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Kieling C, Buchweitz C, Caye A, Silvani J, Ameis SH, Brunoni AR, Cost KT, Courtney DB, Georgiades K, Merikangas KR, Henderson JL, Polanczyk GV, Rohde LA, Salum GA, Szatmari P. Worldwide Prevalence and Disability From Mental Disorders Across Childhood and Adolescence: Evidence From the Global Burden of Disease Study. JAMA Psychiatry 2024; 81:347-356. [PMID: 38294785 PMCID: PMC10831630 DOI: 10.1001/jamapsychiatry.2023.5051] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/03/2023] [Indexed: 02/01/2024]
Abstract
Importance The period from childhood to early adulthood involves increased susceptibility to the onset of mental disorders, with implications for policy making that may be better appreciated by disaggregated analyses of narrow age groups. Objective To estimate the global prevalence and years lived with disability (YLDs) associated with mental disorders and substance use disorders (SUDs) across 4 age groups using data from the 2019 Global Burden of Disease (GBD) study. Design, Setting, and Participants Data from the 2019 GBD study were used for analysis of mental disorders and SUDs. Results were stratified by age group (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and sex. Data for the 2019 GBD study were collected up to 2018, and data were analyzed for this article from April 2022 to September 2023. Exposure Age 5 to 9 years, 10 to 14 years, 15 to 19 years, and 20 to 24 years. Main Outcomes and Measures Prevalence rates with 95% uncertainty intervals (95% UIs) and number of YLDs. Results Globally in 2019, 293 million of 2516 million individuals aged 5 to 24 years had at least 1 mental disorder, and 31 million had an SUD. The mean prevalence was 11.63% for mental disorders and 1.22% for SUDs. For the narrower age groups, the prevalence of mental disorders was 6.80% (95% UI, 5.58-8.03) for those aged 5 to 9 years, 12.40% (95% UI, 10.62-14.59) for those aged 10 to 14 years, 13.96% (95% UI, 12.36-15.78) for those aged 15 to 19 years, and 13.63% (95% UI, 11.90-15.53) for those aged 20 to 24 years. The prevalence of each individual disorder also varied by age groups; sex-specific patterns varied to some extent by age. Mental disorders accounted for 31.14 million of 153.59 million YLDs (20.27% of YLDs from all causes). SUDs accounted for 4.30 million YLDs (2.80% of YLDs from all causes). Over the entire life course, 24.85% of all YLDs attributable to mental disorders were recorded before age 25 years. Conclusions and Relevance An analytical framework that relies on stratified age groups should be adopted for examination of mental disorders and SUDs from childhood to early adulthood. Given the implications of the early onset and lifetime burden of mental disorders and SUDs, age-disaggregated data are essential for the understanding of vulnerability and effective prevention and intervention initiatives.
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Affiliation(s)
- Christian Kieling
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Claudia Buchweitz
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- National Center for Research and Innovation in Mental Health (CISM), São Paulo, Brazil
| | - Juliana Silvani
- Graduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - André R. Brunoni
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Katherine T. Cost
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Darren B. Courtney
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Kathleen Ries Merikangas
- Section on Developmental Genetic Epidemiology, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Joanna L. Henderson
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Guilherme V. Polanczyk
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- National Center for Research and Innovation in Mental Health (CISM), São Paulo, Brazil
| | - Giovanni A. Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Mind Institute, New York, New York
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Division of Child and Youth Mental Health, Centre for Addiction and Mental Health & University of Toronto, University of Toronto, Toronto, Ontario, Canada
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Quilty LC, Tempelaar W, Andrade BF, Kidd SA, Lunsky Y, Chen S, Wang W, Wong JKY, Lau C, Sedrak AB, Kelly R, Sivakumar H, Jani M, Ameis SH, Cleverley K, Goldstein BI, Felsky D, Dickie EW, Foussias G, Kozloff N, Nikolova YS, Polillo A, Diaconescu AO, Wheeler AL, Courtney DB, Hawke LD, Rotenberg M, Voineskos AN. Cognition and Educational Achievement in the Toronto Adolescent and Youth Cohort Study: Rationale, Methods, and Early Data. Biol Psychiatry Cogn Neurosci Neuroimaging 2024; 9:265-274. [PMID: 37979945 DOI: 10.1016/j.bpsc.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Both cognition and educational achievement in youths are linked to psychosis risk. One major aim of the Toronto Adolescent and Youth (TAY) Cohort Study is to characterize how cognitive and educational achievement trajectories inform the course of psychosis spectrum symptoms (PSSs), functioning, and suicidality. Here, we describe the protocol for the cognitive and educational data and early baseline data. METHODS The cognitive assessment design is consistent with youth population cohort studies, including the NIH Toolbox, Rey Auditory Verbal Learning Test, Wechsler Matrix Reasoning Task, and Little Man Task. Participants complete an educational achievement questionnaire, and report cards are requested. Completion rates, descriptive data, and differences across PSS status are reported for the first participants (N = 417) ages 11 to 24 years, who were recruited between May 4, 2021, and February 2, 2023. RESULTS Nearly 84% of the sample completed cognitive testing, and 88.2% completed the educational questionnaire, whereas report cards were collected for only 40.3%. Modifications to workflows were implemented to improve data collection. Participants who met criteria for PSSs demonstrated lower performance than those who did not on numerous key cognitive indices (p < .05) and also had more academic/educational problems. CONCLUSIONS Following youths longitudinally enabled trajectory mapping and prediction based on cognitive and educational performance in relation to PSSs in treatment-seeking youths. Youths with PSSs had lower cognitive performance and worse educational outcomes than youths without PSSs. Results show the feasibility of collecting data on cognitive and educational outcomes in a cohort of youths seeking treatment related to mental illness and substance use.
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Affiliation(s)
- Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wanda Tempelaar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Brendan F Andrade
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sean A Kidd
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yona Lunsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jimmy K Y Wong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Chloe Lau
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada
| | - Andrew B Sedrak
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel Kelly
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Harijah Sivakumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Melanie Jani
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin I Goldstein
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Felsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Kozloff
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Alexia Polillo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andreea O Diaconescu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health Program, Toronto, Ontario, Canada
| | - Darren B Courtney
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Rotenberg
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Cleverley K, Foussias G, Ameis SH, Courtney DB, Goldstein BI, Hawke LD, Kozloff N, Quilty LC, Rotenberg M, Wheeler AL, Andrade BF, Aitken M, Mahleka D, Jani M, Frayne M, Wong JKY, Kelly R, Dickie EW, Felsky D, Haltigan JD, Lai MC, Nikolova YS, Tempelaar W, Wang W, Battaglia M, Husain MO, Kidd S, Kurdyak P, Levitan RD, Lewis SP, Polillo A, Szatmari P, van der Miesen AIR, Ahmadzadasl M, Voineskos AN. The Toronto Adolescent and Youth Cohort Study: Study Design and Early Data Related to Psychosis Spectrum Symptoms, Functioning, and Suicidality. Biol Psychiatry Cogn Neurosci Neuroimaging 2024; 9:253-264. [PMID: 37979943 DOI: 10.1016/j.bpsc.2023.10.011] [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] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Psychosis spectrum symptoms (PSSs) occur in a sizable percentage of youth and are associated with poorer cognitive performance, poorer functioning, and suicidality (i.e., suicidal thoughts and behaviors). PSSs may occur more frequently in youths already experiencing another mental illness, but the antecedents are not well known. The Toronto Adolescent and Youth (TAY) Cohort Study aims to characterize developmental trajectories in youths with mental illness and understand associations with PSSs, functioning, and suicidality. METHODS The TAY Cohort Study is a longitudinal cohort study that aims to assess 1500 youths (age 11-24 years) presenting to tertiary care. In this article, we describe the extensive diagnostic and clinical characterization of psychopathology, substance use, functioning, suicidality, and health service utilization in these youths, with follow-up every 6 months over 5 years, including early baseline data. RESULTS A total of 417 participants were enrolled between May 4, 2021, and February 2, 2023. Participants met diagnostic criteria for an average of 3.5 psychiatric diagnoses, most frequently anxiety and depressive disorders. Forty-nine percent of participants met a pre-established threshold for PSSs and exhibited higher rates of functional impairment, internalizing and externalizing symptoms, and suicidality than participants without PSSs. CONCLUSIONS Initial findings from the TAY Cohort Study demonstrate the feasibility of extensive clinical phenotyping in youths who are seeking help for mental health problems. PSS prevalence is much higher than in community-based studies. Our early data support the critical need to better understand longitudinal trajectories of clinical youth cohorts in relation to psychosis risk, functioning, and suicidality.
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Affiliation(s)
- Kristin Cleverley
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Darren B Courtney
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin I Goldstein
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Kozloff
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Martin Rotenberg
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health Program, Toronto, Ontario, Canada
| | - Brendan F Andrade
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madison Aitken
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Don Mahleka
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Melanie Jani
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Margot Frayne
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jimmy K Y Wong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel Kelly
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Felsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John D Haltigan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; National Taiwan University Hospital and College of Medicine, Taiwan
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wanda Tempelaar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marco Battaglia
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad Omair Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sean Kidd
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert D Levitan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Alexia Polillo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health Program, Toronto, Ontario, Canada
| | - Anna I R van der Miesen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Masoud Ahmadzadasl
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Dickie EW, Ameis SH, Boileau I, Diaconescu AO, Felsky D, Goldstein BI, Gonçalves V, Griffiths JD, Haltigan JD, Husain MO, Rubin-Kahana DS, Iftikhar M, Jani M, Lai MC, Lin HY, MacIntosh BJ, Wheeler AL, Vasdev N, Vieira E, Ahmadzadeh G, Heyland L, Mohan A, Ogunsanya F, Oliver LD, Zhu C, Wong JKY, Charlton C, Truong J, Yu L, Kelly R, Cleverley K, Courtney DB, Foussias G, Hawke LD, Hill S, Kozloff N, Polillo A, Rotenberg M, Quilty LC, Tempelaar W, Wang W, Nikolova YS, Voineskos AN. Neuroimaging and Biosample Collection in the Toronto Adolescent and Youth Cohort Study: Rationale, Methods, and Early Data. Biol Psychiatry Cogn Neurosci Neuroimaging 2024; 9:275-284. [PMID: 37979944 DOI: 10.1016/j.bpsc.2023.10.013] [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] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The Toronto Adolescent and Youth (TAY) Cohort Study will characterize the neurobiological trajectories of psychosis spectrum symptoms, functioning, and suicidality (i.e., suicidal thoughts and behaviors) in youth seeking mental health care. Here, we present the neuroimaging and biosample component of the protocol. We also present feasibility and quality control metrics for the baseline sample collected thus far. METHODS The current study includes youths (ages 11-24 years) who were referred to child and youth mental health services within a large tertiary care center in Toronto, Ontario, Canada, with target recruitment of 1500 participants. Participants were offered the opportunity to provide any or all of the following: 1) 1-hour magnetic resonance imaging (MRI) scan (electroencephalography if ineligible for or declined MRI), 2) blood sample for genomic and proteomic data (or saliva if blood collection was declined or not feasible) and urine sample, and 3) heart rate recording to assess respiratory sinus arrhythmia. RESULTS Of the first 417 participants who consented to participate between May 4, 2021, and February 2, 2023, 412 agreed to participate in the imaging and biosample protocol. Of these, 334 completed imaging, 341 provided a biosample, 338 completed respiratory sinus arrhythmia, and 316 completed all 3. Following quality control, data usability was high (MRI: T1-weighted 99%, diffusion-weighted imaging 99%, arterial spin labeling 90%, resting-state functional MRI 95%, task functional MRI 90%; electroencephalography: 83%; respiratory sinus arrhythmia: 99%). CONCLUSIONS The high consent rates, good completion rates, and high data usability reported here demonstrate the feasibility of collecting and using brain imaging and biosamples in a large clinical cohort of youths seeking mental health care.
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Affiliation(s)
- Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Boileau
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andreea O Diaconescu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Felsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin I Goldstein
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vanessa Gonçalves
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John D Griffiths
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John D Haltigan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad O Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dafna S Rubin-Kahana
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Myera Iftikhar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Melanie Jani
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; National Taiwan University Hospital and College of Medicine, Taiwan
| | - Hsiang-Yuan Lin
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Oslo University Hospital, Oslo, Norway
| | - Anne L Wheeler
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Neil Vasdev
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Erica Vieira
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ghazaleh Ahmadzadeh
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lindsay Heyland
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Acadia University, Wolfville, Nova Scotia, Canada
| | - Akshay Mohan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Feyi Ogunsanya
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Cherrie Zhu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Lunenfeld-Tanenbaum Research Institute at Sinai Health, Toronto, Ontario, Canada
| | - Jimmy K Y Wong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Colleen Charlton
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jennifer Truong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lujia Yu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel Kelly
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Darren B Courtney
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sean Hill
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Nicole Kozloff
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alexia Polillo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Martin Rotenberg
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wanda Tempelaar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Voineskos AN, Hawco C, Neufeld NH, Turner JA, Ameis SH, Anticevic A, Buchanan RW, Cadenhead K, Dazzan P, Dickie EW, Gallucci J, Lahti AC, Malhotra AK, Öngür D, Lencz T, Sarpal DK, Oliver LD. Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions. World Psychiatry 2024; 23:26-51. [PMID: 38214624 PMCID: PMC10786022 DOI: 10.1002/wps.21159] [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: 01/13/2024] Open
Abstract
Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicholas H Neufeld
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression and McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Alan Anticevic
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julia Gallucci
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anil K Malhotra
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Dost Öngür
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Todd Lencz
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Deepak K Sarpal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Nishat E, Scratch SE, Ameis SH, Wheeler AL. Disrupted Maturation of White Matter Microstructure After Concussion Is Associated With Internalizing Behavior Scores in Female Children. Biol Psychiatry 2024:S0006-3223(24)00031-3. [PMID: 38237797 DOI: 10.1016/j.biopsych.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)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/08/2023] [Accepted: 01/08/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Some children who experience concussions, particularly females, develop long-lasting emotional and behavioral problems. Establishing the potential contribution of preexisting behavioral problems and disrupted white matter maturation has been challenging due to a lack of preinjury data. METHODS From the Adolescent Brain Cognitive Development cohort, 239 (90 female) children age 12.1 ± 0.6 years who experienced a concussion after study entry at 10.0 ± 0.6 years were compared to 6438 (3245 female) children without head injuries who were age 9.9 ± 0.6 years at baseline and 12.0 ± 0.6 years at follow-up. The Child Behavior Checklist was used to assess internalizing and externalizing behavior at study entry and follow-up. In the children with magnetic resonance imaging data available (concussion n = 134, comparison n = 3520), deep and superficial white matter was characterized by neurite density from restriction spectrum image modeling of diffusion magnetic resonance imaging. Longitudinal ComBat harmonization removed scanner effects. Linear regressions modeled 1) behavior problems at follow-up controlling for baseline behavior, 2) impact of concussion on white matter maturation, and 3) contribution of deviations in white matter maturation to postconcussion behavior problems. RESULTS Only female children with concussion had higher internalizing behavior problem scores. The youngest children with concussion showed less change in superficial white matter neurite density over 2 years than children with no concussion. In females with concussion, less change in superficial white matter neurite density was correlated with increased internalizing behavior problem scores. CONCLUSIONS Concussions in female children are associated with emotional problems beyond preinjury levels. Injury to superficial white matter may contribute to persistent internalizing behavior problems in females.
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Affiliation(s)
- Eman Nishat
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shannon E Scratch
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Nishat E, Stojanovski S, Scratch SE, Ameis SH, Wheeler AL. Premature white matter microstructure in female children with a history of concussion. Dev Cogn Neurosci 2023; 62:101275. [PMID: 37441978 PMCID: PMC10439504 DOI: 10.1016/j.dcn.2023.101275] [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: 05/09/2022] [Revised: 05/18/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
Childhood concussion may interfere with neurodevelopment and influence cognition. Females are more likely to experience persistent symptoms after concussion, yet the sex-specific impact of concussion on brain microstructure in children is understudied. This study examined white matter and cortical microstructure, based on neurite density (ND) from diffusion-weighted MRI, in 9-to-10-year-old children in the Adolescent Brain Cognitive Development Study with (n = 336) and without (n = 7368) a history of concussion, and its relationship with cognitive performance. Multivariate regression was used to investigate relationships between ND and group, sex, and age in deep and superficial white matter, subcortical structures, and cortex. Partial least square correlation was performed to identify associations between ND and performance on NIH Toolbox tasks in children with concussion. All tissue types demonstrated higher ND with age, reflecting brain maturation. Group comparisons revealed higher ND in deep and superficial white matter in females with concussion. In female but not male children with concussion, there were significant associations between ND and performance on cognitive tests. These results demonstrate a greater long-term impact of childhood concussion on white matter microstructure in females compared to males that is associated with cognitive function. The increase in ND in females may reflect premature white matter maturation.
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Affiliation(s)
- Eman Nishat
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Sonja Stojanovski
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Shannon E Scratch
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G 1V7, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario M4G 1R8, Canada
| | - Stephanie H Ameis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5T 1R8, Canada; Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario M6J 1H4, Canada
| | - Anne L Wheeler
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada.
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Lai MC, Saunders NR, Huang A, Artani A, Wilton AS, Zaheer J, Ameis SH, Brown HK, Lunsky Y. Self-Harm Events and Suicide Deaths Among Autistic Individuals in Ontario, Canada. JAMA Netw Open 2023; 6:e2327415. [PMID: 37552480 PMCID: PMC10410481 DOI: 10.1001/jamanetworkopen.2023.27415] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/25/2023] [Indexed: 08/09/2023] Open
Abstract
IMPORTANCE Reasons for elevated suicide risks among autistic people are unclear, with insufficient population-based research on sex-specific patterns to inform tailored prevention and intervention. OBJECTIVES To examine sex-stratified rates of self-harm events and suicide death among autistic individuals compared with nonautistic individuals, as well as the associated sociodemographic and clinical risk factors. DESIGN, SETTING, AND PARTICIPANTS This population-based matched-cohort study using linked health administrative databases in Ontario, Canada included all individuals with physician-recorded autism diagnoses from April 1, 1988, to March 31, 2018, each matched on age and sex to 4 nonautistic individuals from the general population. Self-harm events resulting in emergency health care from April 1, 2005, to December 31, 2020, were examined for one cohort, and death by suicide and other causes from April 1, 1993, to December 31, 2018, were examined for another cohort. Statistical analyses were conducted between October 2021 and June 2023. EXPOSURE Physician-recorded autism diagnoses from 1988 to 2018 from health administrative databases. MAIN OUTCOMES AND MEASURES Autistic and nonautistic individuals who were sex stratified a priori were compared using Andersen-Gill recurrent event models on self-harm events, and cause-specific competing risk models on death by suicide or other causes. Neighborhood-level income and rurality indices, and individual-level broad diagnostic categories of intellectual disabilities, mood and anxiety disorders, schizophrenia spectrum disorders, substance use disorders, and personality disorders were covariates. RESULTS For self-harm events (cohort, 379 630 individuals; median age at maximum follow-up, 20 years [IQR, 15-28 years]; median age of first autism diagnosis claim for autistic individuals, 9 years [IQR, 4-15 years]; 19 800 autistic females, 56 126 autistic males 79 200 nonautistic females, and 224 504 nonautistic males), among both sexes, autism diagnoses had independent associations with self-harm events (females: relative rate, 1.83; 95% CI, 1.61-2.08; males: relative rate, 1.47; 95% CI, 1.28-1.69) after accounting for income, rurality, intellectual disabilities, and psychiatric diagnoses. For suicide death (cohort, 334 690 individuals; median age at maximum follow-up, 19 years [IQR, 14-27 years]; median age of first autism diagnosis claim for autistic individuals, 10 years [IQR, 5-16 years]; 17 982 autistic females, 48 956 autistic males, 71 928 nonautistic females, 195 824 nonautistic males), there was a significantly higher crude hazard ratio among autistic females (1.98; 95% CI, 1.11-3.56) and a nonsignificantly higher crude hazard ratio among autistic males (1.34; 95% CI, 0.99-1.82); the increased risks were associated with psychiatric diagnoses. CONCLUSIONS AND RELEVANCE This cohort study suggests that autistic individuals experienced increased risks of self-harm events and suicide death. Psychiatric diagnoses were significantly associated with the increased risks among both sexes, especially for suicide death, and in partially sex-unique ways. Autism-tailored and autism-informed clinical and social support to reduce suicide risks should consider multifactorial mechanisms, with a particular focus on the prevention and timely treatment of psychiatric illnesses.
