh and CG in right superior temporal gyrus and abnormal CCF in left inferior frontal gyrus. Further abnormalities were found in right prefrontal cortex (CTh) and left orbitofrontal cortex (CCF). Compared to nAVH patients, individuals with AVH showed abnormal CTh in right prefrontal cortex, along with CCF differences in right transverse temporal, superior parietal, and parahippocampal gyri. CG differences between the patient groups were found in left orbitofrontal cortex. CONCLUSION The data suggest a transdiagnostic neural signature of voice-hearing that converges on key regions involved in speech generation and perception, memory and executive control. It is possible that cortical features of distinct evolutionary and genetic origin, i.e., CTh and CG/CCF, differently contribute to AVH vulnerability in BPD.
Collapse
Affiliation(s)
- Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Viviane Hildebrandt
- Geriatric Center, Agaplesion Bethanien Hospital, Heidelberg University, Heidelberg, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Marie-Luise Otte
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Maurizio Sicorello
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Steinmann
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
9
|
Henemann GM, Schmitgen MM, Wolf ND, Hirjak D, Kubera KM, Sambataro F, Lemenager T, Koenig J, Wolf RC. Neurochemical Correlates of Cue Reactivity in Individuals with Excessive Smartphone Use. Eur Addict Res 2023; 29:71-75. [PMID: 36470225 DOI: 10.1159/000527095] [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: 12/21/2021] [Accepted: 08/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Excessive smartphone use (ESU), that is, a pattern of smartphone use that shows specific features of addictive behavior, has increasingly attracted societal and scientific interest in the past years. On the neurobiological level, ESU has recently been related to structural and functional variation in reward and salience processing networks, as shown by, for example, aberrant patterns of neural activity elicited by specific smartphone cues. OBJECTIVES Expanding on these findings, using cross-modal correlations of magnetic resonance imaging (MRI)-based measures with nuclear imaging-derived estimates, we aimed at identifying neurochemical pathways that are related to ESU. METHODS Cross-modal correlations between functional MRI data derived from a cue-reactivity task administered in persons with and without ESU and specific PET/SPECT receptor probability maps. RESULTS The endogenous mu-opioid receptor (MOR) system was found to be significantly (FDR-corrected) correlated with fMRI data, and z-transformed correlation coefficients showed an association (albeit nonsignificant after FDR-correction) between MOR and the Smartphone Addiction Inventory "withdrawal" dimension. CONCLUSIONS We could identify the MOR system as a neurochemical pathway associated with ESU. The MOR system is closely linked to the reward system, which has been recognized as a key player in addictive disorders. Together with its potential link to withdrawal, the MOR system hints toward a biologically highly relevant marker, which should be taken into consideration in the ongoing scientific discussion on technology-related addictive behaviors.
Collapse
Affiliation(s)
- Gudrun M Henemann
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Nadine D Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Tagrid Lemenager
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, University of Cologne, Faculty of Medicine and University Hospital Cologne, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
10
|
Wolf RC, Fahmy R, Wasfi M, Mamdouh R, Moussa K, Schmitgen MM, Wolf ND, Hirjak D, Sambataro F, Kubera KM. Effects of Mindfulness-Based Interventions on Gray Matter Volume in Patients with Opioid Dependence. Neuropsychobiology 2022; 81:531-538. [PMID: 36380634 DOI: 10.1159/000526952] [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: 12/29/2021] [Accepted: 08/14/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Recently, several mindfulness-based programs showed promising clinical effects in the treatment of psychiatric disorders including substance use disorders. However, very little is known about the effects of mindfulness-based interventions (MBIs) on brain structure in such patients. METHODS This study aimed to detect changes in gray matter volume (GMV) in opioid-dependent patients receiving MBI during their first month of treatment. Thirty patients were assigned to either 3 weeks of MBI (n = 16) or treatment as usual (TAU, n = 14) and were investigated using structural magnetic resonance imaging before and after treatment. Longitudinal pipeline of the Computational Anatomy Toolbox for SPM (CAT12) was used to detect significant treatment-related changes over time. The identified GMV changes following treatment were related to clinically relevant measures such as impulsivity, distress tolerance, and mindfulness. RESULTS After treatment, increased mindfulness scores were found in individuals receiving MBI compared to TAU. In the MBI group, there were also significant differences with respect to distress tolerance and impulsivity. Effects on mindfulness, distress tolerance, and impulsivity were also found in the TAU group. Longitudinal within-group analysis revealed increased left anterior insula GMV in individuals receiving MBI. Anterior insula volume increase was associated with decreased impulsivity levels. In the TAU group, significant GMV changes were found in the right lingual gyrus and right entorhinal cortex. DISCUSSION/CONCLUSION MBI can yield significant clinical effects during early abstinence from opioid dependence. MBI is particularly associated with increased insula GMV, supporting an important role of this region in the context of MBI-induced neural changes.
Collapse
Affiliation(s)
- Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Reham Fahmy
- Department of Psychiatry, Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Wasfi
- Department of Psychiatry, Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania Mamdouh
- Department of Psychiatry, Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Kareem Moussa
- Department of Radiology, Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Nadine D Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany,
| |
Collapse
|
11
|
Renz MP, Zidda F, Andoh J, Prager M, Sack M, Becker R, Ruf M, Schmitgen MM, Wolf RC, Meyer‐Lindenberg A, Tost H. Practical challenges of continuous real-time functional magnetic resonance imaging neurofeedback with multiband accelerated echo-planar imaging and short repetition times. Hum Brain Mapp 2022; 44:1278-1282. [PMID: 36399510 PMCID: PMC9875912 DOI: 10.1002/hbm.26154] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/14/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Continuous real-time functional magnetic resonance imaging (fMRI) neurofeedback is gaining increasing scientific attention in clinical neuroscience and may benefit from the short repetition times of modern multiband echoplanar imaging sequences. However, minimizing feedback delay can result in technical challenges. Here, we report a technical problem we experienced during continuous fMRI neurofeedback with multiband echoplanar imaging and short repetition times. We identify the possible origins of this problem, describe our current interim solution and provide openly available workflows and code to other researchers in case they wish to use a similar approach.
Collapse
Affiliation(s)
- Malika P. Renz
- Department of Psychiatry and Psychotherapy, Medical Faculty MannheimCentral Institute of Mental Health University of HeidelbergMannheimGermany
| | - Francesca Zidda
- Department of Psychiatry and Psychotherapy, Medical Faculty MannheimCentral Institute of Mental Health University of HeidelbergMannheimGermany
| | - Jamila Andoh
- Department of Psychiatry and Psychotherapy, Medical Faculty MannheimCentral Institute of Mental Health University of HeidelbergMannheimGermany
| | - Marcel Prager
- Department of NeuroradiologyHeidelberg University HospitalHeidelbergGermany
| | - Markus Sack
- Department of Neuroimaging, Medical Faculty MannheimCentral Institute of Mental Health, University of HeidelbergMannheimGermany,Center for Innovative Psychiatry and Psychotherapy ResearchMedical Faculty Mannheim, Central Institute of Mental Health, University of HeidelbergMannheimGermany
| | - Robert Becker
- Department of Neuroimaging, Medical Faculty MannheimCentral Institute of Mental Health, University of HeidelbergMannheimGermany,Center for Innovative Psychiatry and Psychotherapy ResearchMedical Faculty Mannheim, Central Institute of Mental Health, University of HeidelbergMannheimGermany
| | - Matthias Ruf
- Department of Neuroimaging, Medical Faculty MannheimCentral Institute of Mental Health, University of HeidelbergMannheimGermany,Center for Innovative Psychiatry and Psychotherapy ResearchMedical Faculty Mannheim, Central Institute of Mental Health, University of HeidelbergMannheimGermany
| | - Mike M. Schmitgen
- Department of General Psychiatry, Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Robert C. Wolf
- Department of General Psychiatry, Center for Psychosocial MedicineHeidelberg UniversityHeidelbergGermany
| | - Andreas Meyer‐Lindenberg
- Department of Psychiatry and Psychotherapy, Medical Faculty MannheimCentral Institute of Mental Health University of HeidelbergMannheimGermany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Medical Faculty MannheimCentral Institute of Mental Health University of HeidelbergMannheimGermany
| |
Collapse
|
12
|
Schmitgen MM, Wolf ND, Sambataro F, Hirjak D, Kubera KM, Koenig J, Wolf RC. Aberrant intrinsic neural network strength in individuals with "smartphone addiction": An MRI data fusion study. Brain Behav 2022; 12:e2739. [PMID: 36043500 PMCID: PMC9480925 DOI: 10.1002/brb3.2739] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Excessive smartphone use, also referred to as "smartphone addiction" (SPA), has increasingly attracted neuroscientific interest due to its similarities with other behavioral addictions, particularly internet gaming disorder. Little is known about the neural mechanisms underlying smartphone addiction. We explored interrelationships between brain structure and function to specify neurobiological correlates of SPA on a neural system level. METHODS Gray matter volume (GMV) and intrinsic neural activity (INA) were investigated in individuals with SPA (n = 20) and controls (n = 24), using multimodal magnetic resonance imaging and multivariate data fusion techniques, that is, parallel independent component analysis. RESULTS The joint analysis of both data modalities explored shared information between GMV and INA. In particular, two amplitudes of low frequency fluctuations-based independent neural systems significantly differed between individuals with SPA and controls. A medial/dorsolateral prefrontal system exhibited lower functional network strength in individuals with SPA versus controls, whereas the opposite pattern was detected in a parietal cortical/cerebellar system. Neural network strength was significantly related to duration of smartphone use and sleep difficulties. DISCUSSION AND CONCLUSIONS We show modality-specific associations of the brain's resting-state activity with distinct and shared SPA symptom dimensions. In particular, the data suggest contributions of aberrant prefrontal and parietal neural network strength as a possible signature of deficient executive control in SPA. SCIENTIFIC SIGNIFICANCE This study suggests distinct neural mechanisms underlying specific biological and behavioral dimensions of excessive smartphone use.
