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Rubia K, Johansson L, Carter B, Stringer D, Santosh P, Mehta MA, Conti AA, Bozhilova N, Eraydin IE, Cortese S. The efficacy of real versus sham external Trigeminal Nerve Stimulation (eTNS) in youth with Attention-Deficit/Hyperactivity Disorder (ADHD) over 4 weeks: a protocol for a multi-centre, double-blind, randomized, parallel-group, phase IIb study (ATTENS). BMC Psychiatry 2024; 24:326. [PMID: 38689273 PMCID: PMC11059677 DOI: 10.1186/s12888-024-05650-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/01/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Attention Deficit/Hyperactivity Disorder (ADHD), if severe, is usually treated with stimulant or non-stimulant medication. However, users prefer non-drug treatments due to side effects. Alternative non-medication treatments have so far only shown modest effects. External trigeminal nerve stimulation (eTNS) is a minimal risk, non-invasive neuromodulation device, targeting the trigeminal system. It was approved for ADHD in 2019 by the USA Food and Drug administration (FDA) based on a small proof of concept randomised controlled trial (RCT) in 62 children with ADHD showing improvement of ADHD symptoms after 4 weeks of nightly real versus sham eTNS with minimal side effects. We present here the protocol of a larger confirmatory phase IIb study testing efficacy, longer-term persistency of effects and underlying mechanisms of action. METHODS A confirmatory, sham-controlled, double-blind, parallel-arm, multi-centre phase IIb RCT of 4 weeks of eTNS in 150 youth with ADHD, recruited in London, Portsmouth, and Southampton, UK. Youth with ADHD will be randomized to either real or sham eTNS, applied nightly for 4 weeks. Primary outcome is the change in the investigator-administered parent rated ADHD rating scale. Secondary outcomes are other clinical and cognitive measures, objective hyperactivity and pupillometry measures, side effects, and maintenance of effects over 6 months. The mechanisms of action will be tested in a subgroup of 56 participants using magnetic resonance imaging (MRI) before and after the 4-week treatment. DISCUSSION This multi-centre phase IIb RCT will confirm whether eTNS is effective in a larger age range of children and adolescents with ADHD, whether it improves cognition and other clinical measures, whether efficacy persists at 6 months and it will test underlying brain mechanisms. The results will establish whether eTNS is effective and safe as a novel non-pharmacological treatment for ADHD. TRIAL REGISTRATION ISRCTN82129325 on 02/08/2021, https://doi.org/10.1186/ISRCTN82129325 .
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Affiliation(s)
- Katya Rubia
- Department of Child & Adolescent Psychiatry/PO46 Institute of Psychiatry, Psychology & Neurosciences King's College London, De Crespigny Park, London, SE5 8AF, UK.
- Department of Child & Adolescent Psychiatry, Technical University, Dresden, Germany.
| | - Lena Johansson
- Department of Child & Adolescent Psychiatry/PO46 Institute of Psychiatry, Psychology & Neurosciences King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- King's Clinical Trial Unit, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dominic Stringer
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- King's Clinical Trial Unit, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paramala Santosh
- Department of Child & Adolescent Psychiatry/PO46 Institute of Psychiatry, Psychology & Neurosciences King's College London, De Crespigny Park, London, SE5 8AF, UK
- National and Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK
| | - Mitul A Mehta
- Department for Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Aldo Alberto Conti
- Department of Child & Adolescent Psychiatry/PO46 Institute of Psychiatry, Psychology & Neurosciences King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Natali Bozhilova
- Department of Child & Adolescent Psychiatry/PO46 Institute of Psychiatry, Psychology & Neurosciences King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Irem Ece Eraydin
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- SOLENT NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Center, New York City, NY, USA
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Pick S, Millman LM, Ward E, Short E, Stanton B, Reinders AS, Winston JS, Nicholson TR, Edwards MJ, Goldstein LH, David AS, Chalder T, Hotopf M, Mehta MA. Unravelling the influence of affective stimulation on functional neurological symptoms: a pilot experiment examining potential mechanisms. J Neurol Neurosurg Psychiatry 2024; 95:461-470. [PMID: 37963722 DOI: 10.1136/jnnp-2023-332364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Differences in affective processing have previously been shown in functional neurological disorder (FND); however, the mechanistic relevance is uncertain. We tested the hypotheses that highly arousing affective stimulation would result in elevated subjective functional neurological symptoms (FNS), and this would be associated with elevated autonomic reactivity. The possible influence of cognitive detachment was also explored. METHOD Individuals diagnosed with FND (motor symptoms/seizures; n=14) and healthy controls (n=14) viewed Positive, Negative and Neutral images in blocks, while passively observing the stimuli ('Watch') or detaching themselves ('Distance'). The FND group rated their primary FNS, and all participants rated subjective physical (arousal, pain, fatigue) and psychological states (positive/negative affect, dissociation), immediately after each block. Skin conductance (SC) and heart rate (HR) were monitored continuously. RESULTS FNS ratings were higher after Negative compared with Positive and Neutral blocks in the FND group (p=0.002, ηp 2=0.386); however, this effect was diminished in the Distance condition relative to the Watch condition (p=0.018, ηp 2=0.267). SC and/or HR correlated with FNS ratings in the Negative-Watch and Neutral-Distance conditions (r values=0.527-0.672, p values=0.006-0.035). The groups did not differ in subjective affect or perceived arousal (p values=0.541-0.919, ηp 2=<0.001-0.015). CONCLUSIONS Emotionally significant events may exert an influence on FNS which is related to autonomic activation rather than altered subjective affect or perceived arousal. This influence may be modulated by cognitive detachment. Further work is needed to determine the relevance and neural bases of these processes in specific FND phenotypes.
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Affiliation(s)
- Susannah Pick
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Ls Merritt Millman
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Emily Ward
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Eleanor Short
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Biba Stanton
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Aat Simone Reinders
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Joel S Winston
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Timothy R Nicholson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mark J Edwards
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Laura H Goldstein
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Anthony S David
- Institute of Mental Health, University College London, London, UK
| | - Trudie Chalder
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Matthew Hotopf
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Mitul A Mehta
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Millman LSM, Short E, Ward E, Stanton B, Bradley-Westguard A, Goldstein LH, Winston JS, Mehta MA, Nicholson TR, Reinders AATS, David AS, Edwards MJ, Chalder T, Hotopf M, Pick S. Etiological Factors and Symptom Triggers in Functional Motor Symptoms and Functional Seizures: A Pilot Investigation. J Neuropsychiatry Clin Neurosci 2024:appineuropsych20230103. [PMID: 38481167 DOI: 10.1176/appi.neuropsych.20230103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE This study examined etiological factors and symptom triggers of functional motor symptoms (FMS) or functional seizures (FS) and assessed potential relationships with relevant clinical features (i.e., functional symptoms, quality of life, and general functioning). METHODS Seventeen participants with FMS or FS and 17 healthy control participants underwent an in-depth clinical interview and completed questionnaires assessing adverse life events, psychological and physical symptoms, alexithymia, autistic traits, illness perceptions, health-related quality of life (HRQoL), and work and social functioning. RESULTS Participants with FMS or FS perceived various causes of the disorder, including physical symptoms (65%), emotional problems (53%), adverse life events (47%), and work-related factors (29%). Triggers of FMS and FS included physical activity or exertion (59%), stress and emotions (59%), sensory experiences (47%), and fatigue (41%). Compared with healthy control participants, participants with FMS or FS reported more adverse events during adolescence and higher levels of alexithymia, somatoform dissociation, psychological dissociation (disengagement, depersonalization, and derealization), anxiety, depression, and physical symptoms. Participants with FMS or FS had worse HRQoL than healthy control participants and impaired work and social functioning. There were inverse associations between HRQoL scores and somatoform dissociation, anxiety, and adverse life events. CONCLUSIONS Participants with FMS or FS reported diverse biopsychosocial etiological factors and symptom triggers. Ongoing psychological symptoms and lifetime adverse experiences were associated with worse HRQoL. Future studies will examine these factors in larger samples of individuals with FMS or FS to better understand their shared and distinct etiological underpinnings.
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Affiliation(s)
- L S Merritt Millman
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Eleanor Short
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Emily Ward
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Biba Stanton
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Abigail Bradley-Westguard
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Laura H Goldstein
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Joel S Winston
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Antje A T S Reinders
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Anthony S David
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Mark J Edwards
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Trudie Chalder
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Susannah Pick
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
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Mehta MA. Improving Attention as a Treatment for Cocaine Use Disorder: Initial, Mechanistic Steps. Biol Psychiatry Cogn Neurosci Neuroimaging 2024; 9:251-252. [PMID: 38458696 DOI: 10.1016/j.bpsc.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
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Biaggi A, Hazelgrove K, Waites F, Bind RH, Lawrence AJ, Fuste M, Conroy S, Howard LM, Mehta MA, Miele M, Seneviratne G, Pawlby S, Pariante CM, Dazzan P. Mother-infant interaction and infant development in women at risk of postpartum psychosis with and without a postpartum relapse. Psychol Med 2024; 54:823-834. [PMID: 37706314 DOI: 10.1017/s0033291723002568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND This study aimed to investigate mother-infant interaction and infant development in women at-risk of postpartum psychosis (PP), with and without a postpartum relapse. METHODS 103 women (and their offspring) were included, 43 at-risk-of-PP because of a diagnosis of bipolar disorder, schizoaffective disorder or previous PP, and 60 with no current/previous mental illness or family history of PP. Of the at-risk women, 18 developed a psychiatric relapse within 4 weeks after delivery (AR-unwell), while 25 remained symptom-free (AR-well). Mother-infant interaction was assessed using the CARE-Index at 8 weeks' and 12 months' postpartum and infant development using the Bayley-III at 12 months' postpartum. RESULTS Women at-risk-of-PP as a group, regardless of whether they developed a psychiatric relapse within 4 weeks after delivery, had less synchronous mother-infant interactions and had infants with less optimal cognitive, language, motor and socio-emotional development than healthy controls. In particular, boys of at-risk women had the lowest scores in cognitive, language and motor development and in mother-infant interaction, while girls of the at-risk women had the lowest scores in socio-emotional development. The synchrony in the dyad predicted infant cognitive and language development. There was no evidence for a difference in mother-infant interaction nor in infant development between the AR-unwell and AR-well groups. CONCLUSIONS These results suggest that, while there is a lack of evidence that an early postpartum relapse in women at-risk-of-PP could represent a risk for the infant per se, maternal risk for PP may be associated with less optimal mother-infant interaction and infant development.
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Affiliation(s)
- Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Freddie Waites
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Montserrat Fuste
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- Perinatal Parent-Infant Mental Health Service, Goodmayes Hospital, North East London Foundation Trust, London, IG3 8XD, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Mitul A Mehta
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, SE5 8AF, UK
| | - Maddalena Miele
- Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, W2 1PF, UK
| | - Gertrude Seneviratne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Alexander L, Hawkins PCT, Evans JW, Mehta MA, Zarate CA. Preliminary evidence that ketamine alters anterior cingulate resting-state functional connectivity in depressed individuals. Transl Psychiatry 2023; 13:371. [PMID: 38040678 PMCID: PMC10692230 DOI: 10.1038/s41398-023-02674-1] [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: 04/28/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023] Open
Abstract
Activity changes within the anterior cingulate cortex (ACC) are implicated in the antidepressant effects of ketamine, but the ACC is cytoarchitectonically and functionally heterogeneous and ketamine's effects may be subregion specific. In the context of a double-blind randomized placebo-controlled crossover trial investigating the clinical and resting-state fMRI effects of intravenous ketamine vs. placebo in patients with treatment resistant depression (TRD) vs. healthy volunteers (HV), we used seed-based resting-state functional connectivity (rsFC) analyses to determine differential changes in subgenual ACC (sgACC), perigenual ACC (pgACC) and dorsal ACC (dACC) rsFC two days post-infusion. Across cingulate subregions, ketamine differentially modulated rsFC to the right insula and anterior ventromedial prefrontal cortex, compared to placebo, in TRD vs. HV; changes to pgACC-insula connectivity correlated with improvements in depression scores. Post-hoc analysis of each cingulate subregion separately revealed differential modulation of sgACC-hippocampal, sgACC-vmPFC, pgACC-posterior cingulate, and dACC-supramarginal gyrus connectivity. By comparing rsFC changes following ketamine vs. placebo in the TRD group alone, we found that sgACC rsFC was most substantially modulated by ketamine vs. placebo. Changes to sgACC-pgACC, sgACC-ventral striatal, and sgACC-dACC connectivity correlated with improvements in anhedonia symptoms. This preliminary evidence suggests that accurate segmentation of the ACC is needed to understand the precise effects of ketamine's antidepressant and anti-anhedonic action.
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Affiliation(s)
- Laith Alexander
- Institute of Psychiatry, Psychology and Neuroscience, King's College London & Centre for Neuroimaging Sciences, King's College London, London, UK.
| | - Peter C T Hawkins
- Institute of Psychiatry, Psychology and Neuroscience, King's College London & Centre for Neuroimaging Sciences, King's College London, London, UK
| | - Jennifer W Evans
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London & Centre for Neuroimaging Sciences, King's College London, London, UK
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
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Pick S, Millman LM, Sun Y, Short E, Stanton B, Winston JS, Mehta MA, Nicholson TR, Reinders AA, David AS, Edwards MJ, Goldstein LH, Hotopf M, Chalder T. Objective and subjective neurocognitive functioning in functional motor symptoms and functional seizures: preliminary findings. J Clin Exp Neuropsychol 2023; 45:970-987. [PMID: 37724767 PMCID: PMC11057846 DOI: 10.1080/13803395.2023.2245110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/30/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION This study aimed to provide a preliminary assessment of objective and subjective neurocognitive functioning in individuals with functional motor symptoms (FMS) and/or functional seizures (FS). We tested the hypotheses that the FMS/FS group would display poorer objective attentional and executive functioning, altered social cognition, and reduced metacognitive accuracy. METHOD Individuals with FMS/FS (n = 16) and healthy controls (HCs, n = 17) completed an abbreviated CANTAB battery, and measures of intellectual functioning, subjective cognitive complaints, performance validity, and comorbid symptoms. Subjective performance ratings were obtained to assess local metacognitive accuracy. RESULTS The groups were comparable in age (p = 0.45), sex (p = 0.62), IQ (p = 0.57), and performance validity (p-values = 0.10-0.91). We observed no impairment on any CANTAB test in this FMS/FS sample compared to HCs, although the FMS/FS group displayed shorter reaction times on the Emotional Bias task (anger) (p = 0.01, np2 = 0.20). The groups did not differ in subjective performance ratings (p-values 0.15). Whilst CANTAB attentional set-shifting performance (total trials/errors) correlated with subjective performance ratings in HCs (p-values<0.005, rs = -0.85), these correlations were non-significant in the FMS/FS sample (p-values = 0.10-0.13, rs-values = -0.46-0.50). The FMS/FS group reported more daily cognitive complaints than HCs (p = 0.006, g = 0.92), which were associated with subjective performance ratings on CANTAB sustained attention (p = 0.001, rs = -0.74) and working memory tests (p < 0.001, rs = -0.75), and with depression (p = 0.003, rs = 0.70), and somatoform (p = 0.003, rs = 0.70) and psychological dissociation (p-values<0.005, rs-values = 0.67-0.85). CONCLUSIONS These results suggest a discordance between objective and subjective neurocognitive functioning in this FMS/FS sample, reflecting intact test performance alongside poorer subjective cognitive functioning. Further investigation of neurocognitive functioning in FND subgroups is necessary.