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Affiliation(s)
- Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Natasha R. Saunders
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Ontario, Canada
- Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Juveria Zaheer
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hilary K. Brown
- ICES, Ontario, Canada
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Yona Lunsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Ontario, Canada
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Nakua H, Hawco C, Forde NJ, Joseph M, Grillet M, Johnson D, Jacobs GR, Hill S, Voineskos A, Wheeler AL, Lai MC, Szatmari P, Georgiades S, Nicolson R, Schachar R, Crosbie J, Anagnostou E, Lerch JP, Arnold PD, Ameis SH. Systematic comparisons of different quality control approaches applied to three large pediatric neuroimaging datasets. Neuroimage 2023; 274:120119. [PMID: 37068719 DOI: 10.1016/j.neuroimage.2023.120119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 03/22/2023] [Accepted: 04/14/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION Poor quality T1-weighted brain scans systematically affect the calculation of brain measures. Removing the influence of such scans requires identifying and excluding scans with noise and artefacts through a quality control (QC) procedure. While QC is critical for brain imaging analyses, it is not yet clear whether different QC approaches lead to the exclusion of the same participants. Further, the removal of poor-quality scans may unintentionally introduce a sampling bias by excluding the subset of participants who are younger and/or feature greater clinical impairment. This study had two aims: 1) examine whether different QC approaches applied to T1-weighted scans would exclude the same participants, and 2) examine how exclusion of poor-quality scans impacts specific demographic, clinical and brain measure characteristics between excluded and included participants in three large pediatric neuroimaging samples. METHODS We used T1-weighted, resting-state fMRI, demographic and clinical data from the Province of Ontario Neurodevelopmental Disorders network (Aim 1: n=553, Aim 2: n=465), the Healthy Brain Network (Aim 1: n=1051, Aim 2: n=558), and the Philadelphia Neurodevelopmental Cohort (Aim 1: n=1087; Aim 2: n=619). Four different QC approaches were applied to T1-weighted MRI (visual QC, metric QC, automated QC, fMRI-derived QC). We used tetrachoric correlation and inter-rater reliability analyses to examine whether different QC approaches excluded the same participants. We examined differences in age, mental health symptoms, everyday/adaptive functioning, IQ and structural MRI-derived brain indices between participants that were included versus excluded following each QC approach. RESULTS Dataset-specific findings revealed mixed results with respect to overlap of QC exclusion. However, in POND and HBN, we found a moderate level of overlap between visual and automated QC approaches (rtet=0.52-0.59). Implementation of QC excluded younger participants, and tended to exclude those with lower IQ, and lower everyday/adaptive functioning scores across several approaches in a dataset-specific manner. Across nearly all datasets and QC approaches examined, excluded participants had lower estimates of cortical thickness and subcortical volume, but this effect did not differ by QC approach. CONCLUSION The results of this study provide insight into the influence of QC decisions on structural pediatric imaging analyses. While different QC approaches exclude different subsets of participants, the variation of influence of different QC approaches on clinical and brain metrics is minimal in large datasets. Overall, implementation of QC tends to exclude participants who are younger, and those who have more cognitive and functional impairment. Given that automated QC is standardized and can reduce between-study differences, the results of this study support the potential to use automated QC for large pediatric neuroimaging datasets.
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Affiliation(s)
- Hajer Nakua
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Natalie J Forde
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Michael Joseph
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Maud Grillet
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Delaney Johnson
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Grace R Jacobs
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Sean Hill
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Aristotle Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Szatmari
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Rob Nicolson
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Russell Schachar
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Jason P Lerch
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Canada; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Nakua H, Yu JC, Abdi H, Hawco C, Voineskos A, Hill S, Lai MC, Wheeler AL, McIntosh AR, Ameis SH. Comparing the stability and reproducibility of brain-behaviour relationships found using Canonical Correlation Analysis and Partial Least Squares within the ABCD Sample. bioRxiv 2023:2023.03.08.531763. [PMID: 36945610 PMCID: PMC10028915 DOI: 10.1101/2023.03.08.531763] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Introduction Canonical Correlation Analysis (CCA) and Partial Least Squares Correlation (PLS) detect associations between two data matrices based on computing a linear combination between the two matrices (called latent variables; LVs). These LVs maximize correlation (CCA) and covariance (PLS). These different maximization criteria may render one approach more stable and reproducible than the other when working with brain and behavioural data at the population-level. This study compared the LVs which emerged from CCA and PLS analyses of brain-behaviour relationships from the Adolescent Brain Cognitive Development (ABCD) dataset and examined their stability and reproducibility. Methods Structural T1-weighted imaging and behavioural data were accessed from the baseline Adolescent Brain Cognitive Development dataset (N > 9000, ages = 9-11 years). The brain matrix consisted of cortical thickness estimates in different cortical regions. The behavioural matrix consisted of 11 subscale scores from the parent-reported Child Behavioral Checklist (CBCL) or 7 cognitive performance measures from the NIH Toolbox. CCA and PLS models were separately applied to the brain-CBCL analysis and brain-cognition analysis. A permutation test was used to assess whether identified LVs were statistically significant. A series of resampling statistical methods were used to assess stability and reproducibility of the LVs. Results When examining the relationship between cortical thickness and CBCL scores, the first LV was found to be significant across both CCA and PLS models (singular value: CCA = .13, PLS = .39, p < .001). LV1 from the CCA model found that covariation of CBCL scores was linked to covariation of cortical thickness. LV1 from the PLS model identified decreased cortical thickness linked to lower CBCL scores. There was limited evidence of stability or reproducibility of LV1 for both CCA and PLS. When examining the relationship between cortical thickness and cognitive performance, there were 6 significant LVs for both CCA and PLS (p < .01). The first LV showed similar relationships between CCA and PLS and was found to be stable and reproducible (singular value: CCA = .21, PLS = .43, p < .001). Conclusion CCA and PLS identify different brain-behaviour relationships with limited stability and reproducibility when examining the relationship between cortical thickness and parent-reported behavioural measures. However, both methods identified relatively similar brain-behaviour relationships that were stable and reproducible when examining the relationship between cortical thickness and cognitive performance. The results of the current study suggest that stability and reproducibility of brain-behaviour relationships identified by CCA and PLS are influenced by characteristics of the analyzed sample and the included behavioural measurements when applied to a large pediatric dataset.
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Affiliation(s)
- Hajer Nakua
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ju-Chi Yu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Hervé Abdi
- The University of Texas at Dallas, Richardson, Texas, United States
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sean Hill
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anne L. Wheeler
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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11
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Lin HY, Abi-Jaoude E, Desarkar P, Wang W, Ameis SH, Lai MC, Lunsky Y, Rajji TK. Nabilone treatment for severe behavioral problems in adults with intellectual and developmental disabilities: Protocol for a phase I open-label clinical trial. PLoS One 2023; 18:e0282114. [PMID: 37043511 PMCID: PMC10096227 DOI: 10.1371/journal.pone.0282114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/04/2023] [Indexed: 04/13/2023] Open
Abstract
Severe behavioral problems (SBPs) are common contributors to morbidity and reduced quality of life for adults with intellectual and developmental disabilities (IDD) and their families. Current medications for SBPs show equivocal effectiveness and are associated with a high risk of side effects. New and safe treatments are urgently needed. While preliminary studies suggest that medical cannabinoids, particularly the synthetic cannabinoid nabilone, are plausible treatment options for SBPs in adults with IDD, data on the tolerability, safety and efficacy of nabilone in this population has never been investigated. Thus, we propose this first-ever Phase I pre-pilot open-label clinical trial to obtain preliminary data on the adherence, tolerability and safety profiles of nabilone in adults with IDD, and explore changes in SBPs pre- to post-treatment. We hypothesize that nabilone has favorable tolerability and safety profile for adults with IDD. The preliminary results will inform the next-stage pilot randomized controlled trials, followed by fully powered clinical trials eventually. This research helps fill the evidence gap in the use of cannabinoids in individuals with IDD to meet the needs of patients, families, and service providers.
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Affiliation(s)
- Hsiang-Yuan Lin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elia Abi-Jaoude
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pushpal Desarkar
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Complex Interventions, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Program in Neurosciences & Mental Health, Sick Kids Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Meng-Chuan Lai
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Program in Neurosciences & Mental Health, Sick Kids Research Institute, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
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12
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Hamdani Y, Kassee C, Walker M, Lunsky Y, Gladstone B, Sawyer A, Ameis SH, Desarkar P, Szatmari P, Lai MC. Roadblocks and detours on pathways to a clinical diagnosis of autism for girls and women: A qualitative secondary analysis. Womens Health (Lond) 2023; 19:17455057231163761. [PMID: 36999318 PMCID: PMC10071154 DOI: 10.1177/17455057231163761] [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] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
BACKGROUND Autism is not always considered for girls and women until later along their clinical diagnostic pathways. Misdiagnosis or late diagnosis can pose significant disadvantages with respect to accessing timely health and autism-related services and supports. Understanding what contributes to roadblocks and detours along clinical pathways to an autism diagnosis can shed light on missed opportunities for earlier recognition. OBJECTIVE Our objective was to examine what contributed to roadblocks, detours, and missed opportunities for earlier recognition and clinical diagnosis of autism for girls and women. DESIGN We conducted a qualitative secondary analysis using data from a Canadian primary study that examined the health and healthcare experiences of autistic girls and women through interviews and focus groups. METHODS Transcript data of 22 girls and women clinically diagnosed with autism and 15 parents were analysed, drawing on reflexive thematic analysis procedures. Techniques included coding data both inductively based on descriptions of roadblocks and detours and deductively based on conceptualizations of sex and gender. Patterns of ideas were categorized into themes and the 'story' of each theme was refined through writing and discussing analytic memos, reflecting on sex and gender assumptions, and creating a visual map of clinical pathways. RESULTS Contributing factors to roadblocks, detours, and missed opportunities for earlier recognition and diagnosis were categorized as follows: (1) age of pre-diagnosis 'red flags' and 'signals'; (2) 'non-autism' mental health diagnoses first; (3) narrow understandings of autism based on male stereotypes; and (4) unavailable and unaffordable diagnostic services. CONCLUSION Professionals providing developmental, mental health, educational, and/or employment supports can be more attuned to nuanced autism presentations. Research in collaboration with autistic girls and women and their childhood caregivers can help to identify examples of nuanced autistic features and how context plays a role in how these are experienced and navigated.
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Affiliation(s)
- Yani Hamdani
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Meaghan Walker
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yona Lunsky
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Brenda Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Amanda Sawyer
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie H Ameis
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Pushpal Desarkar
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Meng-Chuan Lai
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
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13
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Zou Y, Grigorian A, Kennedy KG, Zai CC, Shao S, Kennedy JL, Andreazza AC, Ameis SH, Heyn C, Maclntosh BJ, Goldstein BI. Differential association of antioxidative defense genes with white matter integrity in youth bipolar disorder. Transl Psychiatry 2022; 12:504. [PMID: 36476443 PMCID: PMC9729619 DOI: 10.1038/s41398-022-02261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress is associated with white matter diffusion metrics in adults with bipolar disorder (BD). We examined the association of single-nucleotide polymorphisms in the oxidative stress system, superoxide dismutase-2 (SOD2) rs4880 and glutathione peroxidase-3 (GPX3) rs3792797 with fractional anisotropy (FA) and radial diffusivity (RD) in youth with BD. Participants included 104 youth (age 17.5 ± 1.7 years; 58 BD, 46 healthy controls). Saliva samples were obtained for genotyping, and diffusion tensor imaging was acquired. Voxel-wise whole-brain white matter diffusion analyses controlled for age, sex, and race. There were significant diagnosis-by-SOD2 rs4880 interaction effects for FA and RD in major white matter tracts. Within BD, the group with two copies of the G-allele (GG) showed lower FA and higher RD than A-allele carriers. Whereas within the control group, the GG group showed higher FA and lower RD than A-allele carriers. Additionally, FA was higher and RD was lower within the control GG group compared to the BD GG group. No significant findings were observed for GPX3 rs3793797. The current study revealed that, within matter tracts known to differ in BD, associations of SOD2 rs4880 GG genotype with both FA and RD differed between BD vs healthy control youth. The SOD2 enzyme encoded by the G-allele, has higher antioxidant capacity than the enzyme encoded by the A-allele. We speculate that the current findings of lower FA and higher RD of the BD GG group compared to the other groups reflects attenuation of the salutary antioxidant effects of GG genotype on white matter integrity in youth with BD, in part due to predisposition to oxidative stress. Future studies incorporating other genetic markers and oxidative stress biomarkers are warranted.
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Affiliation(s)
- Yi Zou
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Anahit Grigorian
- grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Kody G. Kennedy
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Clement C. Zai
- grid.155956.b0000 0000 8793 5925Psychiatric Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Suyi Shao
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - James L. Kennedy
- grid.155956.b0000 0000 8793 5925Psychiatric Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Ana C. Andreazza
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Stephanie H. Ameis
- grid.155956.b0000 0000 8793 5925Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Department of Psychiatry, The Hospital for Sick Children, Toronto, ON Canada
| | - Chinthaka Heyn
- grid.413104.30000 0000 9743 1587Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Bradley J. Maclntosh
- grid.17063.330000 0001 2157 2938Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Medical Biophysics, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Benjamin I. Goldstein
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
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14
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Tan V, Dockstader C, Moxon-Emre I, Mendlowitz S, Schacter R, Colasanto M, Voineskos AN, Akingbade A, Nishat E, Mabbott DJ, Arnold PD, Ameis SH. Preliminary Observations of Resting-State Magnetoencephalography in Nonmedicated Children with Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2022; 32:522-532. [PMID: 36548364 PMCID: PMC9917323 DOI: 10.1089/cap.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Cortico-striato-thalamo-cortical (CSTC) network alterations are hypothesized to contribute to symptoms of obsessive-compulsive disorder (OCD). To date, very few studies have examined whether CSTC network alterations are present in children with OCD, who are medication naive. Medication-naive pediatric imaging samples may be optimal to study neural correlates of illness and identify brain-based markers, given the proximity to illness onset. Methods: Magnetoencephalography (MEG) data were analyzed at rest, in 18 medication-naive children with OCD (M = 12.1 years ±2.0 standard deviation [SD]; 10 M/8 F) and 13 typically developing children (M = 12.3 years ±2.2 SD; 6 M/7 F). Whole-brain MEG-derived resting-state functional connectivity (rs-fc), for alpha- and gamma-band frequencies were compared between OCD and typically developing (control) groups. Results: Increased MEG-derived rs-fc across alpha- and gamma-band frequencies was found in the OCD group compared to the control group. Increased MEG-derived rs-fc at alpha-band frequencies was evident across a number of regions within the CSTC circuitry and beyond, including the cerebellum and limbic regions. Increased MEG-derived rs-fc at gamma-band frequencies was restricted to the frontal and temporal cortices. Conclusions: This MEG study provides preliminary evidence of altered alpha and gamma networks, at rest, in medication-naive children with OCD. These results support prior findings pointing to the relevance of CSTC circuitry in pediatric OCD and further support accumulating evidence of altered connectivity between regions that extend beyond this network, including the cerebellum and limbic regions. Given the substantial portion of children and youth whose OCD symptoms do not respond to conventional treatments, our findings have implications for future treatment innovation research aiming to target and track whether brain patterns associated with having OCD may change with treatment and/or predict treatment response.
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Affiliation(s)
- Vinh Tan
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
| | - Colleen Dockstader
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
| | - Iska Moxon-Emre
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sandra Mendlowitz
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Reva Schacter
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Marlena Colasanto
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Aristotle N. Voineskos
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Aquila Akingbade
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
| | - Eman Nishat
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada
- Department of Physiology, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Donald J. Mabbott
- Department of Physiology, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Paul D. Arnold
- Department of Psychiatry, Cumming School of Medicine, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Stephanie H. Ameis
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada
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15
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Ivanov I, Boedhoe PSW, Abe Y, Alonso P, Ameis SH, Arnold PD, Balachander S, Baker JT, Banaj N, Bargalló N, Batistuzzo MC, Benedetti F, Beucke JC, Bollettini I, Brem S, Brennan BP, Buitelaar J, Calvo R, Cheng Y, Cho KIK, Dallaspezia S, Denys D, Diniz JB, Ely BA, Feusner JD, Ferreira S, Fitzgerald KD, Fontaine M, Gruner P, Hanna GL, Hirano Y, Hoexter MQ, Huyser C, Ikari K, James A, Jaspers-Fayer F, Jiang H, Kathmann N, Kaufmann C, Kim M, Koch K, Kwon JS, Lázaro L, Liu Y, Lochner C, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Menchón JM, Minuzzi L, Morer A, Morgado P, Nakagawa A, Nakamae T, Nakao T, Narayanaswamy JC, Nurmi EL, Oh S, Perriello C, Piacentini JC, Picó-Pérez M, Piras F, Piras F, Reddy YCJ, Manrique DR, Sakai Y, Shimizu E, Simpson HB, Soreni N, Soriano-Mas C, Spalletta G, Stern ER, Stevens MC, Stewart SE, Szeszko PR, Tolin DF, van Rooij D, Veltman DJ, van der Werf YD, van Wingen GA, Venkatasubramanian G, Walitza S, Wang Z, Watanabe A, Wolters LH, Xu X, Yun JY, Zarei M, Zhang F, Zhao Q, Jahanshad N, Thomopoulos SI, Thompson PM, Stein DJ, van den Heuvel OA, O'Neill J. Associations of medication with subcortical morphology across the lifespan in OCD: Results from the international ENIGMA Consortium. J Affect Disord 2022; 318:204-216. [PMID: 36041582 DOI: 10.1016/j.jad.2022.08.084] [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: 01/12/2022] [Revised: 08/03/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Widely used psychotropic medications for obsessive-compulsive disorder (OCD) may change the volumes of subcortical brain structures, and differently in children vs. adults. We measured subcortical volumes cross-sectionally in patients finely stratified for age taking various common classes of OCD drugs. METHODS The ENIGMA-OCD consortium sample (1081 medicated/1159 unmedicated OCD patients and 2057 healthy controls aged 6-65) was divided into six successive 6-10-year age-groups. Individual structural MRIs were parcellated automatically using FreeSurfer into 8 regions-of-interest (ROIs). ROI volumes were compared between unmedicated and medicated patients and controls, and between patients taking serotonin reuptake inhibitors (SRIs), tricyclics (TCs), antipsychotics (APs), or benzodiazepines (BZs) and unmedicated patients. RESULTS Compared to unmedicated patients, volumes of accumbens, caudate, and/or putamen were lower in children aged 6-13 and adults aged 50-65 with OCD taking SRIs (Cohen's d = -0.24 to -0.74). Volumes of putamen, pallidum (d = 0.18-0.40), and ventricles (d = 0.31-0.66) were greater in patients aged 20-29 receiving APs. Hippocampal volumes were smaller in patients aged 20 and older taking TCs and/or BZs (d = -0.27 to -1.31). CONCLUSIONS Results suggest that TCs and BZs could potentially aggravate hippocampal atrophy of normal aging in older adults with OCD, whereas SRIs may reduce striatal volumes in young children and older adults. Similar to patients with psychotic disorders, OCD patients aged 20-29 may experience subcortical nuclear and ventricular hypertrophy in relation to APs. Although cross-sectional, present results suggest that commonly prescribed agents exert macroscopic effects on subcortical nuclei of unknown relation to therapeutic response.