Collapse
Affiliation(s)
- Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Nadine D Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neuroscience, Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
13
|
Schmitgen MM, Horvath J, Mundinger C, Wolf DN, Sambataro F, Hirjak D, Kubera MK, Koenig J, Wolf CR. Neuronale Korrelate von Cue-Reactivity bei Personen mit
Smartphonesucht. Suchttherapie 2022. [DOI: 10.1055/s-0042-1756047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
| | - J Horvath
- Universitätsklinikum Heidelberg, Heidelberg
| | | | - D N Wolf
- Universitätsklinikum Heidelberg, Heidelberg
| | | | | | - M K Kubera
- Universitätsklinikum Heidelberg, Heidelberg
| | - J Koenig
- Uniklinik Köln, Köln
- Universitätsklinikum Heidelberg, Heidelberg
| | - C R Wolf
- Universitätsklinikum Heidelberg, Heidelberg
| |
Collapse
|
14
|
Hirjak D, Henemann GM, Schmitgen MM, Götz L, Wolf ND, Kubera KM, Sambataro F, Leménager T, Koenig J, Wolf RC. Cortical surface variation in individuals with excessive smartphone use. Dev Neurobiol 2022; 82:277-287. [PMID: 35332986 DOI: 10.1002/dneu.22872] [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: 10/11/2021] [Revised: 01/14/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022]
Abstract
Excessive smartphone use has been repeatedly related to adverse effects on mental health and psychological well-being in young adults. The continued investigation of the neurobiological mechanism underlying excessive smartphone use - sometimes also referred to as "smartphone addiction" (SPA) - is considered a top priority in system neuroscience research. Despite progress in the past years, cortical morphology associated with SPA is still poorly understood. Here, we used structural magnetic resonance imaging (MRI) at 3 T to investigate two cortical surface markers of distinct neurodevelopmental origin such as the complexity of cortical folding (CCF) and cortical thickness (CTh) in individuals with excessive smartphone use (n = 19) compared to individuals not fulfilling SPA criteria (n-SPA; n = 22). SPA was assessed using the Smartphone Addiction Inventory (SPAI). CCF and CTh were investigated using the Computational Anatomy Toolbox (CAT12). SPA individuals showed lower CCF in the right superior frontal gyrus as well as in the right caudal (cACC) and rostral anterior cingulate cortex (rACC) compared to n-SPA individuals (TFCE, uncorrected at p < 0.001). Following a dimensional approach, across the entire sample CCF of the right cACC was significantly associated with SPAI total score, as well as with distinct SPAI subdimensions, particularly time spent with the device, compulsivity, and sleep interference in all participants (n = 41; p < 0.05, FDR-corrected). Collectively, these findings suggest that SPA is associated with aberrant structural maturation of regions important for cognitive control and emotional regulation. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gudrun M Henemann
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Larissa Götz
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Nadine D Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Tagrid Leménager
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
15
|
Hirjak D, Schmitgen MM, Werler F, Wittemann M, Kubera KM, Wolf ND, Sambataro F, Calhoun VD, Reith W, Wolf RC. Multimodal MRI data fusion reveals distinct structural, functional and neurochemical correlates of heavy cannabis use. Addict Biol 2022; 27:e13113. [PMID: 34808703 DOI: 10.1111/adb.13113] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 07/15/2021] [Revised: 09/24/2021] [Accepted: 10/29/2021] [Indexed: 12/19/2022]
Abstract
Heavy cannabis use (HCU) is frequently associated with a plethora of cognitive, psychopathological and sensorimotor phenomena. Although HCU is frequent, specific patterns of abnormal brain structure and function underlying HCU in individuals presenting without cannabis-use disorder or other current and life-time major mental disorders are unclear at present. This multimodal magnetic resonance imaging (MRI) study examined resting-state functional MRI (rs-fMRI) and structural MRI (sMRI) data from 24 persons with HCU and 16 controls. Parallel independent component analysis (p-ICA) was used to examine covarying components among grey matter volume (GMV) maps computed from sMRI and intrinsic neural activity (INA), as derived from amplitude of low-frequency fluctuations (ALFF) maps computed from rs-fMRI data. Further, we used JuSpace toolbox for cross-modal correlations between MRI-based modalities with nuclear imaging derived estimates, to examine specific neurotransmitter system changes underlying HCU. We identified two transmodal components, which significantly differed between the HCU and controls (GMV: p = 0.01, ALFF p = 0.03, respectively). The GMV component comprised predominantly cerebello-temporo-thalamic regions, whereas the INA component included fronto-parietal regions. Across HCU, loading parameters of both components were significantly associated with distinct HCU behavior. Finally, significant associations between GMV and the serotonergic system as well as between INA and the serotonergic, dopaminergic and μ-opioid receptor system were detected. This study provides novel multimodal neuromechanistic insights into HCU suggesting co-altered structure/function-interactions in neural systems subserving cognitive and sensorimotor functions.
Collapse
Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Mike M. Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Mannheim Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Mannheim Germany
| | - Miriam Wittemann
- Department of Psychiatry and Psychotherapy Saarland University Saarbrücken Germany
| | - Katharina M. Kubera
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Mannheim Germany
| | - Nadine D. Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Mannheim Germany
| | - Fabio Sambataro
- Department of Neurosciences, Padua Neuroscience Center University of Padua Padua Italy
| | - Vince D. Calhoun
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology Emory University Atlanta Georgia USA
| | - Wolfgang Reith
- Department of Neuroradiology Saarland University Saarbrücken Germany
| | - Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Mannheim Germany
| |
Collapse
|
16
|
Fritze S, Harneit A, Waddington JL, Kubera KM, Schmitgen MM, Otte ML, Geiger LS, Tost H, Meyer-Lindenberg A, Wolf RC, Hirjak D. Structural alterations in brainstem, basal ganglia and thalamus associated with parkinsonism in schizophrenia spectrum disorders. Eur Arch Psychiatry Clin Neurosci 2021; 271:1455-1464. [PMID: 33950322 PMCID: PMC8563526 DOI: 10.1007/s00406-021-01270-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/04/2021] [Accepted: 04/22/2021] [Indexed: 12/13/2022]
Abstract
The relative roles of brainstem, thalamus and striatum in parkinsonism in schizophrenia spectrum disorder (SSD) patients are largely unknown. To determine whether topographical alterations of the brainstem, thalamus and striatum contribute to parkinsonism in SSD patients, we conducted structural magnetic resonance imaging (MRI) of SSD patients with (SSD-P, n = 35) and without (SSD-nonP, n = 64) parkinsonism, as defined by a Simpson and Angus Scale (SAS) total score of ≥ 4 and < 4, respectively, in comparison with healthy controls (n = 20). FreeSurfer v6.0 was used for segmentation of four brainstem regions (medulla oblongata, pons, superior cerebellar peduncle and midbrain), caudate nucleus, putamen and thalamus. Patients with parkinsonism had significantly smaller medulla oblongata (p = 0.01, false discovery rate (FDR)-corrected) and putamen (p = 0.02, FDR-corrected) volumes when compared to patients without parkinsonism. Across the entire patient sample (n = 99), significant negative correlations were identified between (a) medulla oblongata volumes and both SAS total (p = 0.034) and glabella-salivation (p = 0.007) scores, and (b) thalamic volumes and both SAS total (p = 0.033) and glabella-salivation (p = 0.007) scores. These results indicate that brainstem and thalamic structures as well as basal ganglia-based motor circuits play a crucial role in the pathogenesis of parkinsonism in SSD.