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Affiliation(s)
- Susannah Pick
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - L.S. Merritt Millman
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Yiqing Sun
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Eleanor Short
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Biba Stanton
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Joel S. Winston
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Mitul A. Mehta
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Timothy R. Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | | | | | - Mark J. Edwards
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Laura H. Goldstein
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
- South London and Maudsley NHS Foundation Trust, UK
| | - Trudie Chalder
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
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Yalin N, Kempton MJ, Mazibuko N, Mehta MA, Young AH, Stokes PRA. Acute effects of mifepristone on emotional processing related brain activity: A functional MRI study. Eur Neuropsychopharmacol 2023; 77:93-102. [PMID: 37742397 DOI: 10.1016/j.euroneuro.2023.08.500] [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: 03/09/2023] [Revised: 08/15/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
The Hypothalamic-pituitary-adrenal (HPA) axis plays an important role in the pathophysiology of mood disorders, and preliminary data suggests that glucocorticoid receptor (GR) antagonism may be an important therapeutic mechanism. The effects of modulating HPA axis function on emotional processing related brain activity, which may be abnormal in depressed mood, is poorly understood. This study used a pharmacological functional magnetic resonance imaging (fMRI) design to determine the effects of the GR and progesterone receptor antagonist mifepristone on emotional faces processing task related brain activations in 19 right-handed healthy male participants. Each participant received 600 mg mifepristone or placebo on two separate imaging days and then performed an emotional processing fMRI task four hours later. The effect of mifepristone on task related brain activations was determined using Region-of-Interest (ROI) analyses and an exploratory whole brain voxel-wise analyses. No significant changes were observed in the defined ROIs (amygdala, anterior cingulate cortex, insula) or in the exploratory whole brain analyses that was associated with mifepristone administration in either the angry vs happy faces or angry and happy faces vs implicit baseline contrasts. Task reaction times and accuracy were similar in both mifepristone and placebo conditions (all p > 0.05). Our study failed to show significant evidence of modulation of emotional processing related brain activity associated with acute mifepristone administration. Future research should use fMRI to investigate the longer-term administration effects of mifepristone on mood in healthy participants and people with mood disorders to provide a deeper understanding of the potential effects on depressive symptoms.
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Affiliation(s)
- Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College of London, UK.
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology &Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Ndaba Mazibuko
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College of London, UK
| | - Paul R A Stokes
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College of London, UK
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9
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Jelen LA, Young AH, Mehta MA. Opioid Mechanisms and the Treatment of Depression. Curr Top Behav Neurosci 2023. [PMID: 37923934 DOI: 10.1007/7854_2023_448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Opioid receptors are widely expressed in the brain, and the opioid system has a key role in modulating mood, reward processing and stress responsivity. There is mounting evidence that the endogenous opioid system may be dysregulated in depression and that drug treatments targeting mu, delta and kappa opioid receptors may show antidepressant potential. The mechanisms underlying the therapeutic effects of opioid system engagement are complex and likely multi-factorial. This chapter explores various pathways through which the modulation of the opioid system may influence depression. These include impacts on monoaminergic systems, the regulation of stress and the hypothalamic-pituitary-adrenal axis, the immune system and inflammation, brain-derived neurotrophic factors, neurogenesis and neuroplasticity, social pain and social reward, as well as expectancy and placebo effects. A greater understanding of the diverse mechanisms through which opioid system modulation may improve depressive symptoms could ultimately aid in the development of safe and effective alternative treatments for individuals with difficult-to-treat depression.
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Affiliation(s)
- Luke A Jelen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
| | - Allan H Young
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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10
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O' Brien S, Sethi A, Blair J, Viding E, Beyh A, Mehta MA, Dallyn R, Ecker C, Petrinovic MM, Doolan M, Blackwood N, Catani M, Murphy DGM, Scott S, Craig MC. Rapid white matter changes in children with conduct problems during a parenting intervention. Transl Psychiatry 2023; 13:339. [PMID: 37925439 PMCID: PMC10625622 DOI: 10.1038/s41398-023-02635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/27/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023] Open
Abstract
Studies report that the microstructural integrity of the uncinate fasciculus (UF; connecting the anterior temporal lobe to the orbitofrontal cortex) is abnormal in adults with psychopathy and children with conduct problems (CP), especially those with high callous-unemotional (CU) traits. However, it is unknown if these abnormalities are 'fixed' or 'reversible'. Therefore, we tested the hypothesis that a reduction in CP symptoms, following a parenting intervention, would be associated with altered microstructural integrity in the UF. Using diffusion tensor imaging tractography we studied microstructural differences (mean diffusivity (MD) and radial diffusivity (RD)) in the UF of 43 typically developing (TD) and 67 boys with CP before and after a 14-week parenting intervention. We also assessed whether clinical response in CP symptoms or CU traits explained changes in microstructure following the intervention. Prior to intervention, measures of MD and RD in the UF were increased in CP compared to TD boys. Following intervention, we found that the CP group had a significant reduction in RD and MD. Further, these microstructural changes were driven by the group of children whose CU traits improved (but not CP symptoms as hypothesized). No significant microstructural changes were observed in the TD group. Our findings suggest, for the first time, that microstructural abnormalities in the brains of children with CP may be reversible following parenting intervention.
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Affiliation(s)
- Suzanne O' Brien
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. suzanne.o'
| | - Arjun Sethi
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James Blair
- Research Unit at Child and Adolescent Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Ahmad Beyh
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robert Dallyn
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, University Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Marija M Petrinovic
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Moira Doolan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nigel Blackwood
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Declan G M Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephen Scott
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael C Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Female Hormone Clinic, Maudsley Hospital, London, UK
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11
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Puledda F, Dipasquale O, Gooddy BJM, Karsan N, Bose R, Mehta MA, Williams SCR, Goadsby PJ. Abnormal Glutamatergic and Serotonergic Connectivity in Visual Snow Syndrome and Migraine with Aura. Ann Neurol 2023; 94:873-884. [PMID: 37466404 DOI: 10.1002/ana.26745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/22/2023] [Accepted: 07/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Neuropharmacological changes in visual snow syndrome (VSS) are poorly understood. We aimed to use receptor target maps combined with resting functional magnetic resonance imaging (fMRI) data to identify which neurotransmitters might modulate brain circuits involved in VSS. METHODS We used Receptor-Enriched Analysis of Functional Connectivity by Targets (REACT) to estimate and compare the molecular-enriched functional networks related to 5 neurotransmitter systems of patients with VSS (n = 24), healthy controls (HCs; n = 24), and migraine patients ([MIG], n = 25, 15 of whom had migraine with aura [MwA]). For REACT we used receptor density templates for the transporters of noradrenaline, dopamine, and serotonin, GABA-A and NMDA receptors, as well as 5HT1B and 5HT2A receptors, and estimated the subject-specific voxel-wise maps of functional connectivity (FC). We then performed voxel-wise comparisons of these maps among HCs, MIG, and VSS. RESULTS Patients with VSS had reduced FC in glutamatergic networks localized in the anterior cingulate cortex (ACC) compared to HCs and patients with migraine, and reduced FC in serotoninergic networks localized in the insula, temporal pole, and orbitofrontal cortex compared to controls, similar to patients with migraine with aura. Patients with VSS also showed reduced FC in 5HT2A -enriched networks, largely localized in occipito-temporo-parietal association cortices. As revealed by subgroup analyses, these changes were independent of, and analogous to, those found in patients with migraine with aura. INTERPRETATION Our results show that glutamate and serotonin are involved in brain connectivity alterations in areas of the visual, salience, and limbic systems in VSS. Importantly, altered serotonergic connectivity is independent of migraine in VSS, and simultaneously comparable to that of migraine with aura, highlighting a shared biology between the disorders. ANN NEUROL 2023;94:873-884.
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Affiliation(s)
- Francesca Puledda
- Headache Group, Wolfson SPaRRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) King's Clinical Research Facility, King's College London, London, UK
| | - Ottavia Dipasquale
- National Institute for Health Research (NIHR) King's Clinical Research Facility, King's College London, London, UK
| | - Benjamin J M Gooddy
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nazia Karsan
- Headache Group, Wolfson SPaRRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) King's Clinical Research Facility, King's College London, London, UK
| | - Ray Bose
- Headache Group, Wolfson SPaRRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) King's Clinical Research Facility, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Steven C R Williams
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter J Goadsby
- Headache Group, Wolfson SPaRRC, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) King's Clinical Research Facility, King's College London, London, UK
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA
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12
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Kowalczyk OS, Cubillo AI, Criaud M, Giampietro V, O'Daly OG, Mehta MA, Rubia K. Single-dose effects of methylphenidate and atomoxetine on functional connectivity during an n-back task in boys with ADHD. Psychopharmacology (Berl) 2023; 240:2045-2060. [PMID: 37500785 PMCID: PMC10506949 DOI: 10.1007/s00213-023-06422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
RATIONALE Working memory deficits and associated neurofunctional abnormalities are frequently reported in attention-deficit/hyperactivity disorder (ADHD). Methylphenidate and atomoxetine improve working memory performance and increase activation of regions under-functioning in ADHD. Additionally, methylphenidate has been observed to modulate functional networks involved in working memory. No research, however, has examined the effects of atomoxetine or compared the two drugs. OBJECTIVES This study aimed to test methylphenidate and atomoxetine effects on functional connectivity during working memory in boys with ADHD. METHODS We tested comparative effects of methylphenidate and atomoxetine on functional connectivity during the n-back task in 19 medication-naïve boys with ADHD (10-15 years old) relative to placebo and assessed potential normalisation effects of brain dysfunctions under placebo relative to 20 age-matched neurotypical boys. Patients were scanned in a randomised, double-blind, cross-over design under single doses of methylphenidate, atomoxetine, and placebo. Controls were scanned once, unmedicated. RESULTS Patients under placebo showed abnormally increased connectivity between right superior parietal gyrus (rSPG) and left central operculum/insula. This hyperconnectivity was not observed when patients were under methylphenidate or atomoxetine. Furthermore, under methylphenidate, patients showed increased connectivity relative to controls between right middle frontal gyrus (rMFG) and cingulo-temporo-parietal and striato-thalamic regions, and between rSPG and cingulo-parietal areas. Interrogating these networks within patients revealed increased connectivity between both rMFG and rSPG and right supramarginal gyrus under methylphenidate relative to placebo. Nonetheless, no differences across drug conditions were observed within patients at whole brain level. No drug effects on performance were observed. CONCLUSIONS This study shows shared modulating effects of methylphenidate and atomoxetine on parieto-insular connectivity but exclusive effects of methylphenidate on connectivity increases in fronto-temporo-parietal and fronto-striato-thalamic networks in ADHD.
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Affiliation(s)
- Olivia S Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Ana I Cubillo
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Jacobs Center for Productive Youth Development, Zurich Center for Neuroeconomics, University of Zürich, Zürich, Switzerland
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Owen G O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Millman LSM, Short E, Stanton B, Winston JS, Nicholson TR, Mehta MA, Reinders AATS, Edwards MJ, Goldstein LH, David AS, Hotopf M, Chalder T, Pick S. Interoception in functional motor symptoms and functional seizures: Preliminary evidence of intact accuracy alongside reduced insight and altered sensibility. Behav Res Ther 2023; 168:104379. [PMID: 37516011 PMCID: PMC10788481 DOI: 10.1016/j.brat.2023.104379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
Altered interoception may be a pathophysiological mechanism in functional neurological disorder (FND). However, findings have been inconsistent across interoceptive dimensions in FND including functional motor symptoms (FMS) and seizures (FS). Here, individuals with FMS/FS (n = 17) and healthy controls (HC, n = 17) completed measures of interoceptive accuracy and insight (adapted heartbeat tracking task [HTT] with confidence ratings), a time estimation control task (TET) and the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA-2) to assess interoceptive sensibility. The groups did not differ in interoceptive accuracy (p = 1.00, g = 0.00) or confidence (p = .99, g = 0.004), although the FMS/FS group displayed lower scores on the "Not-Distracting" (p < .001, g = 1.42) and "Trusting" (p = .005, g = 1.17) MAIA-2 subscales, relative to HCs. The groups did not differ in TET performance (p = .82, g = 0.08). There was a positive relationship between HTT accuracy and confidence (insight) in HCs (r = .61, p = .016) but not in FMS/FS (r = 0.11, p = .69). HTT confidence was positively correlated with MAIA-2 "Self-Regulation" (r = 0.77, p = .002) and negatively correlated with FND symptom severity (r = -0.84, p < .001) and impact (r = -0.86, p < .001) in FMS/FS. Impaired interoceptive accuracy may not be a core feature in FMS/FS, but reduced insight and altered sensibility may be relevant. Reduced certainty in self-evaluations of bodily experiences may contribute to the pathogenesis of FND symptoms.
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Affiliation(s)
- L S Merritt Millman
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Eleanor Short
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Biba Stanton
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Joel S Winston
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Antje A T S Reinders
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Mark J Edwards
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Laura H Goldstein
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | | | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Trudie Chalder
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Susannah Pick
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.