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Affiliation(s)
- Iliyan Ivanov
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Premika S W Boedhoe
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- Department of Clinical Sciences, Bellvitge Biomedical Research Institute-IDIBELL, CIBERSAM, Bellvitge University Hospital, Barcelona, Spain
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Srinivas Balachander
- Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Justin T Baker
- McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nuria Bargalló
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Image Diagnostic Center, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil; Department of Methods and Techniques in Psychology, Pontifical Catholic University of Sao Paulo, SP, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy; Departments of Psychiatry and Medical Genetics, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Jan C Beucke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Irene Bollettini
- Departments of Psychiatry and Medical Genetics, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Brian P Brennan
- McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Jan Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Rosa Calvo
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona (CIBERSAM), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kang Ik K Cho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Brain and Cognitive Sciences, Seoul University College of Natural Science, Seoul, Republic of Korea
| | - Sara Dallaspezia
- Departments of Psychiatry and Medical Genetics, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Damiaan Denys
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Juliana B Diniz
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA
| | - Jamie D Feusner
- Division of Neurosciences & Clinical Translation, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Staglin IMHRO Center for Cognitive Neuroscience, Jane & Terry Semel institute For Neurosciences, University of California, Los Angeles, CA, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, ICVS/3B's PT Government Associate Laboratory, Clinical Academic Center, Braga, Portugal
| | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Martine Fontaine
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Marcelo Q Hoexter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Chaim Huyser
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Keisuke Ikari
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Anthony James
- Department of Psychiatry, Oxford University, Oxford, UK
| | - Fern Jaspers-Fayer
- Britsh Columbia Children's Hospital, BC Mental Health and Substance Use Services Research, University of British Columbia, Vancouver, BC, Canada
| | - Hongyan Jiang
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Minah Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kathrin Koch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Germany
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain and Cognitive Sciences, Seoul University College of Natural Science, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona (CIBERSAM), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Christine Lochner
- SAMRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Rachel Marsh
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Ignacio Martínez-Zalacaín
- Department of Clinical Sciences, Bellvitge Biomedical Research Institute-IDIBELL, CIBERSAM, Bellvitge University Hospital, Barcelona, Spain
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - José M Menchón
- Department of Clinical Sciences, Bellvitge Biomedical Research Institute-IDIBELL, CIBERSAM, Bellvitge University Hospital, Barcelona, Spain
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, St. Joseph's Health Care, Hamilton, Ontario, Canada
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona (CIBERSAM), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, ICVS/3B's PT Government Associate Laboratory, Clinical Academic Center, Braga, Portugal
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Janardhanan C Narayanaswamy
- Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Erika L Nurmi
- Division of Child and Adolescent Psychiatry, Jane & Terry Semel Institute For Neurosciences, University of California, Los Angeles, CA, USA; Staglin IMHRO Center for Cognitive Neuroscience, Jane & Terry Semel institute For Neurosciences, University of California, Los Angeles, CA, USA
| | - Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Gyeonggi-do, Republic of Korea
| | - Chris Perriello
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - John C Piacentini
- Division of Child and Adolescent Psychiatry, Jane & Terry Semel Institute For Neurosciences, University of California, Los Angeles, CA, USA; Staglin IMHRO Center for Cognitive Neuroscience, Jane & Terry Semel institute For Neurosciences, University of California, Los Angeles, CA, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, ICVS/3B's PT Government Associate Laboratory, Clinical Academic Center, Braga, Portugal
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Y C Janardhan Reddy
- Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Daniela Rodriguez Manrique
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Germany
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; ATR Brain Information Communication Research Laboratiry Group, Kyoto, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - H Blair Simpson
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Noam Soreni
- Pediatric OCD Consultation Service, Anxiety Treatment and Research Center, Offord Center of Child Studies, Hamilton, Ontario, Canada
| | - Carles Soriano-Mas
- Department of Clinical Sciences, Bellvitge Biomedical Research Institute-IDIBELL, CIBERSAM, Bellvitge University Hospital, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona- UB, Barcelona,Spain
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University Langone School of Medicine, New York, NY, USA
| | - Michael C Stevens
- Institute of Living/Hartford Hospital, Hartford, CT, USA; Yale University School of Medicine, New Haven, CT, USA
| | - S Evelyn Stewart
- Britsh Columbia Children's Hospital, BC Mental Health and Substance Use Services Research, University of British Columbia, Vancouver, BC, Canada
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David F Tolin
- Institute of Living/Hartford Hospital, Hartford, CT, USA; Yale University School of Medicine, New Haven, CT, USA
| | - Daan van Rooij
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Dick J Veltman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Ysbrand D van der Werf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Guido A van Wingen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Ganesan Venkatasubramanian
- Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lidewij H Wolters
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Fengrui Zhang
- Magnetic Resonance Image Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qing Zhao
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, China
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Joseph O'Neill
- Division of Child and Adolescent Psychiatry, Jane & Terry Semel Institute For Neurosciences, University of California, Los Angeles, CA, USA; Staglin IMHRO Center for Cognitive Neuroscience, Jane & Terry Semel institute For Neurosciences, University of California, Los Angeles, CA, USA
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16
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Moxon-Emre I, Croarkin PE, Daskalakis ZJ, Blumberger DM, Lyon RE, Tani H, Truong P, Lai MC, Desarkar P, Sailasuta N, Szatmari P, Ameis SH. NAA/Glu Ratio Associated with Suicidal Ideation in Pilot Sample of Autistic Youth and Young Adults. Brain Sci 2022; 12:785. [PMID: 35741670 PMCID: PMC9220790 DOI: 10.3390/brainsci12060785] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
Suicidality is increased in autism spectrum disorder (ASD), yet effective interventions are lacking. Developing biologically based approaches for preventing and treating suicidality in ASD hinges on the identification of biomarkers of suicidal ideation (SI). Here, we assessed magnetic resonance spectroscopy (MRS) markers of glutamatergic neurotransmission in ASD youth and young adults. Twenty-eight ASD participants (16-33 years) underwent 1H-MRS, and metabolites were quantified using LCModel. N-acetylaspartate (NAA), glutamate (Glu), and the NAA/Glu ratio from the left dorsolateral prefrontal cortex were compared between ASD SI+ (n = 13) and ASD SI- (n = 15) participants. We found that ASD SI+ participants had a higher NAA/Glu ratio compared ASD SI- participants. The NAA/Glu ratio also predicted SI and significantly discriminated between ASD SI+/SI- participants. All analyses including NAA and Glu alone were non-significant. Here, we provide preliminary evidence for the importance of NAA/Glu in ASD with SI, with implications for biomarker discovery. Further mechanistic research into risk and interventional approaches to address SI in ASD are needed.
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Affiliation(s)
- Iska Moxon-Emre
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (I.M.-E.); (R.E.L.); (H.T.); (M.-C.L.); (P.S.)
| | - Paul E. Croarkin
- Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, Rochester, MN 55905, USA;
| | - Zafiris J. Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H1, Canada; (Z.J.D.); (D.M.B.); (P.D.)
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Daniel M. Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H1, Canada; (Z.J.D.); (D.M.B.); (P.D.)
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Rachael E. Lyon
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (I.M.-E.); (R.E.L.); (H.T.); (M.-C.L.); (P.S.)
| | - Hideaki Tani
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (I.M.-E.); (R.E.L.); (H.T.); (M.-C.L.); (P.S.)
| | - Peter Truong
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (P.T.); (N.S.)
| | - Meng-Chuan Lai
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (I.M.-E.); (R.E.L.); (H.T.); (M.-C.L.); (P.S.)
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Research Institute, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Psychology, University of Toronto, Toronto, ON M5S 3G3, Canada
| | - Pushpal Desarkar
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M6J 1H1, Canada; (Z.J.D.); (D.M.B.); (P.D.)
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Napapon Sailasuta
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (P.T.); (N.S.)
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (I.M.-E.); (R.E.L.); (H.T.); (M.-C.L.); (P.S.)
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Research Institute, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Stephanie H. Ameis
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; (I.M.-E.); (R.E.L.); (H.T.); (M.-C.L.); (P.S.)
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Research Institute, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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17
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Jivraj J, Ameis SH. Is Repetitive Transcranial Magnetic Stimulation (rTMS) Ready for Clinical Use as a Treatment Tool for Mental Health Targets in Children and Youth? J Can Acad Child Adolesc Psychiatry 2022; 31:93-99. [PMID: 35614951 PMCID: PMC9084373] [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] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation tool with potential for broad application in individuals with neuropsychiatric conditions. As in adults, most rTMS research in youth has focused on treatment-resistant depression. A limited number of rTMS studies have also been conducted in children and youth with primary diagnoses of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD) or Tourette's syndrome. Across the available rTMS literature, rTMS appears to be well tolerated with few adverse effects reported when applied to child and youth research samples. However, the potential efficacy of rTMS treatment for a variety of targets in children and youth remains unclear, due in part to limitations of the current literature, including studies using diverse protocols, potential for bias in existing clinical trial designs, variability in the research samples, and the use of heterogenous outcome measures. While rTMS is unlikely to take the place of more accessible treatments (e.g., psychopharmacological, psychosocial, psychotherapeutic), rTMS may provide a valuable alternative treatment option, particularly for those individuals where conventional treatments are inaccessible, poorly tolerated, or ineffective. A more robust body of well-designed, controlled trials, is needed in order to clarify rTMS treatment efficacy across relevant neuropsychiatric conditions, optimize treatment protocols, and meet the critical need for novel mental health interventions in children and youth.
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Affiliation(s)
- Jamil Jivraj
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Stephanie H Ameis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario
- Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
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18
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Ameis SH, Haltigan JD, Lyon RE, Sawyer A, Mirenda P, Kerns CM, Smith IM, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Ungar WJ, Zaidman‐Zait A, Lai M, Szatmari P. Middle-childhood executive functioning mediates associations between early-childhood autism symptoms and adolescent mental health, academic and functional outcomes in autistic children. J Child Psychol Psychiatry 2022; 63:553-562. [PMID: 34382216 PMCID: PMC9291328 DOI: 10.1111/jcpp.13493] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Executive functioning (EF) varies in children with autism spectrum disorder (ASD) and is associated with clinical symptoms, academic, and adaptive functioning. Here, we examined whether middle-childhood EF mediates associations between early-childhood autism symptoms and adolescent outcomes in children with ASD. METHODS The Pathways in ASD Cohort comprising children recruited at the time of ASD diagnosis (at 2-4 years-of-age) and followed prospectively across eight subsequent timepoints over ~10 years was used. A subset of Pathways participants (n = 250) with Behavior Rating Inventory of Executive Function (BRIEF)-Parent Form data from at least one timepoint when participants were school-aged was analyzed. A mediation framework was used to examine whether BRIEF-measured EF across age 7-10 years (middle-childhood) mediated associations between early-childhood autism symptoms (measured using the parent-report Social Responsiveness Scale across age 2-6 years) and clinical, academic, and functional outcomes, indexed at age >10-11.8 years (early-adolescence) using the Child Behavior Checklist (CBCL)-Internalizing and Externalizing Scales, Academic Performance from the Teacher's Report Form, and Vineland Adaptive Behavior Scales. Models were rerun substituting clinician-rated and teacher-rated measures, where possible. RESULTS Mediation models indicated a significant indirect effect of middle-childhood EF on associations between early-childhood autism symptoms and externalizing behavior, academic performance, or adaptive functioning in early adolescence; kappa squared (κ2 ) effect sizes ranged from large to small. Model findings were stable across raters. Middle-childhood EF did not mediate associations between early-childhood autism symptoms and adolescent internalizing behavior. CONCLUSIONS Among children with an ASD diagnosis, middle-childhood EF may be one pathway through which early-childhood autism symptoms influence a variety of outcomes in early-adolescence. An experimental study targeting middle-childhood EF to improve adolescent academic, emotional/behavioral, and adaptive functioning is needed to evaluate the clinical meaningfulness of these findings.
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Affiliation(s)
- Stephanie H. Ameis
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
| | - John D. Haltigan
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of Applied Psychology and Human DevelopmentUniversity of TorontoTorontoONCanada
| | - Rachael E. Lyon
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada
| | - Amanda Sawyer
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Pat Mirenda
- Department of Educational and Counselling Psychology and Special EducationUniversity of British ColumbiaVancouverBCCanada
| | - Connor M. Kerns
- Department of PsychologyUniversity of British ColumbiaVancouverBCCanada
| | - Isabel M. Smith
- Department of PediatricsDalhousie UniversityHalifaxNSCanada,Autism Research CentreDalhousie University and IWK Health CentreHalifaxNSCanada
| | | | - Joanne Volden
- Faculty of Rehabilitation MedicineUniversity of AlbertaEdmontonABCanada
| | - Charlotte Waddell
- Children's Health Policy CentreFaculty of Health SciencesSimon Fraser UniversityVancouverBCCanada
| | - Lonnie Zwaigenbaum
- Department of PediatricsUniversity of AlbertaEdmontonABCanada,Autism Research CentreEdmontonABCanada
| | - Teresa Bennett
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Eric Duku
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Mayada Elsabbagh
- Montreal Neurological InstituteMcGill UniversityMontrealQCCanada
| | - Stelios Georgiades
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Wendy J. Ungar
- Child Health Evaluative SciencesThe Hospital for Sick Children Research InstituteTorontoONCanada,Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoONCanada
| | - Anat Zaidman‐Zait
- Department of School Counseling and Special EducationConstantiner School of EducationTel Aviv UniversityTel AvivIsrael,School of Population and Public HealthFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Meng‐Chuan Lai
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
| | - Peter Szatmari
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
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19
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Nakua H, Hawco C, Forde NJ, Jacobs GR, Joseph M, Voineskos AN, Wheeler AL, Lai MC, Szatmari P, Kelley E, Liu X, Georgiades S, Nicolson R, Schachar R, Crosbie J, Anagnostou E, Lerch JP, Arnold PD, Ameis SH. Cortico-amygdalar connectivity and externalizing/internalizing behavior in children with neurodevelopmental disorders. Brain Struct Funct 2022; 227:1963-1979. [PMID: 35469103 PMCID: PMC9232404 DOI: 10.1007/s00429-022-02483-0] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/15/2022] [Indexed: 12/31/2022]
Abstract
Background Externalizing and internalizing behaviors contribute to clinical impairment in children with neurodevelopmental disorders (NDDs). Although associations between externalizing or internalizing behaviors and cortico-amygdalar connectivity have been found in clinical and non-clinical pediatric samples, no previous study has examined whether similar shared associations are present across children with different NDDs. Methods Multi-modal neuroimaging and behavioral data from the Province of Ontario Neurodevelopmental Disorders (POND) Network were used. POND participants aged 6–18 years with a primary diagnosis of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) or obsessive–compulsive disorder (OCD), as well as typically developing children (TDC) with T1-weighted, resting-state fMRI or diffusion weighted imaging (DWI) and parent-report Child Behavioral Checklist (CBCL) data available, were analyzed (total n = 346). Associations between externalizing or internalizing behavior and cortico-amygdalar structural and functional connectivity indices were examined using linear regressions, controlling for age, gender, and image-modality specific covariates. Behavior-by-diagnosis interaction effects were also examined. Results No significant linear associations (or diagnosis-by-behavior interaction effects) were found between CBCL-measured externalizing or internalizing behaviors and any of the connectivity indices examined. Post-hoc bootstrapping analyses indicated stability and reliability of these null results. Conclusions The current study provides evidence towards an absence of a shared linear relationship between internalizing or externalizing behaviors and cortico-amygdalar connectivity properties across a transdiagnostic sample of children with different primary NDD diagnoses and TDC. Different methodological approaches, including incorporation of multi-dimensional behavioral data (e.g., task-based fMRI) or clustering approaches may be needed to clarify complex brain-behavior relationships relevant to externalizing/internalizing behaviors in heterogeneous clinical NDD populations. Supplementary Information The online version contains supplementary material available at 10.1007/s00429-022-02483-0.
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Affiliation(s)
- Hajer Nakua
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Natalie J Forde
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Grace R Jacobs
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Michael Joseph
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anne L Wheeler
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Peter Szatmari
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Department of Psychiatry, Queens University, Kingston, ON, Canada
| | - Xudong Liu
- Department of Psychology, Department of Psychiatry, Queens University, Kingston, ON, Canada
| | | | - Rob Nicolson
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Russell Schachar
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer Crosbie
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jason P Lerch
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.
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20
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Weeland CJ, Kasprzak S, de Joode NT, Abe Y, Alonso P, Ameis SH, Anticevic A, Arnold PD, Balachander S, Banaj N, Bargallo N, Batistuzzo MC, Benedetti F, Beucke JC, Bollettini I, Brecke V, Brem S, Cappi C, Cheng Y, Cho KIK, Costa DLC, Dallaspezia S, Denys D, Eng GK, Ferreira S, Feusner JD, Fontaine M, Fouche JP, Grazioplene RG, Gruner P, He M, Hirano Y, Hoexter MQ, Huyser C, Hu H, Jaspers-Fayer F, Kathmann N, Kaufmann C, Kim M, Koch K, Bin Kwak Y, Kwon JS, Lazaro L, Li CSR, Lochner C, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Menchón JM, Minnuzi L, Moreira PS, Morgado P, Nakagawa A, Nakamae T, Narayanaswamy JC, Nurmi EL, Ortiz AE, Pariente JC, Piacentini J, Picó-Pérez M, Piras F, Piras F, Pittenger C, Reddy YCJ, Rodriguez-Manrique D, Sakai Y, Shimizu E, Shivakumar V, Simpson HB, Soreni N, Soriano-Mas C, Sousa N, Spalletta G, Stern ER, Stevens MC, Stewart SE, Szeszko PR, Takahashi J, Tanamatis T, Tang J, Thorsen AL, Tolin D, van der Werf YD, van Marle H, van Wingen GA, Vecchio D, Venkatasubramanian G, Walitza S, Wang J, Wang Z, Watanabe A, Wolters LH, Xu X, Yun JY, Zhao Q, White T, Thompson PM, Stein DJ, van den Heuvel OA, Vriend C. The thalamus and its subnuclei-a gateway to obsessive-compulsive disorder. Transl Psychiatry 2022; 12:70. [PMID: 35190533 PMCID: PMC8861046 DOI: 10.1038/s41398-022-01823-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 01/01/2023] Open
Abstract
Larger thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population. Particular thalamic subregions may drive these differences. The ENIGMA-OCD working group conducted mega- and meta-analyses to study thalamic subregional volume in OCD across the lifespan. Structural T1-weighted brain magnetic resonance imaging (MRI) scans from 2649 OCD patients and 2774 healthy controls across 29 sites (50 datasets) were processed using the FreeSurfer built-in ThalamicNuclei pipeline to extract five thalamic subregions. Volume measures were harmonized for site effects using ComBat before running separate multiple linear regression models for children, adolescents, and adults to estimate volumetric group differences. All analyses were pre-registered ( https://osf.io/73dvy ) and adjusted for age, sex and intracranial volume. Unmedicated pediatric OCD patients (<12 years) had larger lateral (d = 0.46), pulvinar (d = 0.33), ventral (d = 0.35) and whole thalamus (d = 0.40) volumes at unadjusted p-values <0.05. Adolescent patients showed no volumetric differences. Adult OCD patients compared with controls had smaller volumes across all subregions (anterior, lateral, pulvinar, medial, and ventral) and smaller whole thalamic volume (d = -0.15 to -0.07) after multiple comparisons correction, mostly driven by medicated patients and associated with symptom severity. The anterior thalamus was also significantly smaller in patients after adjusting for thalamus size. Our results suggest that OCD-related thalamic volume differences are global and not driven by particular subregions and that the direction of effects are driven by both age and medication status.