Collapse
Affiliation(s)
- Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anais Harneit
- Research Group System Neuroscience in Psychiatry, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Marie-Luise Otte
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Lena S Geiger
- Research Group System Neuroscience in Psychiatry, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heike Tost
- Research Group System Neuroscience in Psychiatry, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Research Group System Neuroscience in Psychiatry, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| |
Collapse
|
17
|
Wolf RC, Werler F, Wittemann M, Schmitgen MM, Kubera KM, Wolf ND, Reith W, Hirjak D. Structural correlates of sensorimotor dysfunction in heavy cannabis users. Addict Biol 2021; 26:e13032. [PMID: 33951262 DOI: 10.1111/adb.13032] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/21/2021] [Accepted: 03/05/2021] [Indexed: 12/12/2022]
Abstract
Sensorimotor dysfunction has been previously reported in persons with cannabis dependence. Such individuals can exhibit increased levels of neurological soft signs (NSS), particularly involving motor coordination and sensorimotor integration. Whether such abnormalities may also apply to non-dependent individuals with heavy cannabis use (HCU) is unknown, as much as the neural correlates underlying such deficits. In this study, we investigated associations between NSS and gray matter volume (GMV) in males with HCU and male controls. Twenty-four persons with HCU and 17 controls were examined using standardized assessment of NSS and structural magnetic resonance imaging (MRI) at 3 T. GMV was calculated using voxel-based morphometry algorithms provided by the Computational Anatomy Toolbox (CAT12). Individuals with HCU showed higher NSS total scores compared to controls. In particular, significant NSS-subdomain effects were found for "motor coordination" (MoCo), "complex motor tasks" (CoMT), and "hard signs" (HS) expression in HCU (p < 0.05, Bonferroni-corrected). Compared to controls, persons with HCU showed significant NSS/GMV interactions in putamen and inferior frontal cortex (MoCo), right cerebellum (CoMT) and middle and superior frontal cortices, and bilateral precentral cortex and thalamus (HS). In between-group analyses, individuals with HCU showed lower GMV in the right anterior orbital and precentral gyrus, as well as higher GMV in the right superior frontal gyrus and left supplementary motor cortex compared to controls. The data support the notion of abnormal sensorimotor performance associated with HCU. The data also provide a neuromechanistic understanding of such deficits, particularly with respect to aberrant cortical-thalamic-cerebellar-cortical circuit.
Collapse
Affiliation(s)
- Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Miriam Wittemann
- Department of Psychiatry and Psychotherapy Saarland University Saarbrücken Germany
| | - Mike M. Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Katharina M. Kubera
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Nadine D. Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine Heidelberg University Heidelberg Germany
| | - Wolfgang Reith
- Department of Neuroradiology Saarland University Saarbrücken Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| |
Collapse
|
18
|
Depping MS, Schmitgen MM, Bach C, Listunova L, Kienzle J, Kubera KM, Roesch-Ely D, Wolf RC. Abnormal Cerebellar Volume in Patients with Remitted Major Depression with Persistent Cognitive Deficits. Cerebellum 2021; 19:762-770. [PMID: 32642931 PMCID: PMC8214579 DOI: 10.1007/s12311-020-01157-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cerebellar involvement in major depressive disorder (MDD) has been demonstrated by a growing number of studies, but it is unknown whether cognitive functioning in depressed individuals is related to cerebellar gray matter volume (GMV) abnormalities. Impaired attention and executive dysfunction are characteristic cognitive deficits in MDD, and critically, they often persist despite remission of mood symptoms. In this study, we investigated cerebellar GMV in patients with remitted MDD (rMDD) that showed persistent cognitive impairment. We applied cerebellum-optimized voxel-based morphometry in 37 patients with rMDD and with cognitive deficits, in 12 patients with rMDD and without cognitive deficits, and in 36 healthy controls (HC). Compared with HC, rMDD patients with cognitive deficits had lower GMV in left area VIIA, crus II, and in vermal area VIIB. In patients with rMDD, regression analyses demonstrated significant associations between GMV reductions in both regions and impaired attention and executive dysfunction. Compared with HC, patients without cognitive deficits showed increased GMV in bilateral area VIIIB. This study supports cerebellar contributions to the cognitive dimension of MDD. The data also point towards cerebellar area VII as a potential target for non-invasive brain stimulation to treat cognitive deficits related to MDD.
Collapse
Affiliation(s)
- Malte S Depping
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Claudia Bach
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Lena Listunova
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Johanna Kienzle
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Daniela Roesch-Ely
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - R Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany.
| |
Collapse
|
19
|
Depping MS, Schmitgen MM, Bach C, Listunova L, Kienzle J, Kubera KM, Roesch-Ely D, Wolf RC. Correction to: Abnormal Cerebellar Volume in Patients with Remitted Major Depression with Persistent Cognitive Deficits. Cerebellum 2021; 20:670. [PMID: 34146221 PMCID: PMC8360834 DOI: 10.1007/s12311-021-01294-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Malte S Depping
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Claudia Bach
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Lena Listunova
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Johanna Kienzle
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - Daniela Roesch-Ely
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany
| | - R Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115, Heidelberg, Germany.
| |
Collapse
|
20
|
Wolf RC, Kubera KM, Waddington JL, Schmitgen MM, Fritze S, Rashidi M, Thieme CE, Sambataro F, Geiger LS, Tost H, Hirjak D. A neurodevelopmental signature of parkinsonism in schizophrenia. Schizophr Res 2021; 231:54-60. [PMID: 33770626 DOI: 10.1016/j.schres.2021.03.004] [Citation(s) in RCA: 10] [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: 01/28/2021] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 12/26/2022]
Abstract
While sensorimotor abnormalities in schizophrenia (SZ) are of increasing scientific interest, little is known about structural changes and their developmental origins that may underlie parkinsonism. This multimodal magnetic resonance imaging (MRI) study examined healthy controls (HC, n = 20) and SZ patients with (SZ-P, n = 38) and without (SZ-nonP, n = 35) parkinsonism, as defined by Simpson-Angus Scale total scores of ≥4 or ≤1, respectively. Using the Computational Anatomy Toolbox (CAT12), voxel- and surface-based morphometry were applied to investigate cortical and subcortical gray matter volume (GMV) and three cortical surface markers of distinct neurodevelopmental origin: cortical thickness (CTh), complexity of cortical folding (CCF) and sulcus depth. In a subgroup of patients (29 SZ-nonP, 25 SZ-P), resting-state fMRI data were also analyzed using a regions-of-interest approach based on fractional amplitude of low frequency fluctuations (fALFF). SZ-P patients showed increased CCF in the left supplementary motor cortex (SMC) and decreased left postcentral sulcus (PCS) depth compared to SZ-nonP patients (p < 0.05, FWE-corrected at cluster level). In SMC, CCF was associated negatively with activity, which also differed significantly between the patient groups and between patients and HC. In regression models, severity of parkinsonism was associated negatively with left middle frontal CCF and left anterior cingulate CTh. These data provide novel insights into altered trajectories of cortical development in SZ patients with parkinsonism. These cortical surface changes involve the sensorimotor system, suggesting abnormal neurodevelopmental processes tightly coupled with cortical activity and subcortical morphology that convey increased risk for sensorimotor abnormalities in SZ.
Collapse
Affiliation(s)
- Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mahmoud Rashidi
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cristina E Thieme
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Lena S Geiger
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group System Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
21
|
Wolf RC, Hildebrandt V, Schmitgen MM, Pycha R, Kirchler E, Macina C, Karner M, Hirjak D, Kubera KM, Romanov D, Freudenmann RW, Huber M. Aberrant Gray Matter Volume and Cortical Surface in Paranoid-Type Delusional Disorder. Neuropsychobiology 2021; 79:335-344. [PMID: 32160619 DOI: 10.1159/000505601] [Citation(s) in RCA: 9] [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: 10/25/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Delusions are core symptoms of schizophrenia-spectrum and related disorders. Despite their clinical relevance, the neural correlates underlying such phenomena are unclear. Recent research suggests that specific delusional content may be associated with distinct neural substrates. OBJECTIVE Here, we used structural magnetic resonance imaging to investigate multiple parameters of brain morphology in patients presenting with paranoid type delusional disorder (pt-DD, n = 14) compared to those of healthy controls (HC, n = 25). METHODS Voxel- and surface-based morphometry for structural data was used to investigate gray matter volume (GMV), cortical thickness (CT) and gyrification. RESULTS Compared to HC, patients with pt-DD showed reduced GMV in bilateral amygdala and right inferior frontal gyrus. Higher GMV in patients was found in bilateral orbitofrontal and in left superior frontal cortices. Patients also had lower CT in frontal and temporal regions. Abnormal gyrification in patients was evident in frontal and temporal areas, as well as in bilateral insula. CONCLUSIONS The data suggest the presence of aberrant GMV in a right prefrontal region associated with belief evaluation, as well as distinct structural abnormalities in areas that essentially subserve processing of fear, anxiety and threat in patients with pt-DD. It is possible that cortical features of distinct evolutionary and genetic origin, i.e. CT and gyrification, contribute differently to the pathogenesis of pt-DD.