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14
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Burrows M, Kotoula V, Dipasquale O, Stringaris A, Mehta MA. Ketamine-induced changes in resting state connectivity, 2 h after the drug administration in patients with remitted depression. J Psychopharmacol 2023; 37:784-794. [PMID: 37491833 DOI: 10.1177/02698811231189432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
BACKGROUND Resting state connectivity studies link ketamine's antidepressant effects with normalisation of the brain connectivity changes that are observed in depression. These changes, however, usually co-occur with improvement in depressive symptoms, making it difficult to attribute these changes to ketamine's effects per se. AIMS Our aim is to examine the effects of ketamine in brain connectivity, 2 h after its administration in a cohort of volunteers with remitted depression. Any significant changes observed in this study could provide insight of ketamine's antidepressant mechanism as they are not accompanied by symptom changes. METHODS In total, 35 participants with remitted depression (21 females, mean age = 28.5 years) participated in a double-blind, placebo-controlled study of ketamine (0.5 mg/kg) or saline. Resting state scans were acquired approximately 2 h after the ketamine infusion. Brain connectivity was examined using a seed-based approach (ventral striatum, amygdala, hippocampus, posterior cingulate cortex and subgenual anterior cingulate cortex (sgACC)) and a brain network analysis (independent component analysis). RESULTS Decreased connectivity between the sgACC and the amygdala was observed approximately 2 h after the ketamine infusion, compared to placebo (pFWE < 0.05). The executive network presented with altered connectivity with different cortical and subcortical regions. Within the network, the left hippocampus and right amygdala had decreased connectivity (pFWE < 0.05). CONCLUSIONS Our findings support a model whereby ketamine would change the connectivity of brain areas and networks that are important for cognitive processing and emotional regulation. These changes could also be an indirect indicator of the plasticity changes induced by the drug.
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Affiliation(s)
- Matthew Burrows
- Centre for Neuroimaging Sciences, IoPPN, King's College London, London, UK
| | - Vasileia Kotoula
- Experimental Therapeutics and Pathophysiology Branch, NIMH, Bethesda, MA, USA
| | - Ottavia Dipasquale
- Centre for Neuroimaging Sciences, IoPPN, King's College London, London, UK
| | - Argyris Stringaris
- Division of Psychiatry and Department of Clinical, Educational & Health Psychology, UCL, London, UK
- First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Mitul A Mehta
- Centre for Neuroimaging Sciences, IoPPN, King's College London, London, UK
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15
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Selvaggi P, Jauhar S, Kotoula V, Pepper F, Veronese M, Santangelo B, Zelaya F, Turkheimer FE, Mehta MA, Howes OD. Reduced cortical cerebral blood flow in antipsychotic-free first-episode psychosis and relationship to treatment response. Psychol Med 2023; 53:5235-5245. [PMID: 36004510 PMCID: PMC10476071 DOI: 10.1017/s0033291722002288] [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: 11/24/2021] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Altered cerebral blood flow (CBF) has been found in people at risk for psychosis, with first-episode psychosis (FEP) and with chronic schizophrenia (SCZ). Studies using arterial spin labelling (ASL) have shown reduction of cortical CBF and increased subcortical CBF in SCZ. Previous studies have investigated CBF using ASL in FEP, reporting increased CBF in striatum and reduced CBF in frontal cortex. However, as these people were taking antipsychotics, it is unclear whether these changes are related to the disorder or antipsychotic treatment and how they relate to treatment response. METHODS We examined CBF in FEP free from antipsychotic medication (N = 21), compared to healthy controls (N = 22). Both absolute and relative-to-global CBF were assessed. We also investigated the association between baseline CBF and treatment response in a partially nested follow-up study (N = 14). RESULTS There was significantly lower absolute CBF in frontal cortex (Cohen's d = 0.84, p = 0.009) and no differences in striatum or hippocampus. Whole brain voxel-wise analysis revealed widespread cortical reductions in absolute CBF in large cortical clusters that encompassed occipital, parietal and frontal cortices (Threshold-Free Cluster Enhancement (TFCE)-corrected <0.05). No differences were found in relative-to-global CBF in the selected region of interests and in voxel-wise analysis. Relative-to-global frontal CBF was correlated with percentage change in total Positive and Negative Syndrome Scale after antipsychotic treatment (r = 0.67, p = 0.008). CONCLUSIONS These results show lower cortical absolute perfusion in FEP prior to starting antipsychotic treatment and suggest relative-to-global frontal CBF as assessed with magnetic resonance imaging could potentially serve as a biomarker for antipsychotic response.
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Affiliation(s)
- Pierluigi Selvaggi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Sameer Jauhar
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Early Intervention Psychosis Clinical Academic Group, South London & Maudsley NHS Foundation Trust, London, UK
| | - Vasileia Kotoula
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fiona Pepper
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Barbara Santangelo
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federico E. Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mitul A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Oliver D. Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK
- Faculty of Medicine, Institute of Clinical Sciences (ICS), Imperial College London, Du Cane Road, London W12 0NN, UK
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16
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Dipasquale O, Cohen A, Martins D, Zelaya F, Turkheimer F, Veronese M, Mehta MA, Williams SCR, Yang B, Banerjee S, Wang Y. Molecular-enriched functional connectivity in the human brain using multiband multi-echo simultaneous ASL/BOLD fMRI. Sci Rep 2023; 13:11751. [PMID: 37474568 PMCID: PMC10359289 DOI: 10.1038/s41598-023-38573-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
Receptor-enriched analysis of functional connectivity by targets (REACT) is a strategy to enrich functional MRI (fMRI) data with molecular information on the neurotransmitter distribution density in the human brain, providing a biological basis to the functional connectivity (FC) analysis. Although this approach has been used in BOLD fMRI studies only so far, extending its use to ASL imaging would provide many advantages, including the more direct link of ASL with neuronal activity compared to BOLD and its suitability for pharmacological MRI studies assessing drug effects on baseline brain function. Here, we applied REACT to simultaneous ASL/BOLD resting-state fMRI data of 29 healthy subjects and estimated the ASL and BOLD FC maps related to six molecular systems. We then compared the ASL and BOLD FC maps in terms of spatial similarity, and evaluated and compared the test-retest reproducibility of each modality. We found robust spatial patterns of molecular-enriched FC for both modalities, moderate similarity between BOLD and ASL FC maps and comparable reproducibility for all but one molecular-enriched functional networks. Our findings showed that ASL is as informative as BOLD in detecting functional circuits associated with specific molecular pathways, and that the two modalities may provide complementary information related to these circuits.
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Affiliation(s)
- Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Alexander Cohen
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Federico Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
- Department of Information Engineering, University of Padova, Padua, Italy
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Steven C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | | | | | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
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Cosme G, Arriaga P, Rosa PJ, Mehta MA, Prata D. Temporal profile of intranasal oxytocin in the human autonomic nervous system at rest: An electrocardiography and pupillometry study. J Psychopharmacol 2023:2698811231158233. [PMID: 36891949 DOI: 10.1177/02698811231158233] [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] [Indexed: 03/10/2023]
Abstract
BACKGROUND Human social behavior is modulated by oxytocin (OT). Intranasal administration of OT (IN-OT) is a noninvasive route shown to elicit changes in the autonomic nervous system (ANS) activity; however, IN-OT's effect on the temporal profile of ANS activity at rest is yet to be described. AIMS We aimed to describe the temporal profile of IN-OT at six 10-min time windows from 15- to 100-min post-administration in 20 male participants at rest while continuously recording their pupillary in an eyes-open condition and cardiac activity in eyes-open and eyes-closed conditions. METHODS We used a double-blind, placebo-controlled, within-subjects design study where we extracted two proxies of parasympathetic nervous system (PNS) activity: high-frequency heart rate variability (HF-HRV) and pupillary unrest index (PUI); and a proxy of sympathetic nervous system activity: sample entropy of the pupillary unrest. RESULTS In the eyes-open condition, we found an effect of IN-OT on the proxies of PNS activity: decreased PUI in the three-time windows post-administration spanning 65-100 min, and as an exploratory finding, an increased HF-HRV in the 80-85 min time window. CONCLUSIONS We suggest there is a role of OT in PNS regulation that may be consistent with OT's currently theorized role in the facilitation of alertness and approach behavior.
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Affiliation(s)
- Gonçalo Cosme
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - Patrícia Arriaga
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisboa, Portugal
| | - Pedro J Rosa
- HEI-LAB: Human-Environment Interaction Lab/Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal.,ISMAT, Transdisciplinary Research Center (ISHIP), Portimão, Portugal
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diana Prata
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Mackes NK, Mehta MA, Beyh A, Nkrumah RO, Golm D, Sarkar S, Fairchild G, Dell'Acqua F, Sonuga-Barke EJS. A Prospective Study of the Impact of Severe Childhood Deprivation on Brain White Matter in Adult Adoptees: Widespread Localized Reductions in Volume But Unaffected Microstructural Organization. eNeuro 2022; 9:ENEURO.0188-22.2022. [PMID: 36376082 PMCID: PMC9665880 DOI: 10.1523/eneuro.0188-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
Early childhood neglect can impact brain development across the lifespan. Using voxel-based approaches we recently reported that severe and time-limited institutional deprivation in early childhood was linked to substantial reductions in total brain volume in adulthood, >20 years later. Here, we extend this analysis to explore deprivation-related regional white matter volume and microstructural organization using diffusion-based techniques. A combination of tensor-based morphometry (TBM) analysis and tractography was conducted on diffusion-weighted imaging (DWI) data from 59 young adults who spent between 3 and 41 months in the severely depriving Romanian institutions of the 1980s before being adopted into United Kingdom families, and 20 nondeprived age-matched United Kingdom controls. Independent of total volume, institutional deprivation was associated with smaller volumes in localized regions across a range of white matter tracts including (1) long-ranging association fibers such as bilateral inferior longitudinal fasciculus (ILF), bilateral inferior fronto-occipital fasciculus (IFOF), left superior longitudinal fasciculi (SLFs), and left arcuate fasciculus; (2) tracts of the limbic circuitry including fornix and cingulum; and (3) projection fibers with the corticospinal tract particularly affected. Tractographic analysis found no evidence of altered microstructural organization of any tract in terms of hindrance modulated orientational anisotropy (HMOA), fractional anisotropy (FA), or mean diffusivity (MD). We provide further evidence for the effects of early neglect on brain development and their persistence in adulthood despite many years of environmental enrichment associated with successful adoption. Localized white matter effects appear limited to volumetric changes with microstructural organization unaffected.
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Affiliation(s)
- Nuria K Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Ahmad Beyh
- Department of Forensic & Neurodevelopmental Sciences. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Richard O Nkrumah
- Department of Neuroimaging, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim J5 68159, Germany
| | - Dennis Golm
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton SO17 1PS, United Kingdom
| | - Sagari Sarkar
- Cognitive Neuroscience & Neuropsychiatry, Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, United Kingdom
| | - Graeme Fairchild
- Department of Psychology, University of Bath, Bath BA2 7AY, United Kingdom
| | - Flavio Dell'Acqua
- Department of Forensic & Neurodevelopmental Sciences. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus 8000, Denmark
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Jeyaventhan R, Thanikasalam R, Mehta MA, Solmi F, Pollak TA, Nicholson TR, Pritchard M, Jewell A, Kolliakou A, Amad A, Haroche A, Lewis G, Zandi MS, David AS, Rogers JP. Clinical Neuroimaging Findings in Catatonia: Neuroradiological Reports of MRI Scans of Psychiatric Inpatients With and Without Catatonia. J Neuropsychiatry Clin Neurosci 2022; 34:386-392. [PMID: 35414194 DOI: 10.1176/appi.neuropsych.21070181] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/01/2022]
Abstract
OBJECTIVE Catatonia is a debilitating psychomotor disorder. Previous neuroimaging studies have used small samples with inconsistent results. The authors aimed to describe the structural neuroradiological abnormalities in clinical magnetic resonance imaging (MRI) brain scans of patients with catatonia, comparing them with scans of psychiatric inpatients without catatonia. They report the largest study of catatonia neuroimaging to date. METHODS In this retrospective case-control study, neuroradiological reports of psychiatric inpatients who had undergone MRI brain scans for clinical reasons were examined. Abnormalities were classified by lateralization, localization, and pathology. The primary analysis was prediction of catatonia by presence of an abnormal MRI scan, adjusted for age, sex, Black race-ethnicity, and psychiatric diagnosis. RESULTS Scan reports from 79 patients with catatonia and 711 other psychiatric inpatients were obtained. Mean age was 36.4 (SD=17.3) for the cases and 44.5 (SD=19.9) for the comparison group. Radiological abnormalities were reported in 27 of 79 cases (34.2%) and in 338 of 711 in the comparison group (47.5%) (odds ratio [OR]=0.57, 95% confidence interval [CI]=0.35, 0.93; adjusted OR=1.11, 95% CI=0.58, 2.14). Among the cases, most abnormal scans had bilateral abnormalities (N=23, 29.1%) and involved the forebrain (N=25, 31.6%) and atrophy (N=17, 21.5%). CONCLUSIONS Patients with catatonia were commonly reported to have brain MRI abnormalities, which largely consisted of diffuse cerebral atrophy rather than focal lesions. No evidence was found that these abnormalities were more common than in other psychiatric inpatients undergoing neuroimaging, after adjustment for demographic variables. Study limitations included a heterogeneous control group and selection bias in requesting scans.