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Affiliation(s)
- Cees J. Weeland
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
| | - Selina Kasprzak
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
| | - Niels T. de Joode
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
| | - Yoshinari Abe
- grid.272458.e0000 0001 0667 4960Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- grid.411129.e0000 0000 8836 0780Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain ,grid.469673.90000 0004 5901 7501CIBERSAM, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie H. Ameis
- grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, Ontario Canada ,grid.42327.300000 0004 0473 9646Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON Canada
| | - Alan Anticevic
- grid.47100.320000000419368710Departments of Psychiatry and Neuroscience, Yale University, New Haven, CT USA
| | - Paul D. Arnold
- grid.22072.350000 0004 1936 7697The Mathison Centre for Mental Health Research & Education, Departments of Psychiatry and Medical Genetics, Calgary, Canada ,grid.22072.350000 0004 1936 7697Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Srinivas Balachander
- grid.416861.c0000 0001 1516 2246OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nerisa Banaj
- grid.417778.a0000 0001 0692 3437Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nuria Bargallo
- grid.10403.360000000091771775Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Image Diagnostic Center, Hospital Clinic, Barcelona, Spain
| | - Marcelo C. Batistuzzo
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil ,grid.11899.380000 0004 1937 0722Department of Methods and Techniques in Psychology, Pontificial Catholic University of Sao Paulo, Sao Paulo, SP Brazil
| | - Francesco Benedetti
- grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milano, Italy ,grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Jan C. Beucke
- grid.7468.d0000 0001 2248 7639Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden ,grid.461732.5Department of Medical Psychology, Medical School Hamburg, Hamburg, Germany ,grid.461732.5Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Irene Bollettini
- grid.18887.3e0000000417581884Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Vilde Brecke
- grid.412008.f0000 0000 9753 1393Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
| | - Silvia Brem
- grid.7400.30000 0004 1937 0650Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Carolina Cappi
- grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai Department of Psychiatry, New York, NY USA
| | - Yuqi Cheng
- grid.414902.a0000 0004 1771 3912Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kang Ik K. Cho
- grid.38142.3c000000041936754XPsychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA ,grid.31501.360000 0004 0470 5905Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, Republic of Korea
| | - Daniel L. C. Costa
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP Brazil
| | - Sara Dallaspezia
- grid.18887.3e0000000417581884IRCCS Ospedale San Raffaele, Milano Italy Psychiatry, Milano, Italy
| | - Damiaan Denys
- grid.484519.5Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Goi Khia Eng
- grid.137628.90000 0004 1936 8753Department of Psychiatry, New York University School of Medicine, New York, NY USA ,grid.250263.00000 0001 2189 4777Clinical Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY USA
| | - Sónia Ferreira
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.512329.eClinical Academic Center - Braga, Braga, Portugal
| | - Jamie D. Feusner
- grid.17063.330000 0001 2157 2938Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada ,grid.19006.3e0000 0000 9632 6718Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA
| | - Martine Fontaine
- grid.21729.3f0000000419368729Columbia University Medical College, Columbia University, New York, NY USA
| | - Jean-Paul Fouche
- grid.7836.a0000 0004 1937 1151Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Rachael G. Grazioplene
- grid.47100.320000000419368710Department of Psychiatry, Yale University, New Haven, CT USA
| | - Patricia Gruner
- grid.47100.320000000419368710Department of Psychiatry, Yale University, New Haven, CT USA
| | - Mengxin He
- grid.414902.a0000 0004 1771 3912Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yoshiyuki Hirano
- grid.136304.30000 0004 0370 1101Research Center for Child Mental Development, Chiba University, Chiba, Japan ,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Marcelo Q. Hoexter
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
| | - Chaim Huyser
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands ,grid.509540.d0000 0004 6880 3010Amsterdam UMC, Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Hao Hu
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fern Jaspers-Fayer
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, Canada
| | - Norbert Kathmann
- grid.7468.d0000 0001 2248 7639Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- grid.7468.d0000 0001 2248 7639Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Minah Kim
- grid.412484.f0000 0001 0302 820XSeoul National University Hospital, Department of Neuropsychiatry, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea
| | - Kathrin Koch
- grid.6936.a0000000123222966Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität, München, Germany ,grid.6936.a0000000123222966TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Yoo Bin Kwak
- grid.31501.360000 0004 0470 5905Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, Republic of Korea
| | - Jun Soo Kwon
- grid.31501.360000 0004 0470 5905Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea ,grid.412484.f0000 0001 0302 820XDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, IDIBAPS, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Christine Lochner
- grid.11956.3a0000 0001 2214 904XStellenbosch University, SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch, South Africa
| | - Rachel Marsh
- grid.21729.3f0000000419368729Columbia University Medical College, Columbia University, New York, NY USA
| | - Ignacio Martínez-Zalacaín
- grid.411129.e0000 0000 8836 0780Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - David Mataix-Cols
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden ,grid.467087.a0000 0004 0442 1056Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jose M. Menchón
- grid.411129.e0000 0000 8836 0780Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain ,grid.469673.90000 0004 5901 7501CIBERSAM, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minnuzi
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario Canada ,Offord Centre for Child Studies, Hamilton, Ontario Canada
| | - Pedro Silva Moreira
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.10328.380000 0001 2159 175XPsychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.512329.eClinical Academic Center-Braga (2CA), Braga, Portugal ,grid.436922.80000 0004 4655 1975Hospital de Braga, Braga, Portugal
| | - Akiko Nakagawa
- grid.136304.30000 0004 0370 1101Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Takashi Nakamae
- grid.272458.e0000 0001 0667 4960Graduate School of Medical Science Kyoto Prefectural University of Medicine, Department of Psychiatry, Kyoto, Japan
| | - Janardhanan C. Narayanaswamy
- grid.416861.c0000 0001 1516 2246OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Erika L. Nurmi
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA USA
| | - Ana E. Ortiz
- grid.410458.c0000 0000 9635 9413Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain ,grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jose C. Pariente
- grid.10403.360000000091771775Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - John Piacentini
- grid.19006.3e0000 0000 9632 6718UCLA Semel Institute, Division of Child and Adolescent Psychiatry, Los Angeles, CA USA
| | - Maria Picó-Pérez
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.512329.eClinical Academic Center - Braga, Braga, Portugal
| | - Fabrizio Piras
- grid.417778.a0000 0001 0692 3437Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- grid.417778.a0000 0001 0692 3437Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Christopher Pittenger
- grid.47100.320000000419368710Department of Psychiatry and Yale Child Study Center, Yale University, New Haven, CT USA
| | - Y. C. Janardhan Reddy
- grid.416861.c0000 0001 1516 2246OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daniela Rodriguez-Manrique
- grid.6936.a0000000123222966TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, München, Germany ,grid.6936.a0000000123222966Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany ,grid.5252.00000 0004 1936 973XGraduate School of Systemic Neurosciences (GSN), Ludwig-Maximilians-Universität, Munich, Germany
| | - Yuki Sakai
- grid.272458.e0000 0001 0667 4960Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan ,grid.418163.90000 0001 2291 1583Department of Neural Computation for Decision-Making, Advanced Telecommunications Research Institute International Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Eiji Shimizu
- grid.136304.30000 0004 0370 1101Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- grid.416861.c0000 0001 1516 2246Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Helen Blair Simpson
- grid.21729.3f0000000419368729Columbia University Irving Medical College, Columbia University, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA
| | - Noam Soreni
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario Canada ,Pediatric OCD Consultation Team, Anxiety Treatment and Research Center, Hamilton, Ontario Canada
| | - Carles Soriano-Mas
- grid.411129.e0000 0000 8836 0780Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain ,grid.469673.90000 0004 5901 7501CIBERSAM, Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuno Sousa
- grid.10328.380000 0001 2159 175XLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal ,grid.10328.380000 0001 2159 175XICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal ,grid.512329.eClinical Academic Center - Braga, Braga, Portugal
| | - Gianfranco Spalletta
- grid.417778.a0000 0001 0692 3437IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy ,grid.39382.330000 0001 2160 926XBaylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, TX USA
| | - Emily R. Stern
- grid.137628.90000 0004 1936 8753Department of Psychiatry, New York University School of Medicine, New York, NY USA ,grid.250263.00000 0001 2189 4777Clinical Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY USA
| | - Michael C. Stevens
- grid.277313.30000 0001 0626 2712Institute of Living, Hartford, CT USA ,grid.47100.320000000419368710Yale University School of Medicine, New Haven, CT USA
| | - S. Evelyn Stewart
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, Canada ,grid.498716.50000 0000 8794 2105BC Mental Health and Substance Use Services Research Institute, Vancouver, Canada
| | - Philip R. Szeszko
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.274295.f0000 0004 0420 1184James J. Peters VA Medical Center, Mental Illness Research, Education and Clinical Center, Bronx, NY USA
| | - Jumpei Takahashi
- grid.411321.40000 0004 0632 2959Department of Child Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Tais Tanamatis
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
| | - Jinsong Tang
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China ,grid.13402.340000 0004 1759 700XLiangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
| | - Anders Lillevik Thorsen
- grid.412008.f0000 0000 9753 1393Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway ,grid.7914.b0000 0004 1936 7443Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - David Tolin
- grid.47100.320000000419368710Yale University School of Medicine, New Haven, CT USA ,grid.277313.30000 0001 0626 2712Institute of Living/Hartford Hospital, Hartford, CT USA
| | - Ysbrand D. van der Werf
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
| | - Hein van Marle
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
| | - Guido A. van Wingen
- grid.484519.5Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Daniela Vecchio
- grid.417778.a0000 0001 0692 3437Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - G. Venkatasubramanian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health And Neurosciences, Department of Psychiatry, Bengaluru, India
| | - Susanne Walitza
- grid.7400.30000 0004 1937 0650Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Jicai Wang
- grid.414902.a0000 0004 1771 3912Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhen Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anri Watanabe
- grid.272458.e0000 0001 0667 4960Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lidewij H. Wolters
- grid.509540.d0000 0004 6880 3010Amsterdam UMC, Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands ,Levvel, Academic Center for Child and Adolescent Psychiatry, Post Box 303, 1115 ZG Duivendrecht, the Netherlands
| | - Xiufeng Xu
- grid.414902.a0000 0004 1771 3912Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Je-Yeon Yun
- grid.412484.f0000 0001 0302 820XSeoul National University Hospital, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Qing Zhao
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Tonya White
- grid.5645.2000000040459992XErasmus Medical Center, Department of Child and Adolescent Psychiatry/Psychology, Wytemaweg 8, 3015 GD Rotterdam, the Netherlands ,grid.42505.360000 0001 2156 6853Department of Radiology and Nuclear Medicine, University of Southern California, Los Angeles, CA USA
| | - Paul M. Thompson
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Dan J. Stein
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Odile A. van den Heuvel
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
| | - Chris Vriend
- grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam, The Netherlands
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21
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Moxon-Emre I, Daskalakis ZJ, Blumberger DM, Croarkin PE, Lyon RE, Forde NJ, Tani H, Truong P, Lai MC, Desarkar P, Sailasuta N, Szatmari P, Ameis SH. Modulation of Dorsolateral Prefrontal Cortex Glutamate/Glutamine Levels Following Repetitive Transcranial Magnetic Stimulation in Young Adults With Autism. Front Neurosci 2021; 15:711542. [PMID: 34690671 PMCID: PMC8527173 DOI: 10.3389/fnins.2021.711542] [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: 05/18/2021] [Accepted: 09/13/2021] [Indexed: 12/29/2022] Open
Abstract
Altered excitatory and inhibitory neurotransmission has been implicated in autism spectrum disorder (ASD). Interventions using repetitive transcranial magnetic stimulation (rTMS) to enhance or inhibit cortical excitability are under study for various targets, though the mechanistic effects of rTMS have yet to be examined in ASD. Here, we examined whether an excitatory rTMS treatment course modulates glutamatergic (Glx) or γ-aminobutyric acid (GABA) metabolite levels in emerging adults with ASD. Twenty-eight participants with ASD and executive function impairment [23.3 ± 4.69 years; seven-female] underwent two magnetic resonance spectroscopy (MRS) scans of the left dorsolateral prefrontal cortex (DLPFC). MRS scans were acquired before and after participants with ASD were randomized to receive a 20-session course of active or sham rTMS to the DLPFC. Baseline MRS data was available for 19 typically developing controls [23.8 ± 4.47 years; six-female]. Metabolite levels for Glx and GABA+ were compared between ASD and control groups, at baseline, and metabolite level change, pre-to-post-rTMS treatment, was compared in ASD participants that underwent active vs. sham rTMS. Absolute change in Glx was greater in the active vs. sham-rTMS group [F(1,19) = 6.54, p = 0.02], though the absolute change in GABA+ did not differ between groups. We also examined how baseline metabolite levels related to pre/post-rTMS metabolite level change, in the active vs. sham groups. rTMS group moderated the relation between baseline Glx and pre-to-post-rTMS Glx change, such that baseline Glx predicted Glx change in the active-rTMS group only [b = 1.52, SE = 0.32, t(18) = 4.74, p < 0.001]; Glx levels increased when baseline levels were lower, and decreased when baseline levels were higher. Our results indicate that an interventional course of excitatory rTMS to the DLPFC may modulate local Glx levels in emerging adults with ASD, and align with prior reports of glutamatergic alterations following rTMS. Interventional studies that track glutamatergic markers may provide mechanistic insights into the therapeutic potential of rTMS in ASD. Clinical Trial Registration:Clinicaltrials.gov (ID: NCT02311751), https://clinicaltrials.gov/ct2/show/NCT02311751?term=ameis&rank=1; NCT02311751.
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Affiliation(s)
- Iska Moxon-Emre
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Paul E Croarkin
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Rachael E Lyon
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Natalie J Forde
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Hideaki Tani
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Truong
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Meng-Chuan Lai
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Pushpal Desarkar
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Napapon Sailasuta
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie H Ameis
- Cundill Centre for Child and Youth Depression, The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
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22
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Gharehgazlou A, Vandewouw M, Ziolkowski J, Wong J, Crosbie J, Schachar R, Nicolson R, Georgiades S, Kelley E, Ayub M, Hammill C, Ameis SH, Taylor MJ, Lerch JP, Anagnostou E. Cortical Gyrification Morphology in ASD and ADHD: Implication for Further Similarities or Disorder-Specific Features? Cereb Cortex 2021; 32:2332-2342. [PMID: 34550324 PMCID: PMC9157290 DOI: 10.1093/cercor/bhab326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Shared etiological pathways are suggested in ASD and ADHD given high rates of comorbidity, phenotypic overlap and shared genetic susceptibility. Given the peak of cortical gyrification expansion and emergence of ASD and ADHD symptomology in early development, we investigated gyrification morphology in 539 children and adolescents (6–17 years of age) with ASD (n=197) and ADHD (n=96) compared to typically developing controls (n=246) using the local Gyrification Index (lGI) to provide insight into contributing etiopathological factors in these two disorders. We also examined IQ effects and functional implications of gyrification by exploring the relation between lGI and ASD and ADHD symptomatology beyond diagnosis. General Linear Models yielded no group differences in lGI, and across groups, we identified an age-related decrease of lGI and greater lGI in females compared to males. No diagnosis-by-age interactions were found. Accounting for IQ variability in the model (n=484) yielded similar results. No significant associations were found between lGI and social communication deficits, repetitive and restricted behaviours, inattention or adaptive functioning. By examining both disorders and controls using shared methodology, we found no evidence of atypicality in gyrification as measured by the lGI in these conditions.
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Affiliation(s)
- Avideh Gharehgazlou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto M4G 1R8, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto M5S 1A8, Canada
| | - Marlee Vandewouw
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto M5G 0A4, Canada.,Diagnostic Imaging, The Hospital for Sick Children, Toronto M5G 1X8, Canada.,Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto M4G 1R8, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto M5S 3G9, Canada
| | - Justine Ziolkowski
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto M5G 0A4, Canada.,Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal H4H 1R3, Canada.,Integrated Program in Neuroscience, McGill University, Montreal H3A 1A1, Canada
| | - Jimmy Wong
- Centre for Addiction and Mental Health, Toronto M6J 1H4, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto M5T 1R8, Canada.,Psychiatry Research, The Hospital for Sick Children, Toronto M5G 1X8, Canada
| | - Russell Schachar
- Department of Psychiatry, University of Toronto, Toronto M5T 1R8, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto M5G 1X8, Canada
| | - Rob Nicolson
- The Children's Health Research Institute and Western University, London N6C 2V5, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies & Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton L8N 3K7, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston K7L 3N6, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston K7L7X3, Canada
| | - Christopher Hammill
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto M5G 0A4, Canada.,Mouse Imaging Centre, Hospital for Sick Children, Toronto M5T 3H7, Canada
| | - Stephanie H Ameis
- Program in Brain and Mental Health, The Hospital for Sick Children, Toronto M5G 1X8 , Canada.,The Margaret and Wallace McCain Centre for Child, Youth, & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Toronto M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto M5T 1R8, Canada
| | - Margot J Taylor
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto M5S 1A8, Canada.,Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto M5G 0A4, Canada.,Diagnostic Imaging, The Hospital for Sick Children, Toronto M5G 1X8, Canada.,Department of Medical Imaging, University of Toronto, Toronto M5T 1W7, Canada
| | - Jason P Lerch
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto M5G 0A4, Canada.,Department of Medical Biophysics, University of Toronto, Toronto M5G 1L7, Canada.,Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto M4G 1R8, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto M5S 1A8, Canada.,Department of Pediatrics, University of Toronto, Toronto M5G 1X8, Canada.,Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto M5G 0A4, Canada
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23
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Mo K, Sadoway T, Bonato S, Ameis SH, Anagnostou E, Lerch JP, Taylor MJ, Lai MC. Sex/gender differences in the human autistic brains: A systematic review of 20 years of neuroimaging research. Neuroimage Clin 2021; 32:102811. [PMID: 34509922 PMCID: PMC8436080 DOI: 10.1016/j.nicl.2021.102811] [Citation(s) in RCA: 21] [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] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 06/25/2021] [Accepted: 08/29/2021] [Indexed: 12/01/2022]
Abstract
Our current understanding of autism is largely based on clinical experiences and research involving male individuals given the male-predominance in prevalence and the under-inclusion of female individuals due to small samples, co-occurring conditions, or simply being missed for diagnosis. There is a significantly biased 'male lens' in this field with autistic females insufficiently understood. We therefore conducted a systematic review to examine how sex and gender modulate brain structure and function in autistic individuals. Findings from the past 20 years are yet to converge on specific brain regions/networks with consistent sex/gender-modulating effects. Despite at least three well-powered studies identifying specific patterns of significant sex/gender-modulation of autism-control differences, many other studies are likely underpowered, suggesting a critical need for future investigation into sex/gender-based heterogeneity with better-powered designs. Future research should also formally investigate the effects of gender, beyond biological sex, which is mostly absent in the current literature. Understanding the roles of sex and gender in the development of autism is an imperative step to extend beyond the 'male lens' in this field.
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Affiliation(s)
- Kelly Mo
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Tara Sadoway
- Department of Paediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Canada
| | - Sarah Bonato
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Stephanie H Ameis
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Hospital for Sick Children, Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Evdokia Anagnostou
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jason P Lerch
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom; Neurosciences & Mental Health Program, SickKids Research Institute, Toronto, Canada
| | - Margot J Taylor
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Neurosciences & Mental Health Program, SickKids Research Institute, Toronto, Canada; Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada
| | - Meng-Chuan Lai
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Hospital for Sick Children, Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Neurosciences & Mental Health Program, SickKids Research Institute, Toronto, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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24
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Lai MC, Hull L, Mandy W, Chakrabarti B, Nordahl CW, Lombardo MV, Ameis SH, Szatmari P, Baron-Cohen S, Happé F, Livingston LA. Commentary: 'Camouflaging' in autistic people - reflection on Fombonne (2020). J Child Psychol Psychiatry 2021; 62. [PMID: 33289092 DOI: 10.1111/jcpp.13344] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
Fombonne's (2020) editorial is a thought-provoking appraisal of the literature on 'camouflaging', whereby some autistic people mask or compensate for their autistic characteristics as an attempt to fit in and to cope with disabilities under neurotypical social norms. Fombonne (2020) highlights three issues of contention: (a) construct validity and measurement of camouflaging; (b) camouflaging as a reason for late autism diagnosis in adolescence/adulthood; and (c) camouflaging as a feature of the 'female autism phenotype'. Here, we argue that (a) establishing construct validity and measurement of different aspects of camouflaging is warranted; (b) subjective experiences are important for the differential diagnosis of autism in adolescence/adulthood; and (c) camouflaging is not necessarily a feature of autism in female individuals - nevertheless, taking into account sex and gender influences in development is crucial to understand behavioural manifestations of autism. Future research and clinical directions should involve clarification of associated constructs and measurements, demography, mechanisms, impact (including harms and benefits) and tailored support.
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Affiliation(s)
- Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Laura Hull
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - William Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Bhismadev Chakrabarti
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Centre for Autism, School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK.,India Autism Center, Kolkata, India.,Department of Psychology, Ashoka University, Sonipat, India
| | - Christine Wu Nordahl
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
| | - Michael V Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Szatmari
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucy Anne Livingston
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
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25
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Rodrigues R, Lai MC, Beswick A, Gorman DA, Anagnostou E, Szatmari P, Anderson KK, Ameis SH. Practitioner Review: Pharmacological treatment of attention-deficit/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry 2021; 62:680-700. [PMID: 32845025 DOI: 10.1111/jcpp.13305] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Clinically significant attention-deficit/hyperactivity disorder (ADHD) symptoms are common and impairing in children and youth with autism spectrum disorder(ASD). The aim of this systematic review and meta-analysis was to (a) evaluate the efficacy and safety of pharmacotherapy for the treatment of ADHD symptoms in ASD and (b) distil findings for clinical translation. METHODS We searched electronic databases and clinical trial registries (1992 onwards). We selected randomized controlled trials conducted in participants <25 years of age, diagnosed with ASD that evaluated ADHD outcomes (hyperactivity/impulsivity and inattention) following treatment with stimulants (methylphenidate or amphetamines), atomoxetine, alpha-2 adrenergic receptor agonists, antipsychotics, tricyclic antidepressants, bupropion, modafinil, venlafaxine, or a combination, in comparison with placebo, any of the listed medications, or behavioral therapies. Data were pooled using a random-effects model. RESULTS Twenty-five studies (4 methylphenidate, 4 atomoxetine, 1 guanfacine, 14 antipsychotic, 1 venlafaxine, and 1 tianeptine) were included. Methylphenidate reduced hyperactivity (parent-rated: standardized mean difference [SMD] = -.63, 95%CI = -.95,-.30; teacher-rated: SMD = -.81, 95%CI = -1.43,-.19) and inattention (parent-rated: SMD = -.36, 95%CI = -.64,-.07; teacher-rated: SMD = -.30, 95%CI = -.49,-.11). Atomoxetine reduced inattention (parent-rated: SMD = -.54, 95%CI = -.98,-.09; teacher/investigator-rated: SMD = -0.38, 95%CI = -0.75, -0.01) and parent-rated hyperactivity (parent-rated: SMD = -.49, 95%CI = -.76,-.23; teacher-rated: SMD = -.43, 95%CI = -.92, .06). Indirect evidence for significant reductions in hyperactivity with second-generation antipsychotics was also found. Quality of evidence for all interventions was low/very low. Methylphenidate was associated with a nonsignificant elevated risk of dropout due to adverse events. CONCLUSIONS Direct pooled evidence supports the efficacy and tolerability of methylphenidate or atomoxetine for treatment of ADHD symptoms in children and youth with ASD. The current review highlights the efficacy of standard ADHD pharmacotherapy for treatment of ADHD symptoms in children and youth with ASD. Consideration of the benefits weighed against the limitations of safety/efficacy data and lack of data evaluating long-term continuation is undertaken to help guide clinical decision-making regarding treatment of co-occurring ADHD symptoms in children and youth with ASD.