Collapse
Affiliation(s)
- Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany,
| | - Viviane Hildebrandt
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Roger Pycha
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| | - Erwin Kirchler
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| | - Christian Macina
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| | - Martin Karner
- Department of Radiology, General Hospital Bruneck, Bruneck, Italy
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Dmitry Romanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | | | - Markus Huber
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| |
Collapse
|
22
|
Kubera KM, Wolf ND, Rashidi M, Hirjak D, Northoff G, Schmitgen MM, Romanov DV, Sambataro F, Frasch K, Wolf RC. Functional Decoupling of Language and Self-Reference Networks in Patients with Persistent Auditory Verbal Hallucinations. Neuropsychobiology 2021; 79:345-351. [PMID: 32485705 DOI: 10.1159/000507630] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/29/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Accumulating neuroimaging evidence suggests that abnormal intrinsic neural activity could underlie auditory verbal hallucinations (AVH) in patients with schizophrenia. However, little is known about the functional interplay between distinct intrinsic neural networks and their association with AVH. METHODS We investigated functional network connectivity (FNC) of distinct resting-state networks as well as the relationship between FNC strength and AVH symptom severity. Resting-state functional MRI data at 3 T were obtained for 14 healthy controls and 10 patients with schizophrenia presenting with persistent AVH. The data were analyzed using a spatial group independent component analysis, followed by constrained maximal lag correlations to determine FNC within and between groups. RESULTS Four components of interest, comprising language, attention, executive control networks, as well as the default-mode network (DMN), were selected for subsequent FNC analyses. Patients with persistent AVH showed lower FNC between the language network and the DMN (p < 0.05, corrected for false discovery rate). FNC strength, however, was not significantly related to symptom severity, as measured by the Psychotic Symptom Rating Scale. CONCLUSION These findings suggest that disrupted FNC between a speech-related system and a network subserving self-referential processing is associated with AVH. The data are consistent with a model of disrupted self-attribution of speech generation and perception.
Collapse
Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Nadine D Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Mahmoud Rashidi
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Dmitry V Romanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Mental Health Research Center, Moscow, Russian Federation
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
| | - Karel Frasch
- Department of Psychiatry and Psychotherapy, District Hospital Donauwörth, Donauwörth, Germany.,Department of Psychiatry and Psychotherapy II, District Hospital Günzburg, University of Ulm, Günzburg, Germany
| | - Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany,
| |
Collapse
|
23
|
Wittemann M, Brielmaier J, Rubly M, Kennel J, Werler F, Schmitgen MM, Kubera KM, Hirjak D, Wolf ND, Reith W, Wolf RC. Cognition and Cortical Thickness in Heavy Cannabis Users. Eur Addict Res 2021; 27:115-122. [PMID: 33080597 DOI: 10.1159/000509987] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/07/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Acute and long-term adverse effects of heavy cannabis use (HCU) on neurocognitive function have been suggested, as much as regional changes of brain volume. However, little is known about the relationship between impaired cognition and brain structure in individuals with HCU. OBJECTIVE Here, we investigated associations between cognition and cortical thickness (CT) in males with HCU and male controls. METHODS Twenty-six individuals with HCU and 20 controls were examined using a comprehensive neuropsychological test battery and high-resolution structural MRI at 3T. CT was calculated using the Computational Anatomy Toolbox (CAT12). RESULTS Individuals with HCU differed from controls with respect to verbal learning performance and verbal working memory only. Individuals with HCU showed reduced CT in medial temporal, orbitofrontal, and cingulate regions, as well as in areas of the middle temporal and fusiform cortex (peak voxel family-wise error-corrected p < 0.001, followed by empirically determined correction for spatial extent) compared to HC. Verbal learning performance was associated with right entorhinal and left orbitofrontal CT reductions. Entorhinal CT was also significantly associated with amount and frequency of current weekly cannabis use. CONCLUSIONS The data support the notion of domain-specific cognitive impairment in individuals with HCU and provide a neuromechanistic understanding of such deficits, particularly with respect to abnormal CT in brain areas associated with long-term memory processing.
Collapse
Affiliation(s)
- Miriam Wittemann
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Jule Brielmaier
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany.,Department of Obstetrics and Gynecology, RKH Clinic Ludwigsburg, Ludwigsburg, Germany
| | - Mathias Rubly
- Department of Psychiatry and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Jennifer Kennel
- Department of Psychiatry and Psychotherapy, SHG-Kliniken Saarbrücken, Saarbrücken, Germany
| | - Florian Werler
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadine D Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Wolfgang Reith
- Department of Neuroradiology, Saarland University, Saarbrücken, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry at the Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,
| |
Collapse
|
24
|
Wolf RC, Rashidi M, Schmitgen MM, Fritze S, Sambataro F, Kubera KM, Hirjak D. Neurological Soft Signs Predict Auditory Verbal Hallucinations in Patients With Schizophrenia. Schizophr Bull 2020; 47:433-443. [PMID: 33097950 PMCID: PMC7965075 DOI: 10.1093/schbul/sbaa146] [Citation(s) in RCA: 12] [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] [Indexed: 12/11/2022]
Abstract
Neurological soft signs (NSS) are well documented in individuals with schizophrenia (SZ), yet so far, the relationship between NSS and specific symptom expression is unclear. We studied 76 SZ patients using magnetic resonance imaging (MRI) to determine associations between NSS, positive symptoms, gray matter volume (GMV), and neural activity at rest. SZ patients were hypothesis-driven stratified according to the presence or absence of auditory verbal hallucinations (AVH; n = 34 without vs 42 with AVH) according to the Brief Psychiatric Rating Scale. Structural MRI data were analyzed using voxel-based morphometry, whereas intrinsic neural activity was investigated using regional homogeneity (ReHo) measures. Using ANCOVA, AVH patients showed significantly higher NSS in motor and integrative functions (IF) compared with non-hallucinating (nAVH) patients. Partial correlation revealed that NSS IF were positively associated with AVH symptom severity in AVH patients. Such associations were not confirmed for delusions. In region-of-interest ANCOVAs comprising the left middle and superior temporal gyri, right paracentral lobule, and right inferior parietal lobule (IPL) structure and function, significant differences between AVH and nAVH subgroups were not detected. In a binary logistic regression model, IF scores and right IPL ReHo were significant predictors of AVH. These data suggest significant interrelationships between sensorimotor integration abilities, brain structure and function, and AVH symptom expression.
Collapse
Affiliation(s)
- Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,To whom correspondence should be addressed; Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany; tel: +49-6221-564405, fax: +49-6221-564481, e-mail:
| | - Mahmoud Rashidi
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy,Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
25
|
Fritze S, Thieme CE, Kubera KM, Northoff G, Schmitgen MM, Wolf RC, Hirjak D. Brainstem alterations contribute to catatonia in schizophrenia spectrum disorders. Schizophr Res 2020; 224:82-87. [PMID: 33046340 DOI: 10.1016/j.schres.2020.09.025] [Citation(s) in RCA: 4] [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: 04/06/2020] [Revised: 09/20/2020] [Accepted: 09/26/2020] [Indexed: 01/19/2023]
Abstract
Catatonia is a severe psychomotor syndrome that frequently occurs in patients with schizophrenia spectrum disorders (SSD). Accumulating neuroimaging evidence suggests orbitofrontal, frontoparietal and cerebellar network dysfunction in catatonia. Very little is known about contributions of brainstem regions (as part of the dopaminergic-based subcortical-cortical motor circuit) to catatonia in SSD patients. Here, we used structural magnetic resonance imaging (MRI) at 3 T to examine volumes of brainstem regions in catatonic SSD patients compared to non-catatonic SSD patients. Catatonia severity was measured with the Northoff Catatonia Rating Scale (NCRS). The segmentation of the brainstem in order to investigate the volumes of medulla oblongata, pons, superior cerebellar pedunculus, and midbrain was carried out using FreeSurfer vers. 6.0. Catatonic patients (NCRS total score ≥ 3; at least 1 point in the three different symptom categories; i.e., motor, behavioral, and affective; n = 30) had significantly smaller midbrain volumes (p = 0.004, Bonferroni corr.) when compared to non-catatonic patients (NCRS total score = 0; n = 29). In catatonic patients, significant correlations were detected between NCRS motor scores and whole brainstem (p = 0.015, Bonferroni corr.) volumes. These results support a neuromechanistically important role of brainstem structures in catatonia in SSD, particularly in motor symptom expression.