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Affiliation(s)
- Roshell Jeyaventhan
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Ramya Thanikasalam
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Mitul A Mehta
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Francesca Solmi
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Thomas A Pollak
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Timothy R Nicholson
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Megan Pritchard
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Amelia Jewell
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Anna Kolliakou
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Ali Amad
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Alexandre Haroche
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Glyn Lewis
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Michael S Zandi
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Anthony S David
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
| | - Jonathan P Rogers
- Faculty of Life Sciences and Medicine, King's College London, London (Jeyaventhan, Thanikasalam); Department of Neuroimaging (Mehta) and Department of Psychosis Studies (Pollak, Nicholson, Kolliakou), Institute of Psychiatry Psychology and Neuroscience, King's College London, London; Division of Psychiatry (Solmi, Lewis, Rogers), Queen Square Institute of Neurology (Zandi), and Institute of Mental Health (David), University College London, London; University College London Hospitals NHS Foundation Trust, London (Zandi); South London and Maudsley Mental Health NHS Trust, London (Pritchard, Jewell, Rogers); Psychiatrie and Neurosciences, Le Groupe Hospitalier Universitaire Paris, Paris (Haroche); CHRU de Lille Pôle Psychiatrie Médecine Légale et Médecine en Milieu Pénitentiaire, Lille, France (Amad)
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Patchitt J, Porffy LA, Whomersley G, Szentgyorgyi T, Brett J, Mouchlianitis E, Mehta MA, Nottage JF, Shergill SS. Alpha3/alpha2 power ratios relate to performance on a virtual reality shopping task in ageing adults. Front Aging Neurosci 2022; 14:876832. [PMID: 36212034 PMCID: PMC9540381 DOI: 10.3389/fnagi.2022.876832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background Aspects of cognitive function decline with age. This phenomenon is referred to as age-related cognitive decline (ARCD). Improving the understanding of these changes that occur as part of the ageing process can serve to enhance the detection of the more incapacitating neurodegenerative disorders such as Alzheimer’s disease (AD). In this study, we employ novel methods to assess ARCD by exploring the utility of the alpha3/alpha2 electroencephalogram (EEG) power ratio – a marker of AD, and a novel virtual reality (VR) functional cognition task – VStore, in discriminating between young and ageing healthy adults. Materials and methods Twenty young individuals aged 20–30, and 20 older adults aged 60–70 took part in the study. Participants underwent resting-state EEG and completed VStore and the Cogstate Computerised Cognitive Battery. The difference in alpha3/alpha2 power ratios between the age groups was tested using t-test. In addition, the discriminatory accuracy of VStore and Cogstate were compared using logistic regression and overlying receiver operating characteristic (ROC) curves. Youden’s J statistic was used to establish the optimal threshold for sensitivity and specificity and model performance was evaluated with the DeLong’s test. Finally, alpha3/alpha2 power ratios were correlated with VStote and Cogstate performance. Results The difference in alpha3/alpha2 power ratios between age cohorts was not statistically significant. On the other hand, VStore discriminated between age groups with high sensitivity (94%) and specificity (95%) The Cogstate Pre-clinical Alzheimer’s Battery achieved a sensitivity of 89% and specificity of 60%, and Cogstate Composite Score achieved a sensitivity of 83% and specificity of 85%. The differences between the discriminatory accuracy of VStore and Cogstate models were statistically significant. Finally, high alpha3/alpha2 power ratios correlated strongly with VStore (r = 0.73), the Cogstate Pre-clinical Alzheimer’s Battery (r = -0.67), and Cogstate Composite Score (r = -0.76). Conclusion While we did not find evidence that the alpha3/alpha2 power ratio is elevated in healthy ageing individuals compared to young individuals, we demonstrated that VStore can classify age cohorts with high accuracy, supporting its utility in the assessment of ARCD. In addition, we found preliminary evidence that elevated alpha3/alpha2 power ratio may be linked to lower cognitive performance.
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Affiliation(s)
- Joel Patchitt
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Trafford Centre for Medical Research, University of Sussex, Brighton, United Kingdom
| | - Lilla A. Porffy
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- *Correspondence: Lilla A. Porffy,
| | - Gabriella Whomersley
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Timea Szentgyorgyi
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jack Brett
- Faculty of Media and Communications, Bournemouth University, Poole, United Kingdom
| | - Elias Mouchlianitis
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- School of Psychology, University of East London, London, United Kingdom
| | - Mitul A. Mehta
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Judith F. Nottage
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Sukhi S. Shergill
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Kent and Medway Medical School, Canterbury, United Kingdom
- Kent and Medway National Health Service and Social Care Partnership Trust, Kent, United Kingdom
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Barnby JM, Mehta MA, Moutoussis M. The computational relationship between reinforcement learning, social inference, and paranoia. PLoS Comput Biol 2022; 18:e1010326. [PMID: 35877675 PMCID: PMC9352206 DOI: 10.1371/journal.pcbi.1010326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/04/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
Theoretical accounts suggest heightened uncertainty about the state of the world underpin aberrant belief updates, which in turn increase the risk of developing a persecutory delusion. However, this raises the question as to how an agent’s uncertainty may relate to the precise phenomenology of paranoia, as opposed to other qualitatively different forms of belief. We tested whether the same population (n = 693) responded similarly to non-social and social contingency changes in a probabilistic reversal learning task and a modified repeated reversal Dictator game, and the impact of paranoia on both. We fitted computational models that included closely related parameters that quantified the rigidity across contingency reversals and the uncertainty about the environment/partner. Consistent with prior work we show that paranoia was associated with uncertainty around a partner’s behavioural policy and rigidity in harmful intent attributions in the social task. In the non-social task we found that pre-existing paranoia was associated with larger decision temperatures and commitment to suboptimal cards. We show relationships between decision temperature in the non-social task and priors over harmful intent attributions and uncertainty over beliefs about partners in the social task. Our results converge across both classes of model, suggesting paranoia is associated with a general uncertainty over the state of the world (and agents within it) that takes longer to resolve, although we demonstrate that this uncertainty is expressed asymmetrically in social contexts. Our model and data allow the representation of sociocognitive mechanisms that explain persecutory delusions and provide testable, phenomenologically relevant predictions for causal experiments.
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Affiliation(s)
- Joseph M. Barnby
- Department of Psychology, Royal Holloway, University of London, London, United Kingdom
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
- * E-mail:
| | - Mitul A. Mehta
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max-Planck–UCL Centre for Computational Psychiatry and Ageing, University College London, London, United Kingdom
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Lawn T, Dipasquale O, Vamvakas A, Tsougos I, Mehta MA, Howard MA. Differential contributions of serotonergic and dopaminergic functional connectivity to the phenomenology of LSD. Psychopharmacology (Berl) 2022; 239:1797-1808. [PMID: 35322297 PMCID: PMC9166846 DOI: 10.1007/s00213-022-06117-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/11/2022] [Indexed: 02/25/2023]
Abstract
RATIONALE LSD is the prototypical psychedelic. Despite a clear central role of the 5HT2a receptor in its mechanism of action, the contributions of additional receptors for which it shows affinity and agonist activity remain unclear. OBJECTIVES We employed receptor-enriched analysis of functional connectivity by targets (REACT) to explore differences in functional connectivity (FC) associated with the distributions of the primary targets of LSD-the 5HT1a, 5HT1b, 5HT2a, D1 and D2 receptors. METHODS We performed secondary analyses of an openly available dataset (N = 15) to estimate the LSD-induced alterations in receptor-enriched FC maps associated with these systems. Principal component analysis (PCA) was employed as a dimension reduction strategy for subjective experiences associated with LSD captured by the Altered States of Consciousness (ASC) questionnaire. Correlations between these principal components as well as VAS ratings of subjective effects with receptor-enriched FC were explored. RESULTS Compared to placebo, LSD produced differences in FC when the analysis was enriched with each of the primary serotonergic and dopaminergic receptors. Altered receptor-enriched FC showed relationships with the subjective effects of LSD on conscious experience, with serotonergic and dopaminergic systems being predominantly associated with perceptual effects and perceived selfhood as well as cognition respectively. These relationships were dissociable, with different receptors showing the same relationships within, but not between, the serotonergic and dopaminergic systems. CONCLUSIONS These exploratory findings provide new insights into the pharmacology of LSD and highlight the need for additional investigation of non-5HT2a-mediated mechanisms.
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Affiliation(s)
- Timothy Lawn
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Alexandros Vamvakas
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Medical Physics Department, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Tsougos
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Medical Physics Department, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mitul A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matthew A. Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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23
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Turkheimer FE, Selvaggi P, Mehta MA, Veronese M, Zelaya F, Dazzan P, Vernon AC. Corrigendum to: Normalizing the Abnormal: Do Antipsychotic Drugs Push the Cortex Into an Unsustainable Metabolic Envelope? Schizophr Bull 2022; 48:721. [PMID: 32065235 PMCID: PMC9077407 DOI: 10.1093/schbul/sbz139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Vignando M, Ffytche D, Lewis SJG, Lee PH, Chung SJ, Weil RS, Hu MT, Mackay CE, Griffanti L, Pins D, Dujardin K, Jardri R, Taylor JP, Firbank M, McAlonan G, Mak HKF, Ho SL, Mehta MA. Author Correction: Mapping brain structural differences and neuroreceptor correlates in Parkinson's disease visual hallucinations. Nat Commun 2022; 13:971. [PMID: 35169136 PMCID: PMC8847348 DOI: 10.1038/s41467-022-28491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Miriam Vignando
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Dominic Ffytche
- Department of Old Age Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Phil Hyu Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1M 3BG, UK
- Wellcome Centre for Neuroimaging, University College London, London, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ludovica Griffanti
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Delphine Pins
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - John-Paul Taylor
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Michael Firbank
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Grainne McAlonan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Henry K F Mak
- Division of Neurology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Shu Leong Ho
- Division of Neurology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Mitul A Mehta
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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25
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Ye R, Mazibuko N, Teichert J, Regenthal R, Kehagia AA, Mehta MA. Mapping the effects of atomoxetine during response inhibition across cortical territories and the locus coeruleus. Psychopharmacology (Berl) 2022; 239:365-376. [PMID: 34693457 DOI: 10.1007/s00213-021-05998-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/03/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE The effects of atomoxetine (ATO) on response inhibition have been typically examined using the stop signal task (SST) which is however confounded by attentional capture. The right inferior frontal cortex (rIFC) has been implicated in the modulation of ATO on inhibitory control, but a precise characterisation of its role is complicated by its functional inhomogeneity. OBJECTIVES The current study aimed to directly investigate the effect of ATO in the SST using the imaging contrast unconfounded by attentional capture, to test the specific drug actions in functionally dissociable rIFC subregions, and to explore the role of locus coeruleus (LC), the main source of cortical noradrenaline, in mediating the drug effects. METHODS This imaging study investigated the effect of ATO (40 mg) in 18 human participants during a modified SST that unconfounds attention from inhibition. Functional definitions for rIFC subdivisions were adopted in the analyses to isolate attention and inhibition during action cancellation. The LC integrity was measured in vivo using a neuromelanin-sensitive sequence. RESULTS We identified one mechanism of ATO modulation specific to inhibitory control: ATO enhanced activity in pre-supplementary area (pre-SMA) for motor inhibition, and the recruitment of temporoparietal junction (TPJ) and inferior frontal junction (IFJ) for functional integration during response inhibition. Moreover, drug-related behavioural and neural responses correlated with variations in LC integrity. CONCLUSIONS These findings provide a more nuanced and precise understanding of the effects of ATO on specific and domain general aspects of stopping.
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Affiliation(s)
- Rong Ye
- Department of Clinical Neurosciences and Cambridge University Hospital NHS Trust, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge, CB2 0SZ, UK. .,Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Ndabezinhle Mazibuko
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jens Teichert
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, Leipzig University, Leipzig, Germany
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, Leipzig University, Leipzig, Germany
| | - Angie A Kehagia
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mitul A Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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26
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Porffy LA, Mehta MA, Patchitt J, Boussebaa C, Brett J, D'Oliveira T, Mouchlianitis E, Shergill SS. A Novel Virtual Reality Assessment of Functional Cognition: Validation Study. J Med Internet Res 2022; 24:e27641. [PMID: 35080501 PMCID: PMC8829700 DOI: 10.2196/27641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/05/2021] [Accepted: 10/05/2021] [Indexed: 01/29/2023] Open
Abstract
Background Cognitive deficits are present in several neuropsychiatric disorders, including Alzheimer disease, schizophrenia, and depression. Assessments used to measure cognition in these disorders are time-consuming, burdensome, and have low ecological validity. To address these limitations, we developed a novel virtual reality shopping task—VStore. Objective This study aims to establish the construct validity of VStore in relation to the established computerized cognitive battery, Cogstate, and explore its sensitivity to age-related cognitive decline. Methods A total of 142 healthy volunteers aged 20-79 years participated in the study. The main VStore outcomes included verbal recall of 12 grocery items, time to collect items, time to select items on a self-checkout machine, time to make the payment, time to order coffee, and total completion time. Construct validity was examined through a series of backward elimination regression models to establish which Cogstate tasks, measuring attention, processing speed, verbal and visual learning, working memory, executive function, and paired associate learning, in addition to age and technological familiarity, best predicted VStore performance. In addition, 2 ridge regression and 2 logistic regression models supplemented with receiver operating characteristic curves were built, with VStore outcomes in the first model and Cogstate outcomes in the second model entered as predictors of age and age cohorts, respectively. Results Overall VStore performance, as indexed by the total time spent completing the task, was best explained by Cogstate tasks measuring attention, working memory, paired associate learning, and age and technological familiarity, accounting for 47% of the variance. In addition, with λ=5.16, the ridge regression model selected 5 parameters for VStore when predicting age (mean squared error 185.80, SE 19.34), and with λ=9.49 for Cogstate, the model selected all 8 tasks (mean squared error 226.80, SE 23.48). Finally, VStore was found to be highly sensitive (87%) and specific (91.7%) to age cohorts, with 94.6% of the area under the receiver operating characteristic curve. Conclusions Our findings suggest that VStore is a promising assessment that engages standard cognitive domains and is sensitive to age-related cognitive decline.
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Affiliation(s)
- Lilla Alexandra Porffy
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Joel Patchitt
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Trafford Centre for Medical Research, University of Sussex, Brighton, United Kingdom
| | - Celia Boussebaa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Jack Brett
- Faculty of Media and Communications, Bournemouth University, Bournemouth, United Kingdom
| | - Teresa D'Oliveira
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Sukhi S Shergill
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Kent and Medway Medical School, Canterbuy, United Kingdom.,Kent and Medway National Heath Service and Social Care Partnership Trust, Gillingham, United Kingdom
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27
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Vignando M, Ffytche D, Lewis SJG, Lee PH, Chung SJ, Weil RS, Hu MT, Mackay CE, Griffanti L, Pins D, Dujardin K, Jardri R, Taylor JP, Firbank M, McAlonan G, Mak HKF, Ho SL, Mehta MA. Mapping brain structural differences and neuroreceptor correlates in Parkinson's disease visual hallucinations. Nat Commun 2022; 13:519. [PMID: 35082285 PMCID: PMC8791961 DOI: 10.1038/s41467-022-28087-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/14/2021] [Indexed: 12/16/2022] Open
Abstract
Parkinson's psychosis (PDP) describes a spectrum of symptoms that may arise in Parkinson's disease (PD) including visual hallucinations (VH). Imaging studies investigating the neural correlates of PDP have been inconsistent in their findings, due to differences in study design and limitations of scale. Here we use empirical Bayes harmonisation to pool together structural imaging data from multiple research groups into a large-scale mega-analysis, allowing us to identify cortical regions and networks involved in VH and their relation to receptor binding. Differences of morphometrics analysed show a wider cortical involvement underlying VH than previously recognised, including primary visual cortex and surrounding regions, and the hippocampus, independent of its role in cognitive decline. Structural covariance analyses point to the involvement of the attentional control networks in PD-VH, while associations with receptor density maps suggest neurotransmitter loss may be linked to the cortical changes.