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Affiliation(s)
- Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Adam Beswick
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Daniel A Gorman
- Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Peter Szatmari
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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26
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Desarkar P, Rajji TK, Ameis SH, Blumberger DM, Lai MC, Lunsky Y, Daskalakis ZJ. Assessing and stabilizing atypical plasticity in autism spectrum disorder using rTMS: Results from a proof-of-principle study. Clin Neurophysiol 2021; 141:109-118. [PMID: 34011467 DOI: 10.1016/j.clinph.2021.03.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/08/2021] [Accepted: 03/05/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Emerging evidence implicates atypical plasticity in the neurophysiology of autism spectrum disorder (ASD). Specifically, autistic people demonstrated hyperplasticity in response to theta-burst stimulation (TBS). We hypothesized that autistic adults would display hyperplasticity to TBS and that repetitive transcranial magnetic stimulation (rTMS) - which potentiates brain inhibitory mechanisms - would 'stabilize' hyperplasticity. METHODS Using a randomized, cross-over design, plasticity was assessed using TBS in the left motor cortex (M1) in 31 autistic adults and 30 sex-, intelligence quotient-, and age-matched controls. Autistic adults (n = 29) were further randomized (1:1) to receive a single session of active (n = 14) or sham (n = 15) rTMS (6000 pulses at 20 Hz) over left M1 and plasticity was reassessed on the next day following rTMS. RESULTS Both long-term potentiation (LTP) and long-term depression (LTD) were significantly increased in the ASD group, indicating hyperplasticity. Active, but not sham rTMS, attenuated LTD in autistic adults. CONCLUSIONS We provided further evidence for the presence of brain hyperplasticity in ASD. To our knowledge, this is the first study to show preliminary evidence that an excessive LTD in ASD can be 'stabilized' using rTMS. Such 'stabilizing' effect of rTMS on LTP was not observed, likely due to small sample size or a more specific 'attenuating' effect of rTMS on LTD, compared to LTP. SIGNIFICANCE These findings indicate atypical brain inhibitory mechanisms behind hyperplasticity in ASD. Utilizing a larger sample, future replication studies could investigate therapeutic opportunities of 'mechanism-driven' rTMS.
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Affiliation(s)
- Pushpal Desarkar
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Tarek K Rajji
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Stephanie H Ameis
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daniel M Blumberger
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Meng-Chuan Lai
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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27
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Gharehgazlou A, Freitas C, Ameis SH, Taylor MJ, Lerch JP, Radua J, Anagnostou E. Cortical Gyrification Morphology in Individuals with ASD and ADHD across the Lifespan: A Systematic Review and Meta-Analysis. Cereb Cortex 2021; 31:2653-2669. [PMID: 33386405 PMCID: PMC8023842 DOI: 10.1093/cercor/bhaa381] [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: 05/27/2020] [Revised: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 01/01/2023] Open
Abstract
Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are common neurodevelopmental disorders (NDDs) that may impact brain maturation. A number of studies have examined cortical gyrification morphology in both NDDs. Here we review and when possible pool their results to better understand the shared and potentially disorder-specific gyrification features. We searched MEDLINE, PsycINFO, and EMBASE databases, and 24 and 10 studies met the criteria to be included in the systematic review and meta-analysis portions, respectively. Meta-analysis of local Gyrification Index (lGI) findings across ASD studies was conducted with SDM software adapted for surface-based morphometry studies. Meta-regressions were used to explore effects of age, sex, and sample size on gyrification differences. There were no significant differences in gyrification across groups. Qualitative synthesis of remaining ASD studies highlighted heterogeneity in findings. Large-scale ADHD studies reported no differences in gyrification between cases and controls suggesting that, similar to ASD, there is currently no evidence of differences in gyrification morphology compared with controls. Larger, longitudinal studies are needed to further clarify the effects of age, sex, and IQ on cortical gyrification in these NDDs.
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Affiliation(s)
- Avideh Gharehgazlou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Carina Freitas
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Stephanie H Ameis
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada.,The Margaret and Wallace McCain Centre for Child, Youth, & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Margot J Taylor
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada.,Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Jason P Lerch
- Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Joaquim Radua
- Imaging Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain.,Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Neuroscience & Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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28
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Hammill C, Lerch JP, Taylor MJ, Ameis SH, Chakravarty MM, Szatmari P, Anagnostou E, Lai MC. Quantitative and Qualitative Sex Modulations in the Brain Anatomy of Autism. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 6:898-909. [PMID: 33713843 DOI: 10.1016/j.bpsc.2021.03.001] [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] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sex-based neurobiological heterogeneity in autism is poorly understood. Research is disproportionately biased to males, leading to an unwarranted presumption that autism neurobiology is the same across sexes. Previous neuroimaging studies using amalgamated multicenter datasets to increase autistic female samples are characterized by large statistical noise. METHODS We used a better-powered dataset of 1183 scans of 839 individuals-299 (467 scans) autistic males, 74 (102 scans) autistic females, 240 (334 scans) control males, and 226 (280 scans) control females-to test two whole-brain models of overall/global sex modulations on autism neuroanatomy, by summary measures computed across the brain: the local magnitude model, in which the same brain regions/circuitries are involved across sexes but effect sizes are larger in females, indicating quantitative sex modulation; and spatial dissimilarity model, in which the neuroanatomy differs spatially between sexes, indicating qualitative sex modulation. The male and female autism groups were matched on age, IQ, and autism symptoms. Autism brain features were defined by comparisons with same-sex control individuals. RESULTS Across five metrics (cortical thickness, surface area, volume, mean absolute curvature, and subcortical volume), we found no evidence supporting the local magnitude model. We found indicators supporting the spatial dissimilarity model on cortical mean absolute curvature and subcortical volume, but not on other metrics. CONCLUSIONS The overall/global autism neuroanatomy in females and males does not simply differ quantitatively in the same brain regions/circuitries. They may differ qualitatively in spatial involvement in cortical curvature and subcortical volume. The neuroanatomy of autism may be partly sex specific. Sex stratification to inform autism preclinical/clinical research is needed to identify sex-informed neurodevelopmental targets.
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Affiliation(s)
| | - Jason P Lerch
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, Ontario, Canada; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, Ontario, Canada; Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, Ontario, Canada; Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital and Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, Ontario, Canada; Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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29
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Oliver LD, Moxon-Emre I, Lai MC, Grennan L, Voineskos AN, Ameis SH. Social Cognitive Performance in Schizophrenia Spectrum Disorders Compared With Autism Spectrum Disorder: A Systematic Review, Meta-analysis, and Meta-regression. JAMA Psychiatry 2021; 78:281-292. [PMID: 33291141 PMCID: PMC7724568 DOI: 10.1001/jamapsychiatry.2020.3908] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Schizophrenia spectrum disorders (SSDs) and autism spectrum disorder (ASD) both feature social cognitive deficits; however, these disorders historically have been examined separately using a range of tests and subdomain focus and at different time points in the life span. Moving beyond diagnostic categories and characterizing social cognitive deficits can enhance understanding of shared pathways across these disorders. OBJECTIVE To investigate how deficits in social cognitive domains diverge or overlap between SSDs and ASD based on the extant literature. DATA SOURCES Literature searches were conducted in MEDLINE, PsycInfo, Embase, and Web of Science from database inception until July 26, 2020. STUDY SELECTION Original research articles were selected that reported performance-based measures of social cognition in both SSDs and ASD samples. Selected articles also had to be published in English and use International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, DSM-IV, or more recent diagnostic criteria. DATA EXTRACTION AND SYNTHESIS This systematic review and meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology reporting guidelines, including data extraction and quality assessment using a modified version of the Newcastle-Ottawa Scale. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES Effect sizes were calculated as Hedges g (SSDs vs ASD). The primary outcomes were performance on emotion processing tasks, theory of mind (ToM) tasks, and the Reading the Mind in the Eyes Test (RMET) in SSDs compared with ASD. Meta-regressions were performed for age difference, publication year, quality assessment scores, and antipsychotic medication use. RESULTS Of the 4175 screened articles, 36 studies directly comparing social cognitive performance in individuals with SSDs vs ASD were included in the qualitative analysis (n = 1212 for SSDs groups and n = 1109 for ASD groups), and 33 studies were included in the quantitative analyses (n = 1113 for SSDs groups and n = 1015 for ASD groups). Most study participants were male (number of studies [k] = 36, 72% [878 of 1212] in SSDs groups and 82% [907 of 1109] in ASD groups), and age (k = 35) was older in SSDs groups (mean [SD], 28.4 [9.5] years) than in ASD groups (mean [SD], 23.3 [7.6] years). Included studies highlighted the prevalence of small, male-predominant samples and a paucity of cross-disorder clinical measures. The meta-analyses revealed no statistically significant differences between SSDs and ASD on emotion processing measures (k = 15; g = 0.12 [95% CI, -0.07 to 0.30]; P = .21; I2 = 51.0%; 1 outlier excluded), ToM measures (k = 17; g = -0.01 [95% CI, -0.21 to 0.19]; P = .92; I2 = 56.5%; 1 outlier excluded), or the RMET (k = 13; g = 0.25 [95% CI, -0.04 to 0.53]; P = .10; I2 = 75.3%). However, SSDs vs ASD performance differences between studies were statistically significantly heterogeneous, which was only minimally explained by potential moderators. CONCLUSIONS AND RELEVANCE In this analysis, similar levels of social cognitive impairment were present, on average, in individuals with SSDs and ASD. Cross-disorder studies of social cognition, including larger samples, consensus batteries, and consistent reporting of measures, as well as data across multiple levels of analysis, are needed to help identify subgroups within and across disorders that may be more homogeneous in etiology and treatment response.
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Affiliation(s)
- Lindsay D. Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Iska Moxon-Emre
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Laura Grennan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aristotle N. Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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30
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Nishat E, Dockstader C, Wheeler AL, Tan T, Anderson JAE, Mendlowitz S, Mabbott DJ, Arnold PD, Ameis SH. Visuomotor Activation of Inhibition-Processing in Pediatric Obsessive Compulsive Disorder: A Magnetoencephalography Study. Front Psychiatry 2021; 12:632736. [PMID: 33995145 PMCID: PMC8116532 DOI: 10.3389/fpsyt.2021.632736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Response inhibition engages the cortico-striato-thalamo-cortical (CSTC) circuit, which has been implicated in children, and youth with obsessive compulsive disorder (OCD). This study explored whether CSTC engagement during response inhibition, measured using magnetoencephalography (MEG), differed in a sample of medication-naïve youth with OCD, compared to typically developing controls (TDC). Methods: Data was analyzed in 17 medication-naïve children and youth with OCD (11.7 ± 2.2 SD years) and 13 TDC (12.6 ± 2.2 SD years). MEG was used to localize and characterize neural activity during a Go/No-Go task. Task performance on Go/No-Go conditions and regional differences in amplitude of activity during Go and No-Go condition between OCD vs. TDC were examined using two-sample t-tests. Post-hoc analysis with Bayesian t-tests was used to estimate the certainty of outcomes. Results: No differences in Go/No-Go performance were found between OCD and TDC groups. In response to the visual cue presented during the Go condition, participants with OCD showed significantly increased amplitude of activity in the primary motor (MI) cortex compared to TDC. In addition, significantly reduced amplitude of PCu was found following successful stopping to No-Go cues in OCD vs. TDC during No-Go task performance. Bayesian t-tests indicated high probability and large effect sizes for the differences in MI and PCu amplitude found between groups. Conclusion: Our preliminary study in a small medication-naïve sample extends previous work indicating intact response inhibition in pediatric OCD. While altered neural response in the current study was found during response inhibition performance in OCD, differences localized to regions outside of the CSTC. Our findings suggest that additional imaging research in medication-naïve samples is needed to clarify regional differences associated with OCD vs. influenced by medication effects, and suggest that MEG may be sensitive to detecting such differences.
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Affiliation(s)
- Eman Nishat
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Colleen Dockstader
- Department of Human Biology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Anne L Wheeler
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Thomas Tan
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - John A E Anderson
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sandra Mendlowitz
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Donald J Mabbott
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Stephanie H Ameis
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
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31
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Patel Y, Parker N, Shin J, Howard D, French L, Thomopoulos SI, Pozzi E, Abe Y, Abé C, Anticevic A, Alda M, Aleman A, Alloza C, Alonso-Lana S, Ameis SH, Anagnostou E, McIntosh AA, Arango C, Arnold PD, Asherson P, Assogna F, Auzias G, Ayesa-Arriola R, Bakker G, Banaj N, Banaschewski T, Bandeira CE, Baranov A, Bargalló N, Bau CHD, Baumeister S, Baune BT, Bellgrove MA, Benedetti F, Bertolino A, Boedhoe PSW, Boks M, Bollettini I, Del Mar Bonnin C, Borgers T, Borgwardt S, Brandeis D, Brennan BP, Bruggemann JM, Bülow R, Busatto GF, Calderoni S, Calhoun VD, Calvo R, Canales-Rodríguez EJ, Cannon DM, Carr VJ, Cascella N, Cercignani M, Chaim-Avancini TM, Christakou A, Coghill D, Conzelmann A, Crespo-Facorro B, Cubillo AI, Cullen KR, Cupertino RB, Daly E, Dannlowski U, Davey CG, Denys D, Deruelle C, Di Giorgio A, Dickie EW, Dima D, Dohm K, Ehrlich S, Ely BA, Erwin-Grabner T, Ethofer T, Fair DA, Fallgatter AJ, Faraone SV, Fatjó-Vilas M, Fedor JM, Fitzgerald KD, Ford JM, Frodl T, Fu CHY, Fullerton JM, Gabel MC, Glahn DC, Roberts G, Gogberashvili T, Goikolea JM, Gotlib IH, Goya-Maldonado R, Grabe HJ, Green MJ, Grevet EH, Groenewold NA, Grotegerd D, Gruber O, Gruner P, Guerrero-Pedraza A, Gur RE, Gur RC, Haar S, Haarman BCM, Haavik J, Hahn T, Hajek T, Harrison BJ, Harrison NA, Hartman CA, Whalley HC, Heslenfeld DJ, Hibar DP, Hilland E, Hirano Y, Ho TC, Hoekstra PJ, Hoekstra L, Hohmann S, Hong LE, Höschl C, Høvik MF, Howells FM, Nenadic I, Jalbrzikowski M, James AC, Janssen J, Jaspers-Fayer F, Xu J, Jonassen R, Karkashadze G, King JA, Kircher T, Kirschner M, Koch K, Kochunov P, Kohls G, Konrad K, Krämer B, Krug A, Kuntsi J, Kwon JS, Landén M, Landrø NI, Lazaro L, Lebedeva IS, Leehr EJ, Lera-Miguel S, Lesch KP, Lochner C, Louza MR, Luna B, Lundervold AJ, MacMaster FP, Maglanoc LA, Malpas CB, Portella MJ, Marsh R, Martyn FM, Mataix-Cols D, Mathalon DH, McCarthy H, McDonald C, McPhilemy G, Meinert S, Menchón JM, Minuzzi L, Mitchell PB, Moreno C, Morgado P, Muratori F, Murphy CM, Murphy D, Mwangi B, Nabulsi L, Nakagawa A, Nakamae T, Namazova L, Narayanaswamy J, Jahanshad N, Nguyen DD, Nicolau R, O'Gorman Tuura RL, O'Hearn K, Oosterlaan J, Opel N, Ophoff RA, Oranje B, García de la Foz VO, Overs BJ, Paloyelis Y, Pantelis C, Parellada M, Pauli P, Picó-Pérez M, Picon FA, Piras F, Piras F, Plessen KJ, Pomarol-Clotet E, Preda A, Puig O, Quidé Y, Radua J, Ramos-Quiroga JA, Rasser PE, Rauer L, Reddy J, Redlich R, Reif A, Reneman L, Repple J, Retico A, Richarte V, Richter A, Rosa PGP, Rubia KK, Hashimoto R, Sacchet MD, Salvador R, Santonja J, Sarink K, Sarró S, Satterthwaite TD, Sawa A, Schall U, Schofield PR, Schrantee A, Seitz J, Serpa MH, Setién-Suero E, Shaw P, Shook D, Silk TJ, Sim K, Simon S, Simpson HB, Singh A, Skoch A, Skokauskas N, Soares JC, Soreni N, Soriano-Mas C, Spalletta G, Spaniel F, Lawrie SM, Stern ER, Stewart SE, Takayanagi Y, Temmingh HS, Tolin DF, Tomecek D, Tordesillas-Gutiérrez D, Tosetti M, Uhlmann A, van Amelsvoort T, van der Wee NJA, van der Werff SJA, van Haren NEM, van Wingen GA, Vance A, Vázquez-Bourgon J, Vecchio D, Venkatasubramanian G, Vieta E, Vilarroya O, Vives-Gilabert Y, Voineskos AN, Völzke H, von Polier GG, Walton E, Weickert TW, Weickert CS, Weideman AS, Wittfeld K, Wolf DH, Wu MJ, Yang TT, Yang K, Yoncheva Y, Yun JY, Cheng Y, Zanetti MV, Ziegler GC, Franke B, Hoogman M, Buitelaar JK, van Rooij D, Andreassen OA, Ching CRK, Veltman DJ, Schmaal L, Stein DJ, van den Heuvel OA, Turner JA, van Erp TGM, Pausova Z, Thompson PM, Paus T. Virtual Histology of Cortical Thickness and Shared Neurobiology in 6 Psychiatric Disorders. JAMA Psychiatry 2021; 78:47-63. [PMID: 32857118 PMCID: PMC7450410 DOI: 10.1001/jamapsychiatry.2020.2694] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/12/2020] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Large-scale neuroimaging studies have revealed group differences in cortical thickness across many psychiatric disorders. The underlying neurobiology behind these differences is not well understood. OBJECTIVE To determine neurobiologic correlates of group differences in cortical thickness between cases and controls in 6 disorders: attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and schizophrenia. DESIGN, SETTING, AND PARTICIPANTS Profiles of group differences in cortical thickness between cases and controls were generated using T1-weighted magnetic resonance images. Similarity between interregional profiles of cell-specific gene expression and those in the group differences in cortical thickness were investigated in each disorder. Next, principal component analysis was used to reveal a shared profile of group difference in thickness across the disorders. Analysis for gene coexpression, clustering, and enrichment for genes associated with these disorders were conducted. Data analysis was conducted between June and December 2019. The analysis included 145 cohorts across 6 psychiatric disorders drawn from the ENIGMA consortium. The numbers of cases and controls in each of the 6 disorders were as follows: ADHD: 1814 and 1602; ASD: 1748 and 1770; BD: 1547 and 3405; MDD: 2658 and 3572; OCD: 2266 and 2007; and schizophrenia: 2688 and 3244. MAIN OUTCOMES AND MEASURES Interregional profiles of group difference in cortical thickness between cases and controls. RESULTS A total of 12 721 cases and 15 600 controls, ranging from ages 2 to 89 years, were included in this study. Interregional profiles of group differences in cortical thickness for each of the 6 psychiatric disorders were associated with profiles of gene expression specific to pyramidal (CA1) cells, astrocytes (except for BD), and microglia (except for OCD); collectively, gene-expression profiles of the 3 cell types explain between 25% and 54% of variance in interregional profiles of group differences in cortical thickness. Principal component analysis revealed a shared profile of difference in cortical thickness across the 6 disorders (48% variance explained); interregional profile of this principal component 1 was associated with that of the pyramidal-cell gene expression (explaining 56% of interregional variation). Coexpression analyses of these genes revealed 2 clusters: (1) a prenatal cluster enriched with genes involved in neurodevelopmental (axon guidance) processes and (2) a postnatal cluster enriched with genes involved in synaptic activity and plasticity-related processes. These clusters were enriched with genes associated with all 6 psychiatric disorders. CONCLUSIONS AND RELEVANCE In this study, shared neurobiologic processes were associated with differences in cortical thickness across multiple psychiatric disorders. These processes implicate a common role of prenatal development and postnatal functioning of the cerebral cortex in these disorders.