Collapse
Affiliation(s)
- Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cristina E Thieme
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| |
Collapse
|
26
|
Schneider I, Schmitgen MM, Bach C, Listunova L, Kienzle J, Sambataro F, Depping MS, Kubera KM, Roesch-Ely D, Wolf RC. Cognitive remediation therapy modulates intrinsic neural activity in patients with major depression. Psychol Med 2020; 50:2335-2345. [PMID: 31524112 DOI: 10.1017/s003329171900240x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of major depressive disorder (MDD). Cognitive remediation may improve cognition in MDD, yet so far, the underlying neural mechanisms are unclear. This study investigated changes in intrinsic neural activity in MDD after a cognitive remediation trial. METHODS In a longitudinal design, 20 patients with MDD and pronounced cognitive deficits and 18 healthy controls (HC) were examined using resting-state functional magnetic resonance imaging. MDD patients received structured cognitive remediation therapy (CRT) over 5 weeks. The whole-brain fractional amplitude of low-frequency fluctuations was computed before the first and after the last training session. Univariate methods were used to address regionally-specific effects, and a multivariate data analysis strategy was employed to investigate functional network strength (FNS). RESULTS MDD patients significantly improved in cognitive function after CRT. Baseline comparisons revealed increased right caudate activity and reduced activity in the left frontal cortex, parietal lobule, insula, and precuneus in MDD compared to HC. In patients, reduced FNS was found in a bilateral prefrontal system at baseline (p < 0.05, uncorrected). In MDD, intrinsic neural activity increased in right inferior frontal gyrus after CRT (p < 0.05, small volume corrected). Left inferior parietal lobule, left insula, left precuneus, and right caudate activity showed associations with cognitive improvement (p < 0.05, uncorrected). Prefrontal network strength increased in patients after CRT, but this increase was not associated with improved cognitive performance. CONCLUSIONS Our findings support the role of intrinsic neural activity of the prefrontal cortex as a possible mediator of cognitive improvement following CRT in MDD.
Collapse
Affiliation(s)
- Isabella Schneider
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Claudia Bach
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Lena Listunova
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Johanna Kienzle
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Malte S Depping
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Daniela Roesch-Ely
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg Germany, Voßstr. 4, 69115Heidelberg, Germany
| |
Collapse
|
27
|
Schmitgen MM, Horvath J, Mundinger C, Wolf ND, Sambataro F, Hirjak D, Kubera KM, Koenig J, Wolf RC. Neural correlates of cue reactivity in individuals with smartphone addiction. Addict Behav 2020; 108:106422. [PMID: 32403056 DOI: 10.1016/j.addbeh.2020.106422] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/23/2020] [Accepted: 03/27/2020] [Indexed: 12/15/2022]
Abstract
Popularity of smartphones has dramatically increased in the past years, accompanied by increased concerns regarding potentially adverse effects on physical and mental health. Addictive behavior associated with excessive smartphone use, frequently referred to as "smartphone addiction" (SPA), has attracted increased scientific interest. However the neural correlates of SPA are unknown. We used functional magnetic resonance imaging at 3T to investigate the neural correlates of cue reactivity (CR) in individuals with SPA (n = 21) compared to controls (n = 21). SPA was assessed using the Smartphone Addiction Inventory (SPAI), and neural activity was measured by a modified CR task. Contrasts of images of smartphones vs. neutral stimuli and stimuli including active vs. inactive smartphones (p < 0.001, uncorrected for height, followed by correction for spatial extent) were analyzed. In the first contrast, group differences in medial prefrontal (MPFC), occipital, temporal, and anterior cingulate (ACC) cortices, in temporoparietal regions, and cerebellum were found. For active vs. inactive smartphones, group differences were found in frontal operculum/anterior insula and precentral gyrus. Negative correlations were found between MPFC, ACC, precuneus, and precentral gyrus and specific SPAI subscores, i.e. compulsive behavior, functional impairment and withdrawal. This study suggests spatial similarities of CR-related brain activation between addictive smartphone use and other well-known addictive disorders.
Collapse
|
28
|
Horvath J, Mundinger C, Schmitgen MM, Wolf ND, Sambataro F, Hirjak D, Kubera KM, Koenig J, Christian Wolf R. Structural and functional correlates of smartphone addiction. Addict Behav 2020; 105:106334. [PMID: 32062336 DOI: 10.1016/j.addbeh.2020.106334] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 02/07/2023]
Abstract
Popularity and availability of smartphones have dramatically increased in the past years. This trend is accompanied by increased concerns regarding potentially adverse effects of excessive smartphone use, particularly with respect to physical and mental health. Recently, the term "smartphone addiction" (SPA) has been introduced to describe smartphone-related addictive behavior and associated physical and psychosocial impairment. Here, we used structural and functional magnetic resonance imaging (MRI) at 3 T to investigate gray matter volume (GMV) and intrinsic neural activity in individuals with SPA (n = 22) compared to a control group (n = 26). SPA was assessed using the Smartphone Addiction Inventory (SPAI), GMV was investigated by means of voxel-based morphometry, and intrinsic neural activity was measured by the amplitude of low frequency fluctuations (ALFF). Compared to controls, individuals with SPA showed lower GMV in left anterior insula, inferior temporal and parahippocampal cortex (p < 0.001, uncorrected for height, followed by correction for spatial extent). Lower intrinsic activity in SPA was found in the right anterior cingulate cortex (ACC). A significant negative association was found between SPAI and both ACC volume and activity. In addition, a significant negative association between SPAI scores and left orbitofrontal GMV was found. This study provides first evidence for distinct structural and functional correlates of behavioral addiction in individuals meeting psychometric criteria for SPA. Given their widespread use and increasing popularity, the present study questions the harmlessness of smartphones, at least in individuals that may be at increased risk for developing smartphone-related addictive behaviors.
Collapse
|
29
|
Schneider I, Schmitgen MM, Boll S, Roth C, Nees F, Usai K, Herpertz SC, Wolf RC. Oxytocin modulates intrinsic neural activity in patients with chronic low back pain. Eur J Pain 2020; 24:945-955. [PMID: 32061140 DOI: 10.1002/ejp.1543] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Modulation of pain perception by oxytocin (OXT) has attracted increased scientific and clinical interest. Neural mechanisms underlying these effects are poorly understood. In this study, we aimed to investigate the effects of intranasally applied OXT on intrinsic neural activity in patients with chronic low back pain (cLBP). METHODS Twenty-four male patients with cLBP and 23 healthy males were examined using resting-state functional magnetic resonance imaging. Participants were scanned twice and received either intranasally applied OXT (24 international units) or placebo 40 min before scanning. The fractional amplitude of low-frequency fluctuations (fALFF) was computed to investigate regionally specific effects of OXT on intrinsic neural activity. In addition a multivariate statistical data analysis strategy was employed to explore OXT-effects on functional network strength. RESULTS Differential effects of OXT were observed in cLBP and healthy controls. FALFF decreased in left nucleus accumbens and right thalamus in cLBP and increased in right thalamus in healthy controls after OXT application compared to placebo. OXT also induced activity changes in bilateral thalamus, left caudate nucleus and right amygdala in cLBP. OXT was associated with increased medial frontal, parietal and occipital functional network strength, though this effect was not group-specific. Regression analyses revealed significant associations between left nucleus accumbens, left caudate nucleus and right amygdala with pain-specific psychometric scores in cLBP. CONCLUSIONS These data suggest OXT-related modulation of regional activity and neural network strength in patients with cLBP and healthy controls. In patients, distinct regions of the pain matrix may be responsive to modulation by OXT. SIGNIFICANCE Our data suggest significant oxytocin-related modulation of intrinsic regional activity and neural network strength in patients with chronic low back pain and healthy controls. In patients, distinct regions of the pain matrix may be responsive to modulation by oxytocin. Therapeutic effects of oxytocin for improved pain treatment need to be further investigated.
Collapse
Affiliation(s)
- Isabella Schneider
- Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Sabrina Boll
- Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Corinna Roth
- Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Frauke Nees
- Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany
| | - Katrin Usai
- Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
30
|
Schmitgen MM, Kubera KM, Depping MS, Nolte HM, Hirjak D, Hofer S, Hasenkamp JH, Seidl U, Stieltjes B, Maier-Hein KH, Sambataro F, Sartorius A, Thomann PA, Wolf RC. Exploring cortical predictors of clinical response to electroconvulsive therapy in major depression. Eur Arch Psychiatry Clin Neurosci 2020; 270:253-261. [PMID: 31278421 DOI: 10.1007/s00406-019-01033-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/04/2018] [Accepted: 06/15/2019] [Indexed: 12/11/2022]
Abstract
Electroconvulsive therapy (ECT) is a rapid and highly effective treatment option for treatment-resistant major depressive disorder (TRD). The neural mechanisms underlying such beneficial effects are poorly understood. Exploring associations between changes of brain structure and clinical response is crucial for understanding ECT mechanisms of action and relevant for the validation of potential biomarkers that can facilitate the prediction of ECT efficacy. The aim of this explorative study was to identify cortical predictors of clinical response in TRD patients treated with ECT. We longitudinally investigated 12 TRD patients before and after ECT. Twelve matched healthy controls were studied cross sectionally. Demographical, clinical, and structural magnetic resonance imaging data at 3 T and multiple cortical markers derived from surface-based morphometry (SBM) analyses were considered. Multiple regression models were computed to identify predictors of clinical response to ECT, as reflected by Hamilton Depression Rating Scale (HAMD) score changes. Symptom severity differences pre-post-ECT were predicted by models including demographic data, clinical data and SBM of frontal, cingulate, and entorhinal structures. Using all-subsets regression, a model comprising HAMD score at baseline and cortical thickness of the left rostral anterior cingulate gyrus explained most variance in the data (multiple R2 = 0.82). The data suggest that SBM provides powerful measures for identifying biomarkers for ECT response in TRD. Rostral anterior cingulate thickness and HAMD score at baseline showed the greatest predictive power of clinical response, in contrast to cortical complexity, cortical gyrification, or demographical data.