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Affiliation(s)
- Miriam Vignando
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Dominic Ffytche
- Department of Old Age Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Phil Hyu Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1M 3BG, UK
- Wellcome Centre for Neuroimaging, University College London, London, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ludovica Griffanti
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Delphine Pins
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - John-Paul Taylor
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Michael Firbank
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Grainne McAlonan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Henry K F Mak
- Division of Neurology, Dept of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Shu Leong Ho
- Division of Neurology, Dept of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Mitul A Mehta
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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28
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Zelenina M, Kosilo M, da Cruz J, Antunes M, Figueiredo P, Mehta MA, Prata D. Temporal Dynamics of Intranasal Oxytocin in Human Brain Electrophysiology. Cereb Cortex 2022; 32:3110-3126. [PMID: 34979544 PMCID: PMC9290557 DOI: 10.1093/cercor/bhab404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/05/2021] [Accepted: 10/21/2021] [Indexed: 11/18/2022] Open
Abstract
Oxytocin (OT) is a key modulator of human social cognition, popular in behavioral neuroscience. To adequately design and interpret intranasal OT (IN-OT) research, it is crucial to know for how long it affects human brain function once administered. However, this has been mostly deduced from peripheral body fluids studies, or uncommonly used dosages. We aimed to characterize IN-OT’s effects on human brain function using resting-state EEG microstates across a typical experimental session duration. Nineteen healthy males participated in a double-blind, placebo-controlled, within-subject, cross-over design of 24 IU of IN-OT in 12-min windows 15 min-to-1 h 42min after administration. We observed IN-OT effects on all microstates, across the observation span. During eyes-closed, IN-OT increased duration and contribution of A and contribution and occurrence of D, decreased duration and contribution of B and C; and increased transition probability C-to-B and C-to-D. In eyes-open, it increased A-to-C and A-to-D. As microstates A and D have been related to phonological auditory and attentional networks, respectively, we posit IN-OT may tune the brain for reception of external stimuli, particularly of social nature—tentatively supporting current neurocognitive hypotheses of OT. Moreover, we contrast our overall results against a comprehensive literature review of IN-OT time-course effects in the brain, highlighting comparability issues.
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Affiliation(s)
| | | | - Janir da Cruz
- Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015 , Switzerland
- Institute for Systems and Robotics–Lisbon (LARSyS) and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisboa 1049-001 , Portugal
| | - Marília Antunes
- Centro de Estatística e Aplicações e Departamento de Estatística e Investigação Operacional, Faculdade de Ciências, Universidade de Lisboa, Lisboa 1749-016, Portugal
| | - Patrícia Figueiredo
- Institute for Systems and Robotics–Lisbon (LARSyS) and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisboa 1049-001 , Portugal
- INESC-ID, Instituto Superior Técnico, 1749-016 Lisboa, Portugal
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Diana Prata
- Address correspondence to Dr. Diana Prata, Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Portugal.
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29
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Kotoula V, Webster T, Stone J, Mehta MA. Resting-state connectivity studies as a marker of the acute and delayed effects of subanaesthetic ketamine administration in healthy and depressed individuals: A systematic review. Brain Neurosci Adv 2021; 5:23982128211055426. [PMID: 34805548 PMCID: PMC8597064 DOI: 10.1177/23982128211055426] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/24/2021] [Indexed: 11/15/2022] Open
Abstract
Acute ketamine administration has been widely used in neuroimaging research to mimic psychosis-like symptoms. Within the last two decades, ketamine has also emerged as a potent, fast-acting antidepressant. The delayed effects of the drug, observed 2–48 h after a single infusion, are associated with marked improvements in depressive symptoms. At the systems’ level, several studies have investigated the acute ketamine effects on brain activity and connectivity; however, several questions remain unanswered around the brain changes that accompany the drug’s antidepressant effects and how these changes relate to the brain areas that appear with altered function and connectivity in depression. This review aims to address some of these questions by focusing on resting-state brain connectivity. We summarise the studies that have examined connectivity changes in treatment-naïve, depressed individuals and those studies that have looked at the acute and delayed effects of ketamine in healthy and depressed volunteers. We conclude that brain areas that are important for emotional regulation and reward processing appear with altered connectivity in depression whereas the default mode network presents with increased connectivity in depressed individuals compared to healthy controls. This finding, however, is not as prominent as the literature often assumes. Acute ketamine administration causes an increase in brain connectivity in healthy volunteers. The delayed effects of ketamine on brain connectivity vary in direction and appear to be consistent with the drug normalising the changes observed in depression. The limited number of studies however, as well as the different approaches for resting-state connectivity analysis make it very difficult to draw firm conclusions and highlight the importance of data sharing and larger future studies.
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Affiliation(s)
- Vasileia Kotoula
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Mitul A Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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30
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Golm D, Sarkar S, Mackes NK, Fairchild G, Mehta MA, Rutter M, Sonuga-Barke EJ. The impact of childhood deprivation on adult neuropsychological functioning is associated with ADHD symptom persistence. Psychol Med 2021; 51:2675-2684. [PMID: 32419675 DOI: 10.1017/s0033291720001294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment - the large-scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s -we examined, for the first time, whether such deficits are still present in adulthood and whether they are associated with deprivation-related symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). METHODS Adult neuropsychological functioning was assessed across five domains (inhibitory control, emotion recognition, decision-making, prospective memory and IQ) in 70 previously institutionalized adoptees (mean age = 25.3, 50% female) and 22 non-deprived UK adoptees (comparison group, mean age = 24.6, 41% female). ADHD and ASD symptoms were assessed using parent-completed questionnaires. RESULTS Early institutionalization was associated with impaired performance on all tasks in adulthood. Prospective memory deficits persisted after controlling for IQ. ADHD and ASD symptoms were positively correlated. After controlling for ASD symptoms, ADHD symptoms remained associated with deficits in IQ, prospective memory, proactive inhibition, decision-making quality and emotion recognition. ASD symptoms were not independently associated with neuropsychological deficits when accounting for their overlap with ADHD symptoms. Multiple regression analysis revealed that the link between childhood deprivation and adult ADHD symptoms was statistically explained by deprivation-related differences in adult IQ and prospective memory. CONCLUSIONS These results represent some of the most compelling evidence to date of the enduring power of early, time-limited childhood adversity to impair long-term neuropsychological functioning across the lifespan - effects that are linked specifically to deprivation-related adult ADHD symptoms.
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Affiliation(s)
- Dennis Golm
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
| | - Sagari Sarkar
- Cognitive Neuroscience & Neuropsychiatry Section, University College London, London, UK
| | - Nuria K Mackes
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael Rutter
- MRC Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Edmund J Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
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31
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Biaggi A, Hazelgrove K, Waites F, Fuste M, Conroy S, Howard LM, Mehta MA, Miele M, Seneviratne G, Pawlby S, Pariante CM, Dazzan P. Maternal perceived bonding towards the infant and parenting stress in women at risk of postpartum psychosis with and without a postpartum relapse. J Affect Disord 2021; 294:210-219. [PMID: 34303299 DOI: 10.1016/j.jad.2021.05.076] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 04/19/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Postpartum psychosis (PP) is the most severe psychiatric disorder associated with childbirth. However, there is little research on maternal bonding towards the infant and parenting stress in this clinical population. METHODS We investigated maternal bonding during pregnancy and post-partum in 75 women: 46 at risk of PP (AR), because of a DSM-IV diagnosis of bipolar disorder, schizoaffective disorder or previous PP, and 29 healthy controls. Of the AR women, 19 developed a psychiatric relapse within 4 weeks' post-partum (AR-unwell), while 27 remained symptom-free (AR-well). We investigated childhood maltreatment, parenting stress and psychiatric symptoms as potential predictors of maternal bonding. RESULTS In pregnancy, AR-unwell women reported a more negative affective experience towards their infants than AR-well women (d = 0.87, p = .001), while postnatally there was no significant difference in bonding. In contrast, AR women as a group reported a more negative affective experience than HC postnatally (d = 0.69, p = .002; d = 0.70, p = .010), but not antenatally. Parenting stress and psychiatric symptoms significantly predicted less optimal postnatal bonding (b = -0.10, t = -4.29, p < .001; b = -0.37, t = -4.85, p < .001) but only psychiatric symptoms explained the difference in bonding between AR and HC (b = -1.18, 95% BCa CI [-2.70,-0.04]). LIMITATIONS A relatively small sample size precluded a more in-depth investigation of underlying pathways. CONCLUSION This study provides new information on maternal bonding in women at risk of PP, and particularly in those that do and do not develop a postpartum relapse. The results suggest that improving maternal symptoms and parenting stress in the perinatal period in women at risk of PP could also have positive effects on bonding.
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Affiliation(s)
- Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK.
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Freddie Waites
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Montserrat Fuste
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, UK; Perinatal Parent-Infant Mental Health Service, Goodmayes Hospital, North East London Foundation Trust, London, IG3 8XD, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, SE5 8AF, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Maddalena Miele
- Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, W2 1PF, UK
| | - Gertrude Seneviratne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Kowalczyk OS, Mehta MA, O’Daly OG, Criaud M. Task-based functional connectivity in attention-deficit/hyperactivity disorder: A systematic review. Biological Psychiatry Global Open Science 2021; 2:350-367. [DOI: 10.1016/j.bpsgos.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
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Livingston NR, Hawkins PCT, Gilleen J, Ye R, Valdearenas L, Shergill SS, Mehta MA. Preliminary evidence for the phosphodiesterase type-4 inhibitor, roflumilast, in ameliorating cognitive flexibility deficits in patients with schizophrenia. J Psychopharmacol 2021; 35:1099-1110. [PMID: 33908296 PMCID: PMC8435828 DOI: 10.1177/02698811211000778] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cognitive flexibility deficits are present in patients with schizophrenia and are strong predictors of functional outcome but, as yet, have no pharmacological treatments. AIMS The purpose of this study was to investigate whether the phosphodiesterase type-4 inhibitor, roflumilast, can improve cognitive flexibility performance and functional brain activity in patients with schizophrenia. METHODS This was a within-subject, randomised, double-blind, placebo-controlled, three-period crossover study using a version of the Intradimensional/Extradimensional (ID/ED) task, optimised for functional magnetic resonance imaging (fMRI), in 10 patients with schizophrenia who were scanned after receiving placebo, 100 µg or 250 µg roflumilast for 8 consecutive days. Data from an additional fMRI ID/ED study of 18 healthy participants on placebo was included to contextualise the schizophrenia-related performance and activations. The fMRI analyses included a priori driven region of interest (ROI) analysis of the dorsal frontoparietal attention network. RESULTS Patients on placebo demonstrated broad deficits in task performance compared to the healthy comparison group, accompanied by preserved network activity for solution search, but reduced activity in left ventrolateral prefrontal cortex (VLPFC) and posterior parietal cortex for attentional set-shifting and reduced activity in left dorsolateral prefrontal cortex (DLPFC) for reversal learning. These ROI deficits were ameliorated by 250 µg roflumilast, whereas during solution search 100 µg roflumilast reduced activity in the left orbitofrontal cortex, right DLPFC and bilateral PPC, which was associated with an improvement in formation of attentional sets. CONCLUSIONS The results suggest roflumilast has dose-dependent cognitive enhancing effects on the ID/ED task in patients with schizophrenia, and provides sufficient support for larger studies to test roflumilast's role in improving cognitive flexibility deficits in this clinical population.
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Affiliation(s)
| | | | - James Gilleen
- Department of Psychology, University of Roehampton, London, UK,Department of Psychosis Studies, King’s College London, London, UK
| | - Rong Ye
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Lorena Valdearenas
- North Middlesex University Hospital, Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK
| | - Sukhi S Shergill
- Department of Psychosis Studies, King’s College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, King’s College London, London, UK,Mitul A Mehta, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK.