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Affiliation(s)
- Yash Patel
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Nadine Parker
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jean Shin
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Derek Howard
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Leon French
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles
| | - Elena Pozzi
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Christoph Abé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andre Aleman
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, Groningen, the Netherlands
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Spain
| | - Silvia Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Stephanie H Ameis
- The Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Andrew A McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology and Neuroscience; King's College London, London, England
| | - Francesca Assogna
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Guillaume Auzias
- INT UMR 7289, Aix-Marseille Université, CNRS, Aix-en-Provence, France
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria; Centro de Investigación Biomédica en Red de Salud Mental, Santander, Spain
| | - Geor Bakker
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, the Netherlands
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Cibele E Bandeira
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandr Baranov
- The Research Institute of Pediatrics and Child Health of the Central Clinical Hospital of the Russian Academy of Sciences of the Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Bernhard T Baune
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Premika S W Boedhoe
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neuroscience, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Marco Boks
- Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, the Netherlands
| | - Irene Bollettini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Caterina Del Mar Bonnin
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Tiana Borgers
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Brian P Brennan
- McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jason M Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sara Calderoni
- Department of Developmental Neuroscience - IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia
| | - Rosa Calvo
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); University of Barcelona, Spain
| | - Erick J Canales-Rodríguez
- FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
| | - Nicola Cascella
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mara Cercignani
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, England
| | - Tiffany M Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Anastasia Christakou
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, England
| | - David Coghill
- Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, Australia
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Departamento de Psiquiatria, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Ana I Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London UK; Zurich Center for Neuroeconomics, University of Zurich, Zurich, Switzerland
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota
| | - Renata B Cupertino
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eileen Daly
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Sackler Institute for Translational Neurodevelopment, London, London, England
| | - Udo Dannlowski
- University of Münster, Department of Psychiatry, Münster, Germany
| | | | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, Amsterdam, the Netherlands
| | | | | | - Erin W Dickie
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Danai Dima
- Department of Psychology, School of Arts and Social Sciences, City, University of London, Northampton Square, Clerkenwell, London, England
| | - Katharina Dohm
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Benjamin A Ely
- Department of Psychiatry and Biological Sciences, Albert Einstein College of Medicine, the Bronx, New York
| | - Tracy Erwin-Grabner
- University Medical Center Goettingen, Department of Psychiatry and Psychotherapy, Systems Neuroscience and Imaging in Psychiatry, Göettingen, Germany
| | - Thomas Ethofer
- Department of Psychiatry, University of Tuebingen, Tuebingen, Germany
| | - Damien A Fair
- Behavioral Neuroscience Department, Oregon Health & Science University, Portland
| | | | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - Mar Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Jennifer M Fedor
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kate D Fitzgerald
- Child OCD and Anxiety Disorders Program, Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Judith M Ford
- San Francisco VA Medical Center, San Francisco, California
| | - Thomas Frodl
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Cynthia H Y Fu
- University of East London, School of Psychology, London, England
| | - Janice M Fullerton
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Matt C Gabel
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, England
| | - David C Glahn
- Tommy Fuss Center for Neuropsychiatric Disease Research, Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
| | | | - Jose M Goikolea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Roberto Goya-Maldonado
- University Medical Center Goettingen, Department of Psychiatry and Psychotherapy, Systems Neuroscience and Imaging in Psychiatry, Göettingen, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
| | - Eugenio H Grevet
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nynke A Groenewold
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Patricia Gruner
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | | | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Shlomi Haar
- Department of Bioengineering, Imperial College London, London, England
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Tim Hahn
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Benjamin J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Neil A Harrison
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, England
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland
| | - Dirk J Heslenfeld
- Department of Experimental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | | | - Eva Hilland
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Tiffany C Ho
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Liesbeth Hoekstra
- Radboud University Medical Center, Karakter University Center of Child And Adolescent Psychiatry, Nijmegen, the Netherlands
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - L E Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Cyril Höschl
- National Institute of Mental Health, Klecany, Czech Republic
| | - Marie F Høvik
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Fleur M Howells
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Spain
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming. China
| | - Rune Jonassen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Georgii Karkashadze
- Research Institute of Pediatrics and child health of the Central clinical hospital of the Ministry of Science and Education, Moscow, Russia
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Tilo Kircher
- Department of Psychiatry, Philipps-University Marburg, Marburg, Germany
| | - Matthias Kirschner
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, University Hospital RWTH Aachen, German; JARA-Brain Institute II Molecular Neuroscience and Neuroimaging, Research Centre Juelich, Juelich, Germany
| | - Bernd Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Axel Krug
- Department of Psychiatry, Philipps-University Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology and Neuroscience; King's College London, London, England
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Nils I Landrø
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); University of Barcelona, Spain
| | | | | | - Sara Lera-Miguel
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Mario R Louza
- Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Astri J Lundervold
- Department of Biological and Medical psychology, University of Bergen, Bergen, Norway
| | - Frank P MacMaster
- Departments of Psychiatry and Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Luigi A Maglanoc
- University Centre for Information Technology, University of Oslo, Oslo, Norway
| | - Charles B Malpas
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Maria J Portella
- Group of Research in Mental Health, Institut d'Investigació Biomèdica Sant Pau, IIBSant Pau; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Rachel Marsh
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Fiona M Martyn
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Daniel H Mathalon
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco
| | - Hazel McCarthy
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Genevieve McPhilemy
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Susanne Meinert
- University of Münster, Department of Psychiatry, Münster, Germany
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Luciano Minuzzi
- McMaster University, Mood Disorders Program, SJH Hamilton, Hamilton, Ontario, Canada
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Filippo Muratori
- Department of Developmental Neuroscience - IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa
| | - Clodagh M Murphy
- Department of Forensic and Neurodevelopmental Science, King's College London, London, England
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College, London, England
| | - Benson Mwangi
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston
| | - Leila Nabulsi
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Leyla Namazova
- The Research Institute of Pediatrics and Child Health of the Central Clinical Hospital of the Russian Academy of Sciences of the Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia
| | - Janardhanan Narayanaswamy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles
| | - Danai D Nguyen
- Department of Pediatrics, University of California, Irvine
| | - Rosa Nicolau
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | | | - Kirsten O'Hearn
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, department of Pediatrics, Amsterdam Reproduction and Development, Amsterdam, the Netherlands
| | - Nils Opel
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Roel A Ophoff
- Center for Neurobehavioral Genetics, University of California Los Angeles
| | - Bob Oranje
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Victor Ortiz García de la Foz
- Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| | | | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, England
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Felipe A Picon
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Kerstin J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California, Irvine
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); University of Barcelona, Spain
| | - Yann Quidé
- School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
- Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Paul E Rasser
- Priority Centre for Brain & Mental Health Research, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Lisa Rauer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Janardhan Reddy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Ronny Redlich
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Jonathan Repple
- University of Münster, Department of Psychiatry, Münster, Germany
| | | | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Anja Richter
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Pedro G P Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Katya K Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Matthew D Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Javier Santonja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Facultad de Psicologia, Universidad Autónoma de Madrid
| | - Kelvin Sarink
- University of Münster, Department of Psychiatry, Münster, Germany
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | | | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ulrich Schall
- Priority Centre for Brain & Mental Health Research, The University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, RWTH Aachen University Hospital, Aachen, Germany
| | - Mauricio H Serpa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria; Centro de Investigación Biomédica en Red de Salud Mental, Santander, Spain
| | - Philip Shaw
- National Human Genome Research Institute and National Institute of Mental Health, Bethesda, Maryland
| | - Devon Shook
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Tim J Silk
- School of Psychology, Deakin University, Geelong, Melbourne, Australia
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore
| | - Schmitt Simon
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | | | - Aditya Singh
- University Medical Center Goettingen, Department of Psychiatry and Psychotherapy, Systems Neuroscience and Imaging in Psychiatry, Göettingen, Germany
| | - Antonin Skoch
- National Institute of Mental Health, Klecany, Czech Republic
| | - Norbert Skokauskas
- Center for Child and Adolescent Mental Health, Institute of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jair C Soares
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston
| | - Noam Soreni
- Pediatric OCD Consultation Clinic, Anxiety Treatment and Research Center, SJH Hamilton, Ontario, Canada
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland
| | - Emily R Stern
- Department of Psychiatry, New York University School of Medicine, Nathan Kline Institute, New York
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Henk S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - David F Tolin
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut
| | - David Tomecek
- National Institute of Mental Health, Klecany, Czech Republic
| | - Diana Tordesillas-Gutiérrez
- Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| | - Michela Tosetti
- Laboratory of Medical Physics and Magnetic Resonance - IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Neeltje E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Guido A van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Alasdair Vance
- Academic Child Psychiatry Unit, Department of Pediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria; Centro de Investigación Biomédica en Red de Salud Mental, Santander, Spain
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ganesan Venkatasubramanian
- OCD clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Hospital Clinic, University of Barcelona, Spain
| | - Oscar Vilarroya
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | | | - Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Georg G von Polier
- Department for Child and Adolescent Psychiatry, University Hospital RWTH Aachen, Aachen, Germany
| | - Esther Walton
- Department of Psychology, University of Bath, Bath, England
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Andrea S Weideman
- Clinical Translational Neuroscience Laboratory, University of California Irvine, Irvine, CA; Center for the Neurobiology of Learning and Memory, University of California, Irvine
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mon-Ju Wu
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston
| | - T T Yang
- University of California San Francisco, Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco, Weill Institute for Neurosciences
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yuliya Yoncheva
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, Hassenfeld Children's Hospital at NYU Langone, New York
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Marcus V Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Georg C Ziegler
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud UMC, Nijmegen, the Netherlands
| | - Daan van Rooij
- Donders Centre for Cognitive Neuroimaging, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christopher R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, location VUMC, Amsterdam, the Netherlands
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neuroscience, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Jessica A Turner
- Psychology Department and Neuroscience Institute, Georgia State University, Atlanta, Georgia
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, University of California Irvine, Irvine, CA; Center for the Neurobiology of Learning and Memory, University of California, Irvine
| | - Zdenka Pausova
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles
| | - Tomáš Paus
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Kassee C, Babinski S, Tint A, Lunsky Y, Brown HK, Ameis SH, Szatmari P, Lai MC, Einstein G. Physical health of autistic girls and women: a scoping review. Mol Autism 2020; 11:84. [PMID: 33109257 PMCID: PMC7590704 DOI: 10.1186/s13229-020-00380-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 04/27/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022] Open
Abstract
Background There is a growing recognition of sex and gender influences in autism. Increasingly, studies include comparisons between sexes or genders, but few have focused on clarifying the characteristics of autistic girls’/women’s physical health. Methods A scoping review was conducted to determine what is currently known about the physical health of autistic girls/women. We screened 1112 unique articles, with 40 studies meeting the inclusion criteria. We used a convergent iterative process to synthesize this content into broad thematic areas. Results Autistic girls/women experience more overall physical health challenges compared to non-autistic girls/women and to autistic boys/men. Emerging evidence suggests increased prevalence of epilepsy in autistic girls/women compared to non-autistic girls/women and to autistic boys/men. The literature also suggests increased endocrine and reproductive health conditions in autistic girls/women compared to non-autistic girls/women. Findings regarding gastrointestinal, metabolic, nutritional, and immune-related conditions are preliminary and inconsistent. Limitations The literature has substantial heterogeneity in how physical health conditions were assessed and reported. Further, our explicit focus on physical health may have constrained the ability to examine interactions between mental and physical health. The widely differing research aims and methodologies make it difficult to reach definitive conclusions. Nevertheless, in keeping with the goals of a scoping review, we were able to identify key themes to guide future research. Conclusions The emerging literature suggests that autistic girls/women have heightened rates of physical health challenges compared to non-autistic girls/women and to autistic boys/men. Clinicians should seek to provide holistic care that includes a focus on physical health and develop a women’s health lens when providing clinical care to autistic girls/women.
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Affiliation(s)
- Caroline Kassee
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Stephanie Babinski
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Sociology, University of Toronto, Toronto, Canada
| | - Ami Tint
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Peter Szatmari
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada. .,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Canada. .,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada. .,Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada. .,Department of Psychology, University of Toronto, Toronto, Canada. .,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK. .,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - Gillian Einstein
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada.,Tema Genus, Linköping University, Linköping, Sweden.,Rotman Research Institute, Baycrest Hospital, Toronto, Canada
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33
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Bruin WB, Taylor L, Thomas RM, Shock JP, Zhutovsky P, Abe Y, Alonso P, Ameis SH, Anticevic A, Arnold PD, Assogna F, Benedetti F, Beucke JC, Boedhoe PSW, Bollettini I, Bose A, Brem S, Brennan BP, Buitelaar JK, Calvo R, Cheng Y, Cho KIK, Dallaspezia S, Denys D, Ely BA, Feusner JD, Fitzgerald KD, Fouche JP, Fridgeirsson EA, Gruner P, Gürsel DA, Hauser TU, Hirano Y, Hoexter MQ, Hu H, Huyser C, Ivanov I, James A, Jaspers-Fayer F, Kathmann N, Kaufmann C, Koch K, Kuno M, Kvale G, Kwon JS, Liu Y, Lochner C, Lázaro L, Marques P, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Menchón JM, Minuzzi L, Moreira PS, Morer A, Morgado P, Nakagawa A, Nakamae T, Nakao T, Narayanaswamy JC, Nurmi EL, O'Neill J, Pariente JC, Perriello C, Piacentini J, Piras F, Piras F, Reddy YCJ, Rus-Oswald OG, Sakai Y, Sato JR, Schmaal L, Shimizu E, Simpson HB, Soreni N, Soriano-Mas C, Spalletta G, Stern ER, Stevens MC, Stewart SE, Szeszko PR, Tolin DF, Venkatasubramanian G, Wang Z, Yun JY, van Rooij D, Thompson PM, van den Heuvel OA, Stein DJ, van Wingen GA. Structural neuroimaging biomarkers for obsessive-compulsive disorder in the ENIGMA-OCD consortium: medication matters. Transl Psychiatry 2020; 10:342. [PMID: 33033241 PMCID: PMC7598942 DOI: 10.1038/s41398-020-01013-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 03/30/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 11/08/2022] Open
Abstract
No diagnostic biomarkers are available for obsessive-compulsive disorder (OCD). Here, we aimed to identify magnetic resonance imaging (MRI) biomarkers for OCD, using 46 data sets with 2304 OCD patients and 2068 healthy controls from the ENIGMA consortium. We performed machine learning analysis of regional measures of cortical thickness, surface area and subcortical volume and tested classification performance using cross-validation. Classification performance for OCD vs. controls using the complete sample with different classifiers and cross-validation strategies was poor. When models were validated on data from other sites, model performance did not exceed chance-level. In contrast, fair classification performance was achieved when patients were grouped according to their medication status. These results indicate that medication use is associated with substantial differences in brain anatomy that are widely distributed, and indicate that clinical heterogeneity contributes to the poor performance of structural MRI as a disease marker.
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Affiliation(s)
- Willem B Bruin
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands.
| | - Luke Taylor
- Department of Physiology, Anatomy and Genetics, Oxford, UK
| | - Rajat M Thomas
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Jonathan P Shock
- Department of mathematics and applied mathematics, University of Cape Town, Cape Town, South Africa
| | - Paul Zhutovsky
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomèdica en Red de Salud Mental-CIBERSAM, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Brain and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Paul D Arnold
- Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Francesca Assogna
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Jan C Beucke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Premika S W Boedhoe
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Irene Bollettini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Anushree Bose
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- University of Zurich and ETH Zurich, Neuroscience Center Zurich, Zurich, Switzerland
| | - Brian P Brennan
- McLean Hospital, Harvard Medical School, Belmont, MA, 02115, USA
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Rosa Calvo
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kang Ik K Cho
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Damiaan Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Benjamin A Ely
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 94612, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Egill A Fridgeirsson
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Deniz A Gürsel
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, München, Germany
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Tobias U Hauser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Marcelo Q Hoexter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brasil
| | - Hao Hu
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaim Huyser
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Department of child and adolescent psychiatry Amsterdam UMC, Amsterdam, The Netherlands
| | - Iliyan Ivanov
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Anthony James
- Department of Psychiatry, , Oxford University, Oxford, UK
| | | | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, München, Germany
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Masaru Kuno
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Rachel Marsh
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10027, USA
- The Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, 10027, USA
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomèdica en Red de Salud Mental-CIBERSAM, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Pedro S Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Janardhanan C Narayanaswamy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Erika L Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 94612, USA
| | - Joseph O'Neill
- Division of Child and Adolescent Psychiatry, Jane and Terry Semel Institute For Neurosciences, University of California, Los Angeles, CA, 94612, USA
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
| | - Chris Perriello
- McLean Hospital, Harvard Medical School, Belmont, MA, 02115, USA
- University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 94612, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Y C Janardhan Reddy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Oana G Rus-Oswald
- University of Zürich, University Hospital Zürich, Dept. Neuroradiology, Zürich, Switzerland
- University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - João R Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo Andre, Brazil
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - H Blair Simpson
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10027, USA
- Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Noam Soreni
- Pediatric OCD Consultation service, Anxiety Treatment and Research Center, St. Joseph's HealthCare, Hamilton, ON, L9C 0E3, Canada
- Offord Child Center, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomèdica en Red de Salud Mental-CIBERSAM, Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Emily R Stern
- Department of Psychiatry, New York University Langone School of Medicine, New York, NY, 10016, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA
| | - Michael C Stevens
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, 06106, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, 06510, USA
| | - S Evelyn Stewart
- University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- British Columbia Children's Hospital, Vancouver, BC, V6H 3N1, Canada
- British Columbia Mental Health and Addictions Research Institute, Vancouver, BC, V6H 3N1, Canada
| | - Philip R Szeszko
- Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- James J. Peters VA Medical Center, Bronx, New York, NY, 10468, USA
| | - David F Tolin
- Institute of Living/Hartford Hospital, Hartford, CT, 06119, USA
- Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Ganesan Venkatasubramanian
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Zhen Wang
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Cognitive Neuroimaging, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90007, USA
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Guido A van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands.
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Forde NJ, Jeyachandra J, Joseph M, Jacobs GR, Dickie E, Satterthwaite TD, Shinohara RT, Ameis SH, Voineskos AN. Sex Differences in Variability of Brain Structure Across the Lifespan. Cereb Cortex 2020; 30:5420-5430. [PMID: 32483605 PMCID: PMC7566684 DOI: 10.1093/cercor/bhaa123] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 01/09/2020] [Revised: 03/16/2020] [Accepted: 04/19/2020] [Indexed: 12/13/2022] Open
Abstract
Several brain disorders exhibit sex differences in onset, presentation, and prevalence. Increased understanding of the neurobiology of sex-based differences in variability across the lifespan can provide insight into both disease vulnerability and resilience. In n = 3069 participants, from 8 to 95 years of age, we found widespread greater variability in males compared with females in cortical surface area and global and subcortical volumes for discrete brain regions. In contrast, variance in cortical thickness was similar for males and females. These findings were supported by multivariate analysis accounting for structural covariance, and present and stable across the lifespan. Additionally, we examined variability among brain regions by sex. We found significant age-by-sex interactions across neuroimaging metrics, whereby in very early life males had reduced among-region variability compared with females, while in very late life this was reversed. Overall, our findings of greater regional variability, but less among-region variability in males in early life may aid our understanding of sex-based risk for neurodevelopmental disorders. In contrast, our findings in late life may provide a potential sex-based risk mechanism for dementia.
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Affiliation(s)
- Natalie J Forde
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
| | - Jerrold Jeyachandra
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
| | - Michael Joseph
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
| | - Grace R Jacobs
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, M5S 1A8, Toronto, Canada
| | - Erin Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
| | - Theodore D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Penn-CHOP Lifespan Brain Institute, Philadelphia, PA 19104, USA
| | - Russell T Shinohara
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19103, USA
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, M5T 1R8, Toronto, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, M5T 1R8, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, M5T 1R8, Toronto, Canada
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35
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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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Adriana Di Martino
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Ilan Dinstein
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Pieter J Hoekstra
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Georgii Karkashadze
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Norbert Kathmann
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Leanne Tamm
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - Oscar Vilarroya
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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
- The full list of authors in the ENIGMA working groups, author affiliations, author disclosures, and acknowledgments are provided in online supplements
| | - 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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Ameis SH, Lai MC, Mulsant BH, Szatmari P. Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond. Mol Autism 2020; 11:61. [PMID: 32698850 DOI: 10.1186/s1322902000365-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/15/2020] [Indexed: 05/24/2023] Open
Abstract
The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts.
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Affiliation(s)
- Stephanie H Ameis
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Meng-Chuan Lai
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
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Ameis SH, Lai MC, Mulsant BH, Szatmari P. Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond. Mol Autism 2020; 11:61. [PMID: 32698850 PMCID: PMC7374665 DOI: 10.1186/s13229-020-00365-y] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/15/2020] [Indexed: 12/20/2022] Open
Abstract
The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts.