Collapse
Affiliation(s)
- Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Malte S Depping
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Henrike M Nolte
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefan Hofer
- Department of Anesthesiology, Westpfalz-Klinikum GmbH, Kaiserslautern, Germany
| | - Julia H Hasenkamp
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
| | - Ulrich Seidl
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
- Department of Psychiatry and Psychotherapy, SHG-Kliniken, Saarbrücken, Germany
| | - Bram Stieltjes
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Klaus H Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Philipp A Thomann
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany
- Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vosstrasse 4, 69115, Heidelberg, Germany.
| |
Collapse
|
31
|
Hirjak D, Rashidi M, Kubera KM, Northoff G, Fritze S, Schmitgen MM, Sambataro F, Calhoun VD, Wolf RC. Multimodal Magnetic Resonance Imaging Data Fusion Reveals Distinct Patterns of Abnormal Brain Structure and Function in Catatonia. Schizophr Bull 2020; 46:202-210. [PMID: 31174212 PMCID: PMC6942158 DOI: 10.1093/schbul/sbz042] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [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] [Indexed: 12/27/2022]
Abstract
Catatonia is a nosologically unspecific syndrome, which subsumes a plethora of mostly complex affective, motor, and behavioral phenomena. Although catatonia frequently occurs in schizophrenia spectrum disorders (SSD), specific patterns of abnormal brain structure and function underlying catatonia are unclear at present. Here, we used a multivariate data fusion technique for multimodal magnetic resonance imaging (MRI) data to investigate patterns of aberrant intrinsic neural activity (INA) and gray matter volume (GMV) in SSD patients with and without catatonia. Resting-state functional MRI and structural MRI data were collected from 87 right-handed SSD patients. Catatonic symptoms were examined on the Northoff Catatonia Rating Scale (NCRS). A multivariate analysis approach was used to examine co-altered patterns of INA and GMV. Following a categorical approach, we found predominantly frontothalamic and corticostriatal abnormalities in SSD patients with catatonia (NCRS total score ≥ 3; n = 24) when compared to SSD patients without catatonia (NCRS total score = 0; n = 22) matched for age, gender, education, and medication. Corticostriatal network was associated with NCRS affective scores. Following a dimensional approach, 33 SSD patients with catatonia according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision were identified. NCRS behavioral scores were associated with a joint structural and functional system that predominantly included cerebellar and prefrontal/cortical motor regions. NCRS affective scores were associated with frontoparietal INA. This study provides novel neuromechanistic insights into catatonia in SSD suggesting co-altered structure/function-interactions in neural systems subserving coordinated visuospatial functions and motor behavior.
Collapse
Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany,To whom correspondence should be addressed; tel: 49-621-1703-0, fax: 49-621-1703-2305, e-mail:
| | - Mahmoud Rashidi
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany,Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padova, Italy
| | - Vince D Calhoun
- Department of Electrical and Computer Engineering, The University of New Mexico and the Mind Research Network, Albuquerque, NM
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
32
|
Hirjak D, Kubera KM, Northoff G, Fritze S, Bertolino AL, Topor CE, Schmitgen MM, Wolf RC. Cortical Contributions to Distinct Symptom Dimensions of Catatonia. Schizophr Bull 2019; 45:1184-1194. [PMID: 30753720 PMCID: PMC6811823 DOI: 10.1093/schbul/sby192] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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: 01/06/2023]
Abstract
Catatonia is a central aspect of schizophrenia spectrum disorders (SSD) and most likely associated with abnormalities in affective, motor, and sensorimotor brain regions. However, contributions of different cortical features to the pathophysiology of catatonia in SSD are poorly understood. Here, T1-weighted structural magnetic resonance imaging data at 3 T were obtained from 56 right-handed patients with SSD. Using FreeSurfer version 6.0, we calculated cortical thickness, area, and local gyrification index (LGI). Catatonic symptoms were examined on the Northoff catatonia rating scale (NCRS). Patients with catatonia (NCRS total score ≥3; n = 25) showed reduced surface area in the parietal and medial orbitofrontal gyrus and LGI in the temporal gyrus (P < .05, corrected for cluster-wise probability [CWP]) as well as hypergyrification in rostral cingulate and medial orbitofrontal gyrus when compared with patients without catatonia (n = 22; P < .05, corrected for CWP). Following a dimensional approach, a negative association between NCRS motor and behavior scores and cortical thickness in superior frontal, insular, and precentral cortex was found (34 patients with at least 1 motor and at least 1 other affective or behavioral symptom; P < .05, corrected for CWP). Positive associations were found between NCRS motor and behavior scores and surface area and LGI in superior frontal, posterior cingulate, precentral, and pericalcarine gyrus (P < .05, corrected for CWP). The data support the notion that cortical features of distinct evolutionary and genetic origin differently contribute to catatonia in SSD. Catatonia in SSD may be essentially driven by cortex variations in frontoparietal regions including regions implicated in the coordination and goal-orientation of behavior.
Collapse
Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,To whom correspondence should be addressed; tel: 49-621-1703-0, fax: 0049-621-1703-2305, e-mail:
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alina L Bertolino
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cristina E Topor
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
33
|
Schmitgen MM, Niedtfeld I, Schmitt R, Mancke F, Winter D, Schmahl C, Herpertz SC. Individualized treatment response prediction of dialectical behavior therapy for borderline personality disorder using multimodal magnetic resonance imaging. Brain Behav 2019; 9:e01384. [PMID: 31414575 PMCID: PMC6749487 DOI: 10.1002/brb3.1384] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 02/18/2019] [Revised: 06/05/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Individualized treatment prediction is crucial for the development and selection of personalized psychiatric interventions. Here, we use random forest classification via pretreatment clinical and demographical (CD), functional, and structural magnetic resonance imaging (MRI) data from patients with borderline personality disorder (BPD) to predict individual treatment response. METHODS Before dialectical behavior therapy (DBT), 31 female patients underwent functional (three different emotion regulation tasks) and structural MRI. DBT response was predicted using CD and MRI data in previously identified anatomical regions, which have been reported to be multimodally affected in BPD. RESULTS Amygdala and parahippocampus activation during a cognitive reappraisal task (in contrasts displaying neural activation for emotional challenge and for regulation), along with severity measures of BPD psychopathology and gray matter volume of the amygdala, provided best predictive power with neuronal hyperractivities in nonresponders. All models, except one model using CD data solely, achieved significantly better accuracy (>70.25%) than a simple all-respond model, with sensitivity and specificity of >0.7 and >0.7, as well as positive and negative likelihood ratios of >2.74 and <0.36 each. Surprisingly, a model combining all data modalities only reached rank five of seven. Among the functional tasks, only the activation elicited by a cognitive reappraisal paradigm yielded sufficient predictive power to enter the final models. CONCLUSION This proof of principle study shows that it is possible to achieve good predictions of psychotherapy outcome to find the most valid predictors among numerous variables via using a random forest classification approach.
Collapse
Affiliation(s)
- Mike M Schmitgen
- Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Inga Niedtfeld
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ruth Schmitt
- Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.,Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany
| | - Falk Mancke
- Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Dorina Winter
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
34
|
Kubera KM, Schmitgen MM, Nagel S, Hess K, Herweh C, Hirjak D, Sambataro F, Wolf RC. A search for cortical correlates of trait impulsivity in Parkinson´s disease. Behav Brain Res 2019; 369:111911. [DOI: 10.1016/j.bbr.2019.111911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/27/2019] [Accepted: 04/12/2019] [Indexed: 12/16/2022]
|
35
|
Hirjak D, Rashidi M, Fritze S, Bertolino AL, Geiger LS, Zang Z, Kubera KM, Schmitgen MM, Sambataro F, Calhoun VD, Weisbrod M, Tost H, Wolf RC. Patterns of co-altered brain structure and function underlying neurological soft signs in schizophrenia spectrum disorders. Hum Brain Mapp 2019; 40:5029-5041. [PMID: 31403239 DOI: 10.1002/hbm.24755] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 05/02/2019] [Revised: 06/28/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022] Open
Abstract
Neurological soft signs (NSS) comprise a broad range of subtle neurological deficits and are considered to represent external markers of sensorimotor dysfunction frequently found in mental disorders of presumed neurodevelopmental origin. Although NSS frequently occur in schizophrenia spectrum disorders (SSD), specific patterns of co-altered brain structure and function underlying NSS in SSD have not been investigated so far. It is unclear whether gray matter volume (GMV) alterations or aberrant brain activity or a combination of both, are associated with NSS in SSD. Here, 37 right-handed SSD patients and 37 matched healthy controls underwent motor assessment and magnetic resonance imaging (MRI) at 3 T. NSS were examined on the Heidelberg NSS scale. We used a multivariate data fusion technique for multimodal MRI data-multiset canonical correlation and joint independent component analysis (mCCA + jICA)-to investigate co-altered patterns of GMV and intrinsic neural fluctuations (INF) in SSD patients exhibiting NSS. The mCCA + jICA model indicated two joint group-discriminating components (temporoparietal/cortical sensorimotor and frontocerebellar/frontoparietal networks) and one modality-specific group-discriminating component (p < .05, FDR corrected). NSS motor score was associated with joint frontocerebellar/frontoparietal networks in SSD patients. This study highlights complex neural pathomechanisms underlying NSS in SSD suggesting aberrant structure and function, predominantly in cortical and cerebellar systems that critically subserve sensorimotor dynamics and psychomotor organization.