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Hampshire A, Trender W, Chamberlain SR, Jolly AE, Grant JE, Patrick F, Mazibuko N, Williams SCR, Barnby JM, Hellyer P, Mehta MA. Cognitive deficits in people who have recovered from COVID-19. EClinicalMedicine 2021; 39:101044. [PMID: 34316551 PMCID: PMC8298139 DOI: 10.1016/j.eclinm.2021.101044] [Citation(s) in RCA: 257] [Impact Index Per Article: 85.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is growing concern about possible cognitive consequences of COVID-19, with reports of 'Long COVID' symptoms persisting into the chronic phase and case studies revealing neurological problems in severely affected patients. However, there is little information regarding the nature and broader prevalence of cognitive problems post-infection or across the full spread of disease severity. METHODS We sought to confirm whether there was an association between cross-sectional cognitive performance data from 81,337 participants who between January and December 2020 undertook a clinically validated web-optimized assessment as part of the Great British Intelligence Test, and questionnaire items capturing self-report of suspected and confirmed COVID-19 infection and respiratory symptoms. FINDINGS People who had recovered from COVID-19, including those no longer reporting symptoms, exhibited significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-existing medical disorders, tiredness, depression and anxiety. The deficits were of substantial effect size for people who had been hospitalised (N = 192), but also for non-hospitalised cases who had biological confirmation of COVID-19 infection (N = 326). Analysing markers of premorbid intelligence did not support these differences being present prior to infection. Finer grained analysis of performance across sub-tests supported the hypothesis that COVID-19 has a multi-domain impact on human cognition. INTERPRETATION Interpretation. These results accord with reports of 'Long Covid' cognitive symptoms that persist into the early-chronic phase. They should act as a clarion call for further research with longitudinal and neuroimaging cohorts to plot recovery trajectories and identify the biological basis of cognitive deficits in SARS-COV-2 survivors. FUNDING Funding. AH is supported by the UK Dementia Research Institute Care Research and Technology Centre and Biomedical Research Centre at Imperial College London. WT is supported by the EPSRC Centre for Doctoral Training in Neurotechnology. SRC is funded by a Wellcome Trust Clinical Fellowship 110,049/Z/15/Z. JMB is supported by Medical Research Council (MR/N013700/1). MAM, SCRW and PJH are, in part, supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
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Affiliation(s)
- Adam Hampshire
- Department of Brain Sciences, Dementia Research Institute Care Research and Technology Centre, Imperial College London, 926, Sir Michael Uren Hub 86 Wood Lane, London, W12 0BZ
- Corresponding author.
| | - William Trender
- Department of Brain Sciences, Dementia Research Institute Care Research and Technology Centre, Imperial College London, 926, Sir Michael Uren Hub 86 Wood Lane, London, W12 0BZ
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, United Kingdom
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Amy E. Jolly
- Department of Brain Sciences, Dementia Research Institute Care Research and Technology Centre, Imperial College London, 926, Sir Michael Uren Hub 86 Wood Lane, London, W12 0BZ
| | - Jon E. Grant
- Department of Psychiatry, University of Chicago, United States
| | - Fiona Patrick
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Ndaba Mazibuko
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Steve CR Williams
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Joseph M Barnby
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Peter Hellyer
- Department of Brain Sciences, Dementia Research Institute Care Research and Technology Centre, Imperial College London, 926, Sir Michael Uren Hub 86 Wood Lane, London, W12 0BZ
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Hampshire A, Hellyer PJ, Soreq E, Mehta MA, Ioannidis K, Trender W, Grant JE, Chamberlain SR. Associations between dimensions of behaviour, personality traits, and mental-health during the COVID-19 pandemic in the United Kingdom. Nat Commun 2021; 12:4111. [PMID: 34272365 PMCID: PMC8285408 DOI: 10.1038/s41467-021-24365-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 06/09/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic (including lockdown) is likely to have had profound but diverse implications for mental health and well-being, yet little is known about individual experiences of the pandemic (positive and negative) and how this relates to mental health and well-being, as well as other important contextual variables. Here, we analyse data sampled in a large-scale manner from 379,875 people in the United Kingdom (UK) during 2020 to identify population variables associated with mood and mental health during the COVID-19 pandemic, and to investigate self-perceived pandemic impact in relation to those variables. We report that while there are relatively small population-level differences in mood assessment scores pre- to peak-UK lockdown, the size of the differences is larger for people from specific groups, e.g. older adults and people with lower incomes. Multiple dimensions underlie peoples’ perceptions, both positive and negative, of the pandemic’s impact on daily life. These dimensions explain variance in mental health and can be statistically predicted from age, demographics, home and work circumstances, pre-existing conditions, maladaptive technology use and personality traits (e.g., compulsivity). We conclude that a holistic view, incorporating the broad range of relevant population factors, can better characterise people whose mental health is most at risk during the COVID-19 pandemic. The COVID-19 pandemic has affected people’s health and well-being. Here, the authors characterize self-reported impact of the pandemic (positive and negative) at a large scale in the United Kingdom, and show variance among individual circumstances.
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Affiliation(s)
| | - Peter J Hellyer
- Imperial College London, London, UK.,King's College London, London, UK
| | | | | | - Konstantinos Ioannidis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Jon E Grant
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, UK.,Southern Health NHS Foundation Trust, Southampton, UK
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Kowalczyk OS, Pauls AM, Fusté M, Williams SCR, Hazelgrove K, Vecchio C, Seneviratne G, Pariante CM, Dazzan P, Mehta MA. Neurocognitive correlates of working memory and emotional processing in postpartum psychosis: an fMRI study. Psychol Med 2021; 51:1724-1732. [PMID: 32174288 DOI: 10.1017/s0033291720000471] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Postpartum psychosis (PP) is a severe postpartum disorder. While working memory and emotional processing-related brain function are consistently impaired in psychoses unrelated to the puerperium, no studies have investigated them in PP. METHODS Twenty-four women at risk of developing PP (11 developed an episode - PE; 13 remained well - NPE) and 20 healthy postpartum women completed two functional magnetic resonance imaging tasks within a year of delivery: working memory (n-back) and emotional face recognition (fearful faces). We compared women at-risk of PP to controls, as well as NPE, PE, and controls to test for potential effects of a PP episode occurrence. RESULTS Women at-risk of PP and PE showed hyperactivation of lateral visual areas, precuneus, and posterior cingulate during the n-back task. The at-risk group as a whole, as well as the PE and NPE groups, showed hyperconnectivity of the right dorsolateral prefrontal cortex (DLPFC) with various parieto-occipito-temporo-cerebellar regions compared to controls during several n-back conditions. Increases in connectivity between the right DLPFC and ipsilateral middle temporal gyrus were observed in the PE group compared to NPE during 2-back. During the fearful faces task, at-risk women as a group showed hyperactivation of fronto-cingulo-subcortical regions, and hypoconnectivity between the left amygdala and ipsilateral occipito-parietal regions compared to controls. No significant performance differences were observed. CONCLUSIONS These results present preliminary evidence of a differential nature of functional brain abnormalities in PP compared to the typically observed reduced connectivity with the DLPFC in psychoses unrelated to puerperium, such as bipolar disorder.
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Affiliation(s)
- Olivia S Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Astrid M Pauls
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Montserrat Fusté
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Steven C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Katie Hazelgrove
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Costanza Vecchio
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Gertrude Seneviratne
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Carmine M Pariante
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Hazelgrove K, Biaggi A, Waites F, Fuste M, Osborne S, Conroy S, Howard LM, Mehta MA, Miele M, Nikkheslat N, Seneviratne G, Zunszain PA, Pawlby S, Pariante CM, Dazzan P. Risk factors for postpartum relapse in women at risk of postpartum psychosis: The role of psychosocial stress and the biological stress system. Psychoneuroendocrinology 2021; 128:105218. [PMID: 33892376 DOI: 10.1016/j.psyneuen.2021.105218] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 08/17/2020] [Revised: 02/24/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Postpartum psychosis is the most severe psychiatric disorder associated with childbirth, and the risk is particularly high for women with a history of bipolar disorder, schizoaffective disorder or those who have suffered a previous episode of postpartum psychosis. Whilst there is a lot of evidence linking stress to psychosis unrelated to childbirth, the role of stress in the onset of postpartum psychosis has not been fully investigated. METHODS A prospective longitudinal study of 112 pregnant women, 51 at risk of postpartum psychosis because of a DSM-IV diagnosis of bipolar disorder (n = 41), schizoaffective disorder (n = 6) or a previous postpartum psychosis (n = 4) and 61 healthy women with no past or current DSM-IV diagnosis and no family history of postpartum psychosis. Women were followed up from the third trimester of pregnancy to 4 weeks' post partum. Women at risk who had a psychiatric relapse in the first 4 weeks' post partum (AR-unwell) (n = 22), were compared with those at risk who remained well (AR-well) (n = 29) on measures of psychosocial stress (severe childhood maltreatment and stressful life events) and biological stress (cortisol and inflammatory biomarkers). RESULTS Logistic regression analyses revealed that severe childhood maltreatment (OR = 4.9, 95% CI 0.5-49.2) and higher daily cortisol in the third trimester of pregnancy (OR=3.7, 95% CI 1.2-11.6) predicted psychiatric relapse in the first 4 weeks' post partum in women at risk of postpartum psychosis after adjusting for clinical and sociodemographic covariates. CONCLUSION The current study provides evidence for the role of psychosocial stress and the biological stress system in the risk of postpartum relapse in women at risk of postpartum psychosis.
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Affiliation(s)
- Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Freddie Waites
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Montserrat Fuste
- Perinatal Parent-Infant Mental Health Service, Goodmayes Hospital, North East London Foundation Trust, London IG3 8XD, UK.
| | - Sarah Osborne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Maddalena Miele
- Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London W2 1PF, UK.
| | - Naghmeh Nikkheslat
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Gertrude Seneviratne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Patricia A Zunszain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
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Sambataro F, Cattarinussi G, Lawrence A, Biaggi A, Fusté M, Hazelgrove K, Mehta MA, Pawlby S, Conroy S, Seneviratne G, Craig MC, Pariante CM, Miele M, Dazzan P. Altered dynamics of the prefrontal networks are associated with the risk for postpartum psychosis: a functional magnetic resonance imaging study. Transl Psychiatry 2021; 11:238. [PMID: 33976106 PMCID: PMC8113224 DOI: 10.1038/s41398-021-01351-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 02/15/2021] [Accepted: 03/02/2021] [Indexed: 11/23/2022] Open
Abstract
Postpartum psychosis (PP) is a severe mental disorder that affects women in the first few weeks after delivery. To date there are no biomarkers that distinguish which women at risk (AR) develop a significant psychiatric relapse postpartum. While altered brain connectivity may contribute to the risk for psychoses unrelated to the puerperium, this remains unexplored in PP. We followed up 32 AR and 27 healthy (HC) women from pregnancy to 8-week postpartum. At this point, we classified women as AR-unwell (n = 15) if they had developed a psychiatric relapse meeting DSM-IV diagnostic criteria, or impacting on daily functioning and requiring treatment, or AR-well (n = 17) if they remained asymptomatic. Women also underwent an fMRI scan at rest and during an emotional-processing task, to study within- and between-networks functional connectivity. Women AR, and specifically those in the AR-well group, showed increased resting connectivity within an executive network compared to HC. During the execution of the emotional task, women AR also showed decreased connectivity in the executive network, and altered emotional load-dependent connectivity between executive, salience, and default-mode networks. AR-unwell women particularly showed increased salience network-dependent modulation of the default-mode and executive network relative to AR-well, who showed greater executive network-dependent modulation of the salience network. Our finding that the executive network and its interplay with other brain networks implicated in goal-directed behavior are intrinsically altered suggest that they could be considered neural phenotypes for postpartum psychosis and help advance our understanding of the pathophysiology of this disorder.
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Affiliation(s)
- Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy.
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Andrew Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Montserrat Fusté
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Mitul A Mehta
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Gertrude Seneviratne
- South London and Maudsley NHS Foundation Trust Channi Kumar Mother and Baby Unit, Bethlem Royal Hospital, London, UK
| | - Michael C Craig
- National Female Hormone Clinic, Maudsley Hospital, SLaM NHS Foundation Trust, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, De Crespigny Park, London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Maddalena Miele
- Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Alexander L, Jelen LA, Mehta MA, Young AH. The anterior cingulate cortex as a key locus of ketamine's antidepressant action. Neurosci Biobehav Rev 2021; 127:531-554. [PMID: 33984391 DOI: 10.1016/j.neubiorev.2021.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/02/2021] [Accepted: 05/03/2021] [Indexed: 12/30/2022]
Abstract
The subdivisions of the anterior cingulate cortex (ACC) - including subgenual, perigenual and dorsal zones - are implicated in the etiology, pathogenesis and treatment of major depression. We review an emerging body of evidence which suggests that changes in ACC activity are critically important in mediating the antidepressant effects of ketamine, the prototypical member of an emerging class of rapidly acting antidepressants. Infusions of ketamine induce acute (over minutes) and post-acute (over hours to days) modulations in subgenual and perigenual activity, and importantly, these changes can correlate with antidepressant efficacy. The subgenual and dorsal zones of the ACC have been specifically implicated in ketamine's anti-anhedonic effects. We emphasize the synergistic relationship between neuroimaging studies in humans and brain manipulations in animals to understand the causal relationship between changes in brain activity and therapeutic efficacy. We conclude with circuit-based perspectives on ketamine's action: first, related to ACC function in a central network mediating affective pain, and second, related to its role as the anterior node of the default mode network.
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Affiliation(s)
- Laith Alexander
- Department of Psychological Medicine, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; St Thomas' Hospital, London, United Kingdom.
| | - Luke A Jelen
- Department of Psychological Medicine, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Mitul A Mehta
- Department of Psychological Medicine, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Department of Psychological Medicine, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
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40
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Affiliation(s)
- Oliver D Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,MRC London Institute for Medical Sciences, Hammersmith Hospital, London, UK. .,Translational Neuropsychiatry, H Lundbeck A/S, Valby, Denmark.
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Selvaggi P, Rizzo G, Mehta MA, Turkheimer FE, Veronese M. Integration of human whole-brain transcriptome and neuroimaging data: Practical considerations of current available methods. J Neurosci Methods 2021; 355:109128. [PMID: 33722642 DOI: 10.1016/j.jneumeth.2021.109128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Abstract
The Allen Human Brain Atlas (AHBA) is the first example of human brain transcriptomic mappings and detailed anatomical annotations which, for the first time, has allowed the integration of human brain transcriptomics with neuroimaging. This has been made possible because the AHBA offered an original dataset that contains mRNA expression measures for >20,000 genes covering the whole brain and, critically, in a standard stereotaxic space. In recent years many different methods have been used to integrate this data set with brain imaging data, although this endeavour has lacked harmony in terms of the workflow of data processing and subsequent analyses. In this work we discuss five main issues that experience has highlighted as in need of thorough consideration when integrating the AHBA with neuroimaging. These concerns are corroborated by comparing the performance of three different publicly available methods in correlating the same measures of serotonin receptors density with the correspondent AHBA mRNA maps. In this representative case, we were able to show how these methods can lead to discrepant results, suggesting that processing options are not neutral. We believe that the field should take into serious consideration these issues as they could undermine reproducibility and, in the end, the intrinsic value of the AHBA. We also advise on possible strategies to overcome these discrepancies. Finally, we encourage authors towards practices that will improve reproducibility such as transparency in reporting, algorithm and data sharing, collaboration.