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Affiliation(s)
- Stephanie H Ameis
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Meng-Chuan Lai
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
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Voineskos AN, Jacobs GR, Ameis SH. Neuroimaging Heterogeneity in Psychosis: Neurobiological Underpinnings and Opportunities for Prognostic and Therapeutic Innovation. Biol Psychiatry 2020; 88:95-102. [PMID: 31668548 PMCID: PMC7075720 DOI: 10.1016/j.biopsych.2019.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 06/02/2019] [Revised: 08/01/2019] [Accepted: 09/03/2019] [Indexed: 11/22/2022]
Abstract
Heterogeneity in symptom presentation, outcomes, and treatment response has long been problematic for researchers aiming to identify biological markers of schizophrenia or psychosis. However, there is increasing recognition that there may likely be no such general illness markers, which is consistent with the notion of a group of schizophrenia(s) that may have both shared and unique neurobiological pathways. Instead, strategies aiming to capitalize on or leverage such heterogeneity may help uncover neurobiological pathways that may then be used to stratify groups of patients for prognostic purposes or for therapeutic trials. A shift toward larger sample sizes with adequate statistical power to overcome small effect sizes and disentangle the shared variance among different brain-imaging or behavioral variables has become a priority for the field. In addition, recognition that two individuals with the same clinical diagnosis may be more different from each other (at brain, genetic, and behavioral levels) than from another individual in a different disorder or nonclinical control group-coupled with computational advances-has catapulted data-driven efforts forward. Emerging challenges for this new approach include longitudinal stability of new subgroups, demonstration of validity, and replicability. The "litmus test" will be whether computational approaches that are successfully identifying groups of patients who share features in common, more than current DSM diagnostic constructs, also provide better prognostic accuracy over time and in addition lead to enhancements in treatment response and outcomes. These are the factors that matter most to patients, families, providers, and payers.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Grace R Jacobs
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Brain and Mental Health Program, Hospital for Sick Children, Toronto, Canada
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Kong XZ, Boedhoe PS, Abe Y, Alonso P, Ameis SH, Arnold PD, Assogna F, Baker JT, Batistuzzo MC, Benedetti F, Beucke JC, Bollettini I, Bose A, Brem S, Brennan BP, Buitelaar J, Calvo R, Cheng Y, Cho KIK, Dallaspezia S, Denys D, Ely BA, Feusner J, Fitzgerald KD, Fouche JP, Fridgeirsson EA, Glahn DC, Gruner P, Gürsel DA, Hauser TU, Hirano Y, Hoexter MQ, Hu H, Huyser C, James A, Jaspers-Fayer F, Kathmann N, Kaufmann C, Koch K, Kuno M, Kvale G, Kwon JS, Lazaro L, Liu Y, Lochner C, Marques P, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Medland SE, Menchón JM, Minuzzi L, Moreira PS, Morer A, Morgado P, Nakagawa A, Nakamae T, Nakao T, Narayanaswamy JC, Nurmi EL, O’Neil J, Pariente JC, Perriello C, Piacentini J, Piras F, Piras F, Pittenger C, Reddy YJ, Rus-Oswald OG, Sakai Y, Sato JR, Schmaal L, Simpson HB, Soreni N, Soriano-Mas C, Spalletta G, Stern ER, Stevens MC, Stewart SE, Szeszko PR, Tolin DF, Tsuchiyagaito A, van Rooij D, van Wingen GA, Venkatasubramanian G, Wang Z, Yun JY, Thompson PM, Stein DJ, van den Heuvel OA, Francks C. Mapping Cortical and Subcortical Asymmetry in Obsessive-Compulsive Disorder: Findings From the ENIGMA Consortium. Biol Psychiatry 2020; 87:1022-1034. [PMID: 31178097 PMCID: PMC7094802 DOI: 10.1016/j.biopsych.2019.04.022] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/21/2019] [Accepted: 04/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lateralized dysfunction has been suggested in obsessive-compulsive disorder (OCD). However, it is currently unclear whether OCD is characterized by abnormal patterns of brain structural asymmetry. Here we carried out what is by far the largest study of brain structural asymmetry in OCD. METHODS We studied a collection of 16 pediatric datasets (501 patients with OCD and 439 healthy control subjects), as well as 30 adult datasets (1777 patients and 1654 control subjects) from the OCD Working Group within the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium. Asymmetries of the volumes of subcortical structures, and of measures of regional cortical thickness and surface areas, were assessed based on T1-weighted magnetic resonance imaging scans, using harmonized image analysis and quality control protocols. We investigated possible alterations of brain asymmetry in patients with OCD. We also explored potential associations of asymmetry with specific aspects of the disorder and medication status. RESULTS In the pediatric datasets, the largest case-control differences were observed for volume asymmetry of the thalamus (more leftward; Cohen's d = 0.19) and the pallidum (less leftward; d = -0.21). Additional analyses suggested putative links between these asymmetry patterns and medication status, OCD severity, or anxiety and depression comorbidities. No significant case-control differences were found in the adult datasets. CONCLUSIONS The results suggest subtle changes of the average asymmetry of subcortical structures in pediatric OCD, which are not detectable in adults with the disorder. These findings may reflect altered neurodevelopmental processes in OCD.
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Affiliation(s)
- Xiang-Zhen Kong
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands.
| | - Premika S.W. Boedhoe
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomèdica en Red de Salud Mental-CIBERSAM, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Spain
| | - Stephanie H. Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Centre for Brain and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Paul D. Arnold
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Francesca Assogna
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Marcelo C. Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brasil
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Jan C. Beucke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Irene Bollettini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Anushree Bose
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | | | - Jan Buitelaar
- Department of Cognitive Neurosicence, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, The Netherlands
| | - Rosa Calvo
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Spain
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kang Ik K. Cho
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Damiaan Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands.,Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Benjamin A. Ely
- Department of Neuroscience, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A
| | - Jamie Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, U.S.A
| | - Kate D. Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Jean-Paul Fouche
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa.,Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Egill A. Fridgeirsson
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Olin Neuropsychiatric Research Center, Hartford, CT, USA
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Deniz A. Gürsel
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Germany
| | - Tobias U. Hauser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, UK.,Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Marcelo Q. Hoexter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brasil
| | - Hao Hu
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, PR China
| | - Chaim Huyser
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.,Department of child and adolescent psychiatry Amsterdam UMC, Amsterdam, The Netherlands
| | - Anthony James
- Department of Psychiatry, Oxford University, Oxford, U.K
| | | | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Germany
| | - Masaru Kuno
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Gerd Kvale
- OCD-team, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain & Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Spain.,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Christine Lochner
- SU/UCT MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal..,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal..,Clinical Academic Center-Braga, Braga, Portugal
| | - Rachel Marsh
- Columbia University Irving Medical Center, Columbia University, New York, NY, U.S.A..,The Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, U.S.A
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Spain
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Sarah E. Medland
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomèdica en Red de Salud Mental-CIBERSAM, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Spain
| | - Luciano Minuzzi
- Mood Disorders Clinic, St. Joseph’s HealthCare, Hamilton, Ontario, Canada
| | - Pedro S Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal..,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal..,Clinical Academic Center-Braga, Braga, Portugal
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Spain.,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal..,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal..,Clinical Academic Center-Braga, Braga, Portugal
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Janardhanan. C. Narayanaswamy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, U.S.A
| | - Joseph O’Neil
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, U.S.A
| | - Jose C. Pariente
- Magnetic Resonance Image Core Facility, IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
| | - Chris Perriello
- McLean Hospital, Harvard Medical School, Belmont, MA, U.S.A..,University of Illinois at Urbana-Champaign, Champaign, IL, U.S.A
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, U.S.A
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Y.C. Janardhan Reddy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health & Neurosciences, Bangalore, India
| | | | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Joao R. Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo Andre, Brazil
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - H. Blair Simpson
- Columbia University Irving Medical Center, Columbia University, New York, NY, U.S.A..,Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, U.S.A
| | - Noam Soreni
- Pediatric OCD Consultation service, Anxiety Treatment and Research Center, St. Joseph’s HealthCare, Hamilton, Ontario, Canada
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomèdica en Red de Salud Mental-CIBERSAM, Barcelona, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Emily R. Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, U.S.A..,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, U.S.A
| | - Michael C. Stevens
- Yale University School of Medicine, New Haven, Conneticut, U.S.A.,Clinical Neuroscience and Development Laboratory, Olin Neuropsychiatry Research Center, Hartford, Connecticut, U.S.A
| | - S. Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial Obsessive-Compulsive Disorder Program, British Columbia Children’s Hospital, Vancouver, BC, Canada
| | - Philip R. Szeszko
- Icahn School of Medicine at Mount Sinai, New York, U.S.A..,James J. Peters VA Medical Center, Bronx, New York, U.S.A
| | - David F. Tolin
- Institute of Living/Hartford Hospital, Hartford, Connecticut, USA.,Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Aki Tsuchiyagaito
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Laureate Institute for Brain Research, Tulsa, Oklahoma, U.S.A
| | - Daan van Rooij
- Department of Cognitive Neurosicence, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, The Netherlands
| | - Guido A. van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Ganesan Venkatasubramanian
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Zhen Wang
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, PR China.,Shanghai Key Laboratory of Psychotic Disorders, PR China
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea.,Yeongeon Student Support Center, Seoul national University College of Medicine, Seoul, Republic of Korea
| | | | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, U.S.A
| | - Dan J. Stein
- SU/UCT MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Odile A. van den Heuvel
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Clyde Francks
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.
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40
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Hawco C, Yoganathan L, Voineskos AN, Lyon R, Tan T, Daskalakis ZJ, Blumberger DM, Croarkin PE, Lai MC, Szatmari P, Ameis SH. Greater Individual Variability in Functional Brain Activity during Working Memory Performance in young people with Autism and Executive Function Impairment. Neuroimage Clin 2020; 27:102260. [PMID: 32388347 PMCID: PMC7218076 DOI: 10.1016/j.nicl.2020.102260] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/12/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) often present with executive functioning (EF) deficits, including spatial working memory (SWM) impairment, which impedes real-world functioning. The present study examined task-related brain activity, connectivity and individual variability in fMRI-measured neural response during an SWM task in older youth and young adults with autism and clinically significant EF impairment. METHODS Neuroimaging was analyzed in 29 individuals with ASD without intellectual disability who had clinically significant EF impairment on the Behavior Rating Inventory of Executive Function, and 20 typically developing controls (participant age range=16-34). An SWM N-Back task was performed during fMRI. SWM activity (2-Back vs. 0-Back) and task-related dorsolateral prefrontal cortex (DLPFC) connectivity was examined within and between groups. Variability of neural response during SWM was also examined. RESULTS During SWM performance both groups activated the expected networks, and no group differences in network activation or task-related DLPFC-connectivity were found. However, greater individual variability in the pattern of SWM activity was found in the ASD versus the typically developing control group. CONCLUSIONS While there were no group differences in SWM task-evoked activity or connectivity, fronto-parietal network engagement was found to be more variable/idiosyncratic in ASD. Our results suggest that the fronto-parietal network may be shifted or sub-optimally engaged during SWM performance in participants with ASD with clinically significant EF impairment, with implications for developing targeted interventions for this subgroup.
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Affiliation(s)
- Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Laagishan Yoganathan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Rachael Lyon
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada
| | - Thomas Tan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Daniel M Blumberger
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada.
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41
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Nazeri A, Schifani C, Anderson JAE, Ameis SH, Voineskos AN. In Vivo Imaging of Gray Matter Microstructure in Major Psychiatric Disorders: Opportunities for Clinical Translation. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:855-864. [PMID: 32381477 DOI: 10.1016/j.bpsc.2020.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/11/2022]
Abstract
Postmortem studies reveal that individuals with major neuropsychiatric disorders such as schizophrenia and autism spectrum disorder have gray matter microstructural abnormalities. These include abnormalities in neuropil organization, expression of proteins supporting neuritic and synaptic integrity, and myelination. Genetic and postmortem studies suggest that these changes may be causally linked to the pathogenesis of these disorders. Advances in diffusion-weighted magnetic resonance image (dMRI) acquisition techniques and biophysical modeling allow for the quantification of gray matter microstructure in vivo. While several biophysical models for imaging microstructural properties are available, one in particular, neurite orientation dispersion and density imaging (NODDI), holds great promise for clinical applications. NODDI can be applied to both gray and white matter and requires only a single extra shell beyond a standard dMRI acquisition. Since its development only a few years ago, the NODDI algorithm has been used to characterize gray matter microstructure in schizophrenia, Alzheimer's disease, healthy aging, and development. These investigations have shown that microstructural findings in vivo, using NODDI, align with postmortem findings. Not only do NODDI and other advanced dMRI-based modeling methods provide a window into the brain previously only available postmortem, but they may be more sensitive to certain brain changes than conventional magnetic resonance imaging approaches. This opens up exciting new possibilities for clinicians to more rapidly detect disease signatures and allows earlier intervention in the course of the disease. Given that neurites and gray matter microstructure have the capacity to rapidly remodel, these novel dMRI-based methods represent an opportunity to noninvasively monitor neuroplastic changes posttherapy within much shorter time scales.
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Affiliation(s)
- Arash Nazeri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Christin Schifani
- Kimel Family Translational Imaging Genetics Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John A E Anderson
- Kimel Family Translational Imaging Genetics Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Centre for Brain and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Kimel Family Translational Imaging Genetics Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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42
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Yun JY, Boedhoe PSW, Vriend C, Jahanshad N, Abe Y, Ameis SH, Anticevic A, Arnold PD, Batistuzzo MC, Benedetti F, Beucke JC, Bollettini I, Bose A, Brem S, Calvo A, Cheng Y, Cho KIK, Ciullo V, Dallaspezia S, Denys D, Feusner JD, Fouche JP, Giménez M, Gruner P, Hibar DP, Hoexter MQ, Hu H, Huyser C, Ikari K, Kathmann N, Kaufmann C, Koch K, Lazaro L, Lochner C, Marques P, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Menchón JM, Minuzzi L, Morgado P, Moreira P, Nakamae T, Nakao T, Narayanaswamy JC, Nurmi EL, O'Neill J, Piacentini J, Piras F, Piras F, Reddy YCJ, Sato JR, Simpson HB, Soreni N, Soriano-Mas C, Spalletta G, Stevens MC, Szeszko PR, Tolin DF, Venkatasubramanian G, Walitza S, Wang Z, van Wingen GA, Xu J, Xu X, Zhao Q, Thompson PM, Stein DJ, van den Heuvel OA, Kwon JS. Brain structural covariance networks in obsessive-compulsive disorder: a graph analysis from the ENIGMA Consortium. Brain 2020; 143:684-700. [PMID: 32040561 PMCID: PMC7009583 DOI: 10.1093/brain/awaa001] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 06/11/2019] [Revised: 11/24/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
Brain structural covariance networks reflect covariation in morphology of different brain areas and are thought to reflect common trajectories in brain development and maturation. Large-scale investigation of structural covariance networks in obsessive-compulsive disorder (OCD) may provide clues to the pathophysiology of this neurodevelopmental disorder. Using T1-weighted MRI scans acquired from 1616 individuals with OCD and 1463 healthy controls across 37 datasets participating in the ENIGMA-OCD Working Group, we calculated intra-individual brain structural covariance networks (using the bilaterally-averaged values of 33 cortical surface areas, 33 cortical thickness values, and six subcortical volumes), in which edge weights were proportional to the similarity between two brain morphological features in terms of deviation from healthy controls (i.e. z-score transformed). Global networks were characterized using measures of network segregation (clustering and modularity), network integration (global efficiency), and their balance (small-worldness), and their community membership was assessed. Hub profiling of regional networks was undertaken using measures of betweenness, closeness, and eigenvector centrality. Individually calculated network measures were integrated across the 37 datasets using a meta-analytical approach. These network measures were summated across the network density range of K = 0.10-0.25 per participant, and were integrated across the 37 datasets using a meta-analytical approach. Compared with healthy controls, at a global level, the structural covariance networks of OCD showed lower clustering (P < 0.0001), lower modularity (P < 0.0001), and lower small-worldness (P = 0.017). Detection of community membership emphasized lower network segregation in OCD compared to healthy controls. At the regional level, there were lower (rank-transformed) centrality values in OCD for volume of caudate nucleus and thalamus, and surface area of paracentral cortex, indicative of altered distribution of brain hubs. Centrality of cingulate and orbito-frontal as well as other brain areas was associated with OCD illness duration, suggesting greater involvement of these brain areas with illness chronicity. In summary, the findings of this study, the largest brain structural covariance study of OCD to date, point to a less segregated organization of structural covariance networks in OCD, and reorganization of brain hubs. The segregation findings suggest a possible signature of altered brain morphometry in OCD, while the hub findings point to OCD-related alterations in trajectories of brain development and maturation, particularly in cingulate and orbitofrontal regions.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Premika S W Boedhoe
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Chris Vriend
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Brain and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Paul D Arnold
- Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Jan C Beucke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Irene Bollettini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Anushree Bose
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kang Ik K Cho
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Damiaan Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Jamie D Feusner
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jean-Paul Fouche
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Mònica Giménez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Derrek P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Marcelo Q Hoexter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Hao Hu
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, PR China
| | - Chaim Huyser
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Amsterdam UMC, Department of Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Keisuke Ikari
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Germany
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Germany
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Christine Lochner
- SAMRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Rachel Marsh
- Columbia University Medical College, Columbia University, New York, NY, USA
- The New York State Psychiatric Institute, New York, NY, USA
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Spain
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Spain
| | - Luciano Minuzzi
- McMaster University, Department of Psychiatry and Behavioural Neurosciences, Hamilton, Ontario, Canada
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
- ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal
| | - Pedro Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
- ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Janardhanan C Narayanaswamy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Erika L Nurmi
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Joseph O'Neill
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles, CA, USA
| | - John Piacentini
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles, CA, USA
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Y C Janardhan Reddy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Joao R Sato
- Center for Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo Andre, Brazil
| | - H Blair Simpson
- Columbia University Medical College, Columbia University, New York, NY, USA
- Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - Noam Soreni
- Pediatric OCD Consultation Service, Anxiety Treatment and Research Center, St. Joseph's HealthCare, Hamilton, Ontario, Canada
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Michael C Stevens
- Yale University School of Medicine, New Haven, Connecticut, USA
- Clinical Neuroscience and Development Laboratory, Olin Neuropsychiatry Research Center, Hartford, Connecticut, USA
| | - Philip R Szeszko
- Icahn School of Medicine at Mount Sinai, New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - David F Tolin
- Yale University School of Medicine, New Haven, Connecticut, USA
- Institute of Living/Hartford Hospital, Hartford, Connecticut, USA
| | - Ganesan Venkatasubramanian
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, PR China
- Shanghai Key Laboratory of Psychotic Disorders, PR China
| | - Guido A van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jian Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, PR China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, PR China
| | - Qing Zhao
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, PR China
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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Ameis SH, Blumberger DM, Croarkin PE, Mabbott DJ, Lai MC, Desarkar P, Szatmari P, Daskalakis ZJ. Treatment of Executive Function Deficits in autism spectrum disorder with repetitive transcranial magnetic stimulation: A double-blind, sham-controlled, pilot trial. Brain Stimul 2020; 13:539-547. [PMID: 32289673 PMCID: PMC8129776 DOI: 10.1016/j.brs.2020.01.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/25/2019] [Accepted: 01/08/2020] [Indexed: 01/08/2023] Open
Abstract
Background: In youth and young adults with autism spectrum disorder (ASD), executive function (EF) deficits may be a promising treatment target with potential impact on everyday functioning. Objective: To conduct a pilot randomized, double-blind, parallel, controlled trial evaluating repetitive transcranial magnetic stimulation (rTMS) for EF deficits in ASD. Method: In Toronto, Ontario (November 2014 to June 2017), a 20-session, 4-week course of 20 Hz rTMS targeting dorsolateral prefrontal cortex (DLPFC) (90%RMT) was compared to sham stimulation in 16—35 year-olds with ASD (28 male/12 female), without intellectual disability, who had impaired everyday EF performance (n = 20 active/n = 20 sham). Outcome measures evaluated protocol feasibility and clinical effects of active vs. sham rTMS on EF performance. The moderating effect of baseline functioning was explored. Results: Of eligible participants, 95% were enrolled and 95% of randomized participants completed the protocol. Adverse events across treatment arms were mild-to-moderate. There was no significant difference between active vs. sham rTMS on EF performance. Baseline adaptive functioning moderated the effect of rTMS, such that participants with lower baseline functioning experienced significant EF improvement in the active vs. sham group. Conclusions: Our pilot RCT demonstrated the feasibility and acceptability of using high frequency rTMS targeting DLPFC in youth and young adults with autism. No evidence for efficacy of active versus sham rTMS on EF performance was found. However, we found promising preliminary evidence of EF performance improvement following active versus sham rTMS in participants with ASD with more severe adaptive functioning deficits. Future work could focus on examining efficacy of rTMS in this higher-need population. Clinical trial registration: Repetitive Transcranial Magnetic Stimulation (rTMS) for Executive Function Deficits in Autism Spectrum Disorder and Effects on Brain Structure: A Pilot Study; https://clinicaltrials.gov/ct2/show/NCT02311751?term=ameis&rank=1; NCT02311751. The trial was funded by: an American Academy of Child and Adolescent Psychiatry (AACAP) Pilot Research Award, the Innovation Fund from the Alternate Funding Plan of the Academic Health Sciences Centres of Ontario, and an Ontario Mental Health Foundation (OMHF) Project A Grant and New Investigator Fellowship.