Collapse
Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mahmoud Rashidi
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alina L Bertolino
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lena S Geiger
- Department of Psychiatry and Psychotherapy, Research Group Systems Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Zhenxiang Zang
- Department of Psychiatry and Psychotherapy, Research Group Systems Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padova, Italy
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, New Mexico.,Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, New Mexico.,Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia
| | - Matthias Weisbrod
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.,Department of Adult Psychiatry, SRH-Klinikum, Karlsbad-Langensteinbach, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Research Group Systems Neuroscience in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
36
|
Fritze S, Bertolino AL, Kubera KM, Topor CE, Schmitgen MM, Wolf RC, Hirjak D. Differential contributions of brainstem structures to neurological soft signs in first- and multiple-episode schizophrenia spectrum disorders. Schizophr Res 2019; 210:101-106. [PMID: 31178363 DOI: 10.1016/j.schres.2019.05.041] [Citation(s) in RCA: 10] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/21/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022]
Abstract
Neurological soft signs (NSS) are frequently found in patients with schizophrenia spectrum disorders (SSD) at any stage of the disease. Brainstem structures are crucial for motor control, integration of sensory input and coordination of automatic motor actions. It is unclear whether disease duration has an impact on NSS/brainstem volume relationships. We tested the hypothesis that volumes of brainstem structures differ between first-episode psychosis (FEP) and multiple-episodes psychosis (MEP) patients with SSD, and that alterations of these structures are associated with NSS. T1-weighted structural MRI data at 3 T were obtained from 92 right-handed SSD patients (27 FEP and 65 MEP). FreeSurfer vers. 6.0 was used for segmentation of brainstem structures including the medulla oblongata, pons, superior cerebellar pedunculus (SCP), and midbrain. Multiple regression analyses were used to describe the relationship between brainstem structures and distinct NSS subdomains. In FEP, pons volume had a significant effect on NSS total score (p = 0.001, Bonferroni corr.). Further, medulla oblongata (p = 0.001, Bonferroni corr.) and pons (p = 0.001, Bonferroni corr.) volumes had a significant effect on NSS motor coordination score. In MEP, significant associations between brainstem structures and NSS levels were not found. The present data support the notion that brainstem structures play an important role in the expression of NSS in SSD individuals with FEP, in contrast to individuals with MEP. Our study also emphasizes the need of better characterizing episode-specific brainstem correlates of NSS in SSD.
Collapse
Affiliation(s)
- Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alina L Bertolino
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Cristina E Topor
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| |
Collapse
|
37
|
Kubera KM, Rashidi M, Schmitgen MM, Barth A, Hirjak D, Sambataro F, Calhoun VD, Wolf RC. Structure/function interrelationships in patients with schizophrenia who have persistent auditory verbal hallucinations: A multimodal MRI study using parallel ICA. Prog Neuropsychopharmacol Biol Psychiatry 2019; 93:114-121. [PMID: 30890460 DOI: 10.1016/j.pnpbp.2019.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 01/01/2019] [Revised: 02/28/2019] [Accepted: 03/13/2019] [Indexed: 12/22/2022]
Abstract
There is accumulating neuroimaging evidence for both structural and functional abnormalities in schizophrenia patients with persistent auditory verbal hallucinations (AVH). So far, the direct interrelationships between altered structural and functional changes underlying AVH are unknown. Recently, it has become possible to reveal hidden patterns of neural dysfunction not sufficiently captured by separate analysis of these two modalities. A data-driven fusion method called parallel independent component analysis (p-ICA) is able to identify maximally independent components of each imaging modality as well as the link between them. In the present study, we utilized p-ICA to study covarying components among gray matter volume maps computed from structural MRI (sMRI) and fractional amplitude of low-frequency fluctuations (fALFF) maps computed from resting-state functional MRI (rs-fMRI) data of 15 schizophrenia patients with AVH, 16 non-hallucinating schizophrenia patients (nAVH), and 19 healthy controls (HC). We found a significant correlation (r = 0.548, n = 50, p < .001) between a sMRI component and a rs-fMRI component, which was significantly different between the AVH and non AVH group (nAVH). The rs-fMRI component comprised temporal cortex and cortical midline regions, the sMRI component included predominantly fronto-temporo-parietal regions. Distinct clinical features, as measured by the Psychotic Symptoms Rating Scale (PSYRATS), were associated with two different modality specific rs-fMRI components. There was a significant correlation between a predominantly parietal resting-state network and the physical dimension of PSYRATS and the posterior cingulate/temporal cortex network and the emotional dimension of PSYRATS. These data suggest AVH-specific interrelationships between intrinsic network activity and GMV, together with modality-specific associations with distinct symptom dimensions of AVH.
Collapse
Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Mahmoud Rashidi
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Anja Barth
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Vince D Calhoun
- Department of Electrical and Computer Engineering, The University of New Mexico and the Mind Research Network, Albuquerque, NM, USA
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.
| |
Collapse
|
38
|
Herpertz SC, Schmitgen MM, Fuchs C, Roth C, Wolf RC, Bertsch K, Flor H, Grinevich V, Boll S. Oxytocin Effects on Pain Perception and Pain Anticipation. J Pain 2019; 20:1187-1198. [PMID: 31009765 DOI: 10.1016/j.jpain.2019.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/11/2019] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Abstract
There is an ongoing debate whether the neuropeptide oxytocin (OT) modulates pain processing in humans. This study differentiates behavioral and neuronal OT effects on pain perception and pain anticipation by using a Pavlovian conditioning paradigm. Forty-six males received intranasally administered OT in a randomized, double-blind, placebo-controlled group design. Although OT exerted no direct effect on perceived pain, OT was found to modulate the blood oxygen level-dependent response in the ventral striatum for painful versus warm unconditioned stimuli and to decrease activity in the anterior insula (IS) with repeated thermal pain stimuli. Regarding pain anticipation, OT increased responses to CSpain versus CSminus in the nucleus accumbens. Furthermore, in the OT condition increased correct expectations, particularly for the most certain conditioned stimuli (CS)-unconditioned stimuli associations (CSminus and CSpain) were found, as well as greatest deactivations in the right posterior IS in response to the least certain condition (CSwarm) with posterior IS activity and correct expectancies being positively correlated. In conclusion, OT seems to have both a direct effect on pain processing via the ventral striatum and by inducing habituation in the anterior IS as well as on pain anticipation by boostering associative learning in general and the neuronal conditioned fear of pain response in particular. PERSPECTIVE: The neuropeptide OT has recently raised the hope to offer a novel avenue for modulating pain experience. This study found OT to modulate pain processing and to facilitate the anticipation of pain, inspiring further research on OT effects on the affective dimension of the pain experience.
Collapse
Affiliation(s)
- Sabine C Herpertz
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Mike M Schmitgen
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christine Fuchs
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Corinna Roth
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Robert Christian Wolf
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health Mannheim, University of Heidelberg, Mannheim, Germany
| | - Valery Grinevich
- Schaller Research Group on Neuropeptides, German Cancer Research Center DKFZ, Heidelberg, Germany
| | - Sabrina Boll
- Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| |
Collapse
|
39
|
Schmitgen MM, Depping MS, Bach C, Wolf ND, Kubera KM, Vasic N, Hirjak D, Sambataro F, Wolf RC. Aberrant cortical neurodevelopment in major depressive disorder. J Affect Disord 2019; 243:340-347. [PMID: 30261449 DOI: 10.1016/j.jad.2018.09.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 01/09/2018] [Revised: 08/07/2018] [Accepted: 09/10/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is strong neuroimaging evidence that cortical alterations represent a core pathophysiological feature of major depressive disorder (MDD). Differential contributions of cortical features of neurodevelopmental origin, which may distinctly contribute to MDD vulnerability, disease-onset, or symptom expression, are unclear at present. METHODS We investigated distinct markers of cortical neurodevelopment, i.e. local cortical gyrification (LGI) and thickness (CT) in patients with MDD (n = 38) and healthy controls (HC, n = 22) using 3 T structural magnetic resonance imaging data and surface-based data analysis techniques. CT and LGI were computed using the Computational Anatomy Toolbox (CAT12). Analyses were performed for the entire cortical surface followed by a complementary regions-of-interest approach. RESULTS MDD patients showed significantly greater LGI in frontal, cingulate, parietal, temporal, and occipital regions compared to HC (FDR-corrected at p < 0.05 using threshold-free cluster enhancement). No significant differences of CT were found. In the MDD-group, correlations were found between duration of illness in years and number of depressive episodes and LGI of frontal, temporal, and parietal regions (p < 0.05). LIMITATIONS Main limitations are the relatively modest sample size and a cross-sectional study design. We did not control for early environmental factors potentially influencing neurodevelopment, such as childhood trauma. We report associations uncorrected for multiple comparisons. CONCLUSIONS The data suggest different local trajectories of cortical change in MDD. In addition, our data support the notion that aberrant cortical development may serve as a vulnerability marker of MDD, as well as a potential predictor of disease course.