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Affiliation(s)
- Pierluigi Selvaggi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gaia Rizzo
- Invicro, W12 0NN, London, UK; Division of Brain Sciences, Department of Medicine, Imperial College London, SW72AZ, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federico E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Hawkins PCT, Zelaya FO, O'Daly O, Holiga S, Dukart J, Umbricht D, Mehta MA. The effect of risperidone on reward-related brain activity is robust to drug-induced vascular changes. Hum Brain Mapp 2021; 42:2766-2777. [PMID: 33666305 PMCID: PMC8127149 DOI: 10.1002/hbm.25400] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/22/2021] [Accepted: 02/16/2021] [Indexed: 12/20/2022] Open
Abstract
Dopamine (DA) mediated brain activity is intimately linked to reward‐driven cerebral responses, while aberrant reward processing has been implicated in several psychiatric disorders. fMRI has been a valuable tool in understanding the mechanism by which DA modulators alter reward‐driven responses and how they may exert their therapeutic effect. However, the potential effects of a pharmacological compound on aspects of neurovascular coupling may cloud the interpretability of the BOLD contrast. Here, we assess the effects of risperidone on reward driven BOLD signals produced by reward anticipation and outcome, while attempting to control for potential drug effects on regional cerebral blood flow (CBF) and cerebrovascular reactivity (CVR). Healthy male volunteers (n = 21) each received a single oral dose of either 0.5 mg, 2 mg of risperidone or placebo in a double‐blind, placebo‐controlled, randomised, three‐period cross‐over study design. Participants underwent fMRI scanning while performing the widely used Monetary Incentive Delay (MID) task to assess drug impact on reward function. Measures of CBF (Arterial Spin Labelling) and breath‐hold challenge induced BOLD signal changes (as a proxy for CVR) were also acquired and included as covariates. Risperidone produced divergent, dose‐dependent effects on separate phases of reward processing, even after controlling for potential nonneuronal influences on the BOLD signal. These data suggest the D2 antagonist risperidone has a wide‐ranging influence on DA‐mediated reward function independent of nonneuronal factors. We also illustrate that assessment of potential vascular confounds on the BOLD signal may be advantageous when investigating CNS drug action and advocate for the inclusion of these additional measures into future study designs.
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Affiliation(s)
- Peter C T Hawkins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fernando O Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefan Holiga
- Roche Pharma Research and Early Development, Roche Innovation Centre Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Juergen Dukart
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Daniel Umbricht
- Roche Pharma Research and Early Development, Roche Innovation Centre Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Oakley DA, Walsh E, Mehta MA, Halligan PW, Deeley Q. Direct verbal suggestibility: Measurement and significance. Conscious Cogn 2021; 89:103036. [DOI: 10.1016/j.concog.2020.103036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 08/19/2020] [Accepted: 10/09/2020] [Indexed: 10/22/2022]
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Yalin N, Kempton MJ, Mazibuko N, Mehta MA, Young AH, Stokes PR. Mifepristone enhances the neural efficiency of human visuospatial memory encoding and recall. Psychoneuroendocrinology 2021; 125:105116. [PMID: 33418240 DOI: 10.1016/j.psyneuen.2020.105116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 01/02/2023]
Abstract
Glucocorticoid receptor (GR) antagonism is a promising new treatment for cognitive dysfunction in psychiatric disorders but the effects of GR antagonism on cognition related brain activity is poorly understood. This study examines the effects of the GR and progesterone receptor antagonist mifepristone on the neural correlates of visuospatial learning and working memory in healthy male participants. The study used a pharmacological functional magnetic resonance imaging (fMRI) design to determine mifepristone effects on visuospatial paired associates learning (vPAL) and n-back working memory (WM) fMRI task related brain activations. 20 right-handed healthy male participants received 600 mg mifepristone or placebo on two separate imaging days and each participant performed fMRI tasks four hours later. The effect of mifepristone on task related brain activations was determined using Region of Interest (ROI) fMRI analyses and an exploratory whole brain voxel-wise fMRI task analyses was also conducted. The vPAL task ROI analysis found that mifepristone administration was significantly associated with decreased fusiform cortex activations in first and second encoding blocks (p = 0.007, p = 0.04) and decreased angular and precuneal cortices activations in the first recall block (p = 0.01, p = 0.02). There were no significant differences in fMRI brain activations associated with mifepristone administration in the n-back task ROI's (all p > 0.05). Mifepristone administration did not significantly affect fMRI brain activations in the whole brain voxel-wise analyses for both tasks. N-back and vPAL task reaction times and accuracy were similar in both mifepristone and placebo conditions (all p > 0.05). Our finding of decreased fusiform, angular and precuneal vPAL task related brain activity associated with mifepristone administration for the same behavioural performance as found in the placebo condition may represent improved efficiency of visuospatial memory encoding and recall. These findings provide evidence that mifepristone may enhance the efficiency of human visuospatial memory and calls for further studies in patient populations using an fMRI approach to provide proof of concept for new treatments.
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Affiliation(s)
- Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College of London, London, UK.
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology &Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
| | - Ndaba Mazibuko
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College of London, London, UK.
| | - Paul Ra Stokes
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry & Psychology and Neuroscience, King's College of London, London, UK.
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Gilleen J, Nottage J, Yakub F, Kerins S, Valdearenas L, Uz T, Lahu G, Tsai M, Ogrinc F, Williams SC, Ffytche D, Mehta MA, Shergill SS. The effects of roflumilast, a phosphodiesterase type-4 inhibitor, on EEG biomarkers in schizophrenia: A randomised controlled trial. J Psychopharmacol 2021; 35:15-22. [PMID: 32854568 DOI: 10.1177/0269881120946300] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/29/2022]
Abstract
BACKGROUND Patients with schizophrenia have significant cognitive deficits, which may profoundly impair quality of life. These deficits are also evident at the neurophysiological level with patients demonstrating altered event-related potential in several stages of cognitive processing compared to healthy controls; within the auditory domain, for example, there are replicated alterations in Mismatch Negativity, P300 and Auditory Steady State Response. However, there are no approved pharmacological treatments for cognitive deficits in schizophrenia. AIMS Here we examine whether the phosphodiesterase-4 inhibitor, roflumilast, can improve neurophysiological deficits in schizophrenia. METHODS Using a randomised, double-blind, placebo-controlled, crossover design study in 18 patients with schizophrenia, the effect of the phosphodiesterase-4 inhibitor, roflumilast (100 µg and 250 µg) on auditory steady state response (early stage), mismatch negativity and theta (intermediate stage) and P300 (late stage) was examined using electroencephalogram. A total of 18 subjects were randomised and included in the analysis. RESULTS Roflumilast 250 µg significantly enhanced the amplitude of both the mismatch negativity (p=0.04) and working memory-related theta oscillations (p=0.02) compared to placebo but not in the other (early- or late-stage) cognitive markers. CONCLUSIONS The results suggest that phosphodiesterase-4 inhibition, with roflumilast, can improve electroencephalogram cognitive markers, which are impaired in schizophrenia, and that phosphodiesterase-4 inhibition acts at an intermediate rather than early or late cognitive processing stage. This study also underlines the use of neurophysiological measures as cognitive biomarkers in experimental medicine.
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Affiliation(s)
- James Gilleen
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,Department of Psychology, University of Roehampton, London, UK
| | - Judith Nottage
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Farah Yakub
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Sarah Kerins
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Lorena Valdearenas
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,South London and Maudsley Hospital NHS Foundation Trust, London, UK.,North Middlesex University Hospital, Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK
| | - Tolga Uz
- Takeda Development Center Americas, Deerfield, USA
| | - Gez Lahu
- Takeda Development Center Americas, Deerfield, USA
| | - Max Tsai
- Eli Lilly and Company, Indianapolis, USA
| | - Frank Ogrinc
- Takeda Development Center Americas, Deerfield, USA
| | - Steve C Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Dominic Ffytche
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Sukhi S Shergill
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
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Dukart J, Holiga S, Rullmann M, Lanzenberger R, Hawkins PCT, Mehta MA, Hesse S, Barthel H, Sabri O, Jech R, Eickhoff SB. JuSpace: A tool for spatial correlation analyses of magnetic resonance imaging data with nuclear imaging derived neurotransmitter maps. Hum Brain Mapp 2020; 42:555-566. [PMID: 33079453 PMCID: PMC7814756 DOI: 10.1002/hbm.25244] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/31/2022] Open
Abstract
Recent studies have shown that drug‐induced spatial alteration patterns in resting state functional activity as measured using magnetic resonance imaging (rsfMRI) are associated with the distribution of specific receptor systems targeted by respective compounds. Based on this approach, we introduce a toolbox (JuSpace) allowing for cross‐modal correlation of MRI‐based measures with nuclear imaging derived estimates covering various neurotransmitter systems including dopaminergic, serotonergic, noradrenergic, and GABAergic (gamma‐aminobutric acid) neurotransmission. We apply JuSpace to two datasets covering Parkinson's disease patients (PD) and risperidone‐induced changes in rsfMRI and cerebral blood flow (CBF). Consistently with the predominant neurodegeneration of dopaminergic and serotonergic system in PD, we find significant spatial associations between rsfMRI activity alterations in PD and dopaminergic (D2) and serotonergic systems (5‐HT1b). Risperidone induced CBF alterations were correlated with its main targets in serotonergic and dopaminergic systems. JuSpace provides a biologically meaningful framework for linking neuroimaging to underlying neurotransmitter information.
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Affiliation(s)
- Juergen Dukart
- Institute of Neuroscience and MedicineBrain & Behaviour (INM‐7), Research Centre JülichJülichGermany
- Institute of Systems NeuroscienceMedical Faculty, Heinrich Heine University DüsseldorfDüsseldorfGermany
| | - Stefan Holiga
- Roche Pharma Research and Early DevelopmentRoche Innovation Center Basel, F. Hoffmann‐La Roche Ltd.BaselSwitzerland
| | - Michael Rullmann
- Department of Nuclear MedicineUniversity Hospital of LeipzigLeipzigGermany
| | - Rupert Lanzenberger
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Peter C. T. Hawkins
- Department of NeuroimagingInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Mitul A. Mehta
- Department of NeuroimagingInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Swen Hesse
- Department of Nuclear MedicineUniversity Hospital of LeipzigLeipzigGermany
| | - Henryk Barthel
- Department of Nuclear MedicineUniversity Hospital of LeipzigLeipzigGermany
| | - Osama Sabri
- Department of Nuclear MedicineUniversity Hospital of LeipzigLeipzigGermany
| | - Robert Jech
- Department of Neurology and Center of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University HospitalPragueCzech Republic
| | - Simon B. Eickhoff
- Institute of Neuroscience and MedicineBrain & Behaviour (INM‐7), Research Centre JülichJülichGermany
- Institute of Systems NeuroscienceMedical Faculty, Heinrich Heine University DüsseldorfDüsseldorfGermany
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Barnby JM, Bell V, Mehta MA, Moutoussis M. Reduction in social learning and increased policy uncertainty about harmful intent is associated with pre-existing paranoid beliefs: Evidence from modelling a modified serial dictator game. PLoS Comput Biol 2020; 16:e1008372. [PMID: 33057428 PMCID: PMC7591074 DOI: 10.1371/journal.pcbi.1008372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/27/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023] Open
Abstract
Current computational models suggest that paranoia may be explained by stronger higher-order beliefs about others and increased sensitivity to environments. However, it is unclear whether this applies to social contexts, and whether it is specific to harmful intent attributions, the live expression of paranoia. We sought to fill this gap by fitting a computational model to data (n = 1754) from a modified serial dictator game, to explore whether pre-existing paranoia could be accounted by specific alterations to cognitive parameters characterising harmful intent attributions. We constructed a ‘Bayesian brain’ model of others’ intent, which we fitted to harmful intent and self-interest attributions made over 18 trials, across three different partners. We found that pre-existing paranoia was associated with greater uncertainty about other’s actions. It moderated the relationship between learning rates and harmful intent attributions, making harmful intent attributions less reliant on prior interactions. Overall, the magnitude of harmful intent attributions was directly related to their uncertainty, and importantly, the opposite was true for self-interest attributions. Our results explain how pre-existing paranoia may be the result of an increased need to attend to immediate experiences in determining intentional threat, at the expense of what is already known, and more broadly, they suggest that environments that induce greater probabilities of harmful intent attributions may also induce states of uncertainty, potentially as an adaptive mechanism to better detect threatening others. Importantly, we suggest that if paranoia were able to be explained exclusively by core domain-general alterations we would not observe differential parameter estimates underlying harmful-intent and self-interest attributions. A great deal of work has tried to explain paranoia through general cognitive principles, although relatively little has tried to understand whether paranoia may be explained by specific changes to social learning processes. This question is crucial, as paranoia is inherently a social phenomenon, and requires mechanistic explanations to match with its dynamic phenomenology. In this paper we wanted to test whether pre-existing and live paranoid beliefs about others specifically altered how an individual attributed harmful intent–the live expression of paranoia–to partners over a series of live interactions. To do this we applied a novel computational model and network analysis to behavioural data from a large sample of participants in the general population that had played a modified Dictator game online, and required them to attribute whether the behaviour of their partner was due to their intent to harm, or their self-interest, on two mutually exclusive scales. Pre-existing paranoid beliefs about others reduced the value of new partner behaviours on evolving attributions of harmful intent. We suggest that both pre-existing paranoid beliefs and momentary paranoia may incur an adaptive cognitive state to better track potentially threatening others, and demonstrate phenomenological specificity associated with mechanisms of live paranoia.