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Affiliation(s)
- Stephanie H Ameis
- Centre for Brain and Mental Health, Program in Neurosciences & Mental Health, Sick Kids Research Institute, The Hospital for Sick Children, Toronto, Canada; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Daniel M Blumberger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, Rochester, MN, USA
| | - Donald J Mabbott
- Centre for Brain and Mental Health, Program in Neurosciences & Mental Health, Sick Kids Research Institute, The Hospital for Sick Children, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
| | - Meng-Chuan Lai
- Centre for Brain and Mental Health, Program in Neurosciences & Mental Health, Sick Kids Research Institute, The Hospital for Sick Children, Toronto, Canada; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
| | - Pushpal Desarkar
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- Centre for Brain and Mental Health, Program in Neurosciences & Mental Health, Sick Kids Research Institute, The Hospital for Sick Children, Toronto, Canada; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Zafiris J Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Tremblay LK, Hammill C, Ameis SH, Bhaijiwala M, Mabbott DJ, Anagnostou E, Lerch JP, Schachar RJ. Tracking Inhibitory Control in Youth With ADHD: A Multi-Modal Neuroimaging Approach. Front Psychiatry 2020; 11:00831. [PMID: 33329071 PMCID: PMC7710692 DOI: 10.3389/fpsyt.2020.00831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 07/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A decreased ability to inhibit a speeded motor response is a well-studied deficit in Attention Deficit Hyperactivity Disorder (ADHD), and has been proposed as an endophenotype. Inhibitory control has been assessed reliably with the Stop Signal Task (SST) and is associated with prior documented differences in regional brain function using f-MRI. Here, we advance on these findings by examining their structural connectivity and white matter integrity with the goal of identifying a network underlying a core cognitive deficit in ADHD. METHODS Healthy controls (N=16) and youth diagnosed with ADHD (N=60) were recruited through the Province of Ontario Neurodevelopmental Disorders Network (POND) and the Hospital for Sick Children. An f-MRI activation difference map was co-registered with each participant's white matter imaging data, representing the specific network nodes where ADHD youth diverged significantly from controls while performing the SST. Probabilistic tractography was applied from these nodes, and white matter integrity indices such as fractional anisotropy (FA) within the tracts of interest were contrasted between the groups and correlated with SST output measures, including the measure of inhibitory control, the stop signal reaction time (SSRT). RESULTS The tracts that connected the network nodes belonged primarily to the inferior fronto-occipital fasciculus (IFOF) and cingulum. ADHD subjects showed trend differences in FA compared to controls between right inferior frontal gyrus (IFG) and right superior temporal gyrus (P= 0.09), right IFG and right posterior cingulate (P= 0.01), right anterior cingulate to posterior cingulate (p= 0.08), and between left middle temporal gyrus (BA 39) and left posterior cingulate (P=0.02). A trend correlation was found between radial diffusivity within IFG to STG white matter (IFOF) and SSRT. CONCLUSIONS We identified potential white matter tracts related to deficient inhibitory control, elucidating the brain mechanisms of an important cognitive deficit in ADHD. These findings could be integrated into future endophenotypic biomarker studies, incorporating altogether brain structure, function, and behavior for future studies of ADHD and other psychiatric conditions that exhibit this deficit.
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Affiliation(s)
- Lescia K Tremblay
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Christopher Hammill
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute (CAMH), Toronto, ON, Canada
| | - Mehereen Bhaijiwala
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Donald J Mabbott
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Department of Paediatrics, Holland Bloorview Research Institute, Toronto, ON, Canada
| | - Jason P Lerch
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Russell J Schachar
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
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Lai MC, Kassee C, Besney R, Bonato S, Hull L, Mandy W, Szatmari P, Ameis SH. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry 2019; 6:819-829. [PMID: 31447415 DOI: 10.1016/s2215-0366(19)30289-5] [Citation(s) in RCA: 618] [Impact Index Per Article: 123.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Co-occurring mental health or psychiatric conditions are common in autism, impairing quality of life. Reported prevalences of co-occurring mental health or psychiatric conditions in people with autism range widely. Improved prevalence estimates and identification of moderators are needed to enhance recognition and care, and to guide future research. METHODS In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and grey literature for publications between Jan 1, 1993, and Feb 1, 2019, in English or French, that reported original research using an observational design on the prevalence of co-occurring mental health conditions in people with autism and reported confirmed clinical diagnoses of the co-occurring conditions and autism using DSM or ICD criteria. For co-occurring mental health conditions reported with at least 15 datapoints (studies), we assessed risk of bias and we determined pooled estimates of prevalence for different co-occurring conditions in autism using random-effects models, and descriptively compared these with prevalence estimates for the general population from the literature (post hoc). We investigated heterogeneity in prevalence estimates using random-effects meta-regression models. This systematic review is registered with PROSPERO, CRD42018103176. FINDINGS Of 9746 unique studies identified, 432 were selected for full-text review. 100 studies were eligible for inclusion in our qualitative synthesis, of which 96 were included in our meta-analyses. 11 categories of co-occurring conditions were investigated, of which eight conditions were included in the meta-analyses and three were descriptively synthesised (ie, trauma and stressor-related disorders, substance-related and addictive disorders, and gender dysphoria). From our meta-analyses, we found overall pooled prevalence estimates of 28% (95% CI 25-32) for attention-deficit hyperactivity disorder; 20% (17-23) for anxiety disorders; 13% (9-17) for sleep-wake disorders; 12% (10-15) for disruptive, impulse-control, and conduct disorders; 11% (9-13) for depressive disorders; 9% (7-10) for obsessive-compulsive disorder; 5% (3-6) for bipolar disorders; and 4% (3-5) for schizophrenia spectrum disorders. Estimates in clinical sample-based studies were higher than in population-based and registry-based studies, and these estimates were mostly higher than those in the general population (post hoc). Age, gender, intellectual functioning, and country of study were associated with heterogeneity in prevalence estimates, yet remaining heterogeneity not explained was still substantial (all I2 >95%). INTERPRETATION Co-occurring mental health conditions are more prevalent in the autism population than in the general population. Careful assessment of mental health is an essential component of care for all people on the autism spectrum and should be integrated into clinical practice. FUNDING Academic Scholars Awards, Department of Psychiatry, University of Toronto; O'Brien Scholars Program, Slaight Family Child and Youth Mental Health Innovation Fund, and The Catherine and Maxwell Meighen Foundation via the Centre for Addiction and Mental Health Foundation.
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Affiliation(s)
- Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Centre for Brain and Mental Health and Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - Caroline Kassee
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Richard Besney
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sarah Bonato
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Laura Hull
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - William Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Peter Szatmari
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Centre for Brain and Mental Health and Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Centre for Brain and Mental Health and Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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46
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Wheeler AL, Felsky D, Viviano JD, Stojanovski S, Ameis SH, Szatmari P, Lerch JP, Chakravarty MM, Voineskos AN. BDNF-Dependent Effects on Amygdala-Cortical Circuitry and Depression Risk in Children and Youth. Cereb Cortex 2019; 28:1760-1770. [PMID: 28387866 DOI: 10.1093/cercor/bhx086] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/24/2017] [Indexed: 01/03/2023] Open
Abstract
The brain-derived neurotrophic factor (BDNF) is critical for brain development, and the functional BDNF Val66Met polymorphism is implicated in risk for mood disorders. The objective of this study was to determine how the Val66Met polymorphism influences amygdala-cortical connectivity during neurodevelopment and assess the relevance for mood disorders. Age- and sex-specific effects of the BDNF Val66Met polymorphism on amygdala-cortical connectivity were assessed by examining covariance of amygdala volumes with thickness throughout the cortex in a sample of Caucasian youths ages 8-22 that were part of the Philadelphia Neurodevelopmental Cohort (n = 339). Follow-up analyses assessed corresponding BDNF genotype effects on resting-state functional connectivity (n = 186) and the association between BDNF genotype and major depressive disorder (MDD) (n = 2749). In adolescents, amygdala-cortical covariance was significantly stronger in Met allele carriers compared with Val/Val homozygotes in amygdala-cortical networks implicated in depression; these differences were driven by females. In follow-up analyses, the Met allele was also associated with stronger resting-state functional connectivity in adolescents and increased likelihood of MDD in adolescent females. The BDNF Val66Met polymorphism may confer risk for mood disorders in females through effects on amygdala-cortical connectivity during adolescence, coinciding with a period in the lifespan when onset of depression often occurs, more commonly in females.
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Affiliation(s)
- Anne L Wheeler
- Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada M5T 1R8.,Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 0A4
| | - Daniel Felsky
- Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada M5T 1R8
| | - Joseph D Viviano
- Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8
| | - Sonja Stojanovski
- Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 0A4
| | - Stephanie H Ameis
- Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada M5T 1R8.,Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 0A4.,Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada M5T 1R8.,Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 0A4.,Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8
| | - Jason P Lerch
- Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada M5G 0A4.,Medical Biophysics, University of Toronto, Toronto, Ontario, Canada M5G 1L7
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Institute, Montreal, Quebec, Canada H4H 1R3.,Department of Biomedical Engineering, McGill University, 3775 rue University Montreal, Quebec, Canada H3A 2B4
| | - Aristotle N Voineskos
- Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada M5T 1R8.,Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8
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47
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Jacobs GR, Ameis SH, Ji JL, Viviano JD, Dickie EW, Wheeler AL, Stojanovski S, Anticevic A, Voineskos AN. Developmentally divergent sexual dimorphism in the cortico-striatal-thalamic-cortical psychosis risk pathway. Neuropsychopharmacology 2019; 44:1649-1658. [PMID: 31060043 PMCID: PMC6785143 DOI: 10.1038/s41386-019-0408-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 01/20/2023]
Abstract
Structural and functional cortico-striatal-thalamic-cortical (CSTC) circuit abnormalities have been observed in schizophrenia and the clinical high-risk state. However, this circuit is sexually dimorphic and changes across neurodevelopment. We examined effects of sex and age on structural and functional properties of the CSTC circuit in a large sample of youth with and without psychosis spectrum symptoms (PSS) from the Philadelphia Neurodevelopmental Cohort. T1-weighted and resting-state functional MRI scans were collected on a 3T Siemens scanner, in addition to participants' cognitive and psychopathology data. After quality control, the total sample (aged 11-21) was n = 1095 (males = 485, females = 610). Structural subdivisions of the striatum and thalamus were identified using the MAGeT Brain segmentation tool. Functional seeds were segmented based on brain network connectivity. Interaction effects among PSS group, sex, and age on striatum, thalamus, and subdivision volumes were examined. A similar model was used to test effects on functional connectivity of the CSTC circuit. A sex by PSS group interaction was identified, whereby PSS males had higher volumes and PSS females had lower volumes in striatal and thalamic subdivisions. Reduced functional striato-cortical connectivity was found in PSS youth, primarily driven by males, whereby younger male PSS youth also exhibited thalamo-cortical hypo-connectivity (compared to non-PSS youth), vs. striato-cortical hyper-connectivity in older male PSS youth (compared to non-PSS youth). Youth with PSS demonstrate sex and age-dependent differences in striatal and thalamic subdivision structure and functional connectivity. Further efforts at biomarker discovery and early therapeutic intervention targeting the CSTC circuit in psychosis should consider effects of sex and age.
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Affiliation(s)
- Grace R. Jacobs
- 0000 0001 2157 2938grid.17063.33Kimel Family Translational Imaging Genetics Research Laboratory, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Stephanie H. Ameis
- 0000 0001 2157 2938grid.17063.33Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0004 0473 9646grid.42327.30Centre for Brain and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Jie Lisa Ji
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University School of Medicine, New Haven, USA
| | - Joseph D. Viviano
- 0000 0001 2157 2938grid.17063.33Kimel Family Translational Imaging Genetics Research Laboratory, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Erin W. Dickie
- 0000 0001 2157 2938grid.17063.33Kimel Family Translational Imaging Genetics Research Laboratory, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Anne L. Wheeler
- 0000 0004 0473 9646grid.42327.30Neuroscience and Mental Health Program, The Hospital for Sick Children, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Department of Physiology, University of Toronto, Toronto, Canada
| | - Sonja Stojanovski
- 0000 0004 0473 9646grid.42327.30Neuroscience and Mental Health Program, The Hospital for Sick Children, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Department of Physiology, University of Toronto, Toronto, Canada
| | - Alan Anticevic
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University School of Medicine, New Haven, USA
| | - Aristotle N. Voineskos
- 0000 0001 2157 2938grid.17063.33Kimel Family Translational Imaging Genetics Research Laboratory, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Institute of Medical Science, University of Toronto, Toronto, Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, University of Toronto, Toronto, Canada
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48
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Boedhoe PSW, Heymans MW, Schmaal L, Abe Y, Alonso P, Ameis SH, Anticevic A, Arnold PD, Batistuzzo MC, Benedetti F, Beucke JC, Bollettini I, Bose A, Brem S, Calvo A, Calvo R, Cheng Y, Cho KIK, Ciullo V, Dallaspezia S, Denys D, Feusner JD, Fitzgerald KD, Fouche JP, Fridgeirsson EA, Gruner P, Hanna GL, Hibar DP, Hoexter MQ, Hu H, Huyser C, Jahanshad N, James A, Kathmann N, Kaufmann C, Koch K, Kwon JS, Lazaro L, Lochner C, Marsh R, Martínez-Zalacaín I, Mataix-Cols D, Menchón JM, Minuzzi L, Morer A, Nakamae T, Nakao T, Narayanaswamy JC, Nishida S, Nurmi EL, O'Neill J, Piacentini J, Piras F, Piras F, Reddy YCJ, Reess TJ, Sakai Y, Sato JR, Simpson HB, Soreni N, Soriano-Mas C, Spalletta G, Stevens MC, Szeszko PR, Tolin DF, van Wingen GA, Venkatasubramanian G, Walitza S, Wang Z, Yun JY, Thompson PM, Stein DJ, van den Heuvel OA, Twisk JWR. An Empirical Comparison of Meta- and Mega-Analysis With Data From the ENIGMA Obsessive-Compulsive Disorder Working Group. Front Neuroinform 2019; 12:102. [PMID: 30670959 PMCID: PMC6331928 DOI: 10.3389/fninf.2018.00102] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/13/2018] [Indexed: 01/08/2023] Open
Abstract
Objective: Brain imaging communities focusing on different diseases have increasingly started to collaborate and to pool data to perform well-powered meta- and mega-analyses. Some methodologists claim that a one-stage individual-participant data (IPD) mega-analysis can be superior to a two-stage aggregated data meta-analysis, since more detailed computations can be performed in a mega-analysis. Before definitive conclusions regarding the performance of either method can be drawn, it is necessary to critically evaluate the methodology of, and results obtained by, meta- and mega-analyses. Methods: Here, we compare the inverse variance weighted random-effect meta-analysis model with a multiple linear regression mega-analysis model, as well as with a linear mixed-effects random-intercept mega-analysis model, using data from 38 cohorts including 3,665 participants of the ENIGMA-OCD consortium. We assessed the effect sizes and standard errors, and the fit of the models, to evaluate the performance of the different methods. Results: The mega-analytical models showed lower standard errors and narrower confidence intervals than the meta-analysis. Similar standard errors and confidence intervals were found for the linear regression and linear mixed-effects random-intercept models. Moreover, the linear mixed-effects random-intercept models showed better fit indices compared to linear regression mega-analytical models. Conclusions: Our findings indicate that results obtained by meta- and mega-analysis differ, in favor of the latter. In multi-center studies with a moderate amount of variation between cohorts, a linear mixed-effects random-intercept mega-analytical framework appears to be the better approach to investigate structural neuroimaging data.
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Affiliation(s)
- Premika S W Boedhoe
- Department of Psychiatry, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie H Ameis
- Department of Psychiatry, Faculty of Medicine, The Centre for Addiction and Mental Health, The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, University of Toronto, Toronto, ON, Canada.,The Hospital for Sick Children, Centre for Brain and Mental Health, Toronto, ON, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Paul D Arnold
- Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marcelo C Batistuzzo
- Departamento de Psiquiatria, Faculdade de Medicina, Instituto de Psiquiatria, Universidade de São Paulo, São Paulo, Brazil
| | - Francesco Benedetti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Jan C Beucke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Irene Bollettini
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Anushree Bose
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
| | - Rosa Calvo
- Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic Universitari, Institute of Neurosciences, Barcelona, Spain
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kang Ik K Cho
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, South Korea
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Sara Dallaspezia
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jean-Paul Fouche
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Egill A Fridgeirsson
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Derrek P Hibar
- Imaging Genetics Center, Keck School of Medicine of the University of Southern California, Mark and Mary Stevens Neuroimaging and Informatics Institute, Marina del Rey, CA, United States
| | - Marcelo Q Hoexter
- Departamento de Psiquiatria, Faculdade de Medicina, Instituto de Psiquiatria, Universidade de São Paulo, São Paulo, Brazil
| | - Hao Hu
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaim Huyser
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Neda Jahanshad
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Anthony James
- Department of Psychiatry, Oxford University, Oxford, United Kingdom
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kathrin Koch
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Luisa Lazaro
- Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic Universitari, Institute of Neurosciences, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Christine Lochner
- SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | - Rachel Marsh
- Columbia University Medical College, Columbia University, New York, NY, United States.,The New York State Psychiatric Institute, New York, NY, United States
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minuzzi
- Mood Disorders Clinic, St. Joseph's HealthCare, Hamilton, ON, Canada
| | - Astrid Morer
- Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic Universitari, Institute of Neurosciences, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Janardhanan C Narayanaswamy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Seiji Nishida
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Erika L Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Joseph O'Neill
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Y C Janardhan Reddy
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Tim J Reess
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Joao R Sato
- Center for Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo Andre, Brazil
| | - H Blair Simpson
- Columbia University Medical College, Columbia University, New York, NY, United States.,Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, United States
| | - Noam Soreni
- Anxiety Treatment and Research Center, St. Joseph's HealthCare, Hamilton, ON, Canada
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Michael C Stevens
- Yale University School of Medicine, New Haven, CT, United States.,Clinical Neuroscience and Development Laboratory, Olin Neuropsychiatry Research Center, Hartford, CT, United States
| | - Philip R Szeszko
- Icahn School of Medicine at Mount Sinai, New York, NY, United States.,James J. Peters VA Medical Center, Bronx, NY, United States
| | - David F Tolin
- Yale University School of Medicine, New Haven, CT, United States.,Institute of Living/Hartford Hospital, Hartford, CT, United States
| | - Guido A van Wingen
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Ganesan Venkatasubramanian
- Obsessive-Compulsive Disorder (OCD) Clinic Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Je-Yeon Yun
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Paul M Thompson
- Imaging Genetics Center, Keck School of Medicine of the University of Southern California, Mark and Mary Stevens Neuroimaging and Informatics Institute, Marina del Rey, CA, United States
| | - Dan J Stein
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Ameis SH, Kassee C, Corbett-Dick P, Cole L, Dadhwal S, Lai MC, Veenstra-VanderWeele J, Correll CU. Systematic review and guide to management of core and psychiatric symptoms in youth with autism. Acta Psychiatr Scand 2018; 138:379-400. [PMID: 29904907 DOI: 10.1111/acps.12918] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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] [Accepted: 05/21/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Evidence-based guidance of clinical decision-making for the management of Autism Spectrum Disorder (ASD) is lacking, particularly for co-occurring psychiatric symptoms. This review evaluates treatment evidence for six common symptom targets in children/adolescents with ASD and provides a resource to facilitate application of the evidence to clinical practice. METHOD A systematic search identified randomized controlled trials (RCTs) and high-quality systematic reviews published between 2007 and 2016, focused on: social interaction/communication impairment, stereotypic/repetitive behaviours, irritability/agitation, attention-deficit/hyperactivity disorder symptoms, mood or anxiety symptoms, and sleep difficulties. We then completed qualitative evaluation of high-quality systematic reviews/meta-analyses and quantitative evaluation of recently published RCTs not covered by prior comprehensive systematic reviews. RESULTS Recently published RCTs focused on social interaction and communication impairment (trials = 32) using psychosocial interventions. Interventions for irritability/agitation (trials = 16) were mainly pharmacological. Few RCTs focused on other symptom targets (trials = 2-5/target). Integration of these results with our qualitative review indicated that few established treatment modalities exist, and available evidence is limited by small studies with high risk of bias. CONCLUSION Given the current evidence-base, treatment targets must be clearly defined, and a systematic approach to intervention trials in children/adolescents with ASD must be undertaken with careful consideration of the limitations of safety/efficacy data.
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Affiliation(s)
- S H Ameis
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - C Kassee
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - P Corbett-Dick
- Division of Developmental and Behavioural Pediatrics, University of Rochester School of Nursing, University of Rochester Medical Centre, Rochester, NY, USA
| | - L Cole
- Division of Developmental and Behavioural Pediatrics, University of Rochester School of Nursing, University of Rochester Medical Centre, Rochester, NY, USA
| | - S Dadhwal
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - M-C Lai
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Veenstra-VanderWeele
- New York Presbyterian Hospital Center for Autism and the Developing Brain, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - C U Correll
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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50
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