Collapse
Affiliation(s)
- Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115 Heidelberg, Germany
| | - Malte S Depping
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115 Heidelberg, Germany
| | - Claudia Bach
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115 Heidelberg, Germany
| | - Nadine D Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115 Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115 Heidelberg, Germany
| | - Nenad Vasic
- Department of Psychiatry and Psychotherapy, Clinical Center Christophsbad, Göppingen, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Italy
| | - Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Vosstrasse 4, 69115 Heidelberg, Germany.
| |
Collapse
|
40
|
Depping MS, Thomann PA, Wolf ND, Vasic N, Sosic-Vasic Z, Schmitgen MM, Sambataro F, Wolf RC. Common and distinct patterns of abnormal cortical gyrification in major depression and borderline personality disorder. Eur Neuropsychopharmacol 2018; 28:1115-1125. [PMID: 30119924 DOI: 10.1016/j.euroneuro.2018.07.100] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 12/07/2017] [Revised: 06/15/2018] [Accepted: 07/17/2018] [Indexed: 12/11/2022]
Abstract
Abnormal gray matter volume has been consistently reported in patients with major depressive disorder (MDD), but markers of cortical neurodevelopment have been rarely investigated. Also, it is unclear whether there exist common versus distinct spatial patterns of abnormal cortical development across different disorders presenting with negative emotions and deficient affective regulation. In this study, we used structural MRI at 3T to investigate the local gyrification index (LGI), a marker of fetal/infant neurodevelopment, in adult female patients with MDD (n = 22), in adult female patients with borderline personality disorder (BPD) (n = 17), and in controls (n = 22). Reduced cortical folding of the precuneus, the superior parietal gyrus and the parahippocampal gyrus was found in both MDD and BPD patients when compared to controls (p < 0.05, cluster-wise probability [CWP] corrected). MDD patients showed additional hypogyrification of the middle frontal gyrus and the fusiform gyrus when compared to both controls and BPD patients (p < 0.05, CWP corrected). In MDD patients, lower LGI of prefrontal regions was significantly associated with the age of disease onset and with the number of depressive episodes. In BPD patients, lower LGI of orbitofrontal regions was associated with impulsivity. Our findings suggest abnormal early cortical development in MDD, affecting brain regions that have been frequently implied in MDD pathophysiology. However, LGI abnormalities may not be specific for MDD, since MDD and BPD patients also exhibited common patterns of hypogyrification. Hypogyrification of cortical regions associated with higher-order cognition appears to be most pronounced in MDD. Abnormal early cortical neurodevelopment may mediate vulnerability to disorders of emotion.
Collapse
Affiliation(s)
- Malte S Depping
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | | | - Nadine D Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Nenad Vasic
- Clinical Center Christophsbad, Department of Psychiatry and Psychotherapy, Göppingen, Germany
| | | | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Italy
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Germany.
| |
Collapse
|
41
|
Kubera KM, Schmitgen MM, Maier-Hein KH, Thomann PA, Hirjak D, Wolf RC. Differential contributions of cortical thickness and surface area to trait impulsivity in healthy young adults. Behav Brain Res 2018; 350:65-71. [DOI: 10.1016/j.bbr.2018.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/26/2018] [Accepted: 05/07/2018] [Indexed: 01/21/2023]
|
42
|
Eckstein M, Zietlow AL, Fungisai Gerchen M, Schmitgen MM, Kirsch P, Ditzen B. Proof of Method: A Neurofeedback-Based Intervention for Postpartum Bonding Disorders (The „NeMuK“-Study). Psychother Psych Med 2018. [DOI: 10.1055/s-0038-1668002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Eckstein
- Universitätsklinikum Heidelberg, Zentrum für Psychosoziale Medizin (ZPM), Institut für Medizinische Psychologie, Heidelberg, Deutschland
| | - AL Zietlow
- Universitätsklinikum Heidelberg, Zentrum für Psychosoziale Medizin (ZPM), Institut für Medizinische Psychologie, Heidelberg, Deutschland
| | - M Fungisai Gerchen
- Department of Clinical Psychology, Central Institute for Mental Health (CIMH), Mannheim, Deutschland
| | - MM Schmitgen
- General Psychiatry, Center for Psychosocial Medicine (CPM), University Hospital Heidelberg, Heidelberg, Deutschland
| | - P Kirsch
- Department of Clinical Psychology, Central Institute for Mental Health (CIMH), Mannheim, Deutschland
| | - B Ditzen
- Universitätsklinikum Heidelberg, Zentrum für Psychosoziale Medizin (ZPM), Institut für Medizinische Psychologie, Heidelberg, Deutschland
| |
Collapse
|
43
|
Abstract
Extending beyond the motor domain, the cerebellum is involved in various aspects of cognition and affect. Multidisciplinary evidence has demonstrated topographic organization of higher-order cognitive functions within the cerebellum. We here review recent neuroimaging research that indicates cerebellar contributions to major depressive disorder (MDD). At the structural level, increased volume of lobule IX has been demonstrated in MDD patients, independent of acute or remitted disease state. Successful treatment with electroconvulsive therapy has been associated with increased lobule VIIA volume in depressed patients. At the functional level, connectivity analyses have shown reduced cerebro-cerebellar coupling of lobules VI and VIIA/B with prefrontal, posterior parietal, and limbic regions in patients with MDD. As a limitation, most of this evidence is based on smaller patient samples with incomplete phenotypic and neuropsychological characterization and with heterogenous medication. Some studies did not apply cerebellum-optimized data analysis protocols. Taken together, MDD pathophysiology affects distinct subregions of the cerebellum that communicate with cortical networks subserving cognitive and self-referential processing. This mini-review synthesizes research evidence from cerebellar structural and functional neuroimaging in depression, and provides future perspectives for neuroimaging of cerebellar contributions to MDD.
Collapse
Affiliation(s)
- Malte S Depping
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Mike M Schmitgen
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
44
|
Schmitgen MM, Walter H, Drost S, Rückl S, Schnell K. Stimulus-dependent amygdala involvement in affective theory of mind generation. Neuroimage 2016; 129:450-459. [PMID: 26803059 DOI: 10.1016/j.neuroimage.2016.01.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 12/11/2015] [Accepted: 01/12/2016] [Indexed: 01/03/2023] Open
Abstract
Successful social interaction requires knowledge about another person's emotional states, represented in an affective theory of mind (ToM). This information can be acquired either directly or indirectly, i.e., by observing emotional facial expressions (EFE) or indirectly by inferring emotions through cognitive perspective taking. Therefore, it is of great interest how the function of the cortical ToM network and the limbic system in affective ToM depends on the presence of facial expressions. We addressed this question in a functional magnetic resonance imaging (fMRI) study. The experimental paradigm applied a well-established ToM cartoon task to test functional effects of EFE on the activation of the amygdala and the anterior ToM network during affective ToM judgments. During the task, 22 healthy participants had to judge the changes of the emotional state of the stories protagonist in the presence or absence of EFE. After quality control, 21 data sets entered the final analyses. The presence of EFE during affective ToM judgments was associated with shorter reaction times as well as increased activation of the right amygdala, most probably located in the basolateral nucleus (BLA), coincident with reduced activation of ToM-related regions of the prefrontal cortex. Psychophysiological interactions (PPI) revealed EFE-dependent modulation of connectivity between the right BLA and the contralateral ToM network regions. In combination with the functional interaction of EFE and affective ToM in the right amygdala, our data suggest a complementary but parallel organization of EFE processing and affective ToM. In this framework, the amygdala seems to act as an EFE detector when affective ToM judgments are demanded. Additionally, the facts that EFE induced exclusively right-sided amygdala activation and modulated the connectivity with the contralateral ToM network support the idea of a functional lateralization of stimulus driven components of affective ToM.
Collapse
Affiliation(s)
- Mike M Schmitgen
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany; Division of Medical Psychology, University of Bonn, Bonn, Germany.
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany; Division of Medical Psychology, University of Bonn, Bonn, Germany.
| | - Sarah Drost
- Division of Medical Psychology, University of Bonn, Bonn, Germany.
| | - Sarah Rückl
- Department of Mental Health, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Knut Schnell
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany; Division of Medical Psychology, University of Bonn, Bonn, Germany.
| |
Collapse
|