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Affiliation(s)
- Joseph M. Barnby
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Vaughan Bell
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Mitul A. Mehta
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max-Planck–UCL Centre for Computational Psychiatry and Ageing, University College London, London, United Kingdom
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Boedhoe PSW, van Rooij D, Hoogman M, Twisk JWR, Schmaal L, Abe Y, Alonso P, Ameis SH, Anikin A, Anticevic A, Arango C, Arnold PD, Asherson P, Assogna F, Auzias G, Banaschewski T, Baranov A, Batistuzzo MC, Baumeister S, Baur-Streubel R, Behrmann M, Bellgrove MA, Benedetti F, Beucke JC, Biederman J, Bollettini I, Bose A, Bralten J, Bramati IE, Brandeis D, Brem S, Brennan BP, Busatto GF, Calderoni S, Calvo A, Calvo R, Castellanos FX, Cercignani M, Chaim-Avancini TM, Chantiluke KC, Cheng Y, Cho KIK, Christakou A, Coghill D, Conzelmann A, Cubillo AI, Dale AM, Dallaspezia S, Daly E, Denys D, Deruelle C, Di Martino A, Dinstein I, Doyle AE, Durston S, Earl EA, Ecker C, Ehrlich S, Ely BA, Epstein JN, Ethofer T, Fair DA, Fallgatter AJ, Faraone SV, Fedor J, Feng X, Feusner JD, Fitzgerald J, Fitzgerald KD, Fouche JP, Freitag CM, Fridgeirsson EA, Frodl T, Gabel MC, Gallagher L, Gogberashvili T, Gori I, Gruner P, Gürsel DA, Haar S, Haavik J, Hall GB, Harrison NA, Hartman CA, Heslenfeld DJ, Hirano Y, Hoekstra PJ, Hoexter MQ, Hohmann S, Høvik MF, Hu H, Huyser C, Jahanshad N, Jalbrzikowski M, James A, Janssen J, Jaspers-Fayer F, Jernigan TL, Kapilushniy D, Kardatzki B, Karkashadze G, Kathmann N, Kaufmann C, Kelly C, Khadka S, King JA, Koch K, Kohls G, Konrad K, Kuno M, Kuntsi J, Kvale G, Kwon JS, Lázaro L, Lera-Miguel S, Lesch KP, Hoekstra L, Liu Y, Lochner C, Louza MR, Luna B, Lundervold AJ, Malpas CB, Marques P, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Mattos P, McCarthy H, McGrath J, Mehta MA, Menchón JM, Mennes M, Martinho MM, Moreira PS, Morer A, Morgado P, Muratori F, Murphy CM, Murphy DGM, Nakagawa A, Nakamae T, Nakao T, Namazova-Baranova L, Narayanaswamy JC, Nicolau R, Nigg JT, Novotny SE, Nurmi EL, Weiss EO, O'Gorman Tuura RL, O'Hearn K, O'Neill J, Oosterlaan J, Oranje B, Paloyelis Y, Parellada M, Pauli P, Perriello C, Piacentini J, Piras F, Piras F, Plessen KJ, Puig O, Ramos-Quiroga JA, Reddy YCJ, Reif A, Reneman L, Retico A, Rosa PGP, Rubia K, Rus OG, Sakai Y, Schrantee A, Schwarz L, Schweren LJS, Seitz J, Shaw P, Shook D, Silk TJ, Simpson HB, Skokauskas N, Soliva Vila JC, Solovieva A, Soreni N, Soriano-Mas C, Spalletta G, Stern ER, Stevens MC, Stewart SE, Sudre G, Szeszko PR, Tamm L, Taylor MJ, Tolin DF, Tosetti M, Tovar-Moll F, Tsuchiyagaito A, van Erp TGM, van Wingen GA, Vance A, Venkatasubramanian G, Vilarroya O, Vives-Gilabert Y, von Polier GG, Walitza S, Wallace GL, Wang Z, Wolfers T, Yoncheva YN, Yun JY, Zanetti MV, Zhou F, Ziegler GC, Zierhut KC, Zwiers MP, Thompson PM, Stein DJ, Buitelaar J, Franke B, van den Heuvel OA. Subcortical Brain Volume, Regional Cortical Thickness, and Cortical Surface Area Across Disorders: Findings From the ENIGMA ADHD, ASD, and OCD Working Groups. Am J Psychiatry 2020; 177:834-843. [PMID: 32539527 PMCID: PMC8296070 DOI: 10.1176/appi.ajp.2020.19030331] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and obsessive-compulsive disorder (OCD) are common neurodevelopmental disorders that frequently co-occur. The authors sought to directly compare these disorders using structural brain imaging data from ENIGMA consortium data. METHODS Structural T1-weighted whole-brain MRI data from healthy control subjects (N=5,827) and from patients with ADHD (N=2,271), ASD (N=1,777), and OCD (N=2,323) from 151 cohorts worldwide were analyzed using standardized processing protocols. The authors examined subcortical volume, cortical thickness, and cortical surface area differences within a mega-analytical framework, pooling measures extracted from each cohort. Analyses were performed separately for children, adolescents, and adults, using linear mixed-effects models adjusting for age, sex, and site (and intracranial volume for subcortical and surface area measures). RESULTS No shared differences were found among all three disorders, and shared differences between any two disorders did not survive correction for multiple comparisons. Children with ADHD compared with those with OCD had smaller hippocampal volumes, possibly influenced by IQ. Children and adolescents with ADHD also had smaller intracranial volume than control subjects and those with OCD or ASD. Adults with ASD showed thicker frontal cortices compared with adult control subjects and other clinical groups. No OCD-specific differences were observed across different age groups and surface area differences among all disorders in childhood and adulthood. CONCLUSIONS The study findings suggest robust but subtle differences across different age groups among ADHD, ASD, and OCD. ADHD-specific intracranial volume and hippocampal differences in children and adolescents, and ASD-specific cortical thickness differences in the frontal cortex in adults, support previous work emphasizing structural brain differences in these disorders.
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Affiliation(s)
- Premika S W Boedhoe
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Daan van Rooij
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Martine Hoogman
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jos W R Twisk
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Lianne Schmaal
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yoshinari Abe
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Pino Alonso
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Stephanie H Ameis
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anatoly Anikin
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Alan Anticevic
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Celso Arango
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Paul D Arnold
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Philip Asherson
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Francesca Assogna
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Guillaume Auzias
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Tobias Banaschewski
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Alexander Baranov
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Marcelo C Batistuzzo
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sarah Baumeister
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ramona Baur-Streubel
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Marlene Behrmann
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Mark A Bellgrove
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Francesco Benedetti
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jan C Beucke
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Joseph Biederman
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Irene Bollettini
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anushree Bose
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Janita Bralten
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ivanei E Bramati
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Daniel Brandeis
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Silvia Brem
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Brian P Brennan
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Geraldo F Busatto
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sara Calderoni
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anna Calvo
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Rosa Calvo
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Francisco X Castellanos
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Mara Cercignani
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Tiffany M Chaim-Avancini
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kaylita C Chantiluke
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yuqi Cheng
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kang Ik K Cho
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anastasia Christakou
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - David Coghill
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Annette Conzelmann
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ana I Cubillo
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anders M Dale
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sara Dallaspezia
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Eileen Daly
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| | - Damiaan Denys
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Christine Deruelle
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| | - Adriana Di Martino
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| | - Ilan Dinstein
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| | - Alysa E Doyle
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sarah Durston
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Eric A Earl
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Christine Ecker
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Stefan Ehrlich
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| | - Benjamin A Ely
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jeffrey N Epstein
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| | - Thomas Ethofer
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Damien A Fair
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Andreas J Fallgatter
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Stephen V Faraone
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jennifer Fedor
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Xin Feng
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jamie D Feusner
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| | - Jackie Fitzgerald
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kate D Fitzgerald
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jean-Paul Fouche
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| | - Christine M Freitag
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Egill A Fridgeirsson
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Thomas Frodl
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Matt C Gabel
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Louise Gallagher
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| | - Tinatin Gogberashvili
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ilaria Gori
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| | - Patricia Gruner
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Deniz A Gürsel
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Shlomi Haar
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jan Haavik
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Geoffrey B Hall
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Neil A Harrison
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Catharina A Hartman
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| | - Dirk J Heslenfeld
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yoshiyuki Hirano
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| | - Pieter J Hoekstra
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| | - Marcelo Q Hoexter
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sarah Hohmann
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| | - Marie F Høvik
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Hao Hu
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Chaim Huyser
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Neda Jahanshad
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Maria Jalbrzikowski
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anthony James
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Joost Janssen
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| | - Fern Jaspers-Fayer
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Terry L Jernigan
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Dmitry Kapilushniy
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Bernd Kardatzki
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| | - Georgii Karkashadze
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| | - Norbert Kathmann
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| | - Christian Kaufmann
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Clare Kelly
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sabin Khadka
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Joseph A King
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kathrin Koch
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Gregor Kohls
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kerstin Konrad
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Masaru Kuno
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jonna Kuntsi
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Gerd Kvale
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jun Soo Kwon
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Luisa Lázaro
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Sara Lera-Miguel
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Klaus-Peter Lesch
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Liesbeth Hoekstra
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yanni Liu
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Christine Lochner
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Mario R Louza
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Beatriz Luna
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Astri J Lundervold
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Charles B Malpas
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Paulo Marques
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Rachel Marsh
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ignacio Martínez-Zalacaín
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - David Mataix-Cols
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Paulo Mattos
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Hazel McCarthy
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jane McGrath
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Mitul A Mehta
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - José M Menchón
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Maarten Mennes
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Mauricio Moller Martinho
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Pedro S Moreira
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Astrid Morer
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Pedro Morgado
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Filippo Muratori
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Clodagh M Murphy
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Declan G M Murphy
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Akiko Nakagawa
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Takashi Nakamae
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Tomohiro Nakao
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Leyla Namazova-Baranova
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Janardhanan C Narayanaswamy
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Rosa Nicolau
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Joel T Nigg
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Stephanie E Novotny
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Erika L Nurmi
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Eileen Oberwelland Weiss
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ruth L O'Gorman Tuura
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kirsten O'Hearn
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Joseph O'Neill
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jaap Oosterlaan
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Bob Oranje
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yannis Paloyelis
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Mara Parellada
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Paul Pauli
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Chris Perriello
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - John Piacentini
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Fabrizio Piras
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Federica Piras
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kerstin J Plessen
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Olga Puig
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - J Antoni Ramos-Quiroga
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Y C Janardhan Reddy
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Andreas Reif
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Liesbeth Reneman
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Alessandra Retico
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Pedro G P Rosa
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Katya Rubia
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Oana Georgiana Rus
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yuki Sakai
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Anouk Schrantee
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Lena Schwarz
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Lizanne J S Schweren
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jochen Seitz
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| | - Philip Shaw
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Devon Shook
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Tim J Silk
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - H Blair Simpson
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Norbert Skokauskas
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Juan Carlos Soliva Vila
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| | - Anastasia Solovieva
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Noam Soreni
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Carles Soriano-Mas
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Gianfranco Spalletta
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Emily R Stern
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Michael C Stevens
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - S Evelyn Stewart
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Gustavo Sudre
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Philip R Szeszko
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| | - Leanne Tamm
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| | - Margot J Taylor
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - David F Tolin
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Michela Tosetti
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| | - Fernanda Tovar-Moll
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Aki Tsuchiyagaito
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Theo G M van Erp
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Guido A van Wingen
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Alasdair Vance
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ganesan Venkatasubramanian
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| | - Oscar Vilarroya
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| | - Yolanda Vives-Gilabert
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Georg G von Polier
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Susanne Walitza
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| | - Gregory L Wallace
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Zhen Wang
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Thomas Wolfers
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Yuliya N Yoncheva
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Je-Yeon Yun
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Marcus V Zanetti
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Fengfeng Zhou
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Georg C Ziegler
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Kathrin C Zierhut
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| | - Marcel P Zwiers
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Paul M Thompson
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Dan J Stein
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Jan Buitelaar
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Barbara Franke
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Odile A van den Heuvel
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
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Dipasquale O, Martins D, Sethi A, Veronese M, Hesse S, Rullmann M, Sabri O, Turkheimer F, Harrison NA, Mehta MA, Cercignani M. Unravelling the effects of methylphenidate on the dopaminergic and noradrenergic functional circuits. Neuropsychopharmacology 2020; 45:1482-1489. [PMID: 32473593 PMCID: PMC7360745 DOI: 10.1038/s41386-020-0724-x] [Citation(s) in RCA: 8] [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: 03/09/2020] [Revised: 04/30/2020] [Accepted: 05/15/2020] [Indexed: 11/08/2022]
Abstract
Functional magnetic resonance imaging (fMRI) can be combined with drugs to investigate the system-level functional responses in the brain to such challenges. However, most psychoactive agents act on multiple neurotransmitters, limiting the ability of fMRI to identify functional effects related to actions on discrete pharmacological targets. We recently introduced a multimodal approach, REACT (Receptor-Enriched Analysis of functional Connectivity by Targets), which offers the opportunity to disentangle effects of drugs on different neurotransmitters and clarify the biological mechanisms driving clinical efficacy and side effects of a compound. Here, we focus on methylphenidate (MPH), which binds to the dopamine transporter (DAT) and the norepinephrine transporter (NET), to unravel its effects on dopaminergic and noradrenergic functional circuits in the healthy brain at rest. We then explored the relationship between these target-enriched resting state functional connectivity (FC) maps and inter-individual variability in behavioural responses to a reinforcement-learning task encompassing a novelty manipulation to disentangle the molecular systems underlying specific cognitive/behavioural effects. Our main analysis showed a significant MPH-induced FC increase in sensorimotor areas in the functional circuit associated with DAT. In our exploratory analysis, we found that MPH-induced regional variations in the DAT and NET-enriched FC maps were significantly correlated with some of the inter-individual differences on key behavioural responses associated with the reinforcement-learning task. Our findings show that main MPH-related FC changes at rest can be understood through the distribution of DAT in the brain. Furthermore, they suggest that when compounds have mixed pharmacological profiles, REACT may be able to capture regional functional effects that are underpinned by the same cognitive mechanism but are related to engagement of distinct molecular targets.
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Affiliation(s)
- Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Arjun Sethi
- Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Swen Hesse
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Federico Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Neil A Harrison
- Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mara Cercignani
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK
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50
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Turkheimer FE, Selvaggi P, Mehta MA, Veronese M, Zelaya F, Dazzan P, Vernon AC. Normalizing the Abnormal: Do Antipsychotic Drugs Push the Cortex Into an Unsustainable Metabolic Envelope? Schizophr Bull 2020; 46:484-495. [PMID: 31755955 PMCID: PMC7147598 DOI: 10.1093/schbul/sbz119] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 12/12/2022]
Abstract
The use of antipsychotic medication to manage psychosis, principally in those with a diagnosis of schizophrenia or bipolar disorder, is well established. Antipsychotics are effective in normalizing positive symptoms of psychosis in the short term (delusions, hallucinations and disordered thought). Their long-term use is, however, associated with side effects, including several types of movement (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac disorders. Furthermore, higher lifetime antipsychotic dose-years may be associated with poorer cognitive performance and blunted affect, although the mechanisms driving the latter associations are not well understood. In this article, we propose a novel model of the long-term effects of antipsychotic administration focusing on the changes in brain metabolic homeostasis induced by the medication. We propose here that the brain metabolic normalization, that occurs in parallel to the normalization of psychotic symptoms following antipsychotic treatment, may not ultimately be sustainable by the cerebral tissue of some patients; these patients may be characterized by already reduced oxidative metabolic capacity and this may push the brain into an unsustainable metabolic envelope resulting in tissue remodeling. To support this perspective, we will review the existing data on the brain metabolic trajectories of patients with a diagnosis of schizophrenia as indexed using available neuroimaging tools before and after use of medication. We will also consider data from pre-clinical studies to provide mechanistic support for our model.
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Affiliation(s)
- Federico E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, UK
| | - Pierluigi Selvaggi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Anthony C Vernon
- MRC Centre for Neurodevelopmental Disorders, King’s College London, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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