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Fernández-Linsenbarth I, Planchuelo-Gómez Á, Beño-Ruiz-de-la-Sierra RM, Díez A, Arjona A, Pérez A, Rodríguez-Lorenzana A, Del Valle P, de Luis-García R, Mascialino G, Holgado-Madera P, Segarra-Echevarría R, Gomez-Pilar J, Núñez P, Bote-Boneaechea B, Zambrana-Gómez A, Roig-Herrero A, Molina V. Search for schizophrenia and bipolar biotypes using functional network properties. Brain Behav 2021; 11:e2415. [PMID: 34758203 PMCID: PMC8671779 DOI: 10.1002/brb3.2415] [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: 03/19/2021] [Revised: 09/17/2021] [Accepted: 10/20/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Recent studies support the identification of valid subtypes within schizophrenia and bipolar disorder using cluster analysis. Our aim was to identify meaningful biotypes of psychosis based on network properties of the electroencephalogram. We hypothesized that these parameters would be more altered in a subgroup of patients also characterized by more severe deficits in other clinical, cognitive, and biological measurements. METHODS A clustering analysis was performed using the electroencephalogram-based network parameters derived from graph-theory obtained during a P300 task of 137 schizophrenia (of them, 35 first episodes) and 46 bipolar patients. Both prestimulus and modulation of the electroencephalogram were included in the analysis. Demographic, clinical, cognitive, structural cerebral data, and the modulation of the spectral entropy of the electroencephalogram were compared between clusters. Data from 158 healthy controls were included for further comparisons. RESULTS We identified two clusters of patients. One cluster presented higher prestimulus connectivity strength, clustering coefficient, path-length, and lower small-world index compared to controls. The modulation of clustering coefficient and path-length parameters was smaller in the former cluster, which also showed an altered structural connectivity network and a widespread cortical thinning. The other cluster of patients did not show significant differences with controls in the functional network properties. No significant differences were found between patients´ clusters in first episodes and bipolar proportions, symptoms scores, cognitive performance, or spectral entropy modulation. CONCLUSION These data support the existence of a subgroup within psychosis with altered global properties of functional and structural connectivity.
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Affiliation(s)
| | | | | | - Alvaro Díez
- Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain
| | - Antonio Arjona
- Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain
| | - Adela Pérez
- Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain
| | | | - Pilar Del Valle
- Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain
| | | | - Guido Mascialino
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | | | | | - Javier Gomez-Pilar
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain
| | - Pablo Núñez
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain
| | | | | | | | - Vicente Molina
- Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain.,Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain
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Molina V, Lubeiro A, de Luis Garcia R, Gomez-Pilar J, Martín-Santiago O, Iglesias-Tejedor M, Holgado-Madera P, Segarra-Echeverría R, Recio-Barbero M, Núñez P, Haidar MK, Fernández-Sevillano J, Sanz-Fuentenebro J. Deficits of entropy modulation of the EEG: A biomarker for altered function in schizophrenia and bipolar disorder? J Psychiatry Neurosci 2020; 45:322-333. [PMID: 32100521 PMCID: PMC7850148 DOI: 10.1503/jpn.190032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The synchronized activity of distributed neural assemblies — reflected in the electroencephalogram (EEG) — underpins mental function. In schizophrenia, modulation deficits of EEG spectral content during a P300 task have been replicated. The effects of treatment, chronicity and specificity in these deficits and their possible relationship with anatomic connectivity remain to be explored. METHODS We assessed spectral entropy modulation of the EEG during a P300 task in 79 patients with schizophrenia (of those, 31 werein their first episode), 29 patients with bipolar disorder and 48 healthy controls. Spectral entropy values summarize EEG characteristics by quantifying the irregularity of spectral content. In a subsample, we calculated the network architecture of structural connectivity using diffusion tensor imaging and graph-theory parameters. RESULTS We found significant spectral entropy modulation deficits with task performance in patients with chronic or first-episode schizophrenia and in patients with bipolar disorder, without significant pre-stimulus spectral entropy differences. The deficits were unrelated to treatment doses, and spectral entropy modulation did not differ between patients taking or not taking antipsychotics, lithium, benzodiazepines or antidepressants. Structural connectivity values were unrelated to spectral entropy modulation. In patients with schizophrenia, spectral entropy modulation was inversely related to negative symptoms and directly related to verbal memory. LIMITATIONS All patients were taking medication. Patients with bipolar disorder were euthymic and chronic. The cross-sectional nature of this study prevented a more thorough analysis of state versus trait criteria for spectral entropy changes. CONCLUSION Spectral entropy modulation with task performance is decreased in patients with schizophrenia and bipolar disorder. This deficit was not an effect of psychopharmacological treatment or structural connectivity and might reflect a deficit in the synchronization of the neural assemblies that underlie cognitive activity.
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Affiliation(s)
- Vicente Molina
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Alba Lubeiro
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Rodrigo de Luis Garcia
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Javier Gomez-Pilar
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Oscar Martín-Santiago
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - María Iglesias-Tejedor
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Pedro Holgado-Madera
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Rafael Segarra-Echeverría
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - María Recio-Barbero
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Pablo Núñez
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Mahmoud Karim Haidar
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Jessica Fernández-Sevillano
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
| | - Javier Sanz-Fuentenebro
- From the Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain (Molina, Lubeiro); the Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain (Molina, Martín-Santiago); the Neurosciences Institute of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain (Molina); the Imaging Processing Laboratory, University of Valladolid, Valladolid, Spain (de Luis Garcia); the Biomedical Engineering Group, University of Valladolid, Valladolid, Spain (Gomez-Pilar, Núñez); the Neurophysiology Service, Clinical Hospital of Valladolid, Valladolid, Spain (Iglesias-Tejedor); the Psychiatry Service, Doce de Octubre University Hospital, Madrid, Spain (Holgado-Madera, Sanz-Fuentenebro); the Psychiatry Service, Cruces Hospital, Bilbao, Spain (Segarra-Echeverría, Recio-Barbero); and the Psychiatry Service, Santiago Apostol Hospital, Vitoria, Spain (Haidar, Fernández-Sevillano)